We were mercifully undisturbed on our short walk down to the seventh floor, entering the lift to discover the usual anxious-looking visitors, and a cross-section of staff, fortunately all strangers to me; an apparently terrified junior doctor in an ill fitting jacket and two student nurses who insisted on loudly and enthusiastically discussing some infantile television programme until I silenced them by folding my arms and glaring down my nose, rather coldly, at them. The effect of my well-practiced stare was instantaneous and therefore I would consider it pleasingly effective so I'm not at all sure why I noticed Louisa's lips twitch, as she apparently fought off a smirk, but clearly something had amused her. I can't expect her to understand the importance of the hospital hierarchy, nor the drain on my patience it is, dealing with an endless stream of vacuous young people, apparently with the attention spans of gnats, who appear in the ward under the guise of trainee this or student that. It's even worse when they find themselves in theatre, stupid and insensible, touching the instruments, straying into the sterile field, hopelessly in the way, too moronic and mindless to be aware of their own ignorance.
For all of Louisa's high spirits, it's reassuring to notice how, in an unfamiliar environment, she is far more circumspect, observing her surroundings with apparent interest yet remaining uncharacteristically quiet. It does indicate a rather sensible and perceptive sort of intelligence of which I particularly approve; contemplative and appraising without the requirement for constant commentary, and the proffering of uneducated opinions. It feels like another layer, another lamination of my regard for her which is, in itself, a sort of further reassurance. So much so that I eschew my usual method of walking briskly down the corridors, one of the most effective deterrents to pointless interruptions that I have in my arsenal and, side by side, we cover the short distance in a pleasantly companionable silence. She'd smiled up at me, with just a hint of uncertainty, as I'd held a door open for her, and, as our eyes met, I'd experienced a rather unusual sensation, a pleasant yet unidentifiable feeling I can best describe as a sense of attunement, and it had prompted in me a need to say something to her. Anything really, just some sort of communication between us, some way of making her understand that I am aware of her concern, and that I hope that having me here, to answer any technical questions she may have, is of some reassurance to her.
"Louisa." I say quietly, as I notice her anxiety, and the punishment she metes out to her bottom lip. "Aah, we should...ummm...we should wash our hands..."
The receptionist fixes us with a watchful stare but I ignore her as I pass Louisa a paper towel. Already the irritating cacophony of children is apparent in the distance; a wail here and a shriek there, rising above the loud drone of the usual puerile nonsense that goes on in these wards, under the misnomer of education. I recall that the last time I visited, some fool had put forward the idea that hospital uniforms scared the children and so the entire staff were in some sort of colourful mufti, white coats were forbidden, and one of the registrars was actually prancing around, dressed as a fairy. In truth, I'd been utterly appalled and I'd barely managed to keep the sneer from my face as I'd made my way to the PCCU to meet with Allegra Farr, the Paediatric Consultant.
While she is a capable, reasonably efficient colleague to deal with, I admit that I am unimpressed with Dr. Farr personally; while this is not in itself unusual, there is something about her pale, thin intensity that reminds me rather too much of Edith, and i was particularly disgusted to notice that her desk was liberally adorned with framed photographs of cats, of all things. Worst of all though, she sometimes seems unable to alter her voice pattern and pitch, often preferring to use the same syrupy cloying tones for speaking to a traumatised four year old as she does for discussing complex and demanding cases with a detached and aloof Vascular Consultant. So I find myself proceeding with some caution, keeping Louisa close at hand as we are admitted into the Paediatric Critical Care Unit because, in a vague undefined way, I do have an inkling that Dr. Farr has an interest in me that perhaps goes beyond the purely professional. I bark the name of the registrar at a passing nurse and, after she gazes at me with what seems rather like terror, she scuttles off, apparently in search of him.
"Oh my god, Martin." Louisa mutters, growling in a low voice between clenched teeth. "Is this what it's like? You say jump, and everyone says, how high?"
I frown at her, surprised.
"Yes." I reply simply, not entirely sure of her point, as I indicate that she might like to sit down while we wait.
As is usual in any hospital waiting area, the walls are lined with posters, and pamphlet racks and there are endless Polaroids pinned to the wall; depictions of pointless staff celebrations, tedious official visits, dumbfounded children with endotracheal tubes or full body casts, holding their thumbs up toward the photographer, hopelessly blurred or eerily over exposed. Because it appears that children need to be pandered to, even when they are unwell and oblivious, there is a wallpaper border running around the centre of the wall, depicting balloons, and gaudily wrapped presents and, completely inappropriately, enormous, brightly coloured cakes. It is no wonder there is an obesity epidemic in this country if we actively encourage the least healthy of our citizens to partake enthusiastically in refined carbohydrates and empty calories yet, when I had pointed out the irony of the juxtaposed Diabetes Clinic poster, in this very room, almost everyone at the Health and Safety meeting had regarded me blankly. Now I see that, next to the water cooler, where the offending poster was displayed, someone has drawn a moustache and glasses, rather crudely, on someone called Amy, the earnest-looking Employee of The Month, so it seems clear that, after all, she was not such a popular choice either. Louisa notices too and I hear her let out a tiny snort before she apologises, unconvincingly, on behalf of the anonymous graffiti artist, to 'poor Amy' and flops down into a brightly coloured plastic chair to wait.
I prefer, as usual, to remain on my feet. I always have too many demands on my time and I detest being kept waiting, so I find it useful to stand squarely, a pointed hint if you will, hands behind my back, staring intently in the direction I expect whomever it is that has had the temerity to hold me up, to emerge from. To my relief, it's the registrar who bounces up to greet me, all smiles and affability, holding out his hand and, as I grasp it firmly, I notice with surprise that he is wearing garish and sloppily applied nail varnish on his thumbnail.
He laughs as he notices my appalled stare and glances down at his nails with unabashed delight.
"Whoops!" He says cheerfully. "Keeping my daughter entertained last night! You know how it is..."
One look at my face should clearly indicate to him that I do not know how it is, nor have I any intention of ever finding out. I clear my throat and, as Louisa leaps to her feet, he shakes her hand too and she greets him as she does all strangers, her smile like a flash of lightning in the night sky, grasping his hand warmly and breathlessly introducing herself, her expression as she glances at me revealing an endearing hint of shyness and perhaps even a desire for approbation. As I watch them interact, I realise they are quite similar; surprisingly warm and friendly to each other even though they just been introduced, discussing Louisa's young charge as if they've known each other forever. For a moment I envy them their ability to each be comfortable with strangers, no paralysing shyness, no disconcerting social inadequacy, no awkwardness at all. I listen to him describe the chain of events, how the boy came up from Resuss after arriving at A&E, how he'd been admitted to the PCCU initially but he'd been responding so well to treatment that they had just transferred him to a room on his own. I watched her face transform with relief, and she looked up at me with her eyes sparkling, exuding such joy that I'd been startled to feel my own facial muscles twitch in response. I wanted very badly in that instant to touch her, even if it were just a squeeze of her arm but, as I am discovering, years of intense self discipline are not so easily abandoned and I manage to resist, deciding instead on a slight incline of my head in her direction.
The registrar asks her if she'd like to see the boy, and again she glances at me quickly, as if she seeks reassurance. I nod, feeling slightly surprised but quite relieved, assuming that being permitted visitors must mean his recovery is well under way. We follow him the short distance down a corridor and he ushers us into a small, two bed ward where it seems the boy is the only occupant. It's a ubiquitous hospital room, cluttered bedside table, curved steel bed head, and an atmosphere that is quiet and rather pleasantly cool. The boy's vitals are clearly being monitored closely, he has an IV and a breathing tube, but he is not awake. The smiling registrar tells Louisa we can have five minutes and then he is gone; I assume he has magic tricks to perform or cartwheels to execute down the corridors, all in the name of modern paediatric medicine, and I watch him leave, scarcely attempting to hide my disapproval.
Louisa hesitates by the bed, gazing down at the child, biting at her lip fiercely once more and blinking with worrying frequency. I suppose the electronic sounds seem intimidating if you are not used to them, the monitoring equipment, the lines in his arm, the intubation, possibly frightening if you have little understanding of their function but, as I glance at the monitor, it seems to me that the boy has possibly had an incredibly fortunate reprieve. I pick up his chart and peruse it with interest. I don't know him at all but his apparently excellent prognosis, and the subsequently energising effect that it has had on Louisa, has cheered me considerably. In fact, I feel almost buoyant because the plan I've been ruminating on will be undoubtedly easier to present to a happy Louisa with a positive frame of mind.
"Such a tiny little bed." Louisa says, huskily, resting her hand tentatively on the covers, and sighing heavily as she gazes down at the child.
"Umm...same size as yours, I should think." I reply, impulsively, surprised at the levity in my tone.
A sly smile appears on her face; there's quite a distracting hint of suggestiveness in the look she gives me and, though I know I should be appalled at having a conversation like this in such an inappropriate setting, I'm a little dazed to find myself actually rather enjoying it. I've always taken rather a dim view of flirting in the workplace, and I have brutally skewered several total arses who foolishly believed that skirt-chasing while attending my rounds was a legitimate pastime but, like a complete hypocrite, I allow myself, momentarily, to be the slightest bit tantalised as she holds my gaze.
Almost instantly, I regret my licentiousness, as it's hurriedly replaced by a flash of embarrassment, courtesy of a loudly cleared throat, directly behind me. I feel my face colour and I spin around on my heel, appalled that we should be so interrupted, and about to fire off a vicious salvo at whoever dares to creep up on me. My heart sinks, however, when I realise that it's Dr. Farr who has appeared, and I quickly clamp my jaw closed, lest some stray insults still attempt to escape, and I wait for my moment of shame to pass. Despite my annoyance, it would still be rather poor form to berate the paediatric consultant merely for being on her own department, visiting a patient on her own ward.
"Mr Ellingham." She says, smiling at me, glassily and slightly oddly, her face set in a perplexed frown. "Goodness, this is quite an honour..."
"Not at all, Dr. Farr. " I say, quickly, by way of rebuttal, endeavouring to sound cold and unaffected. "I merely brought Miss Glasson up..."
I notice she is wearing her white coat again, as she takes another step forward, glancing at Louisa with an increasingly puzzled expression. Clearly that particular touchy-feely, no-uniform experiment ended up where it belonged, in the annals of stupidity. She pulls her hands from the pockets and folds them across her chest, fixing her gaze on Louisa who, I can see by the look in her eye, is determined to insert herself into this conversation.
"Hello." She says confidently. "I'm Louisa, lovely to meet you..."
"Oh, are you the boy's mother?" Dr. Farr interrupts quickly, and rather crossly, and I wince as I see Louisa's head fly up, instantly recognising the set of her jaw, and the way her eyes have narrowed. She looks like a particularly beautiful, but fearsomely dangerous type of cobra, alert and ready to strike.
"Umm, no..." I reply hastily, endeavouring to intervene, more than a little concerned at the scornful, disbelieving gasp that emanates from Louisa, as much as I am by her outraged expression.
"Sorry, I'm just trying to understand the connection...between...all of you." Farr says, her voice like cut glass, and even I can detect her slightly suspicious tone, as if she might somehow be being played for a fool.
Louisa glares back at her, equally sceptical, twisting her jaw defiantly and, to my horror, I realise she is squaring off. She lifts her head and tosses her hair back, and my heart sinks.
"It's not all that hard to understand actually." Louisa says haughtily. "I'm Piers' holiday tutor, and Martin is my boyfriend."
Suddenly, I'm in an echo chamber. Already challenging and uncomfortable, the word suddenly now seems ludicrous, reverberating endlessly in my mind, progressively becoming shriller and shriller as if a hysterical, helium-inhaling parrot is shrieking Boyfriend! at fifty decibels, in close proximity to my auditory canal. My grip on the boy's chart becomes vice-like and my blood momentarily feels as if it's frozen, my heart as if it completely and utterly stands still, as a tsunami of adrenalin floods my body. For all the world it seems like Louisa's bald statement, her retaliation for the absolute disgust she clearly felt at Dr Farr's implications, has been delivered, absolutely and irrevocably, to every corner of the hospital, as if she'd used a megaphone or even accessed the Public Address system. Her words continue to ring in my ears, like a tuning fork, humming at a strange and intense frequency, buzzing like an ancient refrigerator, like a dying blowfly in a sunny window.
I eventually find the courage to look up, and they are both gazing at me, expectantly, awaiting either some sort of vigorous confirmation, or a horrified and emphatic denial. I feel myself frown with annoyance; Dr. Farr is nothing to me outside this hospital but the circumstances are such that it is neither appropriate to tell her to shut up, nor instruct her forcefully to mind her own business, so I sigh and swallow hard, glancing tentatively over at the young woman who has just announced our relationship, officially, to the entire world, and I meet her determined stare with a slightly querulous, raised eyebrow. Slowly and deliberately, I place the chart back on the foot of the bed and utter a short affirmation that seems to slide from between my clenched teeth as if it defies containment.
"It was Louisa, who discovered the boy this morning...ahh, it was she who called for the ambulance and, umm, accompanied him to A&E." I add, in a more formal tone, desperate to steer the conversation back to medicine.
"Right, I see." Dr Farr replies haltingly, glancing at me quickly before repeating the registrar's instruction of five minutes allocated visiting time.
There's a moment of awkwardness, and she removes her stethoscope from around her neck and shoves it into the pocket of her coat. For all my inner turmoil at my relationship becoming common knowledge, for all my sensation of helplessly waving the white flag; the anticipation of placing myself in the stocks and waiting for the world to throw wet sponges at me, the face I show her is hewn from stone; imperturbable and self-possessed. As she walks away, calmly, presumably back to her office, and her perplexing and disconcerting feline gallery, she pauses at the door momentarily and turns back to face us.
"And...ahh...well spotted." She adds, a touch begrudgingly, before striding from the room.
I clear my throat, lowering my head to look at Louisa, but she merely gazes back at me provocatively. Nothing I could ever say or do, no icy stare or sharp rebuke would faze or unnerve her, it just seems to double her resolve. When it comes to me, she is all defiance and it never ceases to amaze me that I don't really mind; I never have.
"Just because I've got a country accent." She says, still bristling. "I must have been having babies when I was fourteen..."
I open my mouth to speak, and then hurriedly close it again because I do remember her quite clearly at fourteen as it happens; her desperate situation, her total and utter lack of parental guidance, in fact, an appalling example having been set for her by her own mother, it is a miracle she didn't find herself a teenage mother. I do also seem to recall that I had significant misgivings in that direction; not that I'd ever tell her, but setting up an account at that godforsaken Portwenn pharmacy was more deliberate, more pragmatic than just facilitating her access to appropriate personal hygiene.
"I'm sure it's nothing personal." I say, in an ineffectual attempt to calm her down. It dawns on me it's exactly the sort of tired, distracted assumption that I have occasionally been guilty of making and I can only assume that Dr. Farr won't have made it to the level of consultant by agonising over trivial misunderstandings like that.
"Don't let it..ummm..divert you. We don't have long." I add, and the tone of warning in my voice seems to do the trick.
She glances at me ruefully before lowering herself into the chair beside the bed, pulling it in close to the edge. I hear her, hesitatingly, begin to talk to the boy, softly, her voice quiet and low, her accent adding such a resonance and warmth to his name, and the reassurances she gives him. I glance at my watch as she reaches up and strokes his head, calmly pushing his mop of fair hair back from his eyes with her thumb, speaking to him gently; soothing, melodic, and so very comforting. I hear her telling him where he is, and why he is here, and even how brave he has been and, though I should point out that he is probably completely unaware of her presence, unconscious as he is, I say nothing, watching her from under my brows as I again pick up his chart and pretend to peruse it. Her voice is now even more encouraging as she consoles him, and I feel an intense surge of an unidentifiable emotion, rather disconcerting and very deeply affecting; almost mesmerising in fact, as she bestows her compassion, indeed all of her warm-heartedness, on this child she barely knows.
I find myself now watching her intently, as she rubs his fingers, and squeezes his arm reassuringly, whispering to him, almost hypnotically, and I realise she's telling him about the ambulance ride and how sorry she is that she hadn't got to spend the morning with him as planned. As I listen to her, I think I understand why she wants this small boy to feel like he's important, why she wants him to know that she cares about him, and that he matters; that he hasn't been abandoned and that he isn't alone. His eyes are closed yet she smiles at him as she speaks, reminding him of something he did, something he said when last they were together, and she heaps praise upon him for his cleverness, attempting to press upon him how proud of him she is of him. Because, clearly for Louisa, it's not enough to rise from the ashes of her own childhood, it's about the empathy she has for others, for any vulnerable child that might cross her path. She wants to do what she can to help them ascend from their own deprivations, to turn them from victims to survivors, just as she achieved for herself.
I recall her, distinctly, standing in front of me in my aunt's gazebo, a container of kitchen scraps in her hand, remonstrating with me with such vehemence. The recollection is so vivid that, disconcertingly, I'm convinced for a moment that I can smell the sea, that I can almost hear the infernal racket of Auntie Joan's chickens, the soundtrack to every visit to Portwenn, set against the distant booming, the thundering of the waves against the cliffs. She was an awkward teenage girl then, a waif that had been nowhere, had seen nothing of the world, in fact she knew nothing much outside her miserable cottage and her neglectful parents. She most definitely didn't even know me at all, yet she stood in front of me, holding my gaze so intently, with her enormous green eyes so earnest and imploring, and she'd told me so fervently, that I deserved better. If recall correctly, I was dismissive and, as usual, steadfast in my refusal to engage with her; icy and disapproving as I'd watched her slink away, proud of the fact I hadn't given an inch, relieved that I hadn't provided even the slightest glimpse of my soft underbelly, nor displayed any chink in my armour, immured as I was against the sadness and disappointment that had clearly overcome her.
It would be disingenuous to say now that anything she said that afternoon changed anything for me personally; my inability to understand the subtleties of relationships was not ameliorated by her words, I was still a loner, avoiding as much social interaction as I possibly could, fully prepared to live a life where I fended off every uncomfortable human emotion, where I neither gave nor received attention, and had long since abandoned any notion of either being lovable, or meeting someone I could love. Life had continued as usual, the same difficulties, the same isolation, the same mistrust. As a young child, I'd had summers in Cornwall, and my Aunt and Uncle had done their best to encourage me but, once my father had brutally terminated that arrangement, there was only ever Louisa, the sole person in my adult life to ever tell me that I did actually deserve something better, that I was worthy of something greater than that which I'd received in my life to date.
And now, as she sits up in her chair, whispering to the prone figure of the boy that she will come back to see him tomorrow, I'm suddenly conscious of another seismic shift within me, an explosive high speed collision, a moment of nuclear fission where lifelong disappointment and low expectations, indeed all the disapproval, the joylessness and the grim determination that seems to have underscored my life thus far, seems to implode, to retreat into the far distance. Somewhat tentatively, the future now slides into my consciousness; a hopeful glimpse of a shimmering horizon that I can only dare hope is an oasis and not a mirage. I wonder how much of a transmogrification I am capable of, how far this metamorphosis might take me, as the causal agent for this bewildering desire for change stands up and turns to smile at me; warm, and defiant and so fiercely protective of those she cares about. My makeshift, casual approach is suddenly and desperately not enough; to be bewitched and besotted with her, and living from one day off to the next, spending every moment I am not working pining like an abandoned dog, is no way to exist if there is seemingly just no improvement in sight.
As capable a planner as I am, as organised and structured as I prefer to be, even I cannot fathom how a relationship with Louisa might be reduced to being managed via a spreadsheet, by initials on a calendar or by synchronised diaries. Even for me, a scheduler of time increments par excellence, that seems simply too awful to contemplate. As we make our way back down the corridor, as anxious visitors glance up at us and curious staff silently observe our passing, it seems even more critical that I present my thoughts to her as soon as I can, as unformed and embryonic as they unfortunately still are. In the lift, I punch the button for the Ground Floor and clear my throat uncomfortably, retreating once more to a seemly distance before I broach the subject with her. My face is a mask of neutrality as I ask her vaguely what her plans are for the rest of the day and, when she shrugs and replies that she has none, I suggest, deceptively casually, with my heart thundering in my chest, that she might like to join me for supper.
