Things are further complicated when his on-again, off-again love interest, local schoolteacher Louisa Glasson (Caroline Catz), comes back to Portwenn with some surprising news.
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Doc Martin | Season 4
Life in the beautiful Cornish village of Portwenn has become ever more infuriating for Martin since the heart-wrenching decision to call off his marriage to local headmistress Louisa (Caroline Catz). Louisa has left, and Martin has begun to question what keeps him in Cornwall. It's certainly not his relentlessly annoying patients. On a visit to the hospital, Martin is stunned to meet Edith (Lia Williams), his old girlfriend from medical school days who is now a top-ranking doctor with a flourishing private practice. Martin learns there is a prestigious surgeon's job coming free in London that is perfect for him if he can overcome his blood phobia. But all Martin's thoughts of the future are turned upside-down when Louisa unexpectedly returns to Portwenn. She wants nothing to do with Martin, but she has big news of her own — she's pregnant.
Martin struggles to deal with the news of Louisa's pregnancy. But Louisa is adamant that she does not want Martin involved. She is hired to teach at the local school, but the Headmaster is acting strangely. He has an arm that rises up into the air without him seeming to notice it! The Headmaster comes to see Martin about his constipation, but starts acting in a paranoid manner. Martin notices his strange physical behavior for the first time, but before he can complete his examination, the Headmaster rushes from the surgery. At the hospital for a routine check-up, Louisa discovers that Edith is going to be her doctor. She also learns something about Martin and Edith's relationship during medical school that shocks her. Upon returning to school, Louisa discovers that the Headmaster has taken her pupils down to the treacherous rock pools of Roscarrock Cove for a nature walk. She alerts Martin and he rushes there to try and save the children.
Martin is shocked to find Louisa and Aunt Joan (Stephanie Cole) knocking at his door before his office has opened. Louisa has had a medical scare and wants Martin's reassurance that everything is fine. P.C. Penhale (John Marquez), still officially the world's worst policeman, has an unexpected visitor — his older brother Sam. Martin notices that Sam has some problems with his memory and co-ordination. It's probably just a virus, but when Martin takes Sam's family history, he decides there is a very small possibility that Sam has a rare genetic disease. It turns out that Martin diagnoses a different illness that will change Penhale's opinion of his brother forever.
Martin is called to Louisa's new home after she has a dizzy spell while shifting furniture. Martin urges her to slow down, but is shocked to learn that Louisa has applied to be her school's head teacher again. Aunt Joan is involved in a car crash with the McLynns, an elegant elderly couple. When P.C. Penhale rushes to the scene and tries to impose his authority, he is ignored by both drivers. Edith visits Martin for some advice on her medical research, and Martin reveals he has applied for the prestigious surgeon's job in London. Wanting to confront Martin about his attitude towards her and the head teacher position, Louisa arrives on the scene and is taken aback to find Edith already there. Martin sees Mr. and Mrs. McLynn behaving oddly in the village, and makes an astonishing diagnosis.
Martin is in London to meet with Robert Dashwood, who is leading the selection process for the prestigious London surgeon's job that he has applied for. Pleased that Martin has finally conquered his debilitating blood phobia, Robert is confident that Martin will be hired. On the train back to Cornwall, Martin is annoyed to be seated next to one of his patients, a sheep farmer named Jim Selkirk. Jim falls asleep and slumps onto Martin's shoulder — dead from heart failure! Theo, one of Louisa's students becomes ill in class. His parents, Juliet and Richard Wenn, are certain that their child picked up the illness in Joan's chicken coop during a school field trip. Martin cannot deny it is a possibility and the couple announces their intention to sue Aunt Joan. Mrs. Selkirk returns to Martin's surgery, and tells him she is now seeing visions of her dead husband. When she is found collapsed in her sheep pen, Martin is able to uncover the medical reason behind her hallucinations. Martin receives Theo's test results which point to Joan's innocence and Martin is finally able to identify the real source of his sickness.
Martin meets Portwenn's new midwife, Molly, who will be looking after Louisa. Martin is dismissive of her profession, and the two of them do not hit it off. Martin finds that cognitive behavioral exercises are a great help with his blood phobia and he is able to take blood from P.C. Penhale without reacting. Martin visits Aunt Joan at her farm, and breaks the news that he is intending to become a surgeon in London again. She is supportive, but urges him to tell Louisa. Martin and Molly have their final stand-off when Louisa develops a temperature which Molly tries to sooth with herbal remedies. Martin is furious when he discovers this — believing Molly's homespun ideas are seriously endangering Louisa's health. Edith has big news for Martin that Louisa overhears — Robert is going to offer him the prestigious surgeon's job in London.
To solve her farm's money problems, Aunt Joan starts a small bed-and-breakfast business. Her first guest, unexpectedly, is another local farmer, Ted, who has also got into financial difficulties. Initially they're a good match, but Joan soon finds that Ted is far from the perfect guest. Pauline's suspicions are confirmed when she steams open a confidential letter addressed to Martin and discovers his contract offer for the London job. Suddenly insecure about her own future, she confronts Martin, who offers her no reassurances other than to write her a reference. Martin deals with the victim of an accident without hesitation, proving to both himself and Edith that his blood phobia is completely cured, and he is now fully able to be a surgeon in London again.
Martin and Pauline are surprised by the number of patients coming to see him on the last day before his Surgery closes and he moves to London. Taxi driver Tommy delivers a patient to the surgery, but complains of migraine headaches himself. Martin checks him for any serious brain conditions, and tells him to make an appointment with the new doctor if the headaches continue. Martin is driving out of Portwenn with the moving men when he sees Tasha fall from the Harbour Day stage. With a little bit of help from a guilty Bert (Ian McNeice) and Al (Joe Absolom), he is able to diagnose Tasha's medical condition, and is shocked to learn that she is married to taxi driver Tommy, and that he is driving Louisa to her hospital appointment. Louisa's life is in danger. Martin rushes after Louisa, finding her safe at the scene of a road accident caused by Tommy. Martin and Louisa help Tommy to a nearby inn where his medical condition can be treated; but due to her exertions, Louisa goes into premature labor.