“I remember him,” O’Reilly said. “He died of stomach cancer.” Which, as Barry had advised Fingal, was not going to get Bertie Bishop.
“He did. He was a simple, gentle man. He was more of this world than many of his peers. During the war, he helped save the lives of thousands of Eastern European Jews as a Vatican diplomat in Greece. I held him in the highest regard.”
“Your current bloke is Paul VI. What’s his position?”
“Bit more complicated.” Hugh lined up his shot. He scored sixteen more points before it was O’Reilly’s turn again.
“Tell me more, please, Hugh.”
Father Hugh sighed. “Even as the commission deliberated, Pope Paul received a petition from one hundred and eighty-two theological scholars asking for a far-reaching reappraisal of the church’s position on contraception.” Hugh shook his head. “I’m not the only parish priest who hoped the higher authorities would recognise that very many otherwise devout parishioners were using contraception. Paul VI expanded the commission and put Cardinal Ottaviani in the chair.” He pointed to the table. “Take your shots and I’ll explain the outcome.”
O’Reilly did. His last attempt to pot a red failed. The cue ball came to rest two inches from the blue and there was no direct way past it to any of the reds. Hugh would have to bounce the ball off a side cushion and hope the rebound connected, but the angles were very difficult. In chess terms, he was in check. In snooker parlance he was “snookered.” O’Reilly could not quite suppress a smile. “I remember the day you got a hole in one and your golfing partner, Reverend Robinson, told you it must have been divine intervention.”
“And what has that to do with the price of corn, so?”
O’Reilly gestured to the table. “No using your hotline denied to us laity to get any help here.”
“I wouldn’t dream of it.” Father Hugh chuckled, studied the table, walked from this side to that, sizing up possible ways out of his dilemma. Then he nodded.
Had his opponent found a way out? O’Reilly wondered. Unlikely.
“I’ll let the hare sit for a minute, Fingal.” Hugh took a pull on his pint. “To get back to what I was telling you, the commission, by a large majority, supported permissive change. I was jubilant.”
O’Reilly’s hopes rose farther that Father Hugh O’Toole might be sympathetic to Fiona MacNamee’s difficulties.
“The pope deliberated for two years before he responded. He was much influenced by the seventy-seven-year-old Cardinal Ottaviani, whose motto was Semper Idem—always the same.”
“Oh-oh,” O’Reilly said.
“Yes. Part of the problem was that popes are meant to be infallible. If Paul ruled for the pill, he was making previous papal pronouncements wrong—and challenging the infallibility of his predecessors. Showing that eternal truths were not so eternal.” He pointed to the balls on the table. “The poor man was like me—snookered. Trapped.”
“And he maintained the old position?”
“His encyclical, De Humanis Vitae, ‘Of Human Life,’ condemned contraception as always unlawful.”
“I see.” O’Reilly’s shoulders sagged. “And there’s no way round it?”
Father Hugh studied the end of his cue. Chalked it. “The exact wording is that artificial contraception ‘is always unlawful—even when the reasons given for the latter practice may appear to be upright and serious.’”
“Damnation.”
Father Hugh smiled. “Even if you are a heathen, Fingal Flahertie O’Reilly, Ego te absolvo, I absolve you of that sin. How long have we been friends?”
“Since the day in ’47 when I went into the Duck and you were standing at the bar holding a pint and smoking a cigarette. Two things I never thought a priest would do. You nodded to me, took a pull on your pint, held up your fag, and said, ‘Doctor, these things give you a terrible thirst, so,’ and laughed.” O’Reilly grinned. “I had to like a man who can break rules. Laugh at himself.” He took a pull on his own pint.
“And I have to like a doctor who cares deeply for his patients.” Father Hugh lowered his voice. “Your interest wasn’t purely academic. Was it?”
O’Reilly shook his head. “No, it wasn’t. I have one who shouldn’t conceive again.”
Father Hugh nodded. Lines appeared on his high forehead. The skin round his eyes creased, and his lips drooped at the corners.
O’Reilly had seen that serious look on the priest’s face when he gave one of his flock the last rites.
Father Hugh glanced at the cribbage players, who were engrossed in their game. Fergus was nowhere to be seen, but nevertheless Father Hugh O’Toole dropped his voice. “I don’t want to know who. I don’t want to know the details or exactly why, but would she consider sterilisation?”
O’Reilly took a pace back. “What?”
“I mean it.”
O’Reilly had asked Fiona that very question. “She would. But surely your church prohibits that too?”
“Oh, it does,” said the priest, pulling out a cigarette and lighting up.
O’Reilly shook his head. “So, she’s snookered too.”
Father Hugh exhaled a cloud of blue smoke. “We also bid our adherents to confess their sins. Tubes tied. One confession. One penance. One absolution. One parishioner welcomed back into the fold.” He blew out more smoke. “Huh. Takes a pill daily. Multiple sins. Multiple confessions. She’ll wear out my confession box. Multiple penances. Absolution, but the minute she takes the next pill she’s no longer in a state of grace.” He smiled at O’Reilly. “Now, I’m not suggesting anything…”
“A wink’s as good as a nod to a blind horse,” O’Reilly said, thinking of his subterfuge with Fiona. “And some of my friends do call me the Wily O’Reilly. Thanks, Hugh. Thanks a million.”
“Here,” said Hugh O’Toole, handing O’Reilly the cigarette. “Hold that for a minute.” He picked up the cue, bent low over the table, angling the cue so its tip was beneath the bottom of the white ball. A smart rap and the back-spinning white sprang into the air over the blue, landed, and hit a red that lazily rolled across the baize and dropped into the top left pocket. He smiled at O’Reilly. “I’d have thought you, old friend, would know better than anyone that not all snookers, on the table or in life, are absolute.”
26
Has She No Fault Then?
“And I’ll see you in three months, Jean.” Doctor Graham Harley was showing a sad-looking young woman out of the side ward off ward 23, which he used as a consulting room. He turned and smiled at Barry and Sue. “Doctor and Mrs. Laverty.” That professional formality always in front of the laity. “Please come in.” He stood aside and closed the door behind them. “Please have a seat.”
Graham Harley hitched his backside up on the table’s edge as they settled into their chairs. “How are you, Sue?” he asked. “I’m sure the waiting for this appointment seemed interminable.”
“I’m,” she paused, “alright.” She glanced at Barry and sighed. “Yes, it does seem like forever since we saw you last. I understand it’s all going to take time, but…” She let the sentence hang.
Barry reached out for Sue’s hand, feeling the familiar ache in his chest for her worries.
“I’m afraid that’s true,” Graham said, “but we are moving ahead. May I see your graph?”
“Here,” she said, and handed it over.
He scanned it. “Period started on time?”
Sue nodded. “’Fraid so. And it means I’m still not pregnant.”
“I’m afraid you’re right,” Graham said.
Thank you, Graham, Barry thought, for coming straight to the point. A lot of consultants would chat for a while to put patients at their ease. Graham would know that a woman like Sue wanted to get on with things.
“Did you notice anything about the eighteenth or nineteenth?”
Sue looked down, colour suffusing her cheeks. Barry answered. “We abstained for a week before to increase my sperm count, then made love on both days. It’s wha
t as students we were taught to advise under the circumstances.” Sue’s blush deepened. “Sue said I was the doctor, and if that’s what I’d been taught, that’s what we’d do.” Barry wondered why Graham frowned before he asked, “And did you notice anything else, Sue?”
“I got a sharp pain in my tummy on the eighteenth. It didn’t last long.”
“The day your temperature went up,” Graham said. “Good.”
Sue frowned. “I should have thought pain wasn’t so hot.”
“And most of the time you’d be right, but on the day your temperature rose, you almost certainly experienced mittleschmerz. It’s German for ‘middle pain.’ Middle of your cycle that is, not your body.” Graham smiled.
Barry managed a smile too, and he was pleased to see one flicker across Sue’s face.
“We believe that when an egg is released from the ovary there’s a tiny bit of bleeding, the blood irritates the lining of your abdominal cavity, and you get the pain because of that.”
“Oh,” she said, “that’s interesting. So, you’re saying I did ovulate last month.”
“Your temperature went up and stayed up. You felt mittleschmerz. I am saying you did, and given your menstrual history, I’d say you almost certainly do every month. I’d consider that a step forward.”
Sue rocked her head and pursed her lips. “I’d say yes and no.”
Barry knew how much she was hoping a reason would be found. A reason that could get rid of the killing uncertainty. A reason that could be put right. He, knowing the statistical facts, still hoped nothing was wrong and that the passage of time would do the trick—and soon. Very soon.
Graham nodded. “I understand. There’s been quite a flurry of articles in the press about the use of human hormones extracted from the urine of post-menopausal women to stimulate ovulation. That approach has produced pregnancies in a lot of women who don’t ovulate until they’re treated. Much of the work was done by a Professor Lunenfeld in Israel. I know him. Lovely man. If you weren’t ovulating, there’d be a treatment for you right now once a couple more tests were done, because, Barry, I’ve got the results of your sperm counts.”
Barry sat forward, his hands tightening into fists. He felt all the anxiety of one who may have failed an examination.
Graham explained. “In 1929, Doctors Macomber and Saunders established the rule of the sixties: cutoffs of sixty million sperm per milliliter, sixty percent motility, and sixty percent normal forms. You exceed them all.”
“Thank you,” Barry said. “Thank you very much.” His fists uncurled. He had a pass mark. He took a deep breath and glanced at Sue.
She was saying, “Sixty percent of sixty million moving? That’s thirty-six million. You’d think one of the little devils could get through.”
“You’re right,” Graham said, “and the motility is particularly important. I want to talk to you both about that.” He stood, then parked the other side of his behind on the table. “I’d like to give you advice that might ease some of the strain I know you’re under. There’re a lot of old wives’ tales out there. Abstinence to increase the sperm count is one. Sure, the numbers may go up, but, and it’s a big but, the motility drops. And motility is more important than numbers. So, while you may have more sperm, they’re old, tired, and have probably grown whiskers.” His smile was wry.
The image of a sperm with whiskers hit Barry’s funny bone and he heard Sue’s small laugh.
“Nor does a ‘normal’ sperm count guarantee a man is fertile. There are cases of men with repeatedly normal counts whose first and second wives, both with no apparent disorders, only conceived when they remarried. Not only that, there are plenty of men with low counts—and three kids. At best the count is a rough guide, but it’s all we’ve got for assessing the man.”
Sue’s shoulders slumped. “So, if as best you can tell Barry’s fine, it must be my fault, then.”
Barry flinched. Sue. Sue. Don’t believe that.
Graham said, “Sue?”
“Yes, Graham.”
“I work with couples like you two day and daily. I have to tell all of them, it is nobody’s fault—”
“But, if Barry’s apparently normal, then it must be mine.”
Graham shook his head. “Please listen to me, Sue. Please. Fault implies guilt because of some voluntarily or even accidentally performed act leading to a misfortune. Please tell me what you’ve done wrong, intentionally or unintentionally?”
Sue looked puzzled and hesitated before answering, “Nothing as far as I know. I was on the pill, but I’m not a Catholic.” She looked at Barry. “I took it before we were married.”
That first magical night together in Marseille. The memory helped to ease some of the tension Barry could feel in his stomach.
“I don’t think that counts for much of a crime in 1969,” Graham said. “Queen Victoria’s been dead for sixty-eight years. And there is no research showing a connection between pill use and subsequent difficulty conceiving.” He repeated firmly, “And no matter what any tests to come might or might not show, Susan Laverty, it is not—your—fault.”
Barry saw Sue swallow. A single tear trickled, and she dashed it away. “Thank you, Graham. Thank you very much.”
“And it’s not just storing up sperm that’s suspect. There is no evidence that performing on cue on the ‘right day,’ based on a temperature graph, makes a damn bit of difference to a young couple who make love every three or four days or so.”
“Honestly?” Sue said. “Truly? That’s a relief. Barry said he felt like a prize bull and there certainly wasn’t much spontaneity to it. Can’t say I enjoyed it much.”
Barry nodded. “Making love’s fun. Feeling I have to perform on demand is bloody off-putting.”
Graham smiled. “Despite what I’ve just said, I’m going to ask you to put up with it this coming month so I can do a test. But after that we’ll be quitting both graph and command performances. Sue, you’ll need to take your temperature every morning this cycle until it goes up and stays up for a few days. After that, throw away your thermometer.”
“Really?” Sue said. “Great. If it wouldn’t upset Barry, I could kiss you, Graham. I hate it.”
“Some of my colleagues think I have some unorthodox ideas, but they’re all based on solid, well-performed research, not ‘my boss did it this way so I’ll do it this way too.’” He shook his head. “It’s time for us to move ahead. There are three more avenues to explore.”
Barry hunched forward and Sue did the same.
“To get you pregnant, Sue, Barry’s apparently normal sperm have to keep an assignation with one of your eggs. Once on your cervix, the sperm have to get through a barrier of mucus. For most of the cycle, the mucus is thick and sticky, but it becomes receptive at the time of ovulation. That’s why I need you to keep your temperature for one more month and for the last time make love on cue when you ovulate.”
“Ugh,” Sue said, and sighed, “but if we must, we must.”
“Then you scoot up here the next day and I’ll take a sample to see if the sperm were able to penetrate the mucus.”
“Alright.”
“It’s no worse than having a Pap test.”
“Good.”
“I must investigate your tubes too. I’d like to start today. It’s called tubal insufflation. I’ll pass some carbon dioxide into your uterus and listen with my stethoscope over your lower belly. If I hear gurgling, it means the CO2 has passed through your tubes.”
She frowned and nodded.
“I have everything ready behind the curtains; if you’ll nip in and undress below the waist I’ll be along in a minute.”
Sue rose and vanished behind the curtains.
Soon she called, “I’m ready,” and Graham picked up a stethoscope from his desk and left Barry on his own.
Barry couldn’t sit still. He stood and paced around the small room. At one point, he heard Sue gasp and make a little cry. “Sorry,” said Graham. It seemed an age until h
e said, “All done.”
Graham reappeared. He was smiling. “I’ll explain when Sue’s with us,” he said. “You know, Barry, that I have to steady the cervix with a tenaculum—”
Barry could picture the long forceps-like instrument that ended in two narrow, inwardly angled points that would bite into the outer wall of the cervix. “I understand.” That would account for Sue’s cry.
“I’m afraid it always hurts a little, and she may have a bit of spotting for a day or two. Sorry.”
“I understand.”
Sue, her copper hair untidy, reappeared.
“Come and have a seat,” Graham said.
Barry and Sue sat.
“Right,” said Graham. “I heard the bubbles. No question about it, so it’s fair to assume the tubes are open.”
Sue smiled. “I’m ovulating, have open tubes. Barry’s alright. What’s next?”
“It’s believed the gas may help clear minor blockages, and that often pregnancies occur shortly after the test—”
“Honestly?” Sue said. “That’s wonderful, isn’t it, Barry?”
Barry nodded. Could this be the answer? Some CO2 and a simple procedure? Sue was beaming and that, rather than his own worry, gladdened his heart.
“But,” Graham said, “if you want to keep things moving,” he consulted a calendar on his desk, “we’ll do the postcoital test about February the fourteenth.”
“Wonderful,” Sue said. “Saint Valentine’s Day and we have to make love on demand.” She bit her lip. “Just so I understand, what comes after the postcoital test, if it’s normal?”
“Something called laparoscopy. A German doctor, Hans Frangenheim, and a Parisian physician, Raoul Palmer, have been working on the procedure. And an English gynaecologist, Patrick Steptoe, has been popularising it in the English-speaking world. There’s a young doctor, Patrick Taylor, who’s been doing them in Dundonald hospital.”
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