Mr. O’Hagan’s hymn rose an octave, but he made no other sound.
Barry fed in more of the catheter until he felt the tip hit something solid. He took a deep breath. This would be the tricky bit: getting past the obstruction of the enlarged prostate where it clasped the urethra at the neck of the bladder. He nudged the near end of the red rubber tube over the basin’s lip.
Next he used his left hand to lift the flaccid organ to a vertical position, and he pushed with his right. The second he felt any advance, he dropped his left hand and pushed harder with his right.
Mr. O’Hagan’s single note climbed the scale as the catheter slipped in and bright urine gushed into the basin.
Barry couldn’t help thinking of Madame de Pompadour’s words, “Aprés nous, le déluge.”
Mr. O’Hagan sighed, and Barry glanced up to see a toothless smile.
He used his left hand to exert gentle suprapubic pressure and then waited; when the flow into the basin finally stopped, he slipped the catheter out.
“Boys-a-dear,” said Mr. O’Hagan. “I’ve had that there done a brave wheen of times, but . . . It’s Doctor Laverty?”
Barry nodded.
“Well, young fellah, you’ve a quare soft hand under a duck, so you have.”
Barry smiled, not only at the quaint Ulsterism meaning gentleness, but also because the procedure had gone so smoothly.
“Aye,” he heard Mrs. O’Hagan say from over his shoulder. “And nary a drop spilt on my clean counterpane neither.”
Barry tidied up his equipment, stripped off his rubber gloves, and said, “Try to have a decent night’s sleep, Mr. O’Hagan. And if it happens again don’t hesitate to ring before it gets too bad. I’ll give the hospital a call in the morning to see if we can get them to speed things up.”
“I’d appreciate that, Doc,” the old man said, “but never you worry. If I need it done again, you can come round anytime, so you can.” He smiled.
“Fair enough.” Barry picked up his bundle. “Time I was off.”
“I’ll see you out, Doctor Laverty.” Mrs. O’Hagan left, carrying the half-full bowl. “I’ll just flush this and turn off the taps.”
Barry had wondered about the running taps. He waited in the hall until she came downstairs.
“Would you like a wee cup of tea in your hand, Doctor?”
“No thanks, Mrs. O’Hagan.” Barry was gratified to have been invited. “But I do have a question.”
“Fire away.”
“Why was the bath full and the taps running?”
“Och, Doctor dear,” she said, “we don’t like to disturb people at night, and Doctor O’Reilly had taught us a few wee tricks that work for my man sometimes, so we were giving them a go first.”
Barry waited.
“Aye. Sometimes if Kieran hears the taps running he sort of comes out in sympathy.”
Barry smiled. He’d seen the same trick used to get a patient’s slow bladder going in the hospital, particularly on the gynaecology ward.
“Sometimes if I sit him in the bath . . .”
That was a new one.
“But tonight, divil the bit of use was either.” She beckoned with her finger, and Barry had to bend to hear what she was whispering. “I shouldn’t be telling you this, but you’re a doctor and all, so you are.”
Yes, I am, Barry thought, and it’s nice to have someone notice.
“Well, last week we’d the plumber in to fix the kitchen sink. There was a wee air lock in the water pipe, so there was.”
Barry frowned. Air lock?
“I reckoned maybe Kieran had one . . . now you’ll not tell nobody?”
“Of course not.”
“I tried what worked for the plumber, so I did. I took hold of Kieran’s willy . . . you’re not to laugh . . . and I tried blowing up it . . . the way the plumber did.”
The mental picture of this tiny old woman huffing and puffing into her husband’s penis was almost too much for Barry. He just managed to control himself.
“It didny work so we’d to send for you. We’re main glad you come, so we are. I hate to see my man suffer.” There was a tear on her cheek.
“Glad to help,” Barry said, opening the front door.
“Another wee thing, Doctor Laverty . . .”
“Yes?”
“Don’t you pay no heed to what folks is saying about you. Me and Kieran’ll tell them they’re full of shite, so we will.”
“I appreciate that, Mrs. O’Hagan. I really do. Now,” he said, starting to leave,” I really must be running along.”
He opened Brunhilde’s door, chucked the used pack on the passenger seat, and climbed in. He knew he was smiling broadly, certainly because he could still picture Mrs. O’Hagan’s dramatic attempts to ease her husband’s suffering, but also because of what she had just said.
As he started the engine, Barry wondered had O’Reilly simply wanted to be on his own for a while after confiding a little to Barry about a loss that still troubled the big man? Perhaps. Or was he being devious? O’Reilly would know there were few more grateful patients than those suffering from acute urinary retention once the pressure was relieved. Was that why he’d sent Barry out on his own?
He pulled away from the kerb. If that had been O’Reilly’s plan, it was working. It wouldn’t take many more grateful patients like the O’Hagans to start getting him back on his feet with the locals—and by Friday he’d know how well Colin Brown’s cut had healed and how the treatments of Fergus Finnegan’s conjunctivitis and Myrtle MacVeigh’s pyelonephritis had turned out. Perhaps he’d have a couple more supporters by then.
Barry left the housing estate and drove along Main Street past the lighted windows of the tobacconist’s, the shop that stayed open later than any of the others, and past the darkened windows of the greengrocer, the fishmonger, and the hardware store. He stopped at the traffic light.
The windows of the Mucky Duck were frosted glass, but illuminated by the lights from within he could read the words etched in the glass:
Black Swan
William Dunleavy, Proprietor
Licensed for the Sale of Porters, Stouts, Ales,
Fine Wines, Spirits, and Tobaccos.
He’d half a mind to pop in for a beer, but he hesitated. It was too soon to risk going in, hearing the conversation die, and feeling every eye on him.
He drove on through the green light. O’Reilly was almost certainly right. Patience and a few more grateful patients, and Barry wouldn’t need to feel he had to go from.
He sighed as he parked in the dark back lane. The trouble was, if he was successful in reestablishing himself here in Ballybucklebo, he was going to find it a damn sight more difficult to go to.
Rich and Rare Were the Gems . . .
“Oh Lord,” O’Reilly groaned, peeping through the crack as he held the waiting room door ajar. “Not him. Not on a Tuesday.”
Barry couldn’t see past O’Reilly. “Who, Fingal?”
“The all-high mucky-muck of Ballybucklebo, His Serene Highness, Worshipful Master of the Orange Lodge, Great Panjandrum, and probably first cousin to the Lord of the Flies . . .”
Barry smiled. “Would that be Beelzebub or Councillor Bishop?”
“Bishop. In the flesh,” said O’Reilly, just before he opened the door. “If only that lump of ‘too too solid flesh would melt.’ ”
Hamlet, Barry thought. He heard the chorus of “Good morning, Doctor O’Reilly,” and O’Reilly asking, “Right, who’s first?”
“Who the hell else would it be, O’Reilly?” Barry recognized the councillor’s voice. “Me and the missus have waited long enough, so we have.”
“It’s not quite nine yet,” O’Reilly remarked, “but I’m sure your time is precious. Do come along.”
Barry went into the surgery and sat up on the examining couch. Whatever small start he might be making to reestablish his reputation in the village would not be improved by this consultation. He waited until O’Reilly took his seat
in the swivel chair. Fingal’s nose tip was pallid, reflecting like the upper tenth of an iceberg the dangers lurking beneath the surface.
Councillor Bishop strode in, much, Barry thought, as it is given to a man of five foot four and a good fourteen stone to stride. He wore his customary black suit and across his belly a watch chain from which a miniature, gold Masonic set-square pendant swung. The councillor did not have the courtesy to remove his bowler hat. He sat down hard in one of the wooden chairs, tucked his thumbs under the lapels of his jacket, and without bothering either to turn around or to acknowledge Barry’s presence, snarled, “Would youse get a move on, Flo? I haven’t got all day.”
“Coming, dear.” Mrs. Florence Bishop’s voice was expressionless and as grating as cinders under a door. Kinky had described Florence as one of “nature’s unclaimed treasures” in an effort to explain why a basically decent woman would have settled for marrying a man like Bertie Bishop. It was no secret why he’d married her—for the money she’d inherited.
Florence was probably in her early forties but looked ten years older. Her hair was short, listless, and a peculiar red that could only have been achieved by the liberal use of henna. Her left eye had difficulty remaining aligned with her right, and her floral dress must have been tailored by a company specializing in bell tents. She had calves, Barry thought, like a Mullingar heifer’s, and the flesh of her ankles bulged over a pair of low-heeled brogues.
Barry heard the second wooden chair complain when she sat. From where he was perched, the couple reminded him of Sir John Tenniel’s drawings of Tweedledum and Tweedledee for Through the Looking Glass.
“You took your time,” the councillor said.
“Sorry, dear.”
“And what seems to be the trouble?” asked O’Reilly civilly, looking the councillor in the eye.
“There’s nothing wrong with me, so there’s not. She’s just not up to much. I want you to fix her, O’Reilly.” He seemed to be unaware of his wife’s presence. Barry noticed that Fingal’s recent threat to “gut the councillor like a herring if he forgot it was Doctor O’Reilly,” did not seem to be carrying much weight. Of course, O’Reilly’s ace had been trumped now that it was no longer possible publicly to accuse the councillor of hanky-panky with Julie MacAteer. “And don’t waste your time asking her what’s wrong. She can’t hardly get a sentence out of her.”
Barry sat forwards. Something about the inability to do that rang a tiny bell. He listened intently.
“You’d think she was working on a trade union’s go-slow. She can’t finish a job about the house . . .”
“Sorry, dear . . .”
“And since that Julie MacAteeer, the wee tramp, quit, we’ve no maid, and there’s no one but Flo to do the work.”
“Sorry, dear . . .”
“Houl’ your wheest, woman. I’m talking to the doctor.”
Barry saw her flinch.
“Come the end of the day she’s about as much use as a fart in a high wind. She gets as weak as water.”
“I don’t suppose you’d think of giving Mrs. Bishop a hand?” O’Reilly asked.
“Me? Away off. I’m far too busy.”
Barry frowned. Weakness, inability to finish a task, or a sentence. Damn it, those symptoms were common in a rare neurological disorder, but he couldn’t remember which one. There was another associated symptom and it was . . .
“I’m sorry to hear that, Florence,” O’Reilly said gently. “I really am.” He put a hand on her knee.
“She’s been like that for the last six months. Never mind your sympathy. Do something.” Bishop pulled out his fob watch, flipped open the lid, and scowled at the dial.
Barry felt like a villager waiting on the lower slopes of Mount Vesuvius for the inevitable eruption, but O’Reilly’s virtually guaranteed seismic cataclysm failed to occur.
“I think,” O’Reilly said, rising, “we’d better take a look at you, Florence.”
“Get on with it then.” Bishop made no effort to help his wife stand.
“I wonder if you shouldn’t consult the vet next time, Mr. Bishop?” O’Reilly remarked.
“What are you on about?”
“Vets make diagnoses in patients who can’t explain their symptoms by themselves.”
“Just get on with it. I’m in a hurry. I’m going to be late.”
“ ‘For a very important date,’ no doubt,” said O’Reilly. Helping Mrs. Bishop to stand, he guided her to the examination couch.
Barry, hopping down from the table, had a vivid mental image of Councillor Bishop as the rabbit in Walt Disney’s version of Alice in Wonderland, but he refused to let it distract him from watching O’Reilly carry out a rapid, yet thorough, examination.
O’Reilly frowned. “Come on down,” he said, offering Florence an arm to lean on. With one eyebrow raised, he glanced at Barry and gave an almost imperceptible shrug, as if to say, “Buggered if I know.”
Weakness, inability to finish a task or a sentence, no obvious physical findings? Barry screwed his eyes shut. Sometimes when he did, a remembered page of a textbook would appear. He vaguely saw something about demonstrating pathological fatigue. “Doctor O’Reilly?”
“Yes.”
“May I ask Mrs. Bishop something?”
“Go right ahead.”
“Is it hard to chew?”
“Aye,” she said. “And I love my vittles, so I do.”
Barry smiled at her. “This is going to sound a bit daft, Mrs. Bishop, but could you raise your arm above your head about thirty times?”
She glanced at O’Reilly, who nodded.
“Right,” she said. She started to do as she was asked.
“How much longer is this going to take?” Bishop demanded. “I didn’t come here to watch you put Flo through a bunch of physical jerks.”
“Doctor Laverty?” O’Reilly asked.
“Only a bit longer.”
Barry watched Mrs. Bishop start to sweat, and after twenty repetitions she heaved a deep breath and said, “I can do no more. My arm’s banjaxed.” It hung limply by her side.
“God almighty,” Bishop said, “didn’t I tell you she gets tired?”
“Indeed you did, Bertie,” O’Reilly remarked. “I wonder why?”
Barry wasn’t sure if O’Reilly was struggling to make a diagnosis or hinting that having to live with the councillor would tire an Amazon, never mind an overweight woman like his wife.
“Doctor Laverty,” she said, “I think I can get my arm up again. Should I?”
“Please.”
She lifted it.
“That’s grand,” he said. “Thank you.” He noticed the damp stain in the armpit of her dress.
He was almost certain now. Her symptoms and how she tired rapidly but recovered equally rapidly were typical of—he knew, he knew—but damn it, he still couldn’t quite remember what the disease was. Barry glanced at O’Reilly, who simply shook his head.
“Mrs. Bishop,” Barry said, hating to have to admit defeat, “I think we’ve a pretty good idea what ails you.”
“About bloody time,” the councillor grunted. “What is it then?”
“I’m not exactly sure but—”
“No bloody wonder.” The councillor stood. “A right waste of time this, O’Reilly, so it is.”
“I think,” said O’Reilly, “Doctor Laverty said he wasn’t sure.”
“Aye. And we all know what that means. Laverty’s a useless bugger.”
Barry flinched but inwardly refused to let Bishop’s scorn rattle him. He glanced at O’Reilly, who was taking a deep breath in preparation, no doubt, for giving Bishop the tongue lashing of his life. Barry shook his head and waited to see if O’Reilly would let him handle matters. O’Reilly clamped his lips shut.
Barry ignored Bishop and spoke directly to Mrs. Bishop. “Mrs. Bishop, I’m almost certain I know what ails you, but I’ll need a day or two to talk to a colleague in Belfast. Could you come back on Friday?”
He saw
her glance at Bishop, who shook his head and muttered under his breath.
“Or,” said Barry, “we could send you up to the Royal for a second opinion from one of the consultants.” This is what he and his contemporaries used to refer to scornfully as “kicking for touch,” the safest tactic in a game of rugby football, and in medicine, to some degree, an admission of professional failure.
“Do both,” snapped Bishop. “I want this sorted out as quick as possible, and them highheejins at the Royal have waiting lists as long as Bangor Pier.”
Barry had to admit that the suggestion made sense. He saw O’Reilly nod in agreement.
“All right,” he said. “Mrs. Bishop, please don’t overtire yourself. Come back on Friday, and in the meantime I’ll arrange things at the Royal.”
“Is that it?” Bishop demanded, consulting his watch. “Are you done?”
“I am, Mr. Bishop.”
“Come on then, Flo.” Bishop grabbed his wife’s arm and hustled her to the door. “I’ve to get things sorted out about the Black Swan.”
“And a very good morning to you too, Councillor,” O’Reilly said to the departing backs. “Do close the door after you.”
The door swung shut.
“Gobshite,” O’Reilly growled. “Unmitigated gobshite.” He pulled his half-moon spectacles down his nose and looked over them at Barry. “I thought you handled him very well by the way.”
Barry glanced down.
“So,” O’Reilly asked, “what do you think’s the matter?”
Barry hesitated. “I never was much of a hand at neurology.”
“Nor me,” said O’Reilly. “I always thought it was a race between the clinicians when the patients were alive and the pathologists after they’d died to see who got the diagnosis right.”
Barry smiled. “When I spent my time on that service, we reckoned that the right diagnosis depended on who made it. The more senior the neurologist and the more sonorously he made his pronouncement, the more likely he was to be believed.”
“Sure all of medicine’s like that,” O’Reilly said. “The way we were taught, a thing was so because the professor said it was.” He stood and stretched. “Did you ever read a book called The Cry and the Covenant?
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