An Irish Country Welcome

by Patrick Taylor

  “Barry.” Sue’s voice was tremulous.

  He spun in his seat.

  Sue stood in the doorway. Tears streamed down her cheeks. “Barry. I’m bleeding.”

  Barry was on his feet at once, moved to her, held her. Bloody hell. Could she be losing their baby? Not after all their waiting and hoping, and the final elation once they knew Sue had conceived. Damn it, no. Take a grip, Laverty. It could be other things too, not all as serious. Calm down. You’re a doctor, so behave like one and comfort your wife.

  “Come and sit down.” He led her to the couch. He knew bleeding in pregnancy could be serious. “Try not to be scared, darling.” It was twelve-and-a-half weeks since Sue’s last period. Think, man.

  “What’s happening to me, Barry? Am I going to lose it?”

  He sat beside her and took her hand in both of his. “It may be all right. About one in four women have a little bleeding early in pregnancy. It may not be anything serious.” Which was not entirely true. Half of those who did, lost the pregnancy. But now was not the time to make Sue any more unhappy and scared than she already was.

  Sue lifted her head. “Honestly?”

  “Honestly.”

  Another sob. “Barry, we’ve tried so hard for this baby. I couldn’t bear to lose it. Not now. We’ve only known for a couple of weeks and we were so happy.”

  I know, he thought. And I’ve grown from initial uncertainty about becoming a father to eager anticipation of having a family. Sue wasn’t the only one worried sick. But for her sake he knew he mustn’t show it. As a doctor he’d to decide what was the best thing to do medically and now he hadn’t the slightest doubt what that was. He sat back, took Sue’s face between his hands, and looked into her shining eyes. “Pet, I can’t promise you it’s going to be all right, but I’m sure the odds are in your favour. What colour was the blood?”

  “Bright red.”

  So it was fresh.

  “How much was there?”

  “Lots. A big stain about the size of a soup plate on my knickers. I’ve changed them and put a pad on.”

  It was a well-known adage that a little blood goes a long way. Sue hadn’t lost much.

  “That’s not a lot. Honestly. Any cramps?”

  She shook her head.

  “Good. Your womb isn’t contracting.”

  “That is good, isn’t it?”

  He heard the pleading in her voice. “Yes. It is.”

  Her indrawing of breath was jerky. “So, what should we do? Call Doctor Harley?”

  Barry shook his head. “I want you seen at once, and the Ulster Hospital where you had your laparoscopy is much closer. I’m taking you up there right now. Come on. We’ll grab a towel for you to sit on in the car and get going.” He helped her to her feet and glanced at the television.

  History was being made but suddenly he couldn’t care less about a man walking on the moon. Here, on Earth, an ordinary man and woman were trying to do a most natural thing, have a baby, and had run into what could be a serious snag.

  The TV commentator was going on about when the command module would lift off the moon, but Barry was in a rush. He didn’t even take time to switch off the TV.

  * * *

  Barry drove along the road leading uphill to the front of the Ulster Hospital in Dundonald. The sky was cloudless and the moon, which had been a waxing crescent, had set. The hospital ward blocks were dim, patients should be sleeping, but the emergency entrance and the sign saying EMERGENCY were well lit.

  Little had been said on the fifteen-minute drive over the Ballybucklebo Hills. He’d asked Sue if she thought she was still bleeding and had been told she didn’t think so.

  He parked in the emergency spot outside the front doors. “Wait here. I’ll only be a minute. I’m going to get you a wheelchair.” He trotted through the double front doors and went to the reception desk, where a young, blond, bespectacled woman asked, “Can I help you?”

  “I’m Doctor Laverty. My wife may be threatening to abort.” He used the proper medical term but knew he would never use it when speaking to Sue. She would feel guilty enough without thinking she was being accused of causing the loss. “She’s in the car outside. I need a wheelchair.”

  “I’ll get an orderly, sir. He’ll bring your wife into casualty while you park your car in the visitors’ lot.” She picked up a phone, spoke into it, then replaced the receiver. “He’s on his way. Go you back to your wife, sir. She’ll be worried all alone, but a quick question first. Has she ever been a patient here before?”

  Barry gave her the details of Sue’s admission for the laparoscopy earlier in the year.

  “I’ll get her chart from medical records.”

  “Thank you, miss. Thank you very much.” Barry hurried back to the car. “They’re sending an orderly, Sue. I’ve to park the car once he’s taken you inside, but I won’t be long.”

  “Please don’t be. I’m scared and I need you, Barry. I really do.”

  And Barry Laverty, trying to hide his desperate concern for his wife and unborn child, could find no words of comfort.

  * * *

  “Hello again, Doctor Laverty.” The receptionist smiled. “First door on your left. I spoke to the casualty houseman and she said, you being a doctor and all, she’d just make sure your wife’s not in shock and then send for the gynae senior registrar to come.”

  “Thank you.” The last time he’d been in a casualty department was when he’d done a three-month stint as a houseman at the Royal Victoria in Belfast. Here, as it had been there, all was bustle and noise. Moans coming from a cubicle told of someone in pain. Two nurses hurried by pushing a stretcher-trolley bearing an older man wearing oxygen spectacles, an intravenous line in his left arm. In a small room, four patients sat waiting their turns to be seen. A student nurse stood beside one and held a kidney dish so he could throw up. The smell of acrid vomit was all-pervasive. This was a far cry from the relative tranquility of general practice. There was no sign of Sue in the waiting area. He hoped to God she had not been kept waiting long.

  The sister there, sitting behind a low desk, asked, “May I help you, sir?”

  Her voice startled him. “I’m, uh, that is, you have my wife, Mrs. Laverty.”

  “We do, Doctor Laverty. She’s in there.” Sister indicated curtains closed around a cubicle. “Doctor Lamki is on his way to see her.”

  Barry thanked her, headed to the cubicle, and pulled back the curtains. Sue, her copper plait coming undone, dressed in a blue hospital gown, lay on a stretcher-trolley, propped up on pillows. “I’m very glad to see you.” She managed a small smile.

  He stepped inside the cocoon of the cubicle and closed the curtains behind him. Seeing her smile seemed to make the bustle outside fade. “The young houseman took a quick look. She doesn’t think I’m bleeding much. No fever. Pulse and blood pressure all normal. Perhaps it’s not serious after all?”

  He knew she was seeking reassurance.

  “Probably not, pet.” He dropped a kiss on her head, sat on a chair beside the head of her trolley, and took her warm hand in his. “We’ll find out for sure soon enough. Doctor Harith Lamki’s on his way.” Barry, happy to keep the conversation away from Sue’s condition, smiled. “I’ve met him several times. He’s a good head and his reputation as a clinician is outstanding. He came here to train as an obstetrician and gynaecologist from what had been Zanzibar.”

  Sue nodded. “It united with Tanganyika in 1964 to become Tanzania.”

  “Tick VG in geography, Miss Nolan,” he said, alluding to the letters a teacher would put on a piece of homework. Still the schoolmistress. “A couple of years ago I came up to Ulster to see a patient and ran into Harith. We went for coffee. I’d been reading this book, African Bush Adventures by J. A. Hunter, and was intrigued by the story of a famous Zanzibari ivory and slave trader, Tippu Tib. Naturally I asked Harith if he knew of him. He laughed. ‘Yes,’ he said, ‘he was my great-great-grandfather.’”

  “No.” Sue’s e
yes widened.

  The curtains parted and a big, dark-haired man with coffee-coloured skin let himself in. “I heard that. Yes. He was. His real name was Muhammad bin Hamad. His nickname was meant to imitate the sound of a musket being cocked.” He nodded at Barry and said to Sue, “I’m Harith. May I call you Sue?” His voice was rich, deep, and unaccented.

  “Please do.”

  “And, Barry. Good to see you again.” He offered a hand, which Barry shook before Harith lifted Sue’s chart from a clipboard hanging on the rail at the foot of the bed. “So, Sue. Please tell me what’s happened.”

  Sue glanced at Barry, who nodded encouragement. “Barry and I have been trying to get pregnant for nearly two years. We were seeing Graham Harley, but all our tests were normal, then a bit more than two weeks ago Graham said my pregnancy test was positive. My last period was April twenty-fourth.” She glanced at Barry. “We were so pleased.” Her voice cracked when she said, “I started to bleed about half an hour ago, so Barry brought me straight here. I hope you can do something, Harith. I want this baby.” Her voice rose in pitch. “Please.”

  Barry felt as if a vise were squeezing his heart.

  Harith’s tones were warm. Reassuring. “I’ll try, but I need to know a bit more about you.”

  He took a very thorough history, made notes, then said, “It sounds as if you are having what we call a threatened miscarriage, but I have to exclude some other conditions, so I’d like to feel your tummy, then do a speculum examination.” He rose and used a wall-mounted call button to summon a nurse. “Nurse will help me push the trolley, Sue. I know it’s undignified, but I’ll have to put you in the stirrups in the gynae examining room.”

  “That’s all right.”

  A nurse appeared. “Hello, Mrs. Laverty.” She bent and unlocked the trolley’s wheel brakes. “Doctor Lamki and me’s going til take you for a wee ride.”

  Barry did not want to intrude while Harith worked, so said, “I’ll be here when you get back, Sue.”

  Harith and the nurse left, wheeling Sue.

  Barry took a deep breath. He knew what Harith was looking for. Bleeding in early pregnancy could be associated with several conditions. The worst was an ectopic pregnancy, where the embryo implanted in a Fallopian tube, although Sue would have complained about pain. It was a potentially lethal condition, required surgical removal, and Sue would lose one Fallopian tube, reducing her chances of subsequent conception. Barry did not want to hear that diagnosis.

  Inspecting her perineum and passing a speculum would allow Harith to see if the bleeding was from haemorrhoids or from a lesion like a cervical polyp and completely unrelated to the pregnancy. While both were unpleasant, neither put the pregnancy at risk.

  If Sue’s bleeding were coming through the cervix of her uterus it would be related to her pregnancy, and that was a cause for concern. Sometimes the gestational sac could be seen in the vagina. That was referred to as a complete abortion. Little more could be done but remove the sac. More often what doctors called the products of conception—early placenta, membranes, and the tiny foetus—might be stuck in the cervical canal. Barry dropped his elbows to his knees and put his head in his hands, suddenly feeling exhausted. That would be an incomplete but inevitable abortion. Once again, the pregnancy was doomed. Cervical dilation and uterine curettage were needed to remove the products, an impersonal term for hopes destroyed. Having to help Sue cope with the loss would not be easy. Barry too would be bitterly disappointed, but he knew he must be ready to support her with his love and compassion.

  In most cases like Sue’s, the cervix would be closed and only a trickle of blood escaping. That condition was known as threatened abortion, and the pregnancy was lost in only half those cases. But for all women, the waiting and uncertainty was very hard to bear. Barry pursed his lips. Inhaled. It wasn’t going to be easy for him either. He heard footsteps approaching, and the curtains opened. Harith walked in.

  Barry stood as the nurse parked Sue’s trolley, bent down to lock the wheel brakes, then helped make Sue comfortable, and left.

  “I’m pleased to tell you both that while I know it’s very worrying and I do not mean to belittle things, Sue, you are having a threatened miscarriage and it is very probable that it will settle down and in about twenty-eight more weeks you’ll be a mother. No one can promise you that, but we do know that at least seventy percent of women like you go on to have a perfectly healthy baby.”

  Sue said, “That means I’m more likely to continue than miscarry, doesn’t it?”

  Harith smiled. “Yes, it does. And I’m going to try to help you improve those odds. I’m going to admit you to the gynae ward, do some blood tests at once, and keep you on strict bedrest until the bleeding has stopped for seven days. I’m going to give you a sedative, phenobarbitone thirty milligrams twice a day. It will make you less anxious and may prevent your uterus from contracting. Your first dose will be ready as soon as you get to your room, and you’ll be asleep in about twenty minutes.”

  “Thank you.”

  “Have you any questions for me?”

  “Not just now, Harith,” Sue said. “I’m sure I will have when I’ve collected myself, but I think now I’d like to rest.” She swallowed and a tear trickled.

  Barry stepped beside her and put a hand on her forehead, pushing a piece of coppery hair out of her eyes. “You and the baby are going to be all right. I just know it.” He put force in his words even though he knew nobody could promise Sue that.

  She clasped his hand and said, “Thank you, Barry. Thank you.”

  “If you’ll excuse me,” Harith said, “I’ll go and get things arranged, and Barry, I’ll keep in touch while Sue’s in here.”

  “Thanks for everything,” Barry said.

  Harith smiled, shrugged, and left.

  Barry bent and hugged Sue to him. He felt her tremble. “I love you, darling,” he said, “and it will be all right. It will be.”

  Sue looked Barry in the eyes. “I hope so. I really do hope so. And I love you too.”

  Barry heard a discreet cough and turned to see the orderly who had brought Sue in from the car. He was accompanied by the nurse, who said, “We’re going to take you to the ward now, Mrs. Laverty.”

  Barry straightened and stepped back from the trolley. “Try not to worry, pet. Do you want me to stay? I can take your clothes home and come right back with the things you’ll need in the morning.”

  “Say goodnight to Mrs. Laverty now please, sir,” the nurse said. “You can pick up her clothes when you come in the morning. It’s late enough as it is, and we want Mrs. Laverty to get to sleep as soon as possible.”

  “I understand.” Barry moved forward, dropped a kiss on Sue’s forehead. “Sleep well, pet. The staff here will take good care of you. I’ll see you in the morning.”

  “Thank you, Barry.” She blew him a kiss as the trolley was wheeled away. “I’ll see you in the morning.”

  Barry watched her go and his heart went with her. He could only hope she’d be among those lucky 70 percent for whom the bleeding stopped, and the cherished pregnancy continued. Tonight, he would try not to bedevil himself with his knowledge about how the rates of prematurity, stillbirth, neonatal death, and foetal malformations were higher in those women. And he wasn’t going to tell Sue. By God, nothing would pry that information out of him. But he would know. He would know every single day of these next twenty-eight weeks.

  10

  Shutteth up His Bowel

  Barry collapsed into a dining room chair at Number One and breathed a sigh of relief. The morning’s round of home visits had been busier than usual. A farmer with painful thrombosed haemorrhoids had to be admitted to hospital and the process had been time-consuming. Then he’d had to drive to the other end of the townland to see an elderly woman with a chest complaint, which, unusually for summertime, had turned out to be pneumonia. She had also been admitted.

  O’Reilly was taking the morning’s surgery. Barry heard the senior man�
�s booming voice as he conducted another patient from the waiting room to the surgery. “So, young Stanley here had a sore throat three weeks ago that Doctor Emer treated with penicillin?”

  “Yes, sir. He got better but look at his wee face. Don’t you think it’s swollen up? And he’s been shivering. I’m dead worried about him.”

  “Right, I’d better get a good look at him.” The surgery door closed.

  O’Reilly should be finished soon, and he had agreed to take emergency call this afternoon so Barry could nip over to Dundonald to see Sue.

  Kinky appeared at the dining room door. For a large woman, she was light on her feet, and he had not heard her coming. She was bearing a plate like an offering. “I know you’re in a rush to get to the hospital, Doctor Laverty, but you’ll waste away if you don’t eat, so. I’ve made a proper lunch for Doctor O’Reilly, but he may be some time, so here.” She set a plate of ham sandwiches cut in triangles in front of him. “Eat up however little much is in it.”

  “Bless you, Kinky.” Barry picked one up and took a large bite. The cold ham had been roasted to perfection and he suddenly realized how hungry he was. His solitary breakfast of cold cereal and toast this morning had been five hours ago. Good old Kinky. The hall phone began ringing and Kinky, giving him an encouraging look, headed for the hall.

  Barry started to tuck in to his sandwich but was soon interrupted by O’Reilly. “Kinky’s had a call from Linda Bradshaw. You delivered her wee boy, Tony, seven months ago. She’s worried. Very worried. He’s been vomiting, seems to be having abdominal pain, and is passing mucus and blood. Kinky interrupted my consultation to ask me what to do.”

  “I’ll go.”

  “I would but I’ve to finish with Alma and Stanley Kearney—I think he’s got acute glomerulonephritis—then I’ve got three more patients down there, so I’ll be a while finishing surgery. I know you want to see Sue. I’ll look after any other emergencies this afternoon, but go and see Linda first, please. She lives on the same street as Dapper Frew. Discharged on Monday. Give me a couple of minutes to write him a sick line. If you’d pop in and give it to him when you’ve finished with Linda, I’d be grateful.”