An Irish Country Wedding (16 page)

“How’s about ye, Doc?” Donal appeared from a room to the left. His duncher perched rakishly on a small white bandage. He pointed to it. “Miss Brennan says this here comes off for good on Monday.” He grimaced. “I’ll be quare nor glad to see the back of it. I’d love to get a good scratch at my nut, so I would.”

“Itchiness is a sign of healing,” O’Reilly said. “A good sign.”

“If you say so, Doc, but it’s like I’ve got the whole of the Third Plague of Egypt under there, so it is.”

O’Reilly had to think. What was the third plague Moses had visited on Pharaoh? Lice, that was it. “I can imagine,” he said, and felt itchy himself. “Are we all set to go? Doctor Laverty would have liked to come but he’s visiting Ag— I mean he’s visiting a patient.”

Donal dangled keys. “Oh, aye, I know all about that. Julie saw Cissie Sloan at the grocer’s and she said Miss Brennan asked Doctor Laverty to take a look at Aggie’s very close veins. She’s got a temperature and a ferocious aching in her leg, so she has.”

So much for patient confidentiality, thought O’Reilly with a grin. If Cissie Sloan knew something, the whole of the townland would know inside an hour.

“Your man Dapper Frew, the estate agent, him that’s Mister Coffin the undertaker’s cousin, give me these here,” Donal said, shaking the key ring. “Said for to let ourselves in.”

“Grand,” said O’Reilly. He’d heard that estate agents in North America showed potential buyers round houses for sale. Here in Ulster the owner did the showing, but Myrtle Siggins, who’d lived to the grand age of 101, had been dead for a year now. Clearly Dapper, a fellow piper in the Ballybucklebo Highlanders, trusted Donal to look round on his own. “Let’s go.”

“You be a good girl, Bluebird,” Donal said to the greyhound, who looked from eyes abrim with adoration for her master. He turned to O’Reilly. “Lead on, MacDuff, sir.”

17

The Fury and Mire of Human Veins

Barry parked in the housing estate and headed for one of the identical terrace houses. The drizzle had stopped and the pavement, decorated with the blurred chalk outlines of hopscotch, shone damply in bright contrast to the scummy puddles that had collected where the tarmac was cracked. Cigarette butts disintegrated in the gutters and kept company with discarded fish-and-chip wrappers.

Colleen Brennan opened the door. “Thanks for coming, Doctor Laverty. Aggie’s in the parlour.”

Barry hung his coat on the hall coatstand, the one he’d used three days ago when he’d popped in to make sure Aggie’s superficial thrombophlebitis was getting better. It had been—then. “You think it’s the deep veins?” That’s what Colleen had said on the phone.

Colleen Brennan was a thickset, sandy-haired woman of thirty-five who had been the district nurse in Ballybucklebo for thirteen years. She nodded. “Aggie has a temperature of one hundred point two and says her leg hurts. It is tender.”

“I see.” Both were signs of deep venous thrombosis. “I don’t like the sound of that,” he said. “Let’s take a look at her.”

“This way.”

Barry followed the nurse into a small room. A worn rug covered the linoleum in front of the grate where a coal fire had been banked with slack, little pieces of a low-quality coal. When dampened and put over the ordinary coals, it slowed the rate of burn
ing and saved money. Aggie lay on a couch underneath a red
blanket.
“Afternoon, Doctor,” she said. “I’m terrible sorry to drag youse
out in this mucky weather, so I am.”

“Don’t worry, Aggie,” Barry said. “Miss Brennan wanted me to see you.”

“Aye. Well.” She moved herself farther up the couch. “Before we start on me, how’s Mrs. Kincaid? I knew she’d been taken poorly but Cissie told me she’s still in the Royal and had to have an operation. It’s terrible, so it is. Poor crayter.”

“She was quite sick,” Barry said, “but she’s on the mend.”

“If youse sees her, tell her I was asking after her, so I was.”

“I will,” Barry said. “I’m sure she’ll be pleased.” He moved closer to the couch. “Miss Brennan says you’re not so well, Aggie.”

She shrugged. “Them hot water bottles, and towels, and the aspirin all helped. The red bit’s got much wee-er, but I took an awful ache in my calf this morning, you know. It wasn’t like the first one, but I didn’t want to bother you, sir. I waited until Miss Brennan called by.”

Barry resisted the temptation to remind Aggie that he’d told her not to thole it, but call him if she was worried. She’d not be the first of his patients who, out of consideration for their doctor’s
time, had let their condition deteriorate. “I’d better have a look,” he said. He waited until Aggie had thrown back the blanket. The hem of her tartan wool dressing gown was pulled up. Barry crouched beside her. She lay so her left leg was on the outside of the couch. The red area he’d first seen last Tuesday had practically vanished. “Show me where it hurts,” he said.

She pointed to the centre of her calf. No superficial vessels coursed beneath the skin, but the deeper posterior tibial and peroneal veins drained the calf muscles and were prone to clotting and causing pain. Her ankle looked swollen. “This won’t hurt,” Barry said, and pressed his fingertips into the swollen area above her ankle. Pits formed and were slow to disappear. That was oedema, fluid collecting there because the damaged vein could not carry it away. Another sign. “Tell me if this is sore,” he said, and palpated her calf over the courses of the deep veins.

She sucked in her breath as his fingers probed.

“Sorry,” he said and, before she had time to object, rapidly flexed her ankle toward her shin.

“Owwwwch.” She gasped and screwed up her face. “That’s right sore, so it is, not like the last time you done that.”

A positive Homan’s sign, which, while not infallible, if taken with all the other findings made Barry sure that Aggie did have a deep venous thrombosis. “You were right, Miss Brennan,” he said. “You’ve got trouble in a deep vein, Aggie.”

Colleen inclined her head but did not smile. Barry understood that her concern for the patient outweighed her professional satisfaction at having been correct. And she was right to be worried. Aggie was at risk of a piece of the clot breaking off, being carried to the lungs, and causing pulmonary embolism, a potentially lethal condition.

Treatment was straightforward, but although he could start it here, she would have to be admitted for follow-up and monitoring. “I’m sorry, Aggie,” he said, “but you’ve got a deep clot. We call that phlebothrombosis.”

“Fleebo
 
… fleebo
 
… I’d never get my tongue round the half of that,” she said. “Is fleebo-whatsit bad? It certainly sounds as if it is, so it does.”

He didn’t like not telling the truth, but by the same token he didn’t want to terrify her. “Probably not if we get treatment started straight away. I’ll have to give you an injection.” He stood up.

“I don’t like them needles,” Aggie said, “but if you must, you must.”

“Miss Brennan, could you call the ambulance, please?”

“Of course.” She left.

“Ambulance?” Aggie asked. “Can youse not fix me here, like?”

Barry rummaged in his bag. “I wish I could,” and he did, “but you’ll not be in long. I’ll give you a medicine called heparin here. It’ll work at once and stop the clot spreading.”

“That’s good,” she said.

“You’ll have to get five doses more of it.”

“Needles?”

“’Fraid so, but you’ll get another medicine called warfarin in tablets to thin your blood, prevent more clotting. Once your specialists get the dose of warfarin right, they’ll stop the injections.”

She frowned. “Get the dose right? Should they not know already if they’re specialists?”

“Everybody reacts differently,” Barry said. “The doctors measure a thing called the prothrombin time. Once it’s twice as long as normal, they’ll know that’s the right dose of the medicine for you and they’ll let you come home. I’m sorry I can’t do that for you here. The tests have to be done in a laboratory and you need nurses round the clock to give you the medicines.” He found the bottle of heparin and a prepacked hypodermic syringe and needle.

“Boys-a-dear,” she said, “modern science is a wonderful thing.”

Barry dampened a ball of cotton wool with methylated spirits. The acrid fumes cut through the aroma of the smoking slack and tickled his nose. He turned his head away and sneezed. “Excuse me,” he said, then swabbed the rubber cap of the heparin bottle and rapidly withdrew 15,000 units of the drug.

“They’ll be here in half an hour,” Miss Brennan said.

Barry hadn’t heard her return.

“Good,” he said. “Can you give me a hand?” He held up the loaded syringe. “IV,” he said.

She moved to Aggie. “Hold out your arm, dear.”

Aggie did and Colleen encircled it with both hands above the elbow. The antecubital vein began to distend.

Barry swabbed the elbow’s hollow, slipped the needle into the vein, withdrew the plunger, and was pleased to see smoky turbulence. Blood had entered the barrel, proving the needle was in the vein. “Let go, Miss Brennan.” It took moments to inject the heparin. “All done,” he said, removing the needle and pressing the cotton wool ball over the puncture.

“That wasn’t too bad, sir,” Aggie said. “Thank you.”

Barry smiled. “They’ll have you better in no time.”

“They will,” Colleen Brennan said. She turned to Barry. “I’m sure you’ve other cases, Doctor. I’ll tidy up here. Get Aggie ready to go. Keep her company ’til the ambulance comes.”

Barry did not have any more calls to make, but he did want to hear how O’Reilly had got on with the Donnellys. They were probably back by now. “Thank you,” he said.

“Excuse me, sir,” Aggie said, “before you go?”

“Yes, Aggie.” Barry put the used syringe and heparin bottle back in his bag. He removed the cotton wool ball. Good. She wasn’t bleeding from the puncture. He chucked the ball onto the coals, where it sizzled and burst into a tiny fireball.

“Colin Brown’s mammy, Connie, looked in to see me. Her and me’s in the Ballybucklebo Strolling Players, you know. She was a lovely Juliet last year, so she was. I was Nurse.”

“I’m sorry I missed that,” Barry said, marvelling at the depths that flowed beneath the surface of this place.

“Aye, well, we’re doing Brian Friel’s new play,
Philadelphia Here I Come
, this year. I’m Madge
 
… at least I will be once my leg’s better, and Connie’s Kate Doogan.” Aggie lowered her voice. “When Connie was here, and no harm to youse, sir, but
—
”

Barry knew a criticism was coming. Ulsterfolk always prefaced one that way.

“
—
she told me she didn’t reckon you and Doctor O’Reilly were any great shakes as cooks.”

Barry chuckled. “She’s right.”

“If you pop into my kitchen there’s a cherry cake I baked, and before you get mad, sir, I mixed it all lying here. I only got up to put it in and take it out of the oven, so I did.”

“That’s very kind, Aggie. Thank you.”

“It’s just a wee thanks, sir, for seeing me and for trying to fix things up at my work.”

Barry heard the emphasis on “trying.” “What’s wrong there?”

Aggie shook her head. “I sent them your letter. I got a phone call from Ivan the Terrible’s secretary. She told me that Mister McCluggage and his partner had decided to reduce the workforce and were letting a folder and packer go. Me. I’m getting a month’s notice and severance pay. Nothing to do with my being sick, like. No. No. Not at all.” She curled her lip. “And if you’ll believe that you’ll believe fish walk on legs, but I can’t do nothing, so I can’t. I spoke to the shop steward and he told me the bosses was in their rights.” She stifled a sob. “And me working there for sixteen years.”

“I’m so sorry, Aggie,” Barry said, wondering if there was anything he, or more likely he and the big guns of O’Reilly in full cry, could do. “I truly am.”

“Thank you, sir. You’re very kind.” Aggie took a deep breath, squared her shoulders. “Doctor Laverty, when I’m at the hospital do you think they’d give me a brave wheen of that warfarin for to bring home?”

Barry frowned. “Why would you want a lot? I’ll write you a prescription whenever you need more.”

“Because,” she said, and Barry heard the steel in her voice, “I know what warfarin’s for. It’s not just for thinning the blood. It’s a bloody good rat poison, so it is, and I want to give some to Ivan the Terrible, so I do
 
… and I’ll tell you, that there silent partner? See him whoever he is? He’d be silent as the tomb all right, because he’d be in one, so he would.”

18

A House with Deep Thatch

O’Reilly drove the Rover from the centre of the hairpin bend in the Bangor to Belfast Road to the end of a rutted lane. The tyres crunched on gravel in front of a single-storey thatched building.
Patches of moss marred the straw. “Here we are,” he said, and
parked. The old cottage’s whitewashed walls were grubby and the mullioned lead lattice windows needed washing. Red paint was peeling from the window frames and from the front door set in a narrow porch. Window boxes on sandstone windowsills had been invaded by blue-flowered birdseye speedwell and plantains. “Everybody out.”

Donal leapt from the car and opened the back door for Julie and Arthur.

The drizzle had stopped, and high overhead patches of sky
looked down between slowly drifting clouds. O’Reilly noticed
branches of broom, already covered in bright yellow flowers, straggling through the gravel.

“That there has to go,” Donal said, pointing to the weed. “Give that stuff an inch and it’ll be all over everything like clap on a heifer’s arse.”

“Donal,” said Julie, but her reproach was gentle.

Donal peered at an etched stone fixed to the wall beside the front door. “It says 1795. There’s a thing,” said Donal. “The house was built the year the Orange Order was founded. But what’s the other say, sir? Can you read the Irish?”

O’Reilly scrutinized the lettering but although the carved date was clear, the letters were indistinct. He rubbed some of the moss away and thought he could make out
Dán Buídhe
. “Dawn Bwee,” he said. “It’s Irish for Yellow Poem.”