Chapter 13: See Chapter 1 disclaimer

"Mornin', Doc!" Morwenna called out cheerfully. She had come in a bit early and put her large purse down on the desk, an insulated cup of tea in hand. Under her shabby chic green coat, she had dressed in earth tones, with many layers, and what looked like shearling-topped suede boots. She took a careful sip, steam clearly coming out of the opening. "Ooh, that's hot. Good, though."

Martin was walking out of the consulting room into the waiting area just as she said this. "Mm, right. Good morning." He took yesterday's post from Morwenna's desk and returned to the consulting room. His agenda for today had a few things on it:

- Contact the Sanders family about Ellie

- Contact the hospital about Hughson. Note: get first name

- Email St. Aubyn

- Research GP assistant program, formulate plan

Unable to wait until Monday to finish things with his mother, he had decided to act on settling her estate by emailing St. Aubyn to try to find out more details. Given he had a few minutes, Martin sat at his desk and opened up his laptop. He wasn't sure if the man checked emails on the weekend, but if nothing else it would help him formulate his own thoughts.

After the appropriate salutation, he typed:

"I received your message regarding Margaret Ellingham on Friday. I plan to return the call at midday on Monday. Please be ready to discuss the following:

- Margaret's final living arrangements

- Any bills outstanding that I may be obliged or willing to cover

- The location of my parents' remains

- Any communications or inquiries you've had regarding my mother's death

- The terms of the will

Regards,

Dr. Martin Ellingham"

He hit Send. As it was still too early to call his patients, he then started looking up the requirements of the GP assistant course, as he'd promised Morwenna that he'd be able to discuss it after the weekend.

The course appeared to take nine months, was self-directed, and required half a day per week gaining experience under the GP's tutelage. Morwenna would need a day per week to take the training classes through the portal and need to spend half a day submitting homework and tests to prove that she was learning the material effectively. Martin felt that some of the time spent should be on Morwenna's personal time, as he thought sacrifice important in the achievement of any goal. During the mentoring time, he could have her prepare patients for their appointments in the small room that Louisa originally used for her consultations, so he would need to negotiate the schedule with Louisa. This should not be impossible, as Louisa was working only a few days a week rather than full-time. If this proved too inconvenient, he could have Morwenna take vital statistics on the next patient whilst he was finishing up the notes from the prior patient, all of which could take place in the consulting room. In fact, he liked that idea better. Louisa tended to be a little territorial about her room which, he had to admit, was not ideal for her practice. During his hiatus from practicing medicine, she had been using the surgery consulting room. The return to the storage closet had been a step backward.

Martin decided that Morwenna could spend time on her course during her hours at the surgery on condition that it didn't adversely affect her ability to handle her normal responsibilities. There was a lot of idle time in the surgery reception area, and Morwenna had typically browsed the internet or read. Now she could put that time to better use and look more professional to his patients in the process. Thinking of that, perhaps he could enforce a dress code to tone down those odd outfits she favored.

The unfortunate aspect of the course duration was that she would be giving birth in the middle of it. Therefore, he wanted to get a sense from her that she would indeed pick up the studies after the child's birth and return to Portwenn Surgery as the receptionist after her maternity leave. He had very mixed feelings about this, as he was a firm believer that a child did best when raised by his or her mother. At the same time, he had to admit that James Henry was thriving, despite Louisa's insistence on returning to work. Also, he was in favor of Morwenna bettering her career skills even if she did not return to work right away or to his practice.

He was almost done reading about the stipend received by the surgery during the course when his first patient limped in, leaning on a cane and carrying his notes. He glanced at the notes and said, "Ah, Arthur. Have a seat. What did you do to yourself?" Given Arthur Collins was a fellow Londoner who had certainly made himself useful and neighbourly when Martin had torn his brachial artery, the two were on a first name basis. This was of course instigated by Arthur, but Martin had found it surprisingly natural.

"Happy New Year, Martin. I twisted my blasted ankle yesterday, tripping on a chunk of ice churned up by the cows. I've built some confidence in tending to their less esoteric needs, but it looks as if Lady Luck was giving her attention to someone else yesterday afternoon when I went to muck them out. Your first aide responder did a nice job binding it up, but she said I should come back to have you check it out."

"Right, Morwenna did mention binding up a sprain. Take off your boot and sock and let me examine it."

Arthur gingerly rolled the sock down his foot, exposing a swollen ankle but no bruising. Martin gently took the joint into his two hands and palpated around the ligaments and tendons, then slowly rotated the foot within the tolerance of Arthur's pain threshold.

Arthur winced, "Ah, ow, yes, that is sore. What do you think?"

"Well, I think Morwenna made a good call that you should come see me on a next-day basis. Nothing is broken and the fact that there is no bruising and you're using a cane and not crutches indicates you can put at least a little weight on it. You have a grade 1 sprain. Mrs. Tishell should have a suitable walking boot. You should exercise the RICE protocol: Rest, Ice, Compression, and Elevation. Wear the boot for four weeks even if it feels completely better. Whilst inconvenient, sprained ankles that don't heal completely have a good chance of recurring. Stay off it as much as possible, elevate your foot, keep it wrapped, and ice it for 20 minutes each hour."

"Yes, that's exactly what Morwenna told me, and I've been doing that."

Well done, thought Martin. Morwenna will make an excellent GP assistant. "Right," he told Arthur, "You can put your sock and boot back on. Can you get yourself to Mrs. Tishell's?"

"Sure. I got here, I'm sure I can park at the Platt. Nobody is around in this weather. Thanks, Martin. Once again, handled with your professional aplomb and a minimum of chat."

"Mm. Yes. Apparently, I'd fit right in in Poland," he agreed, sardonically. An idea popped into Martin's head.

Arthur looked at Martin quizzically. "What?"

"Um, later," Martin answered, dismissing that line of conversation to pursue his brainstorm.

Martin walked Arthur out and handed his notes to Morwenna, and told her, "Hold my next patient until I tell you. I need to make a quick phone call."

Martin returned to the consulting room and closed the door. The thought of Poland made him think of Mark Mylow. He would call Mark and mention the smell he'd experienced at the Sanders house. Perhaps Mark would be willing to check out their loo for any issues.

"Mark, this is Dr. Ellingham. I wondered if you would be willing to stop in on the Sanders family in Port Gaverne and check their loo for any mould-like substances or what might look like powdery residues." Some researched he'd done indicated such items could appear where Pseudomonas aeruginosa was present.

"Oh, hey, Doc. Good morning. You're up and at 'em early. The early doc catches the disease, right? Well, not CATCH the disease maybe, more like diagnos.."

"Shush. Can you do this, Mark?"

"Well, physically, of course, but are they okay with it? I mean, I don't usually have person A call me to send me to person B's house. A bit like making an uninvited house call, right?"

Martin replied, "I will clear it with them. I was in their loo yesterday and I smelled something unusual. Rich Sanders had an explanation for it, but it reminded me of what you'd mentioned about Penhale and Janice's complaint."

"What, Doc, you think it might be connected to Janice's sickness?"

Obviously, Martin thought, but resisted the urge to say it aloud. Mark had been a big help when Louisa fell on the ice on Boxing Day. Just because Mark stated the obvious didn't mean he was stupid. It had occurred to Martin that Mark simply expressed his thinking in real time, aloud. Martin chuckled inside. Mark would not make a good Pole.

Instead, Martin replied, "Perhaps. I can't say any more, but I'll call Ann Sanders and mention that I would like you to check out her loo. Stop here on your way to pick up a few sterile containers. I'd like you to take a proper water sample this time. I will have you go to the Police Station and do the same, if you can manage."

"Not at all, Doc. I'll try to get it done by the end of the day. I have three calls and they're all local, so I should be able to fit these in. And I'll even do it for free, like a public service. Don't let the word get out on that though, Doc. A guy has to make a living."

"Good. Thank you, Mark."

"Cheers, see you later."

Martin rang off and called out, "Next patient!"

The next collection of patients was unremarkable except for the fact that no one seemed there just to natter on and waste his time. There was something about Saturday hours and the fact that it was a day off work for most that kept the chit chatters away. After looking up Mr. Hughson's first name at Martin's request, Morwenna packed up and said her farewells. He left the door unlocked, as he was waiting for Mark to pick up the sterile containers.

Martin went into the consulting room and called the Sanders' house. Rich answered, and Martin launched right into his questioning. "Mr. Sanders, it's Dr. Ellingham. How did Ellie fare overnight? Any reaction to the final injection?"

Rich replied, "Afternoon, Doctor. Ellie seems fine, no change that we can tell. She had some breakfast, and Ann is just now getting her to the table for lunch."

This was the result Martin was hoping for. "Good. Now, last night I know you mentioned that the smell in your loo was, um, normal for your sons. Given we don't know how Ellie picked up a Pseudomonas aeruginosa infection, and it is generally associated with wet and moist areas, I'd like a plumber, Mark Mylow, to come by and inspect your plumbing. Is that acceptable?"

Rich and Ann had planned to stay home for the day with Ellie, so it was no problem. "Well, if you think it will help, sure, that's fine. We'll be here."

"Good. I'll let Mark know. In the meantime, how are you feeling?" Martin suspected that Rich's nausea could just as easily be from the bacteria as from IBS.

"Still have a bit of an upset stomach. Why, do you think it's something like what Ellie had?" Rich asked, rubbing his belly having been reminded of it.

"It's a possibility, as it seems to be affecting people with immune system problems primarily," Martin replied. Given that Rich had mentioned both he and his wife would be home, he followed up with, "I'd like to take blood and urine samples from you, if you could come to the surgery. I have time now."

There was a little murmuring in the background as Rich checked with Ann, then he replied, "Uh, yes, that's fine, Doc. I'll be there shortly."

"Right. Thank you," said Martin, then hung up.

He dialed the hospital to check on Nelson Hughson. Fortunately, the news was good. Mr. Hughson was also responding to the antibiotic, and his toe was also starting to heal. He should be ready to be released in two to three days.

Shortly thereafter, Martin heard footsteps in the surgery waiting room. He walked out and found Rich Sanders had arrived. "Come through," he said, turning around and leading Rich to the consulting room. He pointed to the patient chair. "Have a seat, take off your coat and roll up your sleeve."

Rich appreciated Dr. Ellingham's efficiency, even if it seemed a bit rude to completely dispense with a greeting. He had heard that the doctor was a bit of an acquired taste, one that some folks never quite came to appreciate. But after how Doc Martin had cared for Ellie over the holidays and was willing to make a house call to allow her to come home from hospital sooner, Rich was willing to put up with quite a bit from the man.

Martin instructed, "Ok, make a fist." He tied the elastic band around Rich's upper arm, tapped at the vein in the elbow, swabbed the site, inserted the needle, then looked away during the blood draw. Martin removed the elastic, put a gauze pad on the puncture, then asked Rich to hold it whilst he taped it down.

Rich looked bemused. "Hmm, interesting technique, Doctor. Not sure I've seen it done like that before. Is it some sort of personal challenge to extract the right amount without looking?"

Martin was about to bark at the man, thinking he was being wound up, when he remembered that Rich was a new patient and fairly new to the area. It was possible there were still people who hadn't heard about his blood phobia. Martin wasn't sure if that was refreshing or inconvenient, then decided it didn't matter either way. Instead, he said, "Mm. I will send this to the lab, and I should have the results on Monday. In the meantime, wash your hands thoroughly and try to avoid touching too many surfaces. I haven't heard of any patients who were not immune compromised who have gotten infected, but let's not risk your family members, especially Ellie."

"Right, Doctor. By the way, I had to come clean with Ann about my IBS. I can't straight out lie to her, and she asked why I was coming to see you. Frankly, I'm grateful you sort of forced the issue."

"Yes. That's good. Uh, we're through here," Martin said.

"That's me done, then," said Rich, with a smile. So, this is some of the behaviour people complain about. So far, nothing that he couldn't accept. "Thanks again, Doctor. I look forward to hearing from you and I hope your plumber person can help us get to the bottom of things."

Shortly after Rich Sanders had left, Martin again heard footsteps accompanied this time by a cheerful whistle in the waiting room.

"Doc? Doc, it's Mark. I'm here to pick up those containers."

"Right. Hello, Mark. I have them here." Martin handed over two resealable bags containing a plastic container with a screw-on plastic lid. "To take the samples, wash your hands thoroughly in the kitchen and dry them with kitchen roll before opening the package. Fill the vials about three quarters full from the tap in the loo, then screw the cap on tightly. Label the bag, insert the sample, then reseal. I'll be here for the rest of the day, so swing by the surgery on the way home."

"Will do, Doc. So, this is the Sanders house over near Port Gaverne and Penhale's loo in the residence, correct?"

"Yes," confirmed Martin.

Mark continued, "I presume I should take some precautions for myself, like gloves? Anything else?"

Martin agreed. "That's a good point, Mark. Whilst I don't think you are at risk given what I know about your medical history, it doesn't hurt to be careful. If you find the mould-like substance or powdery residue, leave it in place. We don't want it any more airborne than it might already be. Take pictures and send them to me."

"About the odor, any chance you can describe what it is we're look.., ah, smelling for? I know you caught a whiff of something at the Sanders place. Janice wasn't able to describe what she smelled at the station," he said.

Martin thought about it. "The nearest I can describe is stagnant water combined with an artificial smell. It wasn't a good smell, but neither was it something the body would, um, naturally produce."

"Got it, Doc. No post-beans-on-toast aroma, if you, uh, catch my drift," Mark said, smirking a bit.

"Mm, yes." The left edge of Martin's mouth teased up the tiniest bit. It takes a decent grasp of language, some cognitive flexibility, and a quick wit to make a decent pun. Although Mark's pun wasn't the most complex, Martin silently appreciated it.

"OK then, Doc. I'll head out there and you'll have your samples by the end of the day."

Martin made sure Mark had his mobile number to send any photos he took.

"Off I go, Doc. Be in touch soon," Mark said, already heading towards the door.

"Yes. And thank you, Mark," Martin remembered to say. Mark was doing this as a favor to him after all.

Mark left the surgery, and Martin proceeded back to the kitchen, where Louisa was making tea. James was in the living room helping Mary zoom from surface to surface, under Louisa's watchful but casual-looking supervision.

"Hello, Martin. Good day?" Louisa asked.

"Yes, yes, it has been. My appointments were all for actual problems and I have made adequate progress on everything I had on my agenda. I'm waiting for Mark Mylow to report back from inspecting a couple of properties on a hunch I have about a bacterial infection I've seen in patients." He stopped and then quickly remembered to ask, "And how has your day been?"

Louisa smiled. The hand puppet mimicry must have made an impression. "It's been good, yeah. James and Mary and I went for a walk out to the market, and then came back for a snack. I've beguiled James with the idea of how fun it is to help Mary get around, which has been a nice break for me, actually. He enjoys helping his little sister now, which is a far cry from when he tried to wish her out of existence."

"That's good. That was worrisome," recalled Martin. "If you have enough, may I get a cup of tea?"

Louisa poured Martin some tea, and they had a peaceful time sitting in the kitchen watching the children play. It was about 14:00 when Louisa, announced, "Nap time! James, I'm going to take Mary upstairs for a nap and I'm going to lie down myself for a bit. Would you want to come up and read with me first? I have a new book on dragon slayers that's supposed to be good." Louisa knew this book series was intended for an older child, but James' comprehension was advanced, and she thought he could handle it. She also hoped to get James to take a quick nap as well and the reading trick usually worked.

"Yes, Mummy!" James said excitedly, his eyes widening. "Dragons! Knights slay dragons!"

So up the three of them went, leaving Martin to himself. He got his laptop and checked his email, glad to see a reply from St. Aubyn. He opened it up, and it acknowledged the agenda topics and confirmed the time of noon Monday for an expected call. It was less than Martin hoped but at least it gave him a sense of progress.

He then finished his reading on the GP assistant program, finalized his thoughts for Morwenna, and grabbed a medical journal to read whilst he waited for either his family to come back down or Mark Mylow to return.

Author's Note: My thanks to those readers who have been providing both encouraging comments and constructive feedback. They help motivate me to keep writing and improving. At the end of this story, I plan to ask a few detailed questions. I hope readers can take the time to answer. And comments are welcome at any time. Thanks in advance.