An Irish Country Family--An Irish Country Novel

by Patrick Taylor

  They should be there in about two minutes, taking a left up Grosvenor Road, a right turn down the Falls, and a left onto Conway Street.

  Barry took inventory. There was the ECG machine and the portable defibrillator. The nurse was flanked on one side by a storage cabinet and a case containing resuscitation gear and on the other by a case containing drugs. All was in order.

  “Nurse Logan, when we get there you bring the drug case, Jim, the resuscitation gear, and I’ll bring the ECG. The driver knows to put the defibrillator on the trolley and wheel it in.”

  “We’re here,” the driver yelled as he braked.

  Barry and his team bailed out and ran into the house.

  “In here,” a man’s voice called.

  Barry led the way into a front parlour.

  A man of about fifty with grey eyes and a short moustache was kneeling, taking the pulse of a pale and sweating middle-aged man lying on the floor. His pupils were constricted and he was fully conscious, which Barry knew meant he wasn’t fibrillating. At once Barry felt the rush of his adrenaline start to slow down.

  “That was quick. I’m Doctor Halliday, by the way. I’ll brief you. Brendan Kerr here is fifty-eight. His wife, she’s in the kitchen, phoned me ten minutes ago to tell me Brendan had complained of a crushing pain in his chest, radiating down his left arm, and had collapsed on the floor. My surgery is just around the corner so I phoned the hotline as we’d been taught by Doctor Geddes on the Sunday-morning course, and headed here.”

  As Doctor Halliday spoke, Barry was plugging the ECG machine into a house electricity socket and his team members were opening their cases.

  “I got here five minutes ago. His pulse was regular but a hundred and ten beats per minute, he was pale, sweating, and his blood pressure was only one hundred over seventy. I gave him fifteen milligrams of morphine intramuscularly”—that would account for the constricted pupils—“and twenty-five milligrams of Largactil orally as an antiemetic.”

  “Absolutely right,” Barry said, a little embarrassed that he, a houseman, should be praising an experienced GP. He bent to his work. “Sorry, but this is going to sting, Mister Kerr.” He inserted the first of four ECG needle electrodes, one for each limb, and with each the patient sucked in his breath.

  “Excuse me, sir.” The driver stuck his bus-driver-capped head round the door. “The trolley and defib are in the hall.”

  “Thank you,” Barry said. “Leave them there for the minute. Jim, can you put up the intravenous dextrose, please?” And as the student, assisted by the nurse, bent to his task, Barry switched on the ECG machine. It whirred, and from a slot in its side, a narrow strip of pink graph paper inched its way along. Barry was no world authority on reading these strips, but this one showed the classic distortions of the tracing that indicated an anterior wall infarction, a blockage of one of the coronary arteries that supplied oxygenated blood to the heart muscle. “Your diagnosis was spot on, Doctor Halliday. Thank you. Excuse me for a minute.”

  Barry went into the hall. “We’ll not need the defibrillator. Please return it and come back with the trolley so we can get Mister Kerr into the ambulance.”

  “Right, sir.”

  In very short order, Doctor Halliday had explained matters to Mrs. Kerr and had helped her into one of the two seats at the front of the body of the ambulance. Barry disconnected the ECG leads from the machine but left the needles in situ so the patient could be reconnected once aboard and continuously monitored. Barry carried the machine into the ambulance.

  Meanwhile, the driver and the student had loaded Mister Kerr onto the trolley, and with the nurse holding the intravenous bottle above, moved into the ambulance. The nurse and student returned to the house to collect the two cases, and by the time they had replaced them, closed the door, and taken their seats, Barry had reconnected Mister Kerr to the ECG machine and plugged the defibrillator into two twelve-volt batteries. The siren blared and off they set for the return trip. Barry was running the ECG strip through his hands when Mister Kerr made a strangling noise and his eyes rolled up.

  Mrs. Kerr muttered, “Jesus wept,” and started to cry, and the spiky patterns on the graph paper were replaced by a continuous series of low wiggles. “He’s fibrillating,” Barry said, switching on the defibrillator. He’d waste no time giving CPR. He grabbed the two defibrillator electrodes and held them for the nurse to smear them with KY jelly. He placed one on the upper right-hand side of Mister Kerr’s left chest and one over the lower left. “Everybody clear.” Quick visual check. Right. He triggered the machine. The patient twitched and, half turning, Barry was able to see that the tracing had reverted to its earlier series of periodic jagged spikes. He heard the patient haul in a deep breath, and his eyes were open.

  Barry was jubilant. One shock, just one, and he’d brought the patient back. No, he corrected himself, he and his team had. “Well done, everybody,” he said. He was panting, sweating, and wondered what his own heart rate was. This defibrillating business certainly pumped out the adrenaline.

  “What happened?” Mister Kerr said in a small, weak voice. “I feel awful.”

  The ambulance had drawn up outside the ambulance room.

  “We’re at the hospital, Mister Kerr,” Barry said, “and we’re going to get you admitted, then I’ll explain.” While his medical team waited for the driver to come back with another orderly, Barry removed the needle electrodes, turned off the ECG, and tore off the paper strip for further study by the senior cardiologists.

  Once inside the ambulance room, the driver and his mate, accompanied by a nurse and Mrs. Kerr, wheeled Mister Kerr into a cubicle and drew the curtains. The nurse would begin the admission procedure.

  Barry said, “Thanks for all your help. Pretty dramatic, wasn’t it?”

  “Absolutely,” said the student. “I’m still all jittery.” He smiled. “I think I need some grub. Hope there’s some dinner left in the East Wing.”

  “Well, I’m late getting off duty,” said the staff nurse. “It’s not quite as exciting after you’ve done a few.”

  Barry went behind the curtains.

  Mister Kerr had been transferred to the hospital trolley and the student nurse was taking his blood pressure.

  “You did a great job, driver. Thank you.”

  The driver laughed. “We call it the flying squad, sir, but the locals are already calling it the ‘firing squad.’”

  Barry, still collecting himself after the dramatic race to Conway Street, found himself laughing, probably to release the tension, and had to control himself before helping a tearful Mrs. Kerr into a chair at the head end of her husband’s trolley.

  “Sorry to seem to be ignoring you all this time,” Barry said, “but we had to act at once back in the ambulance, and now we have to get your husband admitted.”

  “That’s all right, Doctor,” Mrs. Kerr said. “Doctor Halliday explained that my Brendan, God love him, had had a heart attack.”

  “Yes, he has.”

  A second nurse came in. “Hello, Doctor Laverty? What have we here?”

  “In brief, anterior wall infarction. Ventricular fibrillation successfully treated.”

  “I see,” she said. “I’ll send Doctor Sloan in the minute he’s finished with another patient. It won’t be long.” She left.

  Barry glanced at his watch and felt as if his own heart had received an electric shock. Damn it to hell. Six thirty. He was going to be late again. A week ago he’d promised, come hell or high water, to take Virginia to see Barbra Streisand and Omar Sharif in Funny Girl tonight. He was to have picked her up at six thirty at Musson House.

  Mrs. Kerr brought him back to the present. “I seen a programme on TV about bringing people back from the dead by giving them electric shocks. I think that’s what you done, sir. You saved my Brendan’s life, so you did.” She stroked her husband’s forehead.

  “Well I—”

  “Don’t you be shy, sir. I thank you from the bottom of my heart.”

&n
bsp; Barry smiled and, now wanting to get away to Musson as quickly as possible, said, “Thank you, Mrs. Kerr. It’s my job.”

  Harry Sloan entered. “Doctor Laverty. You’ve brought me a coronary?”

  Now in a rush, Barry said, “Mister Kerr, fifty-six, had an anterior wall infarction about an hour ago, here’s the tracing.” He gave the ECG strip to Harry. “He was given fifteen milligrams of morphine and twenty-five milligrams of Largactil and was defibrillated in the ambulance coming back here.”

  “Right,” said Harry. “I’ll take over. Do the admission. You go and get your tea.”

  “Thanks, Harry.” Barry spoke to Mister Kerr. “This is my colleague, Doctor Sloan. He’ll admit you to—?”

  “There are no beds in the coronary care unit, so we’ll monitor you here in casualty and arrange a transfer to the coronary care unit as soon as possible,” Harry said.

  Even if that happened in the next few hours, Norma, who was going to cover him from six on the ward, could cope, so as of now Barry really had no more responsibility. “I hope you’re feeling much better soon, Mister Kerr,” he said, and left at the run for his room.

  At least The Huts, three minutes from casualty, were on the way to Musson House, but he’d sweated doing the defibrillation and needed to change his shirt. He barged into his room, stripped off the shirt, sponged under his armpits, dabbed on a bit of deodorant, and flung on a clean one. No point wasting time trying to phone. There were only two lines for the student nurses and they were almost invariably busy.

  As he gave his face a lick and a promise, knotted his tie, and put on a sports jacket, he thought about how he had tried to make things up with her since they’d dined at the Causerie in early November. He’d managed to see her nearly every week. They’d been to see Lawrence of Arabia, and last Friday had been the Queen’s University Boat Club formal in the Sir William Whitla Hall on campus.

  He raced out the door, running to the adjacent car park. The strains of the Hank Williams song “Half as Much” pursued him as he left The Huts.

  If you loved me half as much as I love you

  You wouldn’t worry me half as much as you do.

  He fired up Brunhilde, sped over to Musson, parked, and got out. No Virginia. He took a deep breath and began to climb the steps to where Joe the night porter stood. “Good evening, Doctor Laverty. Can I help you?”

  “I was meant to pick up Nurse Clarke at six thirty.”

  “I know, sir. She waited here for ten minutes and went back in. I could let her know you’re here.”

  “Thanks, Joe.” Barry paced back and forth until Virginia appeared. Joe, it seemed, must have sensed trouble and had not accompanied her. She was wearing a grey pantsuit with bell bottoms. It was December but she had no coat and Barry found that disconcerting. Damn it all, he was only fifteen minutes late.

  He started toward her. “Virginia, I—”

  She moved back. “You what, Barry? Had to save another life?” She folded her arms in front of her chest.

  “Virginia. I explained to you a month ago that I had to cover for John Geddes if he wasn’t available to go out with the cardiac ambulance. The call came at five to six. I had no choice. None at all, nor any way to let you know. I’m sorry.”

  She shook her head. “Barry. Barry. I really did think I’d fallen in love with you, but we’ve been going out for four months—”

  “I am in love with you, Virginia.” Barry’s mouth was dry, his palms sweating. “Don’t throw it away. Please.” He could feel his heart racing for the second time tonight, an ache building in his chest. “Please.”

  She unfolded her arms. Let them hang loosely by her sides. “Four months, Barry, and you’ve let me down again.” Her voice was flat.

  “I know. I’m sorry.”

  “At our age, a couple like us can decide to have fun together for a while then go their separate ways, or consider making a lifelong commitment.” She took a deep breath. “You told me at the Causerie you were pretty certain you were going to try general practice.”

  “Yes.”

  “Where you could get to know all your patients the way you got to know Mister Peters?”

  “Yes.”

  “Where your wife and family, if you had one, would be expected never to know when you might be called. Always have to take a backseat to your patients.”

  Barry didn’t know how to reply. He hung his head.

  “Barry, I’m going to miss you, for a while. I’m sorry because I know I’m hurting you now, but I have to think of me. My life. My future. I just don’t see it being with a man like you.”

  Barry took a deep breath. Looked at her green eyes and saw nothing but resolution.

  “Barry, I’m sorry, but it’s over. Good-bye.” She turned and he simply stood watching as Virginia Clarke walked into Musson House and out of his life.

  29

  Telling the Saddest Tale

  May 24, 1969

  Barry, parked outside the Galvins’ house, glanced down at the letter that sat on the passenger seat, then up to the door. He wasn’t sure why he’d brought the letter. It was a standard notice from specialists to a GP about a discharged patient, but reading it ten minutes ago had prompted a slight change in his plans for the afternoon. He had kissed his wife, briefly explained where he was going, secure in the knowledge that she could accompany Fingal and Kitty to the sporting club, and headed to the car, still clutching the letter.

  The door opened and Guffer came out to the front step. Barry climbed out of the car as Guffer Galvin walked slowly toward him. “Och, Doctor Laverty. It is you. What are you doing here on a Saturday?”

  “I just got a letter from Marie Curie telling me Anne was discharged yesterday. How is she?”

  “Come in.” Guffer retraced his steps and stood aside as Barry walked up the path and through the front door. “I have her in her bed.” He led Barry into the familiar living room where three ceramic mallard, garishly painted and decreasing in size, flew up at an angle on the whitewashed chimney breast.

  “Have a seat, Doctor, and I’ll tell you what I know.” Barry sat on the sofa and Guffer on a chair opposite.

  Guffer sighed. “That there radiation has been very rough on her. Quite a bit of throwing up. You can see for yourself how she looks when I take you up til her. The doctors there were great and they’ve not told her what they told me. I think that’s kinder. They told me to understand that while the puking was due to them trying til stop the—you know. It was progressing. It was in her other lung and liver.” He stared down at the carpet for so long that Barry had to say gently, “What else did they tell you, Guffer?” Barry, who had always considered telling patients the facts to be an item of faith, decided at once to put his own opinion aside. If Guffer thought it kinder to his wife to hide the truth, so be it.

  “Dear God, it’s a hard row to hoe.” Guffer swallowed. “They said nobody can predict accurately for an individual, but their experience with patients who’ve got what my Annie has, have had surgery, and had all the radiation that’s safe til give but aren’t getting better, the outlook’s very poor. Maybe a matter of weeks. They said it was my choice. They’d look after her or she could come home.” He looked at Barry. Guffer’s eyes were full of supplication. “Weeks? She’s better in her own bed. I’ve made a couple of long-distance phone calls, told Seamus til come home at once. He’s on his way, and Pat, our older boy, he’s coming up from Dublin on Monday when Seamus gets here.”

  “Good,” Barry said. He stood, moved to Guffer, and put a reassuring hand on his shoulder. “You’ll have to be brave for her. It’s going to tell on you. I’ll do what I can. Arrange for Colleen Brennan, the district nurse, to visit every day. One of us will call regularly too.”

  “Thank you, Doctor. Thanks a lot.” He sighed and dropped his hands to his thighs, rocking himself up to standing, then headed for the door. “Will you come upstairs, please, sir?”

  Barry followed the man up a narrow staircase where a frayed tartan
stair carpet was held in place by dull brass carpet rods. The last time Barry had been here they had been polished. Guffer stood aside to let Barry into a tiny room where chintz curtains were drawn back so he could see across to rooftops, some with broken slates. Spindly TV aerials sprouted from the sides of chimneys.

  He parked himself on Anne’s bedside.

  Guffer slipped into the room and stood at the foot of the bed.

  She lay propped up on pillows and wore a pink bed jacket over a blue flannel nightie. Her head was covered by a woolly hat. Irradiation frequently caused total hair loss. Her National Health Service wire-rimmed granny glasses covered pale blue eyes that seemed to be struggling to focus on him.

  “It’s Doctor Laverty, Annie,” Guffer said.

  Her voice was reedy. “Hello, Doctor.”

  “Hello, Anne.” Enquiring after her health would be superfluous. This was not the Anne Galvin Barry used to know. Her cheeks were sunken, her cheekbones prominent through jaundiced skin as thin as tissue paper. Her right arm lying above the bedclothes was yellow-tinged too, the result of liver damage, and painfully thin, the fingers moving aimlessly. Her breathing was laboured. “Just dropped by to say welcome home. Sorry I’ve not brought Kenny this time, but I will soon.” Apart from offering the Galvins moral support and, if needed, prescribing antiemetic or pain-killing medication, there was little more any physician could do, and he knew from the letter from Marie Curie what her physical findings were, of weight loss, liver enlargement, and consolidation of the lower left lung base.

  “That’s nice.”

  Barry could see that the effort to talk was tiring her. He went through the motions of taking her pulse, more so she could feel the human contact of his hand. “You’ll be glad to be home.”

  “Aye.” She managed to take Barry’s hand in hers. “Doctor. I want you—” She had to pause and catch her breath. “To do something.”