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An Irish Country Welcome Page 34
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“Thank you very much, Bertie.” Fingal accepted the heavy gift, which was soft but gave an interesting clinking sound.
“You just enjoy them,” Bertie said, rising. “Come on, Donal. Time for our pint.”
O’Reilly showed them to the door. “Good night to you both.”
He couldn’t resist taking a peep in the parcel. He peeled off the brown paper to reveal a colourful silk shawl wrapped around four bottles of John Jameson Irish whiskey. Kitty would love the shawl, and the bottles would have pride of place on the O’Reilly sideboard. He glanced into the study and then at the bottles. Bugger it. The paperwork could wait until Monday.
At five minutes past seven, Emer was the first to arrive, accompanied by her fiancée. “Fingal,” she said, “may I introduce you to Eamon McCaffrey. Eamon, Doctor O’Reilly.”
Both men shook hands and said with formality, “How do you do?”
Eamon was about five foot six, blond like Emer, with blue eyes, and wore an old boys’ blazer with the crest of Saint Malachy’s college, Belfast, and its motto, Gloria ab Intus—glory from within—on his breast pocket.
“Oldest Catholic grammar school in Ireland, I believe. Opened in 1833, four years after the Emancipation, when laws prohibiting the education of Catholics in Ireland were repealed.”
“Not many people know that, Doctor.”
“I told you. He’s an Irish history nut,” Emer said with a smile.
“True, and it’s Fingal, Eamon. What would you two like?”
“Lemonade for me, please,” Emer said. “Alcohol makes me easy.”
Fingal coughed. Then smiled. “Ahh, yes.” He surely could not have heard what he thought he’d heard. “No, sorry, Emer. I didn’t quite catch that.” Either he did need to get an audiogram done or he’d just learned more about Emer’s personal life than he really should know.
“I said lemonade for me, please, Fingal. Alcohol makes me queasy.”
“Right. Yes, queasy. I’m sure it would. And Eamon?”
“If you’ve a beer, Fingal?”
“Coming up.” O’Reilly had to turn quickly to hide his laughter, then headed for the sideboard, where bottles of beer and Bertie’s new whiskey rubbed shoulders with open bottles of Jameson and Kitty’s favourite dry gin as well as two bottles of Entre-Deux-Mers in ice buckets. As he poured, he overheard Kitty arrive, introductions being made, and her saying, “So this is the lucky man, Emer. And look at the ring. An oval sapphire in white gold. It’s stunning. A great pleasure to meet you, Eamon. We’re so happy for you both.” Kitty had that knack of instantly putting people at their ease. Fingal turned and carried over the drinks. He thought his wife looked entrancing in a long-sleeved, form-fitting, knee-length dress of turquoise wool.
“Here you are,” he said, giving Emer and Eamon their drinks. He returned to pour a gin and tonic and a Jameson.
“Barry,” Kitty said as the Lavertys came in, “get Sue a seat at once. You poor thing. You must feel like the side wall of a house.”
Sue laughed. “I’m thirty-seven weeks and one day, and I feel more like a great white whale.” She laughed again and gingerly lowered herself into an armchair.
“You, Barry,” O’Reilly said, “are big enough and ugly enough to pour your own. Come and help yourself and get whatever Sue needs.” He carried his and Kitty’s drinks over just as Kinky and Archie arrived with trays of hors d’oeuvres. And as they distributed them to the sideboard and side tables, Sebastian came in. “Sorry I’m a little late…”
O’Reilly saw no reason not to pull the lad’s leg. “Barry and I thought it was a Carson tradition, showing up late. It’s how the three of us first met at the Crawfordsburn Inn in July last year, and on your first day at work here with me.”
“Ouch. Guilty on both counts. This time Mum needed a lift to Ballybucklebo House. She’s having dinner there tonight and—well, one hates to be disloyal, but she took rather longer than usual over her toilette. She hasn’t worn perfume since Dad died.”
“You are forgiven,” O’Reilly said. “And your pleasure?”
“Neat Jameson, please. Good medicine’s not the only thing you’ve taught me about, Fingal.”
O’Reilly poured and said, “That’s everybody. Connor got the short straw because the practice never stops, so he’s on call.” He handed Sebastian his glass. “But Connor’s having dinner with me and Kitty tomorrow night.” He turned to Kinky and asked, “All finished?”
“We are, so.” Kinky beamed and smoothed down her pinafore.
“You know everyone here except Doctor Emer’s fiancée, Mister McCaffrey. Eamon, this is Mister and Mrs. Auchinleck. Mrs. Auchinleck is our part-time housekeeper, and for years the pair of them have been our friends.”
All three made little bows.
“So, what would you and Archie like?”
They looked at each other.
“Come on, Kinky, you’ve been an important part of this practice since 1928. That’s eighteen years more than me. It’s right and proper you should have a drink with us.”
“Thank you, sir.” She winked at her husband. “I do think a glass of that white wine would make a pleasant change from dandelion wine, so.”
“For those of you who don’t know, Mister Auchinleck won the prize for best dandelion wine at the Harvest Festival in October.”
There was a small round of applause.
Archie said, “Thank you all, and I do agree with Kinky. It’s easy to get used to the dandelion stuff and it’s cheap to make, but we opened the marquis’s bottle for Christmas. Boys-a-boys. Chalk and cheese. Kinky and I have tried some more French wines since. I’ll still make the dandelion wine but tonight, a glass of white, please.”
“Good for you, Archie.” O’Reilly poured, and handed over the glasses. “Now everyone has a drink, I want to propose a toast and make an announcement.” He spoke to Emer and Eamon. “You are being married next Friday, so I ask the company to raise their glasses and wish you every happiness—”
“Every happiness.”
“May you be poor in misfortunes, rich in blessings, slow to make enemies, and quick to make friends. And may you know nothing but happiness from that day forward.”
“Thank you very much, Fingal—and everybody,” Eamon said.
And before anybody could speak, O’Reilly cleared his throat. “In early December I had a visit from Barry and Emer. Emer expressed a wish to take a leave of absence beginning in May”—and there was no need to explain why—“but she was very concerned about what effect that might have on the rest of us doctors.” He saw Sebastian nodding. “I have not paid you the courtesy of consulting you, Sebastian, but I have spoken with Professor George Irwin. As of Emer’s departure, you will join the rota independently so there will be no gaps in cover.”
Sebastian smiled and stuttered, “I-I, golly. I’m very flattered. Thank you, Fingal, Barry, for your confidence. I’ll not let you down.” He sighed. “I’m just sorry August the first will come so quickly.”
“Don’t be sorry, Sebastian,” Kitty said. “Everybody knows by now that I will start working part time in August. I’ve been asking Fingal to slow down. And my dear old bear has agreed to it.”
Sebastian frowned. “I’m very happy for you both, Mrs. O’Reilly, but I’m not sure what that has to do with me?”
O’Reilly glanced at his junior partner. “Barry?”
“Fingal has asked me to make you the offer, Sebastian, because come August, I’ll be senior partner. Fingal will work half time from then on. Emer will come back and do the same. We’d like you to stay on once you are fully qualified, to fill what will become the vacant position as an assistant with a view to partnership.”
No one spoke.
Sebastian stared at Barry. Then at O’Reilly. The man paled, clapped his left hand to his chest. Inhaled down to his highly polished brown brogues. Exhaled, and said in a shaky voice, “You’re serious, Barry? It’s not some kind of a practical joke?”
“We do enjoy a
good joke around here, but we’ve never been more serious. Will you take the job, Doctor Carson?”
“Dear God, of course I will.”
O’Reilly offered a hand. “Welcome to Ballybucklebo, Sebastian. You and I will do the legal paperwork next week. I wasn’t able to finish it earlier this evening.”
A sea of voices called out, “Congratulations. Well done. The village will be lucky to have you.”
Sebastian radiated happiness. “Thank you. Thank you. My mother will be so happy.”
The noise faded. O’Reilly had a huge smile on his face, but it fled as Sue struggled to her feet, looking frightened. She leant over to Barry and said in a low voice that O’Reilly had to strain to overhear, “Do something, Barry. I’ve no pain, but my thighs are warm and wet. Either my waters have broken or I’m bleeding.”
35
And the Blood Ran Down
Do not panic, Barry told himself. Keep calm. If Sue’s going into labour, the baby is premature but it’s not a crisis. The little one was only three weeks early, not six like Mildred Anderson’s was when she was delivered.
Bleeding was another matter entirely. And either way Sue would be terrified. He stood and took her pulse. “Hold on, pet.” He looked over to O’Reilly, who was ignoring the party all around him and watching Sue with concern. Barry said in a low voice, “Fingal. We need your help.”
O’Reilly put his drink down abruptly and leaned toward them. “I’m sorry, Barry. I missed that.”
“I need your help with Sue. Either her membranes have popped or she’s bleeding.” He kept looking into her eyes as he spoke. Her pulse was ninety-two per minute. Fast but not surprising given what must be her emotional state, but it was not racing as it would be if she were in shock from loss of blood.
“Right.” O’Reilly raised his voice. “Excuse me. Excuse me. Sue’s having a little difficulty so I’m going to examine her. So, please, everybody, turn your backs for a minute and give the dear girl a bit of privacy. No, no, Archie, no need to leave. We may need you.”
The little crowd hushed immediately, chairs were shifted, and everyone did as they were told.
O’Reilly smiled at Sue. “I’m just going to lift your skirt.”
Barry felt his heart shudder. Under her tights, along the insides of her thighs, he could see bright red bloodstains extending from her groin to halfway to her knees. He comforted himself by remembering that a little blood went a long way. This might just be a “show,” slight normal bleeding that heralded the onset of labour, but the other possibilities were far from normal. He squeezed her hand and she looked at him with frightened eyes. Until it was proved otherwise, she must be treated as suffering from an antepartum haemorrhage, an all-encompassing term that covered a number of possibilities, some of which were potentially lethal to her and the baby.
“Sorry, Sue, but you are bleeding,” O’Reilly said, lowering her skirt.
“Oh God. What’ll we do?”
“Everything we can, and I’m afraid we’re going to have to get you to hospital. Because you are bleeding, the first thing to do is sedate you, because the sedation can stop labour coming on.”
“All right.”
“Barry, under any other circumstances we’d get Sue lying down, give her a quarter grain of morphia, and send for the flying squad in case you need a blood transfusion.”
Sue clutched Barry’s arm. “I’m scared, Fingal.”
“I know, but the morphia will help that too.” He turned to Barry. “But it’ll take the squad at least half an hour to get here. Barry, you can have Sue in the Ulster Hospital in fifteen minutes. They have a blood bank and full obstetrical facilities.
“So.” He turned to the others. “Emer, nip down to the surgery and prepare a quarter of morphia for intramuscular use. Sebastian, go and phone the Ulster, tell them there’s a woman with an APH on her way. Do you know your blood group, Sue?”
“O Rhesus positive,” Barry said.
“Tell them that.”
“And ask them to let Doctor Lamki know who the patient is,” Barry said.
Emer and Sebastian fled.
Sue looked from O’Reilly to Barry and back. “Will my baby be all right?”
“We’ll do everything we can here, and the specialists at the hospital will do more.”
“Fingal’s right, darling.” Barry held her. Let her rest her head on his shoulder.
O’Reilly yelled, “Kinky. A pillow and a blanket to Barry’s car.”
“Yes, sir.” Kinky headed off.
“Right, let’s get this young lady into the car.” Barry let Sue go and watched open-mouthed as O’Reilly bent his knees and put one arm under Sue’s knees and another round her shoulders. With seemingly no effort, he straightened and, carrying Sue, headed for the stairs with Barry in hot pursuit.
Kitty called after them, “Good luck, Sue.”
Sebastian was talking into the telephone when they reached the hall and Emer, loaded syringe in one hand and a cotton swab reeking of methylated spirits in the other, came out of the surgery.
O’Reilly stopped. Barry lifted Sue’s skirt. Thank God the stains were no bigger. “Wipe the spirits on the nylon, Emer, then inject straight through.”
Barry had a sudden flashback to his senior partner giving Vitamin B12 as a tonic straight through the antiseptic-dabbed clothes of a bent-over line of patients when he’d first arrived at the practice.
Sue sucked in her breath as the needle bit.
Time passed in a blur and soon a becoming-drowsy Sue was tucked into the backseat of the Imp and Barry was heading for the Ballybucklebo Hills.
“You all right, Sue?”
A drowsy “Muh-huh” reassured him.
As he drove, he found himself mentally going over what he knew about APH.
The blood could be coming from the placental bed. If the placenta was normally sited, the bleeding was called an accidental haemorrhage or abruptio placentae. If placed low in the uterus, it was a placenta praevia, which occurred in about one in two hundred deliveries. Sometimes the bleeding wasn’t coming from the uterus at all but something related like haemorrhoids, which were common in the later months of pregnancy. He hoped that was the case but was none too hopeful.
He turned right onto the Ballymiscaw Road, then immediately left onto Ballyregan Road. “How are you, pet?”
Another drowsy “Muh-huh” comforted him. The morphine was doing its work.
“Only about five minutes to go.”
No reply.
He sighed. At least if Sue had a placenta praevia, she was in the best place in the world to have it managed. Professor Macafee, who had taught Barry before retiring in 1963, had altered the treatment used worldwide—Barry dipped his headlights to accommodate an approaching car. Unless the haemorrhage was torrential, or the patient was actually in labour, Macafee had prescribed keeping the patient in bed with no interference and gaining as much foetal maturity as possible and then, if circumstances indicated, no hesitation in carrying out a Caesarean section. In this way, as early as 1945, he had reduced the maternal mortality rate of 6 or 7 percent to less than 1 percent and had more than halved the foetal mortality rate, from 50 percent to about 23 percent. Fifteen years later, Macafee was reporting no maternal deaths and the foetal losses were less than 10 percent. This wait-and-see practice was now standard.
Barry took a quick look behind him. Sue’s eyes were closed, and she looked comfortable. His dear Sue. The odds were very good that all would be well, but there was still that 10 percent risk. God damn it, 10 percent of the babies did not make it. After all they—or to be more precise—Sue had gone through, if they lost this child, he would be heartbroken, but he shuddered to think what it would do to Sue.
Barry drove up the curving drive of the hospital into the brightly lit area in front of the admitting area, parked, and got out. “Just be a tick, pet.”
He was met inside the door by a white-suited orderly with a wheelchair. “Doctor Laverty?”
“Yes.”
“We’ve been expecting you. I’ll get your wife.” He headed for the car.
Barry followed and waited as the man roused Sue gently and helped her out and into the chair. “Mrs. Laverty, I’m going to take you straight up to maternity to the antenatal ward. Doctor Lamki’s waiting for you.”
Barry bent and kissed the top of her head. “Darling, I’ll be straight up once I’ve parked.”
He stood for a moment watching the orderly wheel Sue away and jumped into the Imp.
He was short of breath when he arrived on the first-floor antenatal ward to be greeted by a sister midwife. “Doctor Laverty?”
He nodded.
“Please come with me.”
She led him along a corridor, past Sister’s glassed-in office, and past several beds, each containing a patient, some of whom were chatting, reading, knitting, all under treatment for one of the many ailments that could afflict women and required admission to hospital before delivery. She opened a door to her left. “In here, Doctor.”
“Thank you, Sister.” Barry went into the single room and closed the door behind him. Harith was sitting on the side of the bed and a student midwife stood on the far side, taking Sue’s blood pressure. She was now wearing a blue hospital gown.
“Hello, Harith. Thanks for coming in.”
“Barry. It’s no trouble. I know how worried you both must be. Sorry this has happened.” Harith was holding Sue’s antenatal notes. “Once the hiccup at the start settled down, all of your antenatal visits have been very good, Sue.”
She nodded drowsily and Barry hoped she was taking in what Harith was saying.
“You’ve had no excessive weight gain, no high blood pressure, no ankle oedema, no albumin in your urine. So, no pre-eclampsia.”
The still ill-understood condition was associated with stillbirth and one of the other kinds of APH—accidental haemorrhage—which also had a high foetal mortality rate and exposed the mother to several risks like uncontrollable bleeding. It was small comfort, but Barry wanted to hear encouraging things. “That’s good,” he said, and saw Sue’s weak smile.