Her moaning subsided and she stood, sniffling and wiping her eyes.
O’Reilly tipped Bertie’s head back, pinched his nose, took a deep breath and, covering Bertie’s mouth with his own, exhaled into Bertie’s open mouth. Shirley Bassey was singing,
it’s the kiss of death from
Mister Goldfinger …
“Turn that bloody thing off,” he yelled, and bent to his work. He wasn’t sure how long he could keep Bertie’s circulation going with external cardiac massage and mouth-to-mouth artificial respiration—the kiss of life. But he was going to give it everything in his power, at least until he could get his hands on some medication.
Kitty knelt by his side.
“Cardiac arrest,” he said, “can you take over for a minute?”
Kitty, senior nurse that she was, did, and Fingal stood. “Jenny, Bertie Bishop’s in cardiac arrest. Run out to my car, get my bag, bring it here. Your legs are younger than mine.” Just about the same thing Doctor Corrigan had said to O’Reilly back in 1936.
“Right.” She tore off.
The music stopped. People stood in little groups, clearly wondering aloud what was going on. Conversation was muted. O’Reilly said, raising his voice, but keeping it steady, “Can everybody hear me?”
Murmurings of assent.
“Right. Councillor Bishop has been taken ill.” O’Reilly was surprised by the number of voices he heard saying, “Och dear,” and, “The poor soul” and, “Dear love him.”
“I need to give him some treatment. I hate to spoil your fun, but I think those of you with kiddies should collect them up and maybe all of you should go outside and get on with the fireworks display we were going to have later.” He yelled, “Who’s in charge of the fireworks and bonfire?”
“Me, sir,” said Donal, who had returned and stood at the marquis’s side.
“Get people moving and you and whoever’s helping you get things under way, but leave room for an ambulance to get here.”
“Right.” Donal left.
“My lord?”
“Yes?”
“You have keys to the office. When Doctor Bradley comes back, take her to the telephone.”
“Certainly.”
O’Reilly looked down. Kitty was working steadily and Bertie’s colour didn’t look bad. O’Reilly realised that Flo Bishop and Cissie Sloan were standing at his side. Cissie was holding Flo’s hand as if they were a couple of schoolgirls.
“Is he dead, Doctor?” Flo’s voice quavered.
“No, Flo, Bertie’s alive,” O’Reilly said. “But he’s had a heart attack.”
“Oh my God,” she said, “that’s desperate, so it is. Och, Bertie.” She looked down at her husband, then up at the doctor. O’Reilly laid a hand on her shoulder. “He’s very sick, Flo.” No need to tell her that the councillor’s heart had stopped and that it was touch and go. “An ambulance is coming to take him to the Royal.”
“For Doctor Adgey and Doctor Pantridge to look after again, like?”
“That’s right.”
“They’ll do their very best for him, I know that, so I do.” She sighed.
“They will.” He turned to Cissie. “Take Flo back to her table.” He glanced at a tearstained Sylvia. “And Sylvia too. Make sure Aggie’s there and stays with them while you get Flo and Sylvia neat brandies. For their nerves. I’ll come and talk to you all again as soon as I can.”
“I’ll do that, Doctor dear, and never you worry your head about it. I’ll take good care of her, so I will. Flo and me’s been friends since we was…”
O’Reilly paid no further attention and was but vaguely aware of folks moving past on their way out. He knelt beside Kitty. “You all right?”
“I’m fine.” She compressed the chest before breathing into Bertie’s mouth.
“Here.” Jenny handed O’Reilly his bag.
“Thanks. Now go with his lordship and he’ll get you a phone. Get an ambulance.”
“Right,” Jenny said, and took off at a trot.
Found it. The glass ampoule of adrenaline was where he knew it was supposed to be. In seconds he had filled a syringe with 1 mgm. He knelt beside Kitty. “Let me at his chest.”
Fingal counted down from the collarbone. He drove the long needle through the chest wall in the middle of the fourth gap between the ribs on the left, injected the stimulant directly into the heart muscle, and withdrew the needle. Work. Come on, work. He put his fingers at the side of Bertie’s neck. Fight, Bertie. Come on. You’re not the most pleasant of men, but you are a feisty bugger. Fight for your life, Bertie. There it was. Praise be. His fingers felt a pulse in the carotid artery and as Bertie’s chest began to move, the man took a deep, shuddering breath.
Bertie’s heart had started again, but he still had to be taken to the Royal Victoria at full speed where, if he went into cardiac arrest again, they had the recently introduced equipment for delivering an electric shock to the heart muscles in the hopes of getting the heart to beat normally.
O’Reilly put the used syringe into the bag. When Bertie came to, he’d experience excruciating chest pains. Just as Mister Robinson’s bound-up leg muscles were feeling the aching of oxygen lack because the blood flow to them was being interfered with, so Bertie’s heart muscle, which had been damaged by the infarction and was also oxygen-deprived, would respond. And anyone whose chest had been repeatedly shoved at by O’Reilly would not think they’d been caressed by a butterfly. He prepared and administered into the deltoid, the big muscle over the top of the shoulder, an injection of a third of a grain of morphine. Bertie flinched, moaned, put a hand onto his chest. His eyelids flickered and his eyes opened. O’Reilly laid a hand on the man’s forehead and said quietly, “It’s all right, Bertie. It’s all right. Lie still.”
The hell it was. The man’s heart could stop again at any moment. O’Reilly grabbed Bertie’s wrist. The pulse was weak but regular—now. But any one of three cardiac arrhythmias—ventricular extra-systoles, ventricular tachycardia, or ventricular fibrillation—could supervene. O’Reilly had never forgotten a patient in Dublin in 1934, Kevin Doherty, who had died of ventricular fibrillation. And it could only be reversed by that recent innovation, electrical defibrillation, at the Royal. Hang on, Bertie, until the ambulance gets here. If the force of O’Reilly’s will could do anything, Bertie would survive.
“Well done, Fingal,” Kitty said, stood, and put a hand to the small of her back. “I—”
The rest of her words were drowned out by a shrieking whistle and a series of loud bangs. A skyrocket, O’Reilly thought. Flashes flickered through the windows. Donal had got the fireworks going.
Kitty had knelt beside Bertie again and was taking his pulse. “He’s holding his own,” she said, “and the morphine’s working.”
O’Reilly glanced at his watch. Eight forty-five. Bertie’s heart still had to keep functioning for at least another hour to allow time for the ambulance—he thought he could hear a distant siren—to get here, load the patient, drive back to Belfast, and get Bertie admitted to ward five. If he fibrillated there, it could be corrected, but between now and then? Keep going, heart.
Jenny Bradley had come back. “How’s the patient?”
“As well as can be hoped, but—”
“Keep that bloody woman away from me,” Bertie said in a slow, husky voice. “Don’t want her here.”
O’Reilly looked at Jenny and shook his head.
Jenny shrugged. “It’s all—”
The row of the siren outside cut off her words and O’Reilly was sure he had heard tyres crunching on gravel. The siren stopped.
Ambulance attendants came racing into the hall pushing a stretcher on wheels. O’Reilly frowned. Why was a nurse in the blue uniform dress and white apron of the Royal Victoria here, and who was the young doctor in a long white coat?
As the ambulance attendants arrived, stopped and waited, the nurse knelt beside and started to question Kitty, whom she obviously recognised. She clearly paid no a
ttention to the fact she was debriefing Robin Hood.
“Doctor O’Reilly,” Jenny said, “I’d like you to meet Doctor John Geddes. He’s training to be a cardiologist. John and I worked together two years ago. When I phoned the Royal, he was on duty. I spoke to him and asked him if our case was of interest to him. He had to check with his boss, Doctor Pantridge, and he gave the okay.”
Okay for what? O’Reilly wondered. No time for that now. From the corner of his eye, O’Reilly noticed the attendants loading Bertie onto the stretcher. “Pleased to meet you,” O’Reilly said, “excuse my costume,” and offered a hand that was shaken. “We’d better get Bertie aboard.”
“Right, Your Majesty, Doctor O’Reilly. No time to lose,” Doctor Geddes, a soft-spoken man said with a smile. “Can you give me his history and your findings while the attendants get him loaded? I’ll examine him there.”
“Of course. Just a tick.” He nipped over, asked Kitty and Jenny to go and look after Flo and Sylvia, and as he followed the trolley, O’Reilly gave the young man the clinical details. He finished as they reached the back of the vehicle. It was parked under a velvet firmament, where red and green skybursts hung between the constellations. It looked to O’Reilly as if the body of the Plough was for a few moments carrying a stook of blazing straw, and the air smelled of burnt gunpowder. A chorus of “oooohs” and “aaaahs” rang in his ears.
The attendants and nurse began to load Bertie headfirst into the well-lit passenger compartment.
Doctor Geddes climbed in. “We have to get going. I’ll call you. Let you know how he’s doing.”
“I understand,” O’Reilly said, still wondering why Doctor Geddes had arrived with this ambulance. Och well, Jenny could explain. Bertie clearly was in good hands and that was the main thing. He turned to go, but through the still open back doors of the vehicle he heard the nurse. “He’s fibrillating.”
O’Reilly stopped in his tracks. Damnation. There was nothing he could do but await the outcome. He couldn’t make out exactly what was happening, but could see the nurse giving the same resuscitation he and Kitty had while Doctor Geddes made methodical preparations. He flipped some switches—O’Reilly heard a deep electrical humming—then smeared jelly onto two flat metal-plated discs on plastic handles. These were attached by coiled insulated cables to a Heath-Robinson-looking device with bright lights and dials with needles like those on an ammeter. One attendant called, “Charged.”
Doctor Geddes put a padded spatula between Bertie’s teeth as might be done for a patient having an epileptic attack to prevent them biting their tongue. “Everybody clear,” Doctor Geddes said. Everyone stepped away from Bertie, except the doctor, who put the metal plates directly onto Bertie’s naked chest and held them there by pressure on their plastic handles.
Another rocket detonated high overhead, accompanied by the roar of its blast as O’Reilly saw Bertie convulsing like an epileptic. That was what the spatula had been for. Doctor Geddes must have administered an electric current, meant for the heart, but which would also cause Bertie to thrash. When he lay still, Doctor Geddes put his stethoscope to the chest. He smiled. “Sinus rhythm,” he said. “His ticker’s firing on all four cylinders again.”
O’Reilly felt like applauding, dancing a jig. He’d just witnessed the impossible. That weird-looking contraption with the two paddles must be some kind of portable defibrillator. Mirabile dictu. Wondrous things are spoken. “Thank you, Doctor Geddes,” O’Reilly called.
“My pleasure,” the young man said. “Now we’d best get him to the Royal. I’ll be in touch. Thank you for asking us to come.”
Doors were closed and with siren screaming and lights flashing, the ambulance headed back to Belfast.
* * *
O’Reilly went back into the clubhouse. All the lights were on and the once-festive decorations looked tired and tatty. The silence, broken only by the sounds of his boots on the floor, was the silence of the grave that very well might have been Bertie’s fate, but for Doctor Geddes and his crew.
The place was deserted except for Kitty, Jenny, and Terry, who were sitting at a nearby table. He joined them.
“Well?” Kitty asked.
“Bloody miraculous,” he said. “Bertie fibrillated and they shocked his heart and got him restarted on the spot.”
“I don’t believe it,” Kitty said. “Honestly? I’d heard rumours of a portable defibrillator being developed.”
“The rumours were right. Bloody marvelous. I need to tell—” He frowned. “Where are Flo and her friends?”
Jenny said, “Flo and Sylvia were very upset so I gave them each a sedative and Aggie and Cissie took them home.”
“Good.”
She rose as if to go.
“Hold on,” he said. “Tell me about Doctor Geddes and his infernal machine.”
She sat. “Doctor Frank Pantridge—”
“I know him,” O’Reilly said. “He’s got a black Labrador who’s Arthur’s brother. Sure, I know who he is—Doctor Pantridge, won the Military Cross in Singapore, Japanese POW when the fortress fell in 1942. He studied cardiology in Michigan after the war. Known widely, but not to his face, as Frankie P.”
Jenny said, “That’s him.”
“I remember how excited everyone was when he introduced in-hospital defibrillation in 1964,” Kitty said.
“He went one better,” Jenny said. “The death rate for people who fibrillated at home was nearly seventy percent. So Doctor Pantridge remarked, ‘Then we’ll just have to go out and get them, won’t we?’ He got together with John Geddes, who’s making this study his thesis, and then enlisted an electrical technician, Mister Alfred Mawhinney, who rigged up a portable defibrillator using two twelve-volt car batteries and a static inverter. The whole thing weighs about a hundred and fifty pounds, but it works.” She grinned. “I was Frankie P’s houseman in 1963. That’s where I met John, and he’s been keeping me up to date on developments.” She shook her head. “Doctor Pantridge does not suffer fools gladly. There’s been a fair bit of resistance from the medical establishment to his idea for a portable device, but last month he was able to get an ambulance devoted to the project and had a portable defibrillator fitted.”
“And a bloody good thing for Bertie Bishop too,” O’Reilly said.
“We were lucky, or Bertie was,” Jenny said. “The formal study is set up to begin in January 1966 for budgetary reasons. There’ll be trained doctor-and-nurse teams and attendants assigned to the devoted ambulance twenty-four hours a day. They’re going to call it the Mobile Intensive Care Unit, but already it’s been nicknamed ‘the flying squad.’”
“The sooner they get it going the better,” O’Reilly said.
“Doctor Pantridge apparently agrees. John had mentioned to me that his boss was aching to give the setup an unofficial try before January. The ambulance was equipped and sitting in the garage. There are always a couple of spare drivers in the place. Any ward nurse working in the hospital defibrillation programme could be conscripted to assist.”
“I know the nurse who was here tonight,” Kitty said. “June Irwin. She’s a cardiac nurse with a very good head on her shoulders.”
“She has,” Jenny said. “I’ve worked with her.”
“And Frankie P wanted to give the thing a test run?” O’Reilly said.
“All it needed was a G.P. who knew about it, someone like me, and John to be on duty when the G.P. called and a final go-ahead from Frankie P—and he carries a walkie-talkie. He’s not hard to find.”
“That’s amazing,” O’Reilly said. And it was. “I’ve never seen anything like it or heard anything about it. It certainly rescued Bertie.”
“And if he fibrillates again on his way to the Royal they can give him another shock,” Jenny said.
“Do you know,” O’Reilly said, “if Bertie survives—and that’s not guaranteed, but his chances are a damn sight better now—I’m going to make certain that the councillor will be fully informed about exactly who was
responsible for saving him.”
“You really think it will make any difference?” Jenny said, picking up her shepherdess’s crook. “I still say it’s going to take something pretty dramatic to get Bertie Bishop to accept me, or any other woman doctor.”
“And practically dying isn’t dramatic enough?” O’Reilly chuckled. “Even for Bertie, I think that qualifies. Come on, Bo Peep, Kitty, Terry. The fireworks will be over soon and I don’t think the party will survive Bertie’s own fireworks display. Home. I fancy a wee half-un and you could probably use one too. Then, when I hear from your Doctor Geddes, Jenny, I’ll pop round and see Flo.”
Followed by his small entourage, O’Reilly headed for the door, shaking his head. That had been bloody miraculous, a medical-world first, and he was immensely privileged to have been a witness. Nor was it the first time in his life he’d been privy to developments that had revolutionised the way medicine was practised.
37
What Mad Pursuit?
“Good Lord. Here already, Fingal?” Bob Beresford said, looking at his watch and Fingal’s bike. “You got Congreve rockets on that thing?” He took a drag from his Gold Flake.
Fingal, sweating like a galloping horse and breathing quickly and deeply, shoved his bike up the shallow front steps of the building on Merrion Square. “All right to leave it here in the hall?”
“Sure, for the moment. Come on in.” Bob indicated the open door of his flat.
Fingal left the bike and went in. “Thanks for waiting. I hope I haven’t interrupted anything, Bob?”
“Not tonight,” Bob said. “I’m a bit between—” He coughed. “Bette seems to have found someone more glamorous than a humble medical research worker.”
“Sorry to hear that. Look, Bob,” he said, “I need your help.”
“All right, but sit down and tell me about it. Whiskey?”
Fingal shook his head and remained standing. “Red prontosil worked in mice given lethal doses of Streptococcus, didn’t it? It cured them, and other infected mice that weren’t treated died, right?”
Fingal O'Reilly, Irish Doctor Page 30
