An Irish Country Cottage Page 16

  Flo said, “Can we get one today?”

  “It may not be necessary.”

  “Oh?” Flo frowned. “Why not?”

  “Let me put it better, Mrs. Bishop. It may not be necessary right now. The textbook says with his symptoms and physical findings, Mister Bishop should be admitted to hospital. They’d do the X-ray when he was in. He’d have to have complete rest for at least two weeks and be given a special diet.”

  “Oh God,” said Bertie. “I can’t do that. I’ve far too much work til do.”

  Emer looked at Barry. “GPs are encouraged to try to keep patients out of hospital. I’d like to suggest we try something different, but I’m a bit hesitant…” She raised her eyebrows but said nothing.

  Barry thought he knew what that look meant. Emer was still blaming herself for not prescribing intramuscular antibiotics for Willie Lindsay, despite Fingal’s assurance. Damn, it had rocked her self-confidence, but Barry was here to help her get it back. “Let’s hear your suggestion.”

  Bertie sat forward. “Go on. I don’t want til go til hospital.”

  Flo said, “Will it keep him at home? I’d miss the old sod, you know.”

  Emer took a deep breath. “The most important thing is complete bedrest. Only getting up to use the bathroom. In hospital they’d give you a special bland diet of two hourly milky feeds, and junkets, jellies, baked custard, pureed vegetables, and melba toast…”

  Bertie curled his lip and said, “Oh, Lord. Not more pap.”

  Flo tutted. “And do you not think I could cook all of that? It’d be a sight more tastier than the stuff hospitals feed you. That stuff’s more like pig swill.”

  Barry knew how much Bertie Bishop loved his vittles. He might even lose a bit of weight, which would do him no harm.

  “You’d only need the bland things until the pain goes, then,” Emer said, “we can start getting you back to your normal diet.”

  “You just think of one of my steak and kidney pies—and didn’t I get the recipe from Kinky?”

  “Alright.”

  “Would you promise to rest at home, Mister Bishop?”

  “Aye. Once I’ve had a wee word with Donal Donnelly. He’ll have extra work til do. Managerial work, like.”

  “Doctor dear, some of Bertie’s promises are pie-crust—made til be broken—but never you worry. I’ll keep an eye to him, so I will, and that’s as good as gold in the bank.”

  Barry pictured Balor, the one-eyed Fomorian whose gaze could turn men to stone. He’d have no concerns about Bertie Bishop hewing to his regimen with Flo in charge.

  Emer looked at Barry. “Doctor Laverty?”

  “I think anything that relieves an ulcer patient of worry could only be beneficial.”

  “There’s discussion among doctors about various compounds to neutralize stomach acid, but according to my textbook by a Doctor Micks, the best is still the milk and soda bic., every two hours.” She looked at Barry. “If Doctor Laverty agrees, I think we could try that, provided you promise to do exactly, and I mean exactly, as I’ve told you, call here at once if the pain becomes worse, and agree that if you’re no better in two weeks we’ll have you admitted and get that X-ray.”

  “I’ll do whatever you say, Doctor.”

  “Indeed you will, Bertie Bishop,” said Flo. “Indeed you will.” And despite the iron in her words, his wife’s smile was radiant.

  16

  Whether It Be the Heart to Conceive

  Barry came back to the surgery with Donal and Julie in tow. “Now,” Barry said, “sorry about the delay, Donnellys.”

  “Come on, Doc,” Donal said. “There’s nothing urgent about us. Mister Bishop was took right poorly. He had til be seen to. We understand.”

  “Thank you, but you now have our undivided attention.” Barry turned to Emer. “Doctor McCarthy?” He would interfere as little as possible with this consultation.

  Emer said, “Please don’t be embarrassed, Mister Donnelly—”

  “Excuse me, miss—I mean, Doctor, but I’m no mister. Just Donal. Everybody calls me that. Now, what shouldn’t I be embarrassed about?”

  “Alright, Donal. Julie and I were discussing contraception, and since you’re here—”

  Donal swallowed and looked at his wife. “Sure, didn’t she tell me at home why she wanted to come here? And while youse was seeing til the Bishops, Julie explained you two had talked about ‘the pill.’” The excursion of his Adam’s apple reminded Barry of that extraordinary one in the neck of Doctor Ronald Hercules Fitzpatrick, once their associate, now in a Buddhist monastery in Nepal.

  “Julie says that from a money point of view, it would be awkward if she fell pregnant now.”

  “That’s right,” said Donal. “And I’ll not upset you, I hope, talking about all this, you being a lady and all, but I try to help, but I don’t like them French letters one bit.” He lowered his voice. “It’s like washing your feet with your socks on.”

  Barry didn’t quite manage to stifle a laugh, and it seemed that Emer was struggling too.

  Donal, now the floodgates were open, continued, “Nor her Dutch cap.”

  Barry bit back another smile. “French letter” for condom. “Dutch cap” for diaphragm. The English language was masterful at attributing matters with sexual connotations to foreigners.

  “And I hear you have concerns about the hormones in the best form of contraception, the pill.”

  Donal leant his head to one side. Frowned. “I don’t think it’s very natural, is all.”

  “I see.” Emer smiled. “You’re a carpenter by trade?”

  “I am that.”

  “A long time ago, if a saw was needed, folks used ones made from seashells, a hard stone called obsidian, or shark’s teeth. Things like that. They weren’t very efficient. What’s your saw’s blade made of?”

  As usual when Donal was faced with a question, his face writhed, then he smiled and said, “There’s different kinds of saws like panel, and plywood, and rip, but they’re pretty much all made of steel.”

  “And would you rather have a saw made from steel,” she paused, “or shark’s teeth?”

  Donal laughed. “No contest. Steel.”

  Emer said, “And steel is manmade, but it’s a combination of two naturally occurring substances. Iron and carbon.”

  Donal nodded, scratched his carrotty thatch. “Aye. Right enough.”

  “So is the pill. Two families of hormones called oestrogens and progestins both occur naturally in all humans. Scientists have made equivalents in the laboratory and combined them in the pill. And it really works to prevent pregnancy.”

  “So, if I’ve got the hang of this, this pill is a bit like steel. Not quite natural, but based on something natural, and very effective?” Donal frowned. “I see what you’re driving at, but I’ve cut myself on a saw more than once. If Julie took this here pill, would there be any risks to her? I’d not stand for that, so I’d not.”

  “I’ll be honest with you. I don’t really know,” Emer said. “It’s only been in common use since 1962, but four years ago, six and a half million American women were using it.”

  Donal looked at Julie and whistled. “That’s a brave wheen.” He nodded, then smiled. “But sure that’s American women, and you know what Yanks is like. All a bit…” He pointed his index finger at his temple and spun his digit. “Doolally.” His smile faded. “Has many Irish women used it and been studied?”

  “No. There’s too few in the North to study properly, and contraception is illegal in the Republic. We have to go on American findings. So far, the thing we see most is called breakthrough bleeding, spotting between periods, for the first couple of months of use, but that settles down by itself. In 1961, one woman out of a million taking the pill got a blood clot in her leg and it went to her lung, but that can happen to folks not taking medication, and to men too. To be fair, six years’ use isn’t long. More of what are called ‘side effects’ may come to light after longer study, but so far, the
thing seems pretty safe. But I’m a GP, not a specialist. I can be wrong, you know.”

  Barry flinched when she said that. Clearly Bertie Bishop’s relapse was troubling her.

  “We understand,” Donal said, “and we trust you, Doc. I’m no learnèd man, but I reckon there’s nothing you do in this life that doesn’t have some risk.” He smiled. “I heard about a fellah who broke his neck getting out of bed, but I’m not for staying in my bed forever, so I’m not. If you reckon it’s worth it, I’d give it a try … but it’s not me taking it.” He turned to his wife. “What do you think, Julie?”

  “I’d like to give it a go.”

  “Fair enough,” said Donal. “I’m your man.”

  Emer stood. “Then just give me a minute or two to have a quick look at Julie, explain about it to her, and write her prescription.”

  As Emer and Julie went behind the screen, Barry said, “So you’re happy enough with that advice, Donal?”

  “I think it’s dead on, so I do.” He dropped a slow wink at Barry. “I’ll not be sorry til be getting her home from Rasharkin. Know what I mean?”

  Barry chuckled. “I’m a married man.”

  “Aye.” Donal fell silent, moving his duncher from one hand to the other.

  “So,” Barry asked, “any word of when you can get started at Dun Bwee?”

  “I’m hoping til get the go-ahead very soon.”

  They chatted about repairing the cottage until Emer brought Julie back, sat on the swivel chair, and handed her her prescription. “Now, it won’t be effective until six weeks after your next period, when you start taking it, so use other methods until then, and if you think anything’s wrong, don’t wait to contact us, and I’d like to see you in six months for a checkup.”

  “Thanks very much, Doctor McCarthy,” Julie said. “I’ll give it a go.” She cocked her head to one side. “I’m so glad Ulster’s part of the United Kingdom. If we was part of the Republic, this here contraception would be illegal, isn’t that right, Doctor?”

  “That is right, Julie. The Catholic church says contraception is a grave sin, and the government of the Republic of Ireland bowed to that judgement and passed the law.”

  Julie frowned. “I’d like til try to understand why it’s illegal there. Can I ask you a personal question, Doctor McCarthy, you being a lady and a Roman Catholic, and all? I’m just curious, and if I’m talking out of turn, I’m sorry.”

  Emer frowned, then smiled and said, “Of course you can ask.”

  Julie hesitated then said, “If you, a Catholic, was married, would you take the pill yourself?”

  Emer paused and Barry thought she was digesting the question before answering. It would be simple enough for her to refuse to answer.

  “Let me get this straight, Julie,” Emer said. “Your question isn’t medical, is it? You’re not asking me if I’d be scared to take it?”

  “Not at all, Doctor. It’s personal.” She blushed. “Mebbe I am being too forward.”

  “That’s perfectly alright,” Emer said. “You see, if I accepted what was drummed into us at school, that a woman’s main duty is to have babies because Genesis says, ‘increase and multiply,’ and, ‘fill the earth,’ I’d not even be giving you contraceptive advice, never mind a prescription. Many of my Catholic friends who are doctors won’t.”

  Julie nodded and opened her mouth to speak, but Emer continued.

  “Now, not all of my colleagues agree with me, but I choose to think a doctor has no right to bring her personal beliefs into the surgery. Does that answer your question?”

  Neatly done, Barry thought. She’s made her position as a professional clear without giving away personal information. It was a position O’Reilly had taught Barry very early on.

  Julie smiled. “Aye, it does, and thank you very much. I know it was a bit impertinent asking a doctor a question like that, but I was curious.”

  Emer swung from one side to the other and back in the swivel chair. “I think some of us have difficulty with the teachings of Saint Augustine and Saint Thomas Aquinas. They condemned contraception as ‘unlawful’ and ‘wicked.’”

  Julie, clearly emboldened by Emer’s willingness to be so open, said, “And no harm to you, Doctor, but it’s not. My mammy taught me that a woman should be in control of her own body. Not some celibate priest.” She inhaled. “Now, mind, I really like Father O’Toole. He’s a good man. He’s very active in village life. Didn’t he help fix up the cottage we’ll be living in? He doesn’t try til convert us Prods, but I don’t want his church telling the government to tell me what til do, the way it does in the Republic.”

  “Julie has a point,” Donal said. “I agree with her. I’m a law-bestriding citizen.”

  Barry nearly choked. Rigged greyhound races, poaching the marquis’s pheasants, selling “ancient” relics. Donal had a different definition of law-abiding from Barry’s.

  “So, I’ll do what Her Majesty’s government says I’ve til do,” said Donal, “but not some fellah in a mitre in Rome—funny his hat should be called for a woodworking joint—thousands of miles away, no harm til ye, Doctor McCarthy.”

  “No offence taken, Mister Don—I mean, Donal. I don’t think that’ll happen,” Emer said, and smiled. “The established church in the United Kingdom is Anglican and they are happy with the pill.”

  Barry was impressed with Emer being so willing to explain an essentially non-medical matter, but it had been a long morning and he wanted his lunch. “And this is a surgery, not a religious forum. Can we do anything else for you both?”

  Donal got to his feet. “No, sir. And thanks very much til youse. Come on, Julie.”

  Emer said, “Don’t hesitate to get in touch if you notice anything amiss, Julie.”

  “I will, and thanks again,” she looked at Emer, “for everything.” She and Donal let themselves out.

  “Phew,” said Barry. “Not your typical morning surgery.”

  “It certainly wasn’t for me,” Emer said. “I hadn’t expected a simple request for contraceptive advice to turn into a religious discussion.”

  “Nor me,” Barry said.

  Emer said, “I guess it all started when I mentioned my church’s position on contraception, and one thing led to another. But it’s our job to pay attention to what a patient needs to talk about.”

  Barry smiled. “You’ll notice I kept my mouth shut right up to the end. I thought you handled it very professionally. Fingal would be proud of you too.”

  Emer smiled. “Thanks, Barry.” The smile fled. “I just wish I’d done better with Bertie Bishop. I was convinced he had alcoholic gastritis. When I realised I’d missed a peptic ulcer and it looked like he might have perforated, I thought about giving back my licence.”

  “Not really?” Barry said.

  “No,” she said. “Maybe a little, but not seriously. Still, Bertie having complications and Willie Lindsay? It’s a bit much for just a couple of weeks.”

  “Remember what you said to Julie a few minutes ago?”

  Emer frowned. “I said quite a mouthful.”

  “You said, and I quote, ‘But I’m a GP. I can be wrong, you know.’ We all can.” He watched her nodding in agreement.

  “I did, didn’t I?”

  “Yes. Now look,” he said, “we both thought Bertie had gastritis. You, with my approval, treated it correctly. If by bad luck it unmasked an underlying gastric ulcer, that was in the hands of the gods. Yes?”

  She nodded.

  “You did everything right for him this morning. I like your approach of treating him at home. It might not work with other couples, but Flo Bishop? You saw her in action. When she decides to take charge, I promise Bertie will do what you said—to the letter. Fair enough?”

  “Fair enough.”

  He cocked his head. It was still his job to make sure Emer had considered another possible disorder. “It almost certainly is an acute gastric ulcer, but could it be anything else, Emer?”

  “I don’t think so. I
know that what you have in mind is commonest in men of late middle age. The presenting symptoms are indigestion, loss of appetite, and pain that has no relationship with food. If that lasts for more than three weeks and the patient starts losing weight, passes melaena, throws up blood, and becomes anaemic—and clinically Bertie’s not—it is gastric cancer until proven not to be.”

  “Correct. And I agree. Highly unlikely.” He felt like an attorney preparing Emer’s defence if by chance they were both wrong. Barry stood. “I think, Doctor Emer McCarthy, you handled this morning’s surgery very well. I was impressed by how you sensed what was on Julie’s mind. And I fully support your management of Bertie.”

  She smiled. “Thanks, Barry. There’s no reason why Julie should have any concern about another pregnancy, and with these new medical advances and the support of a loving husband like Donal, it’s virtually guaranteed she won’t. I’m glad we were able to help Julie.”

  “You,” he said. “You helped Julie. I was just there for support.” He headed for the door. “And now I’m sure I can hear Kinky’s chicken soup calling to me. Come on. Let’s get lunch.”

  As Barry walked behind her he thought about how he’d watched Sue this morning, sitting on the edge of the bed, hair tousled, eyes blurry with sleep, waiting with a thermometer under her tongue for two minutes. Then taking out the thermometer and squinting at it, muttering, “Bloody thing’s not gone up yet.” For ten days she’d been religiously plotting her temperature on a sheet of clinical graph paper marked in tenths of degrees Fahrenheit on the vertical axis, and days numbered from one to thirty-five on the horizontal, muttering about how many days until their next visit with Doctor Graham Harley. And no matter how much Barry loved Sue, there wasn’t a damn thing he could do for her.

  17

  Asleep the Snow Came Flying

  “You’ll love it,” Sue said as Barry took a long toboggan down from where it hung on a peg in one of the Nolan farm’s outbuildings. “I’ve not been on that thing since I was a nipper. We’re going to have lots of fun. You’ll see.”

  Barry wasn’t so sure. Snow deep enough for sledging was not a common event in Ulster. He could vaguely remember being eight or nine and Dad taking him to the hills of the Bangor Golf Club’s eighteenth fairway. Dad had certainly enjoyed teaching his son tobogganing. Barry for a moment wondered what things he’d be missing teaching his youngsters if Graham wasn’t able to help. He put the thought away and recalled the wind whistling past as he sped downhill, the throngs of other yelling children careering along beside him, and the pileups of laughing bodies sprawled out on the snow like living chess pieces thrown from an overturned board. Perhaps being saddled with a vivid imagination had made him more than a little scared of breaking something. He felt that way now, but Sue was as excited as a kiddie at a birthday party, and if having fun tobogganing could keep her mind off other matters, he couldn’t find it in him to disappoint her.