An Irish Country Family--An Irish Country Novel

by Patrick Taylor

  8

  Useless and Hopeless Sorrow

  August 13, 1963

  A tired Barry wriggled on one of the hard wooden chairs in Bernie’s office. Half an hour ago, Jack had beaten him to the only other comfy one. Bernie, as befitted her station, always had the best one. Barry’s backside was beginning to ache, but not as badly as his feet. Apart from a half hour for lunch, he hadn’t stopped. He’d lost track of the number of cases he’d seen: foreign bodies in eyes—a common complaint from workers at the nearby Mackie’s foundry—cuts, bruises, two broken arms, one foreign body up nose, sore backs, and twisted ankles. Contrary to the way casualty departments were portrayed on TV in Emergency—Ward 10 as all life-threatening drama, in real life it was a long procession of medically minor cases.

  “Well, lads, it’s five fifteen and it has been very quiet for the last half hour,” Sister Bernie O’Byrne said. “Tomorrow you’ll have been here a fortnight, and you know the ropes. I’m sure only one of you needs to stay until six when the others come on duty.” Barry was finishing the eight-A.M.-to-six-P.M. “long day” shift. Norma had shared it with him from eight to noon, and Jack Mills had the noon-to-six “afternoon.”

  Bernie was in one of her generous moods, Barry thought.

  Jack Mills grinned at Barry. “Toss you for it?”

  Barry smiled back. He remembered how in their first years at Campbell College he and Jack had learned early on that one way to avoid falling out over trivia was a coin toss. “Heads,” Barry said.

  “Heads it is.” Jack rummaged in his pocket for a penny and flipped it. “Tails it is, but off you trot anyway,” Jack said with a grin. “You look knackered.”

  Typical Jack. “Thanks, mate,” Barry said. “At least I have tonight off and only the short day tomorrow.” And at four thirty he’d be picking Virginia up for their first date. Mind you, he’d been too busy working and sleeping to have had much time to dwell on it, hardly had time for anything but the occasionally exchanged fond glance when they were both on duty. He savoured the thought of her for a moment before saying to Bernie, “I want to pop in to ward 10, see how Mister Peters is, the man with polycythaemia.”

  “Good Lord,” said Jack. “Do you think you’re Saint Luke, the good physician? You’re getting time off—and you want to see another patient? You’ll make me regret giving you my toss win. Daft.” He shook his head. “Barry, we’ve enough to do here without following admissions on the wards, don’t you agree, Bernie?”

  Bernie shook her head. “Doctor Mills, I’m a nursing sister, not a referee, but if Barry wants to see a patient, why not?”

  Barry smiled. “Jack, this one’s different.” He turned to Bernie. “If you need me back in a hurry, Bernie, you know where to find me.”

  “I do, and you’ll be on ward 6 too, but only for a shmall minute. I need a favour.”

  “Oh?” Perhaps her apparent generosity had a different motivation.

  “Here.” She handed him a ticket. “Wicklow are playing Down at the Gaelic football in Casement Park this Sunday. Sister Kearney of wards 5 and 6 supports Down, silly woman. My brother mailed me the tickets. He’s a Mayo member and he gets them at a discount. That’s hers. She can pay me at the game. She’s going off this evening for a few days and I have paperwork to do here so I might miss her.”

  “I’ll see to it,” Barry said, slipped the ticket into his white coat pocket, and left.

  “Keep me a seat for dinner,” Jack called.

  Barry took a short detour to the suture room, where Virginia was clearing up after the last case. “Just popping in,” he said, “to say I’m looking forward to tomorrow.”

  “Me too.” She flashed him a dazzling smile. “Don’t be late.”

  “I’ll not, and make sure you’ve got on walking shoes. Cave Hill is a bit of a hike.” He backed out and headed for ward 10.

  Barry pushed open the blue plastic doors and walked along a short corridor, passing the rooms connecting 10, the male Sinclair Ward, with its twin, 9, the female Honorary Medical Staff Ward. As usual, the faint niff that disinfectant could not stifle was coming from the sluice where bedpans were washed and housekeeping equipment stored. The ward kitchen came next. Many a frazzled student or houseman had been refreshed there in the small hours by a friendly nurse making “a wee cup of tea in your hand” and warm buttered toast. The side ward to his left was where Barry knew Rusky Peters was being nursed. Each of the twenty paired wards had a similar floor plan. He reached the sister’s desk with its full view of both fourteen-bed wards.

  “… and it’s taken the police five days since the thieves struck to find more clues about the great train robbers.”

  “Is that what they’re calling them now, Sister?” the student nurse asked. “The great train robbers?”

  The senior nurse bent closer to the student nurse, who perched at the edge of her chair. “Aye. They’ve found their hideout at a place called Leatherslade Farm near Oxford. No sign of the villains yet, though.” She turned from her companion and smiled. “Barry. How are you? Come to see your Mister Peters?”

  Barry, who by now felt a proprietary interest in Ivan “Rusky” Peters, liked the “your.” He nodded. “How’s he getting on?”

  “Well as can be expected. You know your diagnosis of polycythaemia was confirmed the day he was admitted. Doctor Nelson came to see him, decided not to use radioactive phosphorous, and went for immediate venesection. We took two pints of blood. That improved things at once. Mister Willoughby Wilson, ward 10’s senior surgeon, amputated the left great and next toe to it on Saturday morning. I’m afraid the other toe went black before we’d taken the blood. As a courtesy to his daughter, Jan, we put him in the side ward.” She inclined her head back along the way Barry had just come. “She’s with him now.”

  Barry knew he had no need to ask permission to visit Rusky Peters in the single-bedded ward that usually was kept for patients who needed isolation or intensive nursing, but sisters were important people to keep sweet. “May I?”

  “Of course.”

  “Thanks, Sister.” Barry turned, retraced his steps, and knocked on the door.

  A woman called, “Come in.”

  He recognised Jan Peters’s voice. He’d worked with her before and she’d been there when he’d kept his promise to pop in on Rusky on Friday evening. Barry let himself into the familiar windowless room with its light yellow walls and single iron bed. Rusky Peters sat propped up on pillows. A bunch of red grapes and a bottle of Lucozade stood on a bedside locker. Radio headphones hung from a hook on the wall and a temperature chart on a clipboard hung from the bed’s foot. His blankets were humped up over a semi-cylindrical metal lattice cage over his left leg to prevent pressure on the surgical site. The white ceiling-mounted curtains surrounding the bed were drawn back.

  Jan Peters sat on a simple wooden chair beside the bed. “Hello, Barry. Good to see you, and I know Daddy appreciates you coming very much.” Her brown eyes sparkled under neatly plucked eyebrows. She must be off duty, because under a lime green woolly cardigan she wore a sleeveless yellow dress with a buttoned blouse, belted waist, and a knee-length flared skirt.

  “Jan. You’re looking well.”

  She lowered her head. “Thank you.”

  “How are you keeping, Rusky?”

  “I can’t complain, Doctor. All my headaches is gone. I don’t get dizzy no more—”

  And certainly his complexion no longer looked like a ripe tomato. The bloodletting had done him a lot of good.

  “—and I know it’s daft, but my toes—and I know they’re gone—but they itch like bejazus. Thanks for warning me that might happen. You were right when you called it ‘phantom toes.’ The things is haunting me.”

  “Forewarned is forearmed,” Barry said. “I’m happy to explain as long as I’m not muddling you. Too much advice can confuse anybody, and your specialists are the experts.”

  “Sure, I know that, but it’s still nice having a doctor who isn’t all cold and te
chnical, like.”

  Barry smiled. It was his idea of good doctoring. That was all, at least he hoped it was, and not simply a way of polishing his own buttons so he’d feel good. A narrow table on wheels, covered in tools, glue, and black-and-white wood veneers, spanned the bed in front of Rusky. On a wooden square, hinged in the middle, Rusky was affixing squares of veneer to create a chessboard. Each square had in its centre a small fleur-de-lis of the colour opposite to that of its background.

  “It’s coming on a treat,” Barry said.

  “Aye,” said Rusky. “I’m not much for the reading, and it gets boring in here, but this here is a great way til pass the time, so it is.”

  “Daddy’s been doing marquetry for as long as I can remember,” Jan said. “He’s very good at it—and he knows lots about it.”

  “I must confess,” Barry said, “I don’t, and I’m a complete jackass when it comes to chess, but I do enjoy a game of draughts.”

  “Maybe if you’ve nothing better to do, Doc—oooh. Jasus. Sometimes that bloody itch is hard til thole.” He took a deep breath.

  “You all right, Daddy?”

  Rusky nodded. “I think there’s about a hundred fleas nipping at me, but it’s passing.”

  “It will get better in time,” Barry said. “I promise.”

  “Thanks, Doc.” Rusky pointed at his handiwork. “Anyroad, as I was trying to say, maybe if I get this here finished before they let me out, you’d come and give me a game or two, sir?”

  “It’s so delicately built I’d be scared to scratch it. It’s a piece of fine art.” He was fascinated by people who were masters of their craft, and this man was a virtuoso, and presumably self-taught. What would Ivan Peters have achieved if he had come from a different background? “Would you ever think of doing this professionally, Rusky?”

  “What? No harm til you, Doc”—Barry noted the Ulster softening of the inevitable contradiction to follow—“but not at all. It’s only a hobby. The wee physio says I’ll be able til get about rightly—in time, on a walking stick, but och, I’m not so sure. And you need til be agile working on them cargo ships.” He looked at Jan and back to Barry. “I hope to God the physio’s right, but I can see me doing nothing but this, playing draughts with my old mates, watching telly, and drawing the sick before I go on the burroo.”

  “The sick” was a sickness benefit paid for thirteen weeks from the time of onset of the illness, after which, if Rusky was still incapacitated, his money would come from the Unemployment Bureau—the burroo.

  “Come on, Daddy,” Jan said, “let’s not worry about that now. Let’s concentrate on getting you better and then home.”

  “That’s very good advice,” Barry said. “I’m delighted to see you coming on so well, Rusky, and I’m truly impressed with your skills. Now, I expect your missus will be here soon for visiting hours and I don’t want to intrude, so I’ll be trotting along. But I’ll pop in again soon.”

  “Thanks, Doc,” Rusky said. “You don’t know how much it’s meant to me. And if you do have time for a game?”

  “I’ll try,” Barry said.

  “Thanks, Barry,” Jan said. “Thank you very much.”

  As he closed the door behind him, Doctor Barry Laverty felt the blush rise and the warmth suffuse him, inside and out. Patients were people, and if you got to know them, as a GP could, they could reveal all kinds of hidden depths. He’d never be like Rusky’s GP. Not an examining doctor.

  A cheerful Barry headed along the bustling main corridor with its terrazzo floors, narrow vaulted ceiling, and clerestory windows. The medical profession at the time of the Royal’s completion in 1903 had put great faith in the curative powers of daylight.

  Barry walked onto ward 6 along the corridor to Sister’s desk. “Sister Kearney.”

  The senior sister turned from where she sat at her desk. She smiled. “Hello, Barry. What can I do for you?”

  He fished out the ticket and proffered it. “Bernie O’Byrne asked me to deliver this. Says you can pay her for it at the game on Sunday.”

  “Thanks a million.” She took the ticket.

  “I’m off for my tea.” Barry turned to go.

  As he walked from the office he saw a familiar fair-haired man in the coronary care unit immediately adjacent to the end of the entrance corridor. Harry Sloan’s ordinarily high complexion was flaming.

  Harry glanced up. “Barry, give me a hand. Quick. Quick.”

  When Barry arrived at the bedside where Harry stood, he saw the patient he’d resuscitated thirteen days ago lying motionless and felt a moment of shame. He’d only dropped in once to visit the man and already he’d forgotten his name. He’d probably seen a hundred patients in the past two weeks.

  The man lay bare-chested on the bed, sightless eyes fixed on the ceiling. The pillow had been removed and a board placed between his back and the mattress to provide a solid surface so that Harry’s compression of the sternum would meet resistance and be effective. Barry looked at the screen of the electrocardiograph. All the lines were nothing but disorganised squiggles. Ventricular fibrillation. Cardiac arrest.

  Barry stepped inside the curtains just before a nurse closed them to hide the drama from the rest of the ward.

  “G-get the Ambu bag.” Harry was already short of breath as he continued to give cardiac massage. Barry started to head for where it would be kept, but realized Harry had been asking the nurse, who produced it and gave it to Barry. He’d barely had time to give the patient a few puffs when the curtains briefly parted and the bespectacled Doctor John Geddes and a staff nurse rushed in pushing a trolley bearing the Lown defibrillator, which the nurse plugged into the mains. It was a bulky box with knobs at its front, a small upper screen for its built-in electrocardiogram, and a lower one indicating energy settings.

  John Geddes nodded to the two men. “Please carry on, Doctors, until we get the defibrillator ready.” Geddes busied himself in front of the trolley.

  The staff nurse connected the defibrillator’s arm, chest, and leg leads, and the ECG screen on the upper half of the defibrillator began to display the chaotic pattern of ventricular fibrillation.

  In what seemed but moments Geddes said, “Right, we’re nearly ready to go. Stop ventilating, but please stay, Barry. We may need you again.”

  Barry, still holding the Ambu bag, stepped aside.

  The staff nurse inserted two cloth-wrapped tongue depressors between the man’s teeth to stop him biting his tongue. The other nurse had applied KY jelly to two metal electrodes on wooden handles that Doctor John Geddes held. Their electrical cords came from the defibrillator. Harry Sloan stopped giving external cardiac massage.

  “Clear,” said Geddes. He waited until no one was touching the patient, placed the metal blades on the man’s chest, repeated, “Clear,” checked that it was, and stood on a foot pedal, sending an electric shock surging through the whole of the man’s body. His arms and legs convulsed. For a few seconds the monitor went blank, because it was automatically turned off when the shock was delivered, lest the current fry its inner workings. When a tracing reappeared, it was a flat line.

  Barry and Harry resumed ventilation and massage until a second attempt to restart the heart had been prepared.

  “Clear.” Again, the man’s limbs twitched. Again the monitor remained flat.

  Three more attempts, three more failures, during which time the staff nurse had filled a syringe equipped with a long spinal needle with adrenaline, one millilitre of one-in-one-thousand solution.

  “Needle,” said Geddes. In moments he had swabbed the skin over the space between the fourth and fifth left ribs, thrust the needle through the chest and heart walls, and into the great left ventricle. When he pulled back on the plunger, smoky blood flowing back into the barrel confirmed he had hit his target. He injected slowly.

  The last gasp of a dedicated team trying to bring a man back to life. The forlorn hope.

  But the luminous green trace on the screen was as flat as the mo
od in the silent private space behind the curtains.

  “Thanks everybody, but—I’m sorry. We tried.” Geddes lifted the patient’s chart. “If you need me, I’ll be in Sister’s office. I’ll talk to the next of kin and fill in the death certificate for them. Thanks a lot, Barry. Good thing you were here. Harry already knows his stuff, but you’ll be ahead of the class.”

  “Class?”

  “I’ll be starting soon to train all the housemen how to deal with cardiac arrest.” He left.

  Harry, still short of breath, jerked his head to the corpse. “I suppose you can’t save them all.”

  Barry nodded, sad that everyone’s best efforts had failed. He himself felt no sense of personal loss. He realised that was because he barely knew the patient. The unfortunate had been one of a crowd. Barry was honest enough with himself to know his earlier visit had been as much to confirm his having saved a life as it was out of concern for a stranger he hardly knew.

  “Nyeh—” Harry often made that nasal sound as a preface to speaking. “God, I could use a smoke.” He glanced at his watch. “I’m still on call, but I don’t need to stay on the ward. Come on. The nurses’ll take care of things here.”

  As soon as they were on the corridor, Harry lit up and strode off. He’d begun his year with this three-month stint on 5 and 6—a position Barry would assume on December 1 when his time in casualty was over. He lengthened his stride and caught up.

  “How are you, Harry?”

  “Rotten.” The man’s lips turned down. His forehead was creased. He took a deep draw on his smoke. “I hate it when we lose them.”

  “Damn.” Barry gritted his teeth. Poor man. He hadn’t looked that old. And Harry was taking the loss hard. Barry immediately touched his friend’s shoulder. “I’m sorry, Harry. I really am.” He held open the door to the East Wing.

  Harry stopped in front of a wall-mounted ashtray and stubbed out the half-smoked cigarette with a vicious twist of his hand. He shook his head. “Jesus, Barry. We were going to discharge him last week, but he had a bout of atrial fibrillation. Not as bad as ventricular. We put him on digitalis and quinidine and seemed to have it under control.” Harry yawned. Inhaled. “I’ve been up since two this morning. We had two admissions and we lost one of them. Your man there, Robbie Martin”—Barry recognised the patient’s name now and yet still felt no real sense of loss—“was the second to go today. He was only sixty-one. It’s bloody unfair.” Harry stared into the middle distance.