A Dublin Student Doctor

  “For bringing you here?”

  “That’s part of it, but thanks for yesterday evening. For listening.” Fingal stretched out his chilled right hand and was warmed inside by the firmness of his brother’s icy handshake.

  By the time the flooding waters nudged the wall of the sea wrack hide and forced them out, Fingal had shot another mallard and Lars had his first mallard and a brace of widgeon. They retraced their steps of the early morning, cased their guns, stripped off their muddy waders, and loaded the ducks in the car’s boot.

  “We’ll get you to Belfast in plenty of time for the train. Hop in,” Lars said, putting Barney into the back. Lars cranked the starting handle until the engine fired. He joined Fingal, slowly closed the choke, and put the car in gear.

  Fingal sat back in his seat as the car rose and fell over the humpback bridge where the stream flowed on as it must have done from time immemorial and would do long after the O’Reilly boys had put away their shotguns for the last time. They left the little estuary behind and his last view of it was of the pale lough waters drowning the silver mud flats.

  “I can see, Lars,” Fingal said, “why this place has such a pull on you. I’d—”

  The engine made a ferocious bang, followed by a grating screech. Smoke spurted from under the bonnet and the engine rasped and fell silent.

  Fingal looked at Lars, who said, “Oops,” and brought the car to a halt.

  They got out and Lars opened the bonnet.

  Fingal could see where oil was dripping through a crack in the crankcase. Blue buggery. “Your crankcase is banjaxed and there’s probably a big end of one of the piston rods gone,” he said.

  “I thought you once told me you didn’t know about engines.”

  “I don’t,” Fingal said, “well, not much, but I had to learn a bit at sea. I reckon that’s a garage job. You’ll have to get a tow.”

  “There’s a garage with a mechanic in Kircubbin. That’s not too far,” Lars said. “Davy McMaster’ll give me a tow with his tractor, but I don’t know about getting you to Belfast in time for your train.”

  21

  Too Late, Too Late

  “Thanks a lot,” Fingal said as he climbed down from the trap.

  “I hope you catch your bus, so I do,” the farmer said, clucked his tongue, and turned the pony into a lane halfway to Kircubbin. It was a start on the road to Belfast. There were still two hours before the twelve o’clock train and Fingal had only twenty miles to cover. No need to panic. Overhead a flock of green plover crying pee-wit, pee-wit tumbled across a gunmetal grey sky. Leafless blackthorn hedges flanked the road. Sheep in a nearby field huddled under the far hedge to shelter from a bitter wind blowing in from the lough. He heard rumbling and a lorry stacked with metal milk churns appeared round the bend. Fingal waved to the driver in his open cab.

  “Could you give me a lift to Kircubbin?”

  “Och, aye. Hop in,” the man said. “We’re no very fast, but we’re steady and I’m going ’til Greyabbey if that’s any good ’til youse. It’s about six miles, so it is.”

  “Wonderful,” Fingal said as he climbed aboard.

  Half an hour later, chilled to the marrow and having been passed by faster vehicles, Fingal wasn’t so sure it was wonderful, but he arrived in Greyabbey in time to catch a bus for Newtownards, where he waited two hours before boarding the Belfast coach. He’d missed the noon train, but there was time to get the three fifteen.

  He’d be late for Kitty, but he’d be there and she’d understand. Since New Year’s Eve when he’d damn nearly told her he loved her, they’d managed four Saturdays out. Neither had talked about deeper feelings, but he knew they were there.

  There was time to think about Kitty and any other subject that came to mind. The bloody vehicle had stopped not just at the marked stops, but for passengers who flagged it down along the way. At the Holywood Arches on the outskirts of Belfast, a collision between a motorcar and a tram kept the bus waiting for the police to finish and clear the road. By the time he got to the railway station the Dublin train was long gone and it was the last one until tomorrow.

  He’d have to let someone at Sir Patrick Dun’s know and try to get a message through to Kitty.

  The Crown Liquor Saloon was across Great Victoria Street. He’d get a bite there and perhaps they’d let him use the phone. He crossed and stopped to admire the ornate mosaic tile work, the stained-glass windows that had been installed by Italian craftsmen in the last century. The men had been brought to Ireland to install stained glass in churches and worked for the publican on their days off.

  Fingal went straight up to the red-granite-topped bar.

  “How’s about ye, sir?” the barman asked as he polished a glass with a tea towel. “What’ll you have?”

  “Pint please, and a menu, and I’m in a bit of a pickle. Could I use your phone?”

  “Where do you want to call?” He stopped polishing.

  “Sir Patrick Dun’s Hospital, Dublin.”

  “Dublin?” The barman started to shake his head. “You’re joking me.”

  Fingal remembered Sister Daly’s trick for fooling the hospital switchboard. “I’m Doctor O’Reilly,” he said. “It’s urgent. I’ll get time and charges from the operator and pay you for it.”

  “Doctor? Right enough? And you’ll pay? ’At’s different.” The barman pointed to a relic from Alexander Graham Bell with a separate earpiece hanging from a forked clip. “Thonder’s the phone, sir.”

  “Thanks.” After a brief conversation with the Belfast operator asking her to ring him back with the cost of the call and giving her the Dublin number, Fingal found himself talking to Alice at Sir Patrick Dun’s switchboard.

  “And did yiz have fun at dem ducks wit’ your brudder, Doctor O’Reilly, Mister O’Reilly?”

  “I did, Alice. Can you give me Saint Patrick’s Ward?”

  A female voice said, “Saint Patrick’s Ward. Nurse McVeigh.”

  He remembered her. From County Donegal. “Ellen,” he said, “it’s Fingal O’Reilly. I’m in Belfast. Would you do something for me?”

  “If I can.”

  “Cromie and Charlie Greer are on duty. Is either one on the ward?”

  “I think Cromie is. Hang on.”

  Fingal waited, until, “What’s up?” Cromie asked.

  “I’m stuck in Belfast. I can’t get back in time to take call tomorrow. Can you or Charlie or Bob—”

  “Jesus. Charlie was on with Hilda yesterday. They’ve both gone for the weekend. Bob’s invited me down to Conlig tomorrow. Some big family do.”

  “Bugger.” For a minute Fingal wondered about hitchhiking.

  “Hang on a minute,” Cromie said.

  Fingal heard indistinct voices then, “Geoff says he’ll help out. Don’t worry and thanks for letting us know. Just get here as quick as you can.”

  Praise be. “Thank him for me, will you? One last thing. Can your Virginia let Kitty know? I’m meant to be seeing her tonight.”

  “Do what I can.”

  “Thanks, pal.” Fingal hung up. That was a load off his mind. Now it was time for a pint, a meal, and if the barman was willing to let him, make a local call to see if an old school friend who lived on Camden Street could offer a bed for the night.

  * * *

  “It’s unconscionable, O’Reilly.” Fitzpatrick stood near Sister’s desk. “You promised to take Hilda’s turn because she’d taken your call on Friday. The fact that you spoke to Cromie last night doesn’t make up for your absence. Doctor Pilkington had to assist at some major surgery because the surgical house officer is sick. I’ve been single-handed since eight o’clock.” His Adam’s apple bobbed. “It’s three o’clock in the afternoon. There are two admissions I’ve not been able to see yet. Doctor Micks is not pleased and I wasn’t having him blaming me. I told him this morning I was on my own. I told him you’d let us down.” He pulled off his pince-nez and polished the lenses with a handkerchief.

  “You didn’t t
ell him I’d phoned? Tried to make arrangements?”

  “Phoning’s not the same as being here. Of course I didn’t.”

  There was no excuse for not showing up as promised, but there was an explanation and he had tried to arrange cover. There’d been no need for Fitzpatrick to drop Fingal in the dirt and put his clerkship in jeopardy.

  He inhaled. No point fighting with Fitzpatrick. “I’ve already apologised,” Fingal said. “I came to the ward straight from the train. I’ll go to work the minute I get back from my room, dump my gear, and get my white coat.”

  “Get a move on,” Fitzpatrick said, pinching the bridge of his nose. “I’m tired.”

  “Leave the charts at the desk for whoever you want me to see.” Fingal turned and left. Bloody Fitzpatrick, he thought.

  Five minutes later, Fingal was trotting back from his room in the resident student quarters. A staff nurse at the desk handed him sets of clinical notes. “Mister O’Reilly, Mister Fitzpatrick asked for you to admit two patients on the women’s ward.”

  He glanced at the social details of the first. Mrs. Roisín Kilmartin, aged thirty-six, married, mother of eight, youngest six months, address Swift’s Alley. Fingal knew the place. Narrow, cobbled, two-storey terraces. He read on. Occupation, cleaner. Religion, Roman Catholic. Complaints: Fatigue. Severe shortness of breath.

  Fingal wasn’t surprised she was tired. In the tenements most of the men were chronically unemployed. The women who did menial tasks were the breadwinners and they were the ones who reared the chisellers too. She had eight. Shortness of breath. Fingal flinched. Paddy Keogh had been short of breath. So had Kevin Doherty. Fingal left Saint Patrick’s Ward and crossed to the west wing. The structure, furnishings, and smells of the women’s ward were identical to those of the men’s. The sounds were softer, but for a high-pitched keening coming from behind drawn screens.

  “Your case, Mrs. RK, is in bed 12,” a staff nurse told him, “and the racket is because a patient, God rest her,” she crossed herself, “has just died of TB and the family’s saying good-bye, God love them.”

  “Thanks, Nurse.” Fingal made his way along the now familiar ward. He smiled at the woman in the bed and closed the screens. “Hello, Mrs. Kilmartin,” he said. “I’m Mister O’Reilly, a student. I’ve been sent to examine you.”

  “Ah sure,” she wrinkled her nose, “dat’s all right.”

  He sat on the side of the bed. She was a small woman. Her bright green eyes were sunken and had bags under them. Her lips were pale. Her chestnut hair was long and lustreless, but it was clean and well brushed. She must take pride in her appearance. Not an easy task in the slums.

  “What brought you to the hospital?” he asked. The students had been taught never to ask leading questions; let patients tell their own stories.

  She thought then said solemnly, “A tram.”

  Fingal smiled and tried again. “What are you complaining of?”

  “Huh.” She pulled in a breath. “Just about every feckin’ t’ing.”

  Fingal waited, but eventually had to prompt, “Such as?”

  “Such as? Me room at home’s too small. It’s damp. Dere’s bedbugs. Me wages as a cleaner, two shillin’s a day, twenty-four pence, wouldn’t keep a feckin’ slave when a stone of spuds is sixpence and Woodbine fags are tuppence for five. Himself, Brendan, my oul’ one, he’s not workin’. He’d not work to warm himself. He spends most of his time on the piss—and a pint of porter’s tenpence. Add dat up. If I spend dat in one day I’ve sixpence left, and the rent’s six shillings.”

  “I’m sorry.”

  “Ah sure, it’s not your fault, son.” She inhaled deeply.

  “I’m trying to find out what’s making you sick.”

  “I’m waitin’.”

  Fingal frowned. “Waiting?”

  “For youse to find out w’at’s wrong wit’ me.”

  How to get her back on track? “When did you first feel sick, Mrs. Kilmartin?” he asked.

  She puffed out her cheeks and gasped. “When did I not? Ever since I married that great bollix Brendan Kilmartin.” She blew her breath down her nose. “I must have been out of my feckin’ mind when I said yes. And me up the builder’s every bleedin’ year since.” She leant forward. “That eejit of mine, all the bugger has to do is hang his trousers on the end of the bed and I’m poulticed again.”

  And yet for all her apparent bitterness Fingal heard affection in her voice. For a moment he marvelled at the number of Irish euphemisms for being pregnant. But no matter what you called it, repeated pregnancy depleted a woman’s iron stores, and the odds of a tenement dweller having a diet sufficiently rich in liver, green vegetables, and egg yolk were remote. He’d pursue that line. Fingal leant forward and said, “Look up. I want to look under your eyelids.”

  “I never knew your eyeballs could make yiz short of breat’,” she said, gasped, then holding her head steady stared up at the ceiling.

  Fingal leant forward and put a thumb on each of her lower eyelids. He pulled down and everted the lids to look at their inner surfaces where tiny capillaries could be seen. Those conjunctival vessels should be rich with blood cells, and scarlet in colour. Hers were carnation pink. She was anaemic. The condition’s symptoms included tiredness and shortness of breath. Step one. The next step would be to define the severity of the anaemia and detect the cause. Fingal smiled and said, “I think you’re anaemic.”

  “I am not one of dem Neemicks,” she said abruptly and crossed herself. “I’m a good feckin’ Catholic. Just you ask Father O’Regan. Sure amn’t I at confession every Sunday? Jasus, Mary, and Joseph. Neemick indeed?”

  O’Reilly released her eyelids and chuckled. He was unsure who or what a “Neemick” might be, but he said, “No. I’m sure you’re not. I’m sorry. I should have explained that I think your blood is very, very thin. And thin blood, what doctors call anaemia, can’t carry oxygen from the air, and that makes you breathless.”

  “Is dat a fact?” She narrowed her eyes. “And would a few pints of Mister Arthur Guinness’s best be a cure? My granny, her dat lives wit’ us, she’s a quare one for building up the blood wit’ porter—the oul’ bowsie.”

  So husband Brendan wasn’t the only one in the household with a strong weakness for the drink. “It might,” he said, “but we need to find out what’s causing the blood’s thinness. I’m going to ask you questions and then examine you, Mrs. Kilmartin.”

  “Ah, sure,” she said with a grin. “It’s Roisín. Mrs. Kilmartin’s Brendan’s ma.”

  By the time he’d finished Fingal was certain she was anaemic, but not because of blood loss. She was too young for bowel cancer and had no symptoms suggesting other intestinal diseases that might bleed. She hadn’t had periods often enough, being so frequently pregnant, for heavy menstruation to be a cause. She wasn’t jaundiced so it was unlikely that she was breaking the haemoglobin in her red cells down too quickly. The most likely cause was poor dietary intake or something amiss with the haematopoetic system that made red blood cells.

  “Roisín,” he said to her, “we’ll need to do some tests.”

  “Fire away.”

  “And I’ll need to discuss it with a senior doctor, but I reckon we’ll have answers for you in a couple of days. We’ll keep you in here.”

  “Grand,” she said. “I’ll postpone me trip to Monte Carlo.” She chuckled and Fingal saw she was toothless.

  Dubliners. They’d make a joke of anything. “I’ll go and make the arrangements for your tests.”

  “Doctor, can I ask you a question?”

  “Of course. And I’m not a doctor, only a student.”

  “Is you the fellah as looked after Paddy Keogh, him w’at was round at our place wit’ Brendan when the doctor sent me here?”

  Fingal nodded and was struck with guilt. “I am. How is he?”

  “He said if I met a big fellah called O’Reilly I was to be sure to tell you Paddy Keogh, himself late a sergeant in,” she curled her lip, “His
Britannic Majesty’s Royal Electrical and Mechanical Engineers, to tell you he’s doing fine.”

  “Thank you, Roisín. I’m pleased to hear that.” And annoyed with myself that I was full of great boasting to Kitty about trying to find Sergeant Paddy a house or a job; and doing nothing about it. Kevin’s death had driven a lot of thoughts from Fingal’s mind, but it was no excuse for having forgotten about Paddy. Now, thanks to Roisín Kilmartin, he knew the sergeant was a man with technical skills, and of a high order at that, otherwise he’d not have risen above private in the REME. It was almost certain that Paddy would be able to read and write, and wasn’t that what the builder, Willy Duggan, had been looking for? Fingal would deal with that later. “Right, Roisín. I’ll get your tests ordered. I’ll see you tomorrow.”

  “Ah sure,” she said, “dat’s all right.”

  But it wasn’t. Doctor Micks was coming onto the ward as Fingal neared the nurses’ desk. “O’Reilly,” he said. “I’m glad you could find time to show up.”

  “I’m sorry, sir.”

  “Is that all you have to say?”

  Fingal nodded.

  “No extenuating circumstances?”

  Fingal hesitated. Father and his, “Never explain. Never complain. Take responsibility for your actions. Don’t make excuses.” All very well, but Doctor Micks would decide if Fingal, indeed any student, would be regarded as satisfactory or would be expected to repeat the whole clerkship.

  “I think,” said Doctor Micks levelly, “or rather, I hope, there are. You’ve been doing well, O’Reilly, but a doctor must be totally responsible. Reliable. Are you certain you have no good reason for being so late? I’d have thought at least you’d have phoned to let us know. Give us a chance to find a replacement. Behaviour like yours makes it very difficult for me to certify satisfactory performance. I certainly considered refusing it this morning regardless of your subsequent explanation.”

  Disaster. Fingal felt chilled. He tensed. Sorry, Father, he thought, but sometimes explanations were called for. “I swapped ward shifts, I was to do today, and went to Portaferry on Friday. To see my brother. He was running me to Belfast on Saturday morning when his car broke down. I missed the Dublin train. I couldn’t get one until today.”