Chapter 59

Martin had just dismissed his patient and was making a few quick notes before calling in the next patient when Miss Newcross poked her head in the door. "Mr. Ellingham, Mrs. Ellingham called and wants you to call her as soon as you are able."

He looked up at her with concern as he pulled his mobile out of his breast pocket, "Did she say what it was about?"

"No, just that she wanted you to call. She sounded anxious."

Anxious, Miss Newcross had excellent social skills and if she sensed that Louisa was anxious, that meant that something had happened. Louisa would never call him during the day unless there was an emergency. A thousand nightmare scenarios flashed though his mind as he pressed her number on his phone's speed dial. He could feel his muscles tense and his chest tighten as he steeled himself for bad news, one of the children badly hurt, or maybe all of them.

He leaned over his desk, supporting his weight with his free hand, as he heard her answer, "Martin."

"Louisa?"

"Your … Miss Margaret has had a stroke."

"Thank God". The words were out before he had a chance to think. He had feared the worst, but it was only his mother. If something had happened to Louisa or one of their children, he didn't think he could bear it. He had always felt that his role as a husband and father was completely separate from his primary identity as a surgeon and researcher. That was who he was, just as he had been when he first saw Louisa in hospital all those years ago. He loved Louisa deeply and cared profoundly for each of his children, but they were separate from the man who headed up Vascular …. Or so he always thought until one of the children was hurt or sick and his heart felt like a vise in his chest, clamping tight in fear. That was when he knew he could never live without any one of them, and that was how he felt that afternoon when he received Louisa's message. His entire body was shaking until she reassured him that they were all fine. It always surprised him, how strongly he was bound by the ties to his wife and children.

It was his mother who had fallen ill. It was inevitable that her health would fail someday. It was with a sense of resignation that he accepted the need for him to consult with her doctors and fly to Portugal to supervise her care in her final hours. He had hoped that she would pass quickly of a heart attack or a massive stroke at night, relieving him and Ruth of the need to provide care, but she was never considerate of others. Louisa would tell him that his feelings were uncharitable. Perhaps they were, but he couldn't control his feelings, only his behaviour.

He would speak with Ruth or Peter when they had something to share. Until then he would finish up with his patients that afternoon, and ask Miss Newcross to reschedule the remaining consultations for the week and to make a plane reservation to Portugal for late the next morning. He should be able to arrive at his mother's hospital by one pm if all went well. But Louisa had one more request, "Would he speak with Joanie and reassure her that all would be well?"

"Of course." How could he deny that request?

"Hi Daddy?" Her gentle voice whispered into his ear.

"Hello Joanie. How are you?"

"It's scary here Daddy. Can you come take us home?"

'Mmm. Hospitals can be noisy with people rushing back and forth. Is that what is scary?"

"Yes."

"Mmm … remember that all those people are working hard to make their patients better, just like I do every day in my hospital. Even though it is noisy and scary, you are safe with Mummy and James and Robert. I will be there tomorrow after lunch, but until then, I need you to be brave. Do you understand?"

"Uh huh."

"I love you very much. Can you ask Mummy to give you a hug for me? And I will see you tomorrow. Okay?"

"Okay."

"And don't forget I love you."

"I love you too Daddy."

"Can you give the phone back to Mummy. I need to tell her one more thing."

After he spoke again with Louisa, he rang off and called Miss Newcross into his office to make arrangements for the remainder of the week. An hour or so later, Peter called him with the information that indeed Margaret had had a haemorrhagic stroke and was now unconscious.

"I've spoken with the doctor who is supervising her care, a Dr. Silvio Fonseca. I believe you spoke with him when your father first consulted you about his stroke several years ago."

'Mmm … the name rings a bell. Do you have his contact information? I'd like to speak with him this afternoon or evening."

"Yes, it's …"

"Better yet, why don't you text it to my mobile. That way I'll have it where I can find it."

"Yes, yes I'll do that as soon as we ring off. Is there anything else I can help you with?"

"No …. Uh …. How do you think Louisa is coping with all this? I hate that she and the children are burdened with this situation."

"As well as can be expected. Don't worry about them. Ruth has taken them all back to our flat until Louisa's mother closes her shop. I managed to convince her that I would be in a better position to interpret anything the medical staff might have to share with the family, and that I might be able to wangle even more information from them than she could."

"Of course. Good. I'm glad she agreed to let you take over. She can be stubborn at times."

Peter chuckled, "Yes. All the Ellingham women can be stubborn, I've discovered."

'Yes. I suppose they are." Martin paused for a moment. "Uh … Peter. Uh … thank you for stepping in like this."

"Actually, I'm enjoying staying behind, observing the Portuguese way of managing their high dependency units."

"Good. I will let you know if I learn anything of value after I speak with this Dr. …"

"Fonseca. I'll send you the contact information immediately. Good-bye for now Martin."

When Martin called Dr. Fonseca after he finished with his consultations, the doctor confirmed that his mother's condition was grave. He wasn't certain that she would last another day. Martin requested that no extreme measures should be taken to extend her life and agreed to fax her advance decision living will authorising that course of action. After his father's illness had impressed upon his mother the necessity of such a document, she had been quite amenable to having end of life documents drafted and signed. She even had their family attorney draft a will directing the distribution of whatever assets she might have remaining upon her death. Martin had no idea what was in her will. He assumed they would find out in due course. The family attorney would be the executor. Christopher might have agreed to have Martin administer his estate, but Margaret had made other arrangements. He assumed that she didn't want or trust him to carry out her wishes. He never really knew why she behaved towards him as she did. It was surprising that she designated him to make decisions regarding her care if she were unable to do so. He supposed she trusted his integrity and knowledge as a doctor. There could be no other reason.

Martin arrived the next day to find that his mother's condition had not changed. He looked over her medical charts and conferred with her doctors, asking that they keep him apprised of her condition. He returned to spend a few minutes alone with her next to her bed in the ward; it seemed the honourable thing to do whilst she lay dying. He pulled the curtain around her bed, sat down in the chair reserved for visitors, and contemplated the woman before him, the woman who had given birth to him over fifty years ago. Should he feel at least some token of affection, sadness or sorrow in her final hours. No, he couldn't conjure up any of those sentiments, only relief, relief that soon she would be out of his life forever. He bid her adieu. Perhaps God, if there were one, would be more compassionate towards her than he could be.

Louisa had picked him up at the airport to drive him to hospital, leaving the children with Ruth and Peter. He was grateful that she was alone; for, despite the sad business of his mother's dying, he was glad to see her, and he greeted her as he nearly always did when they had been apart. "Hello, Mrs. Ellingham."

She responded in kind, "Hello Mr. Ellingham. I've missed you."

He reached out and enfolded her in a tight embrace ignoring the bustle of the other travellers swirling into the arrivals hall, and then held her hand as they wove their way toward the car park. He had packed a small carry-on bag with enough clothing changes to last through the weekend so there was no need to wait at baggage claim.

Louisa had stopped by hospital to check on Margaret on her way to the airport. He asked her for an update. "She's still in a coma. I know just enough Portuguese to understand the nursing staff report that she was unresponsive all night although her vitals are still strong. They are giving her fluids, but she can't eat anything."

Martin nodded his understanding and added, "I've spoken with her doctor and he tells me her prognosis is not good. She is unresponsive to physical stimuli, which indicates substantial loss of brain cells. I sent them her advance decision not to use any extraordinary life sustaining protocols. I will have a better idea of her prognosis once I've examined her myself."

"Will they allow you to examine her?"

"Of course. I'm a doctor and I am responsible for her care."

When he finished with his mother, Martin went searching for Louisa and found her in the canteen, nursing a cup of tea. He gave her a short update and the two of them walked out to the car park to go join Ruth and the children. The visit with his mother had been emotionally draining. He was exhausted and he wanted nothing more than to spend some time alone to sort his thoughts. A long walk on the beach near Ruth's flat would do his soul good, but he knew he had to face the family first, and he braced himself for their questions.

As he settled into the car, he turned to look out the side window, hoping that Louisa would understand that he needed some space. She was usually quite perceptive, reading his body language accurately, but not today. She reached over to touch his cheek and asked if he wanted to talk.

"No." Of course he didn't want to talk; he never wanted to talk; didn't she understand that by now? It was easier to bury the feelings and move on. But try as he might, he couldn't keep the emotions in check, and he blurted out the source of his lifelong misery, "Why? Why did she hate me so?"

He could feel the tears trickling out of his eyes, and he pulled out his handkerchief to blot them away. As he did, she slid over and took him in her arms, and he completely lost control burying his face in her neck as she rocked him like a child. As humiliating as it was for his wife to see him so distraught, it was also consoling; and as he felt the misery of his emotions ease, he pushed her away and sat up straight.

That was his signal that they must leave and join the family, and she started the car and drove out of the airport car park. It was chaotic when they arrived, with the children clamouring to see him, almost knocking him over with the exuberance of their greeting. Their happiness, their sheer joy at his arrival was contagious, and it almost swept away the heartache that had been eating at his soul since leaving hospital.

They made their way into Ruth's flat and he took a few minutes to compose himself before updating the family of his examination of Margaret. As he was telling them of her condition, he watched the expressions on all their faces. James followed his every word, but he felt the need to clarify some of the medical terms for Robert. It was apparent that Robert was ready to learn more about the medical field. Robert would occasionally join James in his study in the evenings when he would discuss his work, but he hadn't properly encouraged his interest. He vowed that would change starting this summer when he would give Robert his first frog to dissect. Yes, the three of them could have many profitable hours working together on all sorts of scientific explorations, not just medical. And in due course, they would include Joanie if she was interested.

The flat Louisa had rented for the next few days was a short walk from Ruth and Peter's flat, and it took only a few minutes to unload the car and carry their bags into the flat and settle the children. It was nearly time for their evening meal, but Martin felt the need for some private time. The children had found a pack of playing cards and were engaged in a game of 'Fish', and Louisa was unpacking the children's clothing in their bedroom. He looked in on her and told her that he needed to stretch his legs and promised to return within a few minutes. He slipped out the door without the children noticing and strode in the direction of the ocean. The air was brisk and fresh and it felt good just walking through the compound.

The grounds were covered with profusions of colourful flowers spilling out over the pavements, but he hardly noticed. His thoughts were with the tasks he must face the next day. First there was the one last visit to his mother's bedside with James and Robert. He was a bit disconcerted at James' request to visit with Margaret in hospital. But Louisa had told him of the special bond between the two, and he knew it was important to Louisa that he try to satisfy James' request. The bond that his son had developed with his mother was unfathomable to him. The woman had always been so hateful to him; how could she be kind to his offspring. It was a mystery.

He was certain that his mother would pass sometime during the night. He certainly hoped she wouldn't linger into the next day. Once she had passed, there would be the call to the mortuary in London to make the arrangements. Should they have the body cremated here in Portugal or should they transport the body to England. He was hopeful that the undertakers would handle all the necessary logistical arrangements; after all that was what they were paid to do. He would agree to whichever procedure they recommended.

After tomorrow, they would have one more day in Portugal before it was time to return to their home in England. He would have to check in every few hours with his team back in London. He could only hope there were no major emergencies whilst he was out of the country. He had tapped Brindall to fill in for him, but it was a last-minute appointment. Brindall was competent, but Martin hadn't had time to brief him on all the current patient complications that required close attention.

He was looking forward to spending time with the family once the arrangements for his mother were completed, and he hoped Louisa would find some activity that they could all share that wouldn't involve joining the children in the pool or the ocean, not this trip. They would have to spend at least a few hours socialising with Louisa's mother and her partner. There was no way he could beg off that. He would make sure Louisa understood that he needed a quiet weekend, without any manic socialising. Despite the relief he knew he would feel once his mother passed, at this point he was still tense with the emotions that her imminent death had stirred up.

He reached the ocean and stood at the edge of the grass where it met the sand. The tide, with its rush to shore and retreat back to the sea, had always been soothing, one of the benefits of frequent visits to Cornwall; he was looking to find the same solace here in southern Portugal. But today the normally calm sea had turned choppy and rising swells were pummelling the shoreline. It was late afternoon and there appeared to be a storm brewing offshore with a blustery wind coming in off the sea, rustling the leaves of the trees under which he was standing. The surf was anything but calming, and the energy inherent in the impending storm made him feel alive, thrilling his spirit with the freedom he was about to secure, a release from the shackles with which his mother had always bound his psyche.

He paced along the edge of the grass, mentally revisiting his arrival at Ruth's that afternoon and his children's greeting, the surprise he felt when they swarmed him as soon as he and Louisa arrived. He shouldn't have been surprised. They were always pleased to see him when he arrived home each evening, grabbing on to him, anxious to tell him about their day. His mother had hated him all her life, but his children seemed to love him unconditionally. It was puzzling. Even Louisa, as they were in the car, had said that he was the best husband she could have had. It suddenly dawned on him that he was deserving of that love, that his mother's hatred of him had sprung entirely from the depths of her character and that it had nothing to do with him.

Yes, he was a man someone could love, a man who was loved. His mother, and his father as well, were unable to love a child. It wasn't anything inherent in his composition or character, and that knowledge, deep in his soul, was liberating, life changing. Years of therapy had convinced him of that fact, intellectually he knew that was the case; but it wasn't until just that moment, with the images in his mind of the family that he loved and who loved him back, that he accepted it as truth. He sat down on a nearby bench and ran his fingers through his hair, basking in the wonder of that understanding until it was time to return and join his family, the family that loved him.