Chapter 15: The Dreaded Obligation

Monday Morning

It was a 40 minute drive from Portwenn to Newquay. It had taken Martin another 10 minutes to locate the campus of the further education college, park at the farthest end of the car park, then locate the proper building, and then the classroom. He was still 20 minutes early.

The classroom was mostly empty, with a woman setting up her papers on the lectern in front. She was a short and slightly stout, perhaps age 40, with greying hair that looked like she cut it herself. She wore a long paisley patterned skirt, a hand knitted-looking cardigan and dangly earrings paired with a wooden necklace. She had written on the white board "Mastering Effective Interpersonal Skills: A Further Education Initiative for Business and Health Care Professionals," with her name underneath "Vanessa Stevenson, Ph.D."

Dread. Pessimism. Procrastination.

Punctuality was a rule with Martin, but he couldn't bring himself to go in just yet. He went outside and took a walk all the way out to his car and then around a bit, before going back inside. The classroom was now full but he lingered in the corridor with his mobile phone, telling himself he needed to check his messages at the surgery.

He could hear a very enthusiastic female voice begin to address the class.

"Welcome to Effective Interpersonal Skills. I'm your instructor Dr. Vanessa Stephenson, you can all call me Nessa. I'm a senior lecturer in the Department of Applied Psychology at the University of North Cornwall, but I want you to think of me more as your guide on a journey of personal discovery and self actualisation.´

Finally, he couldn't delay any longer and slunk in two minutes late. So unlike him.

"This course is designed to help all of you develop your people skills and examine how you communicate and interact with others in your professional lives. I've taught this course a number of times as a weekend program. This is the first time I've expanded it to a full two weeks, so it promises to be a peak growth experience for me, as well as all of you. I'm so looking forward to it and I hope you are too."

All through school, Martin had excelled at virtually every subject required of him; the maths and sciences, of course, but also English, French, Latin, History. In Music he had participated in choir and learnt to play piano passably well, though it had been years since he touched the instrument. In Art he had applied himself to figure drawing, which enhanced eye-hand coordination and helped him learn anatomy. Even in Physical Education, his most hated subject, he was a fast runner, with his long legs, which helped him muddle through various compulsory sports. Once he moved on to his medical education he was always first in his class at Imperial College, gravitating to the most difficult specialty, surgery; then honing his skills to master perhaps the most difficult rank of his specialty, vascular surgery. Even when he fell from grace as a surgeon, his diagnostic skills as a GP were keen enough to… well, to spot open angle glaucoma in a woman's eye from across an airplane seat.

"This is also the first time we've got a few health care professionals, as well as business men and women, participating. This course will help you relate to your patients as people, not just medical complaints. I'm aware that some of you are perhaps not participating entirely voluntarily, however I want to assure you that you are amongst friends here. I've had loads of success with all sorts of personality types, even those who might be considered to border on the autism spectrum, or, as I like to refer to them, fellow travelers on the path to be 'efficient perceptors of reality.'"

Now Martin sat in the back of the class in this further education college, feeling like the dullest dunce who was ever doomed to fail a remedial subject. His bespoke suit felt like an ill-fitting school uniform. Still, he had committed to this course, not just to placate the unctuous, platitudinizing eunuch but to show his commitment to staying in Portwenn. If this was the price to pay for being with Louisa, well, he was willing to grit his teeth to get through it.

"We're going to focus on such concepts as the differences between submissive, aggressive, and assertive behaviour; skills to persuade and influence people and reduce misunderstandings; and handling criticism constructively and with non-hostile humour. We will be practising various interpersonal skills over and over until they become second nature, and engaging in extensive role playing and trust exercises designed to get you outside your normal comfort zones."

Martin ducked his head, hunkered down his tall frame in the hard plastic chair with the tiny desktop attached, and hoped the teacher wouldn't notice him.

Of course, she did.

"Welcome. You must be…" She checked a roster on her desk. "Dr. Martin Ellingham. Now our group is complete. We're all going to be friends here so I've handed out name tags to help everyone get to know each other. Please hand this back to Martin."

The tag was passed back several rows to him. Martin stared at the alien object. Encased in a clear plastic shell with a safety pin attached was a card that read "Hello! My name is _." The card was white with bright red edges. He was already questioning his resolve in getting through the course. He was beginning to experience heart palpitations and hyperventilation, and a touch of nausea was coming up his throat. He loosened his tie and took out a handkerchief to wipe his palms. Honestly, at this point he would rather be back in surgical theatre up to his elbows in bright red than have to do this.

"This course, this journey to greater self awareness, is suitable for anyone who would like to enhance their performance by improving their working relationships, and no doubt it will also enhance your… er, personal relationships… er…"

Martin was still staring at the name tag when he became vaguely aware that the instructor's cheerful voice had trailed off and was replaced with a different voice.

"Doctor, um, Nessa. Are you all right?"

He looked up to see the instructor holding her hands up to her nose, which was bleeding profusely. A man in the front row was offering her a packet of tissues. Martin got up and moved to the front of the classroom.

"It's fine, it'll stop soon. It's been happening to me rather a lot lately," she said.

"How often have you experienced epistaxis… bleeding from the nostrils?"

"It's been coming on every few days for a month or so now. But it happened yesterday and again this morning, and now this."

Martin took her left hand and examined it as she tilted her head up and held the wad of tissue to her nose with her other hand. "You've got a pattern of tiny bruises on your skin," he said. "Those are purpura, minor bleeds from broken capillaries. The small ones are petechiae."

He pulled at the startled woman's lower lip. "You've got a purpuric rash here too. Have you had bleeding gums or menorrhagia?"

"Sorry, men or what?"

"Excessive menstrual bleeding."

"What? That's none of your business! Just who do you think you are?" the instructor demanded. The rest of the class giggled nervously.

"I'm Dr. Martin Ellingham, you already know that. You said it when I came in the room, you silly woman!" The class laughed outright. "Just answer the question."

"Well yes, as a matter of fact," she admitted. "I've been taking Vitamin B and black cohosh for it."

"Black what?"

"Cohosh. It's an herbal remedy for menstrual disorders."

"And what have you been taking for the purpura bruises? Snake oil?"

The class laughed again.

"Martin!" She pulled the tissue wad away from her nose and looked to see if the bleeding was subsiding. "Gavin Peters informed me about you. It seems you more than anyone here would most benefit from this course."

"Well, Nesta, when it comes down to getting a potentially life saving early diagnosis, would you rather have a doctor who excels at trust exercises or one who can spot a serious illness before it progresses beyond treatment?"

"What are you talking about? And it's Nessa!"

"ITP. Idiopathic thrombocytopenic purpura. It's a condition in which the blood doesn't clot properly, possibly caused by an autoimmune response that attacks the platelets in the blood. It often responds well to treatment, but in rare cases can result in bleeding in the brain."

"What?!"

"You should see your GP as soon as possible to get a formal diagnosis. And you might want to rinse those bloodstains in cold water," he suggested.

Her nosebleed was starting to subside and she looked down to see big wet drops had fallen on her cardigan and on her notes for the course. "Oh dear, this isn't going how I had planned at all." She looked out at the class. The laughter had quieted down and they were just watching the spectacle, waiting to see what would happen next. "Perhaps we should cancel for the time being while I get all this sorted. You're all free to go."

Free! Martin strode into the hallway, as his fellow Interpersonal Skills students shuffled out and meandered on their way. He pondered for a moment the many ways the human body could malfunction. Mostly he just felt an overwhelming sense of relief that the ordeal was over before it had really begun.

He moved toward the exit to the car park. "Hey Doc," came a female voice behind him. "Wait up."

To be continued…

Notes: A further education college is similar to a community college in the U.S.

I was always disappointed the show never actually showed Martin having to deal with the Interpersonal Skills course he agreed to take so I just couldn't resist imagining how it would go for him.