Paid for by your company, Bertie, O’Reilly thought.
“—and there’s plenty til eat or snack on, thanks til my Flo, Cissie Sloan, Kinky Auchinleck, and Maggie MacCorkle.”
A low groan from somewhere in the crowd—O’Reilly could not identify the critic—accompanied the mention of the last name. Everyone knew Maggie was unlikely to be representing Ireland at the culinary Olympics in Frankfurt.
“Please, when we’ve finished here, head for the drinks and grub, and give Donal Donnelly and his family a bit of space to have a look at their new home. Now, I’ve said my bit. Father O’Toole, if you please.”
Father Hugh, wearing his cassock and biretta, turned and faced the crowd, his right arm raised, and three fingers held up.
Everyone closed their eyes and bowed their head.
“Oh Lord, we are gathered here today in the spirit of friendship to bless Dun Bwee and the Donnelly family. We beseech you, may you hold them in the palm of your hand, but not close your fist too tightly, may peace and plenty be the first to lift the latch to their door, and happiness be guided to their home. In the name of the Father, Son, and the Holy Ghost. Amen.”
“Amen.”
Father Hugh’s place was taken by the Reverend Robinson, in a black suit and white dog collar. He bowed his head and O’Reilly knew the man’s eyes would be closed. “Dearly beloved,” he began, “we are gathered here today in the sight of God to celebrate and give thanks for our friendship, our community, and the resurrection from the flames of the Donnellys’ cottage, Dun Bwee. We humbly beg thee to bless this house and those who dwell therein. I now ask you all to join me in the Lord’s Prayer. Our Father, which art in heaven—”
The crowd had got as far as “and deliver us from evil” when Tori yelled, “I want a wee-wee,” but was shushed by Julie.
“… forever and ever. Amen.”
Reverend Robinson said, “Out of the mouths of babes and sucklings,” and everybody laughed.
“You’re dead on, Your Reverence,” Bertie Bishop said, “so I’ll let youse all go in a jiffy, but first”—he stood close to Donal—“Mister and Mrs. Donnelly and family. Here’s the key to the door.” He gave Donal two keys on a large ring festooned with a red bow. Donal held up the key ring and waved it in the air as the crowd began to cheer and whistle.
“You can thank my missus for that there bow,” said Bertie. “And you’ll find the house all set up and ready to go, but we thought you’d like to hang your own pictures. Health to you all, to enjoy your home again.”
O’Reilly could see the tears through Donal’s smile. “My lord, my lady, ladies and gentlemen, I don’t know what til say. I’m all choked up, but Julie and me and the girls want til thank everybody here from the bottom of our hearts, to thank Lord MacNeill and Lady Ferguson for gracing us with their presences, and Father O’Toole and the Reverend Robinson for their blessings, and youse all for coming, but now if you’ll excuse us, me and mine are going inside. We’ll be out with youse as soon as we’ve had a good gander, the twins have had their nap, and wee Tori is comfy again. Thank youse all very, very much.” He took Julie’s hand and she held on to Tori’s.
A deafening round of applause disturbed the rooks for a second time.
Big motherly Kinky gave Bluebird’s leash to O’Reilly. “Would you put the dog in her run please, sir?” Then she pushed the twins in their pram toward the now open front door.
The Donnellys were back in their own home at last.
22
Well If That Is So, We Must Go Out and Get These People
November 1, 1963
“Morning, Sister.”
Sister Kearney, the senior sister of wards 5 and 6, looked at Barry over the tops of her half-glasses and smiled when he reported to her desk at eight o’clock exactly on Friday, November 1. He’d been officially on call since midnight but had not been disturbed. At least not by the ward. His worry about Virginia had kept him awake for quite a while.
“Nice to have you back as our new houseman, Barry. Just barely survived your three-month stint in casualty, I hear.”
He could laugh about the mononucleosis now, and he did. “It’s good to be back on your wards, Sister.”
She handed him a chart. “You’re in at the deep end today. As you know, we’ve four beds on ward 6 equipped with ECG machines for continuous cardiac monitoring, but the rest are general medical beds, and we’re on take-in all day.”
“I’m ready.” Maybe the work would stifle his nagging concern about Virginia, who had captured his heart, but did not seem to feel so strongly about him.
“Very good. They’ve sent us a Mister Dennis Carson, who’s just had what sounds like a grand mal epileptic seizure. He’s in bed 7. Off you go.”
Barry grabbed the chart and hurried onto ward 6 with its familiar wooden floor, rows of iron beds evenly spaced along both walls, and plain wooden tables arranged up the centre of the long room. French windows at the far end led to a balcony from which, across a lawn, could be seen the redbrick Royal Maternity Hospital.
Staff and student nurses moved about, attending to their duties. A clinical clerk Barry recognised, Pat Taylor from Bangor, was drawing morning blood samples. The final-year student was a year behind Barry.
The man in bed 13 said in a loud stage whisper to his next-door neighbour, “Look out, Sammy. Here comes Count Dracula.”
“Morning, Pat.”
“Morning, Barry. Both of us starting together here today.”
“I was here for three months as a clinical clerk last year, doing the same thing you are now.”
“And getting called ‘Count Dracula’ by the victims, I’ll bet. Did you know the book was written by a Dublin man, Bram Stoker.”
The overhead curtains round bed 7 were closed. Barry let himself in. A staff nurse was undoing a blood pressure cuff from the arm of a man Barry guessed might be in his thirties. The patient was awake and breathing easily, but pale. “Hello, Doctor Laverty,” she said. “Mister Carson’s blood pressure is normal, one twenty over eighty and”—she indicated a tear-stained young woman sitting on a bedside chair—“this is Mrs. Diana Carson. She was with him when the attack happened.”
“Good morning, Mister and Mrs. Carson. I’m Doctor Laverty.”
“Pleased til meet you, sir,” she said.
The nurse handed Barry the chart. Dennis Carson was thirty-six years old, a plater by trade. The previous medical history referred to the usual childhood fevers, nothing to help make a diagnosis. The commonest cause of fits was epilepsy, and usually there were few if any diagnostic physical signs. Nor did doctors often get to observe the attack. “Can you tell me what happened, Mrs. Carson?”
“Aye. Him and me was in Smithfield Market and says he til me, ‘Diana, can you smell fried onions?’ He sounded all puzzled, like. Then he goes stiff as a board. Falls down like he’s been poleaxed. I was scared rigid myself.” She sniffed. “I was sure he’d hurt himself, he went down so hard.”
Grand mal epilepsy was preceded by an aura that could be of smell, hearing, or hallucinatory. Then came the tonic phase, when all the muscles go into spasm.
“I knelt down and he starts til shudder and shake. I don’t know how long that went on for. And now there’s rubberneckers all round. And him’s frothing at the mouth like a mad dog.” She looked up at Barry and the tears started. “I didn’t know what til do. Then a nice man kneels down and says til me, ‘Missus, your man needs til be in hospital, so he does.’ He whips off his jacket, sticks it under Denny’s head for a pillow, like. He says, says he, ‘I’ll go into a shop and phone the ambulance.’ And off he trots. By now Denny’s stopped having a fit, he’s just lying there. By the time your man gets back, Denny’d woken up.”
She had given a classic description of a grand mal epileptic seizure.
“He said he had a ferocious headache—”
“Still do, Doctor,” Mister Carson said. His voice trembled as he asked, “What the hell happened, anyway?”
“You had a seizure, Mr. Carson, and I’m sorry to hear about your headache. I’ll take care of it in a minute,” Barry said. “Thank you, Mrs. Carson. You’ve been very helpful. Now I’d like to examine you, sir.”
Barry satisfied himself that, except for a bruised elbow, the patient had sustained no injuries from his fall, nor had he exhibited any neurological signs, nearly always the case once the attack was over. The next step would be to try to decide if the cause was some underlying lesion like a brain tumour or whether, more likely, the disease had no obvious cause. “This has been very unpleasant for you both, and I’m sorry I can’t give you a definite diagnosis today.” A diagnosis of epilepsy carried an enormous social stigma, and practical implications like not being allowed to drive. For once Barry was able to accept received wisdom that the word not be mentioned until a firm diagnosis of cause had been made. “But we’ll get you something for that headache, I promise.”
The curtains were being pulled back. Barry turned to see the stately progress of the ward round. The boss, Doctor Pantridge, was accompanied by his registrar; his senior house officer, Doctor John Geddes; Sister Kearney; a student nurse; and half a dozen clinical clerks in their short white coats. Doctor Frank Pantridge was a colourful character and a pioneer in coronary care.
“Ah, Laverty,” Doctor Pantridge said, “welcome back aboard, and what do we have here?”
Barry quickly recapped the history and physical findings and said, being deliberately obfuscatory, “My diagnosis is one of seizure of unknown origin, which will require an electroencephalogram and skull X-ray to begin to look for any underlying cause.”
“Quite right.” Doctor Pantridge’s words were clipped. “And admission to ward 22 under the care of Doctor Millar. See to it, Laverty.”
“Yes, sir.”
The entourage moved on to the next bed.
“Mister and Mrs. Carson, that was the senior consultant. He has asked me to arrange for you to be transferred to the care of Doctor Millar, who specialises in diseases of the nervous system. We mostly treat patients with heart troubles here. I’ll be making the arrangements now, then I’ll have to join the ward round but, chart please, Nurse.” Barry scribbled an order for Panadol. “We’ll give you something for your headache, and I’ll come back and give you a better explanation when I get a chance.”
Barry returned from arranging the transfer to the ward where in September he himself had been a patient, and joined the retinue as it moved from bed to bed. Each patient’s case was presented by one of the clerks in turn, and Franky P. grilled the student about the disease under discussion. The great man was not renowned for his tact.
One of the students applied the bell of his stethoscope to a man’s left chest between the fifth and sixth ribs, frowned, clearly concentrating, removed the bell, and said, “I can hear a presystolic murmur, sir. Mitral stenosis.”
“That is quite amazing,” Franky P. said. “When I examined him yesterday he had the classic systolic murmur of mitral incompetence.” He took a three count. “Tell me, young man, were you born stupid—or have you been practising?” It produced the required laughter from all except the unfortunate butt of the joke. Barry felt for the man, yet Doctor Pantridge was worshipped by his juniors, highly respected by his peers, and dreaded by the hospital administration. An earlier remark of his that “Either Matron goes, or I go—and I’m staying” may have been apocryphal, but it was part of the Royal’s folklore.
When rounds ended, the students and junior doctors returned to their duties, and Doctor Pantridge and Sister Kearney headed to the clinical room for morning tea.
“Welcome back to 5 and 6, Barry,” said John Geddes, a slight, bespectacled man with a soft voice who’d been a houseman here last hospital year. “When you’re free, come and find me. If there’s not much excitement, I’ll be in the side ward of 6 and I’ll give you a briefing about what some of your work here will entail.”
“I’ll get there as soon as I can.”
“Good.” Doctor Geddes went to join his colleagues. Barry knew these morning teas weren’t social, but brainstorming sessions on cardiac resuscitation.
Barry admitted one more patient, a woman in congestive heart failure. Then, true to his word, he headed back to bed 7 on ward 6. But before he reached it, he met an orderly and nurse pushing a trolley onto the ward. The nurse was Jan Peters. “Hello, Jan,” he said, “come for Mister Carson?”
She stopped and nodded. “You asked for him to be admitted to ward 22, the neurology ward, where I work. Doctor Millar will see him there.” She inhaled deeply, then sighed as she began to push the trolley forward.
Barry frowned. “You all right, Jan?”
She shook her head. “Not really. Daddy was readmitted to ward 10 an hour ago. He’s got more gangrene.”
“No. Oh, Jan, I’m so sorry.”
“Thanks, Barry. Any chance you could pop in on him? He’s very upset.”
“Just as soon as I’m free. I promise.”
“Thank you. I’d better get back to work.”
“Jan, I was going to try to explain a bit to the Carsons, but I’m running late. Can you make sure someone has a word with them on their new ward?”
“I will, Barry.”
Damnation, Barry thought. Rotten luck for Jan’s dad. Even if they were on take-in and Barry was probably going to be busy, he would get a lunch break. He’d go and see Rusky Peters then.
John Geddes was not on 5 nor on 6, so Barry let himself into the side ward of ward 6, where John sat in a simple wooden side chair reading a reprint from a cardiology journal. “Have a pew.” He indicated a second chair. “Nine thirty and no more new admissions yet needing my attention.”
“I admitted a woman in heart failure. The registrar was on the ward. He approved of my investigations and proposed treatment.”
“That’s why you didn’t need me?”
“Mmmh.” Barry sat facing a trolley covered with a dust sheet.
“You’re a very lucky doctor to be on this unit at this time, Barry. After three months of the walking wounded down at casualty, you’re going to be part of one of the most exciting advances in medicine of the twentieth century.” His eyes lit up. “And—so you can be—it’s my job to give you some teaching about your new responsibilities. I know you learned cardiopulmonary resuscitation, CPR, last year as students. This year we decided to teach your year of housemen, starting in August, how to use the defibrillator as well as a refresher in CPR. You all have to live in the hospital, so we’ve been building a rota to have twenty-four-hour cover for any cardiac arrests in the hospital. You missed your turn to be instructed when you were sick. The boss, ever practical, said, ‘Laverty’s coming here in November. We’ve enough juniors trained now for inside work. Teach him when he gets here.’”
“I remember the CPR training. I like the bit of medical history you chucked in.”
John smiled. “I could see eyes widen when I told your lot that ‘mouth to mouth’ respiration began in 1767 but fell out of favour because it was aesthetically unpleasing.” He cleared his throat. “The idea of a strange man kissing a woman was simply not acceptable in 1767, and kissing another man? Good Lord.”
Barry chuckled and said, “I thought CPR had worked for a chap called Robbie Martin on my first day in casualty, even if he didn’t last long after he was admitted here. But I really felt I’d done something useful.”
“And by the time we’ve finished with you here,” John said, “you’ll be doing even more good. You might even decide to become a cardiologist. It is a very satisfying speciality, even if we can’t save them all.”
“I’ll have to see about that,” Barry said, “but I’m always eager to learn.”
“All right, now, the nearly final aspect of care after cardiac arrest concerns reversing ventricular fibrillation. There is a completely disorganised contraction of the individual muscle fibres of both ventricles, so the heart stops pumping blood. It was uniformly fatal until 1947 when a Doctor Be
ck successfully defibrillated a fourteen-year-old boy undergoing open heart surgery.”
“So long ago? I thought it was brand new.”
“You’re right about it being a recent development. The breakthrough came last year. Doctor Lown, an American, in part using information provided by Russian scientists, produced a portable DC defibrillator. Doctor Pantridge went to hear him lecture and”—John whipped the sheet off the trolley—“hey, presto, a few months later—”
Barry saw the portable defibrillator that John Geddes had used on the patient he had helped Harry Sloan perform CPR on back in August.
“—our very own Lown model. It lives in here, and we can rush it to the bedside when necessary and plug it into the mains.” He beckoned. “Come on and I’ll show you how this thing works.”
When John had finished teaching Barry the steps and they were sitting in their chairs again, John said, “Now, I’m going to tell you the final and most exciting bit of the cardiac resuscitation story, and some of it involves me, but I’m only telling you the facts. Please don’t think I’m boasting.”
Barry smiled. John Geddes had always been a self-effacing man. Boasting was the last thing Barry would accuse him of.
“Back in April of this year, when Brian Pitt and I were both housemen on ward 21, a hospital worker stuck his head in and told us a man was lying on the ground outside the building. Brian and I yelled for help and ran outside. A pulseless middle-aged man lay on the pavement. I started CPR. Dennis Coppel, an anaesthetist registrar, charged up, pushing an anaesthetic trolley. He intubated the man and connected him to oxygen. Anand Garg, a neurosurgical registrar, helped us load the man on a trolley and we got the patient to a side ward and took an ECG. Ventricular fibrillation.
“Doctor Pantridge was on ward 5. He brought the new portable defibrillator and plugged it in. It only took two shocks to restore a normal heartbeat. That was the first case of successful defibrillation at the Royal.”
“You must have been excited.”
John smiled. “I was.” His smile faded. “But the man died later that night.”
An Irish Country Family--An Irish Country Novel Page 24