An Irish Country Practice

by Patrick Taylor

  * * *

  “I would have appreciated it, Doctor O’Reilly, sir,” Kinky fixed him with a glare, “if someone had the courtesy to let me know that Doctor Stevenson would be at some course at the Royal Victoria and would not be in for lunch today.” Her eyes flashed and her chins quivered, and not from mirth either. “There does be one perfectly good grilled lamb chop wasted.” She stared at O’Reilly’s waistline. “And no, sir. I will not be serving you a second chop. I do have perfectly good knives. The meat taken off the bones can be treats for Arthur and Kenny. The bones would be too brittle after cooking, so.”

  Barry simply sat quietly as she served him his chop, mint sauce, and colcannon. O’Reilly thought briefly about making a jocular reference to it being less than three weeks since her gift had let her predict the winner of the Grand National. Couldn’t she just foresee Nonie’s absence? He took a quick look at Kinky, whose eyes were still flashing and chins still quivering, and decided it would be less than tactful. He bowed his head. “It was an unforgiveable lapse on my part, Mrs. Auchinleck. Please accept my humble apologies.” Although O’Reilly generally worked on the “don’t explain or apologise to anyone” principle, he would always make an exception for Mrs. Kinky Auchinleck. “It won’t happen again. I promise.”

  Kinky’s sniff would have been described by her as “sthrong enough to drag a piglet across a sty.”

  “Truly I am.” O’Reilly bit into his chop. “And it really is a waste. This lamb melts in the mouth.” He sought reinforcements. “Doesn’t it, Barry?”

  “Absolutely delicious,” he said, but O’Reilly heard no great enthusiasm in his young colleague’s voice. He’d be sore. At least the news about Anne Galvin’s X-ray should cheer the lad up. O’Reilly decided that Barry should have the pleasure of being the bearer of such tidings. He waited until Kinky had stumped off, but something about Barry, perhaps the way he was toying with his lunch, gave O’Reilly pause. “You all right, Barry?”

  “Ribs are sore, but it’s more than that.” Barry sighed. “Sue and I had a falling-out on Saturday, and please, Fingal, I don’t want it to go any farther. Not even to Kitty.”

  O’Reilly, who over the years had become unofficial father confessor to most of the village and townland, nodded. “Do you want to spit it out?”

  Barry inhaled. “I dropped a brick. Sue wants children. I’m not sure. I blurted it out at the circus on Saturday. Pretty vehemently. Just as the performance was starting—”

  “When young Sammy lost his lunch.” It wasn’t a question.

  “’Fraid so. Sue’s upset. She wants time to think about it. I’ll not be seeing her for a while.”

  “Mmmmm,” said O’Reilly, and waited.

  Barry looked at him. “And you know, Fingal, I’m not one to go crying on everyone’s shoulder. I keep my troubles to myself, but I’ve known Jack Mills since we were thirteen…”

  “What did he advise?”

  “To accept being a parent as a normal part of life. To realise that Sue, by necessity, would probably be doing much of the childrearing and that’s her choice, and that there would be all sorts of rewards watching and teaching the young ones to grow. To talk about it with Sue again, but to give her time. Don’t rush her.” He shrugged. “All wisdom says Jack’s right and that I’m being a thran buck eejit…”

  O’Reilly shook his head. “No, you are not being stubborn, Barry. This,” O’Reilly tapped his head, “doesn’t always control this,” then pointed to the left side of his chest. Only Kinky, Kitty, and Lars knew of O’Reilly’s wartime loss. It was his turn to look Barry in the eye and say, “What I’m going to tell you goes no farther.”

  “Naturally.”

  “You know I was married once before?”

  “Yes. You told me.”

  And I’m sure Kinky did too, O’Reilly thought. He said, “And you know Deirdre was killed.” And now I can talk about it without feeling pain.

  “I was sorry to hear it. When you told me. I still am.”

  O’Reilly took a very deep breath. “I didn’t tell you that we’d had a conversation about starting a family. Like you, I wasn’t sure. She had to talk me round.”

  Clearly Barry was paying great attention.

  “She was five months pregnant when she was killed.”

  “My God. I never knew. I’m so sorry, Fingal.”

  O’Reilly pursed his lips but was relieved that he’d been able to tell Barry. If hearing of O’Reilly’s loss could help the young man to work things out, so be it. “I’ve always thought that regret is a useless emotion. I grieved for my lost wife and family. But I do regret to this day I never had children.” Until I got the next best thing to a grown-up son, Barry Laverty, but I’d not tell you that.

  Barry sat back. He inhaled and blew out a long breath through pursed lips. “It was hard for you to tell me that, wasn’t it, Fingal?”

  O’Reilly inclined his head.

  “Thank you,” Barry said. “Thank you very much.” He sat, hands on tabletop, staring out the window, clearly deep in thought, lunch neglected before him.

  “By the wee man,” Kinky said, bustling into the dining room and looking at Barry’s unfinished lunch. “Sometimes I wonder why I bother cooking at all, at all. Was it not all right?”

  Barry shook his head. “Sorry, Kinky. I’m afraid I don’t seem to have an appetite. I’m a bit worried—”

  “About a patient,” O’Reilly said. “We both are.”

  “Well,” said Kinky, “in that case I will forgive you, so.”

  “I’m really sorry, Kinky. It looks delicious, but…”

  “You do be forgiven. This once.” She smiled. “There are going to be two very happy doggies today.” She cleared the table and left.

  O’Reilly smiled. “That’s the pair of us have had to apologise to Kinky today. It’s a thing, apologising, a man might just get used to.” He sat back and surveyed Barry, who was looking decidedly uncomfortable. “And when you do get your ideas straight about fatherhood and the like and when you do talk to Sue, you might want to apologise there too. I know she’ll forgive you.”

  Barry managed a weak smile. “I hope so. Thanks, Fingal. You’ve given me a lot to think about.”

  O’Reilly beamed. “And here’s something else to mull over. I told Kinky you’re worried about a patient. Anne Galvin, to be exact. I want you—she’s your patient after all—to pay her a visit this afternoon. If you’re up to it.”

  Barry winced but said, “I’ll not die of a cracked rib. More important, you’ve got the X-ray report, haven’t you?”

  O’Reilly nodded and smiled. “Emphysema, healed TB in the left lung, and no, I repeat, no cancer.”

  “Now that,” said Barry with a grin, “is something to cheer about. I’ll put her top of my list.”

  “Teddy wants a follow-up in six months, but we’ve both examined Anne. I’m sure it’ll be clear then too. If Guffer’s home, I want you to be circumspect in how you tell her. Anne’s rightly concerned she may have cancer, but she’s been keeping it from Guffer.”

  “I understand.” Barry frowned. “And I’ll play down the need for a follow-up. I’m delighted that there’s no evidence of malignancy,” he frowned again, “but how do we account for the blood she coughed up?”

  O’Reilly shook his head. “Dunno for certain,” he said, “and by her account it was very little. It can certainly happen if someone with bronchial or pulmonary inflammation simply coughs too much.” He smiled. “Sometimes ‘there are more things in heaven and earth, Horatio, than are dreamt of in your philosophy.’” He waited, but Barry seemed in no rush to identify the quotation. Too pleased for Anne? Too worried about Sue? He’d let the hare sit. “We may never know about Anne for sure, but I’m convinced the news is good.”

  “Fine by me. I’ll be on my way.”

  “And I’d like you to do something else too.”

  “Oh?”

  “Anne Galvin has fallen madly in love with Carlow Charger of Kilkenny. I wa
s surprised, but petting him seemed to calm her when I went out there the last time. She asked could he visit her again. I promised. His training’s coming on well. He shouldn’t be too much for you to handle.”

  “I’ll be happy to,” Barry said, wincing as he rose. “I’m going to head out there right now. I’ll bring him home on my way to the next call. I want to see how Gracie Miller’s getting on. Her husband’s no better.”

  “Did she ask for a visit?”

  Barry shook his head. “But neither did Maggie MacCorkle that first week I started work here. You just thought you should keep an eye on her.”

  A warm sensation of pride in his friend and protégé bloomed in O’Reilly’s chest. Carrying on with a nagging pain in his side and a nagging worry in his heart. Seeing a patient purely from concern. “Great,” he said. “And one other thing, Barry. Ronald Fitzpatrick’s on call tonight. I know you’re worried about Sue. When you’re finished this afternoon, how’d you like to pop in at the Duck with me for a couple and then have dinner with Kitty and me? Unless you’d rather be on your own and rest up?”

  “I’d like that, Fingal. I’d like that very much. I’ll see you in the Duck.”

  “Good,” said O’Reilly. “Go easy on your rib and, as she’s going to be making something for Kitty to warm up, for God’s sake tell Kinky on your way through the kitchen there’ll be an extra mouth for dinner. One bollicking from that Corkwoman’s plenty for me for one day.”

  21

  Him That Bringeth Good Tidings

  “Come on on in, Doctor.” Anne Galvin met Barry at the door. She held a lit cigarette between the index and middle fingers of her right hand. “And I see you’ve brought my wee friend, Kenny.” She stuck the fag in her mouth, then bent and patted the pup’s head. A light dusting of ash spilled down her calico pinafore.

  “Please come into the sitting room, sir.” Barry followed Kenny as he trotted in, sniffing the air.

  Anne took a deep breath and frowned. “I can clean all I want, but I can never get the smell of smoke out of the air.” She sat, putting a cobweb-laden feather duster on the floor, and sighed. “Can I hold him?”

  “Sure.”

  She took the pup from Barry, and put Kenny in her lap. “Please sit down, sir.”

  Barry sucked in a quick breath and frowned as he sat in the other armchair.

  “How are you feeling, Anne?”

  She cocked her head and gave him a long look. “Never mind me. How are you, sir?”

  “I’m all right, thanks. I cracked a rib yesterday. It’s nothing serious.”

  “That must sting, sir. I’m very sorry, so I am.”

  Barry moved to a more comfortable position and managed a smile. “I’ll live. Now, please don’t worry. I came here to see how you are.”

  Anne gave Kenny a long stroke, from the top of his head right down to his tail. “How am I? That medicine Doctor O’Reilly give me keeps me from coughing at night. No more blood now.”

  “I’m glad to hear it.” Fingal was probably right about the cause of the haemoptysis. Once the coughing was suppressed, the bleeding had stopped.

  “If you’ve got the results from my X-rays, Doctor Laverty, I think you’ll know how I am far better than me, so you will.” She took a deep draw on her smoke, let the blue vapours trickle out of her nostrils, and stopped stroking the pup. “Is it serious?”

  “You don’t have cancer.” Barry waited for his words to sink in. “No cancer.”

  Anne Galvin’s eyes widened. “You’re sure, Doctor? Certain sure? Honest til God?”

  He smiled. Barry saw no reason not to tell her the facts as they stood. “Honest to God. A senior radiology doctor looked at your pictures and phoned Doctor O’Reilly earlier today. The X-ray does show a couple of things, but no cancer. No cancer.”

  Kenny was whining quietly. Barry had read that dogs can sense human emotions and respond in kind, but the pup was unable to distinguish between sadness and Anne Galvin’s sudden tears of happiness and relief.

  They trickled down her cheeks and she grinned through them. “I go til church most Sundays like everybody else, but I’m not good living, not very religious, nor nothing like that … But…” She took a breath that must have reached the soles of her feet, then exhaled. “Thank God. Here’s me thinking all weekend I was going til be banjaxed. And what was Guffer going til do then?”

  Barry recognised that the question was not for him.

  Another deep breath. She stubbed out her cigarette in a half-full ashtray. “Thank God, and thank you and to Doctor O’Reilly, sir.” She pulled out a hanky and dabbed her eyes. She spoke to Kenny. “I don’t have cancer, Kenny. Praise be.” He wagged his tail until his back end wiggled.

  “I don’t want to worry you, Anne. Doctor O’Reilly and I both agree it’s just a precaution, but the specialist thinks you should have another X-ray in six months. It’s routine.”

  Anne smiled. “If you and himself say so, sir, that’s good enough for me, so it is.” She looked into Barry’s eyes.

  Her trust humbled Barry.

  “It’s like I told Doctor O’Reilly when I asked him til keep things til himself, Guffer’d no need to be worried for no good reason.” She smiled. “And our two sons, bless ’em, don’t need to hear a dicky-bird about any of this, so they don’t.”

  Barry heard the deep affection for her children. “It is good news, but I told you that the X-ray did show a couple of things. I need to explain them.”

  “Aye. You did say that. Go on, please.”

  “First of all, you’ve had TB. Mind I said ‘had.’”

  “TB? I never have.” She shook her head, clearly indignant. “Not never in my whole puff.”

  Barry was well aware of the stigma attached to the disease. He hesitated for a moment. He had told her about his rib, it would have been difficult not to, but he’d been taught that doctors should not divulge their own personal information to patients. But he was no longer in school. He could make his own decisions. “I have,” he said.

  Her eyes widened. “Have what?”

  “I’ve had TB.”

  “Were you in the Whiteabbey Sanatorium?” She leant forward, disturbing Kenny, who had fallen asleep.

  Barry shook his head. “No, I didn’t even know I’d been infected until I had a test called a Mantoux to see if I should be vaccinated against the disease. Lots of people, Anne, have been attacked by the bacillus, the germ that causes TB, but most of them threw off the disease.” A lot of them like her, and probably him, had scars in their lungs, reminders of the old battleground where the defenders had defeated the invading forces. “My test was positive. That meant I was immune to TB. Because vaccination was slow to come to Western Europe and I didn’t get one as a baby, the only way I could be immune was to have had the disease. I was lucky. Just like you.”

  “There’s a thing,” she said. “So you reckon I did have TB?”

  He nodded.

  “Aye. Well.” She stroked Kenny. “That’s just between you and me and the pup here, so it is.”

  “Of course.”

  “Thank you.” Anne frowned. “And you said there was a couple of things. What else?”

  “This is a bit tricky to explain, but your lungs are full of little air sacs called alveoli. You know the seaweed, bladder wrack?”

  “The one with all the bubbles?”

  “That’s the one. Your lungs are a bit like that, although the bubbles, the alveoli, are much smaller and their walls are very thin so the oxygen in the air you inhale can get across them and into your bloodstream. With emphysema, the walls between them break down so there’s much bigger bubbles, but far fewer surfaces for the oxygen to get through. The little narrow tubes called bronchioles in your lungs that carry the air to the alveoli get narrowed so it’s harder for the air to get in and out. People with it cough a lot and get short of breath.” He pointed at the ashtray. “An American doctor, George Walbott, in 1953, showed that smoking is a big cause of what chest doctors call
chronic obstructive pulmonary disease. There’s no cure and it’ll only get worse,” he looked her right in the eye, “as long as you go on smoking.”

  She scratched the top of Kenny’s head and he yawned. “Doctor,” she said, “I’ve spent the whole weekend thinking I was going til die. I don’t think I was scared for me, but what would Guffer do? And then thinking I’d never get to see my Seamus again, him being all the way in California. I couldn’t bear that.” She stopped stroking. “But how do I quit?”

  Barry smiled. Don’t tell the patient personal stuff? He shrugged. “I did. Four years ago.”

  “You, sir? How?”

  “Did you see the film The Man with the Golden Arm?”

  “With Frank Sinatra, the drug addict going ‘cold turkey’? Aye.”

  “It’s the only way. And it’s not easy, but it can be done.” Barry remembered the first few weeks of intermittently being hit by nearly overwhelming urges for a smoke, headaches, nausea, wanting sweeties, insomnia. “You know Helen Hewitt?” This was no breach of patient confidentiality.

  “Alan Hewitt’s wee girl? Her that’s going for a doctor up at Queens?”

  “She quit last year.” Barry leant forward. “Anne, if you try to give up the smokes, I’ll help you. I’ve no magic potions, but I’ll pop round from time to time to see how you’re getting on.” He grinned. “Give you a right old tousling if you’ve fallen from grace. Guffer doesn’t smoke, does he?”

  “No. Said he’d tried as a youngster but didn’t take to it.”

  “That’ll help too. And for a while, don’t go to places where everyone is having a fag.”

  She smiled. “That’ll be hard. Just about everybody smokes everywhere. On the bus…” She hesitated. “But only upstairs. The pictures is full of smoke, so are the lounge bars. Maybe I’ll just stay home with Guffer for a while. Just like the Presbyterian hymn. ‘Yield not to temptation for yielding is sin/each victory will help you some other to win’?”