Fingal O'Reilly, Irish Doctor (41 page)

Fingal turned back a faded rug that once upon a time had been a bright tartan. They lay like two spoons; Orla, her long grey hair spread like a fan, wore only her shift and was on her side with her back to the whitewash-peeling brick wall, arms wrapped round a naked Dermot, who was fast asleep, muttering to himself. His breathing was slower, sixteen rather than the eighteen breaths per minute it had been when Fingal had last examined the boy before giving him his third dose of ten grams of Prontosil at two thirty. There’d been no change for the better since he’d had his first dose, and Fingal had had to discipline himself from examining Dermot every ten minutes hoping for a sign. It was a good thing Fingal had slept. This waiting for improvement was driving him daft.

He touched the lad’s forehead. It was clammy, but was it less hot? Fingal couldn’t be sure and was not going to be taken in by wishful thinking. “I’ll just be a minute.” Fingal went to where he’d hung his jacket on his chair, removed the thermometer from the breast pocket, and snapped his wrist several times to shake the mercury level down below the normal mark.

Kneeling, he slipped it into Dermot’s armpit, then took his pulse by feeling his carotid artery at the angle of his jaw. Still up, but at ninety-six was down from its earlier one hundred beats a minute. As Fingal waited for the thermometer to register, he said, “Can you hold the light, so I can see his leg?”

He managed to slip two fingers into the crease of the boy’s groin without disturbing him. Their tips moved from the inside of the thigh to its outside near the iliac crest, the hinch bone, and did not encounter what Fingal had been dreading. There was no sign of hard, rubbery, enlarged lymph glands.

One of the glands’ functions was to act as hubs to collect the lymph and direct it into larger ducts that eventually returned the fluid into the general circulation. If the fluid carried attackers like living bacteria, the lymph glands mobilised the immune system and became barricades, last-ditch redoubts that tried to keep the invaders out.

When that happened, the glands became swollen and hard. But Dermot’s weren’t. They were not fighting the
Streptococci—
at least not yet. Fingal took a deep breath. The microorganisms must still be confined to the wound and the lymphatic channels of the leg. Either Dermot’s own defences were holding their own or, and he hardly dared tempt Providence by wishing it so, the Prontosil was beginning to have an effect.

Fingal moved to Dermot’s foot and took off a soiled dressing. The yellow circle cast by the flame was sufficient for Fingal to make out clearly that the ulcer did not seem to be any bigger. Fingal sniffed. The smell was no worse. He looked at the boy’s calf and Fingal’s left fist clenched. A tiny smile flickered on his lips.

He’d used an indelible pencil at the times of giving the first, second, and third doses to mark the furthest upward extent along Dermot’s leg of the red lines of lymphangitis. Three blue lines crossed the ascending red ones at ninety degrees, each about one inch apart. Since six thirty last evening the progress had been inexorable. It had taken all of Fingal’s willpower not to call a halt at two thirty, admit defeat, arrange for hospital admission and, he took a deep breath, amputation. He’d calculated that as the rate of progress was about one inch every four hours he could take a chance. If the thing did go higher between then and six thirty, the boy would still only lose his foot, not the whole lower leg and now, glory be, there’d been no more advance. Maybe? Maybe? Added to the noninvolvement of the lymph nodes it was promising. “Hold the light steady,” Fingal said. He removed the thermometer and, holding it up to the light, squinted at the silver mercury column. 99.8. It was hardly plummetting from its earlier 100.2, and body temperature tended to be lower in the morning, but it wasn’t getting any higher. He pulled the rug over the sleeping mother and son, taking care to leave the ulcer uncovered. He’d re-dress it in a minute. “Let them sleep,” he said, stood, and inclined his head to Mister Finucane to indicate that they should move back to the fire.

The warmth was pleasant on the back of Fingal’s legs. The scent of burning turf made an heroic attempt, but failed to counter the overpowering tenement smell.

“Well, sir?”

Fingal managed a smile that he hoped might be reassuring. “Dermot’s not out of the woods yet—but he’s holding his own.”

“Will he lose the foot?” Fingal heard the way Minty’s voice trembled. “I’d rather dat dan have him—” He looked down then back at Fingal. “—die. He won’t die, will he, sir? He’s all we’ve feckin’ got.” The man’s voice cracked.

Orla had mentioned that just before Fingal had rushed off to track down a supply of Prontosil. He’d thought it odd that a Catholic family should still only have one child after fourteen years since the birth of their first, but he’d been so concerned for Dermot that he’d refrained from asking why. And now certainly wasn’t the time.

Amputate or go on hoping? Your decision, Fingal O’Reilly, and ask yourself, look in your heart. If you decide to carry on with this treatment, is it for Dermot’s sake—or is it to prove you are right, gain kudos from your colleagues? He clasped his hands behind his neck, pushed his head back, wrestled with the question, then looked at Minty and said, “I think we should wait a while longer. Give the Prontosil more of a chance. Give Dermot more of a chance,” and hoped to God it was the right choice.

Minty pursed his lips. “I heard a doctor say dat once before. When Dermot was born. Orla nearly feckin’ died. She bled after the delivery. The doctor came to me in the waiting room, said he’d packed her womb and that should stop the bleedin’ and we should wait a bit longer. The feck it stopped anything.” He hawked and made as if to spit before he clearly recognised where he was. “They took out her womb, and dat was all right. I’d rather have her alive with a bit missing than feckin’ dead.” He looked Fingal right in the eye. “And dat’s w’at I t’ink about Dermot, sir.”

“I understand,” Fingal said, feeling the worries of the world. “We are doing everything we can.”

“It was God w’at spared Orla back den as much as her operation.” Minty crossed himself.

“And,” said Fingal, “we must pray He’ll heal Dermot and his foot.” The good Lord and an aniline red dye. “Now, I’ll make up the next dose and dress the wound. I think,” he said, “it’s going to be a long day.”

Orla was soon up and dressed and Fingal found himself sharing the water she drew from the courtyard pump for her husband and heated over the fire. The two men used a sliver of soap, and cut-throat razor to shave, but Fingal had declined the offer of a share of the family’s mixture of soot and salt that universally substituted for toothpaste in the Liberties.

While Dermot slept on, Orla had fed them a watery gruel and cups of tea.

Fingal’s belly growled. He’d had nothing to eat since lunch yesterday, except cups of tea, but he didn’t want to leave the patient.

“I’ll just nip over and ask Skylark Brennan to tell dem at Clery’s I’ll not be in today,” Orla said, and left.

Even if it was a Saturday the big department store needed cleaning.

“It’s a feckin’ good t’ing she has regular work,” Minty said. “I’m lucky myself, I’ve a friend, a foreman on the docks, and he’s decent about gettin’ me a job unloading cargo now and again. Ordinarily I’d be out of dis place by now, linin’ up wit’ the rest of my mates to see if there was any oul’ chance today, but—” He inclined his head in the direction of the sleeping area and said no more.

Someone was knocking on the door.

“Who the hell would that be this time of the mornin’?” Minty strode to the door. “It’s yourself, Doctor Corrigan. Good morning to you.”

“And to yerself,” Doctor Corrigan said, “but there’s bugger all good about it. It’s bucketing down.” He pulled off a bowler hat, almost taking his toupee with it, and shook water from the brim.

Fingal rose. “Good morning, Doctor Corrigan.”

Phelim patted his hairpiece into place. “I was out on Swift’s Alley seeing a namesake of yers, a Fingal Flahertie O’Reilly Kilmartin.”

“How is he? I delivered him last April. And how are Roisín and Brendan, and their other son, Declan?” They were all part of his community now.

“The babe is teething, but he’ll be grand. His ma was asking for ye, and his da. Brendan’s still working with another of your ex-patients, a Paddy Keogh, and he’d come round on his motorbike and sidecar to take Brendan off to a hare coursing meet in the Wicklow Mountains. Paddy says hello.”

How the hell, Fingal wondered, did a one-armed man drive a motorbike? Still, he learned soon enough that there wasn’t much Paddy Keogh couldn’t do once he made up his mind to it.

“Do ye know, Doctor O’Reilly, I think half of my practice is yers already?”

“Thank you.” Fingal hesitated then said, “But you didn’t come round here just for that.”

“No. I did not. Yer friend Bob Beresford is a very persistent young man. He tracked me down at home at ten o’clock last night. Asked me on yer behalf if I’d look after emergencies today. Told me why. Told me about the red prontosil.” He cleared his throat and looked Fingal in the eye. “Would ye think it unprofessional if I asked to see yer patient?”

Technically it would be, unless Fingal asked for a second opinion. He hesitated. What if Doctor Corrigan disapproved, told Fingal to get the patient to hospital at once? What was in Dermot’s best interests? Phelim’s advice, that was what. “Mister Finucane, you’d not mind if I asked my senior colleague to consult?”

Minty, who Fingal had noticed had been following every word, nodded. “Sometimes,” he said, “two feckin’ heads are better than one.”

“Thank you.”

“And,” said Minty, “I know how youse medical gentlemen like to have your palavers in private, so I’ll nip across the hall to the Brennans. They’ll make Orla and me a cup of tea. Will you come for us when you’re done?”

“I will,” Fingal said.

He waited until Minty had pulled the blanket-curtain aside, kissed his son’s forehead, and left.

Fingal rapidly told Phelim the history, his physical findings, stressing that the lymphangitis seemed not to be progressing, and waited until the little doctor had finished his examination. He straightened up. “Aye,” Phelim said, “aye.”

Fingal waited. Behind his back he held his left hand in his right, squeezing the fingers in its grasp.

Phelim nodded and said levelly, “It’s a very grave chance ye’re taking, Fingal O’Reilly. The boy might die.”

Fingal tightened his grip. “I know, but if the drug can save the boy’s foot? Let him live a full life?”

“Say that again.”

Fingal frowned. “If the drug can save—”

“That’s what I thought ye said.” Phelim smiled. “If I thought for one minute ye were risking this boy’s life for yer personal glory I’d insist we get him to hospital right now. We’re G.P.s, not research scientists, for God’s sake. It’s not our job to bugger about with untested drugs.” He touched Fingal’s arm. “But ye didn’t say, ‘If
I
can save,’ you said, ‘If the
drug
can save.’ Fingal O’Reilly, I admire that. I’m proud of ye. It is only wee Dermot ye’re thinking of.”

Fingal’s hands relaxed. “Thank you.” And Phelim had helped Fingal answer the question he’d asked himself when Minty had asked if Dermot could die.

“So,” said Phelim, “ye carry on. I trust ye’ll do what’s right for the lad, whatever that is, as the case progresses.”

“I will. Thank you.” He crossed his arms and stroked his chin with his right hand.

Phelim clapped Fingal on the shoulder. “So, ye go and get the Finucanes. Explain to them that I concur. I’ll run on and I’ll look after the emergencies until Monday. Neither one of us can tell how long ye’ll be needed here.”

40

Upon the Walls of Thine House

“I don’t believe it. I simply don’t bloody well believe it,” O’Reilly roared as he stood glowering, arms akimbo, in the doorway. What the hell were Kitty and Kinky doing standing on short stepladders in his waiting room? “Holy thundering Mother of—” Control your tongue, O’Reilly, he thought. You’re with ladies, not sailors from the lower deck of HMS
Warspite.
But by Beëlzebub’s blistering braces, there’s a limit.

It was a Saturday morning and no patients were in the room. Nor was there any furniture, and the floor was covered in old newspapers. He looked down at the newspaper closest to him. It was last Thursday’s, November 11.
Ian Smith Declares UDI,
the headline screamed. O’Reilly at the time had thought it odd that the man should have chosen Remembrance Day to declare Southern Rhodesia’s independence from Britain. Now there’d been another unilateral decision taken—to redecorate a room in his own house without telling him.
Without telling him.
Sacrilege. Blasphemy. Was he master in his own home no more? Bloody hell. Calm down, he told himself.

Normally he would take pleasure from seeing Kinky and Kitty so obviously happy collaborating on a project, Kinky not one bit perturbed that Kitty was changing things at Number One. That would be the final indication that any residual feelings of Kinky being threatened by Kitty had vanished. At that moment, however, he felt as if two of the women in his house had ganged up on him. Made an unholy alliance. He made a growling noise in his throat as he watched, then said, “And Jasus, Kinky Kincaid, I never, never in a month of bloody Sundays thought you’d collaborate in this travesty.”

“Come on, Fingal,” Kitty said with a grin. She pushed on the wide-bladed metal spatula she was using to scrape the rose-covered wallpaper off the wall. His rose-covered wallpaper. “Don’t growl at Kinky. She’s only doing it because I asked you what you thought, didn’t I, Kinky?”

“You did, and I’m sorry, sir, but I agreed and…”

“All right,” O’Reilly said. “I hear you.”

“And it’s not as if you and I haven’t discussed it,” Kitty said. A long curl of paper rolled up ahead of her scraper then tore free and floated down.

He stared down at the strip, lying lifeless on the ground. “Discussed it? When?”