An Irish Country Doctor Page 4

  "Always bring wellies." O'Reilly pointed to his own footwear.

  "Don't worry about your shoes."

  "But these shoes cost--"

  "Christ Almighty! All right, we'll cut through the fields." Barry noticed just a hint of pallor in the tip of O'Reilly's nose. "Get a move on. The match starts in half an hour." O'Reilly hefted his bag, pushed open a rusting five-bar gate in the blackthorn hedge, and strode off. "Close the bloody gate after you," O'Reilly yelled over his shoulder.

  Barry struggled to haul the gate shut, scratching his hand on the wire loop that had to be used to secure the gate to the gatepost. He sucked his bleeding hand and stared at the ruin of his shoes--his only pair of good shoes. He heard O'Reilly yelling, "Is it today you were coming?"

  "Bugger off," Barry muttered, as he walked to where O'Reilly stood. The grass in the pasture was knee-deep, lush, feathered with seeds. And damp, very damp. As Barry walked purposefully ahead, he knew that the grass seeds would cling to his pant legs, and already he could feel his shins growing moist. Oh, well, he thought, at least the dew would wash off some of the mud.

  "What kept you?"

  "Doctor O'Reilly," Barry began, refusing to be intimidated, "I came as fast as I could--"

  "Huh."

  "And my shoes and pants are ruined."

  "What," asked O'Reilly, "do you know about pigs?"

  "I fail to see what pigs have to do with my clothes."

  "Suit yourself, but there's one coming." O'Reilly started to walk rapidly.

  Barry hesitated. Coming towards them was a pink something with the dimensions of a small hippopotamus. It had the same rolling gait as the African animal, but as Barry reckoned such beasts were rare round Ballybucklebo, the creature in question must be a pig, and its eyes--he could see them now that it was appreciably closer--were red and distinctly malevolent. Barry set off at a canter in pursuit of O'Reilly and caught up with him halfway between the gate and the end of the field. "It is a pig."

  "Brilliant," said O'Reilly, lengthening his stride. "I've read somewhere that domesticated boars can turn ugly."

  "Ugly?"

  "Right." O'Reilly was breathing heavily. "Bloody big teeth." O'Reilly's gait moved up to a fully developed trot and opened a fair gap between Barry and himself. Barry, quite aware that glancing back had cost several Olympic hopefuls a gold medal, nevertheless risked a backward glance. The beast was gaining, and if it had intentions of using its "bloody big teeth," it was reasonable to assume that the victim would be the first one it hunted down. He began to sprint. Ten yards from the far hedge, Barry passed a flagging O'Reilly. The extra helping of Mrs Kincaid's steak-and-kidney pudding must be slowing O'Reilly down, Barry thought, as he himself cleared a low gate. He almost collided with a small grinning man in a flat cap, who stood in the farmyard. Before Barry could begin to explain, the quiet of the afternoon was shattered by sounds of crashing and rending, and he saw O'Reilly break through the blackthorn like an American tank smashing through the hedges in the bocage country of Normandy. O'Reilly came to a halt, examined the rents in his tweed suit, and tried to control his laboured breathing. Then he marched over to the cloth-capped stranger who, Barry noticed, had a ferocious squint but was laughing heartily.

  Although O'Reilly's cheeks were scarlet, despite his recent exertions his nose tip was alabaster.

  "Dermot Kennedy," he bellowed, "what's so bloody funny?" There was no answer. Mr. Kennedy was doubled over, holding his tummy and gasping between hiccups of laughter, "Boys-a-dear, thon was a quare sight to see."

  "Dermot Kennedy." O'Reilly drew himself up to his full six foot-two. "You're a menace to civilized people. What in God's name are you doing keeping a man-eating boar in an open field?" Mr. Kennedy straightened, took a hanky from the pocket of his trousers, and wiped his eyes.

  "I'm waiting for an explanation," O'Reilly roared.

  Mr. Kennedy stuffed the hanky back. "Thon's no boar, Doctor dear. Thon's Gertrude, Jeannie's pet sow. She only just wanted her snout scratched."

  "Oh," said O'Reilly.

  "Right," said Barry, still smarting for being yelled at for being tardy. "Animals are, I believe--and please correct me if I'm misquoting you, Doctor O'Reilly--'one of the delights of country practice. You just have to get used to dealing with them.'"

  "You can do that if you like, Doctor sir," said Mr. Kennedy, his laughter quite gone, "but it's really the farmer's job. Doctors keep an eye to the sick and"--he hesitated and glanced down at his boots--"I'm powerful sorry for dragging you out here, so I am, but I'm sore worried about our Jeannie. Would you come in and take a wee look at her, sir?"

  More Haste, Less Speed

  Barry followed Mr. Kennedy and Doctor O'Reilly to the farmhouse, a single-storey building, whitewashed and thatched with straw that, judging by the patches of moss, had not been replaced for many years. Smoke drifted upwards from a chimney. Barry could smell the tang of burning peat. Black shutters flanked every window.

  He heard O'Reilly ask, "How's the barley coming on this year, Dermot?" and Mr. Kennedy replying, "A treat, Doctor . . . and I still have the contract with the whiskey distillery at Bushmills." That, Barry thought, should make O'Reilly happy.

  An open-fronted barn built of grey concrete blocks stood at the far side of the yard, bales of hay stacked against one wall and a Massey-Harris tractor parked under the corrugated-iron roof. Cows peered at Barry from their stalls. Chickens and an arrogant rooster pecked in the straw-strewn mud of the yard. A Border collie peered out of its kennel near the front door.

  Barry heard Mr. Kennedy say, "Go on in, Doctors." Barry glanced at his muddy shoes.

  "There's a boot scraper there, sir." Mr. Kennedy pointed to the scraper beside the door.

  Barry cleaned as much muck off as he could and went in. He found himself in a bright kitchen. A black-enamelled cast-iron range hunkered against the far wall. A wisp of steam from a kettle drifted up to the varnished ceiling beams. The floor was tiled. "The doctors is here, dear," Mr. Kennedy called. A woman stood, pouring tea into a cup patterned with daffodils. By the wrinkles in her neck and the slight twisting of the joints of two fingers in her right hand, Barry took her to be in her early fifties. "Thanks for coming, Doctor O'Reilly."

  O'Reilly parked himself at a solid-looking pine table. "It's no trouble. This is my new assistant, Doctor Laverty." Mrs. Kennedy bobbed her head to Barry.

  She wore an apron. Her grey-flecked dark hair was untidy, and although she smiled at him, her smile was only on her lips. Her eyes, dark circles beneath, gave away her forced humour. "Would you like a cup of tea, Doctor?"

  "Please."

  "Sit down," she said. "I'll fetch another cup." She moved to a Welsh dresser where blue plates stood in racks and a jam jar filled with scarlet and yellow nasturtiums held pride of place in the centre of the lowest shelf.

  Barry pulled out a chair and sat beside O'Reilly. He thanked the woman when she gave him a cup of tea, dark and stewed. "What do you take?"

  "Just milk, please."

  She handed him a jug.

  "And you say Jeannie's been off-colour since yesterday?" O'Reilly's tone, for the first time in Barry's short acquaintance with the man, had none of its usual brusqueness.

  "Aye, Doctor. She'll no' eat nothing. Says her wee tummy hurts."

  "Has she boked?"

  Barry smiled at O'Reilly's use of the country vernacular for "vomited."

  "Just the once. All over the sheets. Jeannie was all embarrassed, so she was. Me and Bridget's been up with her all night." He glanced at his wife.

  "And she's burning up, so she is," Mrs. Kennedy said softly, as her hands gripped the hem of her apron.

  "Did you not tell all this to Mrs. Kincaid when you phoned, Bridget?" O'Reilly said. "I'd have come sooner."

  "Och, Doctor dear, we know how busy you are." Mrs. Kennedy's hands twisted and crumpled the cloth. "Sure, it's only a wee tummy upset, isn't it?"

  "Mmm," said O'Reilly through pursed lips. "Maybe we'd better
take a look at her." He rose.

  Mr. Kennedy looked up at his wife. "You go, Bridget."

  "This way, Doctor," she said, walking to a door. "Come on," said O'Reilly, lifting his bag and standing aside to give Barry room. Barry walked after Mrs. Kennedy into a hall and through the door of a small bedroom. Bright chintz curtains framed the window. A beam of sunlight fell on the counterpane of a child's bed, where a little girl, black hair tied up in bunches, teddy bear clutched to her flushed cheek, lay listlessly against two pillows. She stared at him from overbright, brown eyes.

  "This is Doctor Laverty, Jeannie," Mrs. Kennedy explained. Barry moved to the corner of the room and watched as O'Reilly grinned at the child and sat on the edge of the bed. The springs creaked under his weight.

  "So, Jeannie," he said, "not so good?"

  She shook her head. "My tummy's sore."

  O'Reilly laid the back of his right hand on the child's forehead. 'Hot," he remarked. "Can I take your pulse, Jeannie?" She gave him her right arm.

  "Hundred and ten," said O'Reilly.

  Barry mentally added that fact to the rest of the information.

  With the twenty-four-hour history of abdominal pain, the child not wanting to eat, vomiting, a fever, and a rapid pulse rate, he was already quite sure she had appendicitis. He glanced at Mrs. Kennedy as she stood at the foot of the bed trying to smile at her daughter. "Can I see your teddy, Jeannie?" O'Reilly asked.

  She handed him the stuffed bear, its orange fur worn in places to the net backing, one ear half chewed away. "Now, Teddy," said O'Reilly, laying the toy on the counterpane, "put out your tongue and say ah." He bent and peered at the bear's face. "Good. Now let's have a look at your tummy." He nodded his head wisely. "Too many sweeties," he said.

  Jeannie smiled.

  "Your turn," said O'Reilly softly, returning the bear. "Put out your tongue."

  The child obeyed. He bent forward and sniffed. "Have a look at this, Doctor Laverty."

  Barry stepped forward. The tongue was furred, and the child's breath fetid.

  "Can we pull the bedclothes down, Mummy?" O'Reilly asked. Mrs. Kennedy turned back the covers.

  Barry watched as Jeannie's gaze flickered from her mother to her own stomach and up to O'Reilly's face.

  "Can you point to where the pain started?"

  Her finger hovered over her epigastrium, where her lower ribs flared out.

  "And is it there yet?"

  She solemnly shook her head and pointed to her lower right side. Barry flinched. The next part of the examination would not be pleasant. One of the signs of appendicitis was rebound tenderness. When the abdominal wall was pushed in and then suddenly let go, the movement of the inflamed layers of the peritoneum would cause intense pain. Worse, the textbooks called for the doctor to examine the patient rectally. He had always disliked paediatrics, the terror of the little patients, the tears, the anguish of the parents who did not understand. He particularly hated having to inflict pain on small people, but understood that it was sometimes necessary. "Right," said O'Reilly. To Barry's surprise, O'Reilly gently pulled the bedclothes up over the small body, covering the Peter Rabbit nightgown. "Jeannie, would you like to go for a ride to Belfast?" The little girl looked at O'Reilly and then to her mother, who nodded. Jeannie stared into O'Reilly's craggy face. "All right," she said. "Can Teddy come?"

  "Oh, aye," said O'Reilly. "Now you just lie there like a good girl. I need to have a wee word with your mummy." He rose, bent, and smoothed the child's hair from her forehead; then he straightened and headed for the door. Barry hesitated. This wasn't right. O'Reilly had not been thorough. He'd barely examined the patient. The bloody man was in such a hurry to get back to watch his rugby game that he was cutting corners. It wasn't good enough.

  "Are you coming, Doctor Laverty?"

  Barry looked once more at the little girl, trying to decide whether he should complete the examination. "Laverty."

  No, he decided, he'd do nothing at the moment, but he'd have this out with O'Reilly later. Standing by while O'Reilly gave injections of useless medication through patients' clothes and fobbed off a crazy old lady with vitamins--a woman who in Barry's opinion needed a thorough psychiatric examination--was one thing. But this cavalier treatment of a little girl who was obviously ill... ? "Bye-bye, Jeannie," he said, as he left and returned to the kitchen. Mr. Kennedy stood with one arm around his wife's shoulder. She dabbed at her eyes with the hem of her apron.

  O'Reilly had the phone clapped to one ear. He'd be arranging for an ambulance. That's it, Barry thought. Send the child to hospital; they'll take over, and you can get back to your bloody rugby match. O'Reilly's voice echoed from the roof beams. "What the hell do you mean, you've no beds? I've a kiddie with appendicitis here. She'll be at Sick Children's in half an hour. . . . Balls, young man. You get hold of Sir Donald Cromie. ... I don't give a bugger if it is his day off; you tell him that Doctor Fingal Flahertie O'Reilly called . . . no, not O'Rafferty, you buck eejit. O'Reilly. O . . . bloody . . . Reilly . . . from Ballybucklebo." He slammed the receiver into the cradle. "Bloody junior medical staff."

  "You've called the ambulance already?" Barry asked.

  "Don't be ridiculous," growled O'Reilly. "We'll take her up to Belfast in my car."

  "I thought you wanted to get home to see--"

  "Don't be bloody well daft. Jeannie needs her appendix out. And quick. We haven't time to wait for an ambulance."

  Once the Kennedys had been delivered to the Royal Belfast Hospital for Sick Children, and O'Reilly was satisfied that Sir Donald Cromie agreed with the diagnosis and would operate immediately, he spoke once more with Mrs. Kennedy, grabbed Barry by the arm, and hustled him to the car.

  "Come on, Laverty. If we get a move on, we'll still be able to watch the second half."

  So, thought Barry, as they walked across the car park, he hasn't forgotten about the game, nor have I forgotten about what I watched back in the farmhouse. Admittedly, despite his sloppy practices, O'Reilly had been right about Jeannie Kennedy's appendix, and it had been above and beyond the call of duty to drive the Kennedys to Belfast, but that did not alter how Barry felt.

  As O'Reilly drove from the hospital grounds onto Falls Road, Barry said, "Doctor O'Reilly, I think you were very lucky to make the right diagnosis."

  "Oh?" said O'Reilly mildly, "and why would you think that?"

  "You didn't examine the child properly because you were in a hurry."

  "Was I?"

  "That's what it looked like to me."

  O'Reilly swerved to avoid a cyclist. "Daft bugger," he muttered.

  "Are you calling me daft?"

  "No," said O'Reilly, "but I will if you want me to." He stopped at a red light and turned to Barry. "Son, the diagnosis was as clear as the nose on your face from the minute we walked into the room. You could smell her halitosis." Barry looked at O'Reilly's nose expecting to see the telltale pallor. There was none.

  "Did you want me to prod her belly and stick a finger up her backside just because that's what the book says?"

  "Well, I-"

  "Well, nothing," said O'Reilly, driving on. "That wee girl was terrified; there was no need to hurt her anymore."

  "I suppose . . ." Barry could see O'Reilly's logic. He also knew that there had been no real need for O'Reilly to take the family to Belfast.

  "You just suppose away," said O'Reilly, "and stick with me, son. You'll learn a thing or two the books don't teach you."

  Forty Shades of Green

  Barry sat quietly in the passenger seat. Neither he nor O'Reilly had spoken during the drive through Belfast since their brief discussion about why O'Reilly had decided not to complete the examination of Jeannie Kennedy. And damn it, the more Barry thought of O'Reilly's explanation, the more he recognized that the older man, the experienced man, was probably right not to have inflicted unnecessary pain. Perhaps under his rough facade O'Reilly had a softer side. Barry's ruminations were interrupted as the car moved past the redbrick wa
ll of Campbell College, his old school. It didn't seem like seven years had passed since he'd left there to go to medical school. He'd been a boarder for four years at Campbell, the school that the inmates used to say was run on the lines of Nelson's navy: rum, sodomy, and the lash--without the solace of the rum. Not altogether true, of course, although there had been times when he had been beaten by a prefect for some infringement of the rules. And he had made one good friend there, Jack Mills--he was training as a surgeon in the Royal Victoria Hospital. Jack and Barry had shared a study at Campbell in their senior year, stuck together as medical students, been housemen together. Barry decided he'd give Jack a call and see if they could get together when he had his first Saturday off. He'd be interested to hear his friend's opinion of O'Reilly.

  The car left the city traffic. O'Reilly slammed his foot onto the accelerator and hurled the Rover at the twisting Craigantlet Hill Road. Barry stared ahead as the hedgerows ripped past the window, and he tensed as the car lurched when a wheel bounced off the verge. O'Reilly was saying something.

  "I beg your pardon?"

  "I said, 'We'll be home in no time.'"

  Or upside down in the ditch, Barry thought.

  "Goes like a bird," said O'Reilly. "We're coming up to The Straight. I can really let her out there."

  I wish to God you'd let me out here, Barry thought. He glanced at O'Reilly, who had one hand on the wheel and with the other held a match over the bowl of his pipe. "Aren't we going a bit fast, Doctor O'Reilly?"

  "Nonsense, my boy." O'Reilly puffed smoke like a labouring, coal-fired tank engine and threw the car into a turn.

  Barry ducked as they scraped past a hay wagon coming from the opposite direction. When he slid back up in his seat he could see that the road stretched straight ahead to the horizon. He wondered how many times his dad had driven him over this road after collecting him from or delivering him back to Campbell College. The road's tarmac surface followed the undulations of the hills on either side. This was drumhn country, the rounded mounds left behind by the last ice age. He knew that off to his right was one of the great neolithic hill forts, built thousands of years ago by the original Celtic inhabitants of this corner of Ireland. Dundonald, Irish for "Donal's fort," was a complex of earthen ramparts and burial mounds. And if O'Reilly didn't slow down--the car was rocketing over the contours like an out-of-control roller coaster--there might be a sudden need for two more graves.