An Irish Country Practice Read online

  “I do, sir. I’ll run away off and grab a clatter and we can make my oul fellah more comfy. I’ll be back in a wee minute.”

  “Great,” Barry said.

  She was smiling as she left.

  “Doctor,” Lewis said, “thank you for coming. I was scared skinny I’d gone blind, but”— he managed a weak chuckle— “for a man that’s had a cataract fixed I’m seeing bravely now, so I am, and my right side’s stopped tingling. That was bloody awful, so it was.” Barry felt himself relax a little more. This was a rapid recovery. Lewis’s speech was showing no signs of its earlier distortion.

  Lewis yawned mightily. He said, “I think I’ll just take a wee nap,” and slowly drifted off to snore softly.

  Barry was not concerned, but wished he could make a completely accurate diagnosis, although there were no definitive tests or imaging techniques that would give an exact diagnosis in this case. Indeed, it had been the craic when he’d been a student that neurology, the specialty dealing with nervous diseases, was often a competition between the clinician and the pathologist for the correct diagnosis. Barry would bet a great deal that his patient’s “turn” had been temporary reduction of blood flow to the brain due to a narrow artery. And it was satisfying to be able to think that. But what the future held for the man, Barry Laverty had no idea. And if they were honest with themselves, the specialists didn’t either. Even under the best circumstances, it couldn’t be rosy for any man of eighty-two years.

  Barry had once before been so dissatisfied with how little GPs could do, he had flirted with the notion of specialising, spending six months as a trainee obstetrician. But in the end, the satisfaction of working closely with patients had won out. Today, though, that arrogant registrar had hit a raw nerve. Barry remembered one of his classmates who had been convinced he could make a much bigger contribution in the long run by going into research. Finding a way to prevent diseases rather than trying to treat them one by one. The man was finishing his Ph.D. this year. Barry shook his head. Nah. Living here, accepted as an important part of village society, having a colleague like Fingal, on the verge of wedded bliss—and starting a family. The thought sent a trill of sensation through Barry’s stomach, whether of excitement or panic he wasn’t sure. Sue was certainly bound and determined that soon after they’d moved in here, one bedroom would become a nursery. He frowned and let the thought go. Gracie had returned. “I’ll give you a hand,” he said, holding Lewis forward so she could tuck a pillow behind his back.

  “Thanks a million, Doctor,” she said, spreading a tartan rug over her husband’s lap and legs. “I’ll just have til baby you for a wee while, dear,” she said, and there was such intense love in her voice, Barry suddenly felt like an intruder and had to look away.

  6

  Touch Not the Cat

  O’Reilly sat in the Rover with Kitty cuddling a sleeping Kenny beside him. “I hope we don’t come to regret my suggestion of bringing Kenny home with us,” she whispered. “I’m sure he’s going to be all right with Arthur.” Kitty pursed her lips. “But Lady Macbeth?”

  Is this how Kitty had looked holding a baby when she’d worked in that orphanage in Tenerife before the war? His heart swelled and he stroked his index finger lightly over her cheek, then over the velvet fur of the puppy’s head.

  “I have a plan.”

  “You always have a plan, Fingal O’Reilly. The most resourceful man I know. It’s one of the reasons I fell in love with you.” She paused. “Then and now.”

  He turned off the engine and gave her a grateful look. “I suggest you find her ladyship, bring her into the kitchen. I’ll introduce Arthur to what I hope is going to be his new friend. Then we’ll collect all Kenny’s bits and pieces. My plan is to leave Kenny with Arthur and take the things with Kenny’s scent on them into the kitchen. See how her ladyship reacts.”

  “Fine by me,” Kitty said. “The wee dote.” She kissed the top of Kenny’s head, then handed over the drowsy puppy. “Here.”

  They got out and headed for the back gate. The moment Kitty opened it, Arthur Guinness stuck his head out of his kennel, grinned, and trotted out to greet his people, tail going to and fro like an overheated semaphore.

  “Hello, Arthur,” said Kitty, patting the big dog’s head.

  “Lie down, sir,” said O’Reilly.

  Obediently, the Labrador sat, then flopped onto his tummy, front legs stretched out in front of him, tail still going like the hammers of hell. He sniffed and stared at the bundle in O’Reilly’s arms. Arthur cocked his head to one side, his eyebrows working up and down.

  O’Reilly squatted and offered Kenny for Arthur to sniff. He raised his muzzle, sniffed twice, and nodded. Kenny woke up and O’Reilly set him on the grass. The puppy wobbled, found his too-big feet, and when he saw Arthur his hackles rose, his legs stiffened, his tail stuck out, and he gave a belligerent “yip.”

  “Male pups are already instinctively ready to try to become pack leader,” O’Reilly said. “Don’t think it’s going to work with old Arthur.”

  Arthur Guinness grumbled low in his throat, let his upper lip curl and a sliver of white canine tooth show.

  The impertinent pup, realising he was having ideas well above his station, whimpered and rolled wriggling onto his back in abject submission.

  Arthur lowered his square head—and licked the pup’s tummy.

  Kenny squirmed upright, leapt back stiff-legged, and charged, tail going so hard it moved his whole rear quarters.

  “Feisty little devil,” Kitty said.

  Arthur put one forepaw on the pup’s head. For a moment Kenny stood still then took one step back and licked the paw.

  “Ah, truce. Let’s see what happens now,” O’Reilly said. He started to walk across the grass. “Heel.” Arthur followed and Kenny bounded after like a small dinghy in the wake of a large keelboat. “Seems to me,” said O’Reilly, “they’ve established who’s master.” He stopped. “Sit.”

  Arthur obeyed, but the puppy charged, yipping around Arthur, O’Reilly, and Kitty before pushing between Arthur’s front legs, turning round, sitting, and panting.

  “Well,” Kitty said, surveying the pair, “that’s one step over. You three wait here.” She headed for the house.

  O’Reilly said, “Stay,” and wandered off back up the garden. He turned. Arthur hadn’t budged, but Kenny was staring at O’Reilly, clearly wanting to run to him but confused that Arthur hadn’t. “Stay,” O’Reilly repeated.

  Kenny must have taken that for an invitation. He started off, but Arthur leant forward and, with the gentleness he used when retrieving a bird, lifted Kenny by the scruff of his neck, brought him back, and set him on the grass.

  Good Lord. Arthur Guinness was instructing the wee fellah.

  “Come.” Arthur used his muzzle to nudge Kenny toward their master and followed the little lad to O’Reilly’s side.

  “Sit.” Arthur immediately obeyed and, after looking at his mentor, Kenny followed suit. O’Reilly guffawed. “Good dogs,” he said in the same level tones he’d used for years to reward Arthur for obeying commands. It was really all it took to train such an amenable breed: consistency, firmness, and love, with occasional tangible rewards for everything done right.

  “What were you laughing at?” Kitty asked, returning from the house.

  O’Reilly explained.

  “Pity the Arthur Guinness School of Animal Training never worked with Lady Macbeth. She was snoozing in an armchair. I had to wake her. She was not amused and is now sulking in the kitchen.”

  O’Reilly laughed. “Hang on to him, will you, love?” He set the basket on the ground and took from it a piece of dog chow and a rubber squash ball. “Arthur.” O’Reilly tossed the ball to the end of the garden. “Hi lost.”

  Off Arthur went, and returned with the ball in his mouth. He sat and dutifully offered the ball to O’Reilly. “Good dog.” O’Reilly repeated the exercise twice using the command and noting how closely Kenny was paying attention. “Put Ken
ny down please, Kitty.”

  The pup made a beeline for Arthur, who lowered his head so greeting sniffs could be exchanged. O’Reilly stood beside Kenny. “Sit.” As he spoke, O’Reilly used his hand to exert gentle pressure on Kenny’s rump.

  Arthur obeyed at once.

  The little dog hesitated but, giving in to the pressure of O’Reilly’s hand, followed suit.

  “Good dog.” O’Reilly patted Kenny and gave him the piece of food.

  “Now,” he said to Kitty, “watch this. Arthur. Stay.” He let Kenny sniff the ball, threw it, and before O’Reilly could say “Hi lost,” the chocolate Lab pup had raced off. The instinct to retrieve was deeply bred into the species. Kenny picked it up, turned, and headed back to O’Reilly.

  It was a tussle to get Kenny to release the ball, but after a tugging match it was finally surrendered. “Good dog,” O’Reilly said, but no food. The retrieve had not been perfect. “It’s going to be fun training that one,” O’Reilly said, “and I think Arthur’s going to want to help.”

  Kitty laughed. “Old dog teaching young dog. Might just work with old GPs and young ones too. You will be going up to the Department of General Practice this week, won’t you?”

  “Indeed I will,” said O’Reilly. He spoke to the dogs. “Be good, you two. Come on, Kitty. Let’s see if Lady Macbeth is in a better mood.” They headed for the back door.

  The little white cat was eating from her bowl in front of the range. She turned to look, then returned to eating.

  “Here goes,” said O’Reilly, setting Kenny’s basket on the tiled floor close to the little feline. “What’s that, your ladyship?” O’Reilly asked.

  The cat climbed into the basket, sniffed, arched her back, and growled. Her tail expanded, but not to the full glory she achieved when truly scared or angry. She examined Kenny’s ball, a rubber bone, and a small beige teddy bear. Although a cat can’t shrug and say “so?” her posture conveyed those sentiments. She lay down, curled up, and promptly fell asleep.

  “Begob,” said O’Reilly with a grin, “we’re going to get away with it. Wait here.” He turned and in moments had returned carrying Kenny. He didn’t bother closing the door completely behind him.

  He set Kenny down beside his basket and stepped back.

  The pup’s brow wrinkled and he approached slowly. He cocked his head, took a step forward, then another. His tail began to wag. He put one paw into the basket and nudged the sleeping cat.

  Lady Macbeth’s eyes opened—wide. She stood up, back arched like a long bow at full stretch, tail fluffed like an electrified toilet brush, and screeched. The hairs on the back of O’Reilly’s neck rose.

  Kenny leapt backward in time to avoid a slash from Lady Macbeth’s right front paw, all four wickedly sharp claws fully extended. He howled, a piteous, keening noise.

  Before O’Reilly could grab the pup and hoist him out of harm’s way, the door burst open and Arthur Guinness stalked in. This time his growl was full-throated, both canines were fully exposed, and his hackles were up. He stalked stiff-legged, stood over a whimpering Kenny, and gave a vast “woof,” daring the cat to attack.

  Lady Macbeth gave both dogs her most disdainful look, sheathed her claws, furled her tail, straightened her back, sat, hoisted one leg, and began to lick her backside. The message was clear: “Dogs do not frighten me and this is my kitchen.”

  “Phew,” said Kitty, “for a minute I thought her ladyship was going to maul Kenny.”

  O’Reilly chuckled. “I never knew male dogs could show maternal instinct, but old Arthur certainly did.” He looked fondly at the big Lab, who was licking Kenny to comfort him. “But it hasn’t solved our problem. I’d intended to put Kenny’s stuff in the kitchen where he’d be cosy at night.” He pointed to Lady Macbeth, who had clearly taken possession of Kenny’s basket. “If we do, we’ll have to give her ladyship the run of the rest of the house.”

  Kitty said, “I don’t think so. Watch.”

  O’Reilly turned.

  Arthur was heading slowly for the door with Kenny walking at the big dog’s shoulder. O’Reilly and Kitty followed.

  When they reached Arthur’s doghouse, he looked back at O’Reilly and Kitty as if to say, “Don’t worry about it,” picked Kenny up by the scruff, and lifted the pup over the threshold.

  “I’ll be damned,” said O’Reilly as Arthur climbed in after the pup.

  “I,” said Kitty with a catch in her voice, “will have to go and get a hanky.” She sniffed. “I’ve never seen anything so lovely in my life.”

  And Fingal Flahertie O’Reilly, ex-boxer, ex-rugby player, couldn’t answer. He was going to need a hanky himself.

  * * *

  “Have a pew, Cissie,” Barry said, indicating one of the two hard wooden chairs. He was taking surgery on this Tuesday morning and Cissie Sloan was his last but one.

  Cissie parked her not inconsiderable form, and the torrent began. “How’s about ye, Doctor dear. Fit and well you’re looking. I think thon Miss Nolan’s doing you a power of good, so I do. You know, I seen her yesterday at MacNeill Primary. Thon wee lassie has the loveliest hair I’ve ever seen in my puff—”

  “Thank you, Cissie, but—”

  “And have yiz heard about Bertie Bishop? I hear tell he put in a bid for til build more houses on the council estate, but he never got it, so he never. Flo says he’s a much nicer man since he had thon heart attack, seen the light so to speak, but,” she leant forward and lowered her voice, “I think he’s losing his edge. There was never a tougher businessman than Bertie, but now? See him? See him? He’s going soft, so he is.” She sat back and folded her arms.

  Barry wondered if it were true. It could have implications for more than the Bishops. His workers needed their jobs. He sighed and let Cissie blether on. She was a good-hearted woman and was here today so Barry could keep an eye on her myxoedema, deficiency of thyroid hormone, that he’d diagnosed two and a half years ago.

  “… anyroad, I hear poor Lewis Miller was took poorly and had til go til the Royal on Sunday. Me and Flo’s going til look in on Gracie the day. She’s no spring chicken and she’ll be worried sick, so she will. Flo’s made up some chicken soup, Kinky’s recipe, and—”

  “That’s very kind of you both. I’m sure it will be appreciated, but, Cissie, I need to ask you a question or two about how you are.”

  “Fire away.”

  “Still no muscle cramps, tiredness?”

  “Not—”

  Barry didn’t wait for the “at all” but charged on. “Feeling the cold? Drowsy? Bowels? Monthlies?”

  “Warm as toast, bright as a bee, and them others? Been right as rain since you found out I was short of them wee thingies in my blood. I take my pills every day, so I do and, just like clockwork I—”

  “You sound pretty fit to me, Cissie.” She was evincing none of the usual symptoms of myxoedema. From where he sat at the rolltop desk, Barry could see that her skin was pale, not yellow. The puffiness he’d noticed when he made the diagnosis had gone. Her eyebrows had grown back.

  “Can you hop up on the couch?”

  She laughed. “I’m no great hopper, but I can climb,” and she did, sitting with legs swinging.

  Barry started to take her pulse.

  “Dis yiz hear about—”

  “Hang on, Cissie. I’ve lost count.” Which wasn’t true. Her pulse was perfectly normal. If she were short of thyroid hormone, it would be slow and her blood pressure low. “Take off your coat, please.”

  Cissie must have remembered the routine. She had worn a short-sleeved blouse so Barry could wrap the cuff round her upper arm.

  “It’s one twenty over eighty. Spot on. Turn to one side.” He palpated her neck. No sign of thyroid gland enlargement. He was happy enough to confirm normal thyroid function on clinical grounds. The definitive diagnosis involved measuring the uptake of radioactive iodine by the thyroid, and the less radioactive material injected into an individual the better. “I think the pills are still doi
ng the trick,” he said.

  “Dead on,” she said, “and will I have til have any blood tests? I don’t like them needles. Did you hear about Alice Maloney? Put a needle straight through her thumb on Friday fixing Maggie Houston’s best hat. It’s a wonder she didn’t get the blood poisoning—”

  Before Barry had arrived in the village, the bi-weekly Ballybucklebo and Townland Chronicle had operated for a few years but had eventually folded. By the time it had gone to print, the locals already knew the news anyway. “No, no blood tests, Cissie,” he said, perhaps a little more sharply than he should have. “I’ll give you another scrip for six months and I want to see you a week or so before it runs out.”

  “Fair enough, sir.” She got off the couch and started putting on her coat as Barry rapidly wrote a prescription for sodium l-thyroxine tablets, 0.3 mgm to be taken daily. “Here, and come and see me if you don’t feel at yourself between now and then.” He had her by the elbow and was steering her to the door.

  “Thanks very much, Doctor, but I must tell you a wee thing. It’ll only take but a moment, but it’s to do with one of your doctors.”

  Barry bit back a sigh. “Cissie, it’s probably none of my business.”

  “Sure it is, Doctor dear. I was at the off-licence til get a few bottles of stout, about three o’clock on Saturday, so it was. Who comes in but Doctor Fitzpatrick. All smiles. Now, no harm til him, but we all know he’s a dry ould stick and probably’d wrestle a bear for a ha’penny. Anyroad, your man’s buying two bottles of them expensive French champagnes. Two. Says he til Hughie, him that runs the place next door to the Duck for Willie Dunleavy, ‘I’ve just done rather well on the National.’ What do yiz think of that, sir?”