An Irish Country Village Page 24

  Barry finished putting on his pants, grabbed the damp pair, and hurried downstairs.

  Kinky looked around as he arrived in the hall, where Donal Donnelly stood, cap in hands, just inside the front door. His usual grin had been replaced by a wide-eyed frown. “It’s Julie, Doctor,” his words tumbled out. “Can you come quick? She’s bleeding something fierce.”

  “I’ll get my bag.” Barry shoved his wet trousers at Kinky, ran into the surgery, and grabbed his bag. “Where is she, Donal?”

  “At Brie Lannigan’s. I’d gone round to have my tea with her, like, and all of a sudden she grabbed her belly and let a howl out of her, so she did. I never heard nothing like it.” Barry could see tears on Donal’s cheeks. “And then there was this great big red stain on her dress . . . I got her up to bed as quick as I could. Brie’s no phone, so I come round here as fast as I could pedal.”

  “Where does Brie live, Donal?”

  Donal grabbed Barry’s hand and tugged him to the open door. “Come on quick, Doctor. I’ll show you.”

  He heard Kinky call, “I’ll tell Doctor O’Reilly when he gets back.” But he was so hard pressed to keep up with Donal, he hadn’t time to reply. He saw Donal’s multicoloured bike lying on its side in the rosebushes where it had been abandoned in his rush to get to the door. “Round the back,” Barry yelled. “My car’s there.”

  Barry started the engine, waited for Donal to slam his door, and drove off. “Which way?”

  “Turn left here on Main Street, right at the Maypole, along Station Road for about a mile.” Donal hunched in his seat. “Can you not go any quicker?”

  Barry ignored the question. Damn it, he’d been right to worry when he’d examined Julie last week and thought her uterus didn’t feel quite right. He should have paid more attention yesterday when Donal sought reassurance about Julie’s “wee tummy upset,” but O’Reilly had been right too. Vague aches and pains were so common in early pregnancy that such a complaint was usually brushed off by doctors with an offhand, “Oh, you get that sometimes.” Mind you, he told himself, if a miscarriage is going to happen, there’s not a damn thing can be done to stop it.

  “I’m scared, so I am, Doctor.” Donal lowered his voice. “She . . . she couldn’t die, could she?”

  “Of course not, Donal.” Barry tried to sound confident. If Julie was miscarrying after what would now be eleven weeks since her last period—and he was pretty sure she was—well, the risk of death from haemorrhage, shock, or infection accounted for eighteen percent of all deaths due to pregnancy. He knew that, but what was the point of scaring an already terrified man?

  “Oh, Jesus.” Donal thumped a fist on the dashboard. “It’s all my fault.”

  Barry was too busy trying to cross the oncoming traffic—the light for once was in his favour. He drove through a gap between a car and a lorry, changed down, and took the corner under the bridge onto Station Road. “How in the hell is it your fault, Donal?” Had the man had second thoughts about having to get married? Had he somehow persuaded Julie to go and see an abortionist? Barry shook his head. Impossible. When the pregnancy had been first diagnosed, Julie had insisted that if necessary she would go to England, have the baby, and give it up for adoption. “I asked you—”

  “I heard you. It’s a judgment, so it is.”

  “For what, for God’s sake?” Barry had to swerve to avoid a cyclist. At least, he thought, he hadn’t adopted O’Reilly’s habit of ploughing on regardless and letting the unfortunates fend for themselves.

  “For putting wee Julie in the family way before we was married.”

  “I’d not worry about that now, Donal. Getting a girl pregnant could happen to anyone.” Including me, he thought, if that thunderstorm hadn’t come out of nowhere.

  “If it wasn’t for that, then it was for foxing the English gentleman. I took a hundred pounds off him, so I did, but it was for Julie and me, and the wean.”

  “A hundred?” No wonder the captain had confessed to being a little “stwetched.” Was there any connection between Captain O’Brien-Kelly’s impoverishment and O’Reilly having left to get Sonny? No time to worry about that now. Barry said, “I’d not get upset about that either, Donal. Nobody forced him to buy the half crowns.”

  “Aye, maybe so, but . . . do you think it would help if I gave it back?”

  “I doubt it.”

  Donal looked crestfallen. “Pull in there, Doctor. At that red brick semi.”

  Barry parked, reached into the backseat for his bag, and followed Donal up a path to the right-hand house. Donal had opened the door. Barry followed into a narrow hall and up a flight of stairs. He was just in time to see Donal’s back disappear through a doorway.

  Julie lay on the bed. He could see that she was pale and sweating. A scarlet stain crept across the sheet that covered her lower half. He knew from experience that a little blood went a very long way, but to Julie and Donal it must look as if the bleeding was torrential.

  He glanced under the bed to see if there were ropes of clots forming from blood that had soaked through the mattress. A woman would have to lose two or three pints before that happened. Good. No clots. She hadn’t bled that much—yet.

  Donal sat on a wicker-bottomed chair at the bedside, holding Julie’s hand in his and stroking her blonde hair away from her forehead.

  “Julie,” Barry said, “can you tell me what happened?”

  She tried to struggle up, but he sat on the bed beside her, careless of the bloodstain. “It’s all right.” He took her wrist between his thumb and first two fingers. The skin was clammy, her pulse rapid and very feeble. He didn’t need a sphygmomanometer to tell him her blood pressure must have fallen. She was on the edge of going into shock.

  She forced a weak smile. “It is now you’re here, Doctor.” She laid her head back on the pillow. “I started getting these wee cramps yesterday, and I thought they’d go away. But about an hour ago . . .” She bit her lower lip and screwed her eyes shut. “An hour ago they got to be fierce . . . just like that one, and then I started to bleed down below.”

  Barry glanced at Donal, who was looking up at him as a penitent might look at a priest, a longing for absolution in the man’s eyes. Barry ignored him, opened the bag, and took out a paper packet of sterile gloves and a green-wrapped pack. He undid the outer covering of the pack and tore open the paper. “Where’s the bathroom?”

  “On the left,” Donal said.

  “I’ll be right back.” Barry left, washed his hands, and returned. “I have to examine you, Julie.” He dried his hands on a sterile towel and slipped on the gloves. “Would you wait outside, Donal?” Barry was only vaguely aware of Donal leaving. He pulled back the bloody sheet. The stain on the undersheet had spread to both sides of the bed. “Can you open your legs?”

  Julie did.

  Bright red blood spurted from the vaginal opening. He was aware of its coppery smell. “Sorry,” he said, slipping the first two fingers of his right hand inside. He could feel the cervix; it was partially open. Something spongy was stuck in it. This wasn’t a difficult diagnosis. Julie was aborting, but she had not expelled the tiny fetus and placenta—and until she did, the bleeding would not stop. He tried to dislodge the tissues with his fingertip, but they wouldn’t budge. His patient was going to need a dilatation and curettage—shortened in doctor talk to a D and C—and that had to be done in a hospital.

  Barry removed his fingers, conscious of how the heat of the blood had warmed them, but inside he felt a chill. He tried to keep his face expressionless. “I’m sorry, Julie, but you’re losing the baby. It’s an . . .” He was going to use the medical term “incomplete abortion,” but understood how the word could be misinterpreted. “You’re having a miscarriage. We’ll have to get you to the Royal.”

  “All right,” she whispered. Then she moaned in pain.

  It was all well and good for Barry to sound so damned confident. If he’d learned nothing else when he had studied gynaecology, it was that patients w
ith an incomplete abortion, which was what Julie had, and who were in or close to being in shock, which she was, should not be moved until after they’d had a blood transfusion. To do so could kill the patient. Send for the “flying squad” had been drummed into him; send for the specially equipped ambulance staffed by doctors and nurses from the hospital, professionals who would bring blood with them and transfuse the patient before transport. And if necessary, they’d give her an anaesthetic and do what was required in her own home.

  That was all well and good for those with the training and the instruments, but far beyond the capabilities of a country GP armed with only his bag. And sending for the squad would take time. Too much time.

  Donal had said there was no telephone in the house. He glanced back at the bed. The bloodstain spread as he watched. By the time he found a phone, got through to the dispatcher, the team was assembled, and the ambulance came through the city traffic and covered the ten miles to Ballybucklebo, Julie could bleed to death.

  He had to do something—and do it at once.

  Barry stood, stripped off his gloves, and took a deep breath. He went to his bag and rummaged through it until he found what he needed: morphine to deaden the pain of the uterine contractions and ergometrine to make the uterus contract and to constrict the open blood vessels long enough, he hoped, for him to get Julie to the Royal before she bled again.

  He charged two syringes. Morphine, fifteen milligrams; ergometrine, a half milligram. “I’m going to give you an injection, Julie.” He didn’t wait for a reply but in quick succession stabbed the needles into the muscle of her thigh.

  Julie gasped with each stab, but within five minutes her breathing had gone from short sharp gasps to a steady rhythm, and thank God, the flow of blood had eased to a trickle. “Come in, Donal.” He heard footsteps.

  “Jesus Christ, is she dead?”

  “No. I gave her morphine. It’s knocked her out. And we don’t have much time. I need a hand to get her to my car.” Isn’t that what O’Reilly would do?

  “Doctor, has she lost . . . ?”

  “I’ll explain later,” Barry snapped. While paying attention to the worries of patients and their relatives was an integral part of good medicine, on some occasions, and this was one of them, the practical took precedence over the emotional. He needed Donal now. It was no time for the man to crack up. “Get a clean blanket, and move yourself,” Barry ordered.

  Donal scurried away and returned with a bundle in his arms.

  “Right. Help me get it under her.”

  “Doctor, should we not maybe give her a wee wash? She’d be powerful embarrassed if people saw her like that.”

  “Bugger it, Donal; just help me.” Barry lifted Julie’s head, thinking of a woman he’d seen last year who’d been too shy to ask her doctor about a lump in her breast until the cancer had turned into a festering, ulcerated sore, and the stink of it had so nauseated her family that they had insisted she seek medical advice. Rural inhibitions could kill patients. “Come on, man, move.”

  With Donal’s help, Barry manoeuvered Julie onto the blanket. Together, using the blanket as a makeshift stretcher, they carried her downstairs and out along the path and into the backseat of the Volkswagen. “Get in with her and put her head on your lap. I’ll be back in a minute.” Barry had to collect his bag. If she started to bleed again, he would need the medications in it.

  He was panting when he finally chucked the bag in the passenger seat, climbed in, and started the engine.

  He could remember little about driving to Belfast, not even cursing the traffic slowing him down as he wound his way through the city and on up the Grosvenor Road. He’d stopped the car outside the entrance to the casualty department under the stony gaze of a life-size bronze statue of Queen Victoria, and he’d charged in through the swinging doors. A couple of uniformed ambulance drivers were sitting in the foyer having a smoke and cups of tea.

  “Can you give me a hand?”

  One of the men took a deep pull on his cigarette and slowly looked up. “We’re on our break, so we are.”

  Christ. Barry pictured O’Reilly at the front desk of the convalescent home in Bangor. He steeled himself and said, “Listen, you. I’m Doctor Laverty. I’ve a woman outside bleeding to death. Get a bloody stretcher . . . and get it now.”

  The man jumped to his feet. “Sorry, Doctor. Right. Come on, Danny.”

  Barry waited until the men returned with a wheeled stretcher. “Out here.” He stood and supervised as they loaded Julie onto the canvas sling, covered her with a blanket, and wheeled her straight into the nearest cubicle. He strode through the entry hall to the desk he remembered so well. Behind it, a red-uniformed nursing sister and a white-coated doctor were sitting chatting. He recognized the doctor. She’d been in his class. “Ruth, can you come see a patient of mine?”

  She smiled at him. “Hello, Barry. Sure. What’s up?”

  “Incomplete abortion. She’s lost a lot of blood. A lot.”

  Ruth was on her feet, issuing directions as she headed for the cubicle. “Right. Sister . . .”

  Sister rose. “Nurse Corrigan, get the intravenous kit . . .” A blue-uniformed nurse hurried down the hall. Sister picked up the telephone. “I’ll send for the blood technician, get the gynae registrar.”

  Barry let his shoulders sag. The efficiency of the hospital’s senior nurses had always impressed him, and now that Julie was in good hands he could feel some of the strain slip away. But she wasn’t out of the woods yet. He followed the young doctor and stood watching silently as she rapidly checked Julie’s pulse and blood pressure. It seemed like only seconds after Sister appeared pushing a small, wheeled trolley that saline was dripping from an intravenous set into Julie’s arm.

  Ruth used the back of her wrist to brush a stray wisp of her auburn hair from her forehead. “Right,” she said, “that’ll hold her until gynaecology gets here. What’s the history, Barry?”

  He rapidly briefed his colleague, taking particular care to mention that he had given Julie morphine. As Barry spoke, a young blood technician arrived, took some samples, and vanished.

  “Sounds to me as if you’re spot on, Barry.” Ruth slipped her stethoscope into her ears, inflated the blood pressure cuff, and listened. She smiled. “BP’s coming up. The blood’ll be cross-matched in no time, we’ll get a couple of pints into her, quick D and C, and she’ll be right as rain.”

  “Thanks, Ruth.” He bent over Julie and saw her eyes flicker.

  “Doctor Laverty?”

  “It’s all right, Julie. You’re in the hospital. You’re going to be fine.”

  She stretched out her hand, took his, and squeezed it. “Thanks, Doctor. Is Donal all right?”

  “I’m going to see him now, Julie. Tell him what’s happening.” The staff here might be very efficient, but he knew only too well how relatives were routinely ignored. “I’ll be saying cheerio, but I’ll ask Donal to bring you in to see me in the surgery once you’re discharged.”

  She didn’t reply. She’d drifted off to sleep. He disengaged his hand and spoke to Ruth. “I’ll go and have a word with . . . her husband.” Donal would want to see Julie, perhaps stay so he could see her again when she came back from the operating room, but the visiting rules were very strict. Immediate family only. Boyfriends didn’t count as family. No one would bother to check Barry’s white lie. “Can I send him in when I’ve finished?”

  “Fair enough.”

  “Then I’ll be heading home.”

  Ruth smiled. “You ran her up here in your own car?”

  Barry nodded.

  “Jesus, it’s the Victoria Cross for you, boy.”

  “What?”

  “ ‘Devotion over and above the call of duty.’ Isn’t that what the citation says?”

  “Away off.” Barry blushed. He’d not seen it that way. “There wasn’t time to do anything else.”

  “Huh,” Ruth said, “there are plenty of GPs would have just phoned for the ambulance. I
know. You should see some of the wreckage we get in here.”

  “Not Doctor O’Reilly,” Barry said, without thinking. “Anyway, I’m off. I’m going to be late for my supper.”

  A Mysterious Way, His Wonders

  to Perform

  “Pity you missed the duck,” O’Reilly remarked, pulling a napkin from under his open collar and setting the crumpled linen square on the dining room table. “The sherry trifle was good too. I left you some.”

  Barry looked longingly at the remains of the duck carcass and then at a tureen containing a few dried-up green peas. He saw a bowl with smears of colcannon clinging to the lip, and a nearly empty dish of apple sauce. A Waterford crystal bowl held half a sherry trifle. Its layers of whipped cream, Bird’s custard, raspberries, and sponge cake were as clearly defined as the strata in a paleontological dig.

  “Kinky says you dashed off with Donal Donnelly.” O’Reilly looked vaguely apologetic. “It would have been a shame for me to wait for you and let dinner get cold.” He did not meet Barry’s look. “It would have upset Kinky.”

  That last remark came from a man who made it a point of principle never to make excuses, Barry thought. The bugger might have left me some dinner. He shrugged and said, “Julie aborted. She’s in the Royal.” He sat down. “I had to run her and Donal up there.”

  “Good for you,” O’Reilly said. “Mind you, it’s what I’d expect.”

  Barry made a tiny bow with his head.

  “That’s a shame about Julie,” O’Reilly said, “but she’s young yet. She’ll have plenty more.”

  “I suppose so. Donal was pretty upset. He thinks it’s divine retribution.”

  O’Reilly laughed. “For what?” He hauled out his briar and fired it up.

  “In the first place, for getting her pregnant out of wedlock.”

  “I don’t believe a word of it. Donal was worried about that? It’s not so long ago in the country here a fellah wouldn’t marry his chosen until after she’d proven her fertility in the most practical way. You need strong sons to run a farm.”