An Irish Country Family--An Irish Country Novel

by Patrick Taylor

  He let Bernie chat for a while, but in truth he wasn’t paying close attention. His gaze never left Virginia’s face.

  “… anyway,” said Bernie, “life goes on in casualty, and we’re looking forward to having you back, Barry.” She stood. “I’ll be running along. Nurse Clarke. Hear me now, ten minutes, not a second more.”

  Barry couldn’t wait for Bernie to wash her hands and take off her gown, but he didn’t want to say anything personal yet. “It’s lovely to see you, Virginia. How have you been? I must have given you an awful shock passing out like that.”

  “You did,” Virginia said. “You certainly did. Norma was great. She sorted everything out and got you admitted here.”

  “Your ten minutes is running,” Bernie called just before she closed the door behind her.

  Victoria looked into his eyes. “Barry. Barry. My heart stopped when you collapsed on Thursday. I should have been concerned for that rugby player. I should have been working out what to do, but all I could think of was what if there was something seriously wrong with you, and how much I would hurt if I lost you. I was being selfish, I know, but it hit me then that I was in love with you.”

  “And I’ve been falling in love with you since the day on Cave Hill,” Barry said. “Thank you for sending your love with Jack. It helped. It really did.”

  “I’m glad.” She smiled.

  “I really want to kiss you, hold you,” Barry said, “but”—he shrugged—“Whatever I’ve got I don’t want to pass on to you.”

  “It’s all right. I understand. There’ll be plenty of time when you’re better.”

  Barry hoped to God that Jack was right about sparrows and canaries. “Yes, there will be. I do love you, Virginia. I really do.”

  * * *

  Monday had come at last. Barry sat propped up on pillows and sighed. He’d had the better part of three days of trying to cope with the unknown. It was ten thirty now, and still no sign of Doctor Nelson. Barry was at a point where, despite Jack’s reassurance, repeated again yesterday when he’d visited, a firm diagnosis of Hodgkin’s might be preferable to not knowing.

  The door was opened, and Sister Lynch came in, accompanied by Doctor Swanson and a short, fair-haired older man. With a shock, Barry realized that none was masked or gowned. Whatever diagnosis had been made, the condition was not highly infectious. That wasn’t good. Barry knew his pulse rate had risen and his anxiety had increased.

  They marched over to his bed. Sister said, “Doctor Laverty, we’ve brought Doctor Nelson to see you.”

  Barry sat bolt upright.

  “Morning, young Laverty,” Doctor Nelson said. “Not feeling so hot?”

  Barry recognised the haematologist. He’d been a superb bedside teacher when Barry was a student. “No, sir.”

  “I’m not surprised. Swanson here has told me your symptoms and signs. Sounded pretty flu-like, but the lab work doesn’t agree.”

  Barry waited.

  “While your total white count was low when we first measured it, it was high on the second count.”

  And it was high in Hodgkin’s.

  “The differential showed mostly monocytes and lymphocytes.” Doctor Nelson smiled.

  What the hell was the man smiling at? And what did that mean?

  “I looked at the slides myself this morning. The little devils had a very characteristic abnormality.” Doctor Nelson tapped his fingernail on his front teeth before saying, “And your Paul-Bunnell test was positive, so you certainly don’t have flu.” He cocked his head to one side. “Care to take a guess at what’s wrong?”

  Damn it, this was no time to make Barry his own teaching case. “No, I don’t.” Barry knew he’d spoken sharply, but would somebody please tell him what was wrong?

  “No? Pity. You were always such a good student. All right. I’ll put you out of your misery.”

  Barry shook his head. Nicely phrased, I don’t think.

  “The funny-looking white cells are called ‘glandular fever cells.’ The Paul-Bunnell test is positive in eighty percent of patients with glandular fever, also called infectious mononucleosis. Those who have the disease have a factor in their serum which has the ability to make sheep’s red cells agglutinate.”

  What Doctor Nelson was saying was beginning to sink in. Dear God, Hodgkin’s hadn’t even been mentioned. Mono? Did he have mono?

  “Your serum did, at a very high titre.”

  Barry said, struggling to keep his voice calm, “Sir, you’re telling me I’ve got mononucleosis?” He knew that despite his efforts he’d gone up an octave on the last word, which he repeated. “Mononucleosis? That’s all?”

  “Correct.”

  Barry wasn’t sure if now his worries were relieved he’d like to kiss the haematologist, or having been left in uncertainty over the weekend, to hit someone. Not Doctor Nelson. It wasn’t his fault he’d not been available. One thing was for sure. Doctor Barry Laverty would never, never, leave a patient of his to stew that way.

  “Yes, and its infectivity is very low. There’s no specific treatment except rest and fluids, so there’s no reason you can’t go home for a while. Rest there.”

  “Thank you.” And the realisation took root. He’d worried, shed tears, convinced himself he was going to die for nothing. Nothing.

  “Get well,” Doctor Nelson said. “I’ll square things with the dean, so you’ll not lose credit toward your year of preregistration work. You’ll be fully licensed by next August.”

  “Thank you.” Barry hadn’t even thought about that until just now. Yes. That was important.

  “So, Doctor Swanson and I will be getting back to our duties. Swanson will write to your GP. Go and see him on Friday next. He can decide when you’re fit to come back to work.”

  “I will, sir. And thank you very much.”

  “You hurry up and get better.” And with that, the senior consultant and houseman left.

  “I’m sure you’ll not be sorry to be going home,” Sister Lynch said. “Can someone drive you? You really shouldn’t be behind a wheel until you’re stronger.”

  “If I can use the ward phone, my mother will come and get me.”

  “Good. I’ll send Nurse Peters to give you a hand to get ready, and if you give me your mother’s number I’ll phone her while you’re getting organised. Speed up your discharge.”

  “Bangor two one double five. Please tell her to come to The Huts, our quarters. She knows where they are. And please explain to her it’s glandular fever, not flu, and it’s not serious.” Even without knowing what had bothered Barry so much, Mum would have been worried sick too.

  “I’ll ring straightaway.” She smiled. “We don’t want to rush you, but we do need your bed.”

  He was still chuckling when Sister left, but he had controlled himself by the time Jan Peters appeared.

  “Hello, Barry,” Jan said with a smile. “I hear it’s only mono. That’s great. Here are the clothes you were admitted in, and the sponge bag your friend Jack Mills brought for you.” She laid them on the foot of his bed and opened a screen on wheels, so he could have privacy to change.

  Barry got out of bed. “Mono, that’s right,” he said. “I must say I’m relieved to hear it.” He slipped off his split-up-the-back gown and smiled. Jack Mills had been right years ago when they’d started walking the wards as students. “They take away your dignity, and in return give you a split gown with your arse showing.” Barry dressed quickly. He left his long white coat on the bed and let himself out from behind the screen, which he pushed aside. “Thanks for looking after me, Jan.”

  She smiled at him. “It’s what they pay me to do, and you were no trouble. You did talk in your sleep, though. You were frightened, you poor thing.” Her eyes were pools of sympathy, her voice gentle.

  Barry smoothed down his tuft of fair hair. He always did that when he was embarrassed. He didn’t know Jan Peters well, but already he felt she was someone he could trust. “You’re right. I—I was frightened. I was stup
id enough to try to make my own diagnosis. I’m a little embarrassed that you knew, but happy to tell you I was wrong.”

  She shook her head. “Barry, us nurses see more of the human side of the patients. Most of them feel they have to be on their best behaviour when the doctors are around. You know what Ulster folk are like. Don’t show your feelings in public. But they’ll confide in us, and we’re trained to listen. You could have too, but I’ll bet it’s tough being a doctor and a patient at the same time.”

  He nodded, and thought about what she’d said. None of the teaching he’d received as a student in six years of medical school had ever touched on this. What patients were feeling emotionally, not just physically. It dawned on him that everything in a hospital that he took for granted was new and frightening to the laity. And if as a physician he’d been worried by uncertainty, how must the patients feel? “Your dad said something like that about nobody answering his questions when his father was ill. About nurses not being allowed to in case they contradicted the specialists.”

  She nodded. “It’s true, but it doesn’t stop us being sympathetic, comforting. You were very kind to Dad when he needed it.”

  After the last few days, Barry understood that much better now. “How is he?”

  “Getting better slowly. Worried about whether he’ll ever get back to work. He was up here to outpatients last week to have another pint of blood removed, but dad’s a tough old bird. He’ll be all right.”

  Barry lifted his sponge bag and thought, Polycythaemia does not have the best prognosis. Surely Jan knows that? Perhaps for some people, not facing the truth was a comfort after all? “Tell him I was asking for him, and please give him my regards.”

  “I will. He’ll appreciate that.”

  Barry headed for the door. “Thanks again, Jan.” He looked round the room. “I’m off. I want to get a shave and a bath before Mum comes to take me home.” As he lifted his white coat with his left hand, he winced. The botched bloodletting. Jack had been right. The result of that extra blood test had led to the decision to consult Doctor Nelson, and given Barry three days of emotional torment and a large, aching bruise. And it wasn’t as if Barry needed any other reminders of what uncertainty could do to an anxious patient.

  17

  Observation with Extensive View

  May 2, 1969

  Barry sat at Sue’s bedside, holding her hand. “Won’t be long now.”

  “The sooner the better. I really want to get this over with, Barry. Get some answers at last.”

  Sue had been admitted last night to the gynaecology ward of the Ulster Hospital in Dundonald and was the first case on this morning’s list. As a professional courtesy, Barry had been invited to observe.

  “That’s why we’re here. To get some answers. We’re going to get through this, you know.”

  “I like the ‘we.’ I’m the one who’s getting poked and prodded.” She’d said it lightly, but Barry could detect the tinge of bitterness in her words. He couldn’t blame her.

  “Sorry. I didn’t mean to snap.” She squeezed his hand. “Must be all the stuff they gave me. I’m just nervous, that’s all. Thank you, Barry, for coming today.”

  Barry smiled. “And where else would I be?” he said, leaning down to drop a gentle kiss on her forehead.

  “Thank you for understanding. Such a comfort to have you here.” Her free hand smoothed the sheet at her side. “To know that even while I’m asleep, you’ll be there. I’m sure Doctor Taylor will find something and fix it. I just know it.” The pressure of the grip of her hand increased.

  Barry was not so sure. He had some understanding of what a laparoscopy might detect, but wondered if it would be the answer Sue was looking for. “We’ll see.”

  Barry knew Pat Taylor from Bangor. The young gynaecologist had been a year behind Barry both at Campbell College and as a student, sailed out of Ballyholme Yacht Club, and had passed the examinations of the Royal College of Obstetricians and Gynaecologists in London to qualify early this year. He’d been sent to Oldham in England to be taught the technique by Mister Patrick Steptoe, one of the pioneers. Here in Ulster Hospital, Pat was a registrar, still a junior because of the slow rate of promotion to consultant, but the most experienced laparoscopist in Ireland.

  The curtains were pulled back. “Time to take you to theatre, Mrs. Laverty.” The white-clad male orderly who had spoken was accompanied by a nurse.

  Barry disentangled his hand, stood, bent, and kissed her forehead again. “Good luck, love,” he whispered, then stepped outside the curtains to let the orderly and nurse carry on. As Barry headed for the operating theatre he hoped Sue was right about something getting fixed, but he had his doubts.

  He sat down on a bench in the surgeons’ changing room. He was already wearing surgeon’s trousers and shirt and began pulling on ankle-length white rubber boots. Beside him, Pat Taylor was pulling a white stockingette cap over his fair hair. “Thanks for letting me come, Pat.”

  He was a slight man, five foot eight, slim, clean-shaven. “My pleasure. You know the drill. There’s no need for you to scrub. Keep back until I tell you to come to the table. Don’t touch anything. I’ll give you a running commentary, and when I’ve seen all I want to see, I’ll hold the scope and let you take a gander through the eyepiece.” He put a hand on Barry’s arm. “I know this is going to worry you, with your Sue the patient. Try not to let it. It really is a simple technique and I’m not going to be removing any bits. Just having a look.”

  “Fair enough.” Although Barry would worry. The last time he’d been in an operating theatre, Jack Mills had been performing a gastroscopy on Bertie Bishop. Barry had never been comfortable with surgery during his short time as an obstetrics and gynaecology trainee. He found it difficult to forget that it was a human being he was cutting. It was one of the reasons he had returned to general practice in Ballybucklebo. He admired the obvious self-confidence of surgeons like Jack and Pat.

  “Right,” said Pat, handing Barry a mask. “Let’s do it.” He opened the door to the operating theatre.

  Barry followed his colleague, who greeted those already in the theatre. “Morning, all. This is Doctor Laverty, who has come to observe.” Taylor turned on the taps over a wall-mounted sink and began to scrub.

  The anaesthetist at the head of the table, the gowned and gloved scrub nurse who stood with her instrument trolley on the table’s right side, and the circulating nurse, who was there to carry out nonsterile tasks, all greeted Barry.

  “Good morning,” he said, staring at the table, where Sue lay under a blanket. An intravenous line was running. She was hooked up to the anaesthetic machine. From over the table, the powerful beams of the light limned her belly in brightness. Her legs were supported in stirrups and the table was broken so her buttocks lay on its edge to give the surgeon access.

  Barry watched as Pat and the scrub nurse painted the operative area with pungent-smelling antiseptic and arranged the green sterile towels. The sight of Sue as a surgical patient, looking like patients he’d seen during his time in medical school, was unsettling. This was his darling wife. He wondered if it had been wise to be here. Be at her bedside, yes, but here in the operating theatre?

  “I’m putting a cannula into the uterus,” Pat said from between Sue’s thighs. “It allows me to manipulate the uterus. You’re a sailor, Barry. It’s like a tiller. If I push it to the right, the uterus moves to the left, and”—Taylor placed a large syringe of blue liquid on Sue’s belly as if it were a convenient shelf—“I’ll be using the syringe, which I’ve connected to the cannula with a plastic tube, to test tubal patency.” He moved to the left side of the table and turned to the anaesthetist. “All set?”

  “Go right ahead.”

  “Scalpel.”

  Barry flinched and looked away as Pat made a skin incision along the lower rim of Sue’s umbilicus.

  “Veress needle, please.” He showed it to Barry. At the needle’s top was a fixture for connecting it to a rubbe
r tube. “I have to put this needle into Sue’s belly and then distend the space with carbon dioxide to give me room to work.” Barry closed his eyes and opened them when he heard Pat say, “And we’re in. Gas line, please.”

  Barry swallowed.

  Pat connected the gas line to the needle.

  “Trendelenberg position.”

  The anaesthetist turned a crank and the head end of the table descended so that it was at thirty degrees to the floor.

  “That lets her puddings”—typical surgeons’ talk for bowels—“slip out of the pelvis and out of my way.”

  Sue’s belly was now, Barry sighed at the thought, about as swollen as it would be if she were nine months pregnant.

  “Trocar and cannula.”

  Pat accepted a cylindrical steel outer-sleeve with a trumpet valve at the top, the cannula. The trocar was a solid steel core with a wickedly sharp tip protruding from the lower end of the cannula.

  Barry couldn’t bear to watch. Pat was going to thrust that thing through the incision. Barry turned away again.

  “Scope, please.”

  Barry turned back. Pat had removed the trocar and was depressing the trumpet valve to allow him to pass the telescope. He pointed to a cable running from the scope to a box on a trolley. “What revolutionised this was the work of three Frenchmen, Fourestier, Gladu, and Vulmiere, in 1952. They used fibreoptics, as I’m doing now, to bring powerful illumination from an external source. Now let’s have a look.” He bent and put his eye to the scope’s lens. “Just where we ought to be. Now, watch.”

  Pat’s examination didn’t take long. He could see Sue’s internal genital organs aided by the instrument in her uterus, the probe, and the injection of the blue dye. He stood up straight. “Take a peek.” He held the telescope steady.