A Dublin Student Doctor

  Doctor Micks tapped his upper teeth with his right thumbnail and scrutinised O’Reilly. “I’ll accept that. You arranged cover on Friday. Cars do break down.”

  Fingal’s hunched shoulders began to ease until his senior asked, “But why didn’t you call? Surely you had access to a telephone?”

  Fingal hesitated. “I did phone, sir. I spoke to a friend who was on duty. I thought I’d made arrangements for someone to cover for me today until I could get back.”

  “Was it by any chance Mister Fitzpatrick you spoke to?”

  “No, sir.”

  Doctor Micks stroked his chin. “That might explain why he didn’t tell me this morning.”

  “It might, sir.” Fingal thought it would be petty to say that Fitzpatrick had known bloody well and had no reason not to inform the senior doctor.

  “Very well, O’Reilly. I will accept your explanation—this time. But understand, I’m not pleased that even inadvertently you left this ward understaffed. Medicine is a serious business. You’ll get no thanks from a pregnant patient if you fail to show up for her delivery.”

  “I am sorry, sir.”

  “I’m sure you are.” The consultant frowned, crossed his arms, and drummed his right fingers against his coat. “So, I won’t withhold your certificate—this time—but one more lapse, O’Reilly, and I’ll have to consider how willing I’ll be then to attest to your good standing. You have one more month with us. Put it to good use.”

  Fingal swallowed. The relief. “Yes, sir,” he said, “thank you.”

  “See there are no more slipups,” Doctor Micks said. “Now, tell me about the patient you’ve just admitted.”

  Fingal started the classical litany of patient presentation. “Mrs. Roisín Kilmartin—”

  “Mrs. RK. I thought you’d have learned that by now.”

  “Sorry, sir.” Another gaffe. He took Doctor Micks through the history and physical examination, his differential diagnosis, and suggested blood tests.

  “I see,” said Doctor Micks. “Very well.” He scratched his chin. “You’re probably right that it’s some kind of anaemia. Did you consider one of the leukaemias?”

  “Yes, sir, but they are more common in men, she has no enlarged lymph nodes, no cough, so it’s unlikely that her chest is affected.”

  “That’s usually a late symptom.”

  “Yes, sir. And her spleen’s not enlarged.”

  “Fine. So what tests will we order?”

  “We need a full blood count, sir, and a full white cell count in case I’m wrong about the leukaemia.”

  “Chest X-ray?”

  “No sir. Not unless the white count’s abnormal. Her chest is clear to percussion and auscultation. She’s a smoker, but then everybody in the Liberties is.”

  Doctor Micks nodded.

  “And smoking’s not known to cause any diseases,” Fingal said. “She’s no history of bronchitis, asthma. We can’t completely exclude TB, but I think we should hold off on the X-ray until we see what her blood tests show.”

  “Well done, O’Reilly,” Doctor Micks said. The deputy professor looked at his watch. “Arrange for the bloods to be done in the morning and we’ll discuss the case again on Tuesday rounds. I’ll be off,” he said and added, “Now, keep up the good work between now and the end of this clerkship.” He strode from the ward, a dapper man in a raincoat and a grey trilby hat.

  Fingal exhaled. He hadn’t realised he’d been holding his breath. One bloody thing after another, he thought. Those had been anxious moments when it looked like Doctor Micks had been going to refuse Fingal’s certificate. He still might, but that was in Fingal’s control. He’d make bloody sure there were no more slipups. The senior man was right. Doctors should be reliable. Fingal had not been with his promises to Kitty about Paddy Keogh. He would nip round to outpatients as soon as the opportunity presented and get Willy Duggan’s and Paddy Keogh’s addresses. Perhaps Bob could drive him to see Willy as soon as class was over tomorrow. If that went well, he’d pay a call on Paddy. A promise was a promise.

  22

  In Poverty, Hunger, and Dirt

  The stench on Francis Street was something new to Fingal. He swallowed, wrinkled his nose, and wound up the car’s window. It was as if he’d been transported to seventeenth-century London where the aristocracy walked the thoroughfares with handkerchiefs doused in perfume crammed against their noses. Physicians making home visits then wore grotesque masks with long artificial birds’ beaks stuffed with aromatic herbs to prevent the inhalation of foul airs, miasmas, the supposed causes of disease. The bizarre duck-billed facial coverings gave the doctors their nickname “quacksnifter,” which became shortened to “quack.”

  He inhaled and shuddered, but putting up with a bit of a pong was going to be worth it. Half an hour ago, Willy Duggan, initially surprised to see the student who’d sewn up his chisel cut, had agreed that he certainly could use a clerk and if Paddy could do the job it was his.

  “Jasus,” Bob said, pulling past a pile of refuse and parking under a pole full of washing sticking from a fourth-floor window, “the stink here would gag a maggot, and it’s dark as bedamned.”

  No sun’s rays could filter past the five-storey buildings. No wonder, Fingal thought, that rickets due to lack of exposure to ultraviolet light was so prevalent.

  Fingal and Bob got out. Immediately they and the car were surrounded by a throng of kids, little boys in ragged short pants, hand-me-down shirts, threadbare woollen pullovers, battered caps; girls in ankle-length dresses worn under grubby grey linen pinafores. Not one child, as far as Fingal could tell, wore shoes, and their feet were black from the filth on the cobbles. All the youngsters’ eyes were oversized for their pinched faces. Their shouts filled the air like the babbling of a flock of starlings.

  “It’s Lord feckin’ Muck from Clabber Hill come for to see us,” a boy said.

  Fingal felt a tugging at his coat and looked down at a girl of about six. Her bare toes were turned in and her cornflower-blue eyes stared up at him. “Could yiz spare a couple of bob, yer honour?”

  A boy yelled, “If it’s a mott yiz is after, mister, ye’d be better off in Monto.”

  Fingal smiled. Monto, a corruption on the name Montgomery Street near Amiens Street Station, had been the biggest red-light district in Europe, reputedly employing 1,600 prostitutes. It was said that the Prince of Wales, later King Edward VII, had lost his virginity there. It was closed down in the mid-’20s, but its reputation lived on in folk memory.

  Someone else called, “Would yiz give us a ride, mister? Me and me little brudder? We could go up ’til the Phoenix like toffs.”

  Bob picked the biggest boy, a lad of about fifteen. “You, son.”

  The boy pointed at his chest, hunched his head into his shoulders, and narrowed his eyes. “Me, sir? I done nuttin’ wrong.”

  “I know,” Bob said, “but would you like sixpence?”

  “By Jasus, sixpence?” His eyes narrowed. “What would I have to do for it?”

  “Guard my car while I’m away.”

  He held his head up, cocked it to one side. “If you’ll give me ninepence, sir, a tanner for me and t’ruppence for Jockser over dere,” he pointed at a gangly youth standing smoking at the front of the crowd, “we’re your men.” He spat on a grimy hand and offered it to Bob, who grinned, shook it, and rummaged in his pants’ pocket. “Here’s fourpence on account,” Bob said, “and if you and Jockser clean the windows while we’re gone I’ll take it up to a shilling when we come back.”

  “Fair play to you, sir. Jockser, get your ragged arse over here. You’re going to get rich.”

  Fingal watched Jockser approaching, scratching his head. Probably he had what the locals called “mechanised dandruff,” head lice. Fingal felt the tugging again. “Even sixpence, sir?” The blue eyes bored through to his soul.

  He squatted. “What’s your name?”

  “Finnoula,” she said, “and dat means fair shoulders.”

&nbs
p; “Well, Finnoula of the fair shoulders,” Fingal said, “you take me to where Paddy Keogh lives and you’ll get your sixpence.”

  “Don’t you do no such t’ing, Finnoula Curran. Your man here could be a Peeler in plain clothes.” An older boy stood between Fingal and the little girl. Even though Fingal towered over them both, the lad stood with his legs apart, feet firmly planted. Loathing of the informer had been a thread woven through Irish history since the English had come eight hundred years ago. Fingal stood and faced his accuser, a skinny youth with bad teeth and a bent nose. “I’m no policeman, son. I looked after Paddy when he was in Sir Patrick Dun’s Hospital last year. I just want to see him, that’s all.”

  The youth squinted at Fingal, looked him up and down. “Are you—are you de Big Fellah?”

  Fingal laughed. “I suppose so. How do you know?”

  “Sergeant Keogh told my ma, Missus Kilmartin, to keep an eye out for a big lummox called O’Reilly when she went into Dun’s yesterday.”

  “I’m Fingal O’Reilly, and your ma’s doing well, she’s going to get better, and she’ll be home soon, son. What’s your name?”

  “Declan. Declan Kilmartin.” The youth turned and yelled to the crowd, “It’s all right. De Big Fellah here—”

  Fingal was flattered to be given the same sobriquet, the Big Fellah, as Michael Collins, a hero of the Irish War of Independence, martyred during the Irish Civil War.

  “He’s a doctor. He fixed Paddy Keogh and he’s looking after me ma, so youse w’at was going to feck the car battery when the minders weren’t looking? Leave the car be.” He bent to Finnoula. “Take you your man and his friend to see Sergeant Keogh. He lives at number twenty-one. Top back—”

  Fingal knew the terms for the different tenement rooms. Top back was one of the cheaper. It would cost six shillings weekly and would be a single room at the back of the upper storey. Not nearly so grand, if the term could be used, as a front parlour or a two pair front.

  “And youse two,” Declan pointed at Jockser and his friend, “youse gurriers give dem windows a good polishing as well as a wash.”

  * * *

  “Jasus, sirs, I’m sorry to have yiz find me like dis.” Paddy Keogh spun round. He was sitting on a wooden crate wearing nothing but a collarless shirt, the waist of his pants undone, and his trousers rolled up to his knees. His feet were in a basin of liquid, which to Fingal had a familiar bitter smell. “Me granny swears by mustard for me corns.” He was smoking a cigarette and tried to rise.

  Stale tobacco mingled with odours of fried onions and boiled cabbage. Underlying these was a musty aroma of damp coming from torn mildewed wallpaper behind which the plaster had crumbled. Fingal could see bare laths.

  He clapped a hand on the man’s bony shoulder. “Don’t get up, Paddy. We’ll only take a minute—”

  “Would yiz like a cup of tea?” He smiled. “It’s good of youse to call.”

  “No thanks,” Bob said, “we only popped in.”

  “You’re looking well, Mister O’Reilly, or is it Doctor now, sir?” Paddy said, and coughed.

  “Still Mister for a while, Paddy.” He nodded at Bob. “And you’ll remember Mister Beresford?”

  “I do, sir, from Saint Patrick’s Ward. Good day, sir.”

  “Good afternoon, Sergeant,” Bob said.

  “W’at brings youse two here?” Paddy asked, and held up his hand to embrace the single-windowed plank-floored room.

  Two more crates served as chairs. A table with one short leg resting on a house brick took up space in the middle of the room. A metal basin was piled with chipped plates. The water would have to be hauled upstairs from a pump in the courtyard. A print of the Bleeding Heart of Jesus hung beside a crucifix on one wall above a soot-stained brick fireplace. The back third of the room was hidden behind a curtain. Fingal guessed that was the sleeping end.

  One splash of colour brightened the place. A small, long-tailed, redbreasted bird in a wicker cage trilled a song of joy.

  “Och,” said Paddy, “isn’t the oul’ linnet in grand voice?”

  Fingal had heard that captured wild songbirds were in great demand as pets in the tenements.

  “I suppose yiz needed a bit more luxury for a change.” Despite Paddy’s sarcasm there was no bitterness in his voice, and his grin was broad. “Welcome to Dublin’s answer to the Taj Ma-feckin’-hal.” He lifted his feet out onto a worn towel. “And in case youse is wondering, I’ve seen dat place. I was stationed at Jaipur before the war. De oul’ white tomb was only a couple of hundred miles away.” He dried his feet. Fingal could see the corns.

  “That’s what we’ve come about, Paddy.”

  Paddy frowned. “The Taj or the war?”

  “Partly the war.” Fingal had been worried about asking a grown man if he could read and write. Such a question could be taken as a mortal insult so he would try to find out without enquiring directly. “You were REME?”

  “I was, sir. I was learned a trade.” He straightened his shoulders. There was pride in his voice when he said, “I was a bloody good mechanic. I t’ought it would stand me in good stead on civvy street when I was demobbed, but,” he waved his right arm stump, “a feckin’ great shell in the motor repair depot in 1917—” He shrugged, put the towel on the floor, nipped out his cigarette, blew through it, and put the butt in a small tin. “For later.” He lifted one of his old boots and bent to put it on. “Fair play to the army, sir. Dey didn’t chuck me on the rubbish heap when me stump healed. Dey kept me on for a while.”

  It was Fingal’s turn to frown. What could a one-armed man have done?

  “You’d be amazed, sir, by how many spare parts an army needs for its lorries, motorbikes, and dem new tank things. Dey kept me on as a store-man—at least until ’19. Den the army let me go and when I came back to Dublin nobody in Ireland was giving work to an old English soldier wit’ only one flipper.” He waved the stump again.

  “A store-man?” Fingal wanted to cheer at this news and berate himself at the same time for not following up months ago with Willy Duggan. “Did that mean keeping lists?”

  Paddy started to put on his other boot. “If I’d a penny for every feckin’ list I wrote, me and the rest of the family would have a mansion in Blackrock wit’ the other swells.”

  “Paddy,” Fingal said, “how would you like a job as a store-man on a building site?”

  The clatter of a boot hitting the planks startled Fingal as Paddy dropped it and sat bolt upright. He peered up at O’Reilly. “Youse isn’t codding me, sir?”

  “I am not.”

  “Jasus,” Paddy said, “I’d give me feckin’ right arm for work.” He rubbed his stump with his left hand and laughed. “Dat’s if I’d one to give.”

  “No need, Paddy,” Fingal said. “There’s a Mister Duggan rebuilding after tenements are torn down. He’s been looking for months for someone to keep tabs on his materials. Mister Beresford here and I spoke to him today, didn’t we, Bob.”

  “We did,” Bob said. “Mister O’Reilly told him all about you, Sergeant. We didn’t know then you already had inventory-keeping experience.”

  Paddy sat forward. His hand clutched the edge of the crate. “And?”

  Bob inclined his head to Fingal, who said, “He told me to bring you round to meet him this evening—”

  “Now?” Paddy plucked at his shirt. “Jesus Murphy, I’ve no decent clothes.”

  “Never worry, Paddy,” Fingal said. “There’s very few men in top hats and tails on a building site.”

  Paddy bent, grabbed his boot, and stood. “I’ll get me cap and coat.” He headed for the curtain.

  “Hang on,” Fingal said. “Don’t you want to hear about the job?”

  Paddy turned. “Please, sir.”

  “If Mister Duggan likes the look of you—and he’s bound to, good trained list makers are hard to come by—he’ll start you tomorrow.”

  “Tomorrow?” The word was whispered.

  “The pay’s four shillings a day
for a six-day week.”

  “Holy Mother of God, that’s—one pound and four shillings a week, more than fifty quid a year.” Paddy looked round the room and Fingal saw him curl his lip at the grimy window that looked down into a sunless yard. “I’ll tell you, sir, me and the other Keoghs’ll be out of here by week’s end.”

  “Good,” Fingal said, blessing the chisel cut that had wounded Willy Duggan, but was going to bring a new life to Paddy Keogh and his family. “Go on, Paddy. Mister Beresford will run us over in his car to see Mister Duggan, so get your coat.” He looked straight at Sergeant Paddy Keogh, who was grinning from ear to ear while tears coursed unchecked down his cheeks.

  “I don’t know how to thank you, sir,” he said.

  Fingal looked away. “Go on,” he said gently, and looking round took in the peeling plaster, the curtained-off sleeping area, the stench. A thought struck him. It was something he’d said to Lars. Fingal O’Reilly would be better looking after the living than grieving for the dead, and a doctor who did, could make a difference, even if only in a small way.

  23

  Eating the Bitter Bread of Banishment

  “Mister O’Reilly, your patient,” Doctor Micks said.

  “Yes, sir.” Fingal accepted the chart from Sister Nancy Henry. She was in charge of the women’s ward, a tall, hawk-faced woman from Cootehall, County Roscommon, who, as far as Fingal could tell, had been born lacking a sense of humour and had failed to acquire one in fifty years of living. He moved to the head of the bed.

  He laid a hand on Roisín Kilmartin’s shoulder. “I’m going to tell these other doctors and nurses all about you.”

  She smiled and said, “Ah sure, dat’s all right.”

  Fingal gave a summary of her case, then waited for Doctor Micks to start.

  “Miss Manwell. Your differential diagnosis?”

  Hilda listed her suspicions.

  “Good,” said Doctor Micks.

  “Excuse me, sir,” Fitzpatrick peered over his pince-nez, “but she’s breathless. I think we should consider tuberculosis too. The tenements are riddled with it.” His lip curled.