An angular, middle-aged woman rose. She was wearing a stylishly cut navy blue raincoat, the lines of which were not exactly complimented by her massive rubber galoshes. Her pepper-and-salt hair was pulled back into a severe bun. Her hatchet face wore a scowl that Barry thought might have been stitched on by a plastic surgeon bearing a grudge. She did not use the customary “Me, Doctor,” but merely glared at the other occupants as if daring them to challenge her priority.
“Miss Moloney,” he said. “How nice to see you.” You hypocrite, Laverty, he thought. “Please come this way.”
Miss Moloney was the proprietress of the Ballybucklebo Boutique, the local ladies dress shop. No one had seen her in the village since she’d had an unfortunate run-in with Helen Hewitt, the redhead who had been Julie MacAteer’s bridesmaid. Back in August, Miss Moloney had aquired new stock to be sold to the ladies of the village for a wedding—Sonny and Maggie’s wedding. She’d not bargained for her shop assistant Helen, whom she had been persecuting mercilessly. The day before the big sale Helen had removed every single hat from its box, lined them up on the floor—and stamped every one of them flat.
Helen had quit, and the eczema that had been plaguing her for months had cleared up. Miss Moloney, rather than face the derision of the villagers, had made a diplomatic and prolonged visit to her sister, who lived in the village of Millisle on the Belfast Lough side of the Ards Peninsula. Now, Barry thought, she’s come back.
He followed her into the familiar, thinly carpeted room with its examining couch, folding screens, and instrument cabinet along one green-painted wall. At least the Snellen eye-testing chart above a wall-mounted sphygmomanometer no longer hung crookedly. He’d straightened it a couple of months ago. If O’Reilly had noticed, he hadn’t commented.
Above the old rolltop desk, Barry’s year-old 1963 diploma from Queen’s University, Belfast, signed by Sir Tyrone Guthrie, its script clean and fresh, kept company with O’Reilly’s 1936 degree from Trinity College, Dublin.
“Please have a seat.” He indicated one of the hard wooden chairs.
Miss Moloney sat on the edge of the chair, back erect, hands primly clasped in her lap. Barry moved past her to take the swivel chair on casters. “Welcome back,” he said. “How was Millisle?”
She sniffed. “Cold, damp, windy, and desolate.”
“Well, it is winter, you know.”
“How astute of you to notice, Doctor.”
He cleared his throat. It would seem that the milk of human kindness was still curdled in Miss Moloney. The sooner he got this conversation on a professional level, the better. “So what seems to be the trouble?”
“I’m very tired.”
“I see. And anything else?”
She shook her head.
Not a lot to go on. Tiredness could simply be a reflection of not enough sleep, or overwork, unlikely in her case, or it could be a clue to almost any disorder in the entire medical textbook. Barry sat back. He steepled his fingers, just as he’d seen O’Reilly do a thousand times, and looked at her face.
She was extraordinarily pale. “Hmm,” he said to himself, as he leant forward and took her hand in his. It felt cold and clammy. He held it palm down and looked at her neatly trimmed fingernails. They were a most peculiar shape. Each was concave, like the bowl of a shallow teaspoon; the technical term for this was koilonychia, and it was usually associated with iron-deficiency anaemia. Interesting.
“Just look into the distance, please.” He used one thumb beneath each of her eyes to pull the lower lids down. The membrane that lined them, the conjunctiva, was transparent and allowed for inspection of the fine blood vessels beneath. There should be a healthy red colour, but in Miss Moloney’s case Barry saw a very pallid area. He now was sure she was anaemic. Simple laboratory tests would confirm it.
He sat back. “I’m pretty sure, Miss Moloney, that you are suffering from thin blood.”
“Oh, dear. Is that bad?” Her narrow eyebrows arched upward. Her lower lip trembled.
The truth was that indeed it could be, if, for example, the anaemia was a reflection of blood loss. Some of its causes could be very serious, although in women the most common cause was heavy periods. “How old are you, Miss Moloney?”
She bridled. He knew that in some circles it was considered impolite for a gentleman to ask a lady her age, but heavens above, he was her doctor. “Miss Moloney?”
“Fifty-one.”
“I see. Thank you.” He pursed his lips. Time enough at the next visit to ask if she had experienced “the change of life.” He swivelled to the desk, made a note on her record, filled in a laboratory requisition form, and then spun back to face her. “Now, Miss Moloney. I don’t think you need worry about this,” he said, because he, her doctor, was quite able to be concerned for her. “The first thing we have to do is make sure that you are anaemic.”
“But you said you were sure.” She frowned and tightened her thin lips.
“Pretty sure, but I need to be absolutely certain, so I’d like you to go the lab at Bangor Hospital and have some blood tests.” He handed her the pink form.
“All right.”
“And I’ll see you next week to give you the results.” And if you are anaemic, I’ll decide how to investigate you for any possible underlying cause, he thought, but he kept a gentle smile on his face. He stood to indicate the consultation was over.
Miss Moloney rose and followed him to the door.
“I’ll see you next week,” he said, as she let herself out through the front door. With any luck, he thought, as he walked back to the waiting room, she’ll have a simple iron-deficiency anaemia due to poor dietary intake. He really didn’t want to have any very ill patients, particularly not at this season.
Barry opened the waiting room door. “Next, please.”
“Me, sir.” He knew Cissie Sloan, the very large woman who spoke and rose to her feet. She wore a headscarf over pink, plastic hair curlers, and a gabardine raincoat that Barry thought had probably been built by Omar the tentmaker.
“Good morning, Cissie.” Barry stood aside to let her precede him along the hall to the surgery. “Go on in,” he said. “Have a pew.”
Cissie Sloan sat heavily on one of two plain wooden chairs facing the desk. Barry took the swivel chair on casters in front of the desk. “How are you, Cissie?” he asked, knowing that the question was an invitation for the opening of her verbal floodgates.
“You remember,” she said, in her hoarse voice, “when I come ’til youse first and youse found out I was short of that wee thyroxine thingy in my blood, so I was?”
Barry nodded. He did indeed remember. O’Reilly had missed the diagnosis of hypothyroidism and had been giving her vitamin B12 as a tonic. The hoarseness in her speech was a result of her hypothyroidism.
“And Doctor O’Reilly prescribed me that thyroid extract.” She peered round. “Where is the big fellah the day anyway?”
“He’s got a bit of a cough.”
“Has he, by God? What’s he taking for it?”
“Now, Cissie,” Barry said gently, “I can’t discuss Doctor O’Reilly with you. You know that.”
“Aye, right enough, but—”
“Now, what can I do for you today, Cissie?”
“It’s my throat, so it is.” She leant forward toward him. “Now I know my voice is a bit crakey ever since I got the thyroid thing, but for the last two—no, I’m wrong—for the last three days, or mebbe it’s four . . . no, no, three . . . I remember now. It was the day the milkman, Archie Auchinleck . . . him with the son a soldier in Cyprus . . . Archie dropped my milk on the doorstep, and the bottle broke, and the milk froze, and my cousin Aggie slipped on it and fell on her arse and . . .”
Barry hoped she hadn’t noticed him rolling his eyes to the heavens, but something had brought her back on course.
“Anyways,” Cissie continued, “it’s been raw and sore something chronic.” She leant forward and whispered, “And it hurts to talk.”
Barry had to s
tifle a smile. There could be no greater imposition in Cissie’s life. “Have you been coughing?” he asked.
“Only a wee bit.”
“Have you taken anything for it?” Countryfolk, he knew, often used honey for a sore throat, and he had once seen a child whose mother applied a hot potato in a sock to the front of the neck.
“I did try tying some Saint Brigid’s cotton around my neck.” She opened the collar of her coat, and Barry saw a rough piece of cotton cloth knotted around her throat.
“I’m sorry, Cissie, but I’m not familiar with the treatment.”
She tutted. “You leave the cloth outside the door of the house on the night before February first, that’s Saint Brigid’s Day.” She crossed herself. “The saint herself passes by that night and blesses the cloth.” She rubbed the makeshift scarf. “I’ve had this bit since last year, so I have, but it’s not doing me no good, so it’s not.”
Barry rose and pulled a small penlight from the inside pocket of his jacket. “I’d better have a look.” He went to the instrument trolley and returned with a wooden tongue depressor. “Open wide and put out your tongue.”
She obeyed.
He used the wooden spatula to shove her tongue toward the floor of her mouth and shone the beam of the little torch inside her mouth. “Say, ‘Aaaaah.’ ”
“Aaaaah.”
He could see the back of her pharynx and noted en passant that she had no tonsils or adenoids. The beam lit up the normally pink membrane in her throat. It was an angry red, flecked with yellowish spots, and looked for all the world like a ripe strawberry with yellow instead of white seeds. Bacterial, probably streptococcal, pharyngitis. He removed the tongue depressor and felt the sides of her neck. Good. There were no enlarged lymph glands. “Your gullet’s a bit inflamed, Cissie.”
“Bad is it?”
He shook his head. “A bit of penicillin and a gargle, and you’ll be right as rain in no time.”
“Am I going to need an injection?” She eyed the instrument trolley. “I’ve my stays on.”
“Not today.” Barry could picture the day he’d first met Cissie. O’Reilly had given her an injection through her dress and hit the whalebone of her corset, and the syringe ricocheted across the room like a well-thrown dart.
He returned to the chair, swiveled round to the desk, and wrote a prescription for penicillin V to be taken orally four times daily for five days. “Here.” He handed her the scrip. “And can you make up a gargle of table salt and warm water?”
“Och, aye.”
“Good. Use it three times a day, and go easy on the talking. You mustn’t strain your voice.”
“I will, sir. And will I keep wearing the Saint Brigid’s cotton?”
Five months ago Barry would have told her it was a superstitious waste of time. “Absolutely,” he said solemnly, “and for a couple of days after you’re all better.” He knew by the great grin that creased her face he had said exactly the right thing.
He rose and gently took her arm to help her to her feet. There were other patients waiting. Barry knew that once Cissie Sloan got comfortable in a chair, she could be a hard woman to budge, even if the chair was one of Doctor O’Reilly’s specials with an inch sawed off the front legs so that patients kept sliding down the seat. He steered her to the door to the hall. “If it’s not all better in six days, next Monday, come back in and see me.”
“It’ll have to be better. If you could see the amount of work we’ve to do to get the chapel hall ready for the kiddies’ Nativity play . . .”
“I’m sure you’ll be fine, Cissie.” Barry increased the pressure on her arm. “It’ll take more than a tiny wee germ to knock the stuffing out of a powerful woman like yourself.”
She blushed at what Barry supposed she saw as a compliment and playfully punched his shoulder. He knew he should take such familiarity as an indication of total acceptance by Cissie Sloan, but he rubbed his shoulder and wondered how Cassius Clay, the new world heavyweight champion, would fare after three rounds with the woman. Cissie would probably have destroyed him in the second round.
“I believe you, and thanks a lot, Doctor Laverty,” she said. “It’s early, I know, but if I don’t see you before, you have a very merry Christmas.”
“Thank you, Cissie, and the same to you.”
He was about to leave her to make her own way out the front door when she asked, “And will you be coming to the Nativity play? It’s Christmas week. The Monday.”
“I will.” He opened the surgery door.
Cissie lowered her voice. “And will you be bringing the pretty wee lady that’s over at her studies in England?”
Barry laughed. There were no secrets here in Ballybucklebo. “I will, Cissie. She’s coming home.” And it couldn’t be soon enough for him. He just hoped O’Reilly would be back on his feet so he, Barry, could have as much time off as possible to spend with Patricia Spence, the pretty wee lady who was studying at Cambridge.
He bade good-bye to Cissie and headed back to the waiting room. At least, he thought, the time passed more quickly when he was busy, and trying to solve the patients’ problems left little time for worrying about Patricia. She’d told him she loved him and that should be enough, shouldn’t it?
He opened the door to the waiting room. “Who’s next?”
He was not prepared when Santa Claus, resplendent in his red fur-trimmed suit, black boots, and vast white beard lumbered to his feet and announced, “Me, Doctor sir.”
Barry chuckled, glanced around to make sure his next patients wouldn’t be a bevy of elves, and escorted Saint Nick along to the surgery. He wondered how O’Reilly would deal with this; indeed he wondered, as he shut the door behind him, how O’Reilly was getting on this morning.
A Memory of Yesterday’s Pleasures
O’Reilly reckoned he could be doing a damn sight better. He fidgeted in his armchair in the upstairs sitting room and stared at his unlit pipe in the ashtray. Christ, he wanted a smoke, but the flaming cough refused to go away, and it had kept him awake for half the bloody night.
He twitched his plaid dressing gown shut, tightened the waist tie, and scowled at his pyjamaed legs and slippered feet sticking out from under a blanket where they were propped up on a footstool. He cleared his throat, spat into a big linen handkerchief, and looked at the results.
The sputum was clear and sticky. There wasn’t a large amount. Classically sputum was expected to be like that with early bronchitis, which was almost certainly what ailed him now. Last night he’d had a sore tickly throat and Barry had been right about tracheitis, but by the early hours of this morning O’Reilly’s entire chest had become tight and wheezy.
Acute bronchitis, while hardly life-threatening, was a bit more serious than tracheitis, and it might take just that bit longer for him to recover. He frowned at the gob in his handkerchief. If there were lots of pus cells, the stuff would have a greenish-yellow colour. It didn’t, so he’d not have to worry about acute bacterial bronchitis or pneumonia. In the latter case, there would be a rusty tinge as well. He peered more closely. No blood. Excellent.
Blood in sputum meant one thing and one thing only until proved otherwise. Last night, the expression on young Laverty’s face had told O’Reilly what Barry was thinking, as clearly as if he had spoken his thoughts aloud. He probably assumed that his senior colleague hadn’t read about the connection between smoking and lung cancer. But he had, by God, and as things stood in the research community, cigarettes were definitely implicated. Pipe smoking didn’t seem to be so bad. O’Reilly looked at the gob once more. Definitely no blood. It was a relief. Even doctors were not impervious to worrying about their own health.
He heard the front door slamming below. Young Barry was at his work, showing one patient out and going to get the next. Good for Barry. O’Reilly certainly didn’t feel up to facing the multitudes this morning. He heard the telephone in the hall ringing. No doubt somebody who wanted a home visit, and that would keep Barry occupied fo
r part of the afternoon. O’Reilly half listened to Kinky’s voice coming from below as she answered the phone. It seemed odd that after all the years when he’d had nobody to share the work, he could now happily delegate some to his new assistant.
He yawned, coughed again, stuffed his handkerchief into the pocket of his dressing gown, and with his eyes half closed, lay back against the cushion at the back of the chair. He was sleepy and, he realized, bored.
He heard a quiet “Ahem,” opened his eyes, and turned his head. Kinky came in through the doorway, head cocked to one side, a steaming mug held in one hand.
“Yes, Kinky?”
“Is yourself feeling a bit better, sir?”
“A little, thanks.”
“Huh.” Mrs. Kincaid shrugged. O’Reilly thought she looked as believing as a mother who, having just caught a child out in some minor peccadillo, asks, “What are you doing?” and gets the sheepish reply, “Nothing.”
“Well, my granny used to say, ‘Feed a cold and starve a fever,’ so I’ve made you some beef tea.” She set the mug on the coffee table, stood back with arms folded, and glowered down at O’Reilly. “Here.”
He knew he had no choice but to drink from the mug. He lifted it, and the tangy, meaty smell of the bouillon filled his nostrils. He sipped. “By God, that’s powerful stuff, Kinky.” He was relieved to see her expression soften. “Made it with Oxo, did you? Bovril maybe?” He knew at once that that had been a stupid thing to say. Kinky would never use a proprietary brand of anything if she could make her own.
“I did not.” She frowned. “Indeed not, sir. It’s made from the grade A beef, and—”
“Sorry, Kinky. I should have known, but I’m not altogether myself today.” He took a deeper swallow.
“I’ll forgive you,” she said. “Thousands wouldn’t”—she looked at his mug—“but get that down you, and get the good of it into you.”
He thought she was going to add “like a good little boy.”
“And I’ve a great big bowl of chicken broth for your lunch, so.”
O’Reilly smiled weakly. “And I thought it was the Jews who believed in chicken soup?”
An Irish Country Christmas Page 5