The Vasectomy Doctor (15 page)

I say Paul Brady was doing his best to show me how to do a vasectomy because at the end of the day the operation is an entirely tactile one. It is all about feel and touch and not about seeing as is usually the case in surgery. If right-handed you retract the testicle gently with your right hand and gently palpate the contents of the spermatic cord with your left thumb below and your index and middle finger above. You know you have found the vas by the feel of it.
Gray's Anatomy
describes it as feeling like a ‘whip cord' but since very few of us these days know what a whip cord is, never mind what it feels like, Gray's description is not much good to us. I describe it as feeling like, and being about the size of, a very under-cooked piece of spaghetti. But there is no mistaking it. You either have it or you have not got it. It is never a maybe. Once you can routinely and quickly isolate the vas and anchor it between thumb below and index and middle finger above then you can do a vasectomy because the rest is relatively easy.

It took me about fifty vasectomies before I was confident enough to be able to carry on doing them without needing someone at hand to step in for me should I get into difficulty. Before I returned from Canada to Ireland I had done about one hundred vasectomies, all under local anaesthetic. I did vasectomies in Canada for the same reason that I did tonsillectomies – GP were expected to be able to do that kind of thing there. I had absolutely no idea at the time that vasectomy was to play such a major role in my life when I returned to Ireland a few years later. It simply did not occur to me that one
day I might be the first Irish doctor to perform a vasectomy in Ireland.

To support a practice of the size that I had in Mitchell required that I employ two full-time secretaries and a full-time nurse. I had five inter-connecting examining-rooms and the nurse would always be one room ahead of me preparing a patient for examination or giving a vaccination or weighing a patient or taking their blood pressure or undressing a baby and generally smoothing the way for me so that my time with the patient could be focused and as brief as possible. My nurse, Anne Rowland, made life so much easier for both patient and doctor. We worked well as a team.

One day old Ned Horan came in to see me. Ned had Parkinson's disease and was generally bothered and hard of hearing. ‘Ned, please take your shirt off and hang it in this closet here and I will be back to see you in a few minutes,' I said in my usual breezy way pointing out the closet to him and off I go to see another patient while Ned is getting ready.

After about ten minutes I go back to the room where I thought I had left Ned Horan and there is no sign of him. ‘Where in the name of God has Ned taken himself to?' I ask myself, worried that he has wandered off into another examining-room and caused no end of consternation and embarrassment. Then I spotted it. Down at the bottom of the closet there is the toe of a boot sticking out. My next thought is that he has gone and hung himself – stranger things have happened in doctors' surgeries (or offices as we called them in Canada). I rushed over to the closet and flung the door open and there is poor old Ned Horan and he holding on to the coat hook at the back of the press for his dear life.

‘What in the name of Jesus are you doing in there, Ned and will you come out of that at once?' I said to him more relieved than cross.

His answer was a classic: ‘I'm doing the best I can doctor,' says he, implying that it was my fault that he was in there in the first place. When I asked Ned to hang his shirt in the closet he, being as deaf as a post, thought that I had asked him to hang onto the coat hook himself at the back of the closet and, thinking this to be some kind of new treatment as it were, he complied and in his own words did the best he could. Isn't it quite extraordinary what people used to do if a doctor advised it? I will tell you one thing, that day is long gone and maybe it's just as well.

* * *

I had been in Mitchell for about six months when suddenly and out of the blue the authorities approached me and asked if I would take on the duties of county coroner. This was considered at the time to
be something of a ‘plum job' carrying as it did some status and autho
rity and indeed not a little excitement. It didn't take me long to accept the offer with enthusiasm and they gave me a book to read and some preliminary instructions on how to conduct a coroner's court and when to hold inquests and so on. The only downside as I saw it at the time was that I was required to swear an oath of allegiance to the queen of England as part of the initiation process to becoming a coroner to Perth County. This kind of oath-taking stuck in the craw somewhat but sure who would ever know and what the hell, I didn't mean one word of it and I did want to become a coroner.

I was busy enough at it too. What with seeing sixty to seventy patients in the afternoons in the office, visiting patients in hospital and assisting at surgery in the mornings, making house calls and being on call seven days a week, now on top of all that I was on call to the police at any moment, day or night, to visit the scene of a fatal accident, shooting, stabbing, murder or suicide. And suicides there were a plenty. In rural Ontario during the long cold winters farmers developed what was then referred to as ‘cabin fever', a usually mildly depressive illness that we now call seasonal affective disorder or SAD syndrome. And they killed themselves, usually out in their barns either by hanging or shooting themselves. They typically shot themselves by placing the muzzle of a twelve-bore shotgun into their mouths and discharging the gun by using a length of binding-twine tied to their big toe and the trigger. When you were at a scene like this you would see brain tissue and fragments of skull embedded into the barn roof twenty feet above the unfortunate victim. These poor men must have led lives of quiet desperation. It was all so sad really. What is in the mind of a man who does this to himself?

And then there was the time that all the hot water ran out in an apartment block in Stratford. When the janitor went to investigate the cause of this he made a grim discovery in one of the basement flats. A young man lay face down in a full bath of water with the hot tap still running, now cold of course. He had been there for five days, a rope of ‘soap on a rope' was wrapped around his neck, the soap itself long dissolved and gone. I ordered a post mortem because the whole thing looked so odd. This revealed a fractured skull with subsequent brain haemorrhage and damage. What appeared to
have happened was that the young man, a known alcoholic, had slip
ped backwards and struck the back of his head off the taps and that was his undoing. I will never forget the smell in that bathroom.

There were road traffic accidents too, of course. These in the main were brutal, careless and horrendous carnages that will stay with me for all time. The worst of these, and they were all bad, actually happened in the village of Mitchell one Saturday evening. Drag-racing was all the rage at the time. To drag-race, two very powerful or souped-up cars line up at a given line and rev their engines up to maximum revolutions per second. On a given signal the drivers then let the clutch in and the cars take off like a rocket down a straight line. Whoever crosses the line first, 500 yards down the road, is the winner. Drag-racing is strictly for mindless morons. On a properly laid out circuit it is not too dangerous. But when a few young men attempt a bit of drag-racing down the main street of a village on a busy Saturday afternoon then you might expect some trouble. When the same young men are all fired up on booze and drugs then trouble is inevitable.

They used the traffic lights at the top of the street as a signal to start the drag-race. Things were going well enough until one of the cars lost control, mounted the pavement and ploughed into the innocent Saturday evening shoppers. Five people were killed instantly including the driver and his back-seat passenger, a young fellow called Beatles Bailey who I knew as a patient of mine with a drug problem. The three dead on the street included a young woman and her boyfriend. Her entire leg and buttock had been ripped clean away from her body by the impact and when I arrived on the scene seconds after the accident I could only look helplessly on as she rapidly exsanguinated from this massive wound and died in my arms. Her heart and brain were looking for blood but there was none. It was all out on the pavement in front of me and I could not put it back nor staunch its flow.

Afterwards I ordered an inquest into this wanton waste of young human life and the jury recommended a greater police presence to deter illegal drag-racing and greater fines and punishments for those caught so breaking the law. I have no idea if these recommendations were ever implemented. Coroner's courts then, as now, had minimal
influence on society and human behaviour. A coroner's mission state
ment in Canada at that time was ‘we speak for the dead to protect
the living'. And while I understood that fully and indeed felt honour
ed to have been entrusted with such an onerous task, I remain sceptical as to how well this system works. Perhaps the best that can be said is that at least we tried.

* * *

Joni Mitchell's singing and writing and particularly her first album called
Blue
were hugely influential for both Ann and myself at this time. We
played that record night and day until we had it worn al
most smooth. The marriage at this juncture seemed to be going quite well. Of course we had the common bond of both of us being Irish emigrants and both agreeing that we would, sooner rather than later, return to our native shores. There was peace and love and very few fights.

Family and work commitments meant that sports and hobbies during my time in Canada had to be at a minimum. I was very lucky in that just down the road from us in Mitchell there was a skeet field where, under the guidance of my friend, Louis Morello, I learned how to shoot properly and only then understood how it was that I missed all those pheasants when shooting with Joe Ward a few years
earlier. Skeet is a formal clay-pigeon layout where the targets are fired
from two separate traps in opposite directions. The traps are housed in a ‘high house' and a ‘low house'. Skeet is shot in squads of five guns, each individual shooting in turn and all moving from station one under the ‘high house' through six more stands set in a semicircle until the eighth stand is reached set between the two houses. At some stands you are required to shoot only singles – left to right and right to left. At other stands you are required to shoot doubles when both traps are released together. A round of skeet comprises twenty-five shots per gun. The gun must be held off the shoulder until the target appears which is anytime up to three seconds after you shout, ‘pull'. The whole thing is hugely demanding and requires your full concentration. It is also very sociable and good fun.

The only other way we had of shooting in Canada was at live pigeons driven out of barns. Pigeons tended to winter in farmers' barns where they ate scraps of grain and animal feed and crapped onto the farm machinery from their perches high up in the rafters. As such they were an awful nuisance to the farmers who were only too delighted to give us the opportunity to shoot at them. The farmer would go into his barn and beat around it with a big stick driving the pigeons out through a small aperture under the roof. You never knew if or when one might break for it and a lot more pigeons were missed than hit. But it was an amusing way of shooting.

We were not in Mitchell for too long before making some good friends, again as always, through our music and songs. Joan Gaffney played piano and did a perfect take on Gracie Field's ‘The Biggest Aspidistra in the World' while her daughter, Dianne, played guitar and did Gordon Lightfoot stuff. Ann and I would sing a sea shanty together called ‘Sally Brown', a great rollicking song with close harmony on the ‘rolling go' bit:

I shipped on board of a Liverpool liner

Away hay and a rolling go

We will roll all night and we'll roll till the day

I am going to spend my money along with Sally Brown.

Ann might sing a Napoleon song that went:

Bonaparte he commanded his troops for to stand

And he planted his cannon all over the land

He planted his cannon the whole victory for to gain

And he killed my loyal horseman returning from Spain.

In our company often at these sessions would be John and Nancy Ferguson, John and Liz Moore, the Rubies, the Kellehers and maybe the Taylors from Belfast who were just discovering that there was such a thing as Irish music. We drank mostly Canadian beer in those days. I never could drink rye whiskey and Canadian wine, made from a grape called ‘concord' was, in my opinion, utterly undrinkable.

One day a package arrived in the post that quite transformed our time in Canada. Remember at this stage we were starved of de
cent Irish music or singing. We missed our Hamilton Irish friends and
while the Gaffneys were always generous to a fault their music was not quite what we needed. I had just purchased a state of the art quadrasonic Pioneer sound system. The package contained a copy of the just released
Prosperous
album recorded in the basement of this house and with a picture of the house on the front of the sleeve and my name mentioned twice on the back as having given Christy Moore two of the songs. When we put that record on to this sound system and turned up the volume we were quite simply blown away. When Liam Óg O'Flynn, playing the uilleann pipes, broke into ‘Tabhair dom do Lámh' or ‘Give me your Hand' after Christy's first song ‘The Raggle Taggle Gypsy', I wept for joy. That record was played morning, noon and night. I know every twist and turn of it and played along with it on the whistle where keys agreed.

* * *

News from the home front was not great. My parents, by then both well into their seventies, were involved in a horrible car crash while on their way back from Easter services in Maynooth College. A truck drove right out in front of them at a crossroads. My mother was taken to hospital where there was a failure to spot a fractured cervical vertebra on x-ray. This did not help her recovery one little bit. My father, while naturally very shaken, escaped otherwise uninjured. But this was serious news to have to bear and we were 3,000 miles from home. Given my work commitments as coroner and the difficulty of getting anyone to cover my large practice, getting away at short notice was not easy. But, one's first duties are to oneself and to one's family. Work and patient's welfare should at all times be secondary and doctors, including this one, often forget that.