Disclaimer: Doc Martin is the property of Buffalo Pictures. I own nothing except my imagination.
Trouble in Paradise - Chapter 7
Martin's plans for undertaking surgical procedures at his practice had hit a stumbling block. He'd submitted a detailed proposal to all the necessary authorities as required, only to have it rejected on the grounds of 'insufficient parking and limited access' issues. He was furious.
"Why suggest that I apply and then reject my practice on some stupid technicality – we manage perfectly well with 'insufficient parking and limited access' every day, that's all part of running a rural practice, for God's sake," Martin ranted at Chris.
"Look I'm sorry, I feel bad for suggesting it and getting your hopes up, but apparently it's some new EU regulation, new businesses – and yes, they classify a doctors' surgery as a business - have to prove that if there is likely to be an increase in the volume of traffic, there will be sufficient and adequate vehicular access and parking. It doesn't apply to existing businesses, but due to the quite substantial changes the extra surgery work would bring to your practice, they decided that it comes under the 'new business' category," Chris explained.
"Bloody pen pushers in Brussels interfering in matters that they know nothing about, wasting everybody's time," Martin grumbled. He'd spent a lot of time in the evenings and weekends putting together a very thorough and detailed proposal. Louisa had been helpful and understanding about it all, but now he was cross because it seemed that it was all for nothing. He was pretty disappointed because he'd really thought it was an excellent idea, benefiting patients, and giving him a new challenge.
"Well, all is not lost, Martin. There are a couple of options. One is to simply scale back the proposal a little so that it won't be classified as a new business. Don't know how you'd feel about that?" Chris asked him.
"I suppose it's a possibility, but I thought the whole point was that I'd undertake as wide a range of procedures as possible to make it worthwhile implementing all the necessary changes," Martin said.
"The other option is a bit more….radical, I suppose you could say. Thing is when word got out that you were going back into some sort of surgery again, I received quite a few enquiries asking if you'd possibly consider working as a surgeon in Truro hospital... maybe for just a day or two a week, or even maybe…. full time. If you felt ready for it." Chris looked intently at Martin to see what his reaction was.
Martin was surprised, but pleasantly so. He'd been a lot more open and up front about the therapy he'd had from Doctor Milligan this time. Louisa had told him not to regard getting help as admitting a weakness or failure, and he'd realised she was right – that in itself had been a huge leap forward. As Doctor Milligan had told him originally, 'you're not running from me, but from yourself'. By choosing, of his own free will, with no one pressuring him, to have another go at therapy, he had felt in control. He'd come to respect Doctor Milligan, having always scoffed at doctors in his field. Now Martin accepted that it was just as important to understand the workings of the mind as it was to understand the workings of organs such as the heart. As part of his new openness, Martin felt reasonably comfortable in referring to his therapy, and so he was able to let Doctor Milligan vouch for his full recovery. This meant that other surgeons, who knew of his brilliant skills, felt much more confident in enquiring about him.
"Well, I don't know about that, wasn't expecting it, I'd have to think about it," Martin said slowly. Chris could see that it had definitely sparked some interest in him.
"Look, there's no immediate rush, think about it, talk it over with Louisa, could mean some pretty big changes after all," Chris told him.
xXx
"It's up to you Martin, whatever makes you happy in your job, I'll go along with," Louisa told Martin when he asked what she thought. Martin had been very supportive about her job, so she reasoned she owed him the same in return. In reality, she was more than a little scared of what some of the changes could mean to their home life. It was one thing doing surgery at the practice in Portwenn, quite another being a surgeon in Truro. But if that was what he decided he wanted to do, she would support him 100% - she would never want to think that she had held him back.
Joan, however, expressed more doubts to Martin when he told her of his plans.
"I was thinking that maybe I could do one or two days a week surgery in Truro, and three or four days a week in Portwenn at the practice, maybe extend my practice opening hours to compensate. That way it would be the best of both worlds," Martin explained to her.
"Or is it trying to have your cake and eat it," Joan said disapprovingly. "Isn't there a danger that you'll end up spreading yourself too thinly? I thought that when you decided not to go to London you'd decided against going back into surgery at all, so what's changed now? Wasn't anything that wretched father of yours said when he was here was it, did something he say get to you? What about spending time with your family now that you've finally got one, hmm? And you certainly wouldn't have time to pop home to Louisa in your lunch hour would you?" She looked at Martin knowingly.
Martin looked at her in horror – good God, she hadn't seen…is that why she'd started coming to the front door when she came round, he'd thought that was a bit strange, because she usually came round to the back door.
"Anyway, what does Louisa say about all this?" Joan asked him.
"She says that it's my choice and that she'll support me whatever I decide I want to do," Martin told her. "So are you saying that I should be a surgeon or a GP but not try to do both?"
"I'm just saying that your life is very different now from when you were a surgeon before. Then you could happily spend hours and hours preparing and planning procedures in the evenings and weekends because you were single with nothing else to do. You're a married man now, you've made a commitment to Louisa and Luke, so is it really fair to them to commit yourself to two very demanding jobs? Is that really the kind of life you want now Martin? You're the happiest I've ever seen you these days, so you just be careful that you don't go and spoil things, whatever Louisa says about being happy to support you."
xXx
"What?" Martin irritably answered the phone in his surgery. "Pauline, I'm with a patient, so you don't put calls through, surely you know that by now?"
"Unless it's an emergency, Doc, that's what you said, and Mrs Ellingham said it was," said Pauline huffily.
"Well why didn't you say, put her through," Martin bellowed back.
"What's the matter, what's the emergency Louisa?" he demanded to know.
"It's Luke, I'm probably overreacting, worrying over nothing but…" Louisa started to explain. She was still at home from school for the Easter holidays.
"What's wrong with him?" Martin sat up and took notice now.
"He didn't wake up from his morning nap for his lunch as normal, and you know how unusual that is," Louisa told him. Martin remembered only too well the other day when Luke had cut short their recovery from the episode in the kitchen, by waking up and demanding to be picked up for his lunch.
"So I went up to check him, and he didn't really want to wake up, so I brought him downstairs to give him his lunch, but he didn't want it," Louisa carried on. They both knew that this was really unusual behaviour for their son, because he always loved his food.
"And I'm not sure but I think that maybe his breathing's a bit funny, and his hands and feet look a bit... well, blue. Martin, he's just not his normal self at all, should I bring him down to the surgery for you to check him over, make sure he's alright?" Louisa asked him anxiously.
"Louisa, look carefully, has he got a rash on his body anywhere – this is very important." Martin tried to stay calm and not panic as the worst case scenario was racing through his brain.
"He's got a little bit of a rash, a few spots, on his chest," Louisa said.
"When you press them, do they fade away – press a glass against them so that you can see," Martin instructed her. He waited impatiently while she did this, alarm bells ringing in his mind.
"Oh God Martin, no they don't." Louisa knew enough to know that this was not good.
"Call an ambulance NOW, and tell them it's suspected meningococcal septicaemia. I'll organise some antibiotics to pre-emptively treat him, and I'll be there as soon as I can." Martin's heart felt an ice cold chill envelope it. Luke had several of the classic symptoms, and needed to get to hospital as soon as possible. But the sooner Martin gave him the antibiotics, the better his outlook was, if indeed his provisional diagnosis proved to be correct.
Martin looked at the overweight middle aged lady patient still sat in his surgery that he'd been dealing with.
"Eat less, move around more, then you'll lose weight. This consultation is over. Now go."
He strode out of his consulting room, shouting out at the waiting patients.
"All appointments are cancelled, highly urgent medical emergency, go home."
He quickly scribbled a note and handed it to Pauline.
"Ring Mrs Tishell and tell her to have this ready for you to collect immediately, then bring it up to my house – as fast as you possibly can – it's for Luke," Martin explained as he shot out of the door with his medical bag.
"You heard the man, MOVE IT," Pauline shouted at everyone, as she picked up the phone to call Mrs Tishell.
xXx
Martin ran into their house, calling out "Louisa, where are you?"
"We're up here Martin, in Luke's room," Louisa replied.
Martin rushed up the stairs two at a time, then raced into Luke's room, panting from his exertions.
"Did you call the ambulance, how long did they say they'd be?"
"They said fifteen to twenty minutes, so they should be here soon," Louisa told him, handing Luke over to Martin to examine him.
Martin quickly examined his little boy, and with a sinking heart his worst fears were realised when he did the glass test on the rash – the spots didn't fade. All the other symptoms confirmed the probable diagnosis, as Luke just lay there lethargically.
"Oh God, no," he groaned, then seeing Louisa's white panic stricken face, he pulled himself together.
"How long has he been like this? He seemed alright this morning when he woke up, didn't he?" Hadhemissedsomething,shouldhehavenoticed,washebeinghisusualpreoccupiedself, he wondered guiltily.
"He…he was just a bit quiet, that's all. Oh Martin, this is really bad isn't it?"
Louisa was shaking now, and biting her knuckle to stop herself from crying.
"We don't know that yet, that's why he needs to go to hospital, for tests to confirm what's wrong with him, but just in case, I'm going to treat him for the worst case scenario. Where's Pauline with the antibiotics?" As he said this, they heard Pauline's scooter drive up, so Louisa ran down to let her in.
"Here you are Doc, went as fast as I dared," Pauline said breathlessly as she handed over the drugs. Martin wasted no time in preparing the syringe and giving Luke the injection, heaving a sigh of relief as he heard the ambulance siren.
xXx
"Suspected meningococcal septicaemia case – we'll take it from here," the paramedic said as he started to examine Luke, who was lying in Louisa's arms listlessly.
"I'm the GP – I've given him a pre-emptive shot of broad spectrum antibiotics, but time is of the essence so I suggest we get a move on, quick as you like," Martin told them brusquely, knowing that if he admitted to being the father they would not let him carry on.
"OK – let's get him in the ambulance to set up a drip and oxygen, then we'll be on our way," the paramedic agreed. "We'll radio ahead to tell paediatric intensive care to expect him.
In the ambulance on the way to the hospital with blues and twos going at full pelt, Louisa watched as Martin and the paramedic constantly monitored Luke, not interrupting, guessing his reason for not admitting to being Luke's father. She simply put her total trust in Martin to do whatever he judged best for their son. At the hospital, Luke was rushed into the paediatric intensive care unit. They immediately started working on him, setting up drips and monitors.
Martin came out to explain to Louisa what was going to happen.
"I've already given him a shot of broad spectrum antibiotics in the hope that it will start to kill the infection, but we need to find out if a more specific antibiotic would be better. To do this, Luke will need blood tests, and a lumbar punch to check the cerebrospinal fluid. He is on a fluid drip and oxygen to give him all the support that he needs to fight the infection, and he may possibly be given a steroid injection to help too. He will be carefully monitored, but once the best treatment has been established, it's just a case of wait and see, and hope that he fights off the infection. The next 24 – 48 hours are critical."
Louisa collapsed in tears in Martin's arms. He was just about managing to hold onto his own control, because he knew that he had to be strong for her. Now that Luke was in hospital safely, he had admitted that this child was his own son, allowing the consultant paediatrician to take over, but Martin was still watching them intently to make sure that nothing was missed, and that everything possible was being done.
"Look, I'd better phone Joan and tell her what's happened, it'll be all round the village and I don't want her finding out…."
Before he could finish his sentence, he saw Joan hurrying up, her face worried and anxious.
"Pauline phoned me, told me what had happened, I came as soon as I could – any news?" Joan asked.
Martin silently thanked Pauline. He'd left her to lock up their house and take care of things at the surgery as they'd left in such a panicked hurry. It seemed that she was using her initiative to try to ease things for him.
"Luke's in intensive care, being treated, so now it's just a case of waiting. The next 24 – 48 hours are critical," Martin said.
"I have to be in with him," Louisa said, disappearing into the room.
"So how bad is it Marty – tell me the truth." Joan took Martin to one side.
Martin took a deep breath and exhaled slowly.
"Bad, Auntie Joan, it's bad…." Martin's voice cracked as he covered his eyes with his hand. He'd kept himself on a very tight reign all the time that he'd been responsible for Luke's care at home and in the ambulance, but now that he'd handed him over to the specialist team, and he could do no more, it suddenly hit him very hard.
"We could lose him, he could be severely disabled….I can't bear to think…..our precious boy….."
Joan hugged Martin tightly.
"We have to believe he'll be alright Marty, he's a strong lad, a fighter, you'll see. He has to be alright." Tears were coursing down her face too.
xXx
Over the next two days it seemed to Louisa that they just kept doing test, after test, after test, but if Martin said that it was the right thing to do for Luke, she knew that it was, so she didn't ask too many questions, she simply left that side of things to him. She knew that he was trying to be strong for her, and that his way of coping was to concentrate on the medical aspects of it all, but she could see that he was just as scared as she was when she saw his expression as he looked at Luke, all wired up and monitored, just lying there, stripped down to his nappy. In a way it must be worse for him, she supposed, as he knew only too well what all the possible outcomes were in full detail.
She refused to leave Luke's side other than to go to the loo, or to grab a quick cup of tea and a sandwich. She didn't want to eat, but Martin and Joan told her that she had to keep her strength up for Luke's sake, so she did try to eat, but it might as well have been cardboard for all she tasted of it. Most of the time, she sat stroking Luke's head and holding his hand, willing him to get better.
xXx
Martin knew that everyone believed that he'd never wanted their baby, and that he was a somewhat reluctant father. He supposed that he couldn't blame people for thinking that really, because there were elements of truth in it. If Louisa had come to him when she had very first found out that she was pregnant, he would have advised her to at least consider having an abortion initially, it would have been logical, considering their circumstances at the time. However, he would never have pressured her to have a termination, he would have completely respected and supported her wish to continue with the pregnancy, whatever people might think.
But he'd loved Luke instantly when he'd held him for the first time, and now he loved him more and more every day. In his mind he raged at some unknown God:
Why are you doing this? Are you trying to punish me for not wanting him? Then don't punish him, he's just an innocent little boy, he doesn't deserve this. I'm just getting to grips with being his father, letting myself love him and now you do this. Is it because I've taken him for granted, taken the way that he just gives me his love for granted? Is it because I don't deserve to have him? How is Louisa ever going to get over this if he doesn't make it, or Joan? What have they done to deserve this?
xXx
Joan looked first at Martin, then at Louisa. They were both in a state of shock, this had all happened so quickly. It didn't matter that the doctors told them that they had done all the right things – noticed his symptoms early on, given him the antibiotics straight away, got him to hospital so quickly – none of it mattered if he didn't get better. Luke was the most important thing in Joan's life now. He'd brought pure unadulterated joy to her, given her a reason to get up in the morning, made her feel needed and useful when she looked after him, which she happily did at any time, she'd cancel anything to spend time with her beloved grandchild – that's what he was as far as she was concerned, and she knew that Martin and Louisa thought the same. Looking again at the pair of them, she wondered how their marriage would stand up if anything happened to this little boy – Martin was finally learning to let go and show his feelings, letting himself love and be loved. She knew, that if the worst happened, Martin would most likely just shut down again.
xXx
The doctors called a meeting with Martin, Louisa and Joan. Luke had been in intensive care for 48 hours now, with very little change in his condition.
"We would have expected to have seen an improvement by now, in all honesty. The longer he goes on not responding to treatment, the worse the outlook is I'm afraid. I'm very sorry, but I think that you should prepare yourselves for the worst."
Louisa was paralysed with fear, she felt as if she was stuck in some sort of nightmare that she would wake up from at any minute. She just gripped Martin's hand, unable to speak.
Martin felt like shouting at them 'THEREMUSTBESOMETHINGELSEWECANDO' but in all honesty he knew that they were doing absolutely everything that was possible.
Joan felt her life draining away from her, just as Luke's seemed to be – life wouldn't be worth living without him. Of all the bad things that had happened in her life, this was by far, far the worst.
xXx
Louisa was in a chair next to Luke's bed, having fallen asleep draped on the bed, holding his hand. She hadn't slept in nearly three days, but still refused to leave the hospital. Martin was in a chair on the other side of the bed, fitfully dozing, also refusing to leave the hospital. Joan had reluctantly popped back to get some fresh clothes for Martin and Louisa, torn because she felt unable to watch Luke slip away, but not wanting to leave him either.
xXx
Louisa thought that she must be dreaming, or hallucinating anyway. She could hear a baby, and he sounded just like Luke, so she forced her eyes open, and was shocked because it was Luke. He had finally opened his eyes, and was whimpering a little bit.
"MARTIN….Martin….." she called out in a croaky voice "It's Luke, look."
"What, where…" Martin came to, startled.
They both leant over their son, and saw that he was finally awake.
Staff came running in, checking monitors, calling in more doctors.
"Does this mean…" Louisa hardly dared to ask.
"It's a good sign," Martin told her, hardly daring to hope either.
Over the next few days, finally Luke gradually improved. Tests on him seemed to show that he had not suffered any lasting damage, although he would need to be monitored over the course of the next few months to be sure. He was moved from intensive care, to high dependency, to the normal children's ward, and then finally allowed home.
They knew how lucky they were, how very close they had come to losing their boy. Not everyone has a happy ending when their child is so ill.
"I think it's fair to say that the pre-emptive antibiotics that you gave to your son initially almost certainly saved his life, Doctor Ellingham. It was a good job that you were so nearby, otherwise I'm pretty certain that we would have had a very different outcome," the consultant paediatrician told Martin and Louisa as they gratefully took Luke home.
xXx
"I've made up my mind about my job," Martin told Louisa as they hugged in relief as they looked down at Luke asleep in his cot, in his room, finally at home.
"Really? I wouldn't have thought you'd had time to think about it." Louisa looked at him in surprise.
"I don't need to think about it. Basically Luke would have died if a doctor, who happened to be me, hadn't been here, in the village to give him the antibiotics. Next time it will be another child, someone else's son or daughter that will need the doctor to be close by. I can't be that doctor if I'm in Truro playing at being a surgeon half the week. I've been a surgeon, now I'm a GP, and I want to be the best one that I can. So, I'm going to remain at the surgery full time. It'll also mean that I can still be close to you both, my family, and that we can spend more time together. I'm just going to take on the scaled down proposed surgery, for a session or two a week at my practice, but no more than that." Martin tried to explain to Louisa how he'd reached his decision.
"That sounds just perfect to me," said Louisa, as she leant against him, so happy, relieved and incredibly grateful to be back at home with the two most precious people in her life.