Chapter 20

Martin's day got off to an early start when he was called upon to visit an expectant mother, up on Bodmin Moor. When he arrived there the worried farmer met him at the door and ushered him upstairs where his wife could be heard groaning.

Martin went into the room and could see immediately that his patient was well into the throes of labour. "Mrs Linton, do you know how far apart your contractions are?"

"Nooo, it hurts Doc. Can you give me summat for the pain?"

Martin took her wrist and checked her heartbeat, which was quite strong. When her contraction came again quickly, he judged it to be too late to get her to hospital. "Mr Linton, please get me some clean towels, a bowl of hot water and a small blanket. Firstly though, phone for an ambulance to come here."

"Right you are, Doc" affirmed the farmer and rushed off to do what was required.

"Mrs Linton, I'd like to examine you to see how close you are to being fully dilated. Can you lift your nightdress up for me please?"

The mother-to-be complied and Martin saw that she was indeed very nearly fully dilated. "Is this your first child?" He asked her.

"No, this will be my third." She told him.

Armed with that information he knew she would likely be quite quick to deliver. Putting on his sterile gloves he gently checked the position of the baby and was relieved to find it was in a head down position.

Mr Linton came back into the room with the requested items. He put them down and went to stand next to his wife, who clutched at his hand. "Don't leave me, Steve. Doc says it won't be long now."

Martin laid the towel down on the bed. As another contraction came Mr Linton held tightly on to her hand and encouraged her to breathe through the contraction. As she lifted her knees up it became apparent to Martin that delivery was imminent. "Right Mrs Linton, you are close but I don't want you to push until I say so."

"I want to push" she exclaimed.

"Yes, I know, but the baby is not yet fully engaged. Pant your way through the next contraction," Martin instructed her. After a further three contractions baby's head became engaged and Martin told her to push at the next contraction.

When it came, she bore down and gradually the head became visible. "That's it love, keep pushing." Her husband's hand clasped hers tightly.

She rested as the contraction left her, but was soon pushing and screaming again.

"Push really hard now, Mrs Linton the head and shoulders are out and this last effort should do it."

Martin picked the towel up and got ready to receive the new-born baby. He held it gently in his big hands and announced that they had a girl. He quickly checked the number of fingers and toes then gently rubbed the girl's back. He was rewarded with a mewling cry as she took her first breaths. He handed the baby over to Mrs Linton.

Mrs Linton burst into tears in joy and relief and Mr Linton was saying "well done love, well done."

Martin waited for the afterbirth, putting it into a waste rubbish bag. He checked that all was as it should be before washing his hands in the bowl of water. He heard the knock at the door and the ambulance men coming up the stairs. Mr Linton let them into the bedroom so that they could assess the situation. Quickly, Martin filled in the details for them and advised the Lintons that they should all go along to the hospital so that full checks could be done. He told the paramedics what the Apgar figures were and then he retired to the bathroom where he threw up into the toilet. He washed his hands and face and waited for Mrs Linton to be moved.

Discreetly he picked up the bag of medical waste and went out to his car, watching as the ambulance with the precious cargo moved off. Returning to the surgery he dumped the waste into his special bin and went inside.

He got himself a glass of water and then went into the waiting room.

"Two patients got fed up waiting, Doc and have rescheduled. The rest are ready when you are." Pauline informed him. She handed him a file and asked Harry Worth to go through.

Martin went to his desk and waited for Mr Worth to sit down. "What seems to be the problem, today, Mr Worth?"

"It's my knee, Doc. It hurts when I stand up or try to climb stairs."

"Go and climb up onto the exam couch and drop your trousers." Martin waited for Mr Worth's compliance and then looked at the affected knee. "Have you injured it, in say a fall or collision?"

Worth shook his head. "Not that I know of, Doc."

"I'm going to touch your leg around your knee. Let me know if or when it hurts." Martin palpated the area around the knee and the patient gasped when he felt the front of the knee and top of the tibia. He then asked the patient to bend his knee and turn or twist his leg. Observing the results Martin said "have you started doing more exercises or running, lately?"

Mr Worth shook his head. "I started a new job a month or so ago. I'm a salesman at that new place in Wadebridge. I walk around a lot more now than in my old job." He explained.

"Do up your trousers and come and sit down again."

"What is it, Doc? Is it serious?" Mr Worth was anxious as he needed to keep a regular income coming into the house.

"I don't think it is especially serious. I believe you have patellar tendinitis which is an inflammation of the tendon which holds your kneecap onto your tibia, or long lower leg bone. You can take ordinary painkillers to dull the pain, but you must not exceed the stated dosage. Do warm-up exercises such as flexing your knee on a morning before beginning work. If the pain continues for more than 2 weeks or if you notice fluid build-up around the joint come back and see me. When you go home today, ice the joint for 20 minutes every couple of hours. That should reduce any swelling."

"Was there anything else?" Martin asked.

"No Doc, thanks."

At school Louisa put her tin of chocolates in the staffroom and gave the presents to Pippa and Trish, receiving small packages from each of them, too. In her classroom she called the register and the class settled down to do some work.

"What can you tell me about reindeer?" she asked the children.

Several hands shot up and children bounced in their seats. "Hannah?"

"Reindeer are deer, Mrs Ellingham" Louisa smiled and nodded.

"What else do we know?"

Again, hands were raised. "Mark?"

Mark said "They live in Lapland, Mrs Ellingham."

"Yes, they do Mark. Well done. Do they live anywhere else?"

"In cold countries" answered George.

"Good. The male reindeer is called a stag and the female is called a doe. Did you know that unlike other deer species, both males and females have antlers?"

"Right, get out your drawing things and draw a picture of a reindeer, please."

The children pulled out their books and began to draw. There was a great deal of chatter going on, largely due to the imminence of the holidays. Louisa allowed a quarter of an hour for the drawings and was relieved by the playtime bell. She went to the staff room and got her hot tea to take out into the yard where she was on duty. She watched as the children laughed and ran around. One or two bumped into each other but otherwise everyone was enjoying the fresh air.