A Dublin Student Doctor (13 page)

Fingal heard his man tossing the ball into the tunnel. “Coming in left, Trinity—now.”

The Trinity pack drove their legs against the ground. But no matter how he and his teammates strove, Fingal, purple of face, muscles standing out in his neck, felt himself being driven back. “Ball’s lost.” That was his captain’s voice, but Fingal also heard a stranger call “Bananas.” That was code for some unusual play. He let go of Charlie. Immediately ahead, one of the Wanderers’ players lay flat on the ground. He must have made a flying pass because now the whole of the Wanderers’ back line was rushing forward in echelon in a standard attack. Fingal hesitated. He couldn’t see who was carrying the ball.

He sensed a movement to his right. A Wanderer, ball under one arm, was running like a whippet towards the Trinity goal. Fingal took off. On the command “Bananas” the attacker must have picked up the ball. The elaborate movement of the opposing backs had been a diversion. Fingal put everything into it and after four strides launched himself in a headlong dive. His shoulder crunched into the man’s thighs. The runner fell and his boot clouted Fingal’s cheek, but Fingal ignored the pain as he scrambled to his feet, grabbed the loose ball, and started running.

Ahead he saw two of his own players coming at the charge. As he passed them, they ran in support of him off to his side, but slightly behind. Passing the ball forward was not allowed. Fingal’s nearest opponent tried to tackle but was thrust aside by a brutal straight arm. Now the last Wanderers defender in striking distance must tackle Fingal, who ran straight at his opponent, making no attempt to avoid the tackle, and at the last moment passed the ball.

As he got to his feet and stood, hands on knees gasping for breath, he saw his teammate sliding across the goal line immediately under the crossbar of the goalposts. Bloody marvellous. Trinity twelve. Wanderers nine, and the kicker should have no difficulty adding another point by hammering the ball between the uprights.

*   *   *

“That result, I think,” Charlie said to Fingal in the dressing room as he shrugged into his jacket, “was very satisfactory.”

Fingal shoved his muddy togs and boots into his hold-all and zipped it shut. He laughed. “So do you reckon,” he pointed to the bruised swelling under his slowly closing left eye, “that it was worth getting this?” He opened the door. “And me with a nurse to woo?” He’d spotted Caitlin among the spectators.

“Och sure,” Charlie said, “can’t you always play the wounded warrior?”

“Come on,” said Fingal, “let’s go and see Bob and Caitlin.” He stepped out into the autumn sunshine.

“Fingal. Fingal O’Reilly.” She stood with Bob Beresford, who often came to support the team.

Cromie wasn’t here today. He and Hilda had decently agreed to work for Fingal and Charlie so they could be free to play. Charlie would repay Hilda tomorrow. Cromie said he’d settle for a pint or a return favour in sailing season.

“Bob.” Fingal’s friend looked very dapper in his camel hair overcoat and rakishly worn bowler hat, an ivory-headed ebony walking stick in his left hand.

“Caitlin.” Fingal smiled at her. He’d barely been able to speak to the girl, had only exchanged a few smiles in the past two weeks. She wore a tartan tam. Her hair, usually hidden under her nurses’ headdress, cascaded down to below her shoulders. It was blacker than his own, had a sheen to rival Bob’s cane, and rippled in the light breeze. Those eyes sparkled. Her lips pursed, and she tutted. “That’s a nasty shiner.” He heard the concern in her voice.

Before Fingal could shrug it off, Bob said, “Great tackle, Fingal, and brilliant run.” He lowered his voice. “I saw T. J. Greeves, one of the Irish selectors, watching.”

Fingal, who had been focussing all of his attention on Caitlin, gasped. “Really? Honestly?” One of the men who’d pick the national team? They only came to a match if they were interested in a particular player.

Bob nodded. “We’ll keep our fingers crossed.”

Fingal saw Caitlin looking expectantly at him. “Och,” he said, “they’re probably here to watch Charlie, not me. There’s only room for two second-row forwards on the team. They’d not pick both players from the same club.”

“We’ll see,” Charlie said. “Right now, Bob, I’m more interested in a post-game pint.”

“You go on, boys, Caitlin and I are going to the flicks.” Fingal looked straight at Bob, who must have taken the hint. Bob turned to Caitlin, took her gloved hand in his, bent his head, and raised it almost to his lips. “It has been a great pleasure to make your acquaintance, Miss O’Hallorhan,” he said, “I do hope we shall meet again.” He released her hand.

You’ll bloody well not, Fingal thought. Not unless I’m with her. His vehemence surprised him. He barely knew the girl.

“Thank you, Mr. Beresford,” she said, and smiled.

At least, Fingal thought, it’s not “Bob” and “Caitlin” yet. He wondered why he was feeling so possessive.

“You played well, Fingal,” she said. “It’s not often you see a second-row forward running with the ball. You handed off that Wanderer beautifully.”

Fingal frowned. “I’d have thought a girl would know more about field hockey or camogie.” Rugby football was a boys’ sport.

She put one hand on her hip. “Just because girls don’t play doesn’t mean we can’t understand the game. That’s about as sensible as saying because men have never been pregnant they can’t deliver babies.”

“Point taken,” Fingal said, and laughed.

“My father’s a fanatic for the game,” she said. “He’s taken me to matches for years.”

“Och,” said Fingal, impressed by her knowledge and by her willingness to stand up for herself, “seeing how you understand the game you’d not expect a forward to run and think at the same time, do you? Our man was in the right place to collect the pass. That’s all.”

She looked at him appraisingly, her right eyebrow arched. “You got all covered in confusion a week ago when Kevin Doherty was discharged and he tried to thank you. Are you trying to pretend you didn’t set up that try perfectly? Are you by any chance one of those Irishmen who get all hot and bothered if he’s paid an honest compliment?”

He swallowed. “Caitlin, it’s nearly five o’clock. We don’t want to miss the start of the big picture.” It was a cheap night out when admission cost four pennies each. “Why don’t we get a tram to O’Connell Street?”

“You
are
one,” she said, and laughed deep in her throat. “All right. Let’s get a tram. And never mind the Caitlin, Fingal O’Reilly. It’s Kitty.” Then surprisingly she reached out her hand and took his.

12

Even My Lungs Are Affected

“Your left hand holds the barrel of the syringe,” Geoff Pilkington said to Fingal and Charlie. “Put your index and middle fingers through these stainless steel rings at the top end with your thumb through the central ring on the plunger.”

It was the week before Christmas, and Fingal and Charlie were being taught how to tap a pleural effusion, a collection of fluid between the two layers of the membrane that sheathed the lungs. Geoff was demonstrating with a large syringe. “This,” he said, indicating a device between the syringe and the hub of a wide-bore needle, “is a two-way tap. When you have the handle parallel with the axis of the syringe, fluid can run in or out of the needle. When you put the handle at ninety degrees and shove on the plunger, the fluid in the barrel will come out here.” He pointed to an open tube on the side of the valve.

This was the trickiest procedure he’d learned in three months. He and his friends had become adept at collecting blood from the patients, or setting up intravenous drips. Well, most of them had. Bob Beresford seemed to be cursed with two left thumbs and sometimes took as many as three attempts to find a vein. Cromie had confessed to Fingal over a pint that, for the sake of the patients, Bob was letting Cromie take all the bloods since the patients had started calling Bob “Count Dracula.”

Fingal had even done two cut-downs for patients in such degrees of shock that their veins were too collapsed to find. For them it had been necessary to freeze the skin beside the inner ankle bone, make a small incision, expose the long saphenous vein, incise it, and slide in a narrow tube through which blood or saline could be infused. It had been very gratifying to feel that in a small way he’d helped when both patients recovered and were discharged.

Fingal watched Geoff repeat the actions for a second time. It looked straightforward, but Fingal glanced back at the big needle. “Geoff,” he said, “that looks like something Captain Ahab would have stuck in Moby Dick.” He didn’t like the look of it one bit, nor fancied using it on living flesh. Particularly today’s patient.

“Maybe,” said Geoff, “but it’s what you or Charlie is going to drain that pleural effusion with.”

Fingal looked at Charlie and started to say he’d rather not, but Charlie beat him to the punch. “Me,” he said. “I’m from a farm. I’ve had to help my da often enough to geld bullocks.”

Fingal exhaled. He knew he would need to learn the technique, but not today. He was happy to watch Geoff walk Charlie through the steps again.

Fingal was surprised at his own discomfort. The repetition of doing procedures and the knowledge that they were of benefit had helped him conquer his natural aversion to inflicting pain. Gradually he was becoming inured, but not completely. Today he simply did not want to pierce this particular fellow human with a bloody great skewer the size of a knitting needle. He’d grown fond of the man.

“And that’s it, Charlie,” Geoff said. “You’ll do fine. We’ll get the gear sterilized.” He put the instruments, including a smaller hypodermic, into the water of the sluice’s autoclave, shut the lid, and flicked a switch to heat the water to boiling. “You’ll not be using Big Bertha until you’ve put in some procaine two percent. That’s what the little syringe and its fine needle are for.”

Thank God for local anaesthetics, Fingal thought, taking a deep breath. By now he barely noticed the smells in the bedpan washing room.

“That’ll take twenty minutes to cook,” Geoff said. “Come on. We’ll go and see the patient.”

They followed Geoff out of the sluice onto the, as ever, full Saint Patrick’s Ward. Sister Daly straightened up from speaking to a patient, tugged her apron straight, and walked toward Fingal’s group. She graced them with a smile.

Fingal returned it. He was convinced that the faster their skills improved the more useful she considered them, and the wider her smile grew.

“We’re going to tap the pneumonia in bed 51’s pleural effusion, Sister,” Geoff said.

“Grand, so. I’ll send a nurse with the trolley. I imagine the instruments are being sterilised?”

“They are,” Geoff said, and led the way to bed 51. The plaque read
Gascoigne Bed. Supported by Colonel Trench Gascoigne. 1898.

This bed was inside an oxygen tent like the one that had helped the long discharged Kevin Doherty. This patient was a man of thirty-four. He was skinny as a rake, his upper front two teeth missing, his Old Bill moustache nicotine-stained, and his right arm ending in a stump below the elbow. Fingal had admitted him so it was his job to keep up the daily progress notes and present the case, when required. Fingal had spent quite a bit of time with the little man. “Good afternoon, Sergeant Paddy Keogh,” he said. As many male patients did, the man was wearing a tweed duncher. “How are you today?”

“I’m not altogether at myself, Mister O’Reilly, sir,” he coughed and winced, “but I’m mending, t’anks.”

Dubliners, Fingal thought, could never manage the
th
sound. In the north, folks had trouble with
thr
so instead of “three” they’d say “thee.”

“Always glad to see yourself, sir.” Paddy Keogh tried to smile. His breathing was laboured, his lips and cheeks cyanosed. Even without a stethoscope, Fingal could hear the wheezing of the little sergeant’s lungs. Fingal had admitted the patient at one
A.M.
four nights ago. One disadvantage of living in students’ quarters was that they were easily called at night. Still, it increased the number of patients they saw and so their experience grew.

On that night it had taken Fingal a moment to recognise the beggar he’d given two shillings to last March. Sergeant Pádraig, “Paddy,” Keogh—febrile, sweating, suffering violent pain with every breath, coughing, wheezing, and shivering as he was—had no difficulty recognising Fingal. “Jasus,” he’d gasped, “it’s yourself, sir, w’at gave me a whole feh—” He must have seen the nurse and corrected himself in time, “sorry, a whole two shillings, sir.”

“Och,” Fingal had said, “sure and amn’t I only an eccentric millionaire? Now let’s get you seen to.”

Fingal had busied himself with the admission history and physical examination. Address, 27 Francis Street; age thirty-five; religion, Roman Catholic. He’d recorded the symptoms and signs. The diagnosis was simple, particularly as it wasn’t the man’s first bout of pneumonia. Fingal cursed the Dublin tenements.

With Geoff’s advice, tests had been ordered. A chest X-ray confirmed that the man had left lobar pneumonia and pleurisy: inflammation and infection of his left lung and the membrane surrounding it. Treatment was prescribed; oxygen, sponge baths to try to relieve his temperature, and the drug that had been in vogue since the late 1800s to reduce temperature, acetylsalicylic acid—or aspirin. It might help the pain a little, but morphine was out of the question because of its known suppressant effects on respiratory function. He was going to be in pain for a while.

Fingal had already heard that one of Hilda’s patients, a young woman, had died of pneumonia. Some days after the onset of the disease, the crisis had come heralded by a dramatic rise in temperature. They’d all hoped for an equally dramatic fall in her temperature, followed by a gradual recovery. But at the height of the crisis the woman had died. Victorian novelists like the Brönte sisters and Wilkie Collins had loved to use pneumonic crises for dramatic effect. The course of the disease and its treatment weren’t much different in 1934. What was needed was a medication that killed bacteria, but according to Doctor Micks, in 1930 a Doctor Fleming had abandoned attempts to use a derivative of a fungus called
Penicillium notatum
for such a purpose. The substance was known to stop bacterial growth in the lab but couldn’t be collected and purified well enough for human use. Patients had to rely on their own resistance to fight off the infection.