An Irish Country Cottage Page 19

  “Perhaps I should have done a haemoglobin level, asked for the barium meal sooner?” She sounded uncertain.

  “I don’t think so. Medicine’s still an art and a good physician knows when to go purely on clinical judgement without constant reliance on investigations. We, remember, we agreed on the diagnosis and recommended treatment at home. I believe we were right.”

  Barry parked outside the Bishops’ bungalow. “It is possible to be too thorough, you know.”

  He heard Kenny yip from the backseat and said, “Stay.” When Barry held Emer’s door open, she smiled at him and said, “Thanks, Barry.”

  “Come in, Doctors.” Flo Bishop was standing on the front step and her eyes gave away that she’d been crying. She let Barry and Emer into the hall, where both hung up their coats. “Bertie’s taken a turn for the worser. I have him tucked up in there.” She pointed to a door along the hall. “I’ll wait in the lounge. I hope youse can fix him, so I do.”

  “Thanks, Flo,” Barry said. “We’ll do what we can,” and, bag in hand and followed by Emer, he walked along the Axminster carpet past the wall-hung aneroid barometer and the framed dried flowers.

  Barry knocked on the bedroom door.

  “Come in.” Bertie Bishop’s voice sounded weak. Now wearing red-and-white-striped pyjamas, he lay propped up on pillows in a large double bed arranged with its head against the near wall so any occupant could look out at the view over Belfast Lough through the far picture window. A large cream dressing table, with three mirrors and a glass top supporting enough lotions and potions to stock the cosmetics department of Brands and Normans, stood against the wall to Barry’s left. He noticed two long-handled hairbrushes, their backs covered in needlepoint under glass and held in place by oval silver frames.

  “Good morning, Bertie,” Barry said. “Not so hot?”

  The man was pale and unshaven, with dark bags under his eyes. He managed one shake. “The pain’s there all the time. Kept me awake most of last night. I’ve boked once since Flo phoned and I seen some blood in it. Not much. Just a wee red stain.” He fixed Barry with a stare that penetrated to his soul. “That’s bad, isn’t it?”

  “Yes, it can be, Bertie … but not always. And it doesn’t sound as if you’re seriously haemorrhaging. But we do need to get this sorted out and…” He glanced at Emer, who was biting her lower lip. “… and Doctor McCarthy has already told you she knows what has to be done now.” He looked straight at her, willing her to go through the motions of a physical examination. Clearly Bertie was not in shock from blood loss, and there was still no evidence that perforation had occurred. Peptic ulcer symptoms did get worse in some cases. It was unlikely she would find anything helpful. No concrete diagnosis could be made until after the X-ray, but examining him would help restore Bertie Bishop’s confidence in her.

  Emer said, “Mister Bishop, I’d like to take a look at you.”

  Good lass.

  It took only a short time for Emer to conclude that apart from some tenderness in the V where the ribs met, there were no other important physical signs. No rapid pulse. No fall in blood pressure. “Mister Bishop,” she said, “it’s you for the Royal and the X-ray I talked about.”

  “Just as long as them specialists can make the pain go away.”

  “They will,” Barry said. “Now, we’ll leave you, Bertie, so we can explain to Flo and get her to organise things like a razor and toothbrush to take with you. And I need to make a phone call or two.”

  Bertie Bishop lolled on his pillow. “Right. Thanks for coming.” He rolled onto his side. “I’m knackered,” he said, “I’m going til try til sleep.”

  “Good man.” Barry closed the bedroom door behind him and walked with Emer along the hall, then stopped. “While I’m phoning, please go to the lounge and have a word with Flo. Tell her the ulcer is not responding to treatment at home and Bertie’s going to the Royal.”

  “Shouldn’t I mention,” Emer lowered her voice, “it might be gastric cancer? He’s bled, Barry.”

  Barry shook his head. “Not until it’s certain that it is.” He stopped and put a hand on her arm. “Emer, I honestly don’t think we’ve missed a cancer, but if we have, please understand doctors are not infallible. You said it yourself to Donal and Julie. And in my opinion you have done everything right so far. Now,” he pointed to a phone on the hall table, “I’ll make those calls.”

  After the usual delays, he was connected with the senior registrar on the wards accepting emergencies today. The rank was for those who were qualified in their specialty but not yet full consultants.

  “Mister Mills. Can I help you?”

  “Jack, it’s Barry in Ballybucklebo.”

  “How the hell are you, oul’ hand?”

  “I’m grand, but I’ve a patient here. You’ve met him at the O’Reillys’. Councillor Bertie Bishop.” Barry gave Jack the relevant information.

  “Sounds like an ulcer. Shoot him up to Mister Sinclair Irwin’s ward 13. I’ll admit him, get a barium meal lined up. If it’s just an ulcer and needs diet and nursing, we’ll transfer him to a medical ward. If he needs surgery, he’ll be in the right place. And we’ll try to make him comfy while things are getting done. They may take a day or two.”

  “Thanks, mate.”

  “My absolute pleasure, old boy.” Jack, who was a consummate mimic, had dropped his Cullybackey tones and adopted the upper-class drawl of the character Hercules Grytpype Thynne from the BBC radio’s The Goon Show. He and Jack had enjoyed the show back in the ’50s when they’d met as thirteen-year-olds at Campbell College.

  Barry felt a twinge of nostalgia and had a fleeting thought. What would it be like to be thirteen again? Damn it, he thought, Jack Mills is my oldest friend and I haven’t seen him for weeks. “Jack, what are you up to tomorrow night? Sue and I are off.”

  “I’ll have to see what Helen’s doing, but if she’s free I’d love to get together. I’ll give you a call tonight. Gotta go now. Duty and all that. What? What?”

  Eejit, Barry thought as he smiled and replaced the receiver. He could do with a break, and an evening out with Jack and Helen Hewitt would be just the job. He picked up the phone and dialled ambulance dispatch.

  He went through to the lounge, where Emer must have done a good job of reassuring Flo. She sat on the sofa, clutching a letter. She managed a weak smile.

  “Ambulance will be here soon, Flo,” Barry said. “Please try not to worry too much.”

  She nodded. “I’m sure Bertie’ll be alright. Doctor McCarthy is very confident.”

  Barry understood that while it might be a façade, Emer had made every effort to calm Flo’s worries and, in his opinion, that was right and proper.

  “I was going through the mail, trying to keep my mind off our troubles, and found this here letter. It’s a bit of good news. Doctor O’Reilly’s brother has given us the official go-ahead. The National Trust says construction can start on Dun Bwee. Before he got really sick, Bertie put Donal in charge of the work once it’s ready to go, and it’s to get started first thing next week. I thought you’d like to know. I’ll phone Donal at the building yard to tell them before Bertie goes to Belfast.”

  “Very considerate of you, Flo, to tell us. I’ll pass on the word to Doctor O’Reilly. He’ll be delighted.”

  “Aye. Well,” Flo said. “Life has til go on.” She rose. “If you’ll excuse me, Doctors, I’ll go and see til getting an overnight bag ready for Bertie and keep him company until the ambulance arrives. And thank you both for all you’ve done.”

  “Thanks, Flo,” Barry said. “We’ll be running along.” He glanced at a clock on the mantel. They certainly had time to drop in on Willie Lindsay.

  * * *

  The council estate looked less dismal under a patch of blue sky just visible above the rooftops, chimney pots, and spidery TV aerials. Barry parked outside 31 Comber Gardens. No white Ford Anglia, so Gordon McNab must be at his Holywood bookie’s shop, placing bets for his customers. Kenny stood
up in the backseat, tail thrashing, and yawned mightily. At Barry’s “Stay,” the big dog flopped back down on the seat and rumbled in his throat. “Soon, Kenny,” Barry said, and got out.

  A council road work crew was filling in potholes. One man with a cigarette stuck to his upper lip shovelled in a heap of steaming, pungent, hot tarmac from a battered wheelbarrow, smacked it flat with the blade of his shovel, and stood back. His partner used a heavy, blunt-ended tamper with two handles to compact it and another shovelful was dumped in. “Fingal calls that ‘darning the road,’” Barry said to Emer, who was knocking on the Lindsays’ front door, from behind which came sounds of hoovering.

  The Hoover’s engine note tailed away and Eileen opened the door. Her hair was done up in pink plastic curlers called Spoolies and was half hidden under a scarf knotted at the front. Her hand flew to her head. “Good morning, Doctor Laverty, Doctor McCarthy. I wasn’t expecting company, otherwise…”

  Barry smiled. “Eileen, I’m a married man, and I’m sure Doctor McCarthy’s seen curlers before.”

  “Aye. Right enough.” Eileen smiled. “Gordy and me’s going til see The Lion in Winter in the Ritz up in Belfast the night because wee Willie’s all better, and it’s all thanks to youse two…”

  Barry stole a glance at Emer and was pleased to see the ghost of a smile.

  “… and thon Mister Craig up at the Royal.” She tutted and said, “And here’s me forgetting my manners. Youse’ve come til see Willie?”

  Emer nodded.

  Eileen stepped aside. “Then come on on in. He’s in the parlour.”

  Barry let Emer precede him into the now-familiar front room, where the twelve-year-old Willie, wearing short grey trousers and an open-necked grey shirt under a royal blue V-necked pullover, sat on the carpet surrounded by a Meccano set. He looked up. “Morning, Doctor Emer. Doctor Laverty.”

  “Morning, Willie. How are you?” Emer said, squatting by the boy and smiling at him.

  Barry noticed her looking at his arms and legs.

  “I’m dead on—now,” he said, “but my throat was powerful sore for a few days in the hospital.”

  Barry watched as she looked intently at Willie’s face, then asked, “Have you any pains in your wrists or elbows or knees?”

  “Not at all.”

  “Good. May I have a look at your throat?” Emer asked, producing a tongue depressor and pencil torch.

  Willie, who must have had his throat inspected many times while in the Royal, opened wide, stuck out his tongue, accepted the depressor, and without being asked, said, “Aaaah.”

  Emer stood. “Good as new,” she said. “One more wee thing. Can you pull up your shirt for me?”

  He did. Barry saw a skinny, mildly pigeon-chested front and watched Emer lean over to get a look at the boy’s back.

  “Thank you,” she said, and smiled. “You are indeed better.”

  “Aye,” said Willie, “and I’m going back til school on Monday. Missus Laverty, her what used to be Miss Nolan, our teacher, she’s sticking out, so she is, sir.”

  Barry smiled at the compliment. Anything “sticking out” was very good. Sticking out a mile was superlative. “I’ll tell her this evening that you said so.”

  Emer said with a grin, “You’re sticking out yourself, Willie Lindsay, and your crane’s coming on very well.”

  “Aye,” he said, and Barry heard a small catch in the little lad’s voice. “Before my daddy went away, he drove one of these things at the shipyard, so he did, at Harland and Wolff. He give this here Meccano set til Sammy, but he’s too big for it now, so Sammy give it to me.”

  “You’re making a grand job of it,” Emer said.

  And, Barry thought, your mum’s doing a grand job of bringing up three kids by herself. He wondered how matters were progressing with Gordy McNab.

  Emer looked at Barry and inclined her head to the door.

  “We’ll be off now, Eileen. Willie,” Barry said, and preceded Emer out onto the street where Eileen said, “Once again, Doctors, a million thanks.”

  As they got into the car, Barry noticed that the workmen had left a broad patch of new tarmac. It glistened in the weak sunlight. “So,” he said, putting the car in gear and driving off, “bit happier now about Willie?”

  “Yes,” she said.

  “Good. Now, I’d like to ask—”

  Canine mutterings came from the backseat.

  “Alright, Kenny,” Barry said, and laughed. “We’re going to the beach now. It’s not far. My questions will keep until we get there.”

  Barry parked near the sand dunes. As he let Kenny out, Barry remembered one spring afternoon in 1965 when he’d been exercising old Arthur Guinness here. An idiotic springer spaniel called Max had charged round the dunes and a certain Miss Sue Nolan had appeared soon after. He had a soft spot for this place. “Heel, sir,” he said. “Come on, Emer, that breeze off the sea’s brisk enough. Let’s get walking.”

  They strode along a path between low dunes and out onto the strand. The tide was out and the ochre sand had ripples where the departing waves had scrawled their signatures.

  “Hey on out,” Barry said, and Kenny needed no bidding. He tore off, his paws throwing up little lumps of sand and leaving his spoor behind. Each paw print had four toe marks, just like, as Sue had remarked in the snow at the farm, those of a fox.

  At the water’s edge, wavelets rolled in, and immediately above them a small flock of black-and-white birds with long red bills flew in line astern, inches above the water. “Oystercatchers,” he said.

  Kenny was nearing the sea.

  “Come in,” Barry called. He didn’t want Kenny, bred though he was for it, getting cold, nor the car to stink of damp dog.

  Emer said, “It’s lovely down here. I grew up on the Lisburn Road in Belfast. We didn’t get to the seaside much.”

  “I’m a Bangor boy,” Barry said. He bent and picked up a short stick. “Grew up with the sea.”

  Kenny arrived, barely short of breath.

  “Sit.” Barry tossed the stick as far ahead as he could. “Hi lost.”

  Off went Kenny.

  Barry thought how well O’Reilly had trained his gundog, and Barry hadn’t forgotten he was helping to train Emer. He turned to her. She was smiling as she watched the dog. “I’d started to ask you a few things about Willie Lindsay just before we drove off.”

  Emer was still smiling as Kenny grabbed the stick and headed back. “Go ahead.”

  “Tell me why you asked about joint pains and looked at his face, legs, arms, and chest.”

  Emer said, “He’s not out of the woods yet. There are three possible late complications of a streptococcal infection. Rheumatic fever causes joint pains and can damage the heart. Kidney damage leads to facial swelling, and purpura produces its typical rash on the limbs and upper body. That’s why I asked him to lift his shirt.”

  “I told you his big brother had a kind of purpura back in ’64.”

  “You did,” Emer said.

  “So, you didn’t think it would have been the first thing Eileen would have told us if Willie had blown up a new rash that looked exactly like the one his big brother had when he was so sick?”

  “She very well might, but why assume when you can see for yourself?” Emer said.

  Earlier O’Reilly had described Emer as a very conscientious young woman. He was correct. “I think, Doctor Emer McCarthy, you are absolutely right about seeing for yourself. Well done. And,” he said, “I believe you were right not mentioning the possible complications to Eileen. She’s happy now. It’s highly unlikely that any will arise, and we can’t prevent them anyway. If he’s alright in another couple of weeks, they’re not going to happen, and you can relax and take pride in what I think was a job very well done.”

  Emer said, “I hear you, Barry, and thanks.”

  He heard her in-drawing of breath before she said, “But I’ll never stop wondering if I’d given him intramuscular penicillin would he still have blown
up the abscess?”

  Barry sighed. “And I hear you too, Emer. We all do it at the start, but now you’ve seen with your own eyes that Willie Lindsay’s fine and is probably going to stay fine, and we’ve got things properly under way for Bertie Bishop, you’ve got to stop blaming yourself.” He glanced at her.

  She smiled at him. “Barry. I know you’re right and I’ll try. I’ll certainly try.”

  Kenny, stick in mouth, arrived, sat at Barry’s feet, and presented the retrieve.

  Barry said, “Good,” with the inflection Fingal would have used.

  Kenny wagged his tail.

  And Barry, knowing how the simple word “good” was a great reward for the chocolate Lab, said to Emer, “And I’ll say it again, Doctor McCarthy, I think your management of both Bertie Bishop and Willie Lindsay, from beginning to end, has been exemplary, and you have nothing to blame yourself for. Nothing.”

  “Thank you, Barry,” Emer said, leaning across and pecking his cheek as might a sister to a brother. “Thank you very much.”

  20

  A Ticket for the Peepshow

  Barry walked under a low late-afternoon sun past tennis courts and the temporary wartime hut that still served as accommodation for medical students and junior house officers at the Royal Victoria Hospital. Nicknamed Mortuary Mansions, the hut was next door to that forbidding structure, a place to which Barry sincerely hoped Bertie Bishop was not soon to be bound.

  He turned into the passageway leading past the canteen and headed for the staircase that led to the hospital’s main corridor. As he walked he recalled the bombshell that had exploded during lunch yesterday at Number One.

  O’Reilly had been reading a just-delivered Christmas card. “Heavens,” he’d said, examining the envelope, “this thing was mailed from Nepal in early December. Their postal yak must be sick.” He turned to Emer. “It’s from an old associate, Doctor Ronald Hercules Fitzpatrick. Two years ago, he turned over his practice in the neighbouring Kinnegar to Connor Nelson and left Ulster to become a monk. Seems Ronald has had enough of Nepal, reckons he’s exorcised his demons, and is coming back to Ulster sometime in January. Says he misses home. He’ll pop in and see us—”