An Irish Country Village

by Patrick Taylor

  “No, you can’t,” Barry said. “Right. Stick it out.” He slipped the plaster tube over the finger from the tip to the base. “Now look.” he pressed his own middle finger against his thumb, making a circle like an okay sign until the fingertip angled upwards. “Can you do that?”

  “Ouch.” Donal grimaced but did as he was told.

  “Stick your hand in the bowl of water.”

  “That’s brave and warm, so it is.”

  “Give it here, and keep the pressure on.” Barry moulded the cast to the contours of the finger, feeling the warm water drip between his fingers as he squeezed. “There. Keep holding it against your thumb until the plaster dries.” He went to the sink to wash his hands.

  He could see Donal peering at the cast. “Thing of beauty that, sir.”

  “It’s hardly a work of art, Donal, but it should do the trick.” Barry came back from the sink and felt the cast. “It’s drying nicely, so you trot along and come in and see me tomorrow. I’ll need to make sure the cast’s not too tight.”

  “All right, sir.” Donal stood. “I think I’ll take a run-race on my bike back to Sonny’s, tell Seamus I’ll not be back to work, and get him to come to the Duck with me tonight.” He grinned. “I think Seamus could get most of the boys in the Ballybucklebo Highlanders pipe band to chip in for the roofing job.”

  “You do that,” said O’Reilly, “and leave the door open when you go out.”

  “Right, sir, and thanks again, Doctor Laverty.” Donal left.

  O’Reilly shook his head. “I’m amazed. Who’d have thought Donal Donnelly would be the soul of Christian charity?”

  “Could he really organize a work party, Fingal?”

  “I don’t doubt it for one minute.” He walked to the door. “And speaking of work parties . . . do you think we might get on with the morning’s business?”

  “Sorry, Fingal. Yes, of course.”

  “Good,” said O’Reilly. “I’ll trot along and see who’s next.”

  The telephone was ringing in the hall, and Barry heard Mrs. Kincaid answer. It had been another uneventful surgery. Lunch was over. O’Reilly was muttering under his breath about how if he had to eat one more salad, he’d be like the Johnny Cash song “Forty Shades of Green.” Then he said, “You did a good job this morning, Barry. Many a young doctor would have rushed Donal off for an X-ray.”

  “Would it have made any difference to his treatment?” Barry already knew the answer.

  “Not one whit.” O’Reilly poked a finger behind a tooth and fished out a scrap of raw carrot. “But you’d have covered yourself from any accusations that you neglected the patient.”

  “Do you think I did?”

  “Not at all, and you saved Donal having to go all the way to Belfast to hang about the radiology department for God alone knows how long, and even though it’s not a matter I worry about too much, you saved the taxpayer a few bob. I told you,” he said, rising, “you did well.”

  Before Barry had time to relish the older man’s praise, Mrs. Kincaid came in. “Only one call again today, so. Mrs. Finnegan rang, worried that Declan’s taken a turn for the worse.”

  “The man with Parkinson’s disease and the French wife?” Barry asked.

  “That’s them,” O’Reilly said. “Is that her on the phone now?”

  “No, she called earlier. It’s Mrs. Fotheringham, and she insists on speaking to you, Doctor O’Reilly.”

  “Oh, Lord,” O’Reilly said. “Right. I’ll see to it.” He left.

  Barry twisted in his chair and wondered what the woman could want. Certainly O’Reilly had gone out when her own doctor wasn’t available last Sunday, but Doctor Bowman of the Kinnegar should be on duty today. And if Mrs. Fotheringham had been sufficiently distraught to leave the practice because Barry had misdiagnosed her husband’s cerebral haemorrhage, she’d hardly be wanting anything to do with it now, not since his sudden death.

  Barry heard O’Reilly return, and saw the way he was frowning. “What’s up, Fingal?”

  “Bloody woman,” he said. “She demands to know what killed her husband. I can’t budge her. She’s adamant.”

  “But the results of the postmortem aren’t in yet.”

  “I tried to explain that to her, but she’s convinced you were responsible. I’m sorry, Barry.”

  Barry flinched.

  O’Reilly laid a hand on his shoulder. “It’s worse. She says if she doesn’t get an answer soon, she’ll have to have a word with her lawyer.”

  “What?” Barry heard his own voice rise sharply. “She’s going to sue me?”

  “She is if we don’t get some answers.”

  “Christ almighty.” Yesterday, with Patricia, he’d half decided he wasn’t too concerned about the outcome of the autopsy. Now it was critical, because being sued was every doctor’s nightmare. Until recently, malpractice actions had been virtually unheard of in Ulster. Litigation was a recent American import. It would utterly shatter the reputation he’d been trying so hard to rebuild. He looked up into O’Reilly’s craggy face.

  “I know what you’re thinking, son. If it goes to court, it won’t matter if they find in your favour. Just being sued puts the mark of Cain on a physician. We’ll have to hope to hell the PM finds something.”

  Barry’s head drooped. He’d not told O’Reilly what his old classmate Harry Sloan had said. He’d meant to when he’d come back from Belfast last Wednesday, but the conversation had been cut short by their having to rush out to deliver Jenny Murphy’s baby. Barry had completely forgotten. “So far nothing’s shown up,” he said.

  “What?”

  “I had a word with a pathology registrar last week, an old acquaintance. He was at the initial examination, and he told me that everything looked pretty normal. He said we’d have to wait for the microscopic examination of the tissues.”

  “Bugger. That could take a couple of weeks.”

  “I know, but Harry, my friend, said he’d look at the slides himself. I’d hoped to hear from him by today or tomorrow.”

  O’Reilly paced to the far end of the dining room, then back again. “Right.” He rubbed the web of his hand across his lower face. “Here’s what we need to do . . .”

  Barry waited, wondering what the hell anyone could do.

  “You go and see Declan Finnegan. If he’s worse, and he probably is, we’ll have to get him up to see the neurosurgeons.”

  “I don’t see what that’s got to do with Mrs. Fotheringham—”

  “Listen, will you? If you think it’s what he needs, go on up to the Royal, get hold of the head of neurosurgery, Professor Greer, tell him I sent you—we played rugby together—ask him to see if he can get Declan in soon.”

  “All right.”

  “While you’re doing that, I’ll go see Mrs. Fotheringham and pour a bit of oil on her troubled waters, try to persuade her to hold hard before she goes trotting off to a lawyer.”

  “Would you?”

  “Of course I bloody would,” O’Reilly said. “One thing I’ve learned. If a patient’s really angry—and Mrs. Fotheringham’s madder than a wet hen—the longer you keep them waiting, the worse they get.”

  “But you already said you couldn’t budge her.”

  “Aye, but you hadn’t told me about the PM results then. Maybe I can get her to understand there was no more bleeding in the major’s head, and so whatever killed him wasn’t because you were slow off the mark making that diagnosis.”

  “I suppose it’s worth a try, but why not just phone her?”

  “Because you can’t see somebody’s face over the phone. You can’t judge what they’re really thinking.”

  “God, Fingal, I hope you can get her to see reason.”

  “I don’t know if I can, but I’ll try.” He put a hand on Barry’s shoulder. “The best defence is attack.”

  “How?”

  “Get some solid facts that prove it wasn’t your fault.”

  “I could phone Harry.”

  “
Yes,” said O’Reilly, with a hint of disinterest. “I suppose you could.”

  “Jesus, Fingal, I can do better than that. It’s what you just said. I could go and see him when I’m up at the Royal. Find out everything I can.”

  O’Reilly moved closer to Barry. “Son, you’re like Saul on the road to Damascus. You’ve just seen the light.”

  Despite himself, Barry smiled.

  “Right,” said O’Reilly, heading for the door. “I’m off to beard the lioness in her den.”

  Barry turned back to the table and rested his head on his hands. God, but it was unfair. All that striving to get high enough marks at school so he could be admitted to the medical faculty, six years hard graft as a student, one year as a houseman, five weeks here developing, losing, but steadily rebuilding a reputation—and the whole bloody lot in jeopardy because of one stupid mistake.

  He clenched his fists and asked himself, what would O’Reilly do? And the answer was perfectly clear. He’d not sit here feeling sorry for himself. He’d get on with things and hope for the best. Barry rose. Standing about with both legs the same length wouldn’t get Declan Finnegan seen, or Barry Laverty up to the Royal Victoria Hospital.

  A Lawyer Has No Business

  Barry hurried along the Royal’s main corridor, barely bothering to acknowledge the greetings of acquaintances, oblivious to the old familiar noises and smells. He headed straight for Ward 21, the neurosurgery unit.

  He knew he must get hold of Harry Sloan, but his first priority was to arrange things for Declan Finnegan. Although Barry was desperate to find out if there were any results from Major Fotheringham’s postmortem, and although they would be critical to Barry, the patient himself was beyond help. But Declan Finnegan wasn’t—he hoped.

  Barry had called at the Finnegan house earlier. It had been horribly apparent, even before he had examined Declan thoroughly, that the man’s Parkinsonism had deteriorated badly. He’d lost control of his anal sphincter, and his wife was distressed by constantly having to clean him. But clearly she was more concerned about the assault on her husband’s dignity. She was a French war bride who’d come to Ballybucklebo after the liberation of France in the 1940s. Fortunately she spoke English well; Barry did not have O’Reilly’s fluency in her language.

  Declan needed to be seen by a specialist soon, and to achieve that, O’Reilly had recommended Professor Greer.

  Barry stopped at the front desk of Ward 21. He didn’t know the strikingly handsome, fiftyish, red-uniformed nurse who sat there. “Good afternoon, Sister,” he said.

  Her pepper-and-salt hair peeped out from under her fall, the huge, starched triangular white headpiece worn in the Royal only by those of “staff nurse” rank or higher. It was a holdover, a symbol of nuns’ wimples, although except in the Catholic Mater Infirmorum Hospital in Belfast, nuns were no longer seen on the wards.

  She smiled at him, and he noticed the amber highlights in her grey eyes. “Can I help you?”

  “Please. I’m Doctor Laverty. I was wondering how I could get hold of Professor Greer. I’d like to talk to him about a patient with Parkinson’s disease. Doctor O’Reilly sent me.”

  “Doctor O’Reilly? Fingal Flahertie O’Reilly?”

  “Yes. He’s my boss.”

  “Good God. How is the oul’ reprobate?” Her accent was pure Dublin.

  “He’s fine. You know him?”

  “I used to,” she said—rather sadly, Barry thought. “I knew him when I was a student nurse in Dublin before the war, and he was at Trinity College. He wasn’t a half bad–looking lad when him and Professor Greer played rugby together.” There was definitely something wistful in her voice. “And you want to see the prof?”

  “Please.”

  She frowned and looked at the watch pinned to her apron. “Monday? Three o’clock? He’ll be in his office dictating consultation notes.” She rose. “Doctor Laverty, isn’t it? With Doctor O’Reilly?”

  “That’s right.”

  “Hang on. I’ll see if he can give you a few minutes.”

  Barry waited until she returned. “You’re in luck. I’ll show you the way.” She led him past the desk, along a short corridor, and then stood holding open the door to a small office.

  “Thank you, Sister,” Barry said.

  “Come in, Laverty.” Professor Greer rose from in front of a paper-strewn desk. If anything, the man was even bigger than O’Reilly. His coppery eyebrows jutted over his eyes the way thatch overhangs an eave line, and they matched his shock of shaggy red hair. He offered his hand, with fingers that looked like sausages. His grip was firm but gentle. How, Barry wondered, did such ungainly hands perform the delicate manoeuvers necessary for the professor’s work? “So,” he said, “you’re O’Reilly’s pup?”

  “No, I’m not. I’m his assistant.”

  Greer laughed. “Don’t take on. When I was your age, learners were called pups . . . short for pupils . . . if you’re working with Fingal, you’ll still be learning.”

  “That’s true.” Barry relaxed. “Thanks for taking the time—”

  “To see you? Why wouldn’t I? You’re one of us. Here,” he pulled a chair closer to the desk. “Have a pew.”

  “Thank you, sir.” Barry waited for the professor to take his seat, then sat himself.

  “What can I do for you, Laverty?”

  “Doctor O’Reilly wondered if you could help us with a patient?”

  The professor laughed. “Another one? I did a cerebral artery aneurysm for the pair of you last month.”

  “I know,” Barry said. “He died last Sunday.” He knew his voice trembled as he spoke.

  “Did he, by God?” Greer hunched forward and looked into Barry’s face. “Another bleed?” He sounded concerned.

  Barry shook his head. “The early PM results didn’t show that. They haven’t shown anything. We’re waiting for the histology report.”

  “I’m glad it wasn’t the surgery. I’d hate to have done a sloppy job.” He sat back in his chair and steepled his big fingers. “Anyway, if he’s dead there’s not much I can do for him. It must be someone else you’ve come about.”

  Barry debated asking Greer if he had any idea what might have killed the major, decided it would be unlikely, and so came quickly to the point. “We’ve a man, Declan Finnegan, with very severe Parkinson’s. He and his wife can’t cope anymore. Doctor O’Reilly was wondering if you could see Finnegan with a view to surgery?”

  “How old is he?”

  “Sixty-four.”

  “No history of encephalitis?”

  “Not that I know of, sir.”

  “Is he incontinent?”

  “I’m afraid so.”

  “Probably due to hypertension or atherosclerosis.”

  “Does that mean you won’t be able to operate?” While Barry was quite capable of diagnosing the condition, the finer points of its treatment fell within the specialist’s field.

  “I’ll have to see him first.” The professor frowned, turned to his desk, and consulted a large diary. “Give me his name and address.”

  Barry did and Greer scribbled in his ledger. “Can you get him up here on Wednesday at six? I’ll fit him in as an extra after the clinic. Get things rolling. There might be something we can do.”

  “That’s very kind of you, sir.” Barry wondered if Greer would be willing to put himself out for any GP’s patient, or whether he was doing this as a favour to his old friend.

  “Rubbish.” He turned back to Barry. “It goes with the job, but I’m sure being a GP, you know that? Out at all hours. Unless Fingal’s changed, he’ll be working the legs off you.”

  Barry had to smile. “He is.”

  The professor leaned forward. “You’re enjoying it?”

  “I am, but—”

  “But you still get upset when you lose a patient? You saw people die when you were a student. We’re meant to get used to it.”

  “I know, but it’s still not easy, and this one’s different.”

/>   “I’d guessed that.”

  “How?”

  “I heard your voice, saw the look on your face when you said the man with the aneurysm had popped his clogs.” He leant forward and put a hand on Barry’s knee. “It’s not your fault, lad.”

  Barry sighed, looked into the older man’s eyes, and saw understanding. “This one might have been. I missed the diagnosis initially. Perhaps if we’d got him here sooner?”

  “I doubt it. I remember the case. Small aneurysm. Small bleed. It was easy enough to repair, and the results were very good. He’d have had very little residual damage.”

  Barry took some comfort from the opinion. He wondered how O’Reilly was getting on with trying to persuade Mrs. Fotheringham not to go to her lawyer. Barry realized that if she did sue, he was going to need all the support he could find. He blurted out, “His wife’s talking about suing me.”

  “Shite.” The vehemence of Greer’s obscenity startled Barry. “Bloody lawyers. They should stick to divorces and searching land titles. I suppose you’ve hardly slept since you heard?”

  “I only heard a few hours ago. Doctor O’Reilly’s gone to see the man’s wife. See if he can get her to wait until we know for sure what killed her husband.”

  “Good. If anyone can talk her out of going ahead, it’s Fingal O’Reilly.” The professor frowned, his great eyebrows knitted. “And you said the histology results are still to come?”

  “Yes, sir.”

  “Cheer up. With a bit of luck they’ll let you off the hook.”

  “I hope so.”

  “So do I, but if they don’t . . .”

  Barry felt his fingernails digging into the palms of his hands.

  “If they don’t, you can call on me as an expert witness.” He held out his hand, and Barry was comforted by the warmth in the man’s clasp. “Jesus Christ, if you saw him very early and he just had a stiff neck . . .”

  “I did, sir, and it was the only symptom.”

  “If that was all, I could have missed it too.”

  “Thank you, sir.”

  “Rubbish, and take my advice . . .” The man grinned. “God knows I’ve given it to enough patients. Hope for the best but be prepared for the worst . . . and if the worst does come, you’ll have Fingal and me on your side.” He walked to one wall and indicated a framed photograph of a group of young men in muddy boots, shorts, and green shirts with shamrocks on the right breast pockets. “Irish side, nineteen thirty-nine, at Landsdowne Road in Dublin. We beat Scotland twelve to three. Look.” He pointed.