An Irish Country Doctor Page 20

  "Barry, I. . ."

  "Yes?"

  "I'd still like to see you again." She moved closer to him, and he was aware of her scent.

  To tell me that your career is more important? To hold out a hope and dash it again? He remembered the advice of the professor of surgery: "When you try to treat cancer, catch it early, cut wide, cut deep. Get rid of it all." Better to heed that advice. And yet. . . "I'll not be free again for a couple of weeks."

  "Will you phone me?"

  He hesitated. No. There'd be no future in getting his hopes up. "Please?" She moved closer still, but he simply held out his hand. She ignored it and kissed him, and he held her.

  "I'll phone," he said and swallowed, telling himself he was being stupid. But there could never be another Patricia. Not for him. That was something else he'd learned from the prof. "As long as there's any hope, any hope at all, don't give up the fight."

  "Thank you," she said softly. "Please try to understand."

  "Good-night," Barry said, and closed the door behind him.

  I Fall to Pieces

  "You've a face on you like a Lurgan spade," O'Reilly said, referring to the extra long turf-cutting implements peculiar to that town in County Armagh. "Bad night?"

  "Not really." Barry sipped his tea and stared out through the putty-smudged pane of new glass that Seamus Galvin had installed in the dining-room window. Yes, it had been a bad night. Things had not gone at all the way he had been hoping with Patricia, and as a result he had slept badly, but he saw no reason to confide in O'Reilly. "Kinky said that you were busy."

  "I saw Cissie Sloan." Barry hesitated. He was in no mood for a debate if the older man didn't approve of what had been done.

  "And?"

  "I think you're wrong about her." Barry studied O'Reilly's face. Senior physicians could become bloody-minded if they thought their expertise was being challenged.

  "Is that a fact?"

  "I'm sure she has hypothyroidism."

  "Why?"

  "Well. . ." Barry quickly listed her symptoms.

  "You might just be right." O'Reilly went to the sideboard and helped himself to a second kipper. "Good lad."

  Emboldened, Barry said, "I'm sending her for a radioactive iodine uptake on Monday."

  "Better and better." O'Reilly tucked into the butter-dripping smoked herring. "If you are right, it'll do wonders for your reputation."

  "What about yours?"

  O'Reilly grunted. "I'm big enough and ugly enough to look after myself."

  And generous too, Barry thought. "I'd not mind another kipper," he said rising, realizing that although he was still disappointed about Patricia's attitude, perhaps things might work out if he gave her time. And in the meantime there were the compensations of doing his job here to the best of his ability. "Kinky said you went to see Major Fotheringham."

  Barry rolled his eyes. "Another false alarm. Torticollis. I gave him a squirt of ethyl chloride and told him to call us if there was no improvement."

  "Jesus," said O'Reilly, wiping his mouth with his napkin. "One day that man will have something wrong and we'll miss it. He'll not have just cried wolf. Since I've known him, he's roared on as if he I was being attacked by Akela, Mowgli, and the rest of the whole bloody pack."

  "Kipling," said Barry, returning to the table.

  "The Jungle Book," said O'Reilly. He chuckled. "I always liked the wolves. Canis lupus, to give them their Latin name."

  "I know. You've one of their descendants, Canis familiaris, in your backyard." Far too familiar, Barry thought. "Good old Arthur," O'Reilly said fondly. "And by God, I'd a lot of fun with another canine last night."

  "Donal's Bluebird?"

  "The darling dog. She excelled herself."

  "Oh."

  "She won in the third at twenty to one." Barry's fork stopped on the way to his mouth. "And I suppose you'd backed her."

  "Wouldn't you have if you'd had inside information?" Barry popped a bite-sized lump of kipper into his mouth, savoured the salty taste, swallowed, and said, "All that business about running on water, then running dry?"

  "That's it."

  "Fingal, would you mind explaining?"

  "About racing greyhounds?"

  "No. Einstein's theory of relativity." O'Reilly chuckled. "Actually, greyhounds and relativity are pretty much the same thing."

  "I'm not following you."

  "Look. At the races a bunch of dogs rush round an oval track chasing an electrical hare. Their relative speeds dictate which one wins. And after a few races the bookies figure out the relative likelihood of any given dog winning and on that basis offer odds."

  "Go on."

  "When there's money involved, people will always try to fiddle the system. It's not been above some of the doggy fraternity to help their contender along a bit."

  "How?"

  "Stimulant drugs. That's why all dogs that place are immediately tested." He held one thick finger alongside his bent nose. "But they don't test the losing animals."

  "Why bother?"

  "What do you think the odds will be like after a dog has come last in half a dozen races?"

  "Relatively good."

  "Relatively. See, you're beginning to understand."

  "The hell I am."

  "Water," said O'Reilly conspiratorially.

  "Water?"

  "When Donal told me the dog had been running on water, he meant that he'd kept her thirsty until immediately before each one of her previous outings. Just before the race he let her have all she wanted to drink. No dog can run when it's waterlogged."

  "So the odds go down?"

  "Right," said O'Reilly. "You're not as green as you're cabbage looking."

  "And when Donal said the dog would run dry last night. . ."

  "Exactly. No water. No handicap. Great odds and not a thing to show up on a drug test."

  "But isn't that dishonest?"

  "Totally, absolutely, and utterly, but it keeps the bookies humble, and they've had enough of my hard-earned money over the years."

  "You like a flutter?"

  "Only on the dogs and the so-called sport of kings. A man has to have the occasional vice."

  "How much?"

  "Twenty quid."

  Barry whistled. That's almost as much as I make in a week, he thought. He then did the mental arithmetic. "But that means you won four hundred pounds."

  "Indeed," said O'Reilly, "but it's going to a good cause." The Fingal Flahertie O'Reilly Benevolent Fund, Barry thought. "Donal did well too," said O'Reilly. "All in all a very satisfactory evening."

  "And I suppose to top it off, Sonny's better and your friend is going to buy Seamus Galvin's rocking ducks. You said you were going to see Sonny."

  "And so I did. He's off oxygen. Temperature's normal. Worried i as hell about his dogs but gracious enough to say that once they let him out, he'll go and see Maggie and thank her for looking after them."

  "Good." Barry's words held just an edge of bitterness. "Maybe romance will be rekindled."

  "Mmm," said O'Reilly, looking out the window. "Unfortunately my business friend doesn't want Galvin's ducks. He's probably still laughing about them. Can't say I blame him really." Barry's thoughts had strayed back to Patricia. "What?" He wondered why O'Reilly was beaming.

  "I'm sure something will turn up for Seamus." He winked at Barry, who tried to guess what O'Reilly meant. He was nowhere close to an answer when O'Reilly said, "I did have one other bit of good luck, and so did His Lordship, and that should please you."

  "Why me?"

  "The old boy likes a night at the dogs, an afternoon at the horses. I gave him the nod about Bluebird, and when he'd collected his winnings I asked him if you could have a day or two's fishing on his water. 'Anytime,' he said."

  "Thank you, Fingal."

  "I presume you'll be spending a bit of time there soon."

  "Why do you say that?'

  O'Reilly pushed his plate away. "Young fellows who've been out on dates wi
th beautiful young women generally beam a bit the following morning. You were decidedly deficient in the beaming department. Happy chaps are usually pleased about other folks' good fortune in the romance stakes."

  Barry regretted his sourness when he'd spoken of Sonny and Maggie.

  "I'd guess you and Patricia didn't hit it off." Barry was about to tell O'Reilly to mind his own business, but when he looked at the big man he saw nothing but kindness in his eyes. "You could say that," he said quietly.

  "I just did. You'll get over it. But it'll take time. I know." I know you do, Barry thought, but remembered Kinky's admonition to respect O'Reilly's privacy. He sighed, and as he wondered how to reply he heard the telephone ringing in the hall.

  "If it's one of the customers, I'll go, Barry."

  "Thanks, Fingal, I--"

  Mrs. Kincaid burst in. "It's Mrs. Fotheringham. She says to come at once. Her husband's unconscious."

  Barry glanced at O'Reilly, who was heading for the door. "Wait for me, Fingal."

  "Front door," said O'Reilly. "I parked the car on the street last night."

  O'Reilly hurled the long-nosed Rover along the narrow road. Barry tried to answer O'Reilly's questions and keep an eye on the road. As the car slid out of a blind corner onto a straight section, Barry noticed a cyclist in the distance.

  "Tell me again. Exactly what did you find when you examined him?" O'Reilly's fists grasped the steering wheel, and he stared ahead.

  "Not much. Bit of spasm in the left neck muscles. His pupils were equal in size, not dilated or constricted."

  "What about his reflexes?"

  Barry was temporarily distracted. As the car came within a few yards of the cyclist--Barry recognized Donal Donnelly's ginger hair--the rider's mouth opened in a silent yell, and he hurled himself and his rusty machine into the ditch.

  "Fingal, you nearly hit Donal Donnelly."

  "Nearly doesn't count. What about Fotheringham's reflexes?"

  "I ... I didn't test them." Barry cleared his throat. "I thought Fotheringham was up to his usual tricks."

  "I'd probably have done the same."

  "Would you?"

  "Probably." O'Reilly stamped on the brakes, and Barry was thrown forward. "Out. Open the gate."

  Barry obeyed, waited for the car to pass, and ran up the now familiar gravel drive, past the parked Rover with the driver's door still wide open, and on into the Fotheringhams' house. He caught a glimpse of O'Reilly disappearing into the upstairs bedroom and raced up the stairs. He was short of breath when he arrived. Mrs. Fotheringham stood at the foot of the bed. O'Reilly sat on the side of the four-poster taking the pulse of a clearly unconscious Major Fotheringham and barking questions at his wife. "Doctor Laverty came and examined your husband, sprayed his neck, and the pain got better?"

  "That's right."

  "He told you to phone if it got worse?"

  "Yes. Basil said the spray was working, but his head had started to feel funny so he thought he'd go to bed. He was still asleep when I got up to make the breakfast. I was going to bring his up to him, but I heard him calling for me." She clasped her right fist in her left hand. Tears slid down her cheeks.

  "When did he vomit?"

  Barry was aware of the acrid smell, could see half-digested carrots, little red islands in an ochreous lake on the pillow beside Major Fotheringham's head. Stiff neck, headache, vomiting, coma. God almighty. It couldn't be.

  "I'm sorry I didn't have time to clean it up before you came."

  "Doesn't matter," said O'Reilly. "When did it happen?"

  "I came back up, and he said he thought someone had hit him on the head." She sniffled.

  "I told him not to be silly ... I wish I hadn't." Barry could see the lines in the textbook, word for word, the ones he'd memorized before his finals: "and headache may be so abrupt in onset as to make the patient think he has been struck." Christ. "Go on." O'Reilly produced a penlight and bent to examine the major's eyes. Barry knew, he just knew, that one pupil would be widely dilated and would not respond by constricting when O'Reilly directed the thin beam under the eyelid. Barry held his breath. "Then he boked. Grabbed his head and . . ." Her sobs came in gusts.

  "Right pupil's fixed," said O'Reilly.

  Barry exhaled. He didn't need O'Reilly to demonstrate that there were no muscle reflexes in the patient's left arm or leg, or that when a key was scraped along the sole of his left foot the great toe would curl upwards--the so-called Babinski sign--not down as was normal. Major Fotheringham had suffered an intracranial haemorrhage. And his stiff neck last night had been the earliest sign. O'Reilly stood, moved to the end of the bed, took Mrs. Fotheringham by one arm, and led her to a velvet-covered, button-back armchair. "Sit down."

  She sat and looked up silently at O'Reilly.

  "I'm afraid your husband's had a kind of stroke."

  She crossed her arms in front of her stomach and rocked back and forth, all the while making little keening noises. And if I'd not been in a rush, hadn't been so busy congratulating myself for catching O'Reilly out about Cissie Sloan's thyroid disease . . . Barry's thoughts were interrupted when O'Reilly said, "I'm sorry Doctor Laverty didn't make the diagnosis last night." Barry stiffened. He couldn't believe that O'Reilly was trying to -- an old naval expression that his dad was fond of came to mind -- keep his own yardarm clear.

  "But I doubt if anyone could have." O'Reilly stared at Barry and nodded once, almost imperceptibly.

  "I know. He was very nice." She forced a tiny smile. Barry half accepted O'Reilly's unspoken reassurance, but inwardly he shrank. "Nice" wasn't good enough. What O'Reilly had said, and Barry blessed the older man for his support, would have been true if last night's examination had been thorough, if he had tested the reflexes and found them to be normal. But that hadn't happened. "Right," said O'Reilly. "We'll have to get him to the Royal."

  "Is he going to die?" Mrs. Fotheringham asked. O'Reilly nodded his shaggy head. "I'll not lie to you. He could." Barry was only too aware of the statistics. At least half the number of patients like Fotheringham would not recover. Mrs. Fotheringham yelped and stuffed a fist into her mouth. "He could live but be paralysed."

  "Oh, my God."

  "But until the specialists have done a test called a lumbar puncture, maybe take special X-rays, we'll not know what's caused it." Maybe it's just a bleeding aneurysm, Barry thought, and heard O'Reilly echo the idea.

  "If it's just a leak from a thin-walled blood vessel, they can usually operate. Some patients make a complete recovery."

  "Really?" Barry saw hope in her eyes.

  "Yes. But I won't make any promises."

  Her eyes dulled again. She took a deep breath, stood, and exhaled. "Thank you, Doctor O'Reilly, for telling me the truth." O'Reilly grunted. "Doctor Laverty, could you phone for the ambulance?"

  "Right." Barry rummaged in an inside pocket for a notebook where he kept important telephone numbers. When he opened the book at random, he found himself staring at Patricia's number. As if he needed to be reminded why he had slipped up so badly last night. "I'll go and see to it," he said.

  The Compleat Angler

  "I wonder where Lady Macbeth is?" O'Reilly remarked, walking directly to the sideboard in the upstairs lounge. Barry neither knew nor cared.

  "Get that into you," said O'Reilly, handing Barry a cut-glass tumbler of Irish whiskey.

  "I'd rather have a sherry." Or perhaps some hemlock, Barry thought. It had been more than an hour since Major Fotheringham's intracranial bleeding had been diagnosed and he and his wife dispatched to the Royal. O'Reilly had driven back home. They had exchanged few words.

  "That's a medicinal whiskey. Sit down, drink up, and shut up." Barry sat. The Irish was peat-flavoured, sharp on his tongue. O'Reilly fired up his briar, took a pull from his own glass, lowered himself into the other armchair, looked Barry straight in the eye, and said, "I'm disappointed."

  Barry flinched. He wasn't surprised that O'Reilly felt he'd been let down, but did he have t
o be so blunt about it? Of course he did. That was the mark of the man. And the damnable thing was that he was right to be upset. "There's no point making excuses. So I won't."

  "Excuses? What for?"

  "Come on, Fingal. I told you I was in a hurry last night. I didn't do a complete neurological examination."

  "And if you had, what do you think it would have shown?"

  "Enough so that I could have got him to a hospital before the bleeding into his head got any worse."

  "Maybe, but what did his wife say?"

  "What do you mean?"

  "Everything blew up this morning. Hours after you were there."

  "But-"

  "If he'd had a decent bleed last night, don't you think it would have been as plain as the nose on your face? A second-year student could have seen what was wrong. But he hadn't bled and it wasn't plain."

  "I was wrong last night."

  "And that's why I'm disappointed."

  "Because I didn't do my job right?"

  O'Reilly stood and loomed over Barry. "No, you buck eejit. You knew your patient's history of malingering. You went to see him, and you didn't have to. You put him before yourself, and there was no need to. I know how much you wanted to see that wee girl. You could have been late for your big date."

  "I was."

  "You didn't have to be. I told you Kinky could have handled things. Fotheringham would have been no worse off if you hadn't been conscientious enough to go last night and we'd not gone out there 'til this morning."

  "It's still no excuse."

  "Christ, man. Who do you think you are? Sir William Osier? Hippocrates? Jesus Christ All-fornicating-Mighty?"

  "No. But doctors have certain responsibilities."

  "You're a sanctimonious young--"

  "I don't have to take this." Barry started to rise, but the pressure from the hand that O'Reilly had clamped onto Barry's shoulder forced him back into his seat.

  "By God, you do. Listen, what makes you think you're the only physician to make mistakes? Do you think missing Cissie Sloan's buggered-up thyroid and the Galvin baby's hypospadias are the only bollocks I've ever made?"