The Vasectomy Doctor (16 page)

Back in Ireland I find both my parents in the rehabilitation hospital in Dun Laoghaire. My mother is in a revolving bed on traction to help avoid spinal cord injury arising from her fractured neck. My father is sitting on the edge of his bed upset but very glad to see me. He smokes his Sweet Afton through a black cigarette holder. In time they would both recover but incompletely. At a certain age people never really recover from this kind of assault on their frail bodies. Returning to Canada at this time was very difficult but it had to be done.

Joy was on the way. On 17 March 1972 our long awaited daughter arrived delivered by a lady GP in Stratford General Hospital. St Patrick's Day and there we were with a baby daughter in a foreign land. We christened her Caoilfhionn, meaning the fair-haired one and there was much to celebrate. Both our children were, and of course remain, Canadian and Irish citizens, something that gives them more options should they choose to use them later in life.

* * *

If I have at times seemed to be somewhat critical of Mitchell and its good God-fearing citizens then perhaps I need to make amends. After all here I was, a blow-in and a bit of an impostor, and yet at least seventy per cent of the population of the town and the farmers and their families for a radius of ten miles or more supported my practice and were good and loyal patients of mine. It wasn't as though they had no choice. There were plenty of doctors ten miles away in Stratford and a few more over in Seaforth. Nor was it that I was a brilliant doctor with a lovely bedside manner and oozing with charm. Charm and bedside manner were never part of my armoury against disease and illness. I was practical and matter-of-fact and I think a reasonably good diagnostician. But charming? I hardly think so. No, these good and honest people supported my practice and me because for two and a half years of the four and a half that I spent there I was the only doctor in town and for that reason and that reason alone I think I had solid support and was made to feel that I was needed and that I belonged. And for that I owe the people of Mitchell, Ontario my eternal gratitude.

I did of course try to get help. I was running a single-handed general practice that should have been a two-doctor practice. I was on call all the time. I strongly believed in the concept of group practice and through the advertisement columns of the medical journals and magazines was all the time on the lookout for another doctor to join me. And besides all of that I knew that I was not going to stay there forever and eventually would need someone to take over. But good doctors were very scarce at that particular time and the few that were around wanted to live in the ‘smart' places like London, Ontario or Stratford. Mitchell was seen as something of a backwater, which it was of course, but backwaters too can have their own charm. But try telling that to a young GP just out of training.

Eventually, having been there on my own for two and a half years a second doctor did arrive and set himself up in an office on the main street of Mitchell. Dr Bob Lorimer was a surly Scotsman with an attitude problem against Ireland and the Irish that I never quite understood. I thought everyone loved the Irish but Dr Lorimer was going to dissuade me from such arrogance. But, far more serious than that, Bob had an issue with the demon drink, which was eventually to bring about his early demise. He died from ruptured oesophageal varicoceles, a complication of alcohol-induced liver cirrhosis. He was only in his mid-forties. Because I drink myself and always have done perhaps I am not the best at spotting it when a colleague has a real drinking problem. I did not actually realise at the time how serious Bob's problem was. It is only now when I think back and picture him in my mind's eye and see him sitting on his sundeck at lunchtime with a very large Scotch whiskey in one hand and a can of beer in the other that I wonder just how blind can I have been.

Anyway, drinking problem or no drinking problem, Dr Lorimer and I set up a rota system together which meant that at long last I could have every second night and every second weekend off duty and quite suddenly my quality of life and that of my very young family improved immeasurably. This happy situation was to last for the next two years until we folded our tent and returned to Ireland for good.

Word was out that they had no doctor in Clane, county Kildare. Dr Michael Walsh, who I had known quite well and whose practice I had designs on, had died suddenly. He was only in his early seventies and was, I always believed, killed by overwork. He was of the old dispensary doctor school of practice. These doctors always worked alone and died young. But this event took us somewhat by surprise and of course we couldn't just uproot and come home at a minute's notice to take ‘advantage' of the vacancy left by
Dr
Walsh's death. It was however the catalyst that set events in motion and told us that the time had come for us to start our process of repatriation back to Ireland. We put our new house on the market and sold it within a few weeks with a closing date set for six months hence. I put an advertisement in the medical journals seeking a doctor to replace me. Now the die was truly cast and there was no going back. Were we making the right decision?

Our friends the Gaffneys, the Moores, the Fergusons and the Rubies all thought that we were mad and in fact were genuinely exasperated with us. My nurse, Anne Rowland, and secretary, Ina Moses, were, I am sorry to say, quite hurt also by our decision to go home. My colleague Bob Lorimer thought we were daft. And I can
see their point now perhaps better than then. There I was with a large
thriving and solid medical practice, which was earning me a very considerable income. I was county coroner and had only just turned thirty years of age. I had a lovely house, a wife and two healthy young children. I had my hospital practice and special skill in vasectomy. The world was at our feet. And yet we were going to deliberately and wilfully turn our backs on all of that and simply walk away from it and return to Ireland to nothing. Yes, put that way I can of course see that our friends had a good point.

But this is the point that really can't be explained to others because it is all about feelings, soul and emotions: when we thought about putting down roots and staying on in Canada for the rest of our lives we thought about our Irish colleagues who had made just that decision. We saw that look in their eyes and, in spite of their protesting otherwise, we felt their sadness and loss and we were absolutely determined not to join them, however good they thought their lives to be. But how can you explain that to others?

CHAPTER 8

On 3 January 1974, a cold, sleety, blustery day, we parked the car outside the garda station in Naas while going into the Manor Inn for a bite to eat. My sister pointed out a pink rose that was more or less still in bloom and asked if I was impressed with the way things still grow during the winter in Ireland. ‘I bet you would never see the likes of that in Canada,' she said proudly. But to be quite honest with you I was tired and jetlagged and confused and at that precise time could not have cared less what pink rose grew when or where. Selling our house in Canada and packing all our worldly goods into a car-sized crate and handing my practice over to Dr Bill Payne, saying goodbye to all our good friends in Mitchell and wondering all the while if we were doing the right thing; all of this draining activity had taken its emotional toll on both of us so discussions about extended growing seasons seemed hugely irrelevant.

Our first shock on returning to Ireland after five and a half years in exile was the discovery that there were so few houses available for sale. While in Canada I had invested in a number of houses over the years in Newbridge and elsewhere but we needed to set up in or near Clane, county Kildare where I hoped to establish my medical practice and there quite simply were no houses on the market. Before leaving Canada we had arranged with our old friends Billy and Bridie Travers that we would stay in their guesthouse, Curry Hills House, just outside Prosperous until we found a suitable house to buy. But we thought that would only be a matter of a few weeks at the most. In fact we stayed in Curry Hills for eight full weeks until we bought a semi-detached house in a housing estate outside Clane called Loughbollard. This was not really what we wanted but we had no choice and it would have to make do for the moment.

Our next big annoyance was that our car-sized crate that Luis Marello had made for us and containing all our worldly possessions was being held up in Montreal as a result of some industrial dispute or other. Nobody could tell us exactly where our crate was, much less throw any light on the question as to when, if ever, it might reach us. It contained our beds and furniture and sound equipment and records and two shotguns. But, much more importantly, it contained all my surgical and medical equipment including an examining table, weighing scales, sphygmomanometers and doctor's bag, all of which I now urgently needed in order to start a new general practice.

My first surgery was located in the basement of the parish priest's house on the main street in Clane which Fr Hughes very kindly let me have, rent-free, until something else turned up. By this time, almost a year after his death, Dr Walsh's old practice had all but dissipated so things were very slow indeed. And on top of that I had another problem. In Ireland, then as now, about a third of the population were given a medical card allowing them free access to a doctor of their choice. But not all doctors were allowed access to this so-called free choice of doctor scheme. You had to be in practice in an area for five years before you could be considered for inclusion in the scheme and, in the meantime, you were expected to eke out a living on whatever private practice you could find. Pickings were thin on the ground.

So here I was now twiddling my thumbs down in the basement of Fr Hughes' old house and a little later on twiddling my thumbs up in the old dispensary house where the late Dr Walsh once lived. A few months ago I was seeing sixty patients a day. I had two secretaries and a nurse. I had admitting rights to a good local hospital and I was county coroner and now this desolation and abandonment. But of course there was no one to blame, no one to
complain to. All of this I had knowingly, willingly and
voluntarily brought down upon myself. This was nonetheless a deeply depressing period
of my life with an empty waiting-room and all self-confidence dwind
ling. Why did nobody want my services? Things could only get better and they did.

In or around April of this, my first year home from Canada, news broke that the Irish Family Planning Association was about to offer a vasectomy service for Irish men. You would have to have lived through those years to know just how ground-breaking and radical this development was. Ireland then, and indeed for several years more, was in the iron grip of the Catholic Church which of course forbade all artificial means of contraception including the birth control pill. It is not that we were all Holy Joes or anything like that. It was just that people were almost brainwashed into believing that sexual activity, even within marriage, had always to leave open the possibility for procreation otherwise it was quite simply evil or at least sinful. This is what was being drummed into them practically
every Sunday from the altar and it took considerable courage to stand
up and to question this obsessive dogma that was being rammed down people's throats by a supposedly celibate clergy.

Even as late as the mid-1970s there was this unwritten presumption that if certain practices were forbidden by the Church then all of us, Catholic, Protestant and Atheist alike, were supposed to knuckle under and toe the line. There was a strict network in place to ensure that the status quo was upheld and those who would dare raise objections did so at their peril. Secretive male-dominated clubs and societies like the Knights of Columbanus, Opus Dei and Catholic League of Decency infiltrated the powerhouses of Irish politics, Irish medicine, Irish law and Irish education. Thus if you went to Dr X enquiring if he might prescribe the contraceptive pill you most likely were going to be refused on some quasi-medical pretence, though the real reason was that Dr X was a member of the Legion of Mary.

Or your marriage was in trouble or you were being abused by a drunken loutish husband and you discussed this with solicitor Y. The proper advice should be to move out of the house and sue the abusing husband. But solicitor Y might advise you to hang in there because he was a member of the Knights of Columbanus and did not approve of divorce or separation.

People who held and who still hold these views of course have every right to do so and I have always respected that right. But holding those views, even if the majority shares them, does not give anyone the right to scramble up on high moral ground and impose these rules on the rest of us in what we like to think of as a secular society.

Often in those days I would be asked by a woman with say, six children, if I thought it would be all right if she took the pill. She
wouldn't be asking me if I thought it would be all right from a medi
cal viewpoint. No, she wanted to know if I thought it would be morally all right for her to use contraceptives. Or, in other words, doctors were sometimes looked upon as kind of surrogate priests, a role that I for one thought quite absurd. Frequently when people were leaving the surgery they would mistakenly say, ‘Thank you very much, Father' before correcting themselves. But if there was all this hysteria about the birth control pill you can just imagine what a brouhaha there was going to be about sterilisation or vasectomy.

The first session of four vasectomies in Ireland was conducted at the Irish Family Planning Association's premises on Mountjoy Square in Dublin during the summer of 1974. The operator was a lady ophthalmic surgeon who had been flown into Ireland especially for the occasion. I was there too because as soon as I heard that the IFPA was setting up this service I had phoned them up to say that I had experience in about one hundred vasectomies from Canada and wanted to know if I could be of any service to them. In response to this they asked that I join with the ophthalmic surgeon and do the last operation on the list in order to demonstrate that I knew what I was talking about and that I could in fact do a vasectomy. All of that I thought was fair enough. After all I could have been anyone just chancing my arm as far as they were concerned and as always patient safety was number one. I carried out the last vasectomy on the list without any problems and the ophthalmic surgeon declared me a safe pair of hands and the rest is, as they say, history.