(All my writing is now published first on my (P a TR e on dot com) page. You will find my new DM FF there, plus early access to Wheezer chapters as I create them.)
"Are you nervous?" She asks, bright-eyed and breathless, somehow more beautiful, dreamy and dishevelled by sleep.
It is early, before half past six in the morning and I am at the front door, briefcase in hand. Lifting my chin, I meet her glance. Of course I want to be honest but any loss of dignity must be avoided, my apprehensions must never see the light of day.
"No." I reply, stooping to kiss her, allowing my hand to linger on her arm. "I'm fine."
"See you tonight then…" She says and, for a split second, her smile is luminous; her warmth and light finding every fissure in my armour, penetrating deep into the darkest depths of my soul.
My god, loving her is ridiculously easy. Allowing oneself to be loved is a far more formidable task.
In hindsight, the role at St. John's might not have been what I wanted but, as Louisa had cheerfully philosophised, it was probably exactly what I needed at that time. I glance at my emails, the usual dross directed at department heads; meetings, statistics, reports, alerts. One from the Clinical Director entitled 'Congratulations'; no doubt our department percentages are well above the national average again. A smattering of Curriculum Vitaes; understandable, a successful team always attracting the brightest new young talent from across the globe. Scrolling half-heartedly, it's then I see her name; feeling a familiar faint flush of excitement: strange how two words can still prompt such a sense of disbelief. Louisa Ellingham: how on earth did that ever come about? Creating an entire department from the genesis of an idea might have garnered me professional plaudits; managing a team of eight competitive egos, having one's research papers published across the world, all considered my most notable achievements. Yet only I know Louisa agreeing to marry me is the greatest triumph of my life.
I glance up to ensure the door is securely closed; a reflex action, and rather an utterly pointless one too. While at home she might say things to me that render me incapable of sensible thought, in writing she is nothing if not discrete. My shoulders relax somewhat, of course I need not have worried. She has simply sent me another link to a Land Agent's website, with a brief explanatory message and a small x beside her name. But as I read through it, I am not entirely at my ease. Clearly, the Portwenn property search is escalating and, while I am not entirely comfortable with the implications, on the other hand I know that I'm to blame. I was so determined, intent on spending at least the decade seeing what I could achieve with my career. We negotiated an agreement and she's certainly played her part without complaint. But now it's closer to fourteen years and I can't ignore her growing restlessness, I can't ignore the ticking of her biological clock.
I open the advertisement, keen to utilise the few spare minutes I have before my next appointment: yet another med/tech company promoting their particular endovascular portfolio. More thrombectomy devices, more software, more hardware; undeniably, with the advancement of technology, vascular is certainly becoming a young man's game. Frowning at the screen, I scroll through the images: huge windows facing the sea, apparently notoriously hard to keep clean. High ceilinged rooms, undeniably difficult to heat; from bitter experience I have no doubt that the boiler is on its last legs, if it works at all. My phone rings and I startle: my secretary informing me the American delegation are here and, sighing, I take one last look at the screen. The house definitely meets my prescribed criteria, big enough to accomodate professional rooms and still be a family home. Louisa, of course, has her own separate list of needs. Her priority will have been to have counted all the bedrooms, and I am not sure entirely how that makes me feel.
In the foyer, a round of handshakes; polished salesmen with their blandishments and cajolery on one side, coolly circumspect consultants on the other: Cardiologists, Interventional Radiologists, and half of my vascular team. Occasions such as this only serve to illustrate how the lines between the specialties have become so blurred. Even over my relatively short period of tenure, IR seem to be taking over more endovascular procedures every week. I nod at John Fisher, a respected radiologist, pale skinned, silent and subdued. A steady hand on a guide wire, an expert diagnostician when it comes to contrast-enhanced imagery but, as for reattaching a severed hand, the man would have none of the requisite skills. He grunts at me in greeting, and I wonder just how long a career he will have. I've seen too many radiologists, men in their fifties, overtaken by technology, condemned to a life reading chest X-rays, a professional half-life lived entirely in the dark.
Shifting in the seat, I blame the meeting for feeling so on edge, my impatience compounded by having to suffer through a presentation where ninety percent of the slides are a ridiculous waste of my time. Why on earth would I care about their year of establishment, or their company founder, or the location of their grotesquely opulent headquarters? I fold my arms and scowl at the screen, distracted, and irritated by grammatical errors and American spelling, happy to leave the questions to Swane, a promising vascular consultant who treats the sales process like a sport. His colleague, Ratanayake, listens carefully and seems to be transcribing copious notes. A diligent and committed young man, I make a mental note to take him aside when the presentation is over, Louisa having reminded me to enquire how he and his family are settling in. She always has taken new arrivals enthusiastically under her wing; ensuring the partners are made to feel welcome, especially the emigrés. A Mother Hen, I think to myself; her seemingly inexhaustible well of compassion causing a dull ache to arise in my chest.
What was it that Ruth described her as? An empath, as I recall, struggling now to concentrate, anxiously tapping my top pocket, feeling for my mobile phone. Maternal, she'd added, you can look that up in the dictionary, her expression characteristically wry.
"I must say, given her background, it's rather a surprise she has any nurturing capacity at all…" Ruth had continued later, her tone somewhat arch. "It strikes me as far more likely that her childhood neglect would be a causative factor for an array of cognitive and emotional processing deficits."
I'd glanced up in surprise, recalling the first time I had lain with my head on Louisa's chest, her fingers in my hair, stroking gentle figure eights: it had been an unburdening, succour to a man who had no idea he was so in need of soothing. The softest of kisses on my forehead, fingernails trailing lightly over my back; tears had come to my eyes. How desperately I'd fought to hold them back.
I'd cleared my throat hurriedly at the recollection, unable then to look at my aunt. "She…ahh…Louisa has a singular determination not to be defined by her childhood…not to be a victim of it, if you will…"
Ruth and I were at a small outdoor table on the Kensington High Street. Her choice not mine, as the traffic roared past and the stiff breeze sent the paper napkins fluttering along the pavement. But the coffee was good and there was no one close to overhear us; an important consideration when one's confession was as personal as mine. I'd swallowed hard and held her gaze. How to explain I hadn't thought much beyond my proposal? Opening that particular Pandora's box would expose far too many covert fears.
"She wants children of course?" Ruth had interrupted. "She seems the type…"
"I don't know about 'the type', " I'd muttered dismally. "But, yes, children…umm…they're…well they're very important to her."
"But not to you?" My aunt had ventured quickly, leaning back in her chair, her gaze disturbingly astute.
I shook my head, and I heard her sigh.
"First of all, I have to say, Martin, I am glad that you're considering such matters before the two of you walk down the aisle. Mutual agreement on matters such as having a family is pretty fundamental to the success of any relationship. I'm fond of Louisa too but you must be fair to her. In the long term it really is wiser to call it off if you both want different things…"
The nausea had returned, instantly, the sense of panic; my god, the thought of walking away, of a life without Louisa was unthinkable. Wanting different things would never adequately explain the anguish that I was feeling. I wanted Louisa desperately, and Louisa wanted children. But I'd seen first hand the damage such resentment could inflict on a marriage, I'd been the unwanted child that caused my parent's relationship to fail. The dread was almost unbearable. My chest felt impossibly tight, my words were half strangled in my throat, drowned for good in a reflux of acid.
"Martin, you have actually discussed this with her?" She'd asked, narrowing her eyes at me. "You have told her how you feel?"
I'd nodded miserably. "Another thing we can't agree on…I can't imagine how I will be any good at…it…and she…well, perhaps it's the triumph of hope over experience but she simply doesn't understand why I feel the way I do."
She contemplated me shrewdly, her grey eyes glittering with ferocious intelligence. "I see. So you don't think you've got what takes to be a father and, on the contrary, your optimistic and enthusiastic young fiancée rather feels that you do…"
"Yes." I croak, the word like a bittering agent lingering acridly on my tongue.
"Hmm…" She replied, swallowing the dregs from her cup and dabbing at her mouth with a hastily-retrieved handkerchief. "And you can't imagine what she sees in you that would lead her to such a delusion?"
I steeple my fingers together on the table in front of me, unable to say a word. But I hear her voice well enough, crisp and clear against the dull thrum of the background noise, well-reasoned and without emotion.
"I suppose it could be said that she knows you better than anyone." She continues thoughtfully. "I mean, she's seen you endure some rather testing times, I'm sure she thinks she has a measure of your character...is that a fair assumption?"
"Yes." I mutter unhappily, still rendered almost mute by my discomfort. I loathed the feeling of being under a spotlight, sickened by the idea that anyone might ever have insight into my thoughts. Slapping her hand on her table, she gets to her feet, jolting me as if it were a gun shot.
"I'm sorry Martin," She says with a tiny shrug, "But this time, I think I rather agree with Louisa…"
I startle again, miles away, as an aluminium case clatters on the table before me. The inevitable samples, presented with all the ceremony of the unveiling of the Crown Jewels, and Swane doesn't disappoint me, asking the difficult technical questions in a tone that sounds rather uncannily like mine. He certainly has come a long way from the young man that arrived with such impressive results from St. Andrews, yet who struggled so much in his first six months as a registrar. A couple of missteps and he seemed to lose much of his confidence, apparently taking his errors of judgement very much to heart. But, as Louisa is wont to remind me, everyone is human, everyone makes mistakes. Of course, failing to check a patient's medications thoroughly is potentially far more disastrous than misjudging a car parking space or burning the toast but, over the years, I've learned to moderate my responses. It might even be said the young man now confidently firing off technical objections is, in part, the result of a concerted attempt at guidance on my part.
More restless than ever, I adjust my cuffs, and clear my throat, before reaching into my pocket and retrieving my phone. No missed calls, ninety five percent battery; I exhale sharply, and place it face down on the desk. The company representative is debating micro-catheters with a cardiovascular surgeon whose name escapes me, a pedantic, difficult little man. This conversation could foreseeably drag on for the rest of the day and I glower as I listen to them before I pull rank, and interrupt. Recently, I've been involved with several paediatric endovascular procedures and, the truth is, even the smallest below-the-knee equipment is not optimal for safe vascular access in very young children. And, of course, the need for my involvement seems only to be increasing. God forbid that parents might strap their offspring securely into car seats, and supervise them so they stop falling out of windows, or riding their bicycles into the path of oncoming cars.
"Nothing smaller than a 3-F?" I growl, as he shakes his head, and I find myself profoundly irritated by his obsequious attempt at commiseration, his unnaturally brilliant smile.
"Marvellous." I add, folding my arms, and raising my chin to glare disapprovingly at him.
Is it too much to ask that he should show us anything useful? No, much easier to reinvent the wheel and attempt to secure contracts not by innovation but by such inducements as pointless stationery, glass ware, and the threat of holidays in Hawaii. I stand up, still glowering at him, and now his smile is glassy, the room filling with bombast and discordant sound: awkward coughs, the slamming of briefcases, the cardiologist launching into his tedious line of questioning once again. The air seems heavy, oppressive even, and it's like an epiphany. Suddenly I am so very tired of it all; the interminable meetings, the profligate dinners, the egos, the paperwork, the jumping through administrative hoops like a performing lion at the zoo. I've never wanted any part of this network, of handshake deals done over cigars and expensive brandy, of contracts awarded through spurious inducements. It hits me then like a thunderbolt, and I leap from my chair. My heart is pounding. It's all so shabby, so tedious and disappointing. How on earth can this be my career at its very zenith when I'm further away from the patients than I have ever been?
I stride back to my office, my footfall terse and impatient against the newly laid linoleum. I glance at my phone again, aggravated at how little time I can spare for enquiries that seem now urgent and imperative…and this must be an educated decision…all aspects must be thoroughly researched…must compile an extensive mental list…must make myself familiar with the catchment area…study maps…review population centres…speak informally with contacts within the NHS. And the fiscal implications of the decision…leasing the flat seems the logical solution…but fitting out new premises would require a mortgage…not quite so straight forward without the luxury of two London salaries when filling out the application…on the other hand, this might be an opportunity….hadn't the conversation I'd had at the Bath conference, with Bernard Newton had left me convinced of that? Hadn't my casual enquiry into the consultant shortage in the West Country, revealed a situation more desperate than I'd ever imagined might be the case…one thing is clear…I won't be the first senior consultant to abandon London, to choose lifestyle over my career.
I open my laptop immediately, and set to work creating a series of spreadsheets, in the throes of setting up a formula to calculate loan repayments when the call from my secretary comes in.
"Mr. Ellingham, Louisa is here to see you." She intones and I feel it instantly, that tiny flicker of anticipation. It never varies, it never wavers.
And, while I am never referred to by anything other than my official title, from the cleaners to the Dean, those who have met my wife all refer to her simply as Louisa.
"Ask her to come through." I reply, brisk and business-like, unconsciously smoothing my tie.
Three nights she's been away, accompanying her Year Six class to Paris on a field trip. Three nights when our flat had been stark and subdued, and deathly quiet. No enormous stacks of exercise books on every surface, no folders spread from one end of the living room to the other. No clicking biros, no incredulous snorts, no heavy sighs as she scribbles wearily in the margins of every page. And, god, how I had loathed every minute of her absence, how I had hated crawling alone into that enormous empty bed. From reception, the sound of her laughing carries through to me and I stand up, my eyes fixed on the door until, mercifully, it swings open and she is is framed perfectly by the jamb. The train journey would have been hell, responsibility for all those children can only have been have arduous beyond belief yet here she is, vivacious and vibrant. Sparkling eyes, radiant smile; I have never been more conscious of the promises I've sworn to her, the plans for the future we've made.
"Hello." I say evenly, stepping from behind the desk as she bounces across the room toward me.
"Hi!" She says breathlessly, her suitcase bumping across the floor behind her. "Sorry, my phone went flat half way through the Chunnel."
"No…I mean, it's fine." I reply, relieving her of her luggage. "I was here, and I knew that you were coming. How are you? How was the trip?"
She laughs. "Exhausting! But the kids were great and, honestly, they loved it. A few green faces on the train but, you know what kids are like when they're facing backwards…"
For a split second I consider explaining the theory on why children are more susceptible to motion sickness but I decide instead on an attempt at consolation.
"Unfortunate." I offer, and she nods, demonstrating her usual cheerful tolerance of juvenile idiosyncrasy. "And how was Paris?"
"Hot!" She replies emphatically, as she takes off her cardigan and tosses it onto the chair. "But we had a such a lovely guide, he really couldn't have been nicer actually…"
Her voices lowers. "You know, we'd barely got out of the station, and Amy Summers was sick on the bus,. But Guillaume wouldn't hear of me cleaning it up…honestly, he insisted on doing it himself. And the kids loved him too which took a lot of the pressure off me really…off all of the staff actually…"
Even weariness can never dull her, nor hours enduring stuffy public transport, nor even a week of fat-laden, calorific foreign cooking. Apparently, even children suffering from emesis fail to dampen the positivity of her spirit and, churlishly, I now despise Jean-Luc, who I am sure will have spent all week ogling my wife, her skin bronzed by the warm French sun, and now bright-eyed and so very beautiful before me in a simple floral dress. And don't I know his type, and how they proliferate on the continent. Smooth talkers in crumpled linen, three days growth upon their jaws. Damn the fact we are in my office, in the middle of the afternoon, and damn my rigid professional standards. Sod my own, stupid, self-imposed rules on proprietary and bugger the fact that Louisa never seems to question the sanctity of my office all. If it weren't for the fact I'd be a hypocrite to lay a hand on her, I'd be doing my best right now to expunge Jean-Luc completely from her thoughts.
I fold my arms as she takes another step closer, swallowing hard as her hand goes innocently to my lapel. Cautiously, I retreat, taking half a step back, perching on the edge of my desk so we find ourselves at eye level.
"Well then…did you miss me?" She asks, following me, her expression so familiar, sparkling with mischief; dazzling, spirited, effervescent. "Or did you just enjoy having a nice tidy house to yourself?"
My reply is airy, barely revealing the extent of the truth. "No. I missed you. And I thought of you…umm…I hoped that the trip was…well that it was going well."
She smiles, apparently satisfied; perhaps, after all these years, she can read between the lines, she can hear exactly what it is I struggle so much to say. Is she aware that even as a grown man in my forties, by the third day I was yearning for her physically, weary of the silence, checking my mobile phone a hundred times a day. If only I could tell her how I hated cooking for one, how I was bored with the colourless flat, that a bathroom without her things in it felt like a prison and not at all like a home. Without thinking, my hands go to her waist and I pull her to me, covering her mouth in a kiss that soon becomes emphatic, and I hear her squeak with what I hope is delight, as her hands curve around my jaw; her lips warm, her breath lemony and sweet, pressing herself against me until I remember where we are and I scramble to my feet.
"Gosh, I'll take that as a yes, then." She says with a smirk, as I adjust my suit. "I 'spose you've already eaten lunch?"
"Ah, yes. I have. But I could take you somewhere now if you wanted…if you'd like?"
Her expression is quizzical, cautious. "You mean you could just leave for the day and not come back?"
Closing my laptop and reaching for my briefcase, I nod with feigned indifference.
"Well, why don't we just go home then…?" She says with a hint of a smile.
"Good idea." I tell her and I glance at my watch. "There are some things we really need to discuss."
On the drive home I attempt to verbalise my thoughts. There are some aspects of the move I have already given considerable thought to. Having been fixated on the idea of continuing as a consultant, the two hour return commute to Truro had always been a stumbling block; aggravating enough on a daily basis, unworkable in the case of emergencies and on-call rosters. I'd sought solutions but the idea of taking a flat within walking distance to the hospital was frankly just depressing, as was resigning myself to nights in the on-call room. I simply couldn't bear the thought of it; all that was now behind me, part of an era to which I'd promised we would never return. One thought was always uppermost in my mind; I wanted to be with Louisa, I didn't marry her so we'd spend half our lives apart.
The only time I'd raised the subject previously, there'd been so much unspoken in her expression. I'd been honest when I'd explained to her my options, and the difficulties each presented; clear, unemotional, precise. Her extended silence had demonstrated just how taken aback she was, yet at that moment I'd known exactly what she was thinking: raising children on her own because her husband was always working was obviously never part of her plan. So, I am cautious as I broach the topic again, glancing at her sideways as, casually, I outline my thoughts. I explain that my intent is to now explore the potential of vascular day clinics, in smaller centres like Padstow and Bodmin possibly even Bude. Sharing premises with other specialists or operating weekly outpatient clinics in conjunction with local General Practitioners seems like a possible starting point. Bernard suggested there was merit in setting up varicose vein clinics in close proximity to Looe.
"And perhaps a day or two a week at Royal Cornwall, just to keep my hand in." I add, tentatively, and then I hold my breath.
She turns to face me, her eyes widening, possibly even glinting at the prospect.
"Really?" She says in a voice that's low and husky, and hopeful.
We stop at traffic lights and I sneak a surreptitious glance across at her. I notice how her jaw twists, her teeth sinking into the soft flesh of her lower lip, a gesture so familiar to me that my stomach lurches at the relief my idea seems to have brought her. She turns to face me and her smile is so innocently trusting, as if she has complete and utter faith in me, as if she believes that I could never let her down.
"It's a possibility, definitely." I reply coolly, clearing my throat and distracting myself by pointing out a dangling thread on her collar. What is it she sees that so few others have ever perceived in me? Whatever it is, I have a fresh determination to live up to Louisa's expectations not down to the negative assumptions of almost everyone else.
The rest of the drive is undertaken in a haze of thoughtful silence. There is so much to digest, so much of our future which remains uncertain, undoubtedly we are venturing absolutely into the unknown. I speak not only of my own situation but also that of Louisa's, aware that she has her heart set on a position at the local village school, an idea that seems to me slightly fanciful when even she concedes that, currently, there are no vacancies advertised. I have aways skirted around her notion that she wants both a family and a career. I worry that she is simply too emotional to be planning for the potential outcome of either, that sentimentality might be obscuring her ability to accurately measure the risk. But if we are to move hundreds of miles away, to the poorest county in England, one of us needs secure employment, one of us needs to ensure that all practicalities are addressed.
"Okay, so I'm not exactly sure of the staffing situation. " She admits when I press her again. "But that's another reason for going down there in person, Martin. I'll just… you know…drop in. Meet the principal. See what I can find out…"
I carry her bags up the stairs and, once we are inside, I insist. We sit at the table, diaries open, negotiating our way through her term time responsibilities, her numerous social engagements, and my schedule of clinical commitments, departmental meetings, and the conferences I had pledged to attend.
"Nope, sorry, that won't work." She responds when I offer suggestions. "Parent/Teacher interviews on the Monday…nor will that one either, it's Team Building weekend…nope…sport's day…no…no…nope. Like I said, Martin, it looks like it will have to be the 8th and 9th, if we want to get down there before the end of term…"
"Mmm." I reply briskly, recalling the misery of School Sports Day and shuddering at the idea of whatever it is that 'team building' might entail. I mark the dates off on my year planner, drawing thick lines diagonally across the diary pages. "Alright. I'll book the accomodation."
She smiles then, knowingly. "Joan will be disappointed."
I remove her empty plate and carry it across to the dishwasher. "I'm sure you'll think of something to tell her. " I say, raising an eyebrow.
While visits to my Aunt have become less sporadic over the last ten years, I now refuse to spend a night under her sagging, moss encrusted roof. Lumpy mattresses and substandard plumbing make for unnecessary discomfort, never mind the stentorian roosters jubilating the faintest hint of dawn. And Louisa, taking such great delight in tormenting me too, amused that the presence of my elderly aunt a few yards away, and separated from us only by paper-thin walls, stifles any thought of romance. Furthermore, while I'm very fond of Joan it doesn't mean I need to suffer to her perspective on everything, all day every day. Similarly, her viewpoint on us relocating to the village is hardly neutral nor independent; the only person more excited than Louisa at the prospect appears to be my aunt herself. She's hardly going to be the sort of neutral sounding board Louisa needs. She lives by herself, she has far too much time to form opinions that inevitably go unchallenged.
So I'd been adamant that I'd wanted the weekend to be structured solely around the purpose of our visit, and I thought I'd made my position abundantly clear. The decisions we make about our future are our own private business, and I neither desire nor appreciate anyone else advancing their own point of view. Louisa knows I detest the thought of outsiders being privy to anything so personal yet when I reiterated my wishes to her, she looked at me as if I had actually lost my mind. Sometimes, she really is a mystery to me. How can she say she understands that I feel most comfortable when there is just the two of us together and, in the next breath, inform me she wants to meet for supper with Chris Parsons and wife.
Of course my misgivings turn out to be justified, and I wake in the night, my chest squeezed by feelings of outrage. Booking this place had been intentional, I knew it would mean something to her and I wanted her to know it meant something to me too. I'm aware of how inadequate I am at telling her how I feel about her, but I do now at least understand the importance of gestures, of making an effort, of using other means of expressing myself other than clumsy words. Walking into this room last night, I'd barely muttered more than sentence but I was aware instantly that she knew: I was committed now to this journey. I was going to trust her, and her unwavering belief that I should be the father of her children. And now, like a sand dune after an Atlantic storm, the ground beneath my feet is once more eroding away. The grim silence that enveloped us on our walk back from the restaurant is proof enough of that. As I lie there I am gripped with an irrational fear that everything is already unravelling, that the years of work I'd done to rationalise my fears have been upended by an off-the-cuff remark.
"Not that any one of us could ever picture of the great Martin Ellingham as a father. Perish the thought eh, Mart?"
Beside me, Louisa sleeps; a familiar, gentle purr rhythmic as her chest rises and falls. In the distance I hear the sound of waves, a dull roaring and crashing that reminds me where I am: a remote Cornish coastal village, far from the world we are used to. It is the place in which she was born, that she has thought of as home for as long as I have known her. The place she has waited patiently to return to, the environment in which I have long been aware she hoped to raise her children. Change has never come easily to me but, as the orange dusk descended, we had stood at the top of the hill and gazed down at the warm lights of the village. I'd pulled her into my arms to kiss her and, god, I'd felt something close to utter contentment. Louisa; so beautiful when she cannot suppress her joyfulness. And to think that I was part of that bought a large lump to my throat.
In the morning I am dulled by lack of sleep, worn down by repetitive thoughts that have lead me nowhere but misery. I feel her hand, tentative on the bare skin of my shoulder blade, and I open my eyes as I hear her say my name. This place, so significant to both of us. This room, filled with memories of words I thought I'd never say, a closeness I never knew existed. I feel her heat as she curls into the small of my back, her mouth pressed to my spine, her lips so soft against my tender, weary flesh. In her arms I am that needy child again and I feel embarrassed and ashamed. Reassure me again that this will not be an unmitigated disaster, Louisa, because once we've brought a child into the world, I am living proof that it's too late then to realise it's all just been a horrible mistake.