Fingal O'Reilly, Irish Doctor

  “Yes.” Bob smiled wryly. “Pretty positive data showing that the stuff’s effective—in mice.”

  “But it won’t work in your culture plates?”

  Bob crushed out his cigarette, shaking his head. “No, damn it, and it won’t—ever. So much for my research project.”

  Fingal frowned but ploughed on, “But I’ve just spoken to Oonagh O’Grady at the Rotunda. She told me on the quiet that it is working in Doctor Davidson’s cases of puerperal sepsis. I don’t understand. Puerperal sepsis is caused by haemolytic Streptococcus, the Prontosil seems to be working against it in those women, but Prontosil isn’t effective on your culture plates with the same microorganism?”

  Bob cocked his head. “Fingal O’Reilly,” he said, “you sure as hell didn’t come charging over here all hot and bothered at teatime on a Friday night to get a lesson in bacteriology. What’s up? And would you for God’s sake sit down?”

  Fingal shook his head. “I don’t have time to sit, Bob. I have a kid with a foot infected with Streptococcus, and the infection’s spreading. Unless he has the foot amputated, he’s going to get septicaemia. I thought—I thought—”

  “You thought that you might be able to cure him with red prontosil. That it?”

  Fingal nodded.

  Bob said quietly, “You might just be right.”

  “What? Do you really mean that?”

  “I’ve spent hours in the library since the day we went to Donnybrook—”

  “And?”

  “It’s a long story, but there is early evidence that it does work in humans.”

  “Praise be.” Fingal realised he was trembling. “Bob, can you help me get my hands on some? Please?” Fingal waited. Say yes. Say yes.

  Bob sucked in a breath through tight lips. “We’ve got quite a stock in the lab—”

  “Do you have a key?”

  “Of course.”

  Fingal grabbed Bob’s arm and started hustling him to the door. “Come on. Let’s go.”

  “Hang on,” Bob said, and frowned. “It specifically says on the bottles, ‘Not for use in Humans.’ Professor Bigger will kill me if he finds out. I could lose my job.” His nose wrinkled. “I’d have to take a job like yours. Perish the thought.”

  Fingal exhaled through his nose. Forcibly. Think, man think. How to get Bob to help? A slow smile started. Fingal knew enough about medical researchers to understand their Achilles’ heel. “He’ll not fire you if it works and you help me cure the kid. I’d call that pretty important positive data. Might even be a prize in it for one of Professor Bigger’s top students. And he’d reap some of the glory too. He’d forgive you.”

  Bob cocked his head. “It would be a gamble, but damn it, at pretty short odds. I’ve found out a thing or two about Prontosil since I started reading about it.” He laughed and said, “Who called you ‘the wily O’Riley’?” He headed for the door. “It’ll be quicker in my car. Leave your bike here in my flat.”

  “God bless you, Bob,” Fingal said, grinning from ear to ear and getting his bike from the hall.

  “And just so you know,” Bob said, “we’ve been very good friends for a while. I’d have helped you even without the carrot of possible scientific glory, you bollix. To say nothing of the fact that a little chap’s life is at stake here. When I started this job it was because you suggested it, Fingal, as a better option for me than seeing patients, but the more I read and the deeper I get involved, I’m beginning to undersand that us drones slogging away in laboratories might eventually do more good than all you hands-on doctors. Now come on.”

  Both men were quiet as Bob drove away. “Right,” he said, “it’s only five minutes to Trinity, but the traffic’s bloody so be quiet and let me concentrate.”

  Fingal looked over at his friend with new eyes. Working with Professor Bigger was changing him. And what had he meant about “pretty short odds”? They were what bookies gave on sure things at the track.

  * * *

  Fingal sat in the passenger’s seat clutching a glass bottle stoppered with a large cork. Some traces of paper had stuck to the glass when he’d ripped off the warning label. Inside was a bright red-orange compound. Red prontosil. Bob had brought a glass beaker, scales, a metal spatula, and a glass stirring rod. “And you do think it’ll work, Bob?”

  He stopped at the junction with Nassau Street to let a tram bound for Terenure pass. “I wouldn’t have a couple of weeks ago. All I knew was that it worked in mice, because our profs had told us that when we were students, but it wasn’t working in my lab.”

  “But you said there is evidence that it works in humans.”

  “There is now, but until June of this year all the tiny hints it might work were reported in German or French. Nobody here had heard of them, and if they had, the medical establishment pooh-poohed the idea that a chemical could kill bacteria.” He passed Duke Street with the Mansion House farther down Dawson Street on the left. “There’s Davy Byrnes pub. It’s time we went back for a pint. See Diarmud.”

  “Aye,” said Fingal. “Soon, but not tonight. Go on about Prontosil.”

  “A German chap, Gehard Domagk, first showed it worked in mice in ’32, and he did a human study, but he didn’t publish the combined data until ’35. His article was in Deutsche Medizinische Wochenschraf.”

  “That’s a mouthful you’d need to chew twice,” Fingal said, “but why did he wait so long to publish?”

  “No one’s sure. He was working for a pharmaceutical company. They’d applied for a patent in 1932, but the patent wasn’t approved until ’35. A month later, Domagk’s work appeared in print.”

  Fingal grunted. Three years of lives that might have been saved if the stuff really was effective.

  Bob skirted Saint Stephen’s Green. “Then a Doctor Foerster reported, in German, that he’d cured an infant with septicaemia. Again in ’35.” He shook his head. “You’ve no idea how much time I’ve spent trying to get my hands on obscure foreign journals and then getting the damn things translated.”

  Fingal clutched the bottle more tightly. A single case? One swallow does not a summer make, but anything that would cure something that was universally fatal must have some merit. It must. It must, but there still was that question. “So if it’s so bloody good, why won’t it work in your lab?”

  Bob chuckled and turned onto Cuffe Street. “Bunch of Frenchmen led by a Doctor Trefouel sorted that out. By itself, Prontosil is about as much use as tits on a boar, but once inside a body, it’s broken down into a number of different compounds. Trefouel’s team managed to isolate the main one. It’s called sulphanilamide, and when it comes to holding off hordes of Streptococci, the thing’s like Leonidas’s Spartans at Thermopylae.” He passed Aungier Street and stopped, waiting for a chance to turn right onto Bride Street. “Naturally they published in French and us insular peoples can’t read the bloody language. But it’s there in a journal once you know where to look.”

  “I’m impressed, Bob,” Fingal said. “You’ve certainly been doing your homework.” Bob may have chosen research because he had no desire to practise medicine, but he was clearly taking his job seriously. He could be going to the racetrack and finding a rich woman but he’s hanging out in libraries instead …

  Bob chuckled. “Well, I have to ‘remain a student,’ to justify getting Auntie’s bequest, don’t I?” He drove along Bride Street. “And the best is yet to come. I’m sorry for Doctor Davidson, but he’s been pipped at the post. Priority for curing puerperal sepis with Prontosil will go to two Englishmen, Doctors Colebrook and Kenny. They published their results in the Lancet in June. Four months ago.” He turned left onto Bull Alley. “It worked. It bloody well worked. I’m sure Davidson’s group will know that. They’ll be disappointed not to be first, but all scientific studies need to be replicated by other groups before we should take them seriously. It’s valuable work going on at the Rotunda.”

  “Park here,” Fingal said, halfway along Bull Alley. “Jasus, Bob.” His voice wa
s hushed. “So you think we really do have a chance to cure young Dermot?”

  Bob nodded. “I sure as hell hope so.” He started to get out. “Lead the way. I’ll see where you go, then come back and get a couple of gurriers to keep an eye on my car. It’s getting dark and motorcars go better if they still have their wheels and batteries. I’ll bring my stuff in a minute.”

  * * *

  “T’ank God you’re back, Doctor O’Reilly. Dermot’s gettin’ worser.” Mrs. Finucane stood beside her son’s mattress. “He’s taken a lot of fits of the shudders.”

  Fingal nodded. Not surprising. As the infection spread, more toxins would be released, the fever would go up, and the body would respond by a series of muscle spasms called rigors. “Where’s my bag?”

  “Here, sir.” Mister Finucane, who had shaved, handed the bag to Fingal, who set the Prontosil bottle inside and took out a thermometer. He knelt beside Dermot. He was breathing rapidly at a rate of more than eighteen breaths per minute. Merely to touch his skin showed that the half-conscious boy was burning up. Fingal tucked the glass tube under Dermot’s armpit, then took his pulse, one hundred per minute. He looked at the infected leg and foot. The ulcer did not seem to have gotten any bigger. He bent and sniffed. Still no mousy odour, but the stink of pus made him gag. The red lines had spread farther up and were now just past Dermot’s ankle. The infection was gaining. Would the red prontosil stop it? He was sure that there was still time to save the boy’s life by getting him to hospital for a quick above-ankle amputation, damn it all, but what about what Bob had told Fingal in the car? Prontosil worked. He wondered, Do I have the right to decide for Dermot and his family? hesitated, and then told himself that because he was trained to weigh the pros and cons and Dermot’s parents were not, it was Fingal’s bounden Hippocratic duty to do so. Sometimes being expected to make such decisions on behalf of patients was a heavy load to carry, but it was part of a physician’s job.

  “Who the feck are you?” Minty said.

  Fingal turned to see Mister Finucane blocking Bob’s entrance. “It’s all right. This is Doctor Beresford. He’s a specialist in infections. He’s come to help.”

  “Dat’s all right den. Come in, sir. Didn’t mean to be feckin’ rude.”

  “Quite all right,” said Bob, taking in the shabby room in one sweeping glance, then heading for Dermot’s bed.

  Fingal turned back to his patient, removed the thermometer, went to the paraffin lamp, and held the glass tube in front of it. The thin column of mercury had stopped at the mark showing 100.2° Fahrenheit. Fingal took a deep breath. Any two of the three findings of a respiratory rate of twenty or more, a pulse faster than ninety, and a temperature greater than 100.4° F were diagnostic of septicaemia, blood poisoning, for which modern medicine recognised no cure. So far only one of Dermot’s readings was over the threshold, but how long would that state of affairs last? He stood and said to Bob quietly, “It’s Prontosil or bust. I hope to God your English and French doctors are right. What dose do you reckon to start with?”

  Bob said, “I think Doctor Domagk used ten grams? Why not? And repeat it every four hours.”

  “Fair enough. Will you make up the first dose?”

  “I will. Fortunately it’s water soluble so we can give it as a draught.” Fingal retrieved the bottle from his bag and gave it to Bob, who took it and his scales and other paraphernalia to the table. “Mrs.…?”

  “Finucane,” Fingal said.

  “Mrs. Finucane, could you please heat a kettle of water?”

  “Yes, sir.” She hung one on a cast-iron gallows over the turf fire and turned to Fingal. “Will he be all right, sir?”

  Fingal hesitated then decided to do as he’d seen his old teacher Doctor Micks do when death could be imminent. Hide nothing. “I’m not sure,” he said. Oonagh O’Grady had said if the stuff was going to work it would do so quickly. “But we’ll have a pretty good idea by this time tomorrow.”

  She sobbed and said, “Please make him better, sir. Please.”

  “We are trying. I promise.”

  “Should I send for Father Burke?”

  Fingal shook his head. “If I think it’s coming to that I’ll tell you. I promise.”

  Mister Finucane put his arm round his wife’s thin shoulders. “Come over to the corner, Orla. We’ll say the rosary.” He looked at Fingal. “We’ll let the doctors get on wit’ their work.”

  They moved aside and Fingal, after casting one more glance at Dermot, moved to beside Bob, who now was stirring a mixture of Prontosil and warm water in the glass beaker. The aniline dye swirled like red smoke.

  A quiet, “Hail Mary, full of grace. The Lord is with Thee. Blessèd art thou among women…” came from Dermot’s parents.

  “I’ve mixed it,” Bob said. “Here.”

  Fingal took the beaker. It was warm. He knelt beside Dermot, lifting the boy until he half sat. He put the glass to the boy’s lips. “Drink up.”

  Gagging and spluttering, the boy choked most of it down. He had a red stain round his lips when Fingal lowered the lad onto his pillow.

  Fingal stood and went to a basin of water, washed the beaker, and set it on the table with the bottle of the medication and Bob’s gear. “Thanks, Bob. Thanks for everything.”

  Bob sniffed and wrinkled his nose. “Always glad to help a friend,” he said, then lowering his voice, added, “And you work in places like this every day?”

  “Pretty much.”

  “How do you stand the stink?” He scratched his side. “And I do believe I’ve been bitten by something. Probably a flea, or fleas.”

  “Holy Mary, Mother of God…” the voices droned on.

  Fingal frowned. He was perfectly capable of compounding any further doses. Hadn’t they spent hours under Doctor Micks’s patient tutelage, weighing and measuring grains and minims, ounces and grams? They’d decided to repeat the dose every four hours. How many doctors did that take? “Tell you what, Bob. There’s no real need for you to stay.”

  “Except to keep you company. And to see if—and I hope to God it does—the damn stuff works.”

  “Aye, but I need you to do some other things.” Give him a job and Bob wouldn’t, Fingal hoped, recognise that for the sake of his sensibilities he was being chased off.

  “Oh?”

  “Go home and phone Doctor Corrigan.” Fingal rummaged in his inside pocket, scribbled in a notebook, and ripped out the page. “That’s his number at home and that’s the dispensary number. You’ll have to track him down because he was going out on a delivery the last time I saw him. Explain to him what I’m doing and that I’m staying until it’s over.” One way or the other, Fingal thought, and crossed his fingers. “Tell him I’m sorry, I know it’s not his turn, but will he please cover this weekend?”

  “I’ll do that.”

  Fingal grinned. “Then have a nice hot bath and use that carbolic soap you offered Charlie and me when we first told you about working for a dispensary,” he lowered his voice, “for the fleas, then yourself a nice Napoleon brandy, smoke a Gold Flake or two, and perhaps even send up a prayer—”

  “Holy Mary, Mother of God, pray for us sinners…” came from the corner.

  “And come back here at teatime tomorrow and see if you can get my bike in the back of your car.”

  “All right, Fingal. If you’re sure.”

  “Go on with you. I’ll say your good-byes.” He watched his friend leave quietly and went back to sit beside Dermot when a thought struck. Christ. He’d forgotten about Kitty. As Fingal raced for the door to try to catch Bob and ask him to phone her, he heard two supplicant voices, “… now and in the hour of our death. Amen.”

  38

  Fathom Deep I Am in Love

  “Done for the day, Jenny?” said O’Reilly, starting to rise from his armchair as she came into the upstairs lounge. Her blonde hair was freshly washed and set. She wore a single strand of pearls at her throat, a hint of cleavage showing above the neck of a simple but elegant
black dress. Black satin opera gloves completed the ensemble. Quite a change from the usually modestly blue-suited working physician.

  “Please don’t get up, Fingal,” she said. “Done for the day? Indeed I am. Finale. Finito. Finis. Omnino complevit.”

  Fingal chuckled. “Omnino complevit? Did you enjoy Latin at school?”

  “Mmmm,” she said, “I love learning new things. And it helped me to understand my own language better.”

  “I agree,” said O’Reilly, “but I don’t think you’re going to a Latin class tonight.”

  She laughed, a musical sound. “Not one bit. I’m going up to Belfast to fly my kite. It’s Friday.”

  “Kick up your heels? Good for you, but drive carefully. There’s more frost forecast.” Winter had arrived in the north of Ireland even though it was only the first week of November. The light was gone outside and by six o’clock Kinky had got the curtains closed and a fire roaring in the upstairs grate. Outside the wind growled past the bow windows.

  Kitty should be home soon. He lifted his booted right foot to keep the left one company on a footstool and swirled the Jameson round in his glass. “Seeing Terry Baird again?”

  She smiled. “We’re going for dinner at the Tavern Buttery down by the Law Courts.”

  O’Reilly whistled. “His law practice must be doing well.” The Buttery was a popular and pricey restaurant.

  She laughed. “We go Dutch. I’m a salaried working woman, thanks to you, Fingal, and I like to pay my share.”

  “Can I get you a pre-prandial?” He nodded toward the decanters.

  She shook her head. “I’m driving and I’ll need to be off in fifteen minutes.” She lifted her current read, World’s Best Science Fiction: 1965, from the other armchair and sat. “Just wanted to tell you about a patient I saw this afternoon. She’s one of yours, but, and don’t get cross, Fingal, she wanted a woman’s opinion.”

  He roared with laughter. “Why in the hell would I get cross? I think my practice is getting bigger since you came.”