Despite the gloom and the cold, I'd emerged from the taxi feeling buoyant and almost eager in my anticipation of the day. Regardless of having a full diary, and a less than optimum quota of sleep, I was still quite remarkably suffused with enthusiasm and, even though I had a vague aching tightness across my whole body, I flew up the stairs like a decathlete charging in for the long jump. Pausing at the security door to catch my breath, waiting for the burn in my quads to peak and abate, I pondered the reason for this new, heightened awareness of my physical self. I am conscious that changes in my personal life have required significant mental adjustment, but what of the way I ask my body to function? One thing is certain, the sudden and frequent intensity of one particular function is most certainly responsible for the onset of the acute and widespread myalgia I am currently experiencing. Rolling my shoulders over cautiously, I slide my hand beneath the tail of my coat and press my thumb into my left gluteus maxima, wincing a little as I do so.
I suppose it's understandable, in view of my profession, that I have focused on taking care of myself from an specifically internal, disease-conscious perspective. My body has always done what I have asked of it, so I've considered it satisfactory, ruminating little further on the subject. Things have now become manifestly different though. My blood pressure, kidney function and liver values do not prompt Louisa's declarations of admiration, nor does my cholesterol or lung capacity invite praise in the way that other apparent attributes seem to. For the first time in my life, what lies beneath my carefully cultivated outward appearance seems to matter. As bemused as it makes me, I would have to be made of stone not to find myself nevertheless affected.
I will admit to being surprised when she rests her gaze upon me in a particular fashion, baffled that her observation of me performing even the most mundane of tasks should apparently fascinate her so. Shaving, especially, but she seems compelled, too, to watch closely as I fasten my cufflinks or even knot my tie I find myself rather more aware of her scrutiny when she attempts to wrap her fingers around my bicep or cups my backside in a suggestive squeeze. But it is when she is at her most brazen, watching me emerge from the shower, her eyes sparkling and her mouth curved into an enigmatic smile, that I gain the strongest sense of her approval. As inconceivable as it seems, despite my cynicism, in the deepest fathoms of my mind there is a part of me that very much craves her approbation.
I let myself into my office, opening my briefcase to retrieve my diary, before clearing my telephone messages and making my way downstairs. As hard as I try to recall a previous occasion where I'd felt this invigorated, a time where life had seemed to hold this much opportunity, even an hour where I felt this much hope, I come up empty-handed. Because of that, I allow myself one final revisitation, one last palpable recollection of last night at its zenith, before I close my mind to everything but the task at hand. From dishonour to redemption, the minutes in between had been both agonising and exquisite. Her lips had been so soft, her eyelashes against my cheek, fluttering with the delicacy of a butterfly's wing as she nestled into my shoulder, our legs still entwined and our bodies inseparable.
"Well, that was spectacular.." She'd said after a moment, her breath catching in her throat as she giggled softly, her tone surprisingly, yet reassuringly, incredulous. "Actually, is there a word better than spectacular?"
The memory is still somewhat stirring and the lightness of spirit it evokes stays with me, the vaguest remnants of climactic exhilaration still clinging to me as I make my way down to theatre. Chin up, shoulders back, I'd almost assumed a swagger as I'd passed that arse, Dixon, on the landing, half way down the stairs. Glancing across at him, my jaw seemed determined to twist itself into a satisfied smirk, so much so that my cheeks quivered and my mouth twitched as I tried half-heartedly to resist my own amusement.
"Ellingham." He'd said, a familiar, faint sneer in his voice that, today of all days, seemed utterly to demand a response.
"Sticks." I'd replied briskly, surprising both of us with my adoption of his recently acquired moniker.
Almost apoplectic with mirth, Chris Parsons had telephoned specifically to tell me the story. Dixon, on call on a Saturday night, paged to assist the senior urology consultant perform a microvascular replantation of an amputated penis. Somewhat farcically, the discarded organ had been retrieved by a member of the public and presented to the Paramedics, rather unceremoniously, in a jam jar. As he stood in theatre, waiting his turn, Dixon had apparently changed colour repeatedly, much to everyone's quiet enjoyment, running a gamut of hues, from the more verdant shades of gangrene to as pale and blanched as ancient vellum. Of course, as inured as I was from hospital gossip, I'd been oblivious, and I, too, had flinched as Chris had waxed and chortled, my every orifice twitching as I'd shifted uncomfortably in my seat. More importantly however, I'd made a mental note to look up the case notes, curious as to Dixon's choice of procedure, more specifically whether he'd performed a venous anastomosis and a Winter's shunt. After becoming aware of hospital gossip, to use that intelligence to further my understanding of more complex surgical processes was totally within my character. To address a colleague, in an airy and brash manner, by his new and rather asinine nickname, however, was most certainly not.
Dixon glared back at me ferociously of course, clearly furious that even someone considered as aloof and generally disinterested as I am was aware of his new sobriquet. Ignoring his discomfort, I'd taken some pleasure in responding to his irritation with an expression of lofty supremacy, detesting him as much as I do. I will admit to a slight disappointment in all of this, a vaguely miffed reaction to not having been the specialist vascular pair of hands summoned, especially as nothing as challenging or as complex faced me in theatre this morning. In hindsight though, I must admit that the frustration of missing out would have been far worse for me, had I been simply sitting alone in my flat, with only a dismembered clock and Bach's concertos for company. These days, my Saturday evenings are considerably less structured and solitary, and significantly more companionable and unrestrained. If Dixon wasn't such an aggravating sod, I'd almost feel sorry for him but I really can't find it in myself at all, contenting myself instead with a pointed and pitying nod in his direction as he glares at me and stomps away.
The tasks at hand, the next few minutes, are without a doubt the least favourite part of my responsibilities as a surgeon. Conducting myself with the required dignity and an appropriate sense of authority, I have brief and concise conversations with each of my patients, my attention fixed firmly on their charts, ensuring amongst other things that they understand the process and that they have been properly prepared. After providing brisk, unambiguous answers to their generally ridiculous questions, I leave them to the inane chatter of their designated family members. As I exit the cubicle, I'm forced to glower fiercely at a witless orderly who, in his idiotic tomfoolery, impedes my brisk escape. Even though I say nothing, instantly, his face is a mask of horror as he scuttles fearfully aside and, to my immense satisfaction, he then startles dramatically as, behind me, the patient's chart clatters loudly and dramatically to the floor.
"Pick that up!" I growl, impatiently, as I stride past him, preeminent and unassailable; my position in the hierarchy determining that he will scramble instantly to do as he is told.
Pleased to have the inevitably tedious pre-op conversations out of the way, my sense of levity returns. Next, I speak to the anaesthetist, one of the few colleagues I will be sorry not to work with again in the future. Unflappable, meticulous and always well-prepared, I have considerable respect for both his skill and his unembellished manner, especially as it pertains to communication.
"Ellingham." He says crisply, with the usual economy of speech that I have come to appreciate, not bothering to look up from his clipboard. "All present and correct."
"Good morning." I reply, and, oddly, my voice is almost cheerful, so much so that he glances up at me quickly, the bright light reflecting off his bifocal lenses, and I notice a fleeting expression of curiosity flicker across his usually rather severe and disinterested features.
After a succinct and uncontentious discussion, he disappears into the anaesthesia room, while I make my way to change out of my street clothes, pausing only to speak to my team, most of whom are already assembled. As I approach, I'm encouraged to note a complement of experienced hands, reliable professionals that know their roles well. Even in a routine surgery, I do not need the aggravation of the wrong sutures being placed in the sterile field, or being presented with incompletely assembled instruments. Whether it be by luck or good management, on the whole, each member is well drilled and competent, especially my scrub nurse for today, who is both capable, and above average at anticipating my requirements. Even though the morning's surgeries are relatively straightforward, I will still go through the procedures, calmly and decisively, ensuring that everyone is conversant with my plan. I glance around the familiar, serious faces who gaze back at me.
"Good morning, Mr Ellingham." They intone, in a sort of hushed and respectful chorus, and I nod back at them, just once; my usual form of acknowledgment.
The briefing complete, I glance at my watch. Even now, changing into scrubs fills me with a pleasant sense of anticipation and, even as I carefully secure my suit on its hangers, I feel a sharp surge of excitement. Returning to the theatre suite, it is, as usual, a clamour of activity: theatre sisters issuing instructions in voices that could shatter glass, nurses, grim-faced and purposeful, darting in all directions, the soles of their sensible footwear slapping resoundingly against the industrial grade linoleum, and shambling orderlies skylarking like children, one in particular, loud-mouthed and glib, providing a running commentary on proceedings as he shifts the Boyle's machine into place. And, loitering in the background, is a medical student, timorous and uneasy, unsure of where to go or what to do. When I am satisfied that everything is proceeding smoothly, I instruct both he, and the earnest resident who will be assisting, to follow me as I stride briskly to the scrub room, smiling to myself at how they are forced into a half run just to keep up.
The time spent scrubbing can be a particularly valuable opportunity for the instruction of those in training and this morning is no exception. I start by quizzing the student on acute limb ischaemia, but he falters early, staring at me helplessly when I ask him to name the 'six P's' that are associated with that particular presentation. Even as I turn my attention to the resident, and discuss the choice of incision, I glance back at him, only to note how he appears to be trembling, his expression unblinking and fixed.
Where I would normally show little compassion, where I would usually be tempted to skewer his ignorance and provide short shrift for his lack of preparation, this morning, I merely fix him with a gaze of cold disapproval. Dealing with terrified students is not an unusual occurrence for me, but my reaction to him today most certainly is. Instead of my customary impatience, I'm visited by an odd and rather fleeting feeling of empathy, a tiny modicum of understanding of the depth of his fear. I have spent the greater part of my life stifling my own, similar reactions, and expertly disguising how I feel yet, just last night, I'd found my self control to be wanting, and I'd been unable to conceal my dismay. Aghast, and quivering with shame and self-reproof, I'd felt as if I were barely treading water, shocked and uncomprehending at the strength of my own feelings, and rendered breathless by the horrifying realisation that I'd behaved poorly, having been possessed by some kind of satyric libertine.
"I will ask you again tomorrow." I growl slowly, curious at my strange reluctance to put him to the sword. "Be very sure you know the answer."
"Thank you Mr. Ellingham." He gasps after a moment, in a strangled voice, as I turn my back on both of them.
"Don't waste my time again." I add, threateningly, over my shoulder, and I mean it.
Despite his ineptitude, my mood remains elevated. I watch the soap suds drip off my arm, circling the basin in ever decreasing circles before flowing down the drain. Just as it always does, the water hits the stainless steel with an unmistakeable percussion, rather soothing in its familiarity, and I find myself reflecting on how assured I have become in the skin of the man referred to as Mr. Ellingham. Considering the cold, dispassionate way I conduct myself, it might surprise a lot of people to know just how much I love being a surgeon and, indeed, how fortunate I know I am to have found what I consider my true calling. When I hear that simple prefix, I know I have achieved something. From an awkward, diffident child to a man certain of his purpose in my life; possessing both the desire and the skill to improve the lives of others.
Keeping my elbows elevated I reach for the sterile towels, dabbing carefully at my arms and hands before tossing the used linen aside. A nurse appears behind me and while her face is vaguely familiar, it is her ability to assist me to gown up in complete silence, that is probably more indicative of the fact we have worked together before. I doubt I will ever be entirely comfortable with this process but I have learned to endure it, growling impatiently as scrub ties are fumbled with and nervous hands stray, inadvertently, to touch any part of my person. When I finally march into theatre, and ask if we are ready to begin, every ounce of my concentration is now focused on the patient, and the procedure I am about to perform. With only the sound of machinery to now contend with, and a blade securely in hand, I announce my intentions, and make the first incision.
Three successful procedures later, refreshed by a shower and pleased to again be dressed in my suit, I shut the door to my office to write up my notes. Many consultants enjoy the bonhomie of the surgeon's lounge and prefer to update patient records sprawled inelegantly across the couch, or perched on an armchair, random stacks of papers piled everywhere. I, on the other hand, do not find such an atmosphere conducive to clarity of thought but I do find the communal spaces occasionally useful, strictly for the purposes of professional discussion, spending brief interludes conversing with colleagues with whom I am most at ease. This afternoon, after a furtive glance through the open door, there seems no obstacle present that might dissuade me from striding in with my coffee in hand. A litany of short, undemonstrative greetings echo from around the lounge.
"Ellingham…."
"Gentlemen." I reply, coolly, noting that the absence of any women in the room means no further elaboration is required.
The lounge is about half full and I lower myself into a seat between Jayesh Daya, the interventional radiology chief, and a visiting gastrointestinal consultant who I believe is from GOSH. Though I've forgotten his name, I know that I have met him before, but my only recollection is that he is a colossal bore; a self-important little man, one who behaves as if it were he himself who invented the liver.
"Ellingham." Daya says with rather more warmth than many in this hospital would use to greet me. "Do you know Nigel? Nigel Wright?"
It's strange how, without the adjunct of Mister, hearing myself referred to as simply 'Ellingham' provokes rather a mixed collection of feelings. This terse formality is the way of professional men, considered the appropriate term of address in a masculine environment; a hangover from public schools and extremely competitive universities. These days at least, hearing my surname used, unadorned and in isolation, does not initiate the dread and dismay in me it once did, as was almost always the case when I was at school. Now, even though it might be begrudging, I am confident that I have the respect of my colleagues, and I'm confident that there is nothing to fear within the walls of this hospital, nothing that might cause me either terror or humiliation. In the past however, hearing myself thus identified, my surname ringing out in a dormitory or a hallway, singled-out in the squeaky tenor of prepubescent bully, could cause my blood to momentarily run cold.
Wright holds out his hand and, without looking at him, I shake it, firmly yet indifferently.
"Ah, Ellingham…" he says, smirking at me in a such a way that I feel obliged to glare back at him. "Of course."
On reflection, there was always been something about my surname that seemed to bring out the worst in people, often provoking the most mindless brutality to be directed at me for the flimsiest of reasons. From teasing, and goading, and pathetically infantile rhymes, to torment and violent thuggery at the hands of juvenile sadists, I've been subjected to it all. Fortunately, not only was I able to escape it all unscathed but moreover I put all those hours in which I sought refuge in the library to good use. I read everything I could, regardless of subject, providing me with not only a useful general knowledge but, in learning how to keep myself safe, I acquired a healthy suspicion at the motives of others and very strong instincts for self-preservation.
I turn my attention to the discussion around me, which seems to be focussed on innovations in percutaneous portal decompression. Initially, I listen with considerable interest until my irritation with Nigel Wright begins to mount, and I recall with complete clarity why I had taken such a dislike to him previously. I'm filled with aggravation as he slurps his tea noisily, noting with extreme irritation how he begins every sentence with a condescending chortle, a habit that rapidly begins to set my teeth on edge. Despite the fact I had several points that I wanted to clarify with Mr. Daya, a man known for his zest and enthusiasm for home computers, I find myself wondering if I have the intestinal fortitude to tolerate the conversation much longer. As I adjust my cufflinks, I'm aware of vague and unpleasant familiarity in this tedious man's tone, his answers so smug, and delivered with such arrogant self importance, bound together with an inflection of weariness, as if having to explain himself to inferior minds is a task that has, quite frankly, left him exhausted.
As reluctant as I am to recall even a second of the time I spent with her, the familiarity of manner is suddenly unmistakeable, and I cannot help but hear her bored, dismissive voice ringing in my head. The appearance of her face in my mind is only equaled in unpleasantness by an afternoon spent debriding the ulcers resulting from Type 2 necrotising fasciitis. Haughty, contemptuous Edith who layered so much impatience and scorn into her way of saying my name that, to this very day, it still feels demeaning. Jeering, superior Edith who, inexplicably, refused to use my christian name, despite the fact that I considered it only respectful to use hers. Barking at me like a drill sergeant as she did was rather a significant clue, in hindsight; her insistence on referring to me only as Ellingham proof that there was only the most basic of connections between us, no closeness and definitely no affection.
"Just think of me as one of the boys, Ellingham." She'd laughed, in that cold and joyless way she had and, looking back now, I realise that is exactly how she saw me. One of the boys, one of the many, many boys.
"I don't suppose you were aware of that, Ellingham." Wright says conceitedly, as a statement, rather than a question; his inflection so gloating that it borders on insulting.
Distracted from my thoughts, I glance across at him.
"I was aware, as it happens." I reply, fixing him with a cold, detached stare. "It was one of the several antediluvian theories my research team debunked in the paper we presented at this year's Edinburgh conference. Were you in attendance, Mr. Wright?"
He opens his mouth to speak but says nothing and I take a little satisfaction from watching his face turn to the colour of a ripe strawberry; as shiny and as pitted. Self-assurance is one thing but self-aggrandisement is another, especially when it is a meretricious castle built upon shallow, shifting sands.
"Ah, no…" He replies, licking his lips, and carelessly leaving his mouth still gaping, an unpleasant, cavernous suppuration beneath his rhinophymic nose.
I'm tempted to remind him that our paper was the keynote presentation on the final evening, and that a place the conference audience was highly coveted, being as it was by invitation only but, instead, I'm distracted, my attention drawn to an obvious discoloured greyness about his tongue, the inside of his lower lip and his gums.
"You have oral lichen planus." I inform him calmly, as I rise to my feet.
He stares at me, wide-eyed in apparent horror but, having delivered my diagnosis, he no longer interests me and I turn my back on him. His interminable ramblings mercifully silenced, I must take the opportunity to to speak to my Jayesh Daya on what was my original purpose. I clear my throat purposefully.
"Twenty megabytes, and Word Perfect? Is that still your recommendation?" I ask him briskly as he stares back at me, nodding silently, the expression on his face aghast.
Yet I am unmoved. If he thinks me rude, or considers that my response was uncalled for, I am utterly inured and unaffected. Rambling, opinionated inaccuracy on most subjects is of little interest to me but I do take umbrage at such a brazen display of incompetence and closed-mindedness when it pertains to the field of medicine. In my opinion, Wright's wilful ignorance is not only indefensible but it could also prove fatal, and so he must be corrected. No one will ever convince me that mealy-mouthed obsequiousness will ever surpass honest forthright assessments, and while some may consider a reluctance to upbraid a colleague so obviously in the wrong as tactful and politic, I see it simply as an act of sycophantic boot-licking; nauseating and ineffectual.
Without further comment, I stride from the room, glancing at my watch to check how much time I have available before I must be back in the ward. As I return to my office, Chris Parsons' historic admonishments of my frankness come to mind; I see him shaking his head incredulously, like a disappointed, shiny-faced spectre, folding his arms and staring down at his shoes as he attempts to find a way to convince me.
"Mart! You really have to learn to be a bit more diplomatic!" I'd heard him say so many times, his frustration with me rather clearly apparent. "It's not enough just to be brilliant diagnostician, or a genius in theatre. Like everything, it's all about working with the people around you."
I can't say I'm any closer to believing him but imagining his reaction to the little tableau in the Consultant's Lounge is, today, oddly amusing. In my own way, one could say I'm fond of Chris, and I do trust him, having known him for some time now. Since the very first time he asked my name, he has always called me Mart, an abbreviation of his own invention. It is a usage peculiar to only him, and is usually delivered with either a gasp of disbelief or a horrified chuckle. I do not know where it sprang from and he certainly never asked me if I objected but, since we became friends by osmosis, with little or no effort in my behalf, I'd accepted the moniker like I accepted his acquaintance; friendly, casual, and innocuous, just as he is.
Once I'm back at my desk, I make several phone calls to local electronic suppliers and I speak to a variety of salespeople, receiving a wildly divergent selection of prices and recommendations. I immediately rule out purchasing from either the man who had the temerity to treat me as if I came down in the last shower, or the woman with the post-nasal drip who, between clearing her throat like she was drowning in phlegm, appeared not only bored but highly inconvenienced by my call. Eventually, I find what I want, and decide on a printer. We agree on a price and I confirm that I will call in tomorrow, paying by cheque, with a little extra for delivery. The salesman is jovial, to the point of over-familiarity, and my face contorts into an irritated grimace as he takes down my details.
"Annnnnd, 'oo do I make th' yinvoice out to, then?" He drawls, cheerfully and I can hear him sucking air in through his teeth, noisily, in some sort of gleeful anticipation, as if I have just informed him that he has won the lottery, rather than just having ordered a common or garden, domestic Word Processor.
"Martin Ellingham."
"Can you just spell that for me? A is it?"
"E-double L-I-N-G-H-A-M."
"Ellingham. Righto then Marty, yew know where we are, so we'll catch yew tomorrah, yeah?"
I glower at the wall opposite, regardless of the fact he can't see me.
"Yes." I growl icily, placing the receiver back into the cradle, staring at it as if it disgusts me.
For a moment, my good humour deserts me. His temerity in calling me Marty feels like quite an affront for many reasons, especially since flippancy and presumption are not character traits I admire. It's odd, actually, that I should be so precious but, on reflection I suppose that it's the variation of my name that I associate most closely with Joan and Phil and, therefore, it seems off limits. My reaction isn't a logical, or even a considered response, especially since the expression Little Marty had caught on so rapidly with almost all of their Portwenn cronies and had, apparently, stuck rather firmly in the minds of every one of them. In hindsight, it was a nickname neither offensive nor inappropriate, especially considering my thin, juvenile phenotype and my shy, cautious reserve. As an adult however, 'little' scarcely seems either an accurate or appropriate adjective to describe anything about me, so my aunt has chosen to refer to me more commonly as Marty and I can't say that I am averse. The truth is, it does have pleasant connotations for me, reminiscent of halcyon days and the freedom of Cornwall; safe and secure, robust and rosy-cheeked, nurtured and protected under the warm summer sun.
One of the lights on the telephone is now flashing insistently, and so again I check my messages, signing, and scrawling in my diary as I listen to the glib tones of Bernard Newton, full of his usual puffery and palaver, stammering in that peculiar way that many find charming but which, to me anyway, seems merely tedious and rather affected.
"Martin, dear boy! You-you know, it's high time we-we-we got together for a spot of lunch. I will brook no-no-no excuses now, so, let's be having you. What say you to-to Friday? A w-w-working lunch? Hmm? Come on now, Martin, we've things to discuss!"
Muttering under my breath, I punch the 'delete messages' button and groan loudly. Do these people not understand that, as much as I respect them professionally, I do not feel the need to waste hours of my precious time on long, gossipy lunches, forced to observe their sloppy table manners and watch as they down gallons of expensive claret. I have more regard for Bernard than I have for most other people; despite his foppish ways and propensity to overindulge in restaurants, solely because he is an excellent surgeon, one of the best in fact. He, in turn, has always seemed to return the respect I give him and has been one of my most significant mentors in my career to date. The fact that, of all the thousands of contacts and colleagues I have associated with since I began my career in medicine, he is one of the few that dares refer to me as Martin. But that still doesn't mean I want to have lunch with him.
I once read that my given name is derived from the Roman god of war, Mars, which surely rendered me the most ironically named child in Britain. Despite the most feeble of school boy humour decreeing that I should labour for years under the moniker Fartin Smellingham, I quite like my name. I've always been quite oddly protective of it, in fact, quite attached, used so sparingly as it usually was, brought out primarily on special occasions. Usage was generally confined to my immediate family; Aunt Ruth called me Martin, as had my grandfather, Henry, and since hearing them address me as such generally meant an invite into their conversation, my ears had always pricked up eagerly at its use.
There were other pleasant associations too. The nanny that had read to me, the one that had been so kind, despite her predictably brief spell of employment, had always changed the name of a character in every book to Martin, and I'd been invariably thrilled by this, oblivious as I was to the actual truth. Much later I'd been disappointed to discover that there were no Knights of the Round Table named Martin, nor were their similarly named literary heroes, as I'd been led to believe. But. At the time, I'd listened, wide-eyed and incredulous to the exploits she described, living vicariously through her words; a timorous, fearful, isolated child transformed momentarily by his imagination.
Even though my parents also referred to me as Martin, as a name it had been spared too many ugly connotations simply because I saw them so seldom and any interaction was so infrequent. Moreover, when my mother was angry or disappointed in me, as she so frequently was, she threw insults and accusations at me but never my name. When I was naughty I was simply labelled a stupid, ungrateful little boy, raged at and then dismissed from her sight. Occasionally, when she was attempting to cajole me, or impress her friends with her mothering skills, I would be summoned, and introduced with a sweep of her arm and a waft of Chanel and, subsequently, peered at by a gaggle of women equally as appalling as my mother herself. And once she had received the accolades she desired, I would be summarily discharged, scampering from the room like a frightened rabbit, searching for a safe place to hide.
Growing up, my father was always busy, always distracted, and generally disinterested in me. Absorbed in his work and mostly absent from home, I'm not entirely convinced that he was even concerned at what I was called. A sporty, extrovert son would have captured his attention though, I suspect, in the way a shy, nervous, awkward one could only dream of. To him, the important factor was that he had an heir, one who carried his surname, and the only upside of the inconvenience I caused him, the only return on the costs of his investment in me, was that I might, one day, augment and enhance my family's standing in medicine. And I wanted to be brilliant of course, in the way young men do, still nursing a vain hope that I might one day make my family proud. That is, until Bernard took me gently aside, pointing out gently that I could not win, and that I needed to be competent enough to be noticed, but not so impressive that I might put my own father in the shade. He was right of course, though I was much too insensitive at the time to truly understand.
Still, I consider myself fortunate. A healthy childhood without serious illness, an excellent education which allowed me to achieve the goals I set myself, and a legacy from my grandfather which gave me my independence. Not many are so fortunate that they can claim that for themselves. And, on top of all of my good luck, now there is Louisa, who says my name so melodiously, and with such enthusiasm it sounds like a catchy refrain from a popular song. Until I'd met her again, I was content to proceed through life not caring one iota what anyone called me, appearing invulnerable and keeping everyone at arm's length. After all, even a life that stretches out before you like miles of grey, flat, damp pavement is still, somehow, a life. Frowning at the thought, the very idea that such a solitary existence had once made me content, I slip into my white coat, drape my stethoscope around my neck and make my way briskly to the wards.
The afternoon leaves me no room for further idle introspection. After checking on my post-operative patients, tailed closely by yet more terrified students, I am summoned to the bedside of two new, acute admissions by the duty consultant and I spend some time with him, organising the requisite tests and discussing treatment options. I have no sooner walked away than I am paged to consult with the urologist about yet another dialysis patient requiring a renal stent. On the way back up to my office to complete my notes, I am interrupted by the theatre manager, who informs me of the necessity to re-organise tomorrow's theatre schedule, a task which seems suddenly and rather frustratingly complicated. Finally, with an armful of film clasped beneath my elbow, I make it back to the peace and quiet of my office, intent on reviewing the x-rays and interpreting the test results that have come back from the lab.
It's the time of day when the clerical staff go home, the typing pool crowding into the lifts, garrulous and shrieking with laughter, their earlobes sagging and stretched so painfully by ugly, over sized jewellery that it takes all my self-restraint not to remonstrate with them as they pass. Usually, as the offices fall silent, I find myself relieved, and eager to make the most of the peace, finding it easy to concentrate and churn through the apparently endless paperwork and reportage that my position demands. Tonight however, I feel restless and, even a plethora of interesting blood test results are not enough to hold my attention.
I find myself wondering if Louisa is at home and, on a whim, I pick up the telephone and dial, counting each ring before listening impatiently to my own voice, relieved at the crisp brevity of my own message. The truth is, I'm glad she is not home. As I'd flown out the door, she'd offered to make dinner but, now, the mere thought of her, unsupervised, in the kitchen makes me rather alarmed. The sight that greeted me when I got up this morning was more reminiscent of Rome after it had been sacked, than my usual immaculate surroundings. Almost every drawer was open and every cupboard was ajar. My favourite saucepan seemed lost to me forever and I'd been bent over it, desperately concocting an elixir, a solution of sea salt, baking soda and vinegar that might miraculously shift the coal tar she appeared to have boiled up in it, when she'd wandered in. As usual, she came up behind me, encircling me with her bare arms and resting her chin on my back.
"Oh, yeah, sorry about that…umm..just leave it and I'll sort it before I go…" She'd said, airily.
"Perhaps the elements on the cooker are more…efficient….than you're used to." I'd said, through gritted teeth. "I think the best solution is to leave it soaking for the day and I will deal with it tonight."
"Fine." She'd said, as if she were relieved and I'd turned around to watch her wander dazedly across the kitchen, and back toward the bedroom, tugging at the belt of her robe distractedly as she padded along in her bare feet.
It seemed like last night all over again, the kitchen abandoned to disorder, and left a flagrant mess by an apparently oblivious Louisa. After she'd gone to bed, I'd kept busy, emptying the dishwasher and doing her dishes, all the time trying to make sense of everything that had happened over the course of the evening. I couldn't identify the source of my disquiet but it was there, like a deeply buried splinter or a dull ache in one's jaw. Eventually, after I had tied myself in a series of Aberdeen knots, the only respite seemed like sleep. I'd determined she wasn't awake when I'd slipped under the covers next to her. The room had felt cold, so I'd put on a tee shirt and I had lain there for quite sometime, listening to the faint, gurgling noises she makes as she sleeps. Darkness often brings thoughts of a similar shade and I was suffocated by an avalanche of self-doubt, swaddling myself in fear and dejection, and torturing myself with the bleakness of the unknown. Eventually, exhausted, I must have drifted off, though I have no idea how long for, until I was half woken by a rolling sensation as she climbed from the bed. I hadn't moved a muscle when I'd felt her lips on mine. Really, it has been so gentle, so ephemeral that it might have been a dream, until I heard her bang her shoulder against the doorframe, and I'd listened as she felt her way awkwardly along the darkened hallway, at which point I discovered i was completely awake. More importantly though, it struck me, if I am awake, then her kiss had been real.
But why would someone kiss you if you were asleep though? Without any comparison or point of reference, other than it felt special somehow, and sweetly reassuring, I ponder her reasons, vaguely recalling how, as a very young child, Auntie Joan would come in to wish me goodnight. As I drifted in and out of sleep, she'd smooth my hair, bending to kiss my forehead as I lay curled up beneath the covers. She'd slip my book from my grasp and switch off the little green anglepoise lamp that illuminated me, and it had felt nice then too, reassuring and comforting like I was safe and I didn't need to worry. After considering it all for a moment, it seems logical to me, in view of the way Joan always was with me, that it must have been a genuine gesture of affection. It takes my sleep-addled brain a little longer to conclude that perhaps that's what Louisa means too.
When she'd come back to bed, I'd needed to know. I'm well aware of how tentative I can be, and so there's always been a degree of protecting myself I suppose, hiding behind disbelief and preparing myself for the inevitable, that devastating moment when Louisa realises I'm not the man for her. I'd been hesitant, but when I'd touched her, when I'd discovered how glorious she felt, I'd found myself oddly resentful, furious at a world where I was apparently never enough, where I was conditioned to accept crumbs when everyone else took the whole loaf. It's hard to describe how it feels when every fantasy, every hope, every dream you've ever had appears beside you, a complete contradiction of everything you have come to believe. And when you are finally brave enough to take that step, once your thoughts turn to love, and you finally understand how it feels, you know absolutely that there will never be any going back. You love with an intensity that sometimes cripples you, with a fear that eats away you, and with the overriding understanding that you don't deserve her. And now, worse still, you know beyond a doubt that there are others who did, and others who do.
Even in the pale light, she was beyond provocative, grinning up at me, her arms curled above her head, every curve shimmering and invitingly silky, clad fantastically in some sort of dark, sultry item of lingerie, floaty and deliciously feminine. I'd known then, as clear as day, whatever I'd been content with before was apparently now not enough. All that mattered was hearing her say my name. Not just to say it but to gasp it in a way she's never called out for anyone else before. I needed her to be breathless and yearning, and desperately imploring, as if there had only, would only ever been me and I was so much more than enough. The ferocity of the feeling had been almost overwhelming, so powerful and intense that, for a fleeting few moments, I was not myself. As I took her, I knew I must possess her thoughts. It became imperative that she had no other recollections, she imagined no faces, no actions, indeed not a trace of other boyfriends existed; nothing of her past should linger in her mind. As I'd made love to her there needed to be only one name she'd never forget and that name must be mine.
She'd clung to me like she was drowning, pulling my head down and kissing me fervently as if the depth of her need was equal to my own. With her legs wrapped around me, I was consumed; I could identify desire but what of the rest, the inexplicable fear and the debilitating need? And when, eventually, my self control failed me, all clarity and calmness deserted me, and everything I believed about myself just seemed to implode, I'd felt her grip on me become as tight as a vice. As her body twitched and writhed beneath me, she'd murmured my name, moaning softly like it were an incantation, a cluster of inharmonious chords rendered pitch perfect by her warm, fervent contralto. To hear it, frequent and fervent enough that even the deep pathetic neediness inside me was temporarily assuaged, somehow made me replete, and I'd collapsed, on the one hand so utterly sated, on the other, so ashamed at my lack of restraint.
In the silence that followed, she'd still clutched at my hand, no doubt aware how it shook, eventually pressing it to her lips and asking me, breathlessly, if there was a better word than spectacular, still laughing, and gasping as if she struggled for breath. As I returned to a state of conscious thought, my body vibrating at a frequency all of its own, I'd been overcome by a mad feeling of relief.
"I…can't think of anything just at this moment." I tell her, wracking my brain for a superlative that might adequately describe how I feel. "Spectacular is…good."
"Is that why you're shaking, then Martin?" She asks, and I can't quite tell by her tone what she wants me to say.
"Umm…"
"The shagging was so amazing, it turned you to jelly? Is that what you meant to say?"
I pause, thoughtfully, because in a manner of speaking, she is correct.
"Strictly speaking, umm…they're simply what are commonly referred to as fasciculations… muscle twitches, essentially…a Physiological phenomenon….whereby exertion interferes with normal neural activity. And…ahh, in addition, muscles need oxygen, and overexertion depletes the body's supply…often due to….sudden changes in…intensity which can also… overtax muscles not yet used to this new activity…"
I hear her exhale.
"Oh right." She says, and lets go of my hand.
I can tell now that the lack of sleep has caught up with her. She sounds suddenly weary and worn out and desperately in need of rest. I roll on to my side behind her, wrapping my arms around her as the trembling finally abates. And, as all my qualms seem allayed and my fears are assuaged, it feels like the safest place in the world.
