Barry’s left hand went to the left side of his neck and he could feel the rubbery things there. “I see. Yes, they are.”
“We didn’t think that meant much. They often get swollen with flu.”
“That’s true.” Probably no need for concern. Then why was he feeling so nervous?
Sister continued, “He ran the routine blood screen for all admissions. Blood group. Haemoglobin, ESR, and white count. You are O positive. Your haemoglobin is normal. We all know the estimated sedimentation rate is very nonspecific. Yours is certainly elevated, but just about any fever will do that.”
Barry nodded. She was, of course, right. “I wonder why we still bother doing it, it’s so nonspecific.”
She smiled. “Me too, but routine is routine, and once in a while we do pick up something.” She hesitated, then said, “I’m afraid your white cell count was low—and that is unusual in cases of flu.”
“Low white cells?”
“That’s right. Probably nothing to worry about.”
Probably? What did that mean? Damn. Wasn’t there an infectious disease that suppressed white cell production at first before the count soared as the disease progressed? He shook his head. Usually he could see the pages of a particular book in his head when searching for a diagnosis, but today his mind, fuddled by his temperature, aching muscles, and slight headache, could not find them. Taking in what she was saying was all he could do. Simple fevers like flu or a cold were hardly ever seen in a major hospital. They were mostly looked after by GPs, and Barry was not ashamed to admit his knowledge of them was less than perfect. That was true of most hospital staff. Barry closed his eyes and took a deep breath that ended in a bout of dry coughing.
Sister Lynch handed him a glass of water from the top of his bedside locker. “Here. Have a drink.”
Barry drank and returned the glass. “Thank you.”
“You all right?”
He nodded, but he wasn’t. He was worried, but he wasn’t going to make a fool of himself by questioning a senior sister. It was more important that he paid attention to her rather than struggle to make his own diagnosis.
“Good. That is a nasty cough. I’ll get Doctor Swanson to order a cough suppressant.”
“Thanks, Sister, but you were explaining about my white count.”
“I was. Because it was low, we repeated it today, and also asked for a differential count.”
And what would a differential count show? What were they looking for? The routine was to make a smear of the blood on a glass slide and count all the white blood cells present, the infection fighters, to see if the total count was up. That usually confirmed the presence of an infective agent. The differential was very consumptive of highly trained laboratory technicians’ time. Each individual white cell had to be identified by type through a microscope and counted. It was expensive, so only ordered if something else was suspected. “I see,” he said, but in fact he didn’t. Barry wondered if instead of concern about infection, there was some suspicion that there was something not right—he couldn’t face the word “wrong”—with the white cells themselves.
“Luckily for you, the Royal has one of the finest haematologists in Doctor Gerald Nelson. We’ve asked him to consult.”
“Gerry Nelson? Head of haematology?”
“That’s right.”
Hell’s gates, there was a problem with the white cells in his blood. All thoughts of other potential diagnoses fled. He was going to be under the care of the senior physician specialising in diseases of the blood and lymphatic systems, anaemias, leukaemias—cancers of the white cells—and another disease with all the symptoms he had now. Which blood disorder gave symptoms like flu? Come on. Think. He dismissed the idea that he could have another kind of viral infection. Doctor Gerald Nelson was not consulted for trivia.
Barry shuddered. Cough, fever, weakness, raised evening temperature and—he took a deep breath. Think, man, think. But he still couldn’t remember.
“Unfortunately, Doctor Laverty, today’s Friday, and Doctor Nelson’s in London. Won’t be back until Monday, his secretary says, but we’ll keep you comfy until then. We’ll probably not get the results of the new blood work back until then anyway. So, don’t worry. Just get lots of rest and ask your nurses for anything you need.” She bent and fluffed his pillow. “Now, before I trot along, have you any questions?”
Any? He had a hundred. Was there no one else who could give him a diagnosis? Silly question. Sister would already have thought of that, and the staff here had decided that Barry needed the haematologist’s opinion, not someone else’s. Barry’d have to wait, and he’d been working in hospitals long enough to know that any other queries would be fobbed off with “Try not to worry. Doctor Nelson will be able to answer that on Monday when the other test results are in.” Instead he simply said, “Not really, but thank you.”
“I’ll be off then.”
He put his first two left fingers on his right wrist at the base of his thumb. He could feel the pulse in his radial artery and see the second hand of his wristwatch at the same time. Twenty-seven beats in fifteen seconds. One hundred and eight per minute. Should be eighty-eight. It was racing, and why? Because of his fever, or because there was something sufficiently wrong with his white count to warrant doing a differential count? What else could be wrong with him? Calm down, he told himself. Get a grip. Wasn’t it a well-known fact, and he managed a weak smile, that all medical students diagnosed themselves with at least one lethal disease during their clinical years? It probably was only flu, or as Sister had said, some other virus, but with Doctor Nelson on the scene, there must be cause for concern.
Monday, for Christ’s sake, until Barry’s fears could be resolved—or worse. Was he going to be told that he had something worse than an infection? Was there no way he could get an answer sooner? Harry Sloan had taken the fifth-year prize for microscopic pathology. Might he be able to read the blood smears?
Barry took a deep breath. Not bloody likely. He could not bring himself to ask Harry. Partly out of fear of Harry suspecting Barry had panicked, but more because he had no idea how his friend could legitimately get access to the smears of a patient who was not under his care.
Barry shook his head. He could think of no other options. No way to get an answer. He couldn’t change anything. The old country adage “What can’t be cured must be endured” not only applied to an illness. It covered unchangeable circumstances too. He mustn’t let his anxiety show to other people. They’d think he was a worrywart. Barry took a long, deep breath. He’d simply have to tough it out.
15
Hope Springs Eternal in the Human Breast
April 24, 1969
Kenny made a throaty noise from the backseat of Barry’s Hillman Imp when the car stopped at the traffic light. The two-year-old chocolate Labrador was accompanying Barry and Emer to the last home visit of the morning. Barry glanced across at the Duck and waved at Mary Dunleavy, the publican’s daughter, as she stepped back to admire the window she was washing. Two days ago, he’d popped in for a pint and had run into Anne Galvin’s husband, George, known to everyone as “Guffer.”
“You mind, Doctor, when Anne first took bad you come out til see her,” the man had said shyly, “and you brung Doctor O’Reilly’s pup, Kenny?”
“I do. She fell in love with him.”
“Right enough, she did. Well, could I ask you a wee favour, sir?”
“Certainly.”
“If you’re coming out til see my Annie once she’s discharged, could you mebbe bring Kenny? I know how much it would please her.”
Barry had smiled. “I’ll ask Doctor O’Reilly. I’m sure he won’t mind.”
“Thanks a million, Doc. Now, I know you’re off duty, like, and I didn’t mean til intrude. I’ll leave you to your pint.”
The traffic light turned to green. “Last call of the morning, Emer,” Barry said as they headed for the housing estate. “They sent one of our patients, Anne Galvin, home from
Belvoir earlier today. She’s had a recurrence of lung cancer and is getting radiotherapy. I want to see for myself how she’s doing.”
Emer inhaled. “Doesn’t sound very promising.”
“’Fraid not. The relapse happened twelve days ago. She had her original diagnosis and surgery two years ago. Not one of our better efforts. Fingal and I both diagnosed acute bronchitis initially. We all get it wrong sometimes.”
“I know.” Emer smiled. “I’ll bet you followed up right away, though, and got her into the Royal, but thanks for that, Barry.”
As he drove onto the housing estate he wondered how Sue was getting on at MacNeill Memorial Elementary School. She’d not been in good form when she’d left for work this morning.
Emer was saying something and he realized he hadn’t been listening.
“Sorry, Emer. I missed that.”
“I just asked if you were all right, Barry? You’ve been, I don’t know, a bit distant today. It’s not like you.”
“I’m all right.” But he wasn’t. Sue’s period was due today. She’d hardly spoken a word at breakfast. Waiting for the bad news, if it came, that would again confirm she was not pregnant, was killing her a little bit as each month went by. It wasn’t doing much for his mood either. “Honestly, but it’s kind of you to ask.” It might have helped to talk to another woman, and a doctor at that, but apart from Sue’s mum and Jack Mills, no one knew how worried Barry and Sue were about their apparent infertility.
He parked outside the terrace house. “Hop out.” He grabbed his bag, let Kenny out, and they followed Emer.
Today was Ulster’s spring at its best. The air was warm, soft, not a cloud in the thin strip of blue between the roofs of the houses on either side of the narrow street. Summer was on the way. A cock pigeon, his green-and-purple head shining, pursued a hen along the gutter, and his burbling coos, while not having the purity of a skylark’s song, helped even the gloomy old housing estate to seem brighter and more cheerful. The only gloom was inside Barry’s head.
He knocked on the front door and Guffer answered almost immediately. His completely bald head shone in the sunlight.
“Doctor Laverty, and this must be Doctor Emer. I’ve heard good things about you, lass. How’s about ye? Thanks for coming, and for bringing Kenny. It’s dead on, so it is. I never told her you might, in case Doctor O’Reilly said no, so it’ll be a grand surprise. Come on on in.”
He led them into the familiar parlour where Anne, wearing a tartan dressing gown over her nightie and pink fluffy slippers, sat in one of the armchairs of the maroon three-piece suite. Barry noticed at once that her grey-blonde hair was neatly brushed, she was having no difficulty breathing, and her facial colour was good.
“Hello, Doctors. Nice of youse til drop by. And it’s nice to be home too.” Her face lit up. “And youse brung Kenny. Och, that’s lovely, so it is. Come here, boy. Come here.”
The big Lab, tail wagging, trotted over to Anne and, needing no bidding, sat.
She patted his head. “Who’s a good boy, then?”
Kenny grinned his Labrador grin and his tail never stopped.
“And here’s me forgetting my manners. Would the pair of youse sit down?”
Barry took the other armchair close to and half facing Anne, while Emer sat at the end of the sofa closest to the patient.
“Now, I know it’s near lunchtime, but would youse like a wee cup of tea in your hand? Guffer’s a dab hand at the tea-making, so he is.”
“That would be grand,” Barry said. “Thank you.”
“Away you and see til it, Guffer, love, and bring some of them McVitie’s chocolate digestives.” She ruffled the fur on Kenny’s head.
The dog looked at her with adoration in his big brown eyes.
“I’ll attend til it.” Guffer left.
“You’re looking well, Anne,” Barry said. “We just wanted to see how you are getting along.”
“I’m doing a lot better than the last time you was here, sir. Mister Bingham’s folks at the Royal was great, so they were. Give me a thorough going-over, X-rays and all, then got me straight to thon Marie Curie Centre and them folks there told me that their radiotherapy—that’s what you call it, isn’t it?”
“It is,” Emer said.
Barry heard the high-pitched whistle of a kettle coming from the rear of the house. Like many Ulsterfolk, the Galvins would keep a kettle near to boiling for moments like this when people dropped in.
“Anyroad, they said it would shrink the growth in my chest that had made my lobe collapse, and, by jeekers, it must’ve.” She smiled. “Mind you, it’s scary when they get you all lined up in front of thon big machine with a kind of nozzle that looks like it’s staring at you and they all run off and hide before it starts to hum and buzz. You don’t feel nothing. Not then, anyhow. And glory be—I can breathe again, and I don’t feel anything wrong with me, except I’m tired.”
“That’s to be expected, but otherwise I’m delighted with how you are,” Barry said.
She smiled and patted Kenny’s flank. “And I’m going til be even better on Saturday. Our oldest lad, Pat, and his family’s coming up from Dublin.”
“You’ll enjoy that,” Barry said.
Guffer came in with a tray that he set on a table. “What do youse take in your tea?”
“Just milk for me, please, Mister Galvin,” Emer said.
“Milk and sugar,” said Barry.
As Guffer fussed with cups and saucers, Barry said, “Anne, if you are feeling all right, I don’t think me or Doctor Emer examining you is going to change anything, so unless you’re worried?”
“Not at all. There’s no need for that, sir.”
“Here y’are, Doctors.” Guffer handed a teacup to Emer and another to Barry.
“They’ve it all organised for me. Told me I’d need more courses of treatment, that I’d get queasy and maybe take the skitters, but I have medicines for both.” A hand strayed to her head. “I might lose some hair too, but, och.” She shrugged. “I have all my dates til go back and the ambulance is booked already to take me there.”
Guffer gave her a cup and a biscuit.
“Doctor Laverty,” she said, “could I give half of this biccy to Kenny?”
“You may, but he won’t eat it until you snap your fingers. Dogs have been known to be poisoned by eating things lying about, so Doctor O’Reilly has Kenny trained not to eat anything unless he’s given permission.”
“Boys-a-boys,” Anne said, “that’s quare nor smart.”
As she busied herself with the dog, Barry thought about the woman in front of him and how modern medicine was treating her disease. He knew about lung cancer and its probable course, but he was out of his depth when it came to radiotherapy. They’d had three lectures as students on the effects of nuclear fallout from atomic bombs, but none on the medical applications of radiation. That was left to the experts. “It seems your specialists have pretty much everything taken care of, Anne.”
“Pretty much, and Guffer and me’s dead thankful, so we are, for everything they’re doing.” She reached out and took Barry’s hand. “But we’re grateful til youse Ballybucklebo doctors too.” She looked up at him. “It’s just nice to know you’re always there if we need you, and that you all do, I don’t mean to be forward, but you all do care for your patients.” She let go his hand. “There now. I’ve said it. Thank youse all.”
The lump was so big in Barry’s throat he hoped it wasn’t going to strangle him. He smiled at her. “Thank you, Anne.”
“Aye,” she said, “and I’ve other news too.” Her smile was radiant. “Seamus’s building business in Palm Desert is doing very well—that’s our younger lad, Doctor Emer—and he’ll be coming home from California in a wee while.”
“It’s dead on, so it is,” Guffer said. “We don’t have any dates yet, we’re waiting until we see how the rest of Annie’s treatment goes, but I got a letter from him yesterday. With them there jet aeroplanes now, he can be in B
elfast in less than a couple of days, so if we need him in a hurry”—and from the look in Guffer’s eyes, Barry understood exactly what the man meant—“he’ll come at once.”
“I’m glad,” Barry said. “It’ll be another homecoming for him, and you two’ll be happy to see him.”
“We will that,” Guffer said.
Barry finished his tea, took a quick look at his watch, and stood. “I’m pleased you’re making progress, Anne. Now Doctor McCarthy and I should be running along. You know we’re country GPs and it’s your specialists who will be looking after you for a while, but if you or Guffer are worried?”
“Doctor, dear,” she said, “you’re very kind, but sure we know that.” Then her voice cracked, but she stiffened her shoulders. “And anyroad, Guffer and me both understands that it’s more likely the Reverend Robinson we’ll be calling, so don’t you worry your head, sir.” She bent and gave Kenny a huge hug, and he licked her face.
And for the second time in twelve days, Barry stood in awe of this woman’s courage. “You look after yourselves,” he said. “We’ll be off. Come, Kenny.”
Back in the car with Kenny aboard, Emer said, “I’m glad she’s getting such good care and that the radiation has helped. As a GP, though, it reminds me how useless you can feel in cases like this.”
Barry put the car in gear and drove off. He knew the feeling all too well.
“And I worry,” she said, “the other effects of radiotherapy are going to be much more unpleasant than Anne seems to believe.”
Barry turned on the Belfast to Bangor Road. “I agree, but I’ve had a couple of other patients looked after at Marie Curie. They’re very good at controlling the worst complications. I admire all of those oncology folks, but I couldn’t work with patients when practically all of them are going to die while under my care.” He shuddered.
“I’ve watched you and Fingal for nine months, and I know that’s because you do care about your patients. Anne Galvin was right.” She chuckled. “And how do I know? After what I’ve learned here, it takes one to know one.”
An Irish Country Family--An Irish Country Novel Page 17