The Blood Phobia

This show began with the premise that a highly respected vascular surgeon in London became hemophobic and could no longer perform surgery. He,therefore, made the decision to move to Portwenn in Cornwall where his aunt lived and practice as a GP. Since that opening rationale, the hemophobia has been the one thing about Martin Ellingham that continues to bedevil him.

At first the notion that a vascular surgeon would become phobic of blood seemed ironic and amusing. What a funny thing to have happen to someone who is defined by working with the veins and arteries that carry blood to every part of the body. Although we could, and some viewers do, think of this as being tragic, I am quite sure it was meant to be humorous.

It meant he had to live in a small village where he was very different from the townspeople; he had to become a GP and treat all sorts of medical conditions, sometimes of minor significance and sometimes life threatening, and often due to foolish mistakes made by the patients. He went from a doctor’s doctor, a medical specialist who was referred patients who had serious vascular problems, to a primary care physician who saw anyone who walked in the door. He also lived near a family member for the first time in his life and fell in love with a local woman.

The symptoms of the blood phobia tended to be nausea and/or vomiting and he did his best to hide these from the town. Unfortunately, his secret was discovered and he became a figure of ridicule for a while. (All of this was in the service of adding to the humor of the show to a great extent, although we were given some background information about his childhood that could have contributed.) He had his first signs of this disorder supposedly when he associated surgery with some feelings for a patient and her family. This was, as far as we can tell, the only time when he could not complete his duty as a medical professional.

Each series saw him trying to deal with his hemophobia and having a variety of problems coping with it. Most of the time he has managed to suppress his immediate sense of nausea and recover sufficiently to successfully treat any problem no matter how bloody. However, some series have used the blood phobia as a major theme. In S4 we saw him try to desensitize himself so he could return to doing surgery; in S6 he became depressed and suffered from insomnia; and now, in S8, we have him being told to suspend his medical practice because a patient has accused him of malpractice due to his phobia. Otherwise there has never been a time when his hemophobia has led to him being unable to complete a task, even one involving lots of blood. Several scenes have included blood spraying onto him and during those he has neither fainted nor been unable to continue. One in S8 is a femoral artery that has been cut. Since the femoral artery is below the heart it tends to bleed profusely, as happens in the scene. When he arrives, Penhale is already covered in blood as a result of trying to put pressure on the wound. ME immediately gets sprayed with blood on his face and upper body, yet he suffers no symptoms of his phobia.

It has only made him faint 2-3 times: with Edith in S4; almost on the jetty in S8; and while treating a patient in S8. The time on the wall never really materialized, the other times he fell to the floor. When it caused him to be depressed in S6, he searched for physiological causes. At that time he took his blood pressure and EKG but could not find anything of consequence. In S8E7 he once again takes his blood pressure and pulse rate. Considering that this phobia is often associated with a drop in blood pressure and heart rate, those symptoms would not necessarily indicate anything significant about the health of his heart. At the end of S8E7 he is shown deliberately cutting his finger and looking at it. That, too, does not cause him to feel faint or become nauseous. If we are about to be given a reason to believe that his heart is having problems, that would have to be a separate issue from the hemophobia, IMO. It would be a new development.

On the other hand, it is well accepted that blood phobia is often caused by direct or vicarious trauma in childhood or adolescence. We can easily suppose that childhood trauma might be the basis for his developing hemophobia as much as any event during his surgical career. Or, the surgery he had trouble performing after meeting the family was actually more a reaction to his childhood trauma and was then associated with blood.

Maybe dealing with his childhood, and its obvious deleterious effects on him, through therapy would be the best way to reduce the hemophobia, which isn’t keeping him from functioning anyway. The solicitor who is now accusing him of being unable to treat patients due to his phobia is clearly wrong and I would expect the whole town of Portwenn to be willing to defend him since losing him would mean they would be without their excellent GP.

15 thoughts on “The Blood Phobia

  1. Larry Munden

    What has always frustrated me, is, that as a Doctor he should recognize that he has a problem and get treatment for it . But resolving that issue would eliminate one the the central threads of the the show, and having gotten rid of the will they or won’t they story line between DM and LGE, they may be leery of getting rid of the phobia.

  2. kjacobson@mindspring.com Post author

    Thanks Larry. Very good point. I can imagine treatment protocols that could add something to the show, but it remains to be seen where they decide to take this.

  3. Amy

    I see three paths forward from here:

    1. Martin has to go for therapy to deal with his blood phobia. That sets up S9 as the opportunity to address all his underlying issues and have the series end on an uplifting note that he is now “cured” and a happier person. We get to see how this brings him closer to Louisa and content with his life.

    2. He has a heart problem that is easily treated and is back to his old grumpy self. S9 then is similar to S8 except we see how he adapts to Louisa’s pursuit of her psych career.

    3, The village rallies around him and convinces the licensing people that he is NOT a liability and life goes on as before. See # 2.

    My hope is that #1 is the direction they take. They are showing up in S8 how each character is growing and I am hoping that in S9 they show how each character finds “happiness:” Al marries Morwenna, Joe finds love, Louisa finds contentment in her job and her family, Martin becomes a happier and healthier human being. Not sure where they’d take Ruth, Bert, and Mrs T, but I assume each also finds a better place than where they are now (though Ruth might already be in a good enough place).

    The blood phobia was the engine that got the show started and I think that’s where it will end. With DM cured and accepting life in Portwenn with his lovely wife and child. Maybe that’s just my fantasy, but I am just hoping S9 is more fulfilling than S8 has been.

  4. Amy

    Oh, and for the record, as you know, I have never once found the blood phobia scenes funny. I always have felt sorry for Martin in those scenes. For me, watching others suffer—physically or emotionally—is just never funny. Falling down the stairs, bumping his head, throwing up, passing out—nothing funny to me. Ironic, yes, that a surgeon has a blood phobia. But not funny. From the terrible scene in the pub when they pull the prank on Martin to the scene in S8E7 when he passes out, I have not once found it funny to see the character squirm and struggle.

    But I know you know that’s my reaction to this stuff.

  5. kjacobson@mindspring.com Post author

    So,let’s see…they will never “fix” him and that means your #1 is highly unlikely. I would also find #2 suspect because he has so far never shown any sign of heart problems. The few times when he has been injured have been easily treated and, like most superheroes (he, he), he recovers in no time. I vote for #3 even though that is discouraging. On the other hand, I would still hold out hope for some sort of happy ending because I just don’t think they will end the show without that.

    I really thought that they were going for that with the conclusion of S7. But now that we have an S8&9, they had to find something to cause a disruption and then bring it all rightside up again. It looks like perhaps the plan is to make us wonder if Louisa will really quit her job as headmistress and Martin will possibly lose his employment too. Next week will tell the tale.

  6. kjacobson@mindspring.com Post author

    Of course I know you are among those who don’t see the humor in the design of the show, and I tried so hard to convince you!! I understand that a doctor throwing up whenever he sees blood may elicit some sympathy for him, but you have to also admit that most of the time it is played for laughs. Just take the scene where both Martin and the student vomit together on the boat. Did you feel sorry for Martin or find it amusing?

    I definitely have a different sense of humor from yours, but this isn’t a serious show. Surely this series has proven that, if nothing else. I mean Joe Penhale passing a kidney stone in the back of the church, the stuff with the dog, and Mrs. T driving like a maniac must have made you laugh more than suffer! If not, then I really do believe they would think they have failed in a very fundamental way.

  7. Amy

    I think that they would never fix him if the show was continuing, but I bet they will before S9 ends (cure the hemophobia, not necessarily all his issues).

    Want to place a bet? πŸ™‚

  8. Amy

    * were continuing

    OK, I DID laugh when the two vomited simultaneously. That was definitely played for laughs. But most of the other times—no, I didn’t find it funny at all. Maybe when he vomited on Penhale’s shoes, but mostly because of Penhale’s reaction, not because I was laughing at Martin.

    Sure, the kidney stone was supposed to be funny (I thought it was grotesque), and the fast driving was supposed to be funny (meh). It’s not that I think the show is a serious drama. There are always incidents that make me chuckle (though rarely laugh out loud), and as I wrote in an earlier comment, I am finding Penhale funnier this season—perhaps because there is more depth to his character than in prior seasons. I sometimes find Bert’s lines funny, almost always find Ruth’s sarcasm funny as well as Morwenna’s responses to DM and to some of the patients. I am always tickled more by the verbal jokes than the visual or physical humor. I find it funny when Martin goes on in medical jargon to describe ailments to confused patients, when Joe doesn’t understand or misuses a word, when Bert twists an expression, and so on.

    And that is generally true for me. I find the verbal humor on the Big Bang Theory much funnier than I ever found I Love Lucy’s slapstick and physical humor. I will take a bad pun or a malaproprism over a pie in the face or a fall down the stairs every time. I hated when Moe and Larry hit Curly and when Ollie hit Stan. I loved Robin Williams for the way he used language, same with George Carlin. It’s just the way I am wired. πŸ™‚

  9. Elle

    I hadn’t found the blood phobia funny or particularly upsetting. In the context of series 6 and his depression, we see his struggle and yes, that was very unsettling. I view it little differently now especially after watching this last episode. He passed out and was unable to treat the patient that had lost consciousness. What if this patient began to convulse with seizure or some other life threatening emergency. Her complaint isn’t without merit. If they find that she was on some medication or didn’t follow his instruction to go home and rest, it weakens her case.
    If you read the synopsis for 8, it seems there will be a villager that will need emergency care and, well, you can guess how that wraps up.
    I predict that Series 9 might pick up with some significant passage of time (possibly a year or two).

  10. Elle

    There has not been much in this new series that has inspired or provoked much thought but I did what to mention if anyone had noticed Martin’s moaning as if in pain or discomfort. He fell into bed and moaned or grumbled, and in episode 6 while positioning himself on the sofa (remember the conversation with Louisa about JH’s incident of biting) he leans back with his journal and moans. Listen the next time you watch. MC has back issues so it could be that and it went unnoticed by the sound editor. Caroline has breathing issues (is she asthmatic). The sound editor could edit (cut, alter, mute) the moans, groans, or uneven breathing of the actors.

  11. Santa Traugott

    I agree with Elle that passing out while treating a patient totally justifies an intervention by a medical licensing board of some sort. Being obviously uncomfortable, or even throwing up on someone’s shoes is not the same as leaving an injured patient untended on the floor. In fact, it’s so obvious that this had to happen once the disgruntled patient complained, that it’s implausible that Martin Ellingham was so surprised by it. (It reminds me, sorry for being catty, of the time Martin Clunes was highly and publicly surprised to find that the auto insurance company for which he was making ads, canceled those ads when his driver’s license was suspended for speeding. )

    However, they are tossing in hints that his blood phobia did not cause his faint this time ((as it did in S4). He cut himself and saw his own blood, plus there is the ambiguous medical reading, which was at least captured, for our benefit we have to presume, at a dicey number. Of course, he’s not only a doctor but a vascular specialist, so why in the world wouldn’t he be able to figure out what’s going on, or refer himself to a cardiac person to figure it out?

    But in fact, the whole premise that his blood phobia is such an enormous obstacle to him, has always seemed implausible to me in the first place. Edith gave him the right advice in S4 — find a good cognitive-behavioral therapist and stick with the recommended course of treatment. The usual treatment (or at least it was some years ago, correct me if I’m wrong) for phobias, including blood phobias, is desensitization. The critical point about desensitization is that one has to “overtrain.” That would probably mean, for him, working in a MASH unit, but that’s the theory. He stopped too early, and his phobia went into remission for a while. But as an anxiety disorder,which is what it technically is, it probably can be reactivated by stress, if it is not fully eradicated.

    And if it is an anxiety disorder, or even just a reaction to stress, does it make any sense that he’s particularly anxious or stressed now? He’s had some therapy, he’s worked through his early difficulties in being part of a marriage, which marriage now seems to be on a more solid footing, etc.

    All of the above just supports what Karen often tells us, which (loosely interpreted) is that some things in DM make sense only because this is fiction, not real life, and like a stage play, we’re not meant to examine the scenery too closely, only take an impression from it and go on from there. So here, the back drop is a blood phobia. Don’t look at it too closely or expect it to have a lot of substance, just take it as a given.

    So as to what will happen in S9 — has anyone else considered the possibility that this threat of being struck off will be the catalyst that finally has him deal with the blood phobia, and open up the possibility of a return to London and his surgical practice (and where Louisa, btw, might have an easier time establishing a practice or being taken on by NHS)? That would be a way to wind up the series, quite definitively.

  12. kjacobson@mindspring.com Post author

    Elle, you are absolutely right that passing out when a patient has hit her head and also become unconscious would be a valid reason for a medical board to look into the circumstances. One of my problems comes from the fact that his condition has been well know for a long time and never bothered the board before. The doctor’s friend investigated only because his rapport with patients was at stake, not his blood phobia. Furthermore, Dr. Dibbs arrived in town in a highly aroused state, had not diagnosed her Cushing’s disease, and was self-medicating, yet no official questioned her fitness.

    I suppose like all infractions, some get noticed and others don’t until something like this happens, especially in the presence of an ill-tempered solicitor. But there is a lack of consistency here to some degree.

    Our attempts to predict what might happen for the next series is exactly where they want us. At least they figured that part out right! Oh, deciding to have a passage of time makes some sense even though they’ve never done that before. MC and CC aren’t getting any younger and if James were older, they could have some scenes with him where he’s not sleeping or sitting.

  13. kjacobson@mindspring.com Post author

    As you and I both say, the blood phobia has never been an obstacle before except when he considered moving back to London after their plans to marry the first time ended. His effort to use desensitization techniques on his own was certainly not adequate and they really never wanted to have him lose the blood phobia. Will he seek more therapy? It’s hard for me to imagine them engaging another therapist and having the show include more scenes with therapy sessions.

    What might be more likely is that the emergency they mention for S9 demonstrates both his skills and the importance he has for the village, the solicitor’s accusations are shown to be vengeful, and he agrees to seek therapy, but we never see it.

    A move to London might be a good way to wrap up the series since they would never countenance such a move if they were to continue filming because they always claim the village is a character in the show. Plus all of the cast claim to love going to Cornwall every two years. On the other hand, MC still leaves the door open for more series (no matter how ridiculous we think that would be) and Louisa is supposed to dislike London (although she had been willing to move with Martin in S5). As I said to Elle, our speculating is something they would love to hear and is hard not to do. Every long running show has a finale that its fans guess at. I just hope whatever they come up with feels satisfying.

  14. Amy

    I did consider the option of L and M returning to London, but I agree with Karen that it’s not likely. Louisa loves the village and has refused to leave before. Martin said at the end of S5 that he didn’t care about London or surgery—as long as he could be with Louisa. I think he is finding that being a GP has sufficient challenges, and he does seem less disdainful of the villagers in S8, And I think it would be an unsatisfying ending for the show if the village was left without DM and Louisa. But it’s certainly a possible outcome.

    Karen, I don’t imagine more therapy sessions on the show either—more Martin telling Louisa what he’s learned so we see indirectly how he is working things out and growing closer to her as a result. I know this is wishful thinking on my part,. I just would like to see them depict the couple more warmly in the final season than they have in this one.

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