Expecting

After the old fisherman left, limping on his ruined knee, Martin finished the notes. 'Damaged knee after a life of work and several falls requires replacement. Patient vehemently opposed to surgery,' he wrote. Then he muttered to himself, "When the pain of bone on bone from missing cartilage becomes unbearable then he'll be begging for something to be done; likely at 4 in the morning." He slid the note card into the protective sleeve, placed his pen in its proper place next to his desk blotter (perfectly parallel to the edge of the absorbent pad), got up and walked into reception. The fisherman had just gimped out the door after chatting up Pauline behind the desk.

Martin walked to the filing cabinet and put the patient notes back in place. Then he turned towards Pauline, dressed as usual in her bangles and outrageous attire. "Next patient?"

"Mrs. Marrack," Pauline said in a low voice. "She's expectin'."

Martin took the patient note from her outstretched hand as he turned. "Yes… Mrs. Mary?" A tall woman, blonde haired, young and very pregnant, her enlarged belly and baps stretching her too-tight orange dress, struggled to her feet. Orange was not a good color for her, he thought, not at this point of gravidness.

"Marrack, Doc!" the woman corrected him.

He ducked his head. "Right, go through."

The patient waddled ahead, while Martin slid her card out to read it. Thirty-five weeks pregnant, he read. No signs of problems, so far. Second pregnancy.

Edie Marrack sat on the visitor's chair, watching while the Doc stiffly sat down on his side of the desk, his face impassive.

"What is your compliant?" he asked.

"Baby's been really active, doc," she said with a yawn. "Can't get a lick of sleep."

Martin looked at her, wondering what to say. "You are pregnant."

"Oh, for God's sake, I know that Doc! And this is my second little 'un so I do know the drill. But when the baby's rolling around all night, jumping on my ladder, kicking my ribs…" she swiped at a sudden tear. Bloody men, she thought, they have their fun, then we girls have to literally bear the burden. The baby rolled over and she winged.

Martin stared right at her, unblinking. "Foetal activity is expected, especially since you are five weeks or less from delivery. Have you tried sleeping on your right side and not your back?"

"Doc, I've tried everything but standing on my head!" she complained.

Martin read more in the notes. Married he read, and then recalled her husband was a long-haul lorry driver. "Do you have support, when the baby comes? Your husband? Will he be available when delivery arrives?"

Edie laughed. "Delivery? Ha! Heaven knows. He's somewhere in Brittany just now. Auto parts or sumthin'." She wiped her wet cheek again, so the Doc gave her a tissue. "He… Tim's a good man, but he's been takin' extra shifts when he can get 'em – baby money and all. Expenses, you know. Away a lot."

Martin cleared his throat. "Your other child…" he fumbled for a name.

"Harry," Edie answered. "He's five now, up at yer missus' school. He adores school and her." Her face brightened. "And how is Louisa these days?" She used the tissue to wipe sudden dampness off her brow.

"Fine," Martin said, without adding his usual 'none of your business.'

"Married and all, you two! Is bein' married what you expected?"

He looked away. "Yes…" he cleared his throat, "now about you. Have you been avoiding caffeine?"

She nodded. "Like you told me since I fell pregnant. Plenty of fruit and veg." She lifted a blue water bottle and shook it, so the contents gurgled. "And water – makes me wee a lot."

"Fluid balance is important, of course. I'll take your blood pressure and do a quick physical exam if I may. When is your next OB visit?"

"Thursday, next week," she sighed, "or I'd talk to them about this little jumpin' bean."

Martin looked at her with alarm. "Mrs. Marrack, if you have ANY concerns during this pregnancy, then you must call your OB; day or night. No need to wait. Of course, I am here as a backstop, as it were."

She turned to the exam table. "Need me to get up there? Not been much for getting up and down on things," she said, as she cradled her large belly. And there the baby went all jumping around again.

Martin took her temperature as she sat on the visitor chair. "Normal," he muttered. Then he got his stethoscope and sphygmomanometer out. "Please take off your cardigan, just the left arm." He helped her with the cardi sleeve and then she was able to roll her loose blouse sleeve up to nearly her shoulder.

He got the cuff in place, nervous since his hand was so close to her very large breast. "Sorry," he told her. He put the ear tubes in, the stethoscope diaphragm on the right place on above the elbow and pumped up the cuff.

Edie started to say something about feeling hot, when he shushed her.

Her blood pressure was very high. Hm. He left the cuff on her arm. Then took the heart rate; also very high. "Do I alarm you?" he asked.

"No. Not usually."

"I mean, does going to the doctor make you scared or excited?"

"No," she shook her head. "I don't think so."

He repeated the blood pressure reading. It was the same. Martin sat back. "I need to see your ankles."

"What?"

"Feet as well. Kick off your shoes." He snapped his fingers. "Now." He lifted one leg, pulled her sock down (he noted the material of the sock was not terribly confining) and then he saw it. Her feet and ankles were very enlarged. He pressed into the skin above her ankle bone, and it dented but when he released his squeezing, the dent disappeared and the tissue was spongy. "Odoema." He looked at her hands. "You're not wearing your wedding band."

"Naw, can't get it on. Fingers are swollen."

"Headaches?" he asked.

"Sorta, sometimes."

He stood up, quite alarmed. "Excuse me." He walked out to reception, closing the door behind him. "Pauline!" he hissed. "Call an ambulance."

"Why?"

"Just do it!" he snapped his fingers. "Quickly now. Call my desk when you hear the time of their arrival." He returned to his patient. "You appear to have the signs of…" His desk phone rang, so he snatched it up. "Yes?"

"Sorry, Doc," Pauline said into his ear. "Ambulance service is all tied up! There was a bad accident on the A39, so might not get here for over an hour – maybe more."

Martin's lips clamped together. "Right. Tell them never mind and cancel the rest of my morning patients!"

"Wha?"

Martin hung up on his secretary. "Mrs. Marrack, you have a condition known as preeclampsia. A condition which can occur late in pregnancy. Your blood pressure is very high. I've not done a urine sample test, but I am fairly certain that protein will be found. The ambulance service is unavailable so I will be driving you to hospital."

Edie shook her head. "Pre-what?"

"The word does not matter," he told her firmly, then he stood up. "Get your handbag and water bottle. Now. We are going."

"So… this is serious?" Edie asked him as she got her shoes back onto her feet.

Martin nodded. "Right. But you'll be fine."

=0=0=0=

On the drive to Truro Hospital, Mrs. Marrack was very quiet, which was good to hopefully bring her blood pressure lower. Martin drove swiftly yet safely, until the Truro Hospital sign was visible.

"Doc?" she asked her voice cracking. "Will the baby be okay?"

"With proper care, yes, and you as well."

"But they'll keep me overnight?"

He cleared his throat. "As needed."

"But about my Harry? He's in school and mum lives up in Delabole… hm, maybe she can get him from school? And my Tim?"

"We'll contact her, about your child. And your husband."

Martin drove into the A&E lot, parked and helped Mrs. Marrack out of the car. A wheelchair was sitting outside the building, so he sat her in it and then took her inside. He'd already called ahead about the situation. As soon as he told the female clerk at the A&E desk that he'd brought in the 'preeclamptic patient' a nurse immediately appeared and wheeled her away.

The clerk looked up at him with concern. "Your wife will be fine," she told him soothingly.

"She's not my wife; a patient. However, my wife is pre…" he stopped.

The clerk nodded. "Okay then…" Clearly the man was upset.

Martin cracked his neck. "I'll go into the exam area," he stated.

"And you are?"

He stood tall. "Dr. Martin Ellingham."

The clerk's eyes went wide, for she had heard stories of the fearsome doc. "Sure, whatever…" Suddenly she was addressing thin air for the man had left. "Rude bugger," she muttered.

Mrs. Marrack immediately received medical attention and in between exams, Martin scribbled down the phone numbers of her mother and husband. After calling, her mother told him she would get the bus and travel to Portwenn to intercept her grandchild after school.

The husband on the other hand, two messages went straight to voicemail. Martin stuck his head into the exam room. "Mrs… Miller, what firm does your husband drive for?"

"Marrack! Speedy Transit. They have a depot in Plymouth," he was told.

Martin found a website and a number, which he called. "Hello? This is Dr. Ellingham from Portwenn and… no! No! This is not about arranging a delivery or pickup. LISTEN TO ME! You employ a driver named Tim Marrack and his wife, Edie, is in Truro Hospital. She is pregnant and is having complications. No. No, the baby has not been born. But I AM TRYING TO REACH…" he sighed. "Give me your supervisor or manager. NOW!"

After some delay he was able to tell the tale to someone of authority who assured him that they would be on to the husband straight away.

"Good. Tim Marrack can also call me if he has questions. Yes. I'll give you my mobile number. Oh. You have it. Good. And my name is spelled…" While starting to spell out his name the line dropped. "Damn."

He sighed, leaning back against the wall, while staring at the floor. "Idiot," he spat.

Next he heard a woman's voice say, "I certainly hope you're not talking about me."

His gaze moved to a pair of black pointy women's footwear, bedazzled with rhinestone bows. The shoes reminded him of someone, so he lifted his gaze.

Edith Montgomery tipped her head with a smile when his eyes caught hers. "Ellingham? I was not expecting to see you here."