“And a patient needs you?” Sue smiled, shook her head. “If I’d known what I was getting into before we married. Go on with you. It’s all right. I’ll be all right. I’ll get the tea started. Keep myself occupied.”
Barry realised she was trying to make things easier for him. “Thanks, pet. I’ll be back as quick as I can.”
“Do what you have to, Barry. I do understand. Honestly.” She pecked his cheek.
“I’ll get my bag,” he said, and left.
* * *
“Come on, on in.” George “Guffer” Galvin was a short, bald man whose grey eyes were fanned with laugh lines at their corners. “Thanks for coming so quick, sir, and I’m sorry til bring youse out on a Saturday night, but my poor Annie’s took a turn for the worser. She’s in the parlour. We was waiting for Bruce Forsythe til come on the telly and she says til me, ‘I’m awful short of breath, so I am.’ Now we’re not kiddies. We know what’s been wrong with Anne. We know it can come back, so you’ll not have til spare us the truth, Doctor, but I hate til see my Annie upset.” The man’s grey eyes blurred.
“Let’s see what we can do.” Barry put a reassuring hand on Guffer’s shoulder.
“You go on in, sir. I’ll wait in the kitchen til you’re done.”
“Fair enough.” As Barry watched Guffer Galvin walk slowly along the narrow hall, he took a brief moment to recap what he knew about his patient. Two years ago, both he and Fingal had thought they were dealing with a case of acute bronchitis in a heavy smoker of fifty-seven. They’d been wrong. She had been under the care of Mister John Bingham, consultant thoracic surgeon and his staff at the Royal since her bronchial carcinoma had been diagnosed and treated two years ago this month. And now she was short of breath. Get in there and see to her.
He opened the parlour door and went into the little room that was mostly occupied by a frayed maroon three-piece lounge suite.
Anne Galvin sat bent over on an armchair. Her grey-blond hair was untidy. She raised her head and Barry saw the fear in her eyes behind her wire-framed granny glasses. “How are you, Anne?”
“I’ve been better, sir,” she gasped with a rasping sound ending in a dry, one-bark cough, “so I have.” She screwed up her face and as she inhaled, her nostrils flared and the strap muscles in her neck stood out. Her lips had the slate-blue tint of oxygen shortage. She bared her teeth before making a grunting noise. “That’s ferocious.”
“Don’t try to talk, Anne. Just nod or shake your head.” He pulled a simple wooden chair over from beside the wall, sat, and put his bag on the floor. “You remember I popped in on you a month ago when I was up here seeing one of Eileen Lindsay’s brood.”
“I know, Doctor,” gasp, “and I’d never asked for a call neither.”
He put a hand on her shoulder. “Now, don’t talk. We just like to keep an eye on folks, Anne, and the people at the Royal had written to say your recent checkup with them had been fine. Just wanted to be sure, that’s all.”
“Umgh.” Anne inhaled.
Barry leant forward and laid the back of his hand on her forehead. It wasn’t sweaty or hot, so she probably did not have a fever, but he noticed how her cheeks were sunken.
“Have you been all right since then—until tonight?”
She nodded, cocked her head to one side. Frowned. “But,” gasp, “I think I’ve lost a fair bit of weight.” She managed a weak smile. “I didn’t mind that. Get my figure back.”
Weight loss was ominous. Barry thought he recognised denial when he heard it. Cancer patients were instructed to report any weight loss, but if she wanted to pretend it didn’t matter? Fair enough. “Anything else?”
“Not until the night, about half an hour ago. I got this shortness of breath.”
“And that’s everything?”
She nodded.
“Have you boked? Had the skitters?”
She shook her head. No vomiting. No diarrhoea. No gastrointestinal tract involvement. Time to take a look. “Let me help you to the sofa.”
She stood, leant on Barry, and he soon had her lying down. Already Barry was reasonably sure what he was dealing with. He’d forego the routine examination of pulse and blood pressure. If he was right, those matters could be dealt with once she’d been admitted to the Royal. “Can you pull your blouse up a bit? I need to examine your chest.”
By the classic manoeuvres of inspection, palpation, percussion, and auscultation, Barry concluded that her right lower lobe had collapsed. The cause would almost certainly be blockage of a bronchus by a recurrence. “Just one more thing, and I promise it won’t hurt. Can you sit up and loosen the neck of your blouse?”
She nodded.
Barry rapidly examined the triangular area to the right of her neck between the base of her skull, her collarbone, and her shoulder. It should have been smooth, but he could feel a craggy hard swelling about the size of a child’s marble. Her cancer, as many lung cancers did, had spread to the lymph node there. “All done,” he said. “I’m going to leave you for a minute and get Guffer so I can tell you both what’s going on.” He noticed a phone in the hall, new since he was last here. He’d get the ambulance equipped with portable oxygen on its way. Anne Galvin’s condition was beyond the capability of a country GP.
After being assured a bed would be ready and an ambulance dispatched, Barry went to the kitchen.
Guffer sat at the table, toying with a cup of tea. He pushed it aside and leaped to his feet. “Well?”
“Come on through. I’ll explain to you both.”
Guffer followed Barry.
Back in the parlour, Guffer took an armchair and Barry remained standing.
“All right,” he said. “There is no easy way to say this. I’m sorry, but I believe the disease has spread, Anne.” He heard Guffer’s whispered, “Shite,” and saw Anne nodding. Her features were relaxed.
“I’m not an expert on what ails you, but I believe all is not lost. I—”
“But it’s pretty serious, Doctor?” Guffer said.
“Wheest, dear,” Anne said, and wheezed. “Let the doctor explain.”
“I believe you will need oxygen and be admitted to the Royal. Mister Bingham’s team will look after you, and I expect you’ll be transferred to the Marie Curie Centre at Belvoir, but your specialists will be able to advise you better than me.”
“That’s not good, is it, Doctor?” Guffer asked. “Marie Curie’s the place for X-ray treatments.”
Barry shook his head. “To be honest, I don’t think there will be a cure, but some radiotherapy at the centre may make you comfortable, Anne, for quite a while.” Barry felt a lump in his throat.
Guffer put his hand on Anne’s shoulder.
“Guffer, remember the last time you made up an overnight bag for Anne?”
“I’ll see to it,” said Guffer, his voice trembling. “And thanks, Doc.”
“I think I’ve done very well.” Anne Galvin gulped for air as she watched her husband leave the room. “So I have, considering. All youse doctors have—have done your very best, and I know Mister Bingham’s people won’t give up without a fight.”
Barry found himself biting his lower lip.
“I’ll do whatever I’m bid.” She dragged in more air and looked at Barry with pleading in her eyes, but her voice was strong when she said, “I’m not afraid. I’ve had a good two years to think on it, and if it’s my time, then it’s my time, so it is. The Reverend Robinson has me well prepared.” A single tear trickled. “It’s just I’m sorry for them as will be left behind.”
So, her comment about weight loss hadn’t been denial. It seemed this brave woman had come to terms with her probable fate. Doctor Barry Laverty found himself reaching for his own hanky so he’d appear to be composed when Guffer returned. He took one of Anne Galvin’s hands. It was warm and solid in his hand. His patients were real people to him, not conditions, and that’s the way he wanted it. But as he had learned not so many years ago, beginning with a lovely man with a gangreno
us great toe, sometimes knowing a patient could be painful too.
6
Examine Well Your Blood
August 9, 1963
Barry put the last turn in the tensor bandage and anchored it with a safety pin. “Keep that ankle elevated when you get home, Sandy, and come back in ten days. Should be right as rain by then. It’s only a sprain, but I’d rather you didn’t try weight-bearing until someone’s had a look at it then. And no hurling.”
Barry handed the teen an elbow crutch a nurse had brought from the plaster room. “Don’t forget to bring that back with you in one piece. It’s not a hurling stick, Sandy.”
The youth laughed and looked dubiously at the crutch. “Okay, Doc. I promise. See you in ten days.”
A student nurse stuck her head into the room B cubicle. “Come quick, Doctor. A man’s bleeding next door.”
Barry dashed out and nearly collided with Norma Fitch, who was hurrying in the same direction. “I’ll see to it,” he said.
“Thanks, Barry. Busy this morning.”
Virginia Clarke appeared from the ambulance room, where she’d been working this morning. That was why Barry, still embarrassed after being rebuffed eight days ago, had been trying to avoid her, and had elected to work in room B today. She nodded at Barry, but said to Norma, “Sister’d like you to see a patient next door. The ambulance men said he’d had a fit. He’s stopped now, he’s still unconscious, but she suspects it might be epilepsy.”
As Barry opened the curtains to his cubicle he heard Norma say, “Come on then, Nurse Clarke. Let’s see if we can get this sorted, but it sounds like he’ll need admission to the neurology ward.”
A young man sat on a chair, a bloody towel held to his head. Brown dried blood had caked on his right cheek and coat collar, but no fresh blood was leaking past the towel. The compression was working.
Barry tugged the curtain closed. “Morning…” Barry scanned the eight-by-four card. “Mister Magee. What happened?” According to the card, James Magee was twenty-two, a labourer, and a Protestant, living at 19 Sandy Row.
“A brick fell out of my mate’s hod. Hit me on the nut, sir.”
Barry could picture James Magee’s mate climbing a ladder, holding the long-handled hod with one hand at waist level while its brick-carrying end rested on one shoulder.
Depending on the height from which the brick had fallen, it could have caused anything from a fractured skull with underlying brain damage to a simple scalp laceration. Given the rich blood supply of the scalp, they usually bled heavily. The patient would need a rapid head injury assessment before being trotted over to the suture room to have his wound cleaned and stitched. Barry got started. “Just keep holding the towel firmly to your head, Mister Magee. We’ll get a look at it later. I want you to tell me your name, where you are, and what date it is.”
“I’m Jimmy Magee, Doc. It’s Friday, August the ninth, 1963, and I’m in the Royal, so I am. Nothing wrong with my marleys.”
It didn’t take long for Barry to satisfy himself that there was no brain injury or concussion, and that it was a simple case of laceration. He completed the card. “You’ll need a couple of stitches, Jimmy. Come with me.”
Once in the suture room, Barry sat Jimmy on a chair, greeting a student nurse and an experienced senior medical student, an old friend. “Here’s Jimmy Magee for you, Mike. Head laceration. I’d like to take a look when you have him cleaned up.”
Barry waited until Jimmy was seated again before taking a careful look at a three-inch gash with red pouting lips and a slow trickle of blood draining from one end. “Carry on, Mike. Clip off some of the hair to give yourself a clear field, then three or four stitches should do the trick, Jimmy.”
“Thanks a million, Doc,” Jimmy said.
“You’ll be fine. Mike’s a great stitcher,” Barry said, and left.
The benches in the waiting room were empty, but for a man giving his particulars to the receptionist. Barry noticed the fellow was swaying in his chair. Oh Lord, probably another not-quite-sober drunk coming in after a late-night binge looking for a hangover cure. As usual he’d be put on a stretcher in the ambulance room for fear he might fall off a chair in room B, injure himself, and sue. This one would need seeing to soon, but with a bit of luck he’d be one of the comical ones who just needed to sleep it off. At least there was going to be a short lull in the action, unless an ambulance case showed up.
Barry stepped aside as two ward orderlies hurried by pushing an unconscious man on a stretcher from the ambulance room toward the main corridor and admission to one of the wards. Probably Norma’s epilepsy case.
He checked room B. Empty. He headed to the ambulance room, knocked, and let himself into Bernie’s office, to find Norma Fitch already there.
“Bit of a lull now,” said Bernie, who was reading the Belfast News Letter. “Praise be. Mother of God, would you look at that?” The senior sister handed the paper to Barry.
“Here?” He pointed to the top story, and Bernie nodded. “The General Post Office have confirmed that two-point-six million pounds were stolen in yesterday’s train robbery at Cheddington in Buckinghamshire.”
Norma let out an ear-piercing whistle. “That’s a brave clatter of money.” The five-foot-two brunette from Dungannon in County Tyrone had laughing eyes, full lips, a wicked sense of humour, and astounding stamina. It was a pity there were still some lingering concerns among the men about how she’d deal with belligerent patients. “I can’t actually imagine such a sum.”
“Actually,” Barry said, “at a shilling a pint, it would buy you fifty-two million Guinness. Or, at the three hundred pounds a year they pay us for working eighty-four-hour weeks, the Hospitals’ Authority could hire about eighty-six thousand housemen.”
“Golly. I never knew you were a mental arithmetic wizard, Barry,” Norma said. “I still remember you asking for help with physics calculations in first year.”
Barry laughed. “When it comes to sums, I’m a complete tube,” he said. “Jack Mills worked it out on the back of a beer mat when we were having a pint last night in The Oak on the Grosvenor Road.”
Virginia Clarke stuck her head round the door frame and Barry felt his breath catch in his throat. Despite Jack’s suggestion that Barry try again, he hadn’t. “Sister, we’ve a couple of folks in the waiting room and an ambulance has arrived.” She smiled at Barry, who found he could not meet her gaze, but turned his eyes back to the newspaper in his hands. He would focus on his work and try to forget Virginia Clarke’s green eyes for now.
The trouble was after only eight days on the job, he was getting bored with the routine work in room B and becoming less anxious about, even relishing, the challenges of the tougher ambulance room cases. Today he was on the eight-to-six “long day.” His public school training had conditioned him always to defer to a woman. “Looks like our little break’s over. Your pick, Norma.”
She yawned. “I did the six-P.M.-to-eight-A.M. ‘long night’ last night, and it was a long one. And I’m still here until noon. Did a couple of major cases while you were in room B earlier. Unless there’s more cases than you can handle, Barry, I’d like to do the easy stuff. Is that all right?”
“Fair enough. Off you go.”
The double doors at the far end of the ambulance room, closed today because of a downpour, opened and an ambulance attendant pushed in a man in a wheelchair. His head, which he held between his hands, drooped.
“Cubicle one,” Bernie called to the ambulance man.
“Right, Sister.”
She handed Barry a blank eight-by-four card. “Here, Barry.”
“Thanks.” He left the office and went behind the curtains of cubicle one.
“Bout ye, Doc.” The attendant helped the patient up onto the trolley, putting the man’s head on a pillow and covering him with a blanket. “Dirty morning out there, so it is.” The man shook water off his blue bus driver’s peaked cap. “Even the ducks is sheltering.”
One of the few a
dvantages of living in the hospital, Barry thought, was not having to brave the elements. “What can you tell me…?” he began, but realized he’d never met this ambulance man before.
“It’s Freddy, Doc. Not much. Your man, Mister Ivan Peters here, he’s fifty-six, woke up this morning with a ferocious headache, dead tired, dizzy, and his left big toe had turned blue—”
The cyanosed toe was unusual.
“He lives at 2a Epworth Street. Docker by trade—”
His address, in the district of Ballymacarret, was in Belfast’s dockland, so the man’s occupation came as no surprise.
“His missus thought he’d taken a stroke so she dialled nine-nine-nine.”
“Fair enough.” Barry entered the pertinent details on the card. “‘Morning, Mister Peters. I’m Doctor Laverty. Not feeling so hot?”
The man, with obvious effort, turned his head to look at Barry. “I feel dead rotten, so I do, Doctor.”
Barry heard a cough from behind them.
“Excuse me, sir,” the attendant said. “Unless you need me, I’ll be running along.”
“Thank you, Freddy.” Barry turned back to his patient. Immediately he noticed that the man’s face appeared to be very flushed—plethoric, in technical terms. Add it to the observation about the man’s big toe, and a germ of a diagnostic idea was beginning to form. But routine must be followed. “How long have you been feeling like that?”
Ivan Peters sighed. “I’ve been tired for weeks. Couldn’t tell you how long, but it’s been getting worser. I started getting headaches about three weeks ago, and when one started I’d go dizzy.”
“Have you seen your doctor?”
The man tried to shake his head, but grimaced, stopped, and said, “That stung, so it did.”
Barry waited.
“Seen my doctor? See him? Not at all. He’s one of them there ‘Here’s two aspirins’ boys.”
“You mean you’ve not been examined.”
“Huh. My doctor’s not an examining doctor,” Mister Peters said. “That’s why my missus sent for the ambulance when I took real bad, like.”
An Irish Country Family--An Irish Country Novel Page 7
