A Dublin Student Doctor (2 page)

No reply.

O’Reilly grabbed the man’s wrist. Good. Mrs. Meehan was right; the pulse was strong and regular. “Donal,” he said more loudly, “Donal.”

Donal’s face was chalky. He wore his raincoat reversed and buttoned over his back. It was the practice of country men when riding motorbikes. It stopped the wind of passage getting through.

O’Reilly was hesitant to move Donal. He could have a broken neck. Better to wait for the ambulance. The first law of medicine was
Primum non nocere.
First do no harm. O’Reilly bent lower. “Donal?”

Donal’s eyelids fluttered. “Numuh?”

Better, O’Reilly thought. Donal might only be concussed. If that were the case he should start regaining consciousness. But you could never be certain about head injuries. The damage might range from a simple concussion with complete recovery through to serious brain injury leading to paralysis, permanent brain damage, and even death. O’Reilly gritted his teeth. Donal had a new wife and a wean on the way. O’Reilly’s heart went out to the pregnant Julie Donnelly, née MacAteer. He heard the
nee-naw
of an approaching siren. O’Reilly leant over. “Donal?”

Donal’s eyes flew open. “Doctor O’Reilly? What are youse doing here?” He struggled to rise. “I shouldn’t be in my bed.”

Donal recognised O’Reilly. That was a good sign even if he was unclear where he was. O’Reilly put a restraining hand on the man’s shoulder. “Lie still. You had an accident.”

Donal put his hand to his head. “I must have hit my nut a right clatter,” he said. “It’s pounding to beat Bannagher, so it is.”

“Do you know what day it is?” O’Reilly asked.

Donal frowned. “Uh? Saturday. We made a wheen of money on the oul gee-gees at the races.” He grinned like a small boy who had answered the teacher’s question correctly. “And this here’s the road to Ballybucklebo.” A look of concern crossed his face. “Jesus, is Paddy Regan’s motorbike all right? It’s only on loan.” Donal tried to rise.

“Stay put,” O’Reilly said, and smiled. If Donal knew about events immediately preceding his accident it was probable he had suffered only a minor concussion. Even so, O’Reilly would never forget a footballer who’d been knocked out, recovered, gone back to finish the match, and died from a brain haemorrhage two hours later.

The
nee-naw, nee-naw
grew louder.

“I don’t need no ambulance,” Donal said. “I’m for going home, so I am.”

“Sorry, Donal,” O’Reilly said, “but you’ll be spending tonight in the Royal Victoria Hospital.”

“Och, Doctor—that’s daft. I’ve a motorbike to get back to—”

“The Royal. For observation,” O’Reilly said. “No arguments. I’ll take care of the bike.”

“But—”

“Donal, you’re going to hospital,” O’Reilly said as if speaking to a not overly bright child. “That’s final.” He stood and spoke to Barry. “I’ll do a quick neurological exam once he’s in the ambulance. Establish a baseline in case he gets worse. I’ll go up to the Royal with him. Kitty’s the senior nursing sister on the neurosurgical ward there. She’ll want to come too. She can go with Donal in the back of the ambulance. God knows she’s observed a hundred times more head injuries than you and I put together. She’ll keep an eye on him and warn me if his condition deteriorates. You drive Kinky and the Rover home.”

“I’ll go and get Kitty.” Barry started to turn as a yellow Northern Ireland Hospitals Authority ambulance drew up and its siren was turned off.

“In a minute,” O’Reilly said. “Once the police have come and done whatever they have to do, measure things, take photos and statements, they’ll have you fill in forms. When you’re done, get them to give you a hand to load the bike into the boot of the Rover. At least Paddy Regan won’t need to come all the way here to collect it.”

“Paddy? I’ll let him know,” Barry said.

O’Reilly turned. “Do you hear that, Donal? We’ll get the bike home for you.”

“Thanks, Doc. But what about Julie? She’ll go spare if I don’t get home too.”

O’Reilly frowned. “You’ve no phone, Donal, have you?”

“No, sir.”

“I’ll nip round and see Julie,” Barry said. “Tell her what’s happened. That she’s not to worry.”

“Thanks, Doc.”

Barry turned to leave as two men approached wearing peaked bus drivers’ caps, silver-buttoned blue uniforms, and carrying a stretcher. The bigger one, a burly, open-faced man, spoke to the first-aid lady. “What’s the story, Rosie?” Of course he’d know her. They’d both be Downpatrick locals.

She nodded at O’Reilly. “Better ask your man there, Alfie. That there’s Doctor O’Reilly.”

The man turned to O’Reilly and grinned. “From Ballybucklebo, the wee village near Holywood?”

“That’s right. How did you—?” He frowned. Alfie did look familiar.

“I met you at a rugby game, sir.” He pointed at Donal. “What do you reckon about your man?”

“He came off the bike and hit his head. He was unconscious for a while but he’s awake now. Concussion at least and I’d like him in the Royal for observation. You know head injuries can—”

“I do know. Too bloody well.” The ambulance man frowned. “My brother, God rest him, got a smack on the nut with a hurley ball. He bled into his skull and died.” There was a catch in Alfie’s voice. “He was only nineteen.”

“I’m sorry,” O’Reilly said.

“Aye well.” Alfie tugged at his tie. “Standing here both legs the same length won’t get your man there to the Royal. What do you want us to do, Doc?”

“Before you move him, I’ll give his fore and hind legs a once-over. Then I want you to take him, me, and Sister O’Hallorhan, she’ll be here in a minute, up to the Royal. We’ll radio ahead to arrange for him to be seen in casualty, get things rolling, then have him admitted to the observation ward.”

“Right, Doc. Come on, Bert.” The ambulance men aligned their stretcher alongside Donal as O’Reilly examined Donal’s arms and legs through his clothes. “You’re right, Mrs. Meehan. There are no bones broken,” he said, and stepped back to let the attendants do their work. “Thank you, Mrs. Meehan,” O’Reilly said. “You did a great job. Now go on home and get your tea.”

She smiled, bobbed her head, and left.

O’Reilly climbed aboard the ambulance. “For crying out loud,” Donal said, and tried to sit up. “This is daft, so it is. Going to all this trouble. Sure couldn’t I just get the bike—”

O’Reilly made a noise like an enraged gorilla, one whose last banana had been stolen. “For the last time, Donal Donnelly, you’re going to the Royal. This is not a bleeding debating society—so shut up, lie down, and let me examine you.”

“I will, Doctor O’Reilly, sir,” a clearly chastened Donal said—and did.

Fingal satisfied himself that Donal’s reflexes were normal, that his pupils were equal in size and reacting to light, his pulse was strong and steady and his blood pressure was normal. The only worrying thing was a bruise over Donal’s right temple. The parietal bone there was thin. There was a chance the skull was fractured. O’Reilly didn’t need to reassure himself that getting Donal to hospital was the right thing to do. The middle meningeal artery lay beneath the parietal bone. O’Reilly climbed out to meet Kitty.

Barry was providing information to a uniformed Royal Ulster Constabulary officer. The man had a heavy pistol in a hip holster. Good for Barry, O’Reilly thought, one less chore for me, and frankly, the sooner we get Donal to hospital the happier I’ll be. If his condition did deteriorate, speed of intervention was critical.

The second ambulance attendant climbed into the back and offered his hand to Kitty.

“Hop in,” O’Reilly said. “All his baseline findings are normal, but please keep an eye on him. I’ll be in the front, so if he starts to go downhill, let me know.”

“I will,” she said, taking the proffered hand.

He watched her climb in and as she did so her skirt rode up. God, but she had a well-curved calf, O’Reilly thought, but then, he grinned, she always had.

Barry finished with the officer. “Thanks for seeing to that, Barry,” O’Reilly said. “You’ll have to look after the practice tomorrow too because Lord knows what time I’ll get home.”

“That’s all right.”

“Off you trot.” O’Reilly noticed his bag where he’d left it on the ground. “Take my bag to the car while you’re at it. The ambulance will be fully equipped.”

Barry paused. “How will you and Kitty get home?”

“Kitty lives only a short walk from the hospital. I’ll get a train. Now go on. It’s time we were off.”

O’Reilly stuck his head into the ambulance. “Everything okay, Kitty?”

“No change.”

“Good.” As O’Reilly walked to the front of the ambulance, the last colours of the sunset flared and died. A straggling clamour of rooks flapped untidily across the dimming horizon and Venus rose, a glittering forerunner of the myriad stars that would spangle the sky’s dark dome.

He climbed into the passenger side and shut the cab’s door. “How’s about ye, Doc?” Alfie, the driver, asked.

“Grand,” said O’Reilly. “The lad in the back’s a patient of mine.” And, he thought, as close to being a friend as I’ll let any of my patients be. “I think he’ll be all right.”

“Right,” said the driver, “let’s get going.” He switched on his flashing lights, but not the siren, put the vehicle in gear, and started for Belfast.

“Can we radio ahead?” O’Reilly asked. “Let the neurosurgery people know we’re coming?”

“Aye, certainly, sir.” The driver lifted a microphone, depressed a button, and announced, “Ambulance despatch, ambulance despatch. This is delta alpha two sixer, over.”

In moments O’Reilly had relayed the details to the dispatcher, who would contact the neurosurgery registrar on call. “Who is the senior neurosurgeon on call tonight?” Just in case, and the thought niggled at him, just in case that bruise at the side of Donal’s head was a sign of more ominous damage.

“Mister Greer, sir.” The voice from the speaker was distorted.

“Thank you, despatch. Delta alpha two sixer. Out.” O’Reilly handed the mike back. “Thank you,” he said.

Charlie Greer. He and O’Reilly went back to 1931, and that wasn’t yesterday. He hoped Donal would have no need of Charlie’s services, but if Donal did deteriorate he couldn’t ask for a better brain surgeon.

“How long until we get to Belfast?” O’Reilly asked.

“About an hour and a half—and if you’ll excuse me, sir, I’d better concentrate on driving. The road’s twisty here.”

O’Reilly said, “Pay me no heed.” He sat staring through the window as rays from the dome flashers flickered and the headlights’ beams picked out fluttering moths, the verges and hedges, and dry stone walls draped with straggling brambles. He wondered about Donal. O’Reilly knew that no amount of worrying was going to help anything. Kitty would let him know if anything changed, and if it did, Donal was well on his way to being in the hands of a bloody good neurosurgeon. Charles Edward Greer, M.D., F.R.C.S., from Ballymoney, County Antrim. A long time ago he had been a rugby-playing medical student like O’Reilly at Trinity College Dublin.

O’Reilly had met student nurse Kitty O’Hallorhan while he and Charlie, along with their friends Bob Beresford and Donald Cromie, and a nasty piece of work called Ronald Hercules Fitzpatrick who now practiced in the Kinnegar, had been working in Sir Patrick Dun’s Hospital. Back in 1934.

He’d been twenty-five years old and had completed nearly three years of his medical studies at Trinity College Dublin.

Dublin had been richly described by the playwright Denis Johnston as, “Strumpet city in the sunset. So old, so sick with memories.” The place had memories for O’Reilly, all right.

Trinity College with its Library’s Long Room wherein resided the Book of Kells and the Brian Boru harp. The pubs, Davy Byrnes, the Bailey, Neary’s, and the Stag’s Head. Great broad O’Connell Street crossing Anna Livia, the Dubliners’ name for the River Liffey. The tenement districts like the Liberties, the Coombe, and Monto, filthy, squalid, vermin-plagued, but with indomitable inhabitants. O’Connell Street and, halfway up it, Nelson’s Pillar beside the General Post Office, from the steps of which Pádraig Pearse had read out the Proclamation of the Irish Republic at Eastertide 1916. Its façade and Ionic columns were still pockmarked with British bullets from the siege during the Rising.

O’Reilly was distracted by a sudden movement ahead and leant forward to see the bushy tail of a badger scurrying for cover and its home.

Dublin had become O’Reilly’s home in 1925 when his father, young for the job at forty-five, had been appointed professor of classics and English literature at Trinity. O’Reilly had been born and brought up in Holywood, County Down, Northern Ireland, still part of the United Kingdom, but for eleven years had lived in the Irish Free State. Sometimes he thought he was neither fish, fowl, nor good red meat. He’d loved Ulster all his life, particularly Strangford Lough, where he and his older brother Lars had spent their winter Saturdays wildfowling. But he loved Dublin too.

The ambulance slowed then halted to give a large lorry right of way. O’Reilly turned and slid back a window between the cab and the rear of the vehicle. “Everything all right, Kitty?”

The lighting was dim and he had difficulty making out her features.

Kitty said, “Everything’s fine. Donal’s sleeping.”

If the middle meningeal artery had burst, Donal would be deeply unconscious, not asleep, but surely a nurse with Kitty’s experience—

“It’s all right, Fingal. I’ve no trouble waking him up and there’s no change in any vital signs.”

O’Reilly exhaled. He hadn’t realised he’d been holding his breath, and damn it, he should have known better than to doubt. “Grand,” he said. “We’ll be there soon.” He closed the window as the ambulance began to move. Donal was going to be all right. Of course he was. O’Reilly looked out the windscreen to see the ambulance taking the left-hand fork of a Y junction.

Ireland was full of strange road confluences, the Six Road Ends in County Down, the Five Road Ends at Beal na mBláth in County Cork where Kinky had grown up on a farm, and Michael Collins, head of the armed forces of the Irish Free State, had been assassinated in August 1922.

O’Reilly had come to a crossroads in his own life in ’27. If he hadn’t made his choice about which road to follow, he’d not have Charlie Greer and the others as friends, nor Kitty. Nor would he have been a rural GP, a life he loved, if he’d meekly caved in when Father had decreed over breakfast in the family house on Lansdowne Road in Dublin that no son of his was going to be a physician. The ambulance lurched over a pothole and a goose walked over his grave as he shuddered and remembered that day, September 17, 1927.