Charlie Greer, wearing a long white lab coat with two of the tools of his trade, a tuning fork and a patella hammer, sticking out of a pocket, sat at a plain wooden table surrounded by half a dozen upright chairs.
“Grand, Fingal. Tea or coffee?”
“Tea, please.”
As Charlie went to a sideboard to pour, O’Reilly sat at the table and watched his friend of thirty-eight years. He reckoned Charlie was aging well. He still had shoulders like an ox and fingers like sausages. A potbelly had replaced the athlete’s toned one—and given how often Alice Moloney, the village dressmaker, had to let out O’Reilly’s own waistband, he would not criticise his friend. Charlie’s shock of ginger hair, which once would have rivalled Donal Donnelly’s ruddy thatch, was greying now and he was wearing spectacles. Eyesight going—just like, damn it, I’m trying to ignore the fact that my hearing is.
“Here you are.” He handed O’Reilly a cup. “Have a pew. You want to know about your patient Mister James Frew?”
“Please. And thanks, pal, for putting him in a single room.”
Charlie shrugged.
“I can’t believe it was only Saturday night when Jack Mills—”
“Now there’s a first-class young surgeon.”
That pleased O’Reilly. “—helped me examine Dapper.”
“Your diagnosis of a subarachnoid haemorrhage was top of the possibilities after a thorough examination here on Saturday night. We confirmed it an hour ago by my registrar finding xanthochromic cerebrospinal fluid after a lumbar puncture.”
“I see.” While it was always professionally satisfying to make the correct diagnosis, O’Reilly was more concerned for his patient. “So, what’s next?”
“Apparently, he never lost consciousness, so I think it’s fair to assume while there is blood in his skull, there has been no bleeding into the brain tissue. I’m even more confident now, because he is getting some return of function in his left side and his dysphasia has nearly disappeared.”
“So, he’s recovering?”
“Possibly. It’s too early to tell. I think he’s bled from a small aneurysm, probably on the right middle cerebral artery.”
“Jack said you might do an angiogram next to be sure.”
“Jack’s right. One’s scheduled for ten tomorrow morning, and if it shows what I think it will, I’ll operate on Friday.”
“So, we’ll have something concrete to go on by tomorrow? Can you give me any idea what the chances are of recovery?”
Charlie shook his head. “Overall, about forty percent of subarachnoids don’t recover—”
“You mean they die?”
“I do, but Frew’s probably past the critical stage. I think his prospects are reasonably good, but I can’t promise. Sorry. I hope I’ll have a better idea if the surgery goes smoothly. There is a four percent operative mortality rate too.”
O’Reilly sucked in his breath. While he usually felt it proper to keep patients informed, those figures could not be altered, and he saw no reason to scare Dapper or Donal. For once he’d keep statistics to himself.
“And you’ll keep me posted about the angiogram?”
“I will or my registrar will.” He glanced at his watch. “They keep me on the hop, and if I’m not in theatre in ten minutes a certain lovely Kitty O’Reilly, who is setting up for excision of what is probably a glioma, will geld me.” He rose. “Finish your tea, go and see your patient, and have Kitty give Pixie a ring and let’s have dinner together soon.”
“I’ve a better idea. I’ll need to talk to Kitty, but how about me rounding up Cromie and Button, and you two and your better halves come down to Ballybucklebo? Talk about old times in Dublin?”
“Sounds good.”
“Thanks, on all counts, Charlie,” O’Reilly said to the back of the lab coat of a man in a hurry.
O’Reilly smiled. Pixie and Button. His friends’ wives had both attended Cheltenham Ladies’ College, an exclusive school in England, an institution that mirrored the boys’ public schools’ tradition of handing out nicknames. He finished his tea and walked back along the corridor, stopping at Dapper’s ward. The curtains were closed behind the glass windows that usually made it simple for nurses to keep an eye on their patients. He let himself in.
Donal bounced up from the chair he’d been sitting on at the head of Dapper’s iron-framed bed. “You have the chair, Doctor.”
“Not at all. Sit down.” O’Reilly gently hitched his backside onto the blanket halfway along the bed where Dapper lay on his back with his head on a single pillow. He managed a tiny smile.
“How are you feeling, Dapper?”
“I’d rather not be here but I’m not too bad, sir. My headache cleared up and I’m not losing words much anymore. I’ve til lie flat like this for two hours. The doctor who stuck thon needle in my back said it’s til stop me getting a headache. He said they were quite common after this test.”
“That’s true.”
Donal fidgeted on his chair and O’Reilly watched the man’s face going through its usual contortions, an event that usually indicated that Donal was wrestling with a decision. His features settled and he said, “Doctor O’Reilly, Dapper and me’s busting til know. What did Mister Greer say?”
O’Reilly nodded. “He’s sure, Dapper, you have had a little bleed inside your head. This morning’s test proves it.”
“I see. Little? How big’s little? That doesn’t sound good til me.”
O’Reilly hesitated. Even if he knew the exact amount, there was no point in saying something like “about half a teaspoonful.” It would be meaningless. “When folks have what Mister Greer is sure you have had, bleeding from a weak artery, many become unconscious. The ones that don’t—and you didn’t, I know because I was there—are the ones who get better quickest.”
“That’s good news, Dapper,” Donal said. “Isn’t it, Doc?”
“It is, and I’m here to try to explain what happens next.”
“You said on Saturday, Doctor, that I might need an operation?” There was a tremor in his voice.
“I did. You’re going to have a special X-ray tomorrow. The doctors will inject a dye to outline the blood vessels in your skull, and if it shows a weakness in the wall of one, Mister Greer will operate on Friday.”
“My God.” Dapper tried to sit up but fell back. His fists clenched.
“Lie down,” O’Reilly said, shaking his head. “Eejit. You don’t want to give yourself another headache, do you?”
Donal said, “Could Dapper give himself a percussion instead if he jerks his head like that?”
It took O’Reilly a moment before he said, “Concussion, Donal.”
“Oh, right. Right. I knew that.”
“No concussion. But it’s better if he lies still.”
“And I will. Sorry, sir. It’s just I’m mortal feared of surgery, so I am. And, well, I am getting better. I know that. Like I said, I’ve very little trouble finding words the day. That’s got til be a good sign, isn’t it?”
“It is.”
“So, could they not wait and see for a wee while longer? My brain might just fix itself, like?”
“When I was a young doctor in Dublin, patients like you were treated for at least ten days and some did recover without an operation, but brain surgery was not very advanced then. Mister Greer is a very highly respected brain surgeon. I think we should take his advice.”
Dapper looked as if he might argue, and then sighed. “All right. I’ll bide, sir, but my stomach feels like it’s got about a million butterflies in it, all flying and flopping round.”
“I’ll speak to the houseman. See about getting you some calming medicine.”
“Thanks, Doc.”
“I think it’s wheeker, so I do,” Donal said. “You’ve only four days til wait and then you’ll get fixed up. And mind like I told you, I’ve had brain surgery and I come through it with flying colours and a clean brain.”
“Clean brain? Take yourself off by the
hand, Donal Donnelly, but thanks for trying til cheer me up.” Dapper took a deep breath. “I’ll bide quiet, but I wish it was over, so I do.” He sighed. “Would you have any idea how long I’ll be in for, sir?”
“It’s usually a ten-day stay postop, and Friday’s the eleventh. When all goes well, and I’m sure it will, you should be out by the twenty-first. That’s a Monday.”
“Can I go back til work then?”
O’Reilly shook his head. “I don’t know. Probably not, but Mister Greer will give you a better idea by then.”
“Good, for I’ll have til let my office know when I’ll likely be back. Sales are usually slow in July and August, but if I’ll be out of action, another agent will have to pick up my work. I’ll get sick leave money, but no commissions.”
O’Reilly said, “I’d be pretty surprised if they haven’t already heard you’re in hospital. You know what Ballybucklebo’s like.”
“They know, all right. Joan Eakin, the wee secretary I used til date, come in til visit me yesterday all concerned about me. She’d seen Kinky at church on Sunday.” He inhaled. “But they’ll still need to know when til expect me back.”
“Don’t worry about that. I’ll give them a ring when I get home and explain. And you come and see me when you’re home. I’ll give you a sick line so you can draw your benefits.”
“Thanks, Doctor.”
“Listen, oul’ hand, never you worry about your work,” said Donal. “Your job’s til get better. I’ll do all I can til help. I’ll come and see you at every night’s visiting hours. Bring you anything you need.” Donal took and squeezed Dapper’s hand. “Either Bertie’ll borrow me his van or I’ll get the train and buses.”
“You’re a sound man, Donal.”
O’Reilly heard the catch in Dapper’s voice. “There now, Donal is going to be here every evening, and Mister Greer will keep me advised. You’re not out of the woods yet, Dapper, but things do look promising. But, Donal, you and I mustn’t tire Dapper. He needs to rest.”
“Thank you, Doctor O’Reilly.” Dapper’s frown vanished and his fists unclenched.
“I’ll leave you to say good-bye to Dapper, Donal, but don’t be too long.” He let himself out into the corridor. The next few days would be critical for Dapper, but O’Reilly saw no reason to worry the two men any more than they already were. He was quite able to be concerned for them both.
5
Like Many of the Upper Class
“I reckon we’ll time this to perfection,” O’Reilly said to Barry in the Rover’s passenger seat. O’Reilly wrenched the steering wheel of the big car to turn left off the Belfast to Bangor Road and onto the Crawfordsburn Road. As usual, he was probably driving just a bit too fast—he eased off on the accelerator. Luckily there were no cyclists in sight.
“I didn’t think we’d make it with you up in Belfast, then running Donal to work and having to phone Dapper’s office.” Barry looked over at O’Reilly and smiled. O’Reilly liked that about the young man. He believed in punctuality. Young people these days didn’t always.
“Better three hours too soon than a minute too late. We’re in plenty of time.”
“Merry Wives of Windsor,” said Barry with satisfaction.
“Right you are, sir. We’ll park at the Crawfordsburn Inn and give Kenny the run I thought he was going to have to miss. He loves the little glen there. We’ll still be early for the young man, the trainee applicant George Irwin’s sending down to us—what’s his name.”
“Doctor Sebastian Carson.”
“That’s the one. See if we want him for next clinical year’s attachment to our practice as a trainee GP.”
“Today’s a bit of a scorcher, Fingal. Will Kenny be all right in the car while we’re having lunch?”
“He’ll not be in the car because—Holy thundering Mother of—” O’Reilly pulled the Rover to the side of the road and slammed on the brakes. “Bloody tractors. Look at that.”
The shuddering halt hurled a protesting Barry against his seat belt and forced a yelp of surprise from Kenny in the backseat.
“Come on, Barry.” O’Reilly piled out, slammed his door, ran round the car, clambered over a low dry stone wall, and charged ten yards up a sharply sloping grassy pasture to where the red Massey Harris tractor he’d just seen toppling over lay on its right side. The driver, a middle-aged, florid-faced man, was sprawled on his side, trying and failing to wriggle away. His left foot was on the tractor’s seat, but his right foot was trapped under the steering wheel.
O’Reilly knelt at the man’s head and raised his voice over the engine noise. “I’m Doctor O’Reilly”—Barry stood beside O’Reilly—“and this is Doctor Laverty. Where are you hurt?”
“I’ve split my lip and my ankle’s stuck. I don’t think it’s broke but it’s powerful sore, so it is, and I can’t get it free.”
“Right.” O’Reilly looked at Barry. “Between the pair of us I reckon we can lift it just enough.” He spoke to the driver. “When I yell, ‘Now,’ try to crawl away.”
“Yes, sir.”
O’Reilly stood. “Right, Barry. Trot round to the other side. I’ll lift from under the steering wheel. I want you to pull on it. We only need to make about six inches.” O’Reilly straddled the man’s right leg, squatted, and grasped the lower part of the wheel.
Barry appeared on the opposite side of the tractor and took hold of the steering wheel’s upper quarter. “Ready when you are.”
“Okay,” O’Reilly said. “On three. One, two, three.” He hauled in a deep breath and put everything he had into flexing his forearms and extending his legs. O’Reilly’s abdominal muscles tensed. He was aware of vessels throbbing in his temples and the strap muscles in his neck standing out. He heard a loud grunt coming from Barry and slowly, slowly the wheel began to rise. This had better work. Having to drop it on the ankle again didn’t bear thinking about. O’Reilly clenched his teeth and heaved, felt the thing rise more, and judged there should be enough room. “Now.” Dear God, he couldn’t hold on much longer. He was aware of the farmer’s leg inching out.
“I’m free.”
“Let her go.” O’Reilly felt the additional weight as Barry’s contribution was removed, unclenched his hands, and hopped back as the steering wheel thudded onto the grass, missing his toes by inches. He exhaled and pulled in another lungful. His shirt was sticking to him and he used the back of his hand to wipe his brow. Barry had been right when he’d said today was a scorcher.
He was aware of Barry’s return but rapidly turned to the patient, who was now sitting up, dabbing at his lip with a grubby hanky. “Aye,” O’Reilly said after taking a quick glance, “you have split your lip and it’s going to need stitches.”
“Bugger it.”
“Let’s have a look at your hoof.” O’Reilly, as gently as he could, removed the man’s right Wellington boot and woollen sock. As he did, the farmer sucked in his breath and grunted. “Sorry if I hurt you.” O’Reilly studied the ankle. He could see no deformity, the skin wasn’t broken, but already the bruising had started. “Can you move it?”
The farmer flexed and extended his foot. “Aye, but it’s dead sore.”
“I’m sure it is. And I’m not going to hurt you more by poking it to make the point. My guess is you’ve only sprained it. Doctor Laverty?”
“I agree.”
“So, Mister—?”
“Johnson, Desmond Johnson.”
“Is that your farmhouse there?” O’Reilly pointed across a hedge about fifty yards away to a sturdy-looking grey two-storey house surrounded by outbuildings and facing what must be a farmyard. Two large elms formed a windbreak behind.
“Aye.”
“And that’s the gate into this field from the Crawfordsburn Road?” He nodded to a five-bar rusty iron gate ten yards from where the Rover sat. “Wide enough to get a car through?”
“Aye.”
“Barry, nip off and bring the car, will you?”
Barry headed back t
he way he’d come.
“I’ll be right back, Mister Johnson.” O’Reilly stood, went to the tractor, bent, and turned off the ignition. It was a relief to be rid of the clattering.
“Are you the Doctor O’Reilly from Ballybucklebo?”
“I am.”
“Jasus, sir, I don’t know how til thank you and the young doctor.” He looked at his hands. “Look at that. I’m all a-tremble.”
“I’m not surprised. Shock. You know and I know how lucky you are. Every year farmers get crushed and killed when their tractor rolls over.”
“Indeed I do, sir. And,” he managed a smile, “I’m double lucky, so I am. How many farmers get rescued by two doctors? Thanks a million. You’re not my doctor. Can I pay you something?”
“Don’t be daft.”
A small herd of white-faced, red-coated Hereford bullocks, beef cattle, had wandered over to see what was going on and O’Reilly could smell their breath. One tossed its head, bawled, and took off at the gallop followed by the rest as Barry drove up.
“I’ll help you stand, Mister Johnson.”
It took a bit of manoeuvring to get the man into the back of the car with Kenny.
As Barry drove to the farmhouse, O’Reilly half turned and said, “Have you a phone?”
“Och, aye.”
“Good. I told you you’re going to need stitches, so when we get you home, I’ll call an ambulance to take you to Newtownards Hospital casualty. Then I’ll call them, let them know why you’re coming, and suggest they X-ray your ankle when you get there too. The ambulance men will splint your ankle. Make it less uncomfortable on the drive.”
Barry parked outside the farmhouse’s green front door.
“Just be a few minutes, Barry.” O’Reilly helped the farmer, and in no time Desmond Johnson was sitting on a chair in his kitchen where his wife, having been reassured about her man’s condition, was making a cup of tea.
“Not for me, thanks,” he said. “Ordinarily I’d wait until the ambulance came but my partner and I are already going to be late for an appointment. I’ll make my phone calls and be running on.”
An Irish Country Welcome Page 5
