A Dublin Student Doctor

by Patrick Taylor

  Bridgit said, “I’ll go now at once and get fresh bedclothes out of the airing cupboard. They should be nice and warm, so they should.”

  “And I’ll go back to my kitchen,” Cook said. “I think tomato soup to start with and then the fillets.”

  “Lovely,” Fingal said, “and—is the asparagus ready in the vegetable garden?”

  “I’ll see, sir,” she said, and left.

  “Let’s get started,” Fingal said.

  Lars strode to the door.

  Fingal followed. “I’m glad you’re here, brother.” The stairs were wide enough for them to climb shoulder to shoulder. “Sorry I couldn’t explain more on the phone. I didn’t know then that they’d stopped in Paris to consult a physician. Doctor Micks had given them letters of introduction,” Fingal said. “I talked to him first thing this morning. Asked him to come and see Father. Doctor Micks has had correspondence from his colleague who works in the Sorbonne, a Professor Bleau. He sent all the test results and X-rays from France to my old chief. Apparently Doctor Micks had also been instructed to keep it to himself, not to worry us about it. Now he knows we’ve been told he says he’ll be happy to discuss things with the family. He’ll be here at two thirty.”

  “And we’ll get the details then?” Lars said as they entered the spare bedroom. “I can wait.” He nodded at a single bed. “Let’s get this stripped. We’ll be able to carry it down without taking it apart if we bring the mattress and frame separately.”

  Fingal pulled the eiderdown off.

  “And,” said Lars, “if we put the bed head close to the window, Father’ll have a good view of the bird tables in the side garden. He’s always loved his birds.” There was a catch in Lars’s voice.

  * * *

  “Professor and Mrs. O’Reilly,” Doctor Micks continued from where he sat in Father’s swivel chair, “my colleague in Paris is correct.” As soon as he’d arrived he’d been ushered to the rearranged study where Father lay in bed propped up on pilows. He’d retired there immediately after lunch.

  To Fingal, who stood between Ma’s and Lars’s chairs, it seemed as if his father—tall, stiff-backed, always in control—had shrunk and no longer filled his pyjamas. His hair was thinner and now grey.

  “I don’t want to tire you, Professor, so I’ll come to the point. The disease has progressed. I have reviewed results of your physical examination, laboratory findings, and X-rays. There is evidence of anaemia, large numbers of white cells in the bloodstream, and spread to the lungs.”

  “This does not come as a shock,” Father said. “I’m weak as a kitten.”

  “The travelling tired you too, Connan,” Ma said, stood, and plumped the pillows. “The interminable French train journeys, the English Channel, more trains, and then the Irish Sea crossing to Dun Laoghaire last night? The sea was frightfully rough.”

  Father took a deep breath. His cheeks were ashen, eyes sunken and dull. A cold sore disfigured his lower lip. He coughed, and lay back on his pillows. Ma patted his hand before taking her seat.

  Fingal glanced at Lars, whose moustache drooped, and the wrinkles round his eyes were not laugh lines. Fingal watched his father manage a weak smile before saying, “We understood what the professor was trying to tell us, but even though my French did improve after months on the Riviera, my haematological—I believe that’s the correct term—vocabulary is limited.”

  Doctor Micks said, “I understand, so without being too technical, the bone marrow has increased its production of immature white cells and the X-rays my French colleague took show that your left lung has been—”

  Fingal knew the textbook said “invaded” and that the senior doctor wanted a gentler way of putting it. “Invaded” sounded brutal, like the Nazi occupation of the Rhineland two months ago.

  “—involved. That is one of the reasons why you are short of breath.”

  “There’s another?” Father asked.

  “There should be fourteen grams of haemoglobin, a pigment in red blood cells, per one hundred millilitres of blood. Its purpose is to carry oxygen to the tissues. I’m afraid, Professor, your value is nine. The white cells are suppressing the production of the red.”

  Fingal thought “invaded” was, in fact, an apt term. The forces of the white queen were crushing the defenceless reds, and there was no hope of a relieving column spearheaded by Father’s doctors. The medical profession was as pathetically underarmed against leukaemia as Haile Selassie’s Abyssinian tribesmen against Mussolini’s armies.

  “Under those circumstances I am not surprised that you are feeling exhausted,” Doctor Micks said.

  “Can anything be done?” Father asked.

  “About the low levels of haemoglobin? Not directly,” Doctor Micks said, “but we can improve them in the short term by giving you a blood transfusion.”

  “I don’t like the sound of that,” Ma said, and frowned. “I remember when I was young an aunt had a haemorrhage after childbirth. Her doctor gave her blood, but it clotted in her veins.” She leaned closer to Father. “I’d not want that happening to you, Connan.”

  “Mrs. O’Reilly,” Doctor Micks asked, “would that have been before 1901?”

  Ma frowned, then said, “Why yes. I do believe it was.”

  “A Doctor Landsteiner made a discovery in that year. Not all humans have the same types of blood. He called them blood groups, and if we give blood of one group to a patient of the same group the clotting doesn’t happen. It’s perfectly safe. Karl Landsteiner was given the Nobel Prize for that work.”

  Father whistled. “Nobel? And of course his research will have benefitted tens of thousands. Take note of that, Fingal.”

  Sick as he was, Father was still trying to guide his son’s career. “I will, Father,” he said.

  “You are sure it’s safe?” Ma still sounded doubtful.

  “Perfectly, but, and I must be honest,” Doctor Micks said, “it will be palliative only. It will not cure, but it will give your husband back his strength and energy for a while.”

  “How long,” Father asked “is ‘a while’?”

  “Between six and twelve weeks to start with.”

  Father looked at Ma then turned to Fingal. “When is Graduation Day?”

  “July first,” Fingal said. “If I pass Part Two.”

  “If?” Father said, and glared at Fingal. “If?” Father shook his head. “When, my boy. When you pass.”

  Like the Father of old, brooking no changes to his plans. “When,” Fingal agreed.

  “That’s—that’s, how long from now?” Father asked. He coughed.

  “Seven weeks,” Lars said.

  “So, Doctor Micks,” Father said, “how soon can we arrange this transfusion?”

  A year ago, Ma had told him, “Your father very much wants to come to your convocation. Don’t let him down.” Fingal shook his head. The Lord knew he’d been studying nonstop, attending classes religiously. And yet it was an unshakable part of student lore that every year after Finals’ results were announced, two questions were asked. “How the hell did he pass?” and more ominously, of a student recognised as being an ace by his fellows, “How the hell did he fail?” Luck always played a part. There were no guarantees.

  Doctor Micks said, “Fortunately, Professor O’Reilly, we know your group is B. Professor Bleau had it determined. I must find a donor with the same group, or group O, which is acceptable to people of any blood group, cross-match the bloods—”

  “Cross-match?” Ma asked.

  “To make absolutely certain there is no risk of blood clotting in the veins. We mix a sample of the patient’s blood with a sample of the donor’s blood on a slide, leave them for a few minutes. If the cells haven’t stuck together, it’s safe to proceed. Sometimes we need to look through a microscope to be certain.”

  Fingal said, “Compatability between donor and recipient is often found in close relatives, isn’t it, sir?”

  “It is.”

  “I’m game.” Fingal turned
to his brother. “Lars?”

  “Naturally.”

  Doctor Micks said, “We’ll have you both tested to determine your blood groups.” He turned to Father.

  “How soon?” Father asked.

  Doctor Micks said, “We’ll do the testing tomorrow at Sir Patrick’s. If either of your sons is a match, we’ll take two pints at once, use some anticoagulant, refrigerate the blood, and have it into you here tomorrow afternoon.”

  Father said, “I thought Irishmen went out for their pints.”

  Even Ma managed a small laugh.

  “I’ll arrange with the Master of the Rotunda for Fingal to be available to help me and keep an eye on it until the transfusion’s over.”

  “Thank you, sir,” Fingal said. “It will be easier for Father here.” The likes of Roisín Kilmartin would have been admitted to hospital to receive blood.

  “We’ll give you two bottles tomorrow and another two in a week,” Doctor Micks said.

  “Why wait?” Father asked.

  “You really only need the red cells, but they come with a lot of fluid, the plasma. I don’t want to overload your blood vessels by giving you the lot at once. Four pints will give you an extra five hundred and sixty or so grams of haemoglobin. Initially you’ll feel much better.”

  Father took in a deep breath and said, “I shall look forward to that.”

  “We’ll be at Sir Patrick’s tomorrow, sir,” Fingal said. He looked over to Lars, who caught Fingal’s gaze and slowly nodded in agreement.

  45

  Blood Will Have Blood

  “Nearly finished, Father,” Fingal said. An empty glass bottle, the fourth Father’d had since Doctor Micks’s consultation, hung suspended above the bed. A glass chamber that connected two lengths of red-rubber tubing was half-filled with blood, but the level was falling. No more was dripping into the chamber from the bottle. Fingal waited until the glass was empty then screwed shut a clamp on the lower length of narrow hose that led to a needle in a forearm vein. Letting air in there would not be a good idea. Air embolism was lethal. “You’ll not be sorry to see the end of that.”

  “I’ll not,” Father said, “but I feel better already.” He turned slightly. “Even if the blood didn’t perk me up, seeing that fellow would.” He smiled and pointed through the window.

  Fingal looked to the bird table, which Cook covered in crumbs and tiny pieces of fat every morning. Sparrows, starlings, and a robin redbreast pecked happily, but over in one corner was a stranger. The bird was twice as large as its common cousins. It had a small head and beak, but a long tail. The back, breast, and body were dark pink, and its wings had narrow horizontal alternating stripes of blue and black. “What is it?” he asked.

  “I’ve never seen one in town,” Father said. “They prefer woodlands with oak trees. That’s a jay. Garrulus glandarius. I wonder if it’ll nest in our garden?” He smiled at Fingal. “I’d like that,” Father said, “even if—” He grunted. “I’m sorry. I’m holding you up. Can you unhook me from this infernal device, please?”

  “Of course.” Fingal picked up a wad of cotton wool dampened with Dettol. He pressed it over Father’s forearm where the needle pierced the skin. “It’ll sting,” he said as he pulled the needle free and pressed down with the cotton wool.

  Father sucked in his breath, but smiled. “Well done,” he said, “and thanks, son.”

  A rasping screech came from outside the window.

  “The jay,” Father said. “They screech and they are marvellous mimics.” He laughed.

  Like you, Father, Fingal thought, mimicking a man without a care in the world. Fingal didn’t reply. He was too busy with sticking plaster, taping the swab to the skin, and then dismantling the transfusion set. “All done,” he said when he finished. “Good thing Lars and I are both B like you.”

  “Chips off the old block. And thank you both,” Father said. “Now that’s finished, might I get up?” He inclined his head to the door of the study.

  Fingal understood. After receiving so much fluid Father would want to shift some, and the toilet was across the hall. “Let me help you.”

  “I can manage.” Father swung his legs out of bed, put on a dressing gown and walked more steadily across the floor than he had last week. “Don’t go,” he said. “I’ll be back soon. There’s something I want to say.”

  Fingal sat. The study was much as it had been back in ’27, nine years ago. The same floor-to-ceiling shelves were packed with musty tomes. The rolltop desk was shut. Father’s degrees from Queens and Oxford hung on their wall.

  Through the window Fingal could see the stands of Lansdowne Road stadium against the cloudless sky. Charlie had played in three international games this season and had assured Fingal that the team captain, Jack Siggins, thought that they needed more strength in the second row and that Fingal might be the man for the job. Next season. At the moment it didn’t seem important.

  He heard the door open.

  Father crossed the room, sat in his swivel chair, and crossed his legs. “It is very pleasant to be able to sit in a chair. Bed is so constraining.”

  “I hope the blood’s helping,” Fingal said.

  “It is,” Father said. “Very much.” He smiled. “I never thought it would come in handy to have a doctor, well practically a doctor, in the family.” He leant forward. “I was quite convinced you should study nuclear physics.”

  Fingal sat upright. Father wasn’t going to make a last-ditch attempt to get Fingal to change careers?

  Father sat back, tilted his head, and regarded his son. “I have vivid recollections of the last tête-à-tête we had in here.”

  Please don’t go on about it, Father, Fingal thought.

  “I said, ‘I can’t make you study nuclear physics, yet, but I will not finance your medical studies.’”

  “But you have, Father, for the last two years, and I thank you for it.” And for letting the barriers between us down, he thought.

  “Your mother is a most persuasive woman.” He smiled. “Mind you, had I still been convinced that I was right she would never have changed my mind.”

  Fingal had difficulty believing what he was hearing. A suggestion that Father recognised he’d been wrong?

  “Fingal, I was in error. Utterly and completely and too stiff-necked to recognise it.”

  Fingal’s mouth opened.

  “Doctor Micks seems to believe you are one of the best students he’s had through his hands for years, even if a bit irresponsible at times.”

  Fingal lowered his head then looked up and smiled. “There’s a nurse at Sir Patrick Dun’s, Sister Mary Daly, who would have agreed with that.”

  “I’m sure it’s water under the bridge now, son, and I know from your mother how hard you’ve been working.”

  “Because I fai—”

  “I heard about that too, but you made it up in December.” Father pointed through the window at the stadium. “I can guess what it cost you.”

  “Rugby?” Fingal shrugged. Father didn’t know about Kitty. Losing her cost a hell of a lot more.

  “I’ve also seen you working,” Father smiled, “from a very close distance. You’re considerate and I believe technically skilled. Lars has told me about the patient you lost. How it hurt. How you came back. I admire that.”

  Fingal’s eyes widened.

  “At this point, Fingal Flahertie O’Reilly, I am convinced you have been right ever since you were thirteen. You were predestined for a career in medicine and you had learnt what I’d always preached. ‘To thine own self be true.’ Well done.”

  “Thank you, Father,” Fingal said softly. “As you taught us I’ve tried to follow Polonius’ advice to his son Laertes.”

  “To my chagrin for a while, I admit.” Father inclined his head in acceptance then said, “We may only have one point of disagreement now.”

  “Oh?”

  “I believe, and so does Doctor Micks, that you should follow the advice I was given about you by Doctors Millin
gton Synge and Saint John Gogarty.” Father leant forward and touched Fingal’s knee. “Specialise, my boy. I’m still your father and it is still my responsibility to guide you.”

  No, Father, no it’s not, Fingal thought, but I understand why you believe it is. “I might,” he said. “I’ve nearly finished my midwifery and of all the branches of medicine I’ve enjoyed it most.”

  “Excellent,” Father said. “I am glad we are in agreement. I am delighted.” His smile was radiant.

  It was a tiny deception, but that smile made it worthwhile. Not long after his chat with Paddy Keogh, Fingal had decided that once qualified he’d work as a locum tenens for dispensary doctors in the Liberties, but he was keeping open the thought of a specialist career later. “That’s all very well, but you know that Finals start in less than three weeks. I’ve to pass them first.”

  Father said, “You will. I promised your mother I’d be at your graduation and, by God, I will. I’d have been there four years sooner with none of this to worry about.” He pointed at the used transfusion equipment. “I was wrong. I’m sorry, Fingal. I was wrong. I apologise.” He rose. “Stand up.”

  Fingal obeyed.

  “I am proud of you now, boy, and when I see you up on the platform getting your degree my heart will be so full I’ll be the proudest man in the hall, in all the thirty-two counties of Ireland. Make me proud, son,” and with that he stepped forward and took Fingal in a gentle hug.

  46

  This Is the Beginning of the End

  “I,” muttered Bob Beresford, “I am utterly tee-bloody-totally knackered.” He lit a Gold Flake.

  “You, Beresford, are not alone,” Fingal said. “Nobody suggested Finals would be wee buns.” He shifted in his chair. Early evening sunbeams slipped into Bob’s flat and highlighted the Van Gogh print. To Fingal’s eye it hung skew-whiff.

  “Thank God we’ve only today and tomorrow left to go,” said Charlie Greer.