Chapter 8
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XxXxXx
I may not always love you. But long as there are stars above you
You never need to doubt it, I'll make you so sure about it. God only knows what I'd be without you
If you should ever leave me. Though life would still go on believe me
The world could show nothing to me, So what good would living do me. God only knows what I'd be without you
"God Only Knows" by Beach Boys
XxXxXx
Surprises Come to Thee
I am once again dialing my mobile, this time to Joan.
"Auntie Joan, Louisa was in an accident in London and I need to be with her. I am wondering if you can go with Phillip and me tonight, to London." I announce to a half-asleep Joan.
"Martin, wait a minute. Let me understand what you just announced without warning." Joan takes a moment to fully wake up. "You said Louisa had an accident and is where now?"
"She is in the A&E at St Mary's hospital. They couldn't tell me the seriousness of her injuries as she is currently being examined. They will call when they know the full extent, but I can't wait here in Portwenn, I need to go to London now. Will you accompany us to London tonight?" again I inquire.
"Yes, Martin. I will pack a bag and wait for your arrival as I am assuming you are driving to London."
"Yes. I need to pack a bag for Phillip and me. It may take some time. I'll ring you when I leave."
"See you soon." Joan disconnects, looking around her lounge where she had fallen asleep reading, before getting up and heading upstairs to pack.
A little over an hour later I pull onto the gravel drive at the farm. I quickly escort my aunt to her side of the Lexus and place her bag in the boot; roaring off towards the main road spreading gravel about in my haste to get to London.
XxXxXx
The mobile beeped three separate times to important calls concerning Louisa as the vehicle moves across the English countryside. The first was from Holly informing me Louisa injured her back and wrist. She didn't know anything else but offered her help in setting up a hotel reservation. The second call was from Doctor Kevin Chen. He examined Louisa; he was the doctor at the scene of the accident and ordered her tests. Explaining his decisions doctor-to-doctor medically helped Martin to calm down.
"What did the x-rays show? Will she require surgery?
"We didn't do x-rays, as we were waiting for the labs for a pregnancy test. They came back positive and I will make special arrangements to x-raying her wrist in the morning. My examination was thorough and no x-ray will be needed of the coccyx unless she develops complications overnight."
'Louisa wasn't seriously injured' raced through my mind. Then the positive lab result strikes me like a kick to my solar plexus.
Not noticing a surprised face looking at me from the passenger seat, I continue asking my questions.
"Did you say her lab result for pregnancy came back positive?"
"Yes. I asked Louisa if she thought she could be pregnant and she said 'No' that an IUD was inserted in August. It seems it failed. I requested the test be repeated and it came back with the same positive result. I haven't told her as yet; they were moving her to a room."
"Don't say anything, please. She is upset with her injury. I am on my way to London now and will arrive during early morning rounds. We can talk further on her injuries."
I had one important question, burning difficult thoughts into my brain, 'who was the man with Louisa'. Channeling my socially inept emotion to be polite, I inquired about the other injured person in the lift.
"Ummm… my wife's fellow passenger in the lift, was he seriously injured?" I stammer.
"Doctor Ellingham, you know I can't breach patient medical information to non-family. I can tell you he is also here in the A&E."
Joan continues to look over at me, confused that she thought Louisa was staying with a friend; a female friend. 'I hope it wasn't Danny'. Her mind was racing on the other issue; Louisa was pregnant again, so soon!
The third call is Chris Parsons updating us on Louisa. He didn't mention the positive pregnancy result. My mind is flooded with so many thoughts, how – when – what happened to her IUD.
Joan could see Martin continue to relax after the last two calls; he was no longer driving like a lunatic. Joan felt it was the time for Martin to fill in the missing pieces, as she saw it, of the puzzle.
"Martin, did you two plan on another pregnancy so soon and why were you asking about an injured man with Louisa? The man wasn't Danny? "
"From what I understand Louisa was at a hotel with Holly and her friend. Louisa had an escort, he was another doctor. She left Holly in the lounge, was found in the lift with another man when the power went out. She was injured in the lift along with the man. Now it could just be another person in the lift and Louisa didn't know him. Holly didn't know."
"But you don't know who the other man was and I'm assuming he wasn't the doctor that was her escort."
"No not him. Auntie Joan, why did I let her go to this affair?" Finally, he let go of the anger he had held in since the first phone call. "I don't understand why she…." and in a soft mumbling voice of a hurt child, "would be found lying in the lift with someone else. We worked out the problem of my jealousy of Danny."
"We can't jump to conclusions, Martin. Let Louisa explain when we see her. Holly didn't elaborate on this evening with you?"
"No."
Joan realized that Martins' emotions were unraveling. Without more information, his mind would put it together and it wouldn't be the right answer. He continues to act like an unloved little boy she remembers for so many holidays, his eyes always showing his feelings, his wanting of love. Now he feels that Louisa has deserted him.
A few hours later they are approaching the outskirts of London, still a few hours before the crack of dawn. I hand my phone to Joan,
"Check for a text message from someone named Holly; she is making our hotel reservations."
Joan finds the message and relays the name of the hotel. "Will they allow us to check-in at this hour, Martin?"
Martin didn't answer except to connect his satnav with his phone with the address of the Rubens at the Palace, 39 Buckingham Palace Road, London. The route came upon his satnav; it will take another ninety minutes. Martin calls the number and speaks with reception informing of their arrival time and ensuring Holly mentioned a cot required in the suite for a ten-month-old. Martin wants to get Joan and Phillip situated in the hotel before he takes a taxi over to the hospital to see Louisa.
Ninety minutes later the Lexus pulls into the carpark of the Rubens. After checking in and escorting Joan and Phillip, to their suite, I go back to the car to gather our belongings. As I enter the suite, Auntie Joan is sitting on the sofa with Phillip in her arms as he busily drains his morning bottle. At the sound of the door, Phillip pulls his bottle away just long enough to smile at his daddy before resuming. My eyes smile seeing my son recognize me.
"Good morning, Phillip. Did you get a good night's sleep in the car? I'm sure the motion of the car helped you to sleep."
Joan looks at her nephew, smiles, and looking down at his son, and the resemblance, except for the smile, of course, reminds Joan of when Martin was young here in London.
I notice the faraway look on Joan's face as she looks at Phillip; 'Joan should be tired maybe that is why she looks the way she does'.
"Auntie Joan, why don't you take a nap, I'll clean Phillip up and play with him for a while. The hospital won't allow me on the ward until after rounds this morning."
"Are you sure? I know you want to get to the hospital to examine Louisa for yourself."
"Chris sent me a text earlier, asking me to behave myself. I don't have privileges at St Mary's and London hospitals won't care I once was a surgeon; they will stand by their rules. Chris said please mind my manners."
I take Phillip from Joan, pick up his baby bag and I walk over to my end of the suite, placing the bag on my bed before giving Phillip a morning hug.
"How about a morning bath and clean clothes?" I ask Phillip, in my soft daddy voice I use with Phillip.
Phillip knows this routine with his daddy, slowly presses his forehead to his daddy, and grabs hold of his daddy's ears. I smile and Phillip giggles, our morning hello accomplished. Joan watches bemused; always amazed how Martin so easily became a father to Phillip. 'This is Marty at play,' she smirks before announcing she is going to bed. I don't acknowledge my aunt; my attention is on my son.
"Phillip this room doesn't have a tub for you and your duck. You will need to wait till tonight to play in Auntie Joan's tub, for now, you can shower with daddy."
The Ellingham men spend the next twenty minutes under a warm shower and just as I had hoped Phillip is ready to go back to sleep. I dress Phillip in a clean nappy and sleeper, I pull on the bottoms of the pajamas along with a t-shirt, and the Ellingham men lay in the king-size bed together for a nap. A few hours later, I wake up with my arms still around Phillip and the pillows around Phillip undisturbed. I pull myself up and reposition some pillows to box Phillip in as I unpack a suit from my luggage and get dressed. The sun is just coming up across the city, the sound of traffic announces the city is waking up on this spring Saturday morning; I look out the windows of our suite as I put on my tie. I hear movement to my left and notice Joan coming out of her room,
"Good morning Auntie Joan, did you sleep long enough?"
"Yes, I know you want to get to the hospital and if Master Phillip is sleeping I will shower, and then you can go see Louisa."
I acknowledge with a nod and ring for room service; when Joan reappears dressed for the day, I am placing our coffee cups down on the table.
"I ordered coffee, fresh fruit, and eggs with soldiers for breakfast. I pulled Phillip's jars of food out of his bag and they are warming in the bowl of hot water on the tray. He should be waking up soon."
We sit and sip our coffee and quietly eat our meal when the silence is broken by a series of babbling noises coming from my bed. I am sitting just so I can see through the doorway to my room, walking in just as Phillip sits up; he looks around the room and spies me, greeting me with his smile.
"Good morning Phillip. Are you ready to eat? Auntie Joan is warming your breakfast now so why don't we change your nappy so you can eat."
Phillip smiles his biggest smile while I change him. His legs kicking in his excitement while he holds his purple dinosaur. I often wonder what he is telling it because he is usually very animated when he does converse with it. I pick him up, carrying him into the living room part of the suite; Joan is just pulling the portable feeding chair around to her side preparing for Phillips' feeding. I place Phillip in his seat and Joan attaches his bib, handing Phillip his spoon Joan starts feeding Phillip his rice cereal with applesauce. While Joan feeds Phillip, I call the hospital to find out when a doctor visiting his wife can take place, I mention the Doctors on Louisa's case and I am informed they were expecting my call and I am welcome to come immediately. Upon my arrival have Joy Benedict paged to escort me. I pass this information to Joan, kiss the top of Phillip's head, and leave for the hospital to see his mother.
XxXxXx
Louisa slept fitfully all night. Her mind flashing through different scenarios of the past twelve hours, with her emotions flashing just as quickly from anxiety to anger. Finally able to sleep longer than a few minutes she wakes startled, searching her surroundings before she remembers where she is. Her face is wet and she recalls the horrible dream that wakened her. She questions herself over and over, 'Why did I placate Holly's request over Martin's?' Tears again slide down her cheeks as she remembers her husband's words of agreement. But she should have listened to the sound of his voice, the tone, and the hurt reflected even though he said yes. Now lying in a hospital bed with injuries plaguing her body and needing him to understand how sorry she is for her decision. Will he understand or is her marriage on the rocks again because of her actions. He is always giving of himself to her and she just takes. What have I given him in these past months? Nothing, I am a selfish partner and wife, and that needs to change.
Louisa's thoughts and tears are interrupted when the door to her room opens as the nurse enters. With the little light, the partially open blinds provide the nurse can see the woman on the bed has a tear-streaked face, thinking her patient is in pain immediately starts providing care. "Mrs. Ellingham, what is your pain level?" She asks as she takes hold of Louisa's wrist to measure her pulse.
"About the same, as earlier when you were here last," she responds as she sniffs up her snotty nose.
The nurse lays the box of tissues on the bed within reach for Louisa to dry her tears and snot from her face.
"I brought your ice packs and your pain medication. Do you need to use the loo?"
Louisa nods her head and together they proceed to get her up and off the bed. The nurse supports Louisa on one side as she holds the IV pole for balance and they slowly shuffle to the lavatory door. Louisa accepts all the help she can get as her body protests the movement and positioning on the toilet to relieve herself. When the act is finally completed the painful process is repeated until she is safely on her side in bed again. The nurse places the ice packs along Louisa's back and injects the pain medication in the IV line. As she departs, "It is best to let the medication work and sleep while the pain lessens. I understand Doctor Chen wants you moving about every hour after breakfast," she says as she leaves.
Louisa falls into a deep sleep of medicated bliss, dreaming of Martin holding her securely against his body like he does every night in their bed in Portwenn and forgiving her.
XxXxXx
I hail a taxi to take me to the hospital; the roads are starting to fill as the early morning rush begins, along the way I stare out the window lost in my thoughts. Once again, how did we fail? I trusted my colleague with Louisa's health and we chose the best IUD for her. Where did it fail? How will Louisa react? She said she wanted another child to fill our home, but I doubt she wanted to go through another pregnancy so soon. The driver slides the divider open to announce our arrival at our destination brings me back to the present.
I walk into the lobby, look around and walk over to the desk under the sign and introduce myself to the older receptionist sitting behind the computer screen and give Joy Benedict's name. He asks me to wait over by the green door marked Administration. A few minutes pass and there is no sign of this person, I am just starting my way back to the reception desk when the door opens and three people walk out and approach me. The short older woman introduces herself as Joy Benedict from Administration, and her colleagues' Doctors Chen and Flax.
"I spoke to Chris Parsons last night and he informed me of your wife's accident. Doctor Chen was at the hotel for the special event and treated your wife there. Doctor Flax is our senior A&E resident that treated your wife here in the hospital."
"Can we go see my wife now?" Clearing my throat, I remember Chris's request, and add "Please."
The Benedict woman gives me the look, but Doctor Chen speaks up,
"We thought we would go up to her ward, Doctor Flax and I could go over your wife's condition first. Work with you on our approach to her medical condition."
"Mmm…good," I utter.
He points to a bank of lifts; we enter just before the doors start to close. "Doctor Ellingham, you requested information on the injured person and our vascular colleague would like to talk to you about his medical condition."
"I have no interest of any other patient other than my wife."
"Let's see to your wife and I can explain later, if I may." Doctor Flax says as he looks around to the others in the lift, engrossed in our conversation.
The lift floor indicator dings and the doors open; once again it is Doctor Chen leading us out and down a hallway until he comes to a door with a scan pad, which he scans his badge to gain entry. Once inside I am offered coffee or tea.
"I don't like hospital coffee," I reply.
"Then I think we should get down to business so you can see your wife. My examination last night indicted either a dislocated coccyx or it could be an avulsion fracture, as there is a large hematoma; my observation is I do not believe the coccyx is fractured. I did not request an x-ray due to the positive pregnancy lab result. I will do an ultrasound later this morning if your examination agrees with mine."
"Is there a possibility we could have a false positive twice?"
"No, the lab ran the test on both urine and blood and came up positive with both." He continues with his medical observations on Louisa's condition, "As you know a coccyx fracture or dislocation will heal without any surgery. Currently, she is resting comfortably with pain medication and the lumbar support seat."
"I will want to exam her myself if she will allow. What of her wrist, has it been x-rayed?"
"Yes, we did it very early this morning with extra precaution due to the pregnancy. There is a hairline fracture of the radius; it was cast. I don't see any problems; x-rays will be ordered again in fourteen days if I feel it is necessary."
"May I see my wife now?"
"Of course, you don't have any questions on her current care?" Joy Benedict asks.
"Not at this time; I would like to see my wife," I am trying to stay in control. 'Louisa isn't seriously injured, but will be in pain for weeks, possibly months.'
I start towards the door and open it, stepping out into the corridor, I stop remembering we came from the right I start walking left as the others hurry to catch up.
"She is in here" Doctor Flax points the way to our left. I walk up to the closed door, taking a deep breath calming myself, and push the door open. Lying in the hospital bed is my sleeping wife; my beautiful wife and unknown to her carrying another child. Quietly I walk over, taking her patient notes from the holder, and scan them. Satisfied they are competent at their jobs, I replace them. I notice a basin on the rolling table along with a glass of water, smile, and wonder if she has noticed the early symptoms. I walk up to her side and touch her hand, taking it in mine as I lean over, kiss her forehead. Her eyes flutter a bit as she wakes, as her eyes rest on mine I notice they fill with tears.
"Shhh… are you in pain? Do you need anything?"
She shakes her head as the tears roll down her cheeks. I'm at a loss when I see tears in her eyes. I take my handkerchief from my pocket and dry her tears as I whisper to her.
"Louisa please don't cry I will make sure everything is fine."
She reaches up and I embrace her, kissing the top of her head. She mumbles in my ear how sorry she is for the trouble she has caused.
"Louisa, you haven't caused any trouble. It was an accident; nothing you could have prevented."
"I shouldn't have gone."
"We spoke about it; you were doing a favor for Holly."
"Yes, but I should have left earlier."
"Don't worry about it. Have they explained your injuries?"
"Yes, Kevin did and he said they weren't serious and maybe I can go home sometime today."
"Let's see. May I examine you to make sure they are doing everything possible?"
"Do you think it is necessary?"
"They didn't x-ray your spine; I would feel better if I can ensure his examination is correct."
"Martin, it was so painful, do I need to go through it again?"
"I just need to ensure you are fine."
"Martin, why didn't they x-ray my back, Kevin said it would ensure the correct treatment."
I know now my time has come to break our news to Louisa. I lean in closer, holding her tighter, to rely upon her the news. I quickly think of the words confirming my happiness,
"I have never been a man of many words, expressing my feelings is always hard," I start. The right words never come to mind, so I find them in the recesses of my mind. Thoughts can only go so far, but they are never complete. They touch on a basis of love but are almost vaguely discrete. So how can a man like myself communicate, a love as deep as ours? "There are always ways to express our love, such as chocolate or flowers. External gifts are fun to receive, but their meaning is often short-lived. Let every glance, every kiss, and every sweet word I say, you have made me very happy today." I know by the look in her eyes as she pulls away, I have confused her. So I try to say it another way; "Louisa you will give me another wonderful gift in nine months."
The look of surprise, or is it shock and again tears roll down her cheeks, "Martin how is that possible?"
I give her my tentative smile, hoping she will receive my joke as just as it is nothing more and nothing less. "You seem to be very receptive to my swimmers."
She smiles and the tears flow again, but she is smiling. "I'm just overwhelmed. Martin, how can I be pregnant if I have the best IUD providing protection?"
"They are never perfect; there is always a small percentage of failure; like I said you are very receptive."
She slaps my arm and pulls me close for an embrace, "Martin I love you, and I just never expected to be pregnant so soon. Ahh… that explains a few things, sick when my stomach is empty and my breasts, how far along am I?"
"Not sure, without a scan, but calculating your menses, your irregular cycle and when we made love, I can estimate about ten weeks at most."
"The night, I explained Danny to you."
"Yes, it is most likely the time or the weekend away." Now I seriously look at her; I need to know how badly she is injured. "Louisa, please let me examine you. If your coccyx is broken, it could require surgery. I won't allow another doctor to make a mistake with your health."
"Yes, Martin, if you feel it is necessary, but please be gentle."
"I will." I kiss her and walk to the door; opening it, I request privacy for the examination period. I wash my hands at the sink and return to Louisa's bed, adjusting it to a flat position, and ensure she is on her side. I carry out my examination as gently as possible and agree with Doctor Chen that Louisa either dislocated or seriously bruised her coccyx; her hematoma is spread wide across her lower lumbar, to her pelvic floor muscles and ligaments. I am concerned at the depth of her injury, pregnant and what problems can arise during the pregnancy and her sacrum. I will discuss this with the Doctors.
"Louisa, I agree with their diagnosis on your injuries. You are going to be in pain for some time, I would like you to have an ultra-sound done to ensure you haven't suffered an avulsion fracture of the coccyx." I look into her eyes and deeply feel my love for her. "I want you to come home as soon as possible. Let me get the Doctors in here."
Doctors Chen, Flax enter the room looking at me, waiting on my words, "My examination agrees with yours, Doctor Chen, with that I would like the ultrasound done as soon as possible."
The doctors and I sit with Louisa explaining what the next few weeks will be like for her. "The coccyx will heal, but it will take patience and rest especially in your condition; it will be important your coccyx heals before the weight of the growing feotus puts stress on it and it will be more prone to injury, even fracturing during childbirth," Doctor Chen states.
"I didn't fall that hard, how did I get injured?"
Doctor Chen goes into medical mode explaining my body, the body of any woman with this injury. As he does my eyes catch my husband's eyes, noticing he is also in medical mode, as he listens and nods his head in agreement.
"The coccyx is the triangular bony structure located at the bottom of the vertebral column. It is composed of three to five bony segments held in place by joints and ligaments. The majority of coccyx injuries occur in women because the female pelvis is broader and the coccyx is more exposed. The trauma of the jolting fall with the sudden stop of the lift onto the tailbone in the seated position on the hard ground of the lift will cause this type of injury," he explains.
"Your wrist will take about the same amount of time to heal. Mrs. Ellingham, take the next twelve weeks to relax and just take it easy, nothing strenuous. You can swim, but remember to cover the cast. Gentle stretching or yoga designed for pregnant women. You can do easy walks a couple of times a day."
I look at Louisa as I quietly listen to Doctor Chen and his evaluation of her injuries and his instructions for her recovery; agreeing with everything. Best of all I didn't have to tell Louisa that she would be resting for the next twelve weeks. Unfortunately, I am the one to ensure Louisa does exactly as Doctor Chen instructs.
She looks at each of us with a questioning look, a look I know so well; she wants to continue her course, here in London. "Doctor Chen, I have one more week of this important course, I need to finish it to ensure I have all the information for my school."
"I am sorry Louisa, but you are on bed rest for the next week to allow the swelling to go down."
"Maybe you can finish the course by skype," I suggest as I know how determined Louisa can be for her school.
"Martin that is a good idea; I need to call Holly to bring my course material here to me, so I can call Audrey to see if it is possible."
"I can retrieve your course work and your luggage; I'll ask Holly to pack up your belongings as I am seeing her tonight since our evening was cut short last night. I promised Holly dinner at Hawksmoor Seven Dials tonight as compensation. I will bring it all here tomorrow when I do rounds and your husband will carry it, no lifting."
"Thank you that would be great. When will I be discharged?"
"I would like to continue the cold packs, non-steroidal anti-inflammatory for another twenty-four hours under medical supervision and if I'm happy with the results I'll release you to your husband to continue supervised medical care."
"I noticed muscle tension in her lower spine during my examination. I would suggest applying heat for the next couple of days to relieve the tension, and it could help with the coccydynia."
"I will add that to her notes and have the nurses apply a heating pad throughout today, into tomorrow. Doctor Ellingham, when I release her, I would like to transfer your wife to the Royal Cornwall Hospital in Truro, with Orthopedics specialist Doctor Gee.
Louisa looks forlorn with all the medical information received this morning and there is more to come shortly concerning her pregnancy and there is nothing I can do for her. It is a crushing feeling to my medical ego as I watch others determine the course of action for my wife. I squeeze her hand a bit tighter as I reach back into my medical mind for any answer we have not thought of, but can't change any of it to make it easier for her. For the first time, Louisa's medical care will be under another.
"I have scheduled a consult to have Louisa seen immediately by Doctor Thyring for the removal of her IUD and ultra-scan to ensure the pregnancy is in the uterus. There can be a chance of ectopic pregnancy and we would need to abort the pregnancy to ensure your life, Louisa," Doctor Chen continues.
"You mean I could lose the baby?"
"Louisa only if the pregnancy is ectopic."
This thought brings tears to her eyes and I move to hold her, to ensure her that we will do everything necessary for the baby.
"Let me make a phone call and see if Doctor Thyring is available now." Doctor Chen completes his notes in Louisa's record. "Doctor Ellingham, I will schedule your wife's ultra-sound after Doctor Thyring's procedure." He looks up before he turns and quickly leaves.
As usual, I can't think of any words that can help, so I continue to hold her. I rub her back, wipe away her tears and kiss her quivering lips; finally, the right words come to mind, "Louisa, I love you more now for your strength."
She leans heavily into me and her sniffles slowly end as she says, "I love you too."
End of Chapter
The medical information in this chapter was gathered from different websites to include WebMD. I am not a medical professional.
Ectopic pregnancy is a pregnancy occurring elsewhere than in the cavity of the uterus. Normally, the fertilized egg attaches to the lining of the uterus. An ectopic pregnancy occurs when a fertilized egg implants and grows outside the main cavity of the uterus; most often in a fallopian tube. An ectopic pregnancy can't proceed normally; the fertilized egg can't survive, and the growing tissue may cause life-threatening bleeding if left untreated. The chance of getting pregnant while using an IUD is rare, but it can happen. With an IUD in place and pregnancy occurs it's more likely to be ectopic.
An avulsion fracture occurs when a small chunk of bone attached to a tendon or ligament gets pulled away from the main part of the bone.
Coccydynia is the pain associated with an injury to the Coccyx.