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I apologize if the title is misleading and you were expecting a more important topic. This title could have been an in depth look at first times for things that happen in the show or something.

I admit I’m getting a little silly now, but I have a question to ask. Do you clean as you go when you’re cooking or wait until you’re finished and clean everything then?

There was this great bit in “All in the Family” years ago when Archie was watching Michael put on his socks and shoes. Michael put on his left sock, then his left shoe, and Archie was appalled. Archie tells Michael you should put on both socks, then both shoes. What if there’s a fire? Michael responds that at least he’d have on one shoe. I almost always think of that when I’m putting on my running shoes: sock and a shoe, or sock and a sock?

In S6 on DM when Louisa is cooking, Martin comes in and wants to find things to do. He starts cleaning the cutting board and she tells him she still plans to use it. He says she should clean as she goes and gets an “Oh Really” answer from her. She wants him to stay out of her way and tells him to feed the baby.

So now I’m always thinking about how I clean as I go when I cook. It’s so funny how something minor like that can stand out and sometimes cause conflicts!

Originally posted 2015-03-28 09:09:09.

Everything old is new again

Here’s something to lighten our recent discussions.

I suppose I shouldn’t be surprised to see that the new fashion styles being advertised hark back to the days that I suggested seemed retro when I wrote about the dresses Louisa wears. So much of fashion gets recycled over the years.

It looks like the little floral dresses we are used to seeing Louisa wear are now being promoted as great choices for Spring. See

It  might just be an Easter thing, but there are certainly more stores making pretty floral dresses available this year! (I gotta say most of them don’t appeal to me! But then again, I’m not the right age for them either.)

Originally posted 2015-03-26 09:24:19.

Attached to Feeling Ineffectual

Since I have obviously run out of personally generated ideas, and the NYTimes seems to regularly publish articles that I find relevant to the show, I hope you don’t mind if I continue to refer to what I’ve read.

The Times has been publishing a series of articles called “Couch” that “features essays by psychotherapists, patients and others about the experience of therapy — psychoanalysis, cognitive behavioral therapy, group therapy, marriage therapy, hypnotherapy or any other kind of curative talk between people behind closed doors.” That has turned out to be incredibly fortuitous, especially because we have been mentioning all of the above on this blog.

This week the article is written by a psychiatrist in private practice in Cambridge, MA and is about a possible explanation for having little tolerance for risk and choosing known dangers over unknown ones. The patient in the story and Martin Ellingham have one thing in common: his father is a brilliant, larger-than-life figure who bullied and belittled him. In the patient’s case, he has continued to try to impress his father. When, at last, this patient’s father and he decide to work together on a business venture, he continues to feel disparaged or ignored until their business becomes a success. Oddly, however, it is at this point that the patient feels worse than ever.

The psychiatrist’s assessment is that having success with his father is unknown territory for the patient and that makes him extraordinarily frightened. “What if he lets himself taste victory and it still fails? There is so much to lose now. Maybe even more terrifying, what if he gets what he wants? Then who would he be? He does not know how to assimilate the identity of successful entrepreneur and worthy son, however much he has coveted it. Doing so would represent a bizarre kind of loss: That is not who he has known himself to be.”

Here’s another way of looking at ME and his achievement of marriage to the woman he has pursued for so long. Is ME now overtaken by fear because he has married Louisa and there’s so much to lose if he fails? Furthermore, having a successful love life is alien to him despite having coveted it for a long time, and now he may be having an identity crisis. He wants to change and has wanted to for a long time, but, faced with having reached such an exceptionally desirable state, he’s not sure how to handle it. He is not who he has known himself to be.

In conclusion, the psychiatrist writing the article boldly states: “We are all afraid of acquiring what we can so easily lose, whether professional status or someone to love. We are caught in a dilemma. Pursuing these commitments can be terrifying. But letting ourselves ignore them can be dangerous, even fatal.” Although I’d like to think that many of us can withstand the sense of accomplishment that comes with success in an important chapter of one’s life, I have to agree that these kinds of major adjustments are accompanied by trepidation. In the case of ME, he has allowed himself to be vulnerable because of his supreme love of Louisa. He might find it very anxiety provoking, even to the point of putting him into a dangerous depression, but his decision to follow her and to work on their marriage should take him out of the danger zone.

Success has immobilized him for quite a while; hopefully he will be rescued from the edge of the abyss by his own efforts to accept this change and by discovering Louisa needs him as much as he needs her. It’s her turn to reach down and grab him as he’s falling. (Sorry, sometimes I get carried away.)

Originally posted 2015-03-15 15:50:42.

Opting to Stay

I would have liked to have called this post the same thing as the article in the NYTimes Magazine: “Should We Stay or Should We Go” because I like that so much, but I felt uncomfortable stealing it. Obviously, I am still finding articles in the NYTimes and a few other places that inspire me to write posts for this blog. I am an incorrigible user of material that originates elsewhere!

In this case, the discussion is about how the trend in films has gone from the constant use of the phrase “Let’s get out of here” to the command to stay and be strong enough to stay. “Where ‘Let’s get out of here’ is all bravado and yang, stay is self-absorbed yin. In this context, the balance of cultural power seems to have shifted from the getting-outta-here rebels who used to tell the squares and schoolmarms to kiss off to the squares and schoolmarms themselves, who just wish everyone would hold on a second and think this thing through.” This article also addresses the complications of staying which include the possibility of being oppressive and/or being too protective.

In our case, I see the “Doc Martin” show as following the same progression. (I say this with the full recognition that Portwenn is a place that most people rarely leave. What I’m focusing on is Louisa’s behavior in regard to the relationship that builds with Martin.) Martin arrives at Portwenn because he has decided to get out of London. Leaving London and being a vascular surgeon gives him an opportunity to start a new life. He isn’t thrilled with the place he’s chosen and, for many reasons, decides to leave Portwenn to return to London. Louisa wants to have a relationship with Martin and stay in Portwenn, but she is always leaving the relationship for one reason or another.

Nevertheless, once we reach the end of S5, we have witnessed Martin make a decision to stay so that he can be with Louisa, and Louisa has been convinced of his sincerity and looks forward to having a life in Portwenn with him. S6 finds the couple making a commitment to each other and settling into being in Portwenn. By the end of S6, however, Louisa has decided she would like to leave town, somewhat reminiscent of the end of S3. Her plan to leave is thwarted by a serious medical condition and now she must stay and think things through. So the series has established that Martin and Louisa will stay in Portwenn despite their marital troubles. At this point, we expect them to look at themselves and their marriage and stay — stay in Portwenn, stay together, and stay in their professions.

Probably unwittingly, the show has adopted (or sensed) the trend that has become a part of filmmaking recently and is following it. We can only lean back and enjoy!



Originally posted 2015-03-05 16:05:52.

A Bit More on Louisa

I have written about emotions versus rational thinking, and we have discussed the contrast between Martin’s difficulties with expressing emotion and Louisa’s passionate reactions. We have also done our best to take the Myers-Briggs Personality Inventory as if we are Martin and Louisa. When we did that, we rated Louisa as a definite Extrovert and a Feeling type.

In one comment, Abby explained something about how the brain’s physiological construction operates: “So, regarding Louisa, as long as her middle prefrontal cortex is engaged, she is able to understand Martin and his needs and limitations. However, when she feels threatened, as when he tells her she should stop working (which triggers her fear of depending on anyone) or he withdraws from her due to his depression (which triggers her fear of abandonment), her amygdala starts firing, triggering a fight/flight response, both of which we have seen her do with him. At that point, she is completely running on autopilot; there is no ability to watch her reactions to him and decide whether or not to act on those reactions. She simply REACTS. Her prefrontal cortex is offline at that point.”  (Jan. 10, 2015)

All of the above gives us several reasons for Louisa’s passionate reactions. I now have one more thing to add to why Louisa may be more emotional. In yesterday’s NYTimes Sunday Review, psychiatrist Julie Holland wrote an op-ed about women’s feelings in which she says “Women are moody. By evolutionary design, we are hard-wired to be sensitive to our environments, empathic to our children’s needs and intuitive of our partners’ intentions. This is basic to our survival and that of our offspring. Some research suggests that women are often better at articulating their feelings than men because as the female brain develops, more capacity is reserved for language, memory, hearing and observing emotions in others…Women’s emotionality is a sign of health, not disease; it is a source of power. But we are under constant pressure to restrain our emotional lives. We have been taught to apologize for our tears, to suppress our anger and to fear being called hysterical…Crying isn’t just about sadness. When we are scared, or frustrated, when we see injustice, when we are deeply touched by the poignancy of humanity, we cry. And some women cry more easily than others. It doesn’t mean we’re weak or out of control…We need to stop labeling our sadness and anxiety as uncomfortable symptoms, and to appreciate them as a healthy, adaptive part of our biology.”

As a woman, Louisa is subject to the same biological tendencies that all women have, and that generally leads to being moody, empathic, and more emotional. I think Dr. Holland is right that being emotional is a sign of health and crying is not a sign of weakness. In fact, in Louisa’s case, she does suppress any inclination to cry, and we could consider that unfortunate. I remember one occasion in particular when Louisa wants to cry while talking to Martin but contains her tears after he asks her if she’s crying. (I cannot remember which episode this occurs in. I believe they are standing at the back kitchen door.) To the best of my recollection, this is the only time we see Louisa close to tears even though there are plenty of instances in Louisa’s experiences when we might all tear up. They seem to have decided to represent her strength by having her refrain from crying. We wouldn’t want to see her shedding tears during every emotional scene, on the other hand, a few tears would only make her more human and possibly reduce the sense that some viewers have that she’s too demanding.


Originally posted 2015-03-02 15:18:11.

Martin’s Mothering Morass

Man is of woman born, and her face bends over him in infancy with an expression he can never quite forget. Margaret Fuller, The Dial, IV, July 1843.

(Once again, many apologies for the long break between posts about mothering. There are never enough hours in the day lately!!)

I decided to open with the Margaret Fuller quote because her observation recognizes the very early impact on a baby that a mother has. Its ambiguity encompasses the many facial expressions a baby might see when his/her mother comes into view. Whereas, for example, we can imagine Louisa’s mother looking at her little girl with love in her eyes, we have much more difficulty visualizing Margaret’s face appearing anything but disgusted and resentful towards her baby boy. From what she has told Martin, she was never happy to be a mother and always considered him a wedge between Christopher and her. No matter how Martin was treated at home, even the basic fact that he was not wanted had to have been extremely damaging to his psyche.

We would have to assume that Margaret avoided doing much with her son. Neglect is almost too trite a word for how the absence of a mother’s love should be described. Many studies have been done on the effects of neglect on babies. In most of the classic studies the babies failed to thrive and were generally considered compromised for life. Recently, however, there have been follow-up studies that have found some interesting variations on what neglect can do to babies. One study seems particularly pertinent to what could have happened in Martin’s case. (Again, I want to always make the disclaimer that there is no evidence that anyone from the show might have thought about this. The study I am quoting was only completed within the last year, which means no one on the show would have known about what regions of the brain might have been affected when the show was first written.) What stands out to me is that “the affected brain regions include nerve bundles that support attention, general cognition, and emotion processing…The most affected tracts included nerve circuits involved in general cognitive performance, emotion, maintaining attention and executive function, and sensory processing.”  Thus, early childhood neglect by his mother could have led to Martin’s difficulties with emotions, or to being unable to comprehend the importance of affection, and even having the capacity to reach the decision to stop Louisa from leaving at various pivotal moments.

Another thing in the article that is worth noting is their finding that “white matter losses may be reversible. What worked in Romania to improve brain development—moving children into a supportive family environment—might work elsewhere as a remedy for child neglect. ‘This has really important implications,’ says lead author Johanna Bick, a clinical psychologist at the Boston Children’s Hospital: ‘It suggests that the harm that takes place in a family setting may be reversible, too.'”

In the case of Martin Ellingham, perhaps his stays with Joan were just long enough, and loving enough, to have been able to reverse some of the effects of his mother’s dismissal of him.

In addition, research published in the Proceedings of the National Academy of Sciences in 2012 showed differences between genders in the long-lasting effects of neglect by mothers. While the males had high levels of a stress hormone known as cortisol and low levels of the metabolite of the mood-related neurotransmitter serotonin, this difference was not seen in females. Lead author Gabriella Conti of the University of Chicago suggests that this may be because in the womb, female fetuses are also more resilient than males. (Aside: Of course!)

High levels of stress hormones can increase risk for both mental and physical illnesses, including depression, which also can involve low levels of serotonin.

Martin clearly suffers from depression in S6.  According to the study above, this tendency would be quite likely. So now we have several possible causes for Martin to be depressed. He could, as I mentioned in my post of June 30, 2014, be depressed because many parents experience depression following at 3-6 months postpartum; or he might have had high levels of stress hormones due to his mother’s neglect; or he may have Asperger’s which is often linked to depression. This is not to mention feeling like he’s a failure as a husband and discovering his mother’s primary reason for coming to visit him is to snooker him into giving her some money! Thus, he has both physiological and psychological sources for finding himself depressed, and most of them originate in his mother.

The authors conclude: “[T]he lack of a secure attachment relationship in the early years has detrimental consequences for both physical and mental health later in life, with long-lasting effects that vary by sex.” Louisa may have been abandoned at a young age like Martin, but the likelihood is that she had more love from her mother than Martin ever had from his and that, as a female, she is better equipped to manage any stress or neglect.

Another thing that I feel compelled to mention is that Martin could almost be said to be a better “mother” than many of the women in town. As I know I’ve mentioned before, there is rarely a time when JH is nearby that Martin doesn’t touch him in some way. Many studies have demonstrated the key importance of being touched by another human, especially one’s parents. One of these studies notes: “We all need human touch and loving affection at every stage of our lives for healthy emotional and neurobiological development.” Despite his own parental deprivation, Martin provides his son with the very thing he never got. (If we’re very cynical, we might suggest he knows to touch his son because he’s studied human development. I prefer to think he is supposed to be doing it instinctually.)

Ultimately, there is no denying the importance of a mother’s relationship with her child and the amount of harm that arises from a mother’s neglect. We’ve all recognized the wounds Martin has suffered due to his mother’s treatment of him. I have no doubt the writers, et. al. intended us to attribute some of Martin’s behavior and social ineptitude to how he was treated by his mother. This newer research gives us even more reason to associate her with his emotional and physical awkwardness.


Originally posted 2015-02-24 14:37:46.

The Importance of Being a Mother

In Sept. 2013 I wrote a post called “Mothering” and reviewed the generally poor mothering skills  of the women in Portwenn. I want to revisit the topic of mothering because I have become convinced that the role of mother is eminently important and that when Martin and Louisa enter marriage counseling, they will have to address their experiences with their own mothers.

In Sept. 2013, I wrote that Joan and Louisa were the only women in the show who demonstrated an aptitude for mothering. It’s especially curious that Joan is portrayed as a good mother figure because she has never had children of her own. Instead, Martin’s summer visits seem to have been a vicarious way for her to fulfill her mothering instincts (unless we consider her animals her children). We are led to believe that she always loved Martin and was sincerely hurt when his parents no longer allowed him to visit; however, we also know that whatever mothering she provided was limited to the few months he visited each summer. We also know that during his visits he met John Slater who was actually Joan’s lover, not her husband. What sort of relationship Martin had with Joan’s husband remains unexplored. Therefore, not only was Martin subjected to a biological mother who rejected him, and even resented him, but also the one loving mother figure in his life was only with him a few months each year and had a questionable home life herself. (We have speculated that there might have been a loving nanny/governess during his early childhood years, but we haven’t heard anything about that on the show.)

Louisa demonstrates natural mothering instincts when she has her baby. She has previously told Bert that she wants children of her own, she spends her days working with children as a nurturer and teacher, and she has come to her student Peter Cronk’s rescue more than once. Hence we are not very surprised that she falls easily into her role as mother. From the moment the baby is born, we see Louisa hold the baby close, have difficulty letting the baby cry, worry about whether she’s handling things right and reading the current literature pre and post natal. She starts out breastfeeding, although we aren’t shown too much of that (something that would be much more a part of her daily life under normal circumstances), and she has the baby near her a lot of the time. Once she returns to work, she is conflicted about leaving the baby, except with his father (and sometimes even with his father). Thus, we have the overall sense that Louisa is the kind of mother neither Martin nor she had themselves, and who Martin appears to take delight in when observing her. She would probably be seen by Martin as the sort of mother he would have liked to have had.

What I find most interesting, however, is Louisa’s relationship with her own mother and how that may have played a role in Louisa’s personal development. What we’ve been told about Louisa’s childhood begins at the age of 11. To the best of our knowledge, she was born in or near Portwenn and grew up there. She remembers good times with her father, Terry,  who occasionally took her for ice cream. The most significant memory of her mother, however, is that she left for Spain to be with Javier when Louisa was 11 years old. We have no idea what her home life was like until then, but her mother’s departure to be with another man must have been preceded by some sort of affair with him as well as some sort of estrangement between Eleanor and Terry. It certainly seems as though Louisa and Eleanor have been out of contact with each other much of the time Eleanor has been in Spain, despite the fact that Louisa decided to write her mother about her pregnancy. Clearly Eleanor considered a letter from her daughter significant enough to fly to see her after the baby is born. (She also came because she wanted to make a deal for a seafood supplier for the restaurant in Spain.)

In Eleanor we meet a fun loving, free spirited woman who acts totally unaffected by the long break in their contact with each other. She immediately tells Louisa she looks like she could use a rest and she wants to hold the baby. There’s not even a slight hesitation on her part.

Soon Eleanor becomes involved in their family life and Louisa trusts her, with some reservations, to care for James Henry. They need someone to watch the baby while they both continue to work, and Eleanor appears competent until she adds a few drops of her elixir to JH’s bottle to calm him. Once that somewhat innocent blunder is overcome, Eleanor disappoints again when she  shows up late and hires a questionable teen to watch JH so she can work in Bert’s restaurant. Eleanor is not sufficiently committed to the baby’s care even after she is given this second chance to redeem herself. Moreover, it is at Louisa’s lowest moment that Eleanor decides to leave again.

The unexpected behaviors Louisa exhibits are turning to her mother twice following difficulties with Martin. The first time is in S5 when Louisa decides she can’t stay with Martin due to his consistent failure to consult her about matters of the home. She takes JH in his carriage to her mother’s house and is received there with genuine sympathy. The second time is in the last two episodes of S6 when she decides to fly to Spain with JH to have some time to think about her marriage. As Martin says, in his constant state of bewilderment, she doesn’t even like her mother. But such is the power of mothers and the need for their comforting and nurturing that, despite ongoing conflicted feelings, Louisa looks to her mother for sanctuary.

Because I find the decision to have Louisa seek out her mother under trying circumstances in her marriage so credible and yet so startling, I think it’s worth writing about. While acknowledging that the show needs a place for Louisa to go in both cases, and her mother fulfills that need quite well, it’s also telling that they choose her mother as the person Louisa seeks out. Here’s a thirtysomething woman who has been on her own most of her life and now needs a soft place to land. And the place she decides on is with her mother, the person who abandoned her and has disappointed her many times.

We could think there aren’t many options for Louisa, and we have to say that’s true. However, there could also be something else going on here. To some degree there could be some sense of unresolved abandonment issues in Louisa. Throughout Eleanor’s reappearance in Portwenn following James Henry’s birth, Louisa tries to excuse her behavior. She gives Eleanor second chances, she thinks her mother is having a romantic dinner with an old flame, and is jealous of her, when she’s only going out to close a business deal and has no concern for the man as a person. Once he’s injured and can’t fulfill his contract, she’s off to find someone else. No matter what Eleanor does, Louisa continues to care about her. When she ultimately requires an emergency surgical procedure, Louisa is markedly worried and acts very relieved when it all goes well. Thus, Louisa is depicted as much more compassionate than her mother and towards her mother than her mother is towards her.

Another thing that could be going on is some feelings of self-doubt in Louisa. One source notes the following rather pedestrian, but substantive, observations: “All children who have been abandoned by their mothers, either physically or psychologically, wonder what they did to cause “Mommy” to leave. They ask themselves if they did something wrong; if they did, they want to figure out what it was. These children also wonder if they are lovable.” There is a strong likelihood that Louisa is still blaming herself for her mother’s departure during her childhood and she is probably still yearning for her mother to treat her in a loving manner. When Eleanor ushers Louisa into her home in S5, she is showing Louisa the acceptance and love she craves; and when Eleanor talks to Louisa prior to departing again at the end of S5, she tells her how proud she is of her. To a certain extent, Eleanor has finally answered Louisa’s apprehensions developed in childhood about her mother. After that resolution, minimal as it may appear, perhaps Louisa’s decision to fly to Spain to stay with her mother isn’t so surprising.

It’s also perhaps not surprising that Louisa habitually decides to leave Martin whenever they have dissension in their relationship. According to the same source, “Some children who have experienced a maternal abandonment will come to the mistaken conclusion that they are better off protecting themselves from any more hurt. They also decide that it’s better to do the abandoning than to go through the pain of being abandoned again.” Marriage counseling should at some point identify these inclinations as well as how Louisa’s mother has played a role in her approach to her marriage. Feeling abandoned by one’s mother is traumatic at any age. In this show we have two main characters who have been either physically or psychologically (or both) abandoned by their mothers. It’s a topic of some importance to the show.

We have discussed Martin’s mother’s influence on him to some extent, but in my next post I want to add more to that too. It’s nice to get back to writing another post and I hope to hear from some of you. Sorry for the lengthy break.


Originally posted 2015-02-14 15:21:57.

The Urge to “Fix”

By now you all know how much of a fan of both Breaking Bad and Better Call Saul I am. As it turns out, I’ve been wondering when the third series of Better Call Saul will be shown and just saw an article that gave me hope it will be soon.

But the reason I’m telling you about this is because of something actor Bob Odenkirk said in his answer to one of the last questions he was asked in this interview. In many of our discussions we have noted that MC always asserts that they never want to “fix” Martin Ellingham. Nevertheless, many viewers seem to have trouble restraining their urges to turn him into someone more affectionate, or more socially adept, or who smiles more.

This sort of inclination goes also to the idea of whether people can change, a topic we’ve discussed continuously because it has been addressed in the show.

Well, Bob Odenkirk plays the role of an anti-hero in both Breaking Bad and Better Call Saul and his assessment of his character comes extremely close to what we could say about ME. First he says:

“Saul Goodman, to me, is kind of a guy who’s shut down a lot of his emotional life, because I guess his feelings have been hurt, and he’s decided to play tough with the world. In this season, some pretty bad things happen to Jimmy, and we see him starting to shut down those connections, the way his emotions flow. He starts to shut down in this season—not completely, but it’s like you feel these gates closing around the character, and he’s just getting darker and tougher.

It’s wonderful because that is the journey we’re on, and we’re getting somewhere. But it’s also kind of sad to play him, and to feel a person whose response to disappointment is to close himself off more and more from the world, and from hope.”

Then he’s asked: “Do you ever find yourself being driven mad by Jimmy’s behavior? He’s a guy who’s so easy to root for, and yet he’s also exasperating.” (FYI, Jimmy is his actual name, but he adopts the name of Saul Goodman later in the show.)

And he answers: “Yes. You want to give advice to him. It’s like the way you feel about a friend or a sibling who maybe has…you know, we all have different broken responses to our circumstances. It’s like having someone like that in your life, that you’re close to, and you want to instruct them on not making the same mistake again and again. So I do have those feelings, and I think what’s important for me, as part of a creative team in this effort, is that this desire to fix him is the same desire you have when you watch [Breaking Bad’s] Walter White. You say, ‘Don’t do that! Just take the money and go!’ But he’s on a path, and he’s going to stay on it, and you can’t change it. And the psychological truth that these guys establish and follow is pretty strong and deeply thought out. So, similar to your friend or your family member, you just have to bite your tongue, and suffer, and let them go on their road and root for them.”

What I infer from that is even the actors portraying these troubled characters have an urge to “fix” them and stop them from heading in the wrong direction, but they understand the demands of the plot and accept that changing the characters would damage the storyline. Thus, whether or not we believe that people can change, and whether or not we have this humane desire to warn the character that he is headed in the wrong direction, a fictional story doesn’t allow for that. Not only that, but it’s exactly because we want to “fix” these characters that they are so compelling.

And now I think we are back in the scope of our discussion of the post titled “Should Martin and Louisa Stay Together.” We should not lose sight of the fact that it is a story contrived precisely to cause a wellspring of emotions. We cannot meddle with the story no matter how much we might feel the urge to!

Originally posted 2017-02-16 10:43:52.

Where Do We Go From Here?

As you know I’ve been trying to keep this blog going even though finding something to write about is getting pretty difficult. I have one or two ideas rambling around in my head, but I’ll be honest and admit that I’m definitely stretching myself thin at this point.

From the relatively few comments people are writing, it looks like you are all experiencing “Doc Martin” fatigue. I started this blog thinking that I was mostly writing it for myself and would write it whether I had readers or not. I was delighted when people started making comments and we developed a pretty active blog. Lately, I’m getting the impression that I’m writing more for myself again. I enjoy the reading and writing, and I’ve been excited to learn a lot about all of the topics we’ve had on the blog. So, I’m very happy with how everything turned out.

I will continue writing posts whenever I think of something new that’s worth putting out there. And I am still open to any suggestions anyone might like to float. I just want everyone to know that there may be longer breaks between posts. Of course, when something significant happens, I’ll be back in force. Certainly when S7 begins, this blog will heat up again — or at least I hope it will.

Originally posted 2015-01-24 14:25:18.

Acting & Aging

A few weeks ago Santa suggested a post about how older people are treated in the show. It is remarkable how many older actors have been included in DM. I suppose one reason the show has older villagers is because of the cross-section of ages that makes up the totality of any small town. In this show, Louisa is the headmistress of an elementary school, which means we have quite a few very young actors. Then we have the parents of the young children and a smattering of citizens in their teens, twenties, and thirties. Somehow Portwenn has retained a fairly well distributed group of townspeople in relation to age. But the mainstay of any town is the older citizens who have lived there many years.

Despite my previous mention of Stephanie Cole having the only actual sex scene in the show (see “Women’s Issues, Part 1,” Sept. 9, 2013) , which was significant because she is an older woman and was representing the loneliness and lack of affection that often accompanies being an older woman whose spouse has died, I have not written much about the many older characters in the show. Of course, that scene was also used for comedic purposes, especially because Martin walks in on Aunt Joan and Edward in flagrante delicto and is exceptionally astonished, so much so that he can’t get the image out of his mind and almost runs into Carrie Wilson with his car. The thoroughly modest/moral Martin is offended that his aunt would be willing to carry on an affair with a man young enough to be her son, and that Edward would be at all tempted to have sex with an older and marterteral woman. (Fun fact: I just learned that the female version of avuncular is marterteral.) Basically, Aunt Joan does not appear to be a sexually active woman, yet there she is, having sex on the kitchen table. Not bad for a woman ostensibly in her 70s! (Actually, at the time Stephanie Cole was only 66.)

After giving this subject more thought, I am convinced that we should focus on how many older female thespians appear in this show. I am particularly singling out the women because, sadly, it is much harder for older women to find roles in TV or film. We can certainly add a discussion of the men as well following this post. I’m not sure what emphasis Santa would have put on this subject, but this is my take on it. Hopefully, much of what I say about the position of older women in the show will also be applicable to the men.

As luck would have it, recently there was an article in The New York Times – “Arts and Leisure” section about Jessica Lange and her role in the TV show “American Horror Story.” I have to admit I have not watched this show at all, however, from what the article says, each year the show has found a way to refer to Hollywood metaphorically. This year its subtitle is “Freak Show” and it is about “a troupe of carnival sideshow performers” in 1952. The article goes on to say “Freaks were how older movie stars were regarded in Hollywood after their careers dried up; television was the sideshow where aging performers sought work when studio bosses stopped calling…[T]he sad truth is that the older an actress is, the harder it is for her to be cast as an attractive character, let alone a love interest.” The article notes that television is no longer considered a comedown for stars. It also goes on to say that Jessica Lange, who is 65, creates many poignant characters in this TV show and this year she “hams it up as…an aging German chanteuse with no legs – they were cut off in 1932 for a pornographic snuff film.” We eventually learn that “she went from a failed career in cabaret and carnival side shows to television stardom,” in what is assumed to be a joke about show business. One way of looking at the sex scene with Aunt Joan is as a satirical reenactment of this serious circumstance for aging actresses. On the one hand, I find it admirable that the show addresses the very real feeling of desolation many women face in older age; on the other hand, there is a certain degree of absurdity in finding Joan willingly having intercourse in her kitchen and later in a hotel room where a party for Penhale will soon be taking place. I mean, hormone replacements or not, what happened to Joan’s sense of propriety?

(We shouldn’t forget that seniors are still interested in sex. According to The New England Journal of Medicine, more than a quarter of adults aged 75-85 and over half of adults aged 65-74 are sexually active. Not only that, but “the prevalence of sexually transmitted diseases in people 45 and over has doubled over the past decade, according to the Centers for Disease Control and Prevention (CDC).” Aunt Joan represents that part of the senior population that is still having sex.)

Most of the older actresses on DM have spent their careers in British television. (Indeed, Caroline Catz has done that too, as has Martin Clunes.) There could be many reasons for choosing to act in television; nevertheless, I find it impressive that apart from Eileen Atkins, Claire Bloom, and Phyllida Law, the older actresses have spent decades performing exclusively in television series, including Stephanie Cole. This circumstance could be related to the difficulty women have in being cast in films as well as the evolution of television to a place of prominence rather than a sideshow. Moreover, the approximately 20 older actresses (age ~ 70-90) in DM may be the beneficiaries of an enlightened production company that has faith that older women can be valuable in many roles. Surely, the older actresses must be grateful for the opportunity to participate in a successful show. I think they add a lot of depth and humor to the show while also keeping the show grounded in the reality of life in a small village and in the aging of our populations in general. I want to single out a few examples below.

Another matter of importance to me is the whole idea of fending for oneself. Despite Louisa taking offense when Chris Parsons remarks at the post funeral gathering that after Martin leaves for London, she’ll have to fend for herself (S5,E2), I do not find any reason to consider the idea of “fending” demeaning. In Louisa’s case, she has understood the comment to indicate that Chris thinks it will be hard for her to handle all the responsibilities of childcare and work on her own but, as an independent and self-sufficient woman, she has not thought of Martin as being any more than their baby’s father and her significant other (mate?). She likes knowing he’s there to assist and share duties, but she isn’t dependent on it. Whatever Louisa finds offensive, the fact is that most of us use “fend” in a positive manner, even an assertion of self-assurance. As I see it, the many older female characters in DM are generally on their own and must handle their affairs without any evident help from spouses, children, or other relatives. (There are a few exceptions to this: Muriel Steel has Danny; Beth Sawle has Janet; Helen Pratt has Phil; and Mrs. McLynn has Mr. McLynn. We may or may not consider these counterparts as helpful.) In essence, they are all fending for themselves quite well.

Aunt Joan seems perfectly capable of fending for herself by managing her farm, including chickens, sheep, and vegetables. She comes up against some money difficulties when the downturn in the economy reduces the sales of her vegetables, but she is resourceful and decides to turn her home into a Bed and Breakfast Inn. The Inn never has a real chance to take off, but neither her brother and his effort to take the farm away, nor any financial troubles are able to wrest the farm from her. Not only that, but Phil Pratt and his rifle don’t ruffle her either. She also has her own opinions that she has no hesitation expressing. She’s kind, caring, and motherly while also being strong-willed, determined, and independent.

The Ellingham family has a powerful stubborn streak along with high intelligence and self-sufficiency. Ruth, like Martin, has always lived alone and has no trouble keeping herself busy. She takes up residence in Portwenn and manages to write a book. Furthermore, she continues to consult on criminal cases. Ruth, like Joan, has no antipathy towards people in general, and she interacts with Al, Penhale, Louisa, Mrs. T, and others with insight into their personalities, which we’d expect from a psychiatrist. However, she also has no inclination to share her life or home with anyone else. Like her sister, we see her take matters into her own hands in difficult situations. She deals with the Dunwiches despite the possibility of danger; she handles Robert Campbell without much trepidation; and she immediately shows sympathy for her neighbor Mr. Moysey when he takes ill. She’s been damaged by her upbringing, but she bears few of the scars that plague Martin. Fending is really quotidian for her.

Moreover, both Joan and Ruth often make us laugh. The first episode brings Martin out to reunite with Aunt Joan only to be handed a chicken in order to snap its neck. Next she brings Martin inside and plans to chop off the chicken’s head while he sits at the table. The scene immediately makes him uncomfortable and lets us know that Joan is a no nonsense woman. But Ruth is the aunt that makes us laugh the most. Her dry wit is also in evidence from the moment we meet her and it continues throughout. These two women are key to the structure of the show because of their age. Wisdom may come with age, but so does confidence and imperturbability, at least for these two women.

Besides these two main characters who contribute to the humor of the show, many of the other older women play a major role in adding humor to the show. The two women who liven up S6E4, Mrs. Eddy and Ethel, are the ones that stand out. They have gotten infected by self applied tattoos that read “Do Not Resuscitate.” They are members of a tea club that has pooled its money to buy a medical dictionary. Now Mrs. Eddy feels qualified to diagnose a melanoma. (Of course, as in so many of the cases Doc Martin sees each day, these patients have decided for themselves what is wrong with them and exasperate Doc M. And, as so often happens, they are totally wrong.) The bottom line is that these elderly women are quite aware of their circumstances and have taken matters into their own hands. They’re getting old and physically weaker so they’ve bought an ink gun off the internet and made sure that if they are unable to tell anyone directly, the medical personnel will see clearly what their wishes are. Mrs. Eddy is bright eyed, obstinate, and vigorous. Still, she doesn’t want to trust that the medical establishment will follow any medical directives in her file. Furthermore, these women have been quite resourceful, using modern conveniences like Ebay to make purchases. The tea club appears to be filled with older women who discuss important personal issues rather than sitting around sipping tea and eating cucumber sandwiches. Ethel, who makes a joke out of showing Doc M her tattoo, has also got a rodent ulcer. Once the doc tells her he can remove it, she’s ready to have that done immediately. Old women are not ones to wait. In the last episode, Ethel returns and incorrectly receives a rabies vaccine. Her complaint is of a headache, but Doc M is so distracted by Louisa’s plans to leave that he mistakes her for a different patient. In this scene, too, Ethel is demanding and outspoken. Even during these very troubling moments, she shows no mercy.

Indeed the older women in this show can be best described as feisty, or gutsy, plucky, and overall lively and aggressive. Doc M quizzes Muriel Steel about orientation to day and time and she responds with an answer much more complex than expected, then he prescribes a certain medicine and she hides it in the plant; he tells Beth Sawle to take antibiotics and her sister Janet gives her her own concoction; he tells Mrs. Selkirk she’s hallucinating due to her husband’s sudden death, she objects, and it turns out to be Lyme disease; Mrs. McLynn can’t see so she uses her husband as her guide and refuses to stop driving; he tells Mrs. Averill to stop smoking and she sneaks cigarettes. All of the above include a large dose of humor in each incident while also being good examples of all sorts of difficulties with older patients that doctors have to deal with.

I don’t want to end this post without mentioning the most devious and gutsy older woman of them all, Margaret. We may laugh and find the other older women exemplars of the best kind of aging we can all aspire to; however, Margaret is in a class by herself. She is the only older woman of the group who is imperious. Our introduction to her is accompanied by her unwillingness to be at all congenial even though she hasn’t seen or talked to her son in seven years. Then, when she does finally talk to him, she says extremely hateful things. That same attitude continues in S6 when she returns, and by the end of her visit, she has cemented our impression of her as unkind, judgmental, and dishonest. She’s gutsy, but in a totally different manner from the others. In her case, her aging has solidified her abhorrent qualities.

I think we can say that the older women in this show add dimensions that wouldn’t be possible with only younger characters. Their bodies may be failing them, but their personalities are intact. For the most part, at their stage in life they are doing their best to approach the end of life with sanguinity (there’s that word again!). Apart from Margaret, they are a good way to look at aging.

Originally posted 2015-01-21 19:24:26.

“Into the Woods”

Since it looks like this may be a good time to write about something new, I thought I’d post this little observation just for fun.

I recently saw the movie “Into the Woods” and loved the concept of all sorts of characters from fairy tales being brought together because they must travel through the woods to reach their destinations or complete their missions. The woods have always had the connotation of being dark and scary and we can recall Hansel and Gretel getting lost in the woods, or “The Princess Bride” using the woods for all sorts of fearful objects to overcome. Certainly Little Red Riding Hood has always taken a path into the woods to find her grandmother’s house. In this film Cinderella also escapes by running into the woods, Jack (of beanstalk fame) takes the cow to market by walking through the woods, and Rapunzel lets down her hair while being held prisoner in a tree in the woods.

It occurred to me that, like other examples I used in my post of  June 16, 2014, titled “Doc Martin and the Mystery of the Folktale,” having Martin and Louisa enter the woods (and even mention there’s a difference between a forest and a wood) is another way the writers of the show undercut the concept of the fairytale. In these woods our couple encounter scary animals, an obstacle they must find a way around, and an old man who makes his home in the woods and from whom they seek help but who treats them as intruders instead. Aren’t these all the ingredients of a fairytale? But here, as before, the animal isn’t ominous or threatening-it’s a pony who is just as scared of them as they are of him; the brook they must cross is dealt with by Martin giving Louisa a piggy back ride (after first trying to put her over his shoulder) while they argue (amusingly) over the idea of going on a honeymoon; and the old man turns out to need their help and ends up in a wheelbarrow being (humorously) pushed by them to safety.

They have used all the tropes of Fairytales and turned them into comedic events.

Originally posted 2015-01-17 12:17:16.

Making Hard Choices

Recently I read an article by Ruth Chang, a professor of philosophy at Rutgers University, and then watched her TED talk.  The talk had to do with what makes some choices hard; the article was closely related to that but also about being the person you want to be and creating a new you. When she refers to hard choices, she’s talking about decisions we make between two options that are “‘on a par'” or between alternatives that are equal in value and are difficult to choose between because of that. There is no wrong answer, but they may not be equally good either. What she argues is that the choice we make must be something we can stand behind and commit to and thereby turn it into a position of value. To me, the strongest statement she makes in the article is “when we choose between options that are on a par, we make ourselves the authors of our own lives.” This assertion reverberated with me because it sounds very similar to what Ruth tells Al when he’s at loose ends. She tells him in S6E6, “we are the authors of our lives.” (I doubt the writers knew about Ruth Chang. Her TED talk was given on June 18, 2014 and the filming of S6 was over by that time. However, her earliest articles on this subject appeared in 1997 and thereafter she continued to write about this subject regularly.) Like so many interesting issues in human behavior, there are both psychological and philosophical ways to view them.

There are many hard choices confronting Martin and Louisa. We have been discussing the personality traits of these two characters. Presumably these would play a role in how they would go about deciding between the options they must face now. Ruth Chang’s article uses the tradition of making resolutions for the New Year as a starting point and ends by noting: “Our task then is to reflect on what kind of person we can commit to being when making those choices.” I think we can put this to work for the situation at hand, especially because it relates to making changes that can lead to being a different person, and change is what Martin plans for himself.

I’m going to take a stab at some of the hard “on a par” choices Martin and Louisa have to make and see what all of you think about these and what others you come up with.

1. Louisa must decide whether to return to the house. The alternative is to live in Portwenn and be separated (right now she can’t leave because of her recent surgery). This decision would be on a par because Louisa loves Martin and wants to be married and parent JH with his father; however, Louisa knows being married to Martin is difficult and Martin would continue to have a relationship with JH even if they lived apart.

2. Martin must decide whether to confide in Louisa and admit he needs her help. The alternative is to decide that he continues to be unable to have an intimate conversation with Louisa. This decision is on a par because Martin wants to be with Louisa and he recognizes that she has been very disturbed by his secrecy and unwillingness to reach out to her; however, Martin struggles to allow anyone into his inner world and he knows it will be arduous to convert himself into someone who asks for help and shares his thoughts.

3. They must decide whether to seek counseling, marriage or individual or both. The alternative is to try to reconcile on their own, possibly with Ruth’s help. This decision is on a par because both Martin and Louisa are aware that a counselor could be helpful and counseling has been recommended by both Edith and Ruth; however, Martin is skeptical of most counselors and likes to manage his own care, and both of them will want to go to counseling in a location not well-known by Portwenn villagers. Finding a way to budget the time for that may be too much trouble.

I could go on, but I’ll leave it to you to suggest other hard choices. I’d like to consider how this philosophical view can be combined with the psychological traits we’ve been discussing too.

In addition, I’d like to refer you to an article by Ruth Chang titled “Commitments, Reasons, and the Will” in which she discusses internal commitments. On page 78, Chang explains, “a promise to love and to cherish has greater normative significance than that of incurring an obligation through a promise. This is because it is backed by an internal commitment—something the promisor has done all by himself that gives his subsequent promise special significance or meaning.” We know Martin is a moral man, and we consider Louisa moral as well. They have taken the step to get married after having many vacillations in their interaction as a couple. Now that they’ve taken a vow to be together, they have made an internal commitment that Chang makes a strong argument about — it changes who they are and the significance of their relationship. That has to play some sort of role in what they decide to do and in what kind of people they want to commit to being.

Originally posted 2015-01-14 17:16:21.

And we’re back!

Happy New Year to everyone! I hope you all had a good holiday and are ready to get back to our discussion about the MBTI and the personality traits of Martin and Louisa Ellingham. I’ve had a few moments to think about my view of where these two characters would land on the MBTI spectrum. When I took the MBTI as if I were Martin Ellingham, I came up with ISTJ, or The Examiner. All of the traits had percentages of 90-100%. (Here’s a description of the ISTJ from one website.)  When I took the inventory as if I were Louisa, the results were ENFJ, or The Mentor, but the Extroversion trait was the strongest while the others were in the 60-65% level. (The same website gives this description for the ENFJ.) While answering the questions as each character I noticed where they would overlap in their approach. To me, Louisa is often just as grounded as Martin and relates to the world on a practical and realistic level to a great extent.

It was a fun exercise and I look forward to reading more comments from you about this and to reading what Abby will write when she gets a chance.

I have also read another article about introverts that I would like to refer you to. This article was helpful to me in several ways. I was impressed by the mention of phone conversations being difficult for introverts because I have previously noted that ME often neglects to use the phone when it would be most convenient and expected. In addition, the article notes how much introverts prefer being on stage to being in a mass audience and making small talk. That led me to think that the move for ME from London to Portwenn actually might have been better for him than he realizes. It took him away from the surgery he loved and felt especially accomplished at, but it also removed him from a large city where he was surrounded by commotion and many people all the time. Essentially he is on stage in Portwenn because of his position as GP and its importance to a small town. He continues to dislike small talk, and we see this at the party for Joe Penhale in S3 when he takes Louisa aside rather than mingle with the other partygoers; nevertheless, in Portwenn he has more time to himself despite the fact that being a GP requires him to interact with patients more than being a surgeon had.

I think we can all agree that the most significant difference between these two characters is that Martin is quite prominently an introvert and Louisa is just as much an extrovert. I think they can both be seen as having had some influence on each other relative to these major differences between them. As series 6 advanced, Louisa was able to encourage Martin to interact with the community more in small ways, e.g. attending the school performance, taking JH to the music circle. At the same time, she also appears to have accepted his desire to stay home and there are no more occasions where she goes out with friends while he takes care of JH. Once again I can’t make the argument that there is any effort by the writers to deliberately reference these two characters’ markedly different ways of dealing with the outside world. However, the introversion/extroversion distinction is so pronounced in these characters, that we have to imagine it was planned.

It’s nice to get back to the blog. Please join the conversation!

Originally posted 2015-01-04 14:19:01.

Myers-Briggs Personality Test

The following is a further explication of the Myers-Briggs personality test that we have discussed in earlier posts. Abby has put together an introduction to the test that should give you a good overview of it. In addition, she has provided a link to a website where you can take the test yourselves. Then, if you like, you can take it as if you are Louisa and/or Martin (and hopefully base your answers to the questions on what you know about them through the show) to come up with their profiles. It will be interesting to see how similar our results are and how they compare to what Abby’s findings are. Of course, all of this is meant to be a fun exercise and not predictive of anything. We hope you enjoy this as illuminating, yet simply another way to look at these characters.

Abby writes:

The post “Dr. Martin Ellingham, Patient” seems to have sparked an interest in learning more about the Myers Briggs Type Indicator (MBTI). While I am not an expert in the MBTI, I do use it with most of my clients in order to 1) understand them better; 2) help them understand themselves better; and 3) help them understand other important people in their lives. So, what follows is an explanation of the MBTI model, as I understand it.

There are a number of personality instruments that have been developed over the years. Some are meant to help mental health practitioners with diagnoses; some for use by business and government for hiring purposes; and a few meant to help people understand themselves better. The MBTI is in the latter category, and, as such, does not pathologize. Indeed, every type in the MBTI model is deemed as having the same worth as any other.

The MBTI was developed by a mother-daughter pair of researchers, Katharine Cook Briggs and her daughter, Isabel Briggs Myers, based on Carl Jung’s work on archetypes. The MBTI looks at four aspects of how we function in the world. Each of these four aspects has two possibilities, or preferences, as they are referred to. So, a person who takes the test ends up with four letters, which is their type. The four dichotomous aspects are Extraversion/Introversion (E/I), Intuition/Sensing (N/S), Feeling/Thinking (F/T), and Judging/Perceiving (J/P). It is important to understand that each of these four dichotomous pairs falls on a continuum. That is, we are not all one and none of the other.

The first, E/I, describes how people “recharge their batteries”. It also involves whether we focus our attention primarily on the outer world or on our inner world. So, the questions to ask yourself are 1) When you are tired at the end of the day, do you recharge by going out and being with friends (E) or by going home and being by yourself (or with one or two other close people)(I)? 2) When you are at a party, do you feel energized (E), or do you tire out early in the evening (I)? 3) Do you consider yourself an observant person (E), or do you miss things because you are so focused on your inner life (I)?

The second aspect, N/S, describes how a person gathers information, or perceives things. Sensing types perceive things through their five senses, and are concrete thinkers who tend to be practical people focused on facts and details. Intuitive types perceive things through internal processes in the mind. They are abstract thinkers, who tend to see the big picture and are interested in theory. So, if there were a group of people tasked to do a project, the intuitives would be the ones to come up with the overarching ideas, while the sensing types would take those ideas and figure out how to make the project happen.

The third aspect, F/T, describes how a person makes a decision, after gathering information through intuition or sensing. This is the only aspect where there is a statistical gender difference: Men are 60/40 T/F, while women are 60/40 F/T. Thinking types base their decisions on logic, while for feeling types incorporating values and human impact are important. So, if you have a married couple, where the husband is a thinking type and the wife is a feeling type, and they are planning a road trip, the husband would likely choose the most direct route (logic) to their destination, while the wife would likely want to make a detour to visit Grandma (values/people).

The fourth aspect, J/P, describes how we structure our lives. Judging types tend to be organized, to like routines and schedules, and are good at completing tasks. They also tend to have fixed ideas about how things should be. Js love the closure that comes when a decision is made and feel anxiety when things are open-ended. Perceiving types, on the other hand, are not comfortable with routines and schedules, but prefer a lot of flexibility. They tend to be spontaneous people who are open and flexible in their thinking. They love possibilities, and so feel anxious when having to make a decision, because once the decision is made, all of the other possibilities disappear. Because of their love of possibilities, Ps tend to jump from one task to the next, not finishing the first before they start the second.

As was said above, all of the pairs should be viewed as being on a continuum. Therefore, we may be 60% feeling and 40% thinking. If we are close to 50/50, we will display behaviors of both preferences. If we are more toward the ends of the continuum, we will mostly show our stronger preference. We can, and should, draw on the less preferred preference when appropriate. So, going back to our couple taking the road trip, the husband would be able to see his wife’s point about visiting Grandma, even though his mind didn’t automatically go there. And, his wife is perfectly capable of seeing the logic of taking the most direct route. The MBTI is not about putting people in boxes, but simply to help them understand their “default settings”.

If you would like to take the test yourself, here is a free website: If you take it, be sure you answer the questions quickly, not thinking too much. It’s important to answer as you really are, not the way you wish you were or think others want you to be.

After reading this post and perhaps taking the test, please jump in and make your guesses as to Martin and Louisa’s types. Once we have some responses, I will share my guesses with you. Keep in mind, there are no right or wrong answers on this, because these are fictional characters (WHAT?!) we are talking about. I look forward to reading your replies.

Originally posted 2014-12-20 13:35:57.

A look at Mindfulness

Abby mentioned recently that she would recommend Mindfulness among the therapies useful for dealing with many of the symptoms Martin Ellingham seems to be suffering from. Coincidentally, “60 Minutes” last Sunday had a piece on Mindfulness and I thought I’d provide the link. I would also recommend watching some of the additional segments with Anderson Cooper, especially the Mindfulness and Technology one.

In addition, Abby wants everyone to know that besides the breathing and walking exercises shown by “60 Minutes,” there are other ways of following the breath. “Then there are focusing on the body, focusing on a mantra, and disciplines like Yoga and Tai Chi.  There is also simply noticing anything that comes into your awareness and then letting it float by,” according to Abby.

I found this article on Mindfulness that seems worth mentioning. I don’t think ME has as much anxiety as this author, maybe very few people do, but there is something to this method that seems to really work.

I’d love to hear from anyone who has tried it. I’ve tried meditation and now know I should practice it more frequently – like every day! It looks as though we could all benefit from being more Mindful.



Originally posted 2014-12-17 11:49:46.

NHS News

The following is something I have been thinking about for a while and decided it was time to put it on the blog. It’s not nearly as exciting as some of our other topics, but I think it’s relevant. So here goes:

I am very interested in what’s going on in the UK with their National Health Service for two reasons. I want to understand it better to be able to judge its role in “Doc Martin” and because I want to know how it compares to our health care in the US. I read the BBC News every day for many reasons and I’ve been collecting articles about the NHS. Before I lose track of all the articles, I wanted to post them and make some comments about them.

The way I propose to list these articles is not in chronological order, but in order of significance based on how their content affects health care and can be a reflection of what we see on DM.

The first article was published recently (Nov.) and refers to at risk GP surgeries. Ever since the “doctor’s friend” showed up in Portwenn, I’ve wondered how GPs are monitored. This article makes clear that there is a Care Quality Commission that is a watchdog that pays attention to how patients are treated. According to the article “the CQC look at whether surgeries are safe, effective, caring, responsive, and well-led.” Thus, Gavin Peters was properly looking into the GP in Portwenn following some complaints, and ME was performing all his duties correctly with the possible exception of the “caring” part. As they say in the article, “‘it is only when we inspect we can determine if a practice provides safe, high-quality and compassionate care,'” said CQC chief inspector of general practice Prof Steve Field.” Compassion is the question in ME’s surgery. It’s not clear if ME ever took that course Peters recommended. But it’s clear that caring and compassion are considered essential ingredients to good health care in UK. (Of course, I think we can all agree that those sentiments are important to good care here too. Not only do we prefer to be treated with compassion, but also there have been studies that demonstrate the value of compassionate care by doctors on the outcome of their treatment, e.g.

Another article notes a small number of GP practices have been getting complaints and the CQC has ranked all GP surgeries based on risk of providing poor care. And there has been an increase in complaints made about NHS care, according to this article. Then there is the concern that GPs may be missing diagnoses of lung cancer as a result of not having the proper tools. This article also blames patients for not seeking medical care in a timely fashion. I can imagine that how welcoming the GP is towards his/her patients would be a factor here. There is some tightrope line that must be walked between making sure patients who make appointments are the ones who have valid complaints and patients who need to be seen don’t neglect to come in. On the other hand, there is also a move to punish doctors more harshly for making mistakes, according to this article. In one case reported by the BBC, a doctor was sacked because of substandard care.

In a related article, there is a discussion of how many GPs will be retiring soon, leaving the remaining GPs to take care of more patients. In addition, there is a shortage of GPs entering the medical profession and this article mentions that the NHS needs to increase spending on training GPs and more GPs will need to be recruited. If ME decides to return to doing surgery, finding a new GP for Portwenn might not be so easy. Also, as an adjunct to the first article, the CQC may not have many options when it comes to demanding more compassion from Martin; they may just have to be content that he has so many of the other qualities.

Surgeons are not immune to oversight by the NHS and one article reports that they must publish their mortality rates or be sanctioned.

Not surprisingly, the NHS has some money problems and, according to this article increased funding is something that’s been requested. In October there was a strike by health care workers demanding more pay.

The systems of health care are quite different between the UK and US, yet UK is struggling with many of the same issues we have here in US. The show hasn’t done much with these problems, although I remember Pauline thinking she should get paid more because she was now a phlebotomist as well as a receptionist. Also, like the UK, the US is seeing a shortage of physicians and it’s a concern in terms of access to care, see this article for one. The other thing that we see in DM that is of interest is the procedure for registering with a GP in UK. The GP is usually associated with your postal code and the length of time you plan to be a resident in said location. The minimum stay is 3 months to qualify to register with a GP. New patients can be rejected if the GP is not accepting new patients. In US physicians may consider their practices full too and be unable to take on new patients, but there are no residency requirements. In DM there have been a few occasions when new patients have visited Dr. Ellingham to register, e.g. Julie, the Oakwoods, and it seems they have departed before being residents for 3 months. I’m not sure what actually would have happened with their registration.  All of the above provides some opportunity for a secondary storyline.





Originally posted 2014-12-13 13:02:47.

Dr. Martin Ellingham, patient

The following is an intake assessment of Dr. Martin Ellingham completed as if he were a new patient seeking therapy. It was written by Santa, a retired counselor, with input and advice from Abby, currently practicing as a therapist. I contributed to some degree, mostly by asking questions and getting clarifications. I think you will all find this quite enlightening. Santa exposes many insightful details about ME as her assessment summarizes all that we have learned about Martin Ellingham relevant to what a therapist would want to know. As she has told me, she is impressed with how many personal details the show writers have provided from Martin’s life throughout the 6 series. I am convinced that her efforts will inspire much discussion. I invite any other readers of this blog to add observations of their own.

This initial analysis is meant to provide a basis upon which to elicit various treatment protocols and approaches to therapy for this “patient” from any of you who might venture to recommend them. We are interested in any treatment plans you might like to suggest.

As you will notice, we have included medication in his care. We figured Ruth would be likely to refer Martin to a psychiatrist and that he would prefer to be seen by an MD. Most psychiatrists would recommend medicines. On the other hand, we consider it important that therapy include establishing a relationship with someone who is competent in many sorts of therapeutic methods. Santa and Abby believe Martin would benefit from individual therapy as well as couples therapy with Louisa. Of course, we have no idea how the show will handle therapy in series 7, but since there are only 8 episodes in each series, we expect that couples counseling may be all we see.

Presenting Problem:  Martin Ellingham, M.D.  was referred by Ruth Ellingham, M.D. (his aunt).  Dr. Ellingham says that he has sought help because his wife of 6 months has recently told him that she is not happy in their marriage and needs to take “a break.”  She told him this shortly after she had a serious accident, which patient believes he was instrumental in causing.  She was in fact on her way to Spain with their 9 month old son, to visit her mother for an undetermined period of time, when she was forced to return to Truro for emergency surgery to correct a potentially life threatening arteriovenous malformation.  The threat of losing his marriage is a source of deep distress for Dr. Ellingham. He acknowledges that he must “change” in order for their marriage to succeed.   However, his desire to change is not very specific and he is uncertain about how to proceed and what he needs to do in order to be “a better husband.”

He further states that for some time before his wife indicated her unhappiness with the marriage, he had been preoccupied with worries about his health, precipitated by a return of a hemophobia.  He had lost his appetite and was sleeping poorly.  He tried to self-diagnose a physical disorder that might be causing these somatic symptoms; he did not consult a physician.  He also reports increased irritability and decreased libido during this period.   He states that he “shut out” his wife from these concerns, although he can’t explain why he did so.  He believes this to be one source of his wife’s unhappiness and frustration with him. Furthermore, he states that he has never understood why she was attracted to “someone like me.”  He now acknowledges that these somatic issues may have an emotional origin and is interested in exploring issues in his family of origin that may relate to his present difficulties, especially as they may relate to his wife’s decision to take a break from their marriage.   He denies that the return of his phobia has anything to do with his marriage, stating that he loves his wife and son very much.  He reluctantly admits, however, that the chaos and disorder attendant upon life with an infant, as well as sharing his living space for the first time, and with someone who doesn’t share his habits of tidiness, sometimes have been difficult to deal with.    He says that he has been eating and sleeping a little better since he made the conscious decision to seek help in order to “change.”  He admits to being “very sad” from time to time at the prospect of being separated from his wife and son.

Mental Status, Affect and Mood:  Dr. Ellingham is a tall, immaculately groomed Caucasian man, formally dressed, in his late 40s, who appears to be his stated age. His clothes are somewhat loose and he says that he has lost weight.  His affect is restricted, and his mood is somewhat dysphoric. He denies suicidal ideation.   He shows no evidence of a thought disorder; he is oriented and his judgment is unimpaired.  He makes good eye contact and is responsive.  His answers are concise and to the point.   His insight into his difficulties is somewhat limited.  During the interview, he occasionally appeared anxious or irritated, or sad, but these emotions were quickly suppressed.

Substance Use:  Patient states that he disapproves of liquor and never drinks.  He has never smoked, or used any banned substances.

Relevant Psycho-Social History:  Dr. Ellingham is currently a General Practitioner in Portwenn, Cornwall.  Formerly, he was a surgeon in London, for 12 years head of Vascular Surgery at St. Thomas.   About 5 years ago, he suddenly developed hemophobia, disabling him from the practice of surgery.  He reports that the phobia developed when operating on a patient who he had recently seen interacting with concerned family members.  Their concern and affection for the patient suddenly struck him in a way that was unusual for him.  He was unable to finish the operation or to perform any subsequent operations.   He retrained as a general practitioner, and relocated in Portwenn, a place where he had family (an aunt, since deceased) and had spent time as a boy.  It is unclear why he chose to retrain and relocate rather than to seek treatment for his condition.   About a year ago, he utilized cognitive-behavioral techniques to desensitize himself to the sight and smell of blood.  This succeeded enough that he felt able to apply for and accept a position as surgeon at Imperial Hospital in London.  This position was not taken up, as he decided instead to marry the mother of his child and remain in Portwenn, where she was most comfortable.  He states that he detests Portwenn, and finds dealing with his patients frustrating on account of their unwillingness to follow advice or sound hygienic principles.   He denies, however, that foregoing the opportunity to resume his career as a surgeon, and living in a place that he dislikes, have anything to do with his dysphoric mood or the return of his phobia.

He reports that he did not expect to marry or to have a child, and his relationship with his current wife has been tumultuous, marked by missteps, separations and miscommunication throughout their courtship and in their marriage.   Nevertheless, he states that he is deeply in love with her, and has been since their initial encounter several years ago.  (She is head teacher at the primary school in Portwenn.)  They did not begin living together until after their son was born, and the decision to marry was not made until 3 months after that.

Patient states that this is his first marriage and his first serious relationship since he was in medical school.  His first real relationship  ended when the woman, a fellow student, chose to leave England to study abroad.  He reports that he was devastated by  this.  With few and brief exceptions, he has neither sought nor welcomed female companionship thereafter.  At the same time, he is clear that his orientation is heterosexual.

Social Supports.  He has lived alone all his adult life.  He reports few friendships of any significance, with the exception of a former classmate from medical school, who is now the head of the Cornwall NHS, and who helped him to relocate and later in his effort to find a job in London.  He does admit to being friendly with one or two inhabitants of Portwenn.   He was fond of his aunt, now deceased, who was living in Portwenn when he relocated, and she was a source of support to him both when he moved to Portwenn and as a child.  He is close to another aunt who now lives in Portwenn, and she is perhaps the only person in whom he feels he can confide.   He reports that he has little time for social niceties, which he considers “rubbish,” and always speaks his mind.  He admits that some may find his manner abrasive.  In any case, he feels that finding a friend among the inhabitants of Portwenn is highly unlikely, as he finds most of them extremely irritating.  He has no church affiliation. His sole hobby is repairing antique clocks, an activity that he does alone. His wife does not share this interest.

Family of Origin Issues:  Patient reports a long-standing estrangement from both parents.   He had no communication with them at all for seven years, until a couple of years ago, when they showed up to ask for money and announce their separation.  During this visit, his mother made clear how much she had always resented and disliked him, to the point of saying that she wished he had never been born.  Predictably, the visit ended badly, and he had no further communication with them until a few weeks ago.  At that point, his mother arrived unannounced, and told him that his father had recently died and she had come to re-establish a relationship with him as her sole remaining family.    It developed that she was without financial resources and that  her real goal in contacting him was to obtain from him enough money to support herself.   Upon realizing the extent of her duplicity, Dr. Ellingham asked her to leave his house and indicated that he desired to sever all further relations with her.

Patient’s childhood was marked by bedwetting, social isolation, ridicule and shaming from both parents, little affection, and harsh punishments, including spanking with a belt and enforced enclosure in small spaces for seemingly trivial infractions.  His aunt recently told him that between the ages of 4 and 6, his behavior underwent a change and he became significantly more defended.  He was sent to boarding school from age six on, where he notes that his bedwetting and social isolation continued and he was the object of considerable bullying.  Uncoordinated and physically clumsy, he did not participate in team sports.    He was, however, good at chess and derived some pleasure from winning competitions.

Patient’s father and grandfather were surgeons, and patient seems to have internalized their belief that a surgical career was the top of the medical profession, and that being a GP was far inferior.  His father was contemptuous of his position in Portwenn.

Patient reports that he had only very recently come to understand that he did not deserve his parents’ treatment of him and that, in fact, it was abusive.   He notes the contrast between his childhood, and his wife’s and his own loving interactions with their son.    He wonders if he might possibly have developed a sense that he does not deserve to be treated lovingly.

Summary and Clinical Assessment:  It should be noted that Dr. Ellingham has recently experienced multiple significant stressors, including recent marriage and fatherhood, marital difficulties, death of a parent, and the severing of ties with his mother.   At this point, he certainly meets criteria for a diagnosis of Major Depressive Disorder, with periods of sadness, loss of appetite, difficulty sleeping, loss of interest in usual activities, increased irritability, and feelings of worthlessness, and guilt.  He has agreed to a trial of anti-depressant medication, and medication to help him sleep.

Dr. Ellingham has a specific anxiety disorder, i.e., hemophobia.  The hemophobia is of secondary clinical concern, although it should be addressed at some point, ideally by returning to a course of desensitization, supervised by a cognitive-behavioral therapist to make sure he reaches a point of “overtraining.”

Dr. Ellingham has few interpersonal skills, and little understanding of their utility.  He tends to have little empathy with others, and has lived as a social isolate for most of his life.  He makes good eye contact, however, and his lack of empathy may well be a result of suppressing emotions he considers “soft” rather than an inability to sense the feelings of others.  While a diagnosis on the autism spectrum, i.e., Asperger’s, can be kept in mind, this interviewer does not currently find much support for such a diagnosis

The clinical impression of this interviewer is that Dr. Ellingham is a man of formidable intelligence, who learned very early in his life to formulate a defensive structure that protected his deep sense of vulnerability and defectiveness.  This was necessitated by emotional and physical abuse, but more significantly, a profound failure of maternal attachment.   This defensive structure includes an insistence on order and control, on minimizing affective reactions, and on a degree of autonomy and lack of entanglement in relationships that might expose his neediness and vulnerability.   In short, intimacy presents serious difficulties for him.  He is unable to seek help from others, and because this “counter-dependent” structure emerged so early – certainly by the age of 6 or 7 – he has been unable to manage or integrate emotional responses that occur in later life.  Another way to say this is that much of his emotional development has been frozen at the “child” level.  Thus, “falling in love” was an experience which essentially blind-sided him, and for which he was in no way prepared.   Ultimately, this impulse was too strong for his defensive structure, and he acted on it.   The burden, however, of living intimately with a wife and child and surrendering much of his sense of control, has been another major stressor, under which, this interviewer believes, his anxiety disorder, as well as other somatizing symptoms,  re-emerged.

It is this interviewer’s impression also that his feelings about his loss of his surgical career, both from his hemophobia and the decision to remain in Portwenn, are unresolved and probably contribute to his depression.

Last, there is a hint of some traumatic event between the ages of 4 and 6, which should be explored as the therapeutic alliance becomes stronger and the patient’s symptoms of depression are resolving.

Recommendations:   Dr. Ellingham’s wife, Louisa, should participate in some sessions with the treating therapist.  He has never been able to share much of his inner self with her, and may need support and assistance in doing so.  Helping her to understand his difficulties may go a long way toward healing their marital problems.    Couples counseling is also recommended, if his wife will agree to it.

Nevertheless, Dr. Ellingham could benefit from individual therapy.  He has many losses to grieve, among them the loss of his career (and identification) as a surgeon, and the loss of his parents, both now and as a child.  He needs to repair a sense of himself as defective and undeserving of love.  He certainly needs to develop better access to his own emotional life.   A cognitive-behavioral strategy or “restructuring” negative thoughts would be a good place to start.  The experience of a therapeutic alliance with a treating therapist would be of significant benefit to him.



Originally posted 2014-12-07 14:34:19.

Love Actually (I Know, Not Original)

[Something weird is going on with my blog right now and I can’t figure out how to change it. Please do not click on any links that have the green circle with arrow. They should not be there. I’ll keep trying to remove them.]

As has happened many times in the past, the NYTimes published an article last Sunday that can be applied to this show. (I first learned about it from Santa, and I thank her for bringing it to  my attention. I rarely miss articles in the Sunday Review of the NYT because there are often so many good ones. I’m glad I’ve taken this long to publish this post because the Sunday NYTimes from this week contains several letters in reaction to the article.) Anyway, the article was written by Alain de Botton, a Swiss-born, British-based philosopher who has been elected as a Fellow of the Royal Society of Literature (FRSL), which appears to be quite an honor. He has been writing novels based on the philosophy of love and marriage for some time. This particular article precedes his forthcoming novel The Course of Love and is titled “Why You Will Marry The Wrong Person.” He has some singular ways of viewing marriage.

Botton covers several pertinent issues related to what we’ve seen going on between Martin and Louisa that I want to take on individually. (This article will also give me a chance to reference several of my previous posts and I hope it won’t appear presumptuous if I call your attention to those whenever it seems appropriate.)

The first thing that jumped out at me was his use of the adjective “normal.” To quote him: “We seem normal only to those who don’t know us very well.” I’m pretty sure his use of “normal” here is the common usage that each of us goes about the day fitting into society. And it is generally true that most of us aren’t walking around muttering to ourselves or making strange gestures in public. But, as a philosopher, Botton must be aware that the word “normal” is loaded, as Dr. Timoney says.  [As you probably remember, I wrote a post on what the term “normal” means on Jan. 12, 2016 named “Normal Is A Loaded Word.”]

Nevertheless his concluding paragraph begins with: “Romanticism has been unhelpful to us; it is a harsh philosophy. It has made a lot of what we go through in marriage seem exceptional and appalling. We end up  and convinced that our union, with its imperfections, is not ‘normal.’” In this case Botton is using the term to connote some form of happiness that comes from an idealized notion of how a marriage should look. [ I wrote a post on 11-04-2013 called “Marriage As An Institution” in which I looked at all the reasons why Martin and Louisa would want to marry as well as some of the reasons they might have problems being married. In some ways that post is a companion piece to this one and you may want to read it. I’ve also written 6 posts on “Happiness.” After the subject of change and all of its manifestations, I’d say the topic of happiness is the next most frequent that comes up in the show.]

Although I think that when most people fall in love, they can’t help being blinded to some of the faults in their lovers, and it’s nice to have that period of time when love is blissful, lately we are becoming less likely to rush into marriage. Once you’ve been around your intended for a year or so, it would be surprising if you didn’t pick up on a few of their idiosyncrasies. We still make mistakes, of course, and sometimes that can be due to being a bit starry eyed; nevertheless, I think couples generally don’t miss those foibles in each other; they just believe they can overlook them or overcome them. In Martin and Louisa’s case, they have known each other and lived with each other over a fairly extended period of time. By the time they decide to marry they have had plenty of occasions that should have given them enough opportunities to recognize the potential areas of conflict. Despite all of these moments, we are supposed to believe that Louisa doesn’t realize yet that Martin is inclined to be unwilling/unable to share his innermost thoughts and fears with her. (Interestingly, one letter to the NYTimes notes that “marrying the right person…requires the strength to lower your walls. All of your walls, all the way down.” Apparently there are many people who erect walls and have to find a way to lower them.) We’re also supposed to believe that Martin continues to have trouble knowing what makes Louisa happy. She has explicitly told him at the end of S5 that she wants to hear him say “nice” things to her, and she has been pretty clear that it matters to her that he join her in some school activities. Moreover, they have both stated they plan to do their best to prevent James Henry from becoming as introverted as his father (if we remember what Martin says to Louisa during that conversation at the end of S5, and what Louisa says to Martin when she asks him to take JH to the music group).

Botton’s title for the essay refers to marrying the “wrong” person. What he really means is that people may have an idealized notion of what marriage should be like, and how a marriage should unfold. Botton relates our tendency to have false expectations to the circumstances we experienced during childhood, which definitely plays a role in how  Doc Martin  has been constructed. Botton asserts “we marry the wrong people because we don’t associate being loved with feeling happy.” This takes place if we have had troubled childhoods in which we’ve experienced feelings of “wanting to help an adult who was out of control, [or] of being deprived of a parent’s warmth or scared of his anger, of not feeling secure enough to communicate our wishes.” In Doc Martin Louisa has had to deal with parents who are out of control in the sense that her father’s gambling led to debts and possibly to problems between him and her mother. Martin has definitely been deprived of any warmth from his parents and on the receiving end of unjustified anger. He must have felt insecure. Thus, there is a sort of disconnect between the notion of love and that of happiness.

If Martin has no idea why it’s so important for people to be happy, and why he thinks happiness is overrated, it could be because he has never really known actual happiness. Now when he has brief flashes of happiness, they don’t seem to last, and Botton would consider this expected. Yet Martin is aware that Louisa finds being happy important, and we know that Louisa has had moments of happiness in her childhood (e.g. when her father took her for ice cream). Somewhere buried in Louisa, according to Botton, is that good sensation of happiness during her childhood that she wants to recreate.

But Botton is reassuring. He goes on to say “the good news is that it doesn’t matter if we find we have married the wrong person…We need to swap the Romantic view for a tragic (and at points comedic) awareness that every human will frustrate, anger, annoy, madden and disappoint us — and we will (without any malice) do the same to them. There can be no end to our sense of emptiness and incompleteness. But none of this is unusual or grounds for divorce. Choosing whom to commit ourselves to is merely a case of identifying which particular variety of suffering we would most like to sacrifice ourselves for.” And we can make a case for this point of view using the show as a guide. As a dramedy, Doc Martin uses both the tragic and comic aspects of marriage and shows us that some of the tensions arise out of situations we can laugh about. So when Martin wants Louisa to keep the baby quiet during his workday or when Louisa keeps the house less tidy than Martin would like, it’s amusing and these are very common problems.

By the end of S7, we have arrived at something akin to Botton’s view that “rather than some notional idea of perfect complementarity, it is the capacity to tolerate differences with generosity” that is the key to making a marriage work. Martin is willing to endure more noise and mess while Louisa has decided that she can accept Martin’s quirks. Botton concludes that “we should learn to accommodate ourselves to ‘wrongness,’ striving always to adopt a more forgiving, humorous and kindly perspective on its multiple examples in ourselves and in our partners” and believes that “compatibility is an achievement of love; it must not be its precondition.”

If we agree with Botton, then we can drop any difficulties we might have with whether Martin and Louisa are compatible, and should be married, and recognize that now they have reached a nexus point. Hallelujah!

[Some quotes from Alain de Botton:

“We fall in love because we long to escape from ourselves with someone as beautiful, intelligent, and witty as we are ugly, stupid, and dull. But what if such a perfect being should one day turn around and decide they will love us back? We can only be somewhat shocked-how can they be as wonderful as we had hoped when they have the bad taste to approve of someone like us?”
― Alain de BottonOn Love

“If cynicism and love lie at opposite ends of a spectrum, do we not sometimes fall in love in order to escape the debilitating cynicism to which we are prone? Is there not in every coup de foudre a certain willful exaggeration of the qualities of the beloved, an exaggeration which distracts us from our habitual pessimism and focuses our energies on someone in whom we can believe in a way we have never believed in ourselves?”
― Alain de BottonOn Love

Do you love me enough that I may be weak with you? Everyone loves strength, but do you love me for my weakness? That is the real test.

Alain de Botton]


Originally posted 2016-06-05 18:01:51.

Another post coming soon — Really!

I know it’s been a long time since I published a new post. I honestly thought I’d have one ready by now, but it’s taking me longer than expected. Please do not despair and desert the blog!! We will have several new posts very soon. I’m pretty sure you will like what’s coming up.

My next blog post will be of some interest, I hope. However, here’s a teaser for one that will be popular…Some knowledgable contributors to this blog are putting together something about the Martin Ellingham character that everyone should find exciting and powerful. We’ll try to publish it as soon as possible, so keep checking.

Thanks for your continued support and participation.

Originally posted 2014-12-04 22:23:09.

Some additional comments

I can see our comments have kind of slowed, and I haven’t posted anything new for a little while. I would love to see more discussion about acts of kindness and acts of nastiness or unfriendliness. There’s Mrs. T’s comment that Louisa only had the baby to catch Martin and then her drugged up diatribe about Louisa being a trollop; there’s Edith and her reprehensible decision to make overtures to Martin even though, or maybe because, she knows that he’s about to become a father; and Margaret’s comment to Louisa that she looks terrible when she returns from the hospital; and several other examples. A small town can pull together and help each other out, or it can have a tendency to be petty and self-protective.

I won’t say more about that, and I probably shouldn’t bring this up again either, but I found this article very touching and it makes a number of good points about how clothing can matter. I thought it was worth posting. I particularly like how the author’s mother chose to dress to instill some sense of control over her life. There’s little question that the way ME dresses gives him a sense of control and is part of his armor against the demands of life. We might think of Edith’s clothes functioning similarly and possibly Joan’s and the receptionists’ too.

I also found it lovely that when the author went for her own colonoscopy, she decided to dress in something that made her feel good (and reminded her of her mother). (On the other hand, I would never wear anything nice to a colonoscopy. No offense, but I just want to get in and out of there as fast as possible without much bother.)

I think we can all relate to associating certain clothes with loved ones. I’ve kept a few things in my closet that used to be worn by people who meant a lot to me. They are nice reminiscences. I realize the clothing posts have not been all that stimulating to you, but I’m obviously hardheaded and can’t help saying more.

I hope to write a few other posts soon, although I will be away for the next week. I’ll be checking the blog regularly, however.

Originally posted 2014-11-22 16:47:02.

The Kindness Factor, Part III

Part III

The Role and Significance of Kindness

I believe the kindnesses displayed by the three major female characters outlined above (Part II) play an essentially transformative role for ME’s character and the story line, allowing Martin to reject and transcend his past in order to accept his future.  Kindness begets kindness (or so said Sophocles). It transforms the arena where it is revealed, and it transforms the doer. It keeps us grounded in who we naturally are and it serves as a reminder to those unkind among us, to return to what was once their natural state. (Recall that the root of kindness is from Old English “natural,” something “innate”. Recall Elwood P. Dowd’s comments on overcoming time and space and life’s obstacles to reach a new reality, by being kind. (Part I))

In S2, E6, Martin’s parents appear in the show for the first time. They have arrived to suck out the half-share of the family farm Martin’s father Christopher wants to lay claim to.  Joan, who cannot buy him out and will have to leave the farm, is in despair. It is in this episode that Martin’s mother Margaret informs her son that he is the problem, and that “40 years of my life was wasted because of you.” Delivered in a matter-of-fact tone, this is probably the most devastatingly cruel and unkind remark made in the entire show.  No child should ever have to hear it. Yet Martin takes it stoically. Says nothing.

When Margaret returns alone to Portwenn in S6 E6, she announces Christopher Ellingham’s death. Margaret tries to manipulate Martin claiming his father loved him but couldn’t tell him. In that same episode, she feigns contrition and says she wishes to make amends with him, as “we are all the family we have left.”

Martin decides to stand up to Margaret, and taking James in his arms replies, “I have a family. I have a wife, and I have a son, and I have Ruth .”  What he is saying here is that he has decided that what he wants is the genuine family he has been rejecting through Series 6 (subconsciously), not the birth family he’s had. He is saying he is ready, finally, to move out of his comfort zone and accept the sticky emotional ties of wife and child and aunt and all that that has to offer in unconditional love and emotional affection. He may also know too, at some level, that choosing to love them, he will no longer “be in the way” or a “problem,” as Margaret told him he was for her, since his birth. (S2 S6.)

By S6 E7, the sports day scene has occurred and Louisa has had her car crash. By S6 E8, Margaret is forced to depart after Martin refuses to give her any money and tells her he doesn’t want to see her anymore. In the face of Martin’s dismissal of her, Margaret makes off with Martin’s valuable clock, the only way she will ever extract any money from him. Louisa confronts her in the airport and reinforces (in her own way) Martin’s insight that Margaret is not good for Martin and she is not the “family” he wants.

Over several episodes, here in these moments of rejecting his mother, he is choosing to reject his family of birth, choosing to leave hate, selfishness, rancor, manipulation and unkindness, and to acknowledge that these were his birth family’s attributes. Finally realizing the depths of his mother’s narcissism, her conniving and dishonest ways, her unkindness, he now sees the differences clearly. He sees the hatred his own childhood was steeped in, and in those scenes, he chooses instead its opposite: love, care, kindness, generosity.

Those scenes with his mother (S6 E6, E7, E8) bring full circle the metaphor of the women-of-kindness in this show, and close out the cruelty of his upbringing, the manipulative narcissism of his mother and the cold disdain of his absent father.  In these encounters, he is showing that he has found the courage and strength he needs to acknowledge his past and change himself in order to keep his family of choice. I believe the source of courage and strength Martin finds comes from the three kind women he prefers over his mother.

The role of kindness exhibited especially by the three women, shows Martin a different way of being in the world, one that while risky, not so “secure,” and definitely outside his comfort zone, is also a world that can contain love and affection, providing an emotional and psychological “safety” he has never known.

Santa wrote in her October 28 post that she believed Martin is attracted to Louisa because she has parts of what he is missing.  She referred to Martin’s interest in Louisa as a longing for that “split-off part of him” that is gone or buried. Santa wrote: “The essence of Louisa is that high level of emotion that is the antithesis of Martin’s way of being in the world… at bottom, she seems to be a deeply loving person…I’m pretty sure that is a large part of what draws Martin to her.

On one level, being emotionally able to be socially kind is a part of himself that he is “missing”—or that he may yearn for (subconsciously). That is, the openly generous, affectionate side of himself Aunt Ruth described that he had as a little boy, but now replaced by gruffness and minimalist, shut-down behaviors.  But on another level, that quality of gruffness and off-putting behavior masks a deeper gap that goes to the heart of his problem: an inability to be close and intimate with another.

By aligning himself with Louisa and the Aunts, he is seeking and finding a way to return to it. Perhaps his special attraction to Louisa is to find/absorb/re-learn an aspect of himself that has been part of the split-off side of Martin—the “authentic self” that Santa talks about. By modeling the way Martin wants or might prefer to be in the world (if he could only learn), Louisa’s warmth and emotional generosity, along with the Aunt’s kindnesses, act as transformative agents to regenerate some of his missing parts.

And internalizing some of all three women’s kindnesses towards him, he has come to know some emotional and psychological safety.  He has suppressed and buried his ability to show kindness to protect himself from psychological danger and pain, but now he is realizing that it will be safe to exhume it.

Kindness is one of the big roadmaps Martin needs to follow to help him return to his original self. In those scenes where he rejects and ejects his mother, he is preparing himself to make the relationship with Louisa work. To do what he must do to acquire the tools he needs to be in full community with the new family he has made.

As referenced earlier, Aunt Ruth says that Martin was not unkind or un-affectionate to begin with, but rather the opposite as a child. Ruth’s stern and amazing lecture chastising Margaret in the café (S6 E7), makes clear Ruth’s convictions that Margaret has emotionally pummeled and psychologically brutalized her son by pushing him as far away as she could. Ruth’s analysis is that Martin’s defense against that rejection was to put up barriers.  To let them go, he must believe in a new reality. He must overcome the old reality. The main female characters he embraces as an adult are truly opposite from his parents, and it is through them that he comes to know that his barriers are no longer necessary with those who genuinely and honestly love him now.

I think the point of their kindness in this TV series is to help Martin return to his own natural state of kindness, sensitivity, generosity—the qualities that Aunt Ruth has described in him as being lost long ago, even by age 6. These qualities would increase his capacity for an “authentic” life based on the beloved community.

I tried to think of another quality that might have been so effective in helping Martin make a transition to fully accepting Louisa’s love, being less defensive and resistant to affection, and more easy in his own skin.  I could not think of an alternative.

* * * * * *

A Revolution in Kindness

About ten years ago, a book came out called A Revolution in Kindness. It was a collection of essays, quotes and questions by 180 contributors about what a society based on kindness might look like. For example, what would the world look like if people were kinder to nature, the environment, to animals? What would our health care system be like if it were kinder? Or if businesses were required to be kind? What if politicians and leaders were bound by kindness? Or industry in product safety, or parents towards their children?  The list was endless. On the back cover was a quote from Kahil Gibran:

Tenderness and kindness are not signs of weakness and despair, but manifestations of strength and resolution.


Originally posted 2014-11-13 11:54:38.

The Kindness Factor, Part II


Part II

Examples of Kindness in the Three Main Female Characters 

Reviewing the entire show, I found over 80 acts of kindness by all the characters  (women and men) spanning all 46 episodes; the three main female characters, however, account for almost half of them.  Cataloguing the three women’s kindnesses, both in relation to Martin, and in general, as their way of being in the world, was a revealing exercise. Aunt Joan is the show’s contest winner for most kindnesses performed. The rankings for the three women are: 16 for Aunt Joan, 11 for Louisa, 9 for Aunt Ruth.

Using our criteria for genuine kindness (doing something nice for someone without reward, see Part I), we can look at just 6 examples from each of the women—in chronologic order—that demonstrate their various kindnesses. (I’m sure readers will think of their own additional examples and are invited to share them.)

S1 E2: Louisa repeatedly tries to help Roger Fenn through his throat cancer operation, visiting him in hospital, showing him support and thoughtfulness. She knows he’s alone and needs someone. Though his animosity towards her and his anger at losing his job keep ricocheting back on her, she persists, and he finally accepts her friendship and she wins him over. So much so that he becomes the person who “gives her away” at the first fateful non-wedding a few episodes later. He also drops his bitterness and is able to move on to a “better place” himself with new love, a new life and a new family in the show.

S2 E2: Louisa, realizing the economic stress on parents whose children have contracted a contagious skin infection, defies the Doc’s orders to keep infected kids at home, sets up instead a separate room at the school, and quarantines them together so their parents can go to work during the day for much needed income. The kids are all safe, but Louisa incurs Martin’s anger and risks her own future job as head mistress in so doing….

S2 E3: Aunt Joan gently responds to Al when he asks her about who his real father is—since he has blue eyes and neither Bert nor his mother did.  Instead of stating what she knows which would be hurtful (that Al’s mother had a fling with another man) Joan instead focuses Al’s mind on how wonderful Bert has been as a father, and how much Bert loves him.  She helps Al see that what’s important is the care he’s been given and the love he has from a good father. This helps Al straighten his own ship and move forward in his life, accepting and reconciling with Bert.

S2 E8: Louisa, encountering Mrs. Tishall in her store one day, finds her despondent. She gets Mrs. T to tell her what’s bothering her: the Doc has chastised her for always wearing a neck collar, suggesting it’s a psychological crutch. Louisa encourages her to remove it, and prove she is not dependent. When the collar is removed, there is a momentary celebration, but when Mrs. T turns her head the wrong way, she experiences excruciating pain. This leads to the discovery of a prolapsed disk from a crushed spine (a fall in the bathtub) that allows Mrs. T the satisfaction of knowing her collar was not a psychological need, but a real need that now should be treated.

S2 E9: Aunt Joan displays great kindness to Louisa when, for many years, she withheld from Louisa her personal knowledge of Louisa’s father’s theft of the community life boat fund.  That kindness acted as a cushion for Louisa in her growing-up years while Terry Glasson, her father, was the solo parent. Though she finally confronted the truth when his sudden return to the village (and his shenanigans) brought the problem back to the surface, Joan’s years of silence were a kindness to a young girl, who had been abandoned by her mother as a young teen, and didn’t need another blow.

S3, E3: Aunt Joan intercedes for Penhale whose agoraphobia seriously impedes his job as constable. The Doc is about to write a report saying he is not competent, triggering his departure. Rather than do this, Aunt Joan asks Martin to consider getting him “treatment” instead – arguing that like many people with phobias, they can carry on working while getting help. Martin has an insightful moment and sees himself in Penhale’s dilemma.  Martin accedes to Joan’s request and prescribes Cognitive Behavioral Therapy while enabling Joe to continue to work.

S4 E2, E3: Aunt Joan is warm and welcoming to Louisa after her return from London pregnant. She takes her to the clinic, offers to help look after the baby, offers housing and even finds her old man’s Routledge’s apartment in the village to rent so Louisa can be close to school. Joan’s concern for Louisa is genuine and freely given. It stands in contrast to Martin’s steadfast decision “not to get involved.” It acts as a challenge to his behavior and heightens the tension his “hands off” approach causes in his relationship with Louisa.

S4 E5: Aunt Joan, though very tired and personally distressed over her desperate financial state, decides to “stop by after deliveries” to look in on and comfort a distraught Mrs. Selkirk who has just lost her husband to a heart attack. Mrs. Selkirk has been dismissed by Martin as suffering only fatigue and stress from her loss, and that her “hearing voices” is only imaginary. Arriving at Mrs. Selkirk’s sheep farm, Joan finds the woman injured in the sheep pen, unable to get up and stays with her until Martin arrives. He sees the telltale bulls-eye rash on Mrs. Selkirk’s arm, and realizes the woman is suffering from potentially serious Lyme disease that has caused her delusional condition. Martin is a witness to Joan’s act of kindness, which probably saved Mrs. Selkirk’s life.

S4 E8: Aunt Joan, in this final episode of her appearance on DM, thoughtfully brings Martin a “last supper” out of concern for her departing nephew. She also stops and asks if Louisa needs a lift to the clinic, but L declines and goes in the bio-fuels taxi instead.  Joan goes back to the Surgery to wave Martin off. She gives him a hug, cries, trying to be brave, showing him how much she loves him. It is on that day that Joan dies of a heart attack on the Bodmin road, and James Henry is born. Life meets Death for Martin.

S5 E3: Aunt Ruth, while trying to retrieve her stolen hub caps, encounters an arsenic-poisoned neighbor, Mrs. Shirley Dunwich, whose loony-tune, mood-swinging conversation tries Ruth’s patience and causes her alarm. She worries about the woman’s well-being and returns repeatedly to check on her—at considerable risk to herself (possibly at the hands of crazy son Michael). On the last check-in she is confronted by the son with a gun, and tries to avoid violent confrontation. No thanks to Penhale, a violent confrontation is avoided. But it is Aunt Ruth’s persistence and kindly manner that defuses the situation and brings the Doc to the house that leads to his discovery of Mrs. Dunwich’s arsenic poisoning. Knowing it is not dementia allows mother and son to be reconciled.

S5, E4: Louisa is kind to her mother after many years of absence. She allows her to take care of the baby and even forgives her after discovering that Eleanor has given the baby an alcohol-laced drink and Eleanor apologizes. It is another example for Martin.

S5, E7: Aunt Ruth is kind to Al by keeping him on as a worker at the farm despite Al’s use of her money to bail out Bert from the loan sharks.  She wouldn’t even take his motor-bike in partial payment, asking how he would get to the farm each day? While she could find another farm hand, she likes Al, and wants to see him succeed. She gives him the benefit of the doubt. Her continued support eventually leads Al to a new career and a newfound confidence in life.

S6, E1: Louisa shows her generosity and natural kindness towards the villagers when , upon seeing all the uninvited guests who’ve shown up at their wedding reception, and with Martin bristling at their appearance, turns to him and says: “They just showed up to wish us well Martin, that’s all.” She messages once again that it is important to be kind and give people the benefit of the doubt.

S6, E4: Aunt Ruth discovers that her neighbor Mr. Moysey’s water tank has broken and water is damaging her house. As off-putting as Martin can be, Mr. Moysey is worse. But Ruth persists with him and senses the old man is ill and needs help. She alerts Martin and gets Moysey examined. Martin discovers that his diet and Vitamin C deficiency is causing him to be very ill. Ruth probably has saved his life, and again Martin is witness.

S6, E5: Aunt Ruth, sensing Louisa’s anxiety over Mrs. T’s return to the village, offers to check on her to “reassure” Louisa that she is ok.  When she goes to Mrs. T., she is even quite kind to her, saying “So good to see you back. Hope you are feeling well.” Mrs. T is a bit taken aback by Ruth’s niceness, and tries to answer honestly. (Only the Cognitive Behavior elastic is a give away that all is not 100% well…increasing the sense of foreboding in the show of more problems to come with Mrs. T). Ruth returns to Louisa and reassures her that Mrs. T seems be ok now.

S6, E6: Louisa, upon meeting Martin’s mother Margaret for the first time, and wanting to put her new mother-in-law at ease, tries to make conversation and says to her kindly (but naively): “You must be so happy to see your son after all these years.”  Even after the rude non-response, Louisa offers Margaret James’ room, much to the horror of Martin. She is acting out her natural generous self, and again challenging Martin (rightly or wrongly).

S6, E7: Aunt Ruth deliberately corners Margaret while she is walking JH, and insists on speaking to her in the café. Over tea, she clearly and unequivocally chastises Margaret for being a very bad mother to Martin, and for emotionally and psychologically terrorizing him during his upbringing.  Ruth is warning Margaret off Martin now, and is doing so to protect Martin and to keep Margaret out of his life.  This took great courage and showed very strong and genuine love for Martin.

S6, E8: Aunt Ruth performs one of her greatest acts of kindness when she speaks what she has withheld from Martin for so long. Having learned that Louisa and their baby are leaving for Spain, Martin goes to Aunt Ruth for advice. She tells him that both his fear of blood and his emotional detachment (sometimes paralysis) stem from his loveless upbringing.  He must work on himself and look deeply into his own past for the crippling emotional handicaps placed on him by his distant, unkind and selfish parents. She advises him to work to change so he can stay with Louisa. At that moment, he is able to receive what she has said and he makes up his mind to do it. In addition, he finds the strength to confront his mother and throws her out of his house—and life—for good.  It moves the story forward to the most crucial turning point for Martin—his rejection of his mother.


Originally posted 2014-11-13 11:54:22.

The Kindness Factor


The following post is a guest posting that has been underway for quite some time. Marta approached me with this idea and offered to write it. She asked for my approval and feedback. I think Marta has identified an aspect of the show that is important and that I had not noticed was so significant until she delineated it.

Today (Nov. 13th) is World Kindness Day and we decided this was the ideal time to publish this post. The post has been divided into 3 parts so that reading it doesn’t become too onerous. We hope you enjoy reading it.

The Kindness Factor in the Doc Martin Show

 (A 3-Part Post by Marta D–Waxwings)

Part I

Why Kindness 

Three things in human life are important. The first is to be kind. The second is to be kind. And the third is to be kind. — Henry James  

In the 1944 Pulitzer Prize winning play Harvey (written by American playwright Mary Chase, about an imaginary 6’ 3” rabbit and the nature of reality) the affable and charming main character, Elwood P. Dowd, claims it is possible—like Einstein—to overcome time and space, and all normal reality. “In this world,” Elwood says, quoting his mother, “you must be oh so smart, or oh so kind. For years, I was smart. I recommend kind.” (He may have said pleasant, but kind was the meaning in the play.)

The kindness factor in the Doc Martin series interested me almost immediately. I found it ironic that there should be so much of it in a show whose main character is a grumpy, insulting, mostly unkind village GP whose exterior abrasiveness and constant fog of self-awareness—about himself and his negative impact on others—is exasperating.  While the kindness of others softens some of the Doc’s sharpness and makes him more bearable, that is not the only part it plays.

The pervasive presence of kindness throughout the series also contrasts dramatically with its antithesis—the shockingly cruel and truly unkind behavior of the main character’s parents—Margaret and Christopher Ellingham—whose influence on Martin’s sense of what is “normal” serves as subtext for so much of the show’s tension.  They have not only had a crucial role in shaping his anti-social behaviors, but his fear of intimacy as well, and his inability to co-exist and live easily within the “beloved community.”

The Doc is not an unkind person at heart, as his aunt Ruth assures him on the cliff scene, S6E8, in which she describes an affectionate, sensitive little boy, even at age 4. His choice to practice medicine also shows that he cares for people and wants to heal them; he is quick to fix everyone’s medical problems, though he is rude and irritated with his patients’ ignorance, neglect and limitations. He even does several real kindnesses for others in the show. It is the emotional expression of kindness—either coming in our going out—that the Doc has trouble with. He’s buried or suppressed his own once affectionate persona, and replaced it with a protective wall, and overlaid it with a gruff, closed exterior. These are but symptoms of a greater underlying problem within Martin.

On this blog site we’ve discussed in various ways (including a recent post on “Happiness Is….”) how Martin Ellingham’s childhood influenced his adult behavior and was probably an impediment to his ability to navigate love, intimacy and marriage. Looking at the kindness factor that weaves through the show is another way to explore how other influences may work positively on the adult Martin Ellingham, to help him, as Santa, a writer on this blog site, would say, become his “authentic” self.

In Part II, I list examples of the kindness we find in this show; in Part III, I explore the questions: What is the role of kindness in the series, and why does it matter? My conclusions are that the kindness factor is transformative and plays a critical part in Martin’s own struggle for understanding himself and the “world” (marriage, family, community), and it provides the necessary vehicle that will allow him to work toward, and accept, another way of being in the world that is much closer to his natural self.

Kindness Defined

The OED defines kindness as “the quality of being generous and considerate, sympathetic or charitable towards another.” The word is from 14th c. Middle English kyndnes meaning “nation; produce, an increase.”  In fact the word “kind” is one of the oldest in the English language dating back to the 10th c. Old English word gekynde, meaning “natural,” or something that is innate, as in, “it feels right.”

In Book Two of Aristotle’s Rhetoric, kindness is defined as being “helpfulness towards someone in need, not in return for anything, nor for the advantage of the helper himself, but for that of the person helped….” This assumes empathy, compassion, generosity, charity.  It expresses sympathetic concern for the sufferings of others—especially an ability to imagine “other” or another’s pain, distress, need.

Empathy and sympathy are at the root of this deeper understanding. An important aspect here is the idea that one who performs a kindness does not seek reward or reciprocity. The mystics pondering this would say that openness of the heart is required: to see deeply, beneath surfaces—that there are no degrees of separation between us, but that we are each other.  “Say I am you,” wrote Rumi.

For a small village in a harsh environment, with Portwenn’s challenging and dangerous maritime work, dependence upon one another is a given; to find expressions of kindness shot through the events in the village may not be so exceptional then, but to have so many of them woven throughout the series by its major characters is notable. And when these acts are magnified primarily in the personalities of three of the show’s main female characters—who are all supporters of Martin—we have to think this is probably not accidental, not random. It is through these women that Martin will find his confidence to risk throwing over his past and stepping into a new future.

The Three Women

With definitions in hand, we can turn and look now at the three women and examine their place in Martin’s life. Playing his opposite co-star in the show is Louisa Glasson—a very kind, open, generous and naturally compassionate woman who senses the needs, and feels the pains of Portwenn’s villagers, the economic desperation of her students’ parents, and the emotional and physical distresses of her friends. Her demeanor towards everyone is quite open, sympathetic, empathetic and helpful. She is also kind towards her own selfish, absent parents and amazingly, still wants to see good in them. It is Louisa to whom Martin is deeply attracted, and she anchors half the show.

In addition, Martin is also drawn to his two aunts—Joan and Ruth—who echo and buttress Louisa’s kindness, and who rank high or higher on the kindness scale. All three lovingly surround Martin and stand as counterpoints to his social and emotional maladroitness and his stunted or repressed ability to show affection, social kindness and love. It’s my belief that these women recognize his genuine goodness, and work to help him—each in their own way—to protect his vulnerability and challenge his self-awareness to grow and embrace a different world than the one he has known. Together they also represent the opposite of what Martin’s parents embody in the show.

It is probably worth noting the differences in the types of kindness each of the three women model because it takes all three varieties to act as transformative agents on Martin’s psyche:

  • Louisa is open and unreserved in her empathy, warmth and sensitivity towards others; she is universally available and willing to help someone out. She does not hesitate to do a kindness or to speak a kindness. When it comes to Martin her love and kindnesses towards him are unreserved. That generosity and style of kindness is a large part of what attracts Martin to her.
  • Joan’s kindnesses, while equally grounded in empathy, are more motherly, and protective; she has a keen sensitivity towards the sufferings of others; she is also approachable. When it comes to Martin her love is unconditional and so are her many thoughtful gestures of kindness and care towards him.
  • Unlike Louisa or Joan, Ruth is not an “open” person, is quite reserved, and is picky about who she does her kindnesses for. She does not reveal a lot of empathy, but is keenly sensitive, however, to most of those she comes in contact with, and she can be quite generous towards those she tries to help. She selects her acts of kindness carefully, almost as a duty, and goes all the way when she does, as when she goes after Margaret in the cafe.

Originally posted 2014-11-13 11:54:00.

Clothing: Edith v. Louisa

While I’m waiting for a much more significant post to be completed, I thought that comparing how Edith is dressed to how Louisa is dressed in S4 would be a good way to point out how clothes can be used to define a character, especially since TV and film are such visual media.

Here we have two strong, independent women who are brought together through their association with Martin Ellingham. Edith, the former fiancee and med school colleague, and Louisa the former fiancee and love obsession who returns pregnant following a couple of nights of intimacy. Both women have known ME in the biblical sense, or at least we know he’s seen them both naked. At some point both women decided they didn’t want to marry Martin, but Edith went on to pursue medicine, and even surgery, like Martin (and got married briefly), while Louisa continued her profession of school teacher and decided pregnancy was her future plan. In S4 we get the contest between them magnified by their skirmishes due to Louisa having chosen to be followed in Truro and Edith being the obstetrician who takes her case. The stage is set for fireworks and we get them, but in an understated way — and the clothing they wear contributes substantially, if subtly.

Apart from Edith’s bright red spikey hair and lack of any curvaceousness, she is almost exclusively dressed in dark, severe clothes. We are already predisposed to dislike her because we root for Martin and Louisa to be together, then they create a woman who lacks sensitivity for her patients and misdiagnoses both diverticulitis and SGA (or small for gestational age). (Admittedly she could have been using the SGA diagnosis as a way to elicit the information about Martin and Louisa’s sexual history. She should do a differential diagnosis and she has no business asking about the date they last had sex.) She knows the situation between Martin and Louisa and still pursues him, a decision that is disconcerting at best. On more than one occasion, Edith schemes to manipulate Martin to distance himself from Louisa and from Portwenn. Sadly for her, his disdain for some of his circumstances is overshadowed by his sense of duty to Louisa as well as his genuine love for her. Edith’s clothes accentuate her masculinity despite her impractical shoes. She is primarily dressed in slacks with a vest and jacket and man-collared shirt. In fact, in S4E7, Edith and Martin are nearly dressed identically: Edith wears a blue and white striped shirt under a black vest and slacks while Martin wears the same sort of blue and white striped shirt under his dark suit. Dressing them alike insinuates that in addition to being a surgeon who went through medical school with Martin, Edith is too similar to him (or too masculine) to appeal to him as a love interest.

She wears a dark dress with tan polka dots on two occasions, and at the conference, she puts on a white, ruffle front blouse with her trademark black slacks. This time her ruffled blouse is reminiscent of Louisa’s blue ruffle front dress she wears walking to the baby shower when Martin sees her on his way out to meet Edith. It’s almost like they’re begging us to determine which woman looks better in ruffles and, in my opinion, they weight it decidedly towards Louisa. The last time we see Edith is after the conference when she barges into Martin’s last day of seeing patients. She’s back to wearing a pin-stripe vested suit with grey blouse and unwilling to believe that she has lost the battle for any amorous attention from him.

Meanwhile, throughout S4 Louisa wears many flowered dresses with cardigans of various bright colors: white, red, yellow. Or she wears a variety of other feminine outfits, including a blue and white striped sailor style top with bow when she makes the trip to the hospital for another check up. Of course, a pregnant woman has plenty of curves and looks about as feminine as possible. Often people say that pregnant women have a certain glow about them and Louisa reflects that throughout this series. There is a major contrast between how each of these women behaves, and their clothes contrast significantly too. We see two assertive and self-assured professional women clash in terms of how their appearance represents who they are. Edith may hold the upper hand in that Louisa is dependent on her care, however, Louisa is the one carrying Martin’s baby and there’s no way for Edith to change that fact. (Unfortunately, we also may be seeing how female doctors feel they must dress in order to achieve respect in a masculine dominated profession as opposed to the latitude allowed women working in what is perceived to be a feminine profession.)

There are two standoffs between Louisa and Edith — one when they meet for the first time at the hospital and Louisa is wearing a green floral dress; next when Louisa has an ultrasound and is wearing the sailor top. I particularly like the first confrontation between them because Edith tries to belittle Louisa and Portwenn and Louisa gives as good as she gets. The second time, Louisa has fallen part way off the bed in an effort to get a better view of the ultrasound scan when Edith appears. Not only is this funny, but also it puts Louisa at a disadvantage. Most of us feel at a disadvantage when talking to a doctor anyway. In this case, Louisa is particularly compromised as Edith’s patient. She has to rely on Edith’s judgements as well as expect her questions to be appropriate. But Louisa is always self-protective and does her best to deflect Edith’s personal inquiries. To me it looks like Edith is somewhat surprised to learn that Louisa and Martin had sex more than once, and I would think Louisa got some pleasure out of telling Edith their intimacy wasn’t just a one night event.

In the realm of clothing, S4 is a really good example of how it can be used to augment the interpersonal interactions of a scene. I hope I’ve made a stronger argument for the importance of how clothing functions. The wardrobe for each character is a distinguishing feature before they say a word. We could just look at the clothes of most of the characters on “Doc Martin” and know, without seeing their heads, who they belong to. More than that, though, two female characters with somewhat similar temperaments can be dressed totally differently and still appear self-reliant. But, really, is there any doubt that Martin would find Louisa a more attractive choice after we see these two women together?

Originally posted 2014-11-08 14:16:14.

“See the garment, think the person”

When I mentioned Louisa’s fashion style in my recent post about this character, not much commentary came of it. Maybe I’m strange, but I find clothing choices quite telling and now I have learned that I’m not the only one.

It turns out that this past week in London at the Design Museum an exhibit called “Women Fashion Power” opened. (Of course, I saw this in the NYTimes.) It’s co-curator, Donna Loveday, is quoted as saying, “’It felt like it was the right time to look at the rise of women in contemporary power roles, and how they view and use fashion to facilitate their place in the world.’”

According to Times Fashion critic Vanessa Friedman, “the show includes 25 high-profile women happy to go public with their thoughts on clothing. This includes the usual suspects: fashion professionals like Natalie Massenet, the executive chairwoman of Net-a-Porter; the designer Vivienne Westwood; and the model Naomi Campbell. But it also includes Wei Sun Christianson, a co-chief executive of Morgan Stanley Asia Pacific; Anne Hidalgo, the mayor of Paris (who also opened the exhibition); Alfiya Kuanysheva, the chief executive of the Kazakhstan finance group BATT; and Kirsty Wark, the British broadcaster.

That, it seems to me, is an enormous and meaningful change in the conversation about achievement and gender. The idea that women whose power is undeniable and exists in traditionally male sectors like banking and politics may stand up and say, for the record and posterity, that clothes matter and require (and deserve) thought is, in my experience, unprecedented.” Vanessa should know, “Friedman was the Fashion Features Director for In Style UK, a position she held since 2000 to 2002. Prior to this, she worked as a Fashion Correspondent for the FT, as an Arts Contributor at The Economist and was the European Editor at Elle (magazine) US. She has also written extensively on a freelance basis for Entertainment Weekly, Vogue magazine, The New Yorker and Vanity Fair.” (Wikipedia)

Friedman goes on to say, “what women wear is an embodiment of their voice, and identifying it helps identify their agenda (as it does with men, for that matter).”

So, when I tried to start a conversation about Louisa and the clothes she wears, I wasn’t just making a silly side comment. I really consider her clothes an important feature of her as a woman. I would submit that Louisa is put in dresses that identify her immediately — we see the dress, we know it’s Louisa. (We also identify her through her hair, especially her ponytail.) What do these dresses tell us about her? Is she the rural country woman, quintessentially English because her clothes are filled with flowers and have that classic cut? Do they say independence and individualism are her hallmarks? Are they conservative in that they hark back to Victorian times, or are they merely professional and modest? In S6, Louisa has totally left the blue jeans and sneakers behind and now dresses in more sophisticated versions of her former flowered dresses or even wears a more contemporary look of leggings and jacket with scarf. She has married the doctor who always wears a suit. Perhaps this is a way to mirror him and his social status in the community.

I find it significant and noticeable. Isn’t there anyone else who thinks there is something important going on in terms of Louisa’s clothes?

Originally posted 2014-11-04 17:06:23.

An in depth look at Louisa

When mentioning the importance of story and expressing a hope that we will learn more of Martin and Louisa’s backstories, I ended up thinking more about Louisa. There’s quite a lot about the character of Louisa that brings up questions. All we know is that her mother left her with her father at the age of 11 so that she could move to Spain and be with Javier, and her father is a gambler and has been involved in illegal activities. (Age 11 seems to be the magic age for both Martin and Louisa to have had the rug pulled out from under them by their parents.) Nevertheless, Louisa has fond memories of times with her father and is the one person who believes he is innocent of stealing the lifeboat money until she finally confronts him and forces him to tell her the truth. Although she has a lot of resentment towards her mother for leaving her at such an early age, she is willing to rely on her mother again even after she learns that her mother has entrusted the local juvenile delinquent with her baby. It seems there’s almost nothing her mother can do to utterly destroy Louisa’s willingness to give her another chance. We recognize this as a character trait because she has treated Martin that way as well. Perhaps Louisa’s tendency to give her parents and others second chances stems from a deep impulse to believe people will eventually stop disappointing her. As Alexander Pope wrote, “Hope springs eternal in the human breast.”

We know she, Danny and Isobel went to school in Portwenn, and when she went to college in London, she met Holly. We don’t know how she decided to go there and how she was able to pay for it. Where did she get her values, her desire to work with children, her drive? (I think we can come up with explanations for these on our own, but we don’t get any from the show.) Although she appears to be quite level-headed, she has returned to Portwenn with plans to stay despite its many limitations for a single woman, especially one who wants to meet the right man and have a family. In fact, she returns to Portwenn two times from London – once after her college days and again after her first wedding is aborted and she moves to London. London is not for her! Everyone is certain that any school in London would be lucky to have her as a teacher, but when she returns to Portwenn pregnant, she says the school was not happy with her pregnancy. Never mind her argument in a later episode that it is against the rules to use pregnancy as a reason not to hire a teacher. (Presumably also not to fire one.)

She describes Martin as moral and straighforward. She, too, could be described with those adjectives, and she is described as liking people. She demonstrates personal concern and sympathy for many others, including Peter Cronk and his mother, Mrs. Tishell, Allison, and Ruth. We can’t leave out that she is feisty. She immediately challenges Martin during his interview to become the new GP in Portwenn, and there are many great moments when she defends herself or her decisions. She’s not afraid to stand up to Martin, Bert, or Mrs. Tishell. In one scene, prior to her first attempt at marrying Martin, she gives the whole group at her house a talking to.

It’s pertinent to look at the clothes they choose for her too. To a great extent much of her clothing seems to come from the line of Laura Ashley clothing. Here we are in the 2000s, up to and including 2013, and Louisa is, for the most part, still wearing little flowered dresses with pink and red cardigans. Her clothes are distinct from all the other women in Portwenn, especially any of the receptionists.

The dresses are actually quite ambiguous to me. I decided to look into this style and discovered some interesting information about them. I learned that Laura Ashley designs according to this website conjure up terms like:
Florals. Milkmaids. Folksy. Quintessentially English.

It goes on to say, “from the beginning, their designs were rooted in the past, looking to Victorian designs to create headscarves which were a success. Women loved the fantasy of pastoral lifestyle and likewise, their homewards also fitted into this aspiration.”

On the other hand, Jane Ashley, Laura’s daughter, “just so happen [sic] to go to art school with two girls from punk band The Slits and Mick Jones and Paul Simonen from The Clash and so they also did a spot of modelling for the brand.” You can check out some pictures of them here. In case, like me, you aren’t sure what punk is, Wikipedia states “Punk bands created fast, hard-edged music, typically with short songs, stripped-down instrumentation, and often political, anti-establishment lyrics…it became a major cultural phenomenon in the United Kingdom. For the most part, punk took root in local scenes that tended to reject association with the mainstream. An associated punk subculture emerged, expressing youthful rebellion and characterized by distinctive styles of clothing and adornment (ranging from deliberately offensive T-shirts, leather jackets, spike bands and other studded or spiked jewelry to bondage and S&M clothes). They add, “Even as nostalgia was discarded, many in the scene adopted a nihilistic attitude summed up by the Sex Pistols slogan “No Future”; in the later words of one observer, amid the unemployment and social unrest in 1977, ‘punk’s nihilistic swagger was the most thrilling thing in England.'” Jane deliberately mixed the traditional style of the Ashley brand with punk stars in her photographic representations, something of a subversion of the brand. (The little I know about Caroline Catz’s sense of style leads me to wonder if she, too, considers wearing the floral Ashley designs as a means of being alternative. She has been involved in producing films and documentaries that indicate her appreciation of the music of the 70s, she has worn one of the dresses used in Doc Martin to a showing of her most recent music documentary, and the picture of her at the Specsavers Crime Thriller Awards shows her in a lacy dress that looks sort of retro to me. She may collaborate on the wardrobe choices for Louisa.)

When Princess Diana was a fan of the brand, it marked a Sloane Ranger association despite the fact that the clothes were still very much affordable and from the high street. Again from Wikipedia: “The exemplar female Sloane Ranger was considered to be Lady Diana Spencer before marrying the Prince of Wales, when she was an aristocrat from the Spencer family. However, most Sloanes were not aristocrats as Lady Diana was. Considered typical of SRs was patriotism and traditionalism, and a belief in the values of upper class and upper-middle class culture, confidence in themselves and their given places in the world, a fondness for life in the countryside, country sports in particular, philistinism and anti-intellectualism.”

Today Kate Middleton is considered a Sloane but the brand has changed somewhat and wearing Laura Ashley type dresses is no longer popular amongst Sloanes. Here’s one reference in regard to Kate and her Sloane connection. (It’s kind of eerie that Kate follows in Diana’s footsteps.)

So is wearing this type of dress and cardigan indicative of Louisa being a part of the establishment and settled in her rural life or is it something of a playful way to impart individualism and rebellion? Laura Ashley designs are still made today and sometimes shown with models wearing high top sneakers or other disparate footwear. Jane Ashley’s 70s combination of punk with Victorian style dresses may have been a precursor for today’s fashions.

In my opinion, the outfits Louisa wears when pregnant in the show are the nicest and most flattering to her. That sounds odd, I know, but they appeal to me as more contemporary and sophisticated. S6 used more of that sort of wardrobe too with leggings and scarves, and I think Caroline has aged well and looks more attractive in S6 than in any of the other series. Louisa has matured into a married woman with a child who struggles with many of the same difficulties other working mothers have today. S1E1 began with her wearing something like the corset Edith wears in S4. I found it quite surprising that she would wear a sort of bustier under a cardigan to a serious meeting. But then we could say it was a sign of strength and independence. It was nice to see her relax in jeans at times, even when entertaining Martin for dinner and despite knowing he would be in a suit.

Louisa is a free spirit to some extent and we shouldn’t lose sight of that. Her mother is a non-conformist and Louisa grew up fending for herself from a young age. That she figures she can fend for herself when she’s pregnant comes as no surprise. Louisa is a great female character who contains a lot of ambiguity while also being a symbol of femininity at its best. Is she too harsh in S6? Maybe. But I get a kick out of her.

Originally posted 2014-10-26 09:15:02.

The Importance of Story

I plan to respond to all the intriguing comments that have recently been posted about loneliness, aloneness, marriage conditions, and happiness. I have been trying to organize my thoughts so I can manage a cogent reply.

Until I get that together, I wanted to post another article I read in the NYTimes that says so much that I find important, for our discussion of the show and in general. Please read

First of all, for many years my contention has been that doctors can learn from not only the stories their patients tell, but also from stories told by highly observant writers. My literary studies have focused on 19th century literature where, I believe, we can find all sorts of perceptive work on disorders that were unnamed at the time. Many writers described signs and symptoms of nascent and previously unrecognized conditions that have now become well defined.

Secondly, the article makes a strong case for listening to patients and using anecdotal evidence as a means of transferring meaningful data to other doctors. I am excited that the NEJM published a report that stated “stories are better at capturing a different type of ‘big picture.'” I would apply this dictum to the show by drawing analogies among the stories we hear, read, or view on TV. We can learn from the examples of various conditions referred to on this show. The main thrust of the show is not to inform about medical problems; however, all of us are expanding our knowledge of these sorts of issues as its audience. We are also better able to grasp all of this information because of how it’s delivered. And that includes what we’ve been discussing recently about mid-life concerns.

Moreover, the article mentions the subject of Cognitive Behavioral Therapy and how it has become a popular treatment protocol. What Kramer argues is that change can come from listening to case vignettes and from including stories in the overall treatment plan. We know that CBT was used with Mrs. T and probably Joe Penhale. There’s no question that it can be very effective, but I like the idea of integrating storytelling with other forms of psychotherapy. I also like how this article dovetails with our discussion of what might happen in counseling sessions that Martin and Louisa may participate in. Their stories are what the show is about, and we have yet to really hear them.

Originally posted 2014-10-19 15:35:10.

Happiness is…

It seems to be a good time to revisit the concept of happiness. Rather than look at the many theories of happiness, it might be more productive if we stick to the show for evidence of what they consider signs of happiness.

What has been hardest for me is grasping how in two episodes Martin can go from, “Marry Me, I can’t bear to be without you,” to “You wouldn’t make me happy either.” It’s a bit easier to understand how Louisa, who has vacillated between finding Martin exasperating and being passionately drawn to him, could come to the conclusion that getting married might not be appropriate at this time. She hears all the jibes about Martin and his temperament and can only muster that he’s straightforward and moral when trying to describe him. For someone who’s been seen bicycling, surfing, enjoying the scene at the pub, and going out with friends, his preference for staying home and rarely doing anything beyond reading or working on his clocks might finally make her think twice. (I should say here that due to her upbringing and parents who were inclined to party a little too much perhaps, she might like someone who’s trustworthy and grounded even if he could be a bit dull.) We certainly have to take into account that throughout the final episode nearly everyone has been cautioning them against marriage and the Fates are against their marriage as well. We watch as Murphy’s Law takes charge. But if Martin can’t bear to be without Louisa, that would necessarily mean that he is miserable without her and bereft of any sense of happiness. That is exactly how he appears after their date goes wrong. Why is he now thinking that he wouldn’t be happy with her (ostensibly only 3 weeks later)?

Also, when in S4, Louisa snidely remarks that he may find being with someone prickly and emotionless like Edith makes him happy but she’d rather remain hormonal and filled with emotion, she is tacitly saying that she wouldn’t make him happy after all. Of course, Martin is once again totally baffled by her reference to Edith. Still, after S1, there is a concerted effort to keep Martin from looking happy in any overt way. The closest we ever get to seeing him look happy is a hint of a smile when he takes Louisa’s hand or when she says something complimentary to him, or when he looks at the ultrasound of their baby.

The first question we should ask is do we think there is evidence that ME has any awareness of the state of being happy? To answer this question we actually do have to consider the 4 major theories of happiness: Hedonism Theory, Desire Theory, Objective List Theory, and Authentic Theory. Simple descriptions of each can be found here. The proponents of the Authentic Theory believe that their theory takes all of the other theories into account. Happiness is a pretty complex subject that continues to be debated and refined. The dissertation by Ryan Hanlon Bremner written in 2011 does a very good job of addressing the various ways we use the term “happy.” While interrogating the philosophical approaches to this state, Bremner notes: “As long as the vast majority of people in Anglophone societies claim that one of their major, if not their main, goal is to ‘be happy,’ this desire and correspondent striving possesses a magnitude of importance that should not be ignored.” The fact that DM writers have made a point of whether Martin and Louisa are happy, both at the end of S3 and in S6, inspires us to look into what that means. They, too, are indicating that being happy is an important goal.

So what could Martin mean by saying Louisa wouldn’t make him happy after recently being despondent that she doesn’t want to see him anymore? At the risk of overthinking this, and not simply dismissing it as a goof or miscalculation by the writers/producers, it could mean that he’s nervous that he will have to make too many changes in his life to accommodate her. Daniel Haybron, a contemporary philosopher, believes that “well-being consists mainly in the fulfillment of the self’s emotional and rational aspects—i.e., in being authentically happy, and in success regarding the commitments that shape one’s identity. But our subpersonal natures may also count, so we might add, secondarily, the fulfillment of our “nutritive” and “animal” natures: health and pleasure.”

When given a chance to reflect, Martin may have gotten cold feet because he has reached a sense of well-being by distancing himself from others, sticking to his routine, and being content to treat medical conditions successfully and even insightfully. In addition, he has his own diet that he follows quite faithfully. He’s been doing all these things for around twenty years which means they are rather entrenched. He is pretty inflexible when it comes to his daily regimen and he resists modifying it. When Peter Cronk stays with him, for example, Martin is lost because he has trouble finding a way to manage someone else in his home and he doesn’t do very well with it.

What makes him happy? Well, his sense of well-being comes primarily from his work. He is confident of his medical knowledge and ability and we see him display satisfaction in saving a life or making a diagnosis. He accepts the gratitude he gets from the many patients, who sometimes grudgingly admit that he saved their lives, with some puffing out of his chest or pulling down of his shirt cuffs. He’s clearly pleased with himself. Next may be preparing fish/dinner. He takes pride in knowing how to clean and cook the fresh fish and vegetables he buys regularly, and putting together a nutritious meal. We can’t forget the clocks he enjoys working on. Saving the clocks is somewhat analogous to saving lives in that he staves off likely termination.

All of the above touches him on some personal level; however, his connection to people beyond medical cases boils down to family, Edith, and Louisa. We know that the only affection he’s gotten from family really comes from Aunt Joan. He must have had some intimate contact with Edith considering she alludes to his having seen her naked before. Hopefully he didn’t get stabbed by her hair or protruding bones! Once he sees Louisa, he knows he wants to get closer to her. Eventually that happens and the embrace they have after he’s asked her to marry him and she’s agreed shows him with an expression of joy and relief. We see expressions akin to this when he holds her hand both at the concert and then at the Castle, when she gives birth to their baby, and when he sees her at the entrance to the church on their wedding day. I cannot imagine that we aren’t supposed to think that he achieves a sense of well-being when he’s with Louisa.

My conclusion is that Martin does experience happiness on many occasions, but that his life hasn’t always been happy. Conversely, as philosopher G. H. Von Wright believes, it would be possible to say that someone had a happy life, even if for a long period of time he was a most unhappy person. We see both of these scenarios being played out and now we hope to see the happy periods combined with an overall sense of well-being. He’s got a wife, a son, and Ruth. He’s got his medical practice and ability. He should stop being so miserable!!

Originally posted 2014-10-14 18:11:55.

Now What?

I have to admit that I am pretty tapped out in terms of ideas for posts. I may have one or two more in me, but I need your advice on where to go from here. If anyone has a suggestion, I’m very happy to see it.

I also wondered if there might be some previous posts that could bear more looking into. I’m open for all thoughts, notions, proposals, etc.

There’s a long time before we have more material to work with and I want to keep the blog going. But how should we proceed?

Originally posted 2014-10-12 12:58:40.