Chapter 54
Sunday saw Martin closeted in the surgery wrestling with the accounts. Sometimes he felt they ganged up on him causing figures to slide gently into the wrong columns. He sighed, looked at his watch and decided it was coffee time. He walked quietly into the kitchen and saw Louisa busy with marking. He started to speak and she jumped. "Oh! Martin – you startled me." She was a bit breathless.
"Sorry, Louisa. I'll try and make some noise when I move about. I was just going to ask you if you wanted some coffee?"
"Yes please. How are the accounts coming? I've heard some disturbing noises coming from the direction of your surgery," she teased him.
"Huh! Don't ask. Three times I've added up one column and had three different answers."
She patted his hand and said, "Don't worry, it will come right in the end. I've got faith in you."
He put his arms around her, giving her a squeeze. "I enjoyed our time last night," he said huskily. "I think that is why I can't concentrate today. Why don't we go upstairs again and perhaps another dose of that magic you hand out, would cure me?"
"Wasn't it Dickens who said 'procrastination is the thief of time'? When will you do the accounts, if not today?" Louisa used her practical voice and he scowled.
He handed her a mug of coffee and then jerked his head to one side to indicate he was going back to the accounts. She blew him a kiss, to help him on his way. "Hmf." Was his rejoinder.
It wasn't long before she finished her marking and put the books away. Moving upstairs she stripped and re-made the bed, before going and cleaning the bathroom.
She put the sheets in the washing machine and started on washing the dishes. Unlike Martin, who washed up as he went along, she tended to leave it until there was enough to make it worth her while.
Eventually she made a couple of cheese sandwiches and called him through for lunch. He came in all smiles and she guessed he'd conquered the accounts. "Done?"
"Yes, thanks be."
"What are you going to do this afternoon?"
"Working on my clock, unless you have other ideas?" he leered.
"Perhaps later? I'm going to pop down to Bert's and see how he's doing. When I come back, I'll make a start on tea," she informed him.
"Ah, good. I mean that's fine. Be careful going down those steps," he cautioned her.
"I will, thank you Martin."
He left once more for the surgery, and she washed up before gingerly walking down to see Bert.
"Hello, my luvver. What brings you down 'ere?" Bert was ever, as jovial as possible.
"Came to see how you are, Bert, and Al too, of course."
"I'm getting better every day, Louiser. But I'm struggling with my puds. Doc said I wasn't to eat them anymore, if I wanted to play with my gran'kids." He looked so mournful that Louisa nearly laughed out loud.
"Bert, Martin is only thinking of you. I know it's hard to only eat certain things. Martin's always on at me to eat healthily now I'm pregnant. Even though I know he's only thinking about the health of the two of us, it still comes hard." She was full of sympathy for the man. Large, by both name and circumference.
"I have to say, Bert you look much better than you did. How's Al?"
"He's out with Pauline now. Said something about going to Delabole for a darts match. His ribs don't bother him so much now, but he's bein' careful not to do too much."
They chattered on for a while, before Louisa said she must go home. Bert escorted her to the bottom of the stairs and watched as she carefully made her way to the top. "Thanks Bert, see you later." She waved goodbye and crossed the road to the surgery.
She knocked on the surgery door and heard Martin say "Yes." Going in she crossed to the desk and kissed his cheek.
"I'm back."
"So I see," he said dryly.
"I'm going to make a start on tea, so you carry on playing, I'll see you later."
"I'm not playing," he yelped. She grinned at him before shutting the door.
She'd decided earlier on tuna steaks with salad, followed by fresh fruit. Preparing the salad was soon accomplished, but she knew the steaks would have to wait for a while. It was too early to put them on to cook.
Sitting on the couch she picked up one of her new books and began to read. She woke to the scent of steaks cooking and saw Martin expertly turning them over in the frying pan.
"I was going to do that!" she gasped.
"Drat," he said. "The handsome Prince didn't get to wake Sleeping Beauty." He looked disappointedly at her and she laughed.
"Come here, I'll make amends." Actions suited words and he retired back to the oven with a smile on his face.
The rest of Sunday night passed quietly enough.
Louisa looked at the calendar and saw that next Sunday was the date fixed for the Parson's visit. She got out her notebook and made a list of what she required in the shape of food. The next items were of the housework required and finally, but not least, what she would wear.
Martin, oblivious to these plans, got on with mending his clock, interspersed with dreaming of Louisa, scantily clad, waiting in the bedroom. He shook his head at these lascivious thoughts and decided he must be making up for the years when he'd nothing special to look forward to.
Breakfast the next morning saw both of them contemplating the week ahead. Martin foresaw the usual malingerers coming in for sicknotes, whilst Louisa hoped that Year 5 would not be as boisterous today as they had been last week. In the event, Martin was called out to the outer edge of the village where Mrs Parks was in extremis. He knew there was nothing he could do except ease any pain she was suffering. She'd been diagnosed with breast cancer and had had all the treatments from mastectomy to radiation treatment but the cancer had spread throughout her chest, and to her liver.
Mr Parks was sat quietly holding her hand until she passed away, whereupon he shed sobs and tears in equal measure. Martin left the room to give him some quiet time with his wife.
When he returned, he recorded the time of death and filled in the death certificate. "I'm sorry, Mr Parks, but there will have to be a post mortem. I'll call the coroner and their office will arrange for Mrs Parks to be taken to the mortuary. Is there anything you wish to ask about your wife's illness, or what happens now?"
Mr Parks shook his head. "Thanks Doc, I know you did everything you could."
Martin waited until the coroner's vehicle came to take her body away and then left the grieving widower. He climbed into his car and bowed his head. Although he'd seen it many times in his career, a patient's death left him anguished that he'd not been able to do more. With a deep sigh he set off for home.
When he returned to the surgery, Pauline informed him that most of his morning patients had made new appointments and only three remained to be seen. Martin noted that Bert and Malcolm Rayner were amongst the "die-hard" group. They would be seen today come hell or high water.
"Come through, Bert."
He waited as Bert, still waddling, but not as much, entered the office. "Climb on the scales Bert and we'll see if you've lost more weight." He adjusted the scale weights and found that Bert had lost another 4lbs. "Well done, Bert, you are coming down nicely."
"Here Doc, it's not coming off very quick. I've been doing what you said, an' all!"
"When you start a diet, you tend to lose liquids first and then fat. You will also lose some muscle which weighs more than fat. We are now starting to see the fat move off you. Yes, it will still take time to remove all that should go, and I'm afraid that as you approach your target the loss will slow down even more. I don't want you to lose heart, though, Bert. You are making good progress. Did you want to see me about anything else?"
"Yeah Doc, I needs a new sicknote. How long do you think it'll be before I can work again?"
Martin wrote out the new note and said, "Let's see where you are in four weeks' time. Keep up with what you are doing to lose weight. By the way, have you had any difficulties breathing, or pain from your collar bone?"
"To be honest, Doc, my breathing seems a bit easier. I'm not wheezing as much. My collar bone isn't paining me at all."
"Good to hear, Bert. See you in a month's time."
Bert shambled out and Malcolm Raynor swiftly took his place.
"What seems to be the trouble, Mr Raynor?"
"Doc, it's me ears. I can hear a constant whistling in both ears!"
Martin took out his otoscope and asked Malcolm to sit still while he checked out the ear canal and ear drum. He couldn't see any blockage in either ear and sat back down again. "Has this come on suddenly due to exposure to loud sounds, or has it built up gradually?"
"I've not been near any loud sounds for quite a while Doc. I did used to work for the Council when they was using a pneumatic drill to lift pavements and roads. Is that what you mean?"
"Yes, that could be a cause. I think you have what is known as tinnitus, or as you say, a ringing in the ears. Of itself, it is not life-threatening and you can learn to ignore it. However, I want to give you a full medical to make sure there isn't another underlying cause. Make a double appointment with Pauline, for later on this week. Ask her to give you a sample bottle and bring a urine sample when you come. Was there anything else?"
Malcolm sat there with a pale and worried face. "Do you think I've got something serious, Doc?"
"No, Mr Raynor, I don't, but I have to do my job to the best of my ability and that means just checking for underlying conditions."
"Right, I'll see you later, then." Malcolm took his leave, still shaking his head in worry.
Martin called out for the last patient.
A new patient came in and sat down opposite Martin.
"Mrs Young?" What can I do for you, today?"
The woman sitting opposite him looked frail, with a pale face and nervous hands twisting on her lap. "I 'aven't been feeling well, Doc. We just moved to the area from the Midlands. Came down 'cos me husband got the Assistant Manager's job at the supermarket. Anyway, my periods have been heavier than usual and I've had a lot of pain down here." She indicated her lower abdomen.
"Have you lost weight, at all?"
"Oh yes, Doc. Lost a stone and a half, since September."
"Would it be alright if I examined you? I can call in the receptionist, if you would prefer another woman to be present? If you would rather, you can make another appointment and bring a relative. If you opt for that I would encourage you to come back as soon as possible." Martin outlined the procedures, possible.
"Could the receptionist be in the room, Doc?" She was nervous and obviously needed some kind of back up.
Martin nodded and asked her to go behind the screen and undress her lower half, then climb up onto the couch. "I'll go and speak to Pauline while you do that."
He left the room and went to speak to Pauline. "I've a patient who needs a pelvic examination, Pauline, and she would like there to be another woman to be in the room while I do it. I need you to be in the room, but behind the screen and out of sight of the woman. Do you understand?"
"Yes Doc. Do you want me in there now?"
"I'll give her another few minutes to get ready. Is she my last patient this morning?"
"Yeah doc. You only have four this afternoon, so we might get away early." Pauline was ever hopeful.
Martin went back into the surgery with Pauline trailing behind him. "Mrs Young, are you ready?"
"Yes Doc."
"Mrs Young my receptionist, Pauline Lamb, is in the room as well."
"Morning Mrs Young." Pauline greeted the woman and hoped that would settle her down.
Martin pulled on his gloves and went behind the screen. "I have to do an internal examination, but I'll be as gentle as I can and it will be over soon." He tried to reassure her. He pulled aside the sheet and got her to raise her knees up. Carefully he inserted his fingers into the vagina, but couldn't feel anything untoward. "I'll have to do an endometrial biopsy which involves taking a small sample of tissue from inside the uterus." He picked up a speculum and inserted it into the vagina. He enlarged the speculum, inserted a long thin tube and with gentle aspiration removed some cells from the womb lining. He withdrew it and put the sample into a bottle.
Pauline called out, "Are you alright, Mrs Young?"
"Yes, thank you."
Martin asked Mrs Young to get dressed and he stepped away from the couch.
"Pauline, label that and get it sent off for an urgent biopsy, please. And ask them to send me the results as soon as possible."
The receptionist took the sample bottle and went back into the front of the surgery.
Mrs Young reappeared from behind the screen and sat back down. "What do you think the problem is, Doc."
"I'd like to ask you a few more questions, first, before I can say what the problem is. You say you've lost weight, since September. Is that when you first noticed the problems with your period?"
"They'd been getting heavy since July, Doc. The pains began in November. Occasionally there have been spots of blood, even when I'm not having a period."
"Has there been any pain during sexual intercourse, Mrs Young?"
"No, but to be honest, I've been so tired lately, that we haven't had sex that often." Her cheeks reddened as she said this.
Martin looked kindly at her. "Do you have a job, Mrs Young? Do you need a sicknote?"
"No, no I've not got a job yet. Work's not easy to find in Portwenn. Especially at this time of the year."
"What about children? Do you have any?"
At this Mrs Young's face broke into a smile. "I've got a boy and a girl. Six and eight, they are. Davy's in Miss Soames' class at the primary school, while Josie is in Mrs Ellingham's class." As she explained about her children, she realised the implication of what she'd just said. "Is Mrs Ellingham, your wife?"
"Erm yes, she is." Martin almost broke into a smile, but quickly turned the conversation back to the problem at hand.
"I've sent the samples off for a biopsy. This test will show what we are dealing with."
Mrs Young raised fearful eyes to his. "Is it cancer, Doc?"
"I can't say for definite until we get the results back. If it is, then I'm hoping we've caught it early enough so that appropriate treatment may be effective. When I've got the results, I'll contact you and ask you to come in to discuss them. The sooner we get you in to see the specialist, the sooner treatment can be started."
She started to cry. "What will become of me and my bairns, Doc?"
"At the moment we can't do anything. Once the results show what we are dealing with, I'm hopeful that a great deal will be possible. I know this is a lot to take in, at one go, but please try and be optimistic. That is the best way to begin combatting this."
"In the meantime, perhaps you could talk about this with your husband? If you have some pain from the test, ordinary paracetamol should be sufficient. The biopsy results will take about two weeks to come back."
She gulped and said, "Right Doc. I'll wait for you to get in touch." Getting up she went to the door. "Thanks for being honest with me."
Martin nodded, as she left. He heaved a sigh and hoped the afternoon appointments would be more straightforward to deal with.