An Irish Country Family--An Irish Country Novel

by Patrick Taylor

  O’Reilly heard Kitty muttering under her breath. “It’s such a great day, Fingal, could we not leave politics alone for once?”

  “I couldn’t agree with you more, Fingal,” John MacNeill said.

  Lars said, “Pity the poor man had to resign five days later because of the bombs.”

  “I believe,” Myrna said, “it was because he had lost the confidence of his Unionist Party. You may be pleased by the suffrage thing, Lars, but I’m none too happy about James Chichester-Clark, O’Neill’s successor. Granting amnesty for people who organised demonstrations? And then releasing Ian Paisley and Major Bunting four days ago? That’s more trouble in the making.”

  “Perhaps they’ll settle down,” Lars said. “Having learned their lesson.”

  “Those two?” There was an edge in her voice. Myrna frowned at O’Reilly’s brother and shook her head. “That’s always been your trouble, Lars O’Reilly. Typical. You’d’ve found a bright side on the blooming Titanic.”

  O’Reilly saw Lars tense up, and ached for the man. Better perhaps that he and Myrna had gone their separate ways two years ago.

  John MacNeill said, “It has been, from time immemorial, forbidden in the officers’ mess to discuss politics, religion, and women. And I know you feel strongly, Myrna, but please don’t cast a shadow on what has been a lovely day so far.”

  Myrna coloured and looked as if she might argue with her brother. Then her shoulders relaxed. “Yes, John. Absolutely right. Sorry, Lars. Didn’t mean to snap. These are tense times.”

  Lars’s moustache lifted in a smile. “All is forgiven, and you are right. I do have a habit of optimism.”

  “Takes after our late mother,” O’Reilly said. “During the war she set up a local ‘Buy a Spitfire’ fund. We didn’t think she’d raise the money—but she did.” The ham, chicken, and most of the smoked salmon on his plate had disappeared.

  Kitty, clearly sensing the need for more diversion, said, “Look at that,” and pointed.

  Dapper Frew, a longstanding member of the Ballybucklebo Highlanders, stood in his usual clothes but with a set of Great Highland pipes, bag under his left arm, the three drones over his left shoulder, blowpipe mouthpiece between his lips, chanter held by his fingers. He smacked the inflated bag and the pipes howled. Bag under his arm, he squeezed, and above the roaring of the drones the slow melody rang loud and clear.

  “Do any of you know that tune?” Kitty asked.

  “Yes,” said John MacNeill, “and it’s singularly appropriate. It’s a slow march called ‘My Home.’ And thinking of slow marches reminds me, Fingal, that I did see my friend at the War Office and a couple of other folks when I was in London.” John MacNeill’s gaze fixed on Fingal O’Reilly’s eyes. “It’s not something I wish to go into the details of today on such a happy occasion, but I promise you I have enough ammunition, to mix a metaphor, to spike Colonel Mullan’s guns for good. Today’s the tenth. The borough council meeting’s not until May nineteenth. Could you meet me outside the clubhouse at two o’clock on the fourteenth? It’s a Wednesday and there’s an out-of-season game to be played.”

  “Of course. And we know he’ll be home because he told us he works from one until four.”

  “I’ll phone you tomorrow and brief you then.”

  “Fair enough.” O’Reilly would have liked more information, but he could be patient because he knew John MacNeill always delivered on his promises. “Let’s enjoy the afternoon.” And he knew he could now, because he was suddenly flooded with the pleasing belief that, although Colonel Oliver Mullan had thought he’d won earlier today, on Wednesday, May 14, he was going to realise that it had only been a skirmish. O’Reilly and John MacNeill were going to declare war.

  24

  Bringer of Unwelcome News.

  November 1, 1963

  “Lunchtime. Off you trot, Barry. I’ll hold the fort,” John Geddes said.

  “Thanks, John.” That was typical of the man who, nominally Barry’s senior, was not above picking up Barry’s duties. “I’ll get back as quickly as I can.” He walked along the ward, pushed through the blue plastic flap doors, and turned left on the main corridor with its usual bustle of uniformed staff, patients, and visitors. It was time to keep his promise to Jan Peters.

  It was only two weeks short of three months since Rusky’s last admission. Barry was no haematologist, but he had read up on polycythaemia after getting to know the dockworker. It seemed the more severe the disease, the less time between relapses and the worse the long-term prognosis.

  He entered ward 10 and immediately ran into Virginia, who was carrying a towel-draped bedpan and heading for the sluice. As always when he saw her, his breath caught in his throat. He smiled at her. “Hello. Sorry about tonight,” he said.

  “Are you not on take-in? I thought you’d be on your wards.” He heard little warmth in her words.

  “I’m on my lunch break. I’ve come to see an old patient.” Oops, he thought. I can practically hear her thinking Oh? I thought you’d come to see me.

  “Excuse me, Barry,” she said, “this bedpan is quite ripe.” She slid past him and into the sluice.

  So she was still angry. He sighed. He wasn’t going to pursue her into the sluice. He knew well what Jack’s advice would be: “Give the bird time to cool down.” He would stop worrying about her and see Rusky Peters as he’d planned. He headed for the ward sister’s desk.

  She smiled. “Hello, Barry. Come to see Mister Peters?”

  “Jan told me he’d been readmitted, and he’d like a visit.”

  “He’s really down in the dumps. Try to cheer him up, if only a little. And it won’t be easy. The senior surgeon’s already seen him.” She inhaled. “It’s not good. We’re waiting for Doctor Nelson to consult, but if he gives the haematological go-ahead, with respect to reducing the risk of possible postoperative bleeding, it’ll be an above-knee amputation of the left leg sometime this afternoon. We haven’t told him yet.”

  “Amputation?” Barry sucked in his breath. “No, not good at all. Where is he?”

  “In the side ward. Like last time.”

  “Thanks, Sister.” As Barry headed there, he remembered how, as a student, he’d assisted the senior surgeon, Mister Willoughby Wilson, in an above-knee amputation, helping the surgeon form two flaps from the skin and flesh in front of and behind the now-exposed nacreous femur. Barry knew it would probably take many years to forget the sounds he heard that day—the grating of the bone saw, the thump of the amputated lower leg into a bucket held by the circulating nurse. But the surgeon’s speed and skill in sewing up the flaps to form a cushion over the end of the bone had been a joy to observe. Technically, Rusky Peters was in very good hands.

  Barry went into the side ward to find Rusky propped up on pillows, lying in bed wearing his own blue-and-white-striped pyjamas. His face was plum coloured and screwed up in a grimace. “Sorry to see you here again, Rusky,” Barry said. “Jan told me you’d been admitted.”

  A nurse had finished taking the patient’s blood pressure.

  “Thanks for coming, Doctor Laverty, and I’m the better for seeing you, sir, but I took a fierce headache, so I did, and keeled over again at home. Scared the missus half to death, and, well, I’m scared, too, sir.”

  “I can understand that. I’d be very worried too. Tell me what’s been happening.”

  “Well, the missus sent for the ambulance like Doctor Nelson told us to if anything like that happened. They brung me til casualty and got me admitted here. One of the young doctors there ordered a wheen of blood tests and give me codeine to take the edge off my headache.”

  “Mister Peters’s blood pressure is normal, Doctor, and so is his pulse,” said the nurse. She entered them on a chart.

  “Thank you, Nurse.”

  She left.

  Rusky’s eyes followed the nurse out of the room, then returned to look intently at Barry, but he said nothing.

  “Blood pressure and pulse both normal. That’s goo
d,” said Barry.

  “Aye, well, the rest of the news isn’t. I don’t want to burden you with my troubles, Doctor.”

  “If all patients thought that way, you’d put me out of a job, Rusky Peters. Tell me how you feel. It always helps to get things out in the open.”

  “The whole thing, Doctor, it’s worser than last time. From the knee down, I can’t feel nothing, and the leg’s the same colour my toes was. I’ve got gangrene in my left leg below the knee. Both the houseman here who admitted me and one they call the surgical registrar told me I’d have til see the consultant surgeon, Mister Wilson.”

  “I’ve worked with Mister Wilson. He’s an excellent man.”

  “He’s been and examined me and he wants an opinion from my haematologist, Doctor Nelson, but that was all they said.” Rusky Peters’s voice cracked. “I’m sure it’ll have til come off.” He took several deep breaths, banged his fist on the blanket. “They’re just whittling me away piece by bloody piece.” And he gazed up with the look of a man about to face a firing squad. Barry thought, Why is it so difficult to tell a patient what they suspect and give them a chance to try to come to terms instead of keeping them in suspense? Rusky’s “I’m sure it’ll have til come off,” was really a question, not a statement. What harm would it do to tell him? Barry opened his mouth, but the door opened, and Doctor Gerry Nelson, accompanied by his registrar and another nurse, came in. “Hello, Barry,” Doctor Nelson said. “You’re looking a lot better than the last time I saw you. You the houseman here now?”

  “Thank you, sir, and no, I’m on 5 and 6. Mister Peters is a friend. May I stay?”

  “Of course.” He moved to the bedside. “Hello, Mister Peters. Sorry to see you back.” He inclined his head. “And you know my registrar, Doctor Muz Khan.”

  “Hello, Doctors.”

  “Once I’ve confirmed your history, Mister Peters, I’m going to examine you and tell the young doctors what I find, then the three of us are going to leave you alone for a while so we can consult.”

  Barry waited as Doctor Nelson made his examination. When Rusky pulled up his left trouser leg, Barry gritted his teeth. The lower leg was a dusky blue-black, darker in the remaining toes and in the stumps of the missing great and next toes.

  Doctor Nelson put his fingers on the instep just below the ankle. “No dorsal pedal artery pulse.” He pressed. Hard. “What do you feel, Mister Peters?”

  “N-Nothing, Doctor. Nothing at all.”

  This was bad, but it was not unexpected.

  “Please undo your pyjama cord.” Doctor Nelson slipped his right hand under the material and felt in the groin. “I can feel the pulse of the femoral artery.”

  That was the main blood supply to the leg. There was no blockage there.

  “Please roll on your right side.” Doctor Nelson put his right fingertips into the hollow behind the left knee. “No popliteal artery pulse.”

  No doubt Willoughby Wilson had found the same. “Thank you, Mister Peters. Nurse, can you make Mister Peters comfy while we go and discuss the findings?”

  Rusky stared at Barry, who caught the pleading in the man’s gaze, a look that to Barry said, Come back and talk to me. Barry nodded.

  He followed the two doctors out into the corridor and down the hall. Who was going to break this horrible news to Rusky? Since Barry’s own bout with the unknown two months ago, he had believed as an item of faith that patients were entitled to the truth about their condition. How did anyone tell a man of only fifty-six, a man who Jan had told Barry over a coffee in the staff cafeteria had been overjoyed to be back at work a week ago? Rusky was as much a friend as a patient. How did you tell him he was going to lose his leg above the knee? Barry took a deep breath.

  “Right,” said Doctor Nelson as the three men headed into the clinical room and arrayed themselves around a small table. “You both know the clinical findings. No question. That leg has to go, and Willoughby Wilson has already made that decision. He wants us to comment on the patient’s haematological status. The houseman in casualty ordered a complete blood count. I’ll read each significant result and, Barry, as I recall, you seemed too distraught to tell me what a Paul-Bunnell test meant when you were sick. But I’d like you to comment on each result.”

  “Yes, sir.”

  “Red cell count: in excess of one hundred million per cubic millimetre.”

  “It should be less than six-point-nine million.”

  “Correct. White cell count: twenty thousand.”

  “Normal range four point three to ten point eight thousand, so twice normal.”

  “Yes. Platelets: five hundred thousand.”

  “Wow. Upper normal’s three hundred and fifty thousand. And we already know he’s got polycythaemia.”

  Doctor Nelson nodded. “But the question is, is he fit for surgery?” He turned to Doctor Khan. “Muz?”

  Muz Khan was a tall man from Islamabad who had won the hardly ever awarded first-class honours in finals three years ago. “No. With so many cells, the capillaries are congested and liable to bleed. It could be difficult to keep the stump from oozing.”

  That was the paradox of polycythaemia. Too many blood cells could and did form clots that blocked major vessels, which was why Rusky had a gangrenous leg. But as Muz had just said, it could also cause bleeding from the smallest blood vessels.

  “And you’d suggest?”

  “Reduce the count by bleeding him. Take off a pint, then he’ll be fit for surgery. There’ll still be a higher risk of capillary oozing, but I’m sure Mister Wilson will be well aware of the risk—he did the toes amputation—but the incision should be drained so no blood collects under the flaps. I’ll speak to Mister Wilson’s registrar, collect my gear from our unit, and come back to do the phlebotomy to reduce the red cell count.”

  “Fine, Muz. Thanks.” Doctor Nelson turned to Barry. “Any questions?

  “The medicine is clear, sir. I admitted the patient through casualty back in August, so I read up about polycythaemia then. Mister Peters suspects he’s going to lose his leg.” And as is often the case, Barry thought, some junior on ward 10 would stop by, deliver the news, and move on. “I’m not on his ward, but—” He thought of John Geddes’s words: “A lot of patients succumb. I don’t mean to sound callous, but for your own sanity, you have to develop a fairly thick skin. Do not get personally involved.” Well, John Geddes be damned. “He knows me. May I tell him what’s in store?”

  “Please do. But may I ask—you say the man is a friend. Did you know him before he was admitted?”

  “No, sir.”

  “Then this friendship, as you call it, has sprung up while he was in hospital.”

  “That’s right. I knew his daughter before. She’s a staff nurse here.”

  “I see. Well, I’m happy for you to tell Mister Peters about the amputation, but I must caution you, Barry. There is a fine line between compassion and getting too close to your patients. Be sure you learn to walk it wisely.”

  “I will, sir. Thank you.” It was conditional, but that was all the permission Barry needed.

  “You carry on, Barry. Come on, Muz, we’ll have a word with Sister, and you brief the registrar.”

  The three men left the clinical room, Barry to go back to the side ward.

  “Thanks for coming back, Doctor Laverty. I appreciate it.” Rusky gulped. “Are you going to tell me what’s going til happen?”

  Barry nodded and took a seat by the bedside. “I am.”

  “So, what’s the verdict?” Rusky’s smile, which was clearly forced, must hide his fear. “Would you shoot me if I was a horse?”

  Barry took a deep breath and steeled himself. “Rusky,” to hell with formality, “you know as well as I do your disease has got worse.”

  “I was due for another bleeding next week. It seemed to be working, but…”

  “Doctor Nelson wants to get that done today, so Doctor Khan’s gone to get the gear. He’ll be back soon.”

  “That’s no
t bad. Just a wee jag in your arm, and I know the headache’ll go once it’s done.” He shook his head then pointed down. “But I suppose the leg’ll have to go?” His voice shook.

  Barry nodded. “I’m afraid so. I’m truly sorry.”

  “Och, Jasus.” Rusky Peters took a deep breath. “Life’s not very fair, is it, Doctor Laverty?”

  “You’re right. It’s not.”

  Ulstermen weren’t supposed to cry, but Rusky’s eyes filled and tears spilled onto his cheeks.

  Without thinking, Barry put his arms round the man’s shoulders and felt him shake. There were no words of comfort that would not sound trite.

  Rusky stiffened. Straightened his shoulders. “Sorry about that,” he said, and wiped his nose on the back of his hand. “Thanks, Doctor Laverty. Thank you very much. It is better to know the truth, so it is, than lie here hoping it’s not so and worrying yourself sick.”

  Barry had to agree, although in his case the truth had come as a relief.

  “Does Jan know?”

  “I’ll nip up to 22 and tell her.”

  “Thanks, Doctor.” Rusky’s voice held supplication. “And you’ll come and see me after the operation? Talk to the missus and me, like?”

  “I will. I promise.” He put a hand on Rusky’s shoulder. “But I’ll have to leave you now, see Jan, and get back on duty.”

  “Fair enough.” And Rusky Peters rolled on his side and closed his eyes.

  You poor bastard, Barry thought as he walked down the ward, and you are right, Rusky. Life isn’t fair, but I hope I’ve helped you a little, my friend. There was some satisfaction in that.

  25

  Let Us Hope for Better Things

  May 12, 1969

  Barry paid the cashier, picked up a tray on which sat two cups of coffee, and headed back to the alcove in the Royal Victoria’s The Caves, the under-the-wards cafeteria. Sue was waiting in a partially enclosed semicircular booth, and as usual the room was humming with the conversation of nurses, medical students, physios, radiographers, and junior medical staff. Barry set Sue’s cup and saucer in front of her, put the tray on the table, and sat beside her. He shook his head and laughed. “You and your ‘I don’t want to be a second late for our appointment with Doctor Harley.’”