A Dublin Student Doctor

by Patrick Taylor

“Feels more like a lifetime,” Cromie said. “It’s been a desperate way to spend the start of June.”

  Fingal ambled over to the picture and adjusted the alignment of the frame. On Monday, ten days ago, they’d started at nine and for two days had answered three one-hour essay questions in morning and after-lunch sessions. Their knowledge of medicine, surgery, midwifery, and gynaecology had been tested at a theoretical level. Fingal’s fingers still had writer’s cramp. He hoped the examiners had been able to decipher his scrawl. He squinted at the whorls of painted stars. “That straight, Bob?”

  “Near enough,” Bob said. “I’m more worried about getting my answers straight tomorrow.”

  Every evening the lads congregated here for a postmortem of their day and a discussion of what the next session might hold for them.

  Since writing the papers, the students had each on a daily basis been assigned to one of Dublin’s teaching hospitals. There they had been doing their “clinicals” by examining a case relevant to a particular speciality, making a working diagnosis, and presenting their findings and proposed investigations and treatment options to two examiners. That completed, they were tested orally later in the day in the same discipline.

  “So,” Fingal said, plopping back down in his chair and pulling out his briar, “what do the inquisitors of the Trinity College School of Physic have in store for you lot tomorrow?”

  “Midwifery clinical in the morning at ten, oral in the afternoon. At the Rotunda,” Bob said.

  “Me too,” Fingal said. Getting from hospital to hospital could be a nightmare.

  “I’ll give you a lift. Pick you up at nine.”

  “Thanks, Bob.” Now that all their courses were over, Fingal was living at Lansdowne Road. It gave him a base and the sustenance of Cook’s meals. It also allowed him to keep an eye on Father, who still, apart from a nagging cough, seemed well. The transfusions, like the Spartans at Thermopylae, were fighting a stern rearguard action and holding fast. Ma was naturally delighted to have her grown-up boy back at home.

  “You two?” Fingal asked Cromie and Charlie.

  “Surgery,” Cromie said, “I hear Professor Fullerton can be tough.” He rolled his eyes. “I’ll be at Doctor Steevens’ Hospital tomorrow.”

  “Mental diseases,” said Charlie. “I’ve practiced ‘filling in a form to commit a lunatic to a public mental hospital’ ’til I can do it in my sleep. They always ask you to do one. It’s in the regulations. I had my surgery yesterday. I’d great luck. A case of gallstones in a man, but he presented exactly like that lass who thought Fitzpatrick was calling her a feckin female.”

  “Colleen Donovan,” Fingal said. “I remember her.” A heavy blonde who’d fixed Fitzpatrick with a steely glare and demanded, “W’at’s wrong wit’ bein’ a woman?”

  Bob said, “Talking of luck, did anyone hear what a jammy bugger Fitzpatrick is?”

  “What happened?” Charlie said.

  “Thyroid disease,” Bob said.

  “You mean he’s got it?” Cromie said. “Nothing trivial I hope?”

  Bob shook his head. “No, he’s the picture of health, but the fates aren’t so much smiling on the bastard as having fits of hysterical laughter. Being a betting man, I’d not like to have called the odds of it happening, but each of his cases so far, surgery, midder, and gynaecology, have all been patients with thyroid disease. A subject about which naturally he is a walking encyclopaedia.”

  “So,” Fingal said, “he must be doing well.” And despite his desire to prevent Fitzpatrick winning the prize, Fingal hadn’t been able to come up with a way to stop him.

  “‘Doing well?’ That’s like saying the American sprinter Jesse Owens just ambles along. That bloody prize is guaranteed to go to Fitzpatrick,” Bob said, curling his lip, “unless he really messes up on his medicine case.”

  “I wonder,” said Fingal quietly, “if we could help that happen? I’d not want him to fail, but the thought of him getting a prize really grates.”

  “Don’t look at me,” Cromie said, “I’ve no ideas, but if you do come up with anything, Fingal, let us know. I’d hate to see the medal go to that arrogant gobshite.”

  “Hear, hear,” Bob and Charlie said together.

  “If I do, I’ll let you know, but I’m much more interested in us. Where did you do your surgery exam, Charlie?”

  “I was at Baggot Street. And I, uh, that is—” Charlie fidgeted with his fingers, then looked Fingal in the eye. “I ran into Kitty.”

  Fingal had a vivid recollection of an essay question in the written exam. Discuss eclampsia. It was a condition in which apparently healthy pregnant patients could throw an unexpected violent fit. The Greek eklampein literally meant “a bolt from a clear sky.” Fingal, who tried to avoid remembering his disastrous meeting with Kitty in January, thought the description particularly apt at the moment. “How is she?” He was surprised when he was able to get the words out and sound unconcerned.

  “She wishes us all the very best of luck. Asked me to give you her regards,” Charlie said. “And seeing how she’d had to put up with us lot at Sir Patrick Dun’s, she’s coming with Virginia on Friday night when she holds Cromie’s hand as the dean reads out the results.”

  “I’ll take all the support I can get,” Cromie said. “No impersonal list on a notice board after Finals Part Two. The examiners meet at five P.M. on Friday. Regular bloody Star Chamber. They decide who passes.”

  Fingal noted Cromie had omitted uttering the dreaded F word as if saying “fail” might portend bad luck.

  “Then his high holiness, the dean, resplendent in his academic robes, will appear in the Trinity quad and solemnly read from an alphabetical list.” Cromie intoned sonorously, “‘Anderson—pass. Cumberland—’” He shook his head. “Strong men have been known to faint.”

  If Kitty had sent him a personal message and was coming on Friday, did it mean she’d turned down the marriage proposal? Wanted an excuse to see him? Fingal didn’t dare hope, and yet.

  As he often did when he needed time to think, he fired up his briar and hid behind a smoke screen.

  * * *

  Fingal sat on a hard wooden chair in the corridor outside the antenatal ward of the Rotunda. He inhaled hospital smells. The new antiseptic Dettol overpowered most of them. Groups of midwives passed him chatting, laughing, unconcerned. He envied them their routine. In a moment he’d be summoned to examine his obstetrical case.

  He ran over his mental checklist. Date of last period, regularity of cycle, estimated date of confinement, number of previous pregnancies and what had happened in each. That last was critical. The teachers always stressed how much of midder practice was trying to anticipate possible complications by understanding antecedent events. For five months here at the Rotunda it had been, “Lord help the student who doesn’t know the previous history.”

  In this exam Fingal would have twenty minutes to take the history, examine the patient, make a working diagnosis, order tests, and suggest treatment. One examiner was none other than Doctor Bethel Solomons, Dublin’s High Panjandrum of obstetrics and gynaecology.

  The door opened. “Mister O’Reilly.” Sister smiled at him. “Bed 6. Good luck with Mrs. EF.”

  “Thank you.” He walked down the ward and slipped through the curtains closed round the bed. A rosy-cheeked woman sat up. She looked about forty. Her grey hair was done up in a tight bun. Her belly was distended. “Would you be my student chap?” she said, smiling at him.

  “I am. Fingal O’Reilly. I’m here to examine you, Mrs.?”

  “Grand, so, and it’s Eithne Flynn.” Her accent was pure County Cork. “It’s for your exams?”

  “It is. I’m going to ask you a few questions, examine you if that’s all right.”

  “Fire away.”

  Fingal rapidly ran through the routine and discovered she was thirty-nine and her pregnancy was at twenty-eight weeks. She was due on September 3. She’d answered clearly and accurately. This was going to be a bre
eze.

  He smiled and asked, “And how many’s this one, Mrs. Flynn?” Five or six most certainly, he thought.

  “Twenty-one.” She smiled and cocked her head at him.

  Fingal’s jaw dropped. How in the name of the wee man was he going to get the details of twenty previous pregnancies in twenty minutes, never mind take the rest of her history, examine her, and work out a diagnosis? Twenty-one? Why him? He gritted his teeth. No help for it. Get on with it, man. “And when, when was the first?”

  She frowned. Her lips moved. She ticked off the fingers of one hand with the index finger of the other. “The first was Eugene and that was in 1914.”

  “Any complications?”

  “Oh yes.”

  God help me if the other nineteen were complicated too.

  “The complication is that I’m wrong. The first was Ambrose and he was born in 1915.” She shook her head. “Jasus, but my head’s full of hobby horse shite. It was not Ambrose at all. He was 1917. It was Noreen, and she was in ’15, or was it in ’13?” She paused, screwed up her face, then said, “If it helps, I remember it was the year the Home Rule for Ireland Bill was thrown out by the English House of Lords, the bollixes.” She looked up as if seeking inspiration.

  “That was 1913,” Fingal said. He imagined the cartoon character Felix the Cat banging his head on a brick wall in frustration. Fingal glanced at his watch. Three minutes gone already. At this rate it would take an hour just to work out all twenty. He took a deep breath. Just be calm, he told himself. “Take your time, Eithne,” he said. “Do your best. I’m in no rush. I’m sure it’s difficult for you. I’ve trouble remembering things myself sometimes, and twenty’s a brave wheen.” But please, please try. And hurry.

  She leaned across the bed. “Mister O’Reilly is it?”

  “It is.”

  “You are in a rush, I understand, but you’re not being cross with me. And you called me Eithne. That’s nice. You’re not like the nasty young man who came yesterday, so.”

  Fingal resigned himself. He’d let her chat for a few minutes then concentrate on her present problems. Perhaps the examiners would be understanding if he got that right. “Thank you.” He wiped a sweaty palm on the leg of his trousers.

  “A Mister Fitzpatrick.” She curled her lip. “Here I was, just like I am with you, sir, and he told me I was a thick, stupid, bog-trotting woman. Just because I still have my Cork accent, so even if I have lived in the Liberties for the last thirty years. He told me to get a bloody move on. He hadn’t all day to waste on an eejit. A very important and grumpy young man was Mister Fitzpatrick, bye.”

  Fingal could sympathise with Fitzpatrick, but there had been no need to be rude, not to an apparently simple woman who was doing her best. Fingal looked down at Eithne Flynn and then to the incomplete chart that he should have half-filled in by now. Hold on. Hadn’t Bob said Fitzpatrick’s midder case was one of thyroid disease? Some patients were used more than once in the exams and students didn’t think it cheating to discuss what they had seen as long as they didn’t identify the specific patient. Was this a bit of divine intervention? An unexpected clue to a working diagnosis?

  She patted his hand and said, “And what’s funny is that I was teasing him. I was teasing him. I’ve been a ‘case’ for exams before. I know you youngsters only have twenty minutes. He’d have got it all from me in jig time if he’d been nice like you. He still got the answers, but I made the amadán work for them and I thought if all you students were as bad as him, bye, I’d have a bit of fun with the next one too. And that’s yourself. I reckoned I’d put the heart sideways into you and I did, didn’t I?”

  “I was terrified,” Fingal said. “Really planking it.”

  “Well, don’t you worry your head. First off. I’ve had twenty pregnancies, twenty-one if you count this one, but,” and she smiled, “the Lord above was good to me. I’d one, then He took fourteen to Him before I was three months gone.”

  Fourteen miscarriages. And the Irish Free State had outlawed contraception in 1935? Fingal shook his head. Why the hell should any woman be treated like a brood mare?

  “It was a clever doctor at Sir Patrick Dun’s found out my thyroid was out of kilter and treated me. I’d five more after that. I can tell you about all my six babbies in a flash and about all else like the thyroid that ails me.”

  And she did. She was a walking textbook when it came to her condition. Fingal finished with five minutes to spare.

  “Mrs. Eithne Flynn,” Fingal said, as he made a final note, “if I wasn’t in love already and you weren’t wed, I’d fall for you, head over heels. Thank you.”

  “Go way out of that,” she said, and grinned. “Now you tell the professor what you know about me and you’ll be bound to pass, so.”

  47

  Vaulting Ambition, Which O’erleaps Itself

  Fingal waited on the footpath, collar turned to a persistent morning drizzle. A lorry with O’CONNOR AND SONS. FISHMONGERS TO THE QUALITY painted on its canvas sides turned off Grand Canal Street. Its solid rubber tyres rattled through the gateway of Sir Patrick Dun’s. Abstaining from red meat on Fridays had been demanded by Saint Paul in his Epistle to the Corinthians. Failing to do so had been decreed to be a mortal sin by Pope Nicholas I in the ninth century. The hospital’s kitchen would need fresh supplies today to prepare meals for Catholic patients.

  Fingal followed the vehicle into the courtyard, skirted the outpatients building, then stopped and looked up at the inscription beneath the clock over the entrance. Nosocomium Patr. Dun. Eq. MDCCCXIV. It didn’t seem nearly two years since Charlie had been asked to translate the Latin by Doctor Micks.

  Fingal climbed the front steps. As ever, like the ones to Dublin’s churches, the heavy double doors were wide open to admit those in need. He passed the brass war memorial table and skirted the Grand Staircase. Old friends now.

  He headed to the ward. He had one last patient to examine there, then he’d be grilled by two examiners. The medicine oral was this afternoon and that was it. The results would be anounced sometime after five o’clock. He’d know his fate and that of his friends within ten hours. Six hundred minutes. Fingal took a deep breath. The last lap of five years’ study, he hoped. Tonight he would be Doctor O’Reilly. He corrected himself. Could be. It wasn’t a sure thing. In two more weeks he could be attending convocation for the conferring of his degree, watched, he prayed, by Father and Ma.

  Five weeks ago the old man had said, “Fingal, I was in error. Utterly and completely,” and had hugged his son, an act Fingal could but barely remember from nursery days. Thank you, Father. Thank you. It had been at that moment that Fingal had realised his father had not been the only stiff-necked one. He smiled. Perhaps, like blood groups, stubbornness ran in families?

  As he turned onto Saint Patrick’s Ward, he tried to close his mind to everything other than the task ahead.

  “Morning, Sister Daly,” he said, craning past her to read a list of this morning’s candidates on her desk. He was first, Fitzpatrick was to be shortly after. Hilda would be examined here at ten.

  “Bed 51, Fingal,” Sister Daly said. “Mister OG. And good luck, bye.” She smiled and touched his arm lightly. A change from the stern woman who eighteen months ago had held his certificate of good standing in the palm of her hand.

  “Thanks, Sister.”

  The black-painted walls were as familiar as the flocked wallpaper in his bedroom on Lansdowne Road. In the picture over the fireplace, Saint Patrick preached on to Ossian. The floor creaked as it had always done when he passed bed 79, “The OTC Commemoration Bed,” where the condition of a young man with rheumatic valvular disease, a man called Kevin Doherty, had deteriorated badly and Fingal at the start of his clinical training had overstepped his authority and prescribed quinidine to stop Kevin’s atrial fibrillation. The drug had worked. That time. If there is a Heaven, Fingal thought, I hope you’re there, Kevin Doherty.

  Bed 51, named for Colonel Tench Gascoigne, had its m
emories too. Of a one-armed, ex-REME sergeant. “You mean they’re going to stick a feckin’ great needle into me back?” the feisty little man had said before Fingal had tapped his first pleural effusion. Paddy Keogh, now out of the Liberties tenements and living in a decent flat and working as foreman on a building site. Well done, Paddy.

  This place is full of ghosts, Fingal thought, of Doctor Micks, the deputy professor of materia medica and therapeutics saying, “I won’t put you on probation—this time, but one more lapse.” And Geoff Pilkington, the houseman, saying, “Don’t take it personally. We can’t save them all.” True, Geoff. We can’t.

  Fingal knew he had to stifle the memories and concentrate on the case. It and the oral this afternoon were the final hurdles. Bob had described them last night like fences thirteen and fourteen in the famous British Grand National horse race. A lot of tired horses fell at number fourteen every year.

  He opened the screens, glanced at the bedside table, and remembered one more ghost. A grey-eyed nurse named Caitlin O’Hallorhan who’d washed all the old men’s false teeth at once and had told him he’d a quare brass neck for singing “Kitty My Love Will You Marry Me?” as he’d helped her wash the dentures.

  “Good morning.” The man who lay on the bed was in his midthirties with thinning sandy hair and had a scar running from the corner of his left eye to his chin. The swelling at the base of his throat was obvious, and had been when Fingal had last seen the patient at medical outpatients. Not once, but twice.

  Mister? Mister OG. Fingal had to dig into his memory. Oliver Gourley. “Good morning, Mr. Gourley.” The man from Boyle, far from the sea, had a colloid goitre, an enlargement of the thyroid caused by iodine deficiency. It was often seen in people from the midlands of Ireland who ate pike or trout, but rarely bothered with sea fish, the prime source of iodine. “How are ye, sir—” The emphasis on the “ye” gave away his County Roscommon origin. “Nice to see ye again. Here for your exam?”

  “Supposed to be.” After Fingal had last examined the man, treatment had been started with thyroid extract and small doses of sodium iodide. “Did the treatment we gave you work?” Fingal asked.