Chapter 85
Martin pulled up outside the Evan's house and strode rapidly to the door. A loud knock was swiftly answered by Mrs Evans. "Thank you for coming so quickly, Doc. He's out on the garden path." She led the way, through the kitchen and out to the path.
Mr Evans lay groaning in pain, on the path.
"Mr Evans? Can you tell me what's wrong?" Martin enquired.
"Uggh Doc. My leg here hurts very much. I can't move it." He'd pointed to his thigh bone.
Martin couldn't see any bleeding, so assumed that if it was broken, the break was an internal one. "I'm going to touch your thigh; can you tell me where it hurts?"
"Do yer 'ave to Doc? I'm sure it's broke.
"I'll be as gentle as I can be." He felt along the bone and Mr Evans cried out as Martin's hand got close to the hip. "How did this happen?"
I came out of the greenhouse and was going to go into the house. I tripped over a paving stone and landed here. As soon as I did it, I knew summat serious was wrong."
"Did you hit your head, or does anywhere else hurt?"
"I don't think I did. Just me leg."
Martin turned to the hovering Mrs Evans, "Would you go and call for an ambulance? Tell them it's a fractured femur."
She nodded and went quickly off to the phone.
"Now Mr Evans, I'll give you some painkillers but you must stay as still as possible. I'll open your trousers and inject the top of your leg."
Evans paled at the thought of what was to come.
Martin loosened the belt and unzipped the trousers. As carefully as he could he opened the trouser and pulled it down, exposing the break site. The leg was very bruised, but as Martin thought, there were no bone fragments outside the skin. He injected the painkiller and then stepped back. "Are you sure you didn't damage anywhere else?"
"No, I put my arm out to stop myself from hitting my head."
"Show me your hand and arm," he instructed.
Evans gingerly raised his arm to show Martin. As he did so a spasm of pain went through him, and he cried out.
Martin checked the arm and could see a bruise building up on the forearm. "You may have also broken one of the bones in your arm. I'll ask them to X-ray that as well as your hip."
Mrs Evans came out of the house. "They say it will be at least 25 minutes before it gets here Doc."
"Would you get a pillow and a blanket to cover him up, with? He'll need to be kept warm, while we wait. How long ago did you do this?"
"I fell at around 4:00 pm, Doc. The missus was out and I had to wait until she came in. I've shouted but no-one's heard me."
A quick glance at his watch showed Martin that it was more than an hour and a half ago.
Mrs Evans came out with the pillow and blanket and Martin helped her to wrap it around the prone figure and support his head.
"You should be able to accompany your husband to hospital, Mrs Evans. Do you need to arrange a car to bring you home?"
"Thanks Doc, but I drive and I'll follow the ambulance there. Will they keep him in overnight?"
"Err, I think he'll need an operation on his leg and so he will be in for a while. His arm will possibly have to be operated on as well. However the X-rays and scans will show exactly what we're dealing with. I suggest you get some shaving kit etc and anything else he might need, and bring it with you."
"How are you feeling now, Mr Evans? Have the painkillers taken effect, yet?"
"Yeah , Doc. I don't feel much pain now. I'm tired and want to go to sleep." Mr Evans closed his eyes and seemed to drift off to sleep.
The ambulance was heard and Mrs Evans opened the side gate to allow them access with the trolley to the rear garden.
"Now then Doc, what we got 'ere?" one of the paramedics asked.
"Potential broken femur, and possibly broken radius/ulna. I've given painkillers, but he needs X-rays and CT scans immediately. The danger of a cut leg artery needs checking as well."
The paramedics nodded. They'd dealt with enough of Martin's cases to know that he was generally correct in his diagnoses. "Right you are Doc. We'll put a collar on him and get 'im back to Truro."
When the ambulance went away on blue lights, Mrs Evans came out and told Martin she had everything she needed and had locked up.
"Do you have anyone who can go with you? A relative? It could be a long wait until we find out exactly what the problem is."
"I can phone my sister in Wadebridge and see if she will come. I can pick her up on the way." Gloria nodded to herself, she would need someone to talk to, to pass the time away. That Martin had mentioned it didn't seem at all out of character.
Martin tucked his chin in, "Er, I'll go to the hospital and check that everything is being done properly," he volunteered.
They set off and Martin allowed her to go first, through the narrow streets and on to Wadebridge. When she diverted to collect her sister, Martin increased his speed as much as he could to get to the hospital.
As he drove along, he was considering the potential pitfalls of the situation. He hadn't liked that his patient was soon asleep. The risk of blood loss into the leg through a torn artery, couldn't be overlooked. He knew the paramedic would put a drip in to Mr Evans, but given the length of time he'd lain in the garden the situation was problematical.
Martin arrived at the A&E entrance and lost no time parking in one of the empty spaces, normally used by consultants.
He went in to the reception desk and asked about Mr Evans.
"They took him straight to X-Ray, Dr Ellingham. He'll be at least another 20 minutes."
Martin nodded, "Let me know when he comes back, please? Also his wife will be arriving shortly." He went to the waiting area and settled himself down in one of the uncomfortable seats. His large frame was seldom accommodated comfortably in the chairs provided.
Mrs Evans bustled in a quarter of an hour later, together with another lady, obviously her sister. "What's happening, Doc? Has he had 'is X-ray yet?"
"Ah, they've taken him down, but he's not come back yet. As soon as he does, they will let us know."
"This is Lily, my sister, Doc."
Martin acknowledged her and then resumed his seat alongside the two women. As always in these cases, the wait seemed interminable.
Nearly half-an-hour later a nurse came across to them. "Mrs Evans? You can see your husband for a short while but he needs an urgent operation on his leg." The nurse explained as he ushered the ladies to the cubicle. As the ladies went in the nurse turned back to Martin.
"Dr Ellingham? You were correct about the blood leakage into the leg, and the broken femur. He has also broken his ulna. He may be some time in theatre as the damage will need to assessed before any further action is taken."
"Amputation?"
The nurse said, "I'm afraid I don't know right now, but I'm told it could be a possibility."
"Tell them to try and save it, if possible."
"Yes sir, I'll do that. Will you be waiting with the family?"
Martin agreed to wait and so went outside to phone Louisa. As she answered she heard his soft voice, saying "Louisa? I'm at the hospital now and my patient needs an urgent operation. Have your meal, but I doubt whether I will want mine."
"Are you alright, Martin?"
"Yes," he sighed. "This will take longer than I initially thought, so if I'm not back by bedtime, go up without me."
"I'll miss you. Take care driving home, love you." Louisa smiled as he softly said, "Love you too." Before he switched his phone off.
Martin returned to the waiting room and Mrs Evans and her sister. He looked around for some more comfortable seats and then asked the admin nurse if there was anywhere more suited to long waits?
"Only the canteen, Dr Ellingham, and even those seats aren't that comfortable," he admitted.
"Ladies, this is going to be a long wait. May I suggest we adjourn to the canteen and wait there for a while?"
Mrs Evans looked a bit doubtful, but Martin explained that the operation could take at least two hours, if not longer. She agreed and the ladies trailed in his wake, along to the canteen.
Lily volunteered to go and get some tea, but Martin declined saying he didn't like hospital tea. "I'll go and get some water."
As he approached the water cooler, a familiar voice hailed him. "Mart, what are you doing here?"
"Evening Chris, I'm with a patient's relatives. He's fractured his femur and I don't know how they'll repair it. Possibly external fixators, but hopefully internal ones will be possible." Martin spoke softly so that he wouldn't be overheard. "His wife and sister-in-law are over there, and they don't know the seriousness of the operation, just yet."
Chris turned to look quickly at the women. Fortunately they were in conversation themselves and didn't notice him.
"I see," he said.
"We've had to come down here because there aren't any suitable chairs in the A&E waiting room. Why don't you offer a room equipped with decent chairs, Chris?"
"You of all people must know that we don't want people waiting around. They could go home and wait there." Chris was slightly defensive of the hospital policy.
"What, back to Portwenn? It's hardly close, Chris."
"Hm, I take your point. However budgets are tight, and not likely to improve anytime soon." He changed topics quickly. "How's Louisa, and the pregnancy going?"
"Both are progressing well. Louisa is just over the 6 months mark, and er, I felt the baby move last week."
Chris looked delighted to hear that good news, although he was slightly surprised that Martin would actually say anything of that nature. "Why don't you and Louisa come for lunch in the next couple of weekends?"
Knowing that Louisa would enjoy a trip to see Chris and Carol, he agreed, but inwardly groaned.
"I'll find out from Carol when we're free and give you a call to arrange which weekend, OK?"
"Right, have to dash, mate. Give my regards to Louisa!" and with that he hurried off.
Martin took his water back to the table and sat down. He didn't want to engage in conversation with the women, in case they asked an awkward question about Mr Evans.
"Here Doc. How long will we have to wait for Gabe to come back from the operation?"
"I'm afraid he'll be gone for a couple of hours or more. Not only do they have to see to his leg, but his arm will need attention as well."
Martin didn't volunteer any more information than that. The ladies returned to their conversation and Martin got his phone out, indicated to them he was going to make a call, and then left to go outside.
"Louisa? I bumped into Chris Parsons here and he asked if we'd like to come across for lunch on one of the weekends coming up?"
Louisa's squeal of delight informed him she'd love to go for lunch. He cringed as the shrill tones hit his ears. "Chris will consult with Carol, and then call me to let me know when. Do we have any dates booked in that you know about?"
"No Martin. We've not been back long enough to make any plans. Oh, this is good news. I'm really looking forward to it."
Martin could hear in her voice just how pleased she was.
"Louisa, I may be here some time, because the operation is a tricky one and could be difficult to perform. I definitely won't be back before 11 p.m. As I said, don't wait up."
"Pity, Martin. I'll have to postpone my plans then."
Martin sighed; he'd been very much looking forward to the activities of the evening.
"I'm sorry, Louisa. I'll take a rain check, as the Americans would say. Definitely looking forward to it."
Louisa smiled at the dejection in his voice. "Don't worry Martin. Plans can be rearranged; we'll get to it eventually."
"Well, I'd better say goodnight. Love you." He heard her reciprocate and then switched his phone off.