An Irish Country Practice Read online

  “I’ve been worser, so I have,” she said, “but I’ve had a chest cold for the last four days. An ould niggly cough, you know. I’ve took my granny’s Dublin mixture—porter, milk, and sugar—but it never done me no good. I was going til come til the surgery on Monday, but about half an hour ago I had a real hacking fit, so I did.” She wheezed as she inhaled. “I thought it was never going til stop, so I asked Guffer til send for yiz.” She handed him her bunched-up hanky. “I kept that for yiz til see.”

  Her pulse was one hundred, raised from the normal eighty-eight, her skin warm. At this point, he still could not exclude pneumonia. He took the hanky, but before examining its contents, he fished a thermometer out of his inside pocket. “Here,” he said after he’d shaken down the mercury, “pop this into your armpit.”

  “Right, sir.” She coughed again, moist and hacking. “Sorry,” she said. “Can I have my hanky back, please?” She hawked and spat into it.

  “Tell me about the cough.”

  “Och, Doctor dear, sure haven’t I smoked like a chimney since I was fourteen? All the girls in the linen mill did. I’ve had a smoker’s cough for donkey’s years.” She smiled. “Just like my oul da, God rest him, used to say, ‘My idea of breakfast is a cup of sweet tea, a cigarette, a good cough, and a spit til clear the pipes.’”

  “I’m sorry to hear about your father.” Family history might be important. “What did he die of?”

  “He’d a heart attack, sir, going on ten years back.”

  “I am sorry.” Smoking might have caused it, but it was no help with this present case. “About your usual smoker’s cough, do you bring up anything every day?”

  “Aye.” She looked down as if ashamed to be discussing such a thing. “Clear phlegm, but only in the mornings.”

  “I see.” Pretty well every smoker brought up the mucus that had accumulated in the lungs overnight. Barry had before he’d quit four years ago. The worst had happened in the few weeks after his last cigarette. As the cilia, mobile hairlike protuberances from the cells lining the air passages, recovered from the paralysing effects of the smoke, their renewed vigour moved a lot of mucus upward. He was better off not smoking, but quitting was one of the hardest things he had ever done.

  “And have you ever coughed up blood?”

  “Blood? Not at all, and if I had, you or himself, your Doctor O’Reilly, would have known about it quick. But the stuff I’m bringing up now has a different colour. See for yourself.” She handed him the hanky.

  He took a look. No frank blood. No blood tingeing the yellow mucus on the bright white hanky. That yellowness suggested infection, but probably confined to the bronchi and not affecting the lungs. He leant forward and retrieved the thermometer. “Your temperature’s up, at one hundred point two, but that’s not a killing matter.” Pneumonia usually caused a much greater elevation, which led to a feeling of being cold. “Any shivering fits?”

  “Not at all, sir, just the cough, and the goo coming up, and a burning pain behind here.” She pointed at her breastbone. Her laugh was embarrassed. “It gets worse when I have a fag.”

  “You really should try to quit, you know,” said Barry, having a vision of a certain King Canute ordering the tide not to come in.

  “Oh, aye, don’t I know it,” she said without emotion, “but I’ve been smoking for more than forty years, Doctor. When I started, the craic was, ‘Do you know what the big chimney said til the wee chimney?’”

  “No.”

  “‘Yiz is too young til be smoking…’”

  Barry, who had heard the old chestnut as a boy, chuckled.

  “Sure everyone smoked.”

  Barry nodded. She’d only quit, if ever, when she wanted to. He was nearly certain that she was suffering from acute bronchitis. Given that she was a smoker, he would have given serious consideration to a diagnosis of lung cancer. After all, heavy smoking had been implicated as a cause as long ago as 1953. But usually with that disease the cough was dry, not productive, and often accompanied by haemoptysis, coughing up blood. An examination would still be required, but he was sure it would be simply to confirm his belief—and his relief.

  He hated dealing with potentially lethal diseases, and now, after nearly three years in practice, he was still trying to decide whether a completely honest answer or a little prevarication initially was kinder. He’d been taught as a student to be perfectly truthful with the nearest next of kin, but to shield the victim. He smiled inwardly. He’d not be having to decide here today. “Right,” he said. “Let’s have a look.”

  “Yes, sir.”

  He turned his back as she started to unbutton her bed jacket.

  Barry examined her with the routine steps of inspection, palpation, percussion, and auscultation. The only additional positive findings were widespread rhonchi, musical squeaks that came up his stethoscope as Anne exhaled. He was as certain of his diagnosis as O’Reilly had been that his horse was going to win or, Barry corrected himself, Kinky had been.

  “Nothing really to worry about. I’ll give Guffer a yell, ask him to come up so I can explain to you both what’s wrong and what we’re going to do.”

  She was wracked with another coughing fit, but nodded her agreement.

  He rose and took a step to the doorway. “Mister Galvin, come on up.” Barry glanced at the book on the bed. “I see you still enjoy a good romance, Mrs. Galvin.”

  “Thanks to these—” she said, touching the glasses on her nose, then coughed, holding her chest and grimacing. “Thanks to these specs.” The cough subsided and she relaxed into her pillow. “This here one takes place in some big plantation in Africa. The hero’s lovely, so he is.”

  Guffer appeared and stood at the end of the bed. “You going to be all right, girl? I heard you coughing just now.”

  “Aye,” she said, “and nice young Doctor Laverty here’s going til explain it til us.”

  Barry nodded. “Anne, I’m sure you’ve got a touch of acute bronchitis.”

  “Boys-a-dear,” Guffer said. “Is that like the brownkitees? There’s a quare bit of it about at the shipyards.”

  Barry knew the man was a welder at Harland and Wolff’s.

  “One and the same, Mister Galvin,” he said, “and your wife should be right as rain in a few days. I’m going to give you a scrip for the black bottle…”

  “Dead on,” said Guffer. “I’ll nip down til the chemist in a wee minute.”

  The locals put great faith in mist morph et ipecac. The morphine was an excellent cough suppressant, which overrode the mild expectorant effects of the ipecacuanha.

  “Yeugh,” Anne said, and screwed up her face.

  The ipecacuanha gave it its black colour and foul taste, thus, it was widely believed, enhancing the medicine’s effectiveness. “Take two teaspoonsful every six hours.” Barry took out his pad and scribbled the prescription.

  “Thank you, sir.” Guffer accepted the piece of paper. “Thanks very much. He’s going til have you right in no time, love.”

  “Have you an electric kettle?”

  “Aye.”

  “Bring it up, get the room steamy. That’ll help. Light diet. Plenty of fluids…”

  “I’ll get you Lucozade when I’m at the chemist’s,” Guffer said.

  “Good. And you’ll be better in four or five days. I’ll pop in tomorrow, and you know to send for us if you’re worried.”

  “Excuse me, Doctor,” Guffer said. “Now, I’m not trying to teach my granny how til suck eggs, but would them antibiotics be any use, like?”

  Barry shook his head. “Mister Galvin, I’m a GP, not an infectious disease specialist, but the profs taught us when I was a student that antibiotics don’t help coughs, colds, the flu, or acute bronchitis. And, you know, people can have severe reactions to those medicines. Safer to avoid them.”

  “Fair enough, but you don’t mind me asking, sir?”

  “Not at all, Mister Galvin.” Barry half turned to go, but noticed a photo in a silver frame on
the dresser. A young man, a pretty wife, a toddler, and babe in arms. “Is that Seamus and his family?” Barry still remembered with pleasure his first home delivery in Ballybucklebo, Seamus and Mary’s little boy, named Barry Fingal Galvin in honour of his attending physicians. “Young Barry’s growing like a weed, and I see they’ve got another.”

  “Wee girl called Colleen, and another one on the way, so they have,” Anne said, and Barry detected sadness in her voice. She sighed. “Seamus writes twice a month. He’s doing very good. He went out for til work for his big brother Pat, who owned a construction company. Pat’s wife Jeannie is a lovely Dublin girl. Couldn’t stand America, wanted to come home, so Pat had to sell the company to a Yankee. They moved back to Dublin a year ago, but Seamus loves it out there. He stayed on. He hasn’t missed a day’s work since he started.”

  “We’re quare nor proud of him—of both of them,” Guffer said.

  “Och, we are, right enough,” said Anne. “But hasn’t it always been like this? Poor Irishmen leaving home for Liverpool or America or Canada and the ones across the Atlantic never ever getting home again.”

  “Aye,” said Guffer, clearly to comfort his wife, “but that was back when there was sailing ships or liners and covered wagons and trains. There’s jet planes now, so there is.”

  “Seamus never lets on in his letters,” Anne said, “but I’m sure he’s homesick.”

  “And Anne’s very brave too,” Guffer said. “She never moans about it, but I know fine well she misses our son, because I do, and what granny wouldn’t want til see her grandchildren?” He looked fondly at his wife.

  “That Maureen, she has her head screwed on good and tight.” Anne coughed. “They will come home—one day. Maybe only for a visit, like, but I know they will.” There was a catch in her voice.

  “Aye,” said Guffer, “but we have til get you better first. I’ll get my bike out and—”

  “Stick it in the back of my car, Mister Galvin,” Barry said. “I’ll give you a lift to the chemist and I’ll pop by tomorrow just to be sure you’re on the mend, Anne.”

  3

  Walk Up and Down with Me

  “That did be a very lovely afternoon, so,” said Kinky, gently decanting Lady Macbeth from her lap and standing. “Thank you very much, Doctor and Kitty, for having us.” Kinky and Archie had stayed after Ronald and Sue had left.

  “Our pleasure,” Kitty said. “We are delighted with your win.” She smiled. “And Fingal and I will respect your request, won’t we, dear?”

  “Of course,” O’Reilly said. “And will we see you on Monday morning as usual, Kinky? Or now that you’re a rich woman, perhaps you’ll have better things to do.”

  “You will see me, sir,” Kinky said. “Even if I were the richest woman in all the six counties, I would still be here at Number One Main on Monday morning.” Kinky gave O’Reilly a penetrating look and then she laughed and took her husband’s hand. “Come along, Archie. The walk home will do us good, and I do have braised lamb shanks for our tea, bye. They are marinating now.” She smiled at O’Reilly. “We’ll see ourselves out. Slán agat, sir.” The Irish leaver’s good-bye.

  “Slán leat,” O’Reilly gave the customary reply from the one staying behind. “Archie’s a lucky duck,” he said. O’Reilly could practically taste the delicate flavour of lamb accented by garlic, bay, rosemary, and thyme that Kinky used for the dish. Enough to make a fellah salivate. He sighed.

  “Don’t sigh, Fingal,” Kitty said. “What do you think’s on for our supper tonight?”

  “I dunno.”

  “How many legs does a lamb have?”

  “Usually four.”

  “And the other two are in our kitchen waiting to be popped in the oven. Kinky prepared them yesterday. And there’s champ and spring cabbage and a roly-poly jam pudding for dessert.”

  “Lovely,” he said, “and bugger the horse racing. Water under the bridge.” He grabbed her, swung her to her feet, and kissed her soundly. “With you, Kitty O’Reilly, for a wife who I love dearly, Kinky still doing her magic in the kitchen, a partner I’d trust with my life doing my work for me, and a new assistant, I’m the luckiest man in all Ireland.”

  She laughed. “But if you don’t get a bit of exercise, you’ll not only be the luckiest, Fingal Flahertie O’Reilly, you’ll be the tubbiest too. Let’s take Arthur for a walk.”

  “You’re on,” said O’Reilly. “We’ll head up into the Ballybucklebo Hills. It’ll make a change from the shore, and Arthur’ll be in his element pushing rabbits out of the whin bushes.”

  “I’ll just be a jiffy,” she said, heading for the hall, “I need to change. High heels and hills don’t go very well together.” He heard her light tread on the stairs and he took out his briar, filled it from his recent purchase, lit up, and puffed his contentment in blue clouds to the ceiling of the cosy room.

  * * *

  O’Reilly stopped at the end of a rutted lane in front of a rusty five-bar gate in a tall blackthorn hedge. The white flowers shone in the sun’s rays. Before he could move, Kitty said, “I’ll open the gate,” and hopped out.

  Arthur, sensing they had nearly arrived, intensified his usual refrain of throaty mutterings that had begun as soon as the Rover had left the main road for this country lane.

  “Wheest, dog,” O’Reilly said as he drove past Kitty at the gate to park in a grassy field. Waste of breath, he thought. It was the otherwise perfectly behaved gun dog’s only flaw. He could never control his excitement when he realised he was in the country. O’Reilly found it endearing because it mirrored his own love of the outdoors. “Come on, old fellah,” he said, climbing out of the Rover and opening the back door for Arthur. O’Reilly inhaled the aroma of a stand of spruce trees off to his left and the distinctive odour of red fox. One must have passed by here recently or perhaps there was a den nearby. He reckoned a vixen might have newborn cubs. “Heel,” he said to an excited Arthur, who had probably got the scent too, because his nose was to the ground, tail thrashing.

  Arthur sighed and tucked in. O’Reilly walked to where Kitty stood after closing the gate. She was frowning and her right eyebrow was raised in a question. “Er, Fingal? What on earth is that?” She pointed.

  A bicycle was propped against the hedge, but this was no ordinary velocipede. Someone had decorated it in multihued splendour. He laughed. “A biblical scholar would assume it belonged to Jacob to complement his coat of many colours, but, and I’m sure it’ll come as no surprise, that machine is the property of one Donal Donnelly.”

  “Oh,” Kitty said with a smile, “I suppose I should have guessed.”

  “It used to be black and rusty, but he got the idea of redoing it with the contents of some nearly finished cans of paint.”

  She looked more closely. “You know,” she said, “he could probably exhibit it in a modern art gallery. It’s like something Jackson Pollock would have done with his ‘drip’ technique. Give the thing a title like ‘Rigid Rainbow.’”

  O’Reilly laughed and said, “For God’s sake, don’t tell Donal. He’ll start a production line and sell them for five quid a piece. You know what he’s like.” O’Reilly glanced round. “If Donal’s bike’s here, it’s a fair bet so’s Donal. Probably giving his greyhound Bluebird a run.” He took her hand. “Come on, let’s get our legs stretched.”

  They set off uphill across the grassy field.

  “Hey on out.”

  A joyous Arthur ran off, nose to the ground, quartering from left to right, right to left.

  Overhead a flock of argumentative black jackdaws flapped lazily across a sky done in pastels. Blue bird’s-eye speedwell and red dove’s-foot cranesbill flowered between the blades of grass. They only grew in land that was ploughed very infrequently.

  Arthur crashed into a clump of yellow whins and out rushed two rabbits, grey-brown fur, long ears, bounding and jinking, heading for a warren farther uphill that O’Reilly had known about for years. He and Arthur occasionally came out here to sho
ot a rabbit for the pot.

  Arthur, as a well-behaved gundog should, did not tear after the creatures, but sat so as not to obstruct his master’s shot, which of course never came. Arthur looked up at O’Reilly. The panting dog shook his head as if to say, “Sometimes, boss, I wonder why I bother.”

  The rabbits had reached safety. “Hey on out, boy,” and the big Lab trotted off again. There was a stiffness in the movements of his hind legs.

  “He’s having fun,” Kitty said.

  “But,” said O’Reilly, “a couple of years ago he’d have raced off as fast as those rabbits. He’s like me and my old gramophone. He’s getting on. He’s not as fast as he used to be.”

  Kitty squeezed O’Reilly’s hand. “And you may not be boxing or playing rugby football anymore, but there’s many a good tune played on an old fiddle.”

  “And there’s life in my old dog yet. As long as he’s fit, he’ll have fun.”

  Kitty chuckled. “Sometimes, Doctor O’Reilly,” she said, “you have a one-track mind.”

  He stopped, grabbed her, and kissed her. Hard. “Not true, Mrs. O’Reilly.” He kissed her again. “There are lots of other things I think about,” and he gave her bottom a squeeze.

  Kitty burst out laughing. “A man of many appetites,” she said, “and I do love you, but control yourself.” She kissed him then he felt the tip of her tongue in his ear and heard her whisper, “Later.” She looked past him. “Oh, Lord. Behave yourself, Fingal. Your friend Donal has just appeared from the spruce wood.” She stepped back.

  Sure enough, Donal Donnelly, sucking on a straw, tweed duncher set at a rakish angle over his carroty thatch, was striding at an angle downhill toward them. He carried a small sack in his right hand.

  “How’s about youse, Doctor and Mrs. O’Reilly,” Donal called as he drew near. He was grinning from ear to ear, but was now holding the sack behind his back.

  “Very well, Donal,” O’Reilly said. “And yourself, and Julie, and wee Tori?” What was in that sack?