An Irish Country Cottage Page 14

  Willie whimpered.

  Emer used a tongue depressor and said, “Doctor O’Reilly, now, please.”

  O’Reilly shone his torch into Willie’s mouth. He angled the beam a little upward but couldn’t see because Emer’s head blocked his view.

  “Alright. Thank you. Willie, you can put your tongue back and close your mouth.”

  The boy tried to comply, but his lips remained open a slit and saliva drooled down his chin.

  “I’ll explain in a minute, I just need to brief Doctor O’Reilly.” She turned her back to them. “There’s a diffuse swelling of the soft palate above the left tonsil and evidence of suppuration.”

  And that, O’Reilly knew, meant only one thing.

  “Eileen,” Emer said, turning back to face them. “Willie has a quinsy. It’s an abscess of the space round the tonsils. I’d like to give him a painkiller and then perhaps we can discuss this with Mister McNab as well.”

  “A quinsy?” Eileen said. “Is that serious?”

  “I’ll give him the painkiller and then we can all talk about it. What does Willie weigh?”

  “Six stone, two, Doctor,” Eileen said in a choked voice, taking her son’s hand and rubbing it slowly.

  “Thirty-nine kilos, so at one point one milligrams per kilo, a dose of pethidine of forty-three point nine milligrams. I’ll see to it.” She opened her bag, removed a rubber-topped bottle of medication, used methylated spirits to sterilize the rubber, and drew up the dose into a hypodermic.

  O’Reilly was humbled by how rapidly Emer had calculated the reduced dose for a child, all the while aware that Eileen was close to breaking down.

  Willie Lindsay drifted off to sleep soon after the injection had been given and O’Reilly, Emer, and Eileen joined Gordy in the living room, now bereft of Christmas cards and the tree.

  “Everybody sit down, please,” Eileen said.

  Emer said, “Eileen, Gordy, I’m afraid Willie has a collection of pus under his soft palate and around his left tonsil. He’ll have to go to the ear, nose, and throat department in the Royal. I’ll arrange for him to be seen by Mister David Hanna Craig.” Emer smiled. “I know him. He’s particularly good with children. Willie will be in the best hands.”

  “If youse’ll arrange it, Doctors,” Gordy said, “I’ll run Eileen and Willie up.” He glanced down. “I have a wee bookie’s shop in Holywood. There’s no racing the day anywhere so I’m free.”

  “It’ll be quicker than sending for the ambulance,” O’Reilly said. The abscess needed to be drained by a surgeon. Ambulance attendants could do nothing to help the child anyway.

  “And don’t worry about the other two, Eileen, pet,” Gordy said. “I’ll leave a note for Sammy to look after Mary until we get home. He has the latch key.”

  Eileen looked from Emer to O’Reilly, but he was pleased she directed her question to his trainee. “What’ll the surgeon do, Doctor?”

  “Usually,” Emer said, “he’ll lance it. Let the pus out. He may decide to take the tonsil out too, but Willie is going to be fine either way.”

  “Thank you, Doctor,” Eileen said, her eyes wide, hand encircling her own throat, no doubt picturing cold, sharp steel in such a soft place. She lowered her hand and straightened her shoulders. “I’ll go and get Willie ready.”

  “Try not to be scared, Eileen,” said O’Reilly. “They are very expert at the Royal. You’ll have Willie home and good as new in no time. Honestly.”

  * * *

  “I thought you handled that very well, Emer,” O’Reilly said as they drove away, heading back to Number One. “And I’m not referring to the quinsy either. You saw Eileen. Up to high doh because she and Gordy had gone back to bed. There’s more to doctoring than being technically accurate. I like the way you did your best to set her mind at rest.”

  Emer shook her head. “If anyone should feel guilty it’s me.”

  “Good God. Why?”

  “Maybe if I’d given the boy intramuscular penicillin instead of oral.”

  “And, why didn’t you?” O’Reilly asked, making sure there was no hint of reproach in his tone.

  Emer sighed. “I’ve a soft spot for kiddies. I hate to see them in pain and I’ve been told that an intramuscular penicillin injection feels like you’ve suddenly got the worst toothache you’ve ever had—in your hip. I took the easy way out with the lad.”

  “Mmm,” said O’Reilly, “and did Barry agree with your choice?”

  Emer nodded.

  “So, let’s get this straight. You diagnosed scarlet fever correctly. You made a rational choice of treatment. Your mentor did not disagree. Now the child has a very rare complication and you think it’s your fault?”

  Emer whispered, “Yes.”

  “Well, it’s not.” He emphasised the final word.

  She sighed. “I didn’t warn her of possible complications back then.”

  “Because?” I’ve got to stop her self-flagellation, O’Reilly thought.

  “Because I didn’t want to scare her.”

  “And, by God, you were right. And you were again today too. Young Willie Lindsay’s still not out of the woods, but they’ve enough to worry about without having their heads filled with what we know could—could, but almost certainly won’t happen.” He wanted to get her off this tack. “Now,” he said, turning right at the main Bangor to Belfast Road, “how much do you know about Irish history?”

  “A fair bit. Why?”

  “How might Ireland’s history have been radically changed if a certain famous figure had died of quinsy—remember, no surgery back then—before he’d done something that haunts this poor divided country to this day?”

  “I’ve no idea.”

  “Pope Adrian IV, the only pope to have come from England and—”

  “No, don’t tell me. I remember now. He wrote the papal bull Laudabiliter in 1155, didn’t he? He urged England’s King Henry II, sixth monarch after William the Conqueror, a Norman really, to take possession of Ireland. And the English have been here ever since.”

  “Correct,” said O’Reilly. “Not only are you a dab hand at the mental arithmetic, you do know your Irish history.”

  “I’ve read Táin Bó Cúialange, ‘The Cattle Raid of Cooley,’ and the An Fhiannaíocht, the Fenian Cycle, about the doings of the followers of Finn MacCool, the giant.” Emer smiled. “I love Irish history and the myths and legends. Lady Gregory, a great friend of W. B. Yeats, wrote a terrific book about it.”

  O’Reilly nodded. “Her Complete Irish Mythology. There’s a copy in the upstairs lounge back home. It’s been a hobby of mine too. My dad was a professor of literature at Trinity. He got me and my brother hooked when we were young.”

  He sensed her staring at him. “And did he teach you how to comfort young doctors who were letting their imaginations run away with them?”

  “Have I?” It always embarrassed O’Reilly to be complimented.

  Emer ignored the question. “Don’t be coy, Doctor Fingal O’Reilly.”

  From the corner of his eye he saw a small smile on her lips.

  “Impudent young pup.” He tried, but failed to stop a smile appearing on his own face.

  “Thank you for comforting me. I know I’m just out of school. I’ve still a lot to learn. Perhaps I’m too much of a perfectionist, but when things don’t go well, like with young Willie, I’m sure it’s my fault and I feel horribly guilty.”

  “Now listen, Doctor Emer McCarthy, there are two kinds of doctors; the self-appointed god-like ones. I’ve known my share.” And he thought of a certain Surgeon-Commander Fraser in Haslar Hospital in 1940. “And the human, self-doubting ones. The first are incurable and insufferable. The second have insight, but suffer, as you are doing—”

  “Thank you, Fingal.” He heard humility in her voice, but damn it, he wasn’t finished.

  “Don’t interrupt.”

  She bit her lip. “Sorry.”

  “As I said, the second do suffer, but with growing experience they a
ccept they are fallible and stop beating themselves up when things don’t always go as planned. Those are the ones who make fine physicians.” Unless, he thought, they are mistaken, or insist on believing they are, too often early in their careers, and decide to specialise in disciplines like pathology or anaesthesia, where they have no or little contact with patients at all. In truth, would intramuscular penicillin have prevented the quinsy? No one could tell. He said, “You’ll be fine because you are a good diagnostician and you care.” Emer McCarthy mustn’t be allowed to lose confidence.

  “Thank you, Fingal,” she said. “Thank you very much.”

  O’Reilly hauled on the steering wheel as a rabbit darted across the road. He missed it by a whisker. “Silly bugger,” he said, and laughed. “See that, Emer. All God’s creatures make mistakes. That one’s going to live despite having done so. And according to Alexander Pope, to err is human.”

  She chuckled and asked in her most innocent voice, “And does that mean, in forgiving the rabbit, that makes you divine, Doctor O’Reilly?”

  He guffawed and they were both still laughing when he parked the car back in the garage.

  14

  The Right to Be Consulted

  “I still can’t believe your Doctor Harley is seeing us so soon,” Sue whispered to Barry as a blue-uniformed staff nurse showed them into a room on ward 23, the gynaecology ward of the Royal Victoria Hospital.

  Not for the first time, Barry wondered why it was people automatically lowered their voices in hospitals the way they might in a church.

  “Doctor Harley’s expecting you,” the nurse said. “He’ll be here soon.” She smiled and left.

  “I told you about professional courtesy, and Graham’s a real gent when it comes to looking after colleagues’ wives. I phoned his secretary on the Monday after we knew you weren’t pregnant, and bingo, here we are two days later.”

  The gynaecology ward had been added after the Royal Victoria and Royal Maternity hospitals had been built. It was a simple, flat-roofed wooden structure joined to the maternity hospital by a covered walkway. Barry remembered how students had disliked being called here in the winter when cold winds howled through the flimsy structure, just as they were today.

  Inside, the ward had the classic Florence Nightingale pattern of eighteen beds arranged in two rows facing each other. In the daytime it was lit by rows of windows, but on a gloomy day like today the overhead lights were on too.

  This single room where Barry sat with Sue was for the occasional patient who needed to be nursed in isolation. Doctor Harley used it for his consulting room. Barry glanced at his watch. “He should be here in a few minutes. You alright?”

  “I’m nervous,” she said, managing a smile. “I half want him to find something so he can try to fix it and I’m half hoping he doesn’t find anything.”

  “Let’s wait and see, pet.” He took her hand. It was cold, and he chafed it gently. “You feeling chilly?” She nodded. She was trying to seem calm, but Barry knew from past experience of dealing with such patients how much turmoil went on under the seemingly collected surface. It wasn’t done in Ulster to show too much emotion. Nor was it for their husbands to either, but deep inside Barry was already beginning to ask himself how would he feel if they were unable to conceive? At least some steps were being taken, starting now.

  Sue and he sat on comfortable chairs facing a plain wooden table upon which lay an in/out tray, a Dictaphone, a desk calendar, and a beige file containing, he suspected, a medical record. Behind the desk a high-backed leather swivel chair on casters remained empty. One corner of the room was screened off by ceiling-to-floor curtains. Behind them, Barry knew, was a hospital bed for any inpatients, an examining couch equipped with stirrups, instrument cabinets, and a sink with soap, paper towels, and a convenient pedal-bin. The walls were painted primrose yellow and interestingly there were no diplomas on display. Clearly Doctor Harley felt no need to try to overawe his patients with his qualifications.

  Barry turned when the door opened, and a neat, short man wearing a long white coat over a white shirt, a Royal College tie, and grey flannels came in. His dark hair was trimmed and parted to the right. A sharp nose separated lively blue eyes. “Morning, Barry. Mrs. Laverty.” His thin lips had always seemed to wear a permanent smile.

  Barry started to rise, but a hand on his shoulder reseated him. “No need for that. You’re not in the presence of royalty.” Graham Harley parked his hip on the edge of the table. “I don’t like having a table between me and my patients,” he said. “Puts up a barrier.”

  Considerate, Barry thought. “Thanks for seeing us so quickly, Doctor Harley,” Barry said.

  The doctor shook his head. “I believe we are colleagues. I remember you as a student. My name’s Graham and,” he smiled at Sue, “you would be?”

  “Sue. Sue Laverty,” she said.

  Barry had always heard a certain foreignness in the man’s voice, probably because, although a Scot, Graham Harley had been born in Demerara, a county in what had been, until 1966, British Guiana.

  “Pleased to meet you, Sue. And let me set your mind at rest about today. I know why you’re here, and I’m going to do everything I can to see if there is anything the matter and if there is, try my damnedest to fix it.”

  “Thank you,” Sue said.

  Barry heard the relief in her voice.

  “But we’re not going to rush it. How old were you when you got married, Sue?”

  “Twenty-four.”

  Graham Harley nodded, the smile still on his lips. “According to our best statistics, only eight percent of women like you haven’t started a family by the time they’re thirty-four. I can’t give you any better short-term odds until I’ve taken your history and examined you, and by the time the tests are all done we’ll have a much better picture of the future.”

  Sue nodded gravely.

  Tactful, Barry thought. As a physician, he knew that this was the beginning of the investigation of a case of infertility, but that was a harsh word, one that scared patients and made them doubt their own value. Tactful of Graham not to say it out loud. And with any luck, the situation might still resolve itself with the simple passage of time.

  “So,” Graham said, “let’s get started.” He reached round to get the file. “All I’m going to do is ask you and Barry some routine questions and examine you both, then we’ll work out a plan of attack. Alright?”

  Sue glanced at Barry and, apparently reassured, said, “That sounds fine.”

  Barry was surprised that he was to be examined. Most gynaecologists only examined the woman partner, but Graham Harley’s reputation was for being in the forefront of reproductive medicine. Barry nodded.

  “Actually,” Doctor Harley said, “we can save a bit of time if—” He opened the file and fixed two medical records to clipboards. Handing one and a Bic pen each to Barry and Sue, he continued, “—you two fill in the routine questions, please.”

  It took very little time for Barry to enter his name, address, age, phone number, occupation—and religion. This was one occasion when a person’s religion could be asked for without offence being taken: a pastoral visit might be needed from one of the hospital’s several chaplains. He ticked off the boxes concerning his family history, not much there; previous medical history, which apart from having had his tonsils out, aged six, had been uneventful. Ex-smoker. Moderate drinker. All that was to establish a baseline for the patients.

  Women were asked about their menstrual cycles, details of previous pregnancies, and contraceptive use. Biologically at least, a previous delivery spoke volumes.

  The man’s form also had boxes for previous marriages and whether or not he had fathered any children. That was the only real proof of his fertility. Enquiries were made about testicular injury or post-pubertal mumps, which could destroy the testes’ ability to produce sperm. Barry only needed to fill in the last box, frequency of intercourse. He handed the clipboard back.

  Sue took a littl
e longer.

  “Thank you,” Graham said, and scanned the pages quickly. He laughed. “I always wonder why we ask for a family history when we’re helping a couple to become pregnant. Somehow, ‘Was your mother or father infertile?’ doesn’t make much sense. If either had been, the patients wouldn’t be here, would they?”

  That produced a smile from Sue.

  “The really tricky one is when we find a difference in the rate of reported love-making…”

  Sue glanced at Barry, who couldn’t hide his grin. He’d heard Graham Harley’s patter before.

  “Perhaps we should change it to frequency—with each other.”

  That made her giggle.

  Barry admired the man’s ability to set patients at their ease.

  “Barry, I’ll not be asking you much more. I know you know what’s important—you should do. I taught you. But I do need to talk to Sue.” He turned to her. “Would you be more comfortable if I asked Barry to step outside for a while?”

  Sue shook her head. “I’ve no secrets from Barry, and anyway he’s a doctor.”

  And for the moment Graham Harley became serious. “Despite the opinions of some of our more senior colleagues, who might disagree with me, us doctors are not some kind of superior beings. We have feelings, hopes, fears, sensibilities just like anybody else, and it is my responsibility to remember and respect that when I have one and his wife for patients.”

  “I see,” Sue said. “I do see, but fire away, Doctor Harley. I don’t mind talking about these things in front of Barry.”

  The consultant said to Barry, “I assume you’d like to be in on the consultation. You’re comfortable staying?”

  “Please.”

  “Right.”

  Barry paid rapt attention and by the time Graham Harley had finished asking his questions of Sue, Barry didn’t think there were any obvious clues, but, of course, he wasn’t an expert like Graham.

  “Thank you, Sue. Now, if you’ll excuse us.” He rose. “Come on, Barry,” he said, and led the way behind the screens. As he washed his hands, he said, “Drop your breeks.”