A Dublin Student Doctor Read online

  To Dorothy

  ACKNOWLEDGMENTS

  This is book six in the Irish Country series, books that wouldn’t exist but for the unflagging efforts of some very special people.

  In North America

  Simon Hally, who started it all.

  Natalia Aponte, my agent, who acquired the first book for Forge, persuaded Tom Doherty to publish it and its successors, and who is a never failing support when the muse goes on vacation.

  Rosie and Jessica Buckman, foreign rights agents. Their successes in placing my works lead me to believe they could persuade the Innu people of Nitassinan in Arctic Canada to buy blocks of ice.

  Carolyn Bateman, my personal editor. Together we have been through the rough and smooth of nine books over fifteen years and are now working on book ten. Whenever my bicycle wobbles off course, she gently, but oh so firmly, puts me back on track.

  Paul Stevens, my editor at Forge, for whom no question is ever stupid, no request too much trouble, and who likes Mrs. Kincaid’s recipes.

  Irene Gallo and the Art Department at Forge, and Gregory Manchess, the artist who renders the jacket art. No author could ask for a more sympathetic group of creative people who will accept authorial intrusion without complaint. Their efforts have made the Irish Country series instantly recognisable because the covers always reflect the contents of the work.

  Patty Garcia and Alexis Saarela from Publicity. Much of their work goes unheralded, but without them, no one would know the books are out there.

  Christina MacDonald, whose sharp eye in copy edit has rescued this book from its author’s very personal style of touch typing and his persistent belief that George Gershwin wrote “Smoke Gets in Your Eyes.”

  “Old men forget.” I wish I could remember who said that. So do old physicians. Once more, Doctors Thomas Baskett and Linda Vickars have freely provided their expertise on matters respectively obstetrical and haematological.

  In The Republic of Ireland

  Much of A Dublin Student Doctor was written while we were living in Ireland. My efforts to strive for authenticity would have been feeble indeed, but for the untiring support of:

  The Librarian of the Royal College of Physicians of Ireland,

  The Librarian of the Royal College of Surgeons in Ireland,

  The Librarian of the Rotunda Hospital and her staff.

  My limitless questions and requests for photocopying were dealt with by all of these experts with the grace of nobles and the patience of Job.

  The people of Cootehall, County Roscommon, and Dublin City who allowed an Ulsterman to renew his feel for the life and the speech patterns in the Republic’s rural and metropolitan regions.

  To you all, Doctor Fingal Flahertie O’Reilly and I offer our most sincere thanks.

  CONTENTS

  Title Page

  Dedication

  Acknowledgments

  Maps

  1. It’s a Long, Long Road from Which There Is No Return

  2. It Is a Wise Father that Knows His Own Child

  3. I Feared It Might Injure the Brain

  4. A Memory of Yesterday’s Pleasures

  5. The Fleeting Image of a Shade

  6. Mother Will Be There

  7. Social Comfort, in a Hospital

  8. City of the Soul

  9. There Shall Be Weeping and Gnashing of Teeth

  10. For This Relief Much Thanks

  11. Nazi Germany Had Become a Menace

  12. Even My Lungs Are Affected

  13. We Will Go into a Public House

  14. Have Felt My Soul in a Kiss

  15. ’Tis the Season to Be Jolly

  16. We’ll Keep Our Christmas Merry Still

  17. Why He a Wauling Bagpipe

  18. Heal What Is Wounded

  19. The Heart No Longer Stirred

  20. The Feathered Race with Pinions Skims the Air

  21. Too Late, Too Late

  22. In Poverty, Hunger, and Dirt

  23. Eating the Bitter Bread of Banishment

  24. And Great Was the Fall of It

  25. That Where Mystery Begins

  26. The Stag at Eve Had Drunk His Fill

  27. The Fever and the Fret

  28. These Things into My Ear

  29. The Sensation of a Short, Sharp, Shock

  30. Children Casual as Birds

  31. It Is Never Good to Bring Bad News

  32. Examinations Are Formidable, Even to the Best Prepared

  33. A Disinclination to Inflict Pain

  34. A Time to Every Purpose Under Heaven

  35. You Can Cut That Right Out

  36. Windy Night; a Rainy Morrow

  37. Must Often Wipe a Bloody Nose

  38. I Am Disappointed

  39. Success Is Counted Sweetest

  40. The Foxes Have Holes

  41. From His Mother’s Womb Untimely Ripp’d

  42. Give Crowns and Pounds and Guineas, But Not Your Heart Away

  43. To Change What We Can; To Better What We Can

  44. Home and Rest on the Couch

  45. Blood Will Have Blood

  46. This Is the Beginning of the End

  47. Vaulting Ambition, Which O’erleaps Itself

  48. If You Can Meet with Success and Failure

  49. The Wheel Is Come Full Circle

  Afterword

  Glossary

  Author’s Note

  By Patrick Taylor

  Copyright

  1

  It’s a Long, Long Road from Which There Is No Return

  Fingal Flahertie O’Reilly, Doctor Fingal Flahertie O’Reilly, edged the long-bonnetted Rover out of the car park. “Lord Jasus,” he remarked, “but this twenty-fourth day of April in the year of our Lord 1965 has been one for the book of lifetime memories.” He smiled at Kitty O’Hallorhan in the passenger’s seat. “For all kinds of reasons,” he said, “and now that the Downpatrick Races are over, it’s home to Ballybucklebo.” He accelerated.

  Kitty yelled, “Will you slow down?” then said more gently, “Fingal, there are pedestrians and cyclists. I’d rather not see any in the ditch.” The afternoon sun highlighted the amber flecks in her grey eyes. She put slim fingers on his arm.

  “Just for you, Kitty.” He slowed and whistled “Slow Boat to China.” “All right in the back?”

  “Fine, Fingal,” said O’Reilly’s assistant, young Doctor Barry Laverty.

  “Grand, so.” Mrs. Maureen “Kinky” Kincaid was O’Reilly’s housekeeper, as she had been for Doctor Flanagan. Fingal had met Kinky when he’d come as an assistant to Thómas Flanagan in 1938. She’d stayed on when a thirty-seven-year-old O’Reilly returned in 1946 from his service in the Second World War and bought the general practice from Doctor Flanagan’s estate.

  They’d been a good nineteen years, he thought as he put the car into a tight bend between two rows of ancient elms. So had his years as a medical student at Dublin’s Trinity College in the ’30s.

  “Jasus thundering Murphy.” O’Reilly stamped on the brake. The Rover shuddered to a halt five yards from a man standing waving his arms.

  O’Reilly’s bushy eyebrows met. He could feel his temper rise and the tip of his bent nose blanch. “Everyone all right?” he roared, and was relieved to hear a chorus of reassurance. He hurled his door open and stamped up the road. “What in the blue bloody blazes are you doing standing there waving your arms like an out-of-kilter semaphore? I could have squashed you flatter than a flaming flounder-fish.”

  The stranger wore Wellington boots, moleskin trousers, and a hacking jacket. He had a russet beard, a squint, and was no more than five foot two. O’Reilly expected him at least to take a step back, apologise, but he stood his ground.

  “
There’s no need for youse ’til be losing the bap, so there’s not. There’s been an accident, and I’m here to stop big buggers like youse driving into it, so I am. See for yourself.” He pointed to a knot of people and the slowly rotating rear wheel of a motorbike that lay on its side.

  “Accident?” said O’Reilly. He spun on his heel. “Barry. Grab my bag and come here.” He turned back. “I’m Doctor O’Reilly. Doctor Laverty’s coming.”

  “Doctor? Thank God for that, sir. A motorcyclist took a purler on an oil slick, you know. Somebody’s gone for the ambulance and police.”

  “Here you are.” Barry handed O’Reilly his bag. “What’s up?”

  “Motorbike accident.” He spoke to the short man. “You’d be safer back down the road where drivers can see you before they’re on top of you.”

  “Right enough. I’ll go, sir.” He started walking.

  O’Reilly yelled, “Kitty. Kinky. There’s been an accident. Stay with the car.” Kitty would have the wit to pull the car over to the verge. “Come on, Barry.” O’Reilly marched straight to the little crowd. Time to use the voice that could be heard over a gale when he’d served on the battleship HMS Warspite. “We’re doctors. Let us through.”

  Ruddy-cheeked country faces turned. Murmuring people shuffled aside and a path opened.

  A motorbike lay on the road, an exclamation mark at the end of two long black scrawls of rubber. The engine ticked and the stink of oil and burnt tyre hung over the smell of ploughed earth from a field and the almond scent of whin flowers.

  A middle-aged woman knelt beside the rider. The victim’s head was turned away from O’Reilly, but there could only be one owner of that red thatch. A duncher lay a few yards away. It irritated O’Reilly that Ulstermen wouldn’t wear crash helmets but favoured cloth caps, worn with the peak at the back.

  He knelt beside the woman and set his bag on the ground. “He’s unconscious, he’s breathing regular, his airway’s clear, his pulse is eighty and regular, and he’s not bleeding. There don’t seem to be any bones broken,” she said, and added, “I’m a first-aider, you know.”

  “Thank you, Mrs.?”

  “Meehan. Rosie Meehan.”

  O’Reilly smiled at her. “Donal? Donal?” he said gently. Fifteen minutes ago he’d seen Ballybucklebo’s arch schemer, Donal Donnelly, riding the motorbike from the car park.

  No reply.

  O’Reilly grabbed the man’s wrist. Good. Mrs. Meehan was right; the pulse was strong and regular. “Donal,” he said more loudly, “Donal.”

  Donal’s face was chalky. He wore his raincoat reversed and buttoned over his back. It was the practice of country men when riding motorbikes. It stopped the wind of passage getting through.

  O’Reilly was hesitant to move Donal. He could have a broken neck. Better to wait for the ambulance. The first law of medicine was Primum non nocere. First do no harm. O’Reilly bent lower. “Donal?”

  Donal’s eyelids fluttered. “Numuh?”

  Better, O’Reilly thought. Donal might only be concussed. If that were the case he should start regaining consciousness. But you could never be certain about head injuries. The damage might range from a simple concussion with complete recovery through to serious brain injury leading to paralysis, permanent brain damage, and even death. O’Reilly gritted his teeth. Donal had a new wife and a wean on the way. O’Reilly’s heart went out to the pregnant Julie Donnelly, née MacAteer. He heard the nee-naw of an approaching siren. O’Reilly leant over. “Donal?”

  Donal’s eyes flew open. “Doctor O’Reilly? What are youse doing here?” He struggled to rise. “I shouldn’t be in my bed.”

  Donal recognised O’Reilly. That was a good sign even if he was unclear where he was. O’Reilly put a restraining hand on the man’s shoulder. “Lie still. You had an accident.”

  Donal put his hand to his head. “I must have hit my nut a right clatter,” he said. “It’s pounding to beat Bannagher, so it is.”

  “Do you know what day it is?” O’Reilly asked.

  Donal frowned. “Uh? Saturday. We made a wheen of money on the oul gee-gees at the races.” He grinned like a small boy who had answered the teacher’s question correctly. “And this here’s the road to Ballybucklebo.” A look of concern crossed his face. “Jesus, is Paddy Regan’s motorbike all right? It’s only on loan.” Donal tried to rise.

  “Stay put,” O’Reilly said, and smiled. If Donal knew about events immediately preceding his accident it was probable he had suffered only a minor concussion. Even so, O’Reilly would never forget a footballer who’d been knocked out, recovered, gone back to finish the match, and died from a brain haemorrhage two hours later.

  The nee-naw, nee-naw grew louder.

  “I don’t need no ambulance,” Donal said. “I’m for going home, so I am.”

  “Sorry, Donal,” O’Reilly said, “but you’ll be spending tonight in the Royal Victoria Hospital.”

  “Och, Doctor—that’s daft. I’ve a motorbike to get back to—”

  “The Royal. For observation,” O’Reilly said. “No arguments. I’ll take care of the bike.”

  “But—”

  “Donal, you’re going to hospital,” O’Reilly said as if speaking to a not overly bright child. “That’s final.” He stood and spoke to Barry. “I’ll do a quick neurological exam once he’s in the ambulance. Establish a baseline in case he gets worse. I’ll go up to the Royal with him. Kitty’s the senior nursing sister on the neurosurgical ward there. She’ll want to come too. She can go with Donal in the back of the ambulance. God knows she’s observed a hundred times more head injuries than you and I put together. She’ll keep an eye on him and warn me if his condition deteriorates. You drive Kinky and the Rover home.”

  “I’ll go and get Kitty.” Barry started to turn as a yellow Northern Ireland Hospitals Authority ambulance drew up and its siren was turned off.

  “In a minute,” O’Reilly said. “Once the police have come and done whatever they have to do, measure things, take photos and statements, they’ll have you fill in forms. When you’re done, get them to give you a hand to load the bike into the boot of the Rover. At least Paddy Regan won’t need to come all the way here to collect it.”

  “Paddy? I’ll let him know,” Barry said.

  O’Reilly turned. “Do you hear that, Donal? We’ll get the bike home for you.”

  “Thanks, Doc. But what about Julie? She’ll go spare if I don’t get home too.”

  O’Reilly frowned. “You’ve no phone, Donal, have you?”

  “No, sir.”

  “I’ll nip round and see Julie,” Barry said. “Tell her what’s happened. That she’s not to worry.”

  “Thanks, Doc.”

  Barry turned to leave as two men approached wearing peaked bus drivers’ caps, silver-buttoned blue uniforms, and carrying a stretcher. The bigger one, a burly, open-faced man, spoke to the first-aid lady. “What’s the story, Rosie?” Of course he’d know her. They’d both be Downpatrick locals.

  She nodded at O’Reilly. “Better ask your man there, Alfie. That there’s Doctor O’Reilly.”

  The man turned to O’Reilly and grinned. “From Ballybucklebo, the wee village near Holywood?”

  “That’s right. How did you—?” He frowned. Alfie did look familiar.

  “I met you at a rugby game, sir.” He pointed at Donal. “What do you reckon about your man?”

  “He came off the bike and hit his head. He was unconscious for a while but he’s awake now. Concussion at least and I’d like him in the Royal for observation. You know head injuries can—”

  “I do know. Too bloody well.” The ambulance man frowned. “My brother, God rest him, got a smack on the nut with a hurley ball. He bled into his skull and died.” There was a catch in Alfie’s voice. “He was only nineteen.”

  “I’m sorry,” O’Reilly said.

  “Aye well.” Alfie tugged at his tie. “Standing here both legs the same length won’t get your man there to the Royal. What do you want
us to do, Doc?”

  “Before you move him, I’ll give his fore and hind legs a once-over. Then I want you to take him, me, and Sister O’Hallorhan, she’ll be here in a minute, up to the Royal. We’ll radio ahead to arrange for him to be seen in casualty, get things rolling, then have him admitted to the observation ward.”

  “Right, Doc. Come on, Bert.” The ambulance men aligned their stretcher alongside Donal as O’Reilly examined Donal’s arms and legs through his clothes. “You’re right, Mrs. Meehan. There are no bones broken,” he said, and stepped back to let the attendants do their work. “Thank you, Mrs. Meehan,” O’Reilly said. “You did a great job. Now go on home and get your tea.”

  She smiled, bobbed her head, and left.

  O’Reilly climbed aboard the ambulance. “For crying out loud,” Donal said, and tried to sit up. “This is daft, so it is. Going to all this trouble. Sure couldn’t I just get the bike—”

  O’Reilly made a noise like an enraged gorilla, one whose last banana had been stolen. “For the last time, Donal Donnelly, you’re going to the Royal. This is not a bleeding debating society—so shut up, lie down, and let me examine you.”

  “I will, Doctor O’Reilly, sir,” a clearly chastened Donal said—and did.

  Fingal satisfied himself that Donal’s reflexes were normal, that his pupils were equal in size and reacting to light, his pulse was strong and steady and his blood pressure was normal. The only worrying thing was a bruise over Donal’s right temple. The parietal bone there was thin. There was a chance the skull was fractured. O’Reilly didn’t need to reassure himself that getting Donal to hospital was the right thing to do. The middle meningeal artery lay beneath the parietal bone. O’Reilly climbed out to meet Kitty.

  Barry was providing information to a uniformed Royal Ulster Constabulary officer. The man had a heavy pistol in a hip holster. Good for Barry, O’Reilly thought, one less chore for me, and frankly, the sooner we get Donal to hospital the happier I’ll be. If his condition did deteriorate, speed of intervention was critical.

  The second ambulance attendant climbed into the back and offered his hand to Kitty.

  “Hop in,” O’Reilly said. “All his baseline findings are normal, but please keep an eye on him. I’ll be in the front, so if he starts to go downhill, let me know.”