A Dublin Student Doctor

  “Och sure,” said Fingal as he stood and removed Fitzpatrick’s white coat from its hook. “Dat’s all right.”

  * * *

  Fingal and the rest stood round a trolley upon which lay a young man with sandy hair, blue eyes, and a narrow nose between plum-coloured cheeks. He was propped up on pillows and his pyjama jacket was unbuttoned.

  The trolley was positioned head toward a blackboard, feet to the semicircular tiers of benches and the members of the Pilgrims. Fingal scanned the faces of the soberly dressed men. Victor Millington Synge, physician to Baggot Street Hospital and recently appointed King’s Professor of the Practice of Medicine at Trinity College, sat in the centre of the front row.

  “Pilgrims, welcome to Sir Patrick Dun’s,” said Doctor Micks. “We’ve a full day arranged where you can visit our new facilities, observe a new surgical procedure, and, of course, the banquet in the Royal College of Physicians this evening. But first we’d like you to see our students in action. Mister SH here is used to his trips to Sir Patrick’s. He is a willing volunteer when we need to demonstrate his condition and has often been used as a case for our students to diagnose in the medical part of their Finals Part II practical exams. How often?” he asked the patient.

  “I’ve bin an exam case turteen times, sir.” He grinned. “It’s a great day out for me. Gets me away from herself and the feckin’ chisellers. And the hospital gives me a grand lunch. And I’ve learned a fair bit of medical lingo.”

  “Quite,” said Doctor Micks.

  Fingal saw Professor Synge smiling broadly at Mister SH’s last remark. The professor was in his midfifties and bore a striking resemblance to the pictures of his famous uncle. His hair had receded as far back as his ears and from there a central patch of shiny pate was surrounded by a rim of hair. He wore spectacles and was paying attention as Doctor Micks said, “And the net result of his condition has been damage to the heart’s valves.”

  Fingal glanced at his classmates. Hilda had been let in on the plot. She and the three others looked innocent. Fitzpatrick was staring eagerly at Doctor Micks, who said, “Here at Sir Patrick Dun’s we take pride in our students being well grounded in the finer points of cardiac auscultation.

  “We have here today six typical, late-fourth-year Trinity students. I should like one to examine the patient.”

  Fitzpatrick nearly tripped in his haste to step forward.

  “Very well,” Doctor Micks said.

  If the swelling of a pigeon chest was ever accompanied by an explosion, Fingal thought, the attendees would have been deafened.

  The assembled professors leaned forward.

  Fitzpatrick, a supercilious smile on his lips, fumbled in the pocket of his white coat, produced his stethoscope, plugged in the earpieces, stepped forward, and without a word to the patient clapped the instrument on his chest.

  By the way Mister SH flinched, the bell must have been cold.

  “There is a—” Fitzpatrick frowned, moved the bell a couple of inches. “There is a—” He blanched. Beads of sweat appeared on his forehead. He pulled out the earpieces, stuck a finger in each ear in turn, replaced the earpieces, stared at the bell, and put it on the patient’s chest. He remained immobile, then shook his head. “I can’t hear anything,” he said hoarsely. “Nothing. Nothing at all.”

  Fingal didn’t dare look at the lads.

  A muted murmuring arose from the audience.

  “Well,” said Doctor Micks, “anyone can have an off day.”

  “Excuse me,” Professor Synge asked. “May I see that stethoscope?”

  Fitzpatrick crossed the well of the theatre and handed over the equipment in question.

  Meanwhile Doctor Micks, with a scowl like thunder, said, “Miss Manwell, please.”

  Hilda approached the patient. “Hello,” she said, “I’m going to examine you.”

  “Ah sure, grand,” he said, “and such a pretty wee mott, yiz can be my doctor anytime.”

  Hilda smiled and bent to her work.

  Fingal snatched a glance at Professor Synge, who had removed the bell from Fitzpatrick’s stethoscope and was fishing up the rubber tubing with a narrow propelling pencil.

  Hilda said, “I’m pretty sure I can hear an opening snap—” her brows knitted, “a low-pitched rumbling diastolic murmur, and—and presystolic accentuation.” She straightened and looked at Doctor Micks.

  Fingal hoped she was right. He had learned that there were many combinations of sounds depending upon which valve or valves of the four in the heart and blood vessels were damaged.

  The patient said, “You take the prize, miss. Dat’s w’at all the professors say.”

  Doctor Micks smiled. “Well done, Miss Manwell. Very well done.” He addressed the audience. “I can assure you she is absolutely right, gentlemen.”

  “That’s impressive, young woman,” Professor Synge said. “And Robert—”

  Fingal realised he was addressing Doctor Micks.

  “Don’t be too hard on the young man. It would be impossible to hear anything,” he held up the offending objects, “when the tubing of your stethoscope is stuffed with cotton wool.”

  The laughter began slowly, but soon everybody was laughing—everybody but a red-faced Fitzpatrick.

  Doctor Micks cleared his throat. “Very well. Now Mister O’Reilly?”

  “Yes, sir.”

  “You heard Miss Manwell. Those murmurs are diagnostic of?”

  “Mitral stenosis, sir.”

  “Sure it’s not mitral incompetence?”

  “Yes, sir. The systolic murmur of that occurs when the ventricle contracts in systole, not when it relaxes in diastole.”

  “Good.”

  There was a small round of applause. Doctor Micks smiled and inclined his head to the audience.

  “If you’ll excuse me, Robert?” Professor Synge said.

  “Of course.”

  “I think I can speak for all of the Pilgrims when I say we are impressed with your last two students and have sympathy for the first.”

  There was a muttering of assent.

  “You have every right to take pride not only in the skills of your students, but in their sense of humour. That’s only the second time I’ve seen the cotton wool trick. The first was when Edgar there,” he pointed at another Pilgrim, “did it to me in front of old Professor Purser.”

  To a man, the Pilgrims chuckled.

  “Thank you, Victor,” Doctor Micks said. “Most understanding.”

  “I take it,” Professor Synge continued, “these youngsters are near the end of their clerkship?”

  “They are,” Doctor Micks said. “They have one more week to go. Sister’s reports earlier today on them are all favourable.” He glanced at Fingal.

  What? I love you, Sister Daly, Fingal thought. The minute I’m out of here I’m off to the ward to thank you.

  “And unless one of them commits a felony in the next seven days they’ll all be getting their certificates of good standing.”

  Fingal wasn’t sure—but had Doctor Micks actually winked at him?

  “In view of Professor Synge’s intercession I shall ignore the recent—um, incident.”

  “I’m delighted to hear it,” Professor Synge said. “It’s not so long ago we were students ourselves. Good luck to you all.” He looked at Fitzpatrick. “Don’t take it too hard, son. We all had a good laugh.”

  The look Fitzpatrick gave O’Reilly might have been lethal. So what? Fitzpatrick had been punished and the dark cloud hanging over Fingal had blown away. He’d have no difficulty persuading the lads to head to the Bailey for a few pints.

  He’d miss Saint Patrick’s Ward and Doctor Micks’s regular teaching sessions, but it was time to move on to new aspects of the trade. And they’d be back on the old ward with its black walls and painting of Saint Patrick and Oisín in July to start their surgery.

  25

  That Where Mystery Begins

  “Life as a medical student,” observed Cromie, from
his seat in Davy Byrnes pub, “as I have before remarked, is one of long periods of relaxation punctuated by short spells of intense horror.” He took a pull from his pint.

  “Horror as in the Finals Part One exam in sixteen days,” Fingal said, swallowing a mouthful of Guinness then emitting a puff of smoke. He could afford Erinmore Flake these days. The better tobacco was pleasant and so was the restoration of diplomatic relations with Father.

  “Indeed,” said Charlie. “I hope we’re all well read.”

  “We bloody well ought to be,” Bob said. “Fingal here’s been keeping everyone’s nose to the grindstone for the past three months since he wrung that promise out of me back in March.”

  “I have medical jurisprudence and materia medica coming out my ears,” Charlie said. “What I don’t have is the fresh pint I need. Anyone else?”

  “I’m fine,” Cromie said. “I’m seeing Virginia later and meeting Fingal and Kitty in the Stag’s Head off O’Connell Street tonight. I’d better heel tap.”

  Finally, Fingal thought, Cromie was learning to handle his drink. “Kitty’s going with her sister and nephew to the zoo this afternoon. I’m meeting her there in Phoenix Park, but we’ll see you two at seven.”

  “I’m not waiting until seven for a jar. It’s Saturday,” Bob said. “Jameson, please, Charlie, then I’ve a date with the horses at two thirty over at Leopardstown. Want to come?” He lit a cigarette.

  Charlie shook his head. “No thanks, Bob, I’m going to buy some trousers, and put my feet up tonight. Listen to Raidió Éireann. Fingal? Pint?”

  “Not for me. I’m heading home.” Earlier this week Ma had dropped him a note practically demanding he visit today. It wasn’t like her. She usually made her invitations informal. Fingal had written to say he’d drop by this afternoon and had tried not to worry.

  He watched Charlie rise and amble over to the long bar, stopping to greet a nonmedical acquaintance. Byrnes was a friendly place. No wonder James Joyce had spent so much time in here writing Ulysses.

  “So, Fingal, how goes the studying?” Bob said. “Are you and Charlie catching up with Cromie, and much as it hurts an old chronic to say it—with me?”

  “I think so.”

  Bob cocked an eyebrow at Fingal. “You’ve missed a fair number of pathology and bacteriology lectures on those Thursday afternoons you’ve gone to rugby.”

  “I know, but I am making up,” Fingal said, hoping it was enough.

  Bob leant forward and tapped his glass. “I was disappointed there was no Irish selection for you or Charlie this year.”

  So was Fingal, but he didn’t want to let it show. “Always next year, Bob. And I’m in top condition.”

  “So,” said Charlie, “is my pint.” He set it on the table. “Here, Bob.” He handed Bob his whiskey. “Sláinte.”

  “Cheers,” said Bob. “Here’s to July first and the end of those three bloody awful months of psychiatry.”

  “I’ll drink to that,” said Fingal, raising the last of his pint. “I don’t think I saw a single patient improve. Sedating folks with chloral hydrate or barbiturates is about all doctors can do. You feel so bloody useless.”

  Bob sipped from his glass, Charlie raised his pint, and Fingal puffed on his pipe.

  “Begod,” said Fingal, “I wonder if they’d not do better with a jar or a smoke or two?”

  “I’ll drink to that,” said Charlie.

  “At least Jameson’s tastes better than chloral hydrate,” Bob said. “I tried it.” He grimaced.

  The friends looked at each other and burst into laughter.

  * * *

  “Fingal.” Ma rose from her chair in the living room and hugged her son. “It’s been a while.”

  “I’m sorry, Ma,” he said, “life’s pretty hectic.”

  “Perfectly all right,” she said, “now come and sit down.”

  Fingal thought she looked pale.

  “I’m so glad you could come.”

  “What’s up, Ma? Something’s bothering you.”

  “I wanted to talk to you alone. Father’s gone to see an exhibition at the Royal Hibernian Art Gallery,” she said. “Percy French watercolours.” She made a little moue. “I let him go alone. I don’t like watercolours. Much prefer oils.”

  “I know,” he said, thinking of the Yeats in the dining room and the veritable gallery in heavy gilt frames that adorned the rooms, halls, and staircase walls.

  She leant forward and her pearls swung away from her throat. “That’s why I asked you to come today. Lars was here yesterday.” She smiled. “He’s still got some of the tan he got in Villefranche. I think the time away did him good.”

  The last time Fingal had been home in March, Lars, recently returned from France, had been tanned and seemed to be feeling less hurt by Jean Neely.

  “I think you’re right.” Fingal frowned. “I didn’t know he’d been in town this week.”

  “No,” she said. “He was only able to get away yesterday and I wanted his advice before I spoke to you. Father was in Trinity Library when Lars popped in. He did agree it was a good idea to seek your advice.” She fiddled with the loop of the necklace. “I worried about writing to you earlier, but I did want to see you, son.”

  “About what?”

  “Father.” Her voice was flat.

  “Father?” What in the world could he, Fingal, advise about Father?

  She looked straight at him. “He’s not well, Fingal, and he refuses to admit it.”

  “Not well?” Fingal leant forward. “How exactly is he not well?”

  Ma’s fingers plucked at her skirt. “He tires so easily. He’s getting very short of breath. You remember when you and Lars were here last year and Father’d let his assistant take the Saturday tutorial?”

  “Yes.” Fingal had noticed that.

  “He confessed to me he’d been feeling run down.”

  Fingal started to work out a differential diagnosis. On those two symptoms it was a long list. “Has he seen his doctor?”

  Ma shook her head. “He gets angry if I even hint at it. I thought you might have an opinion about whether he really needs to see someone. If you do, I’ll find a way to make him go.”

  Fingal heard the iron in her voice. Despite his worry he smiled. “Have you,” he asked, “noticed anything else?”

  Ma’s eyes glistened. “He’s—that is, I think he’s losing weight and—and he looks terribly wan.”

  Losing weight was always worrying. Cancer patients lost weight. Tired, short of breath, pale? Ma could be describing Roisín Kilmartin, she of the pernicious anaemia. It would be a coincidence if Father had the same condition, but it certainly sounded as if it might be some kind of anaemia.

  “Lars thought that as you are almost a doctor you’d have some ideas.” She touched his knee. “I do hope so.”

  Having strangers as patients could be upsetting, but your own father? “I’m certain,” Fingal said, “that someone needs to examine him. That might be enough, but if it’s not, some simple blood tests, perhaps an X-ray, might tell if anything’s wrong.”

  She smiled. “Thank you, Fingal. Lars was sure I was right to want to ask you.”

  “Perhaps,” he said, “but you’ll have to persuade Father to go. I can’t examine him.” He grinned. “They say a doctor who treats his own family has idiots for patients.”

  Ma nodded. “I understand, but I will find a way to get him to go,” she said, “and I want him to see a good doctor—a really good doctor.”

  “I know the one,” Fingal said. “A consultant who taught me for six months. Doctor Micks. He was our clinical clerkship supervisor. I don’t see much of him now we’ve moved on to studying other branches of medicine, but I’m sure he’d be willing to do one of his old students a favour. I’ll ask him on Monday.”

  “If he agrees, Father will keep his appointment.”

  Fingal had no doubt about that.

  “I’d be so very grateful, son. It would take a great load off my mind.??
?

  Fingal could hear the pleading in her voice. He struggled not to let his concern show. “First thing on Monday I’ll see my old chief and I’ll phone you. I’m sure Sister Daly won’t mind.”

  She smiled. “You’re a good lad, son. But then, you always were.”

  Fingal smiled back. “Och,” he said, “the last time I heard tell you only get issued with one ma. You’re meant to keep an eye on her.”

  She chuckled and sat more straight, her hands clasped in her lap. “Now,” she said, “now that we’ve got the unpleasant business out of the way, tell me about everything else in your life.”

  Fingal sat back. “Let’s see,” he said, “at work things are chugging along nicely. I should be qualified in twelve months. Only two more exams to go, one this month. No rugby until September.” He could tell by her smile she was perfectly happy that he was unlikely to get injured for a while. He winked at her. “This evening I’m going for a walk in the Phoenix with a young lady. Her name’s Caitlin O’Hallorhan. Her dad’s an accountant and she’s a nursing student.”

  “Is she indeed?” Ma asked, and smiled. She cocked her head to one side. “And is she the kind you might like to bring home to meet us?”

  Fingal laughed. Typical of Ma never to enquire about her sons’ romantic lives, but if they volunteered information she’d come to the point, but not directly. She was really asking was he serious about Kitty. “Not yet, Ma. Not yet, but in a while? You never know what might happen. You never know at all.” If he did bring her, which was tantamount to telling his parents he was thinking of proposing, it wouldn’t be until after Finals Part II next year, and the more he saw of Kitty O’Hallorhan the more he hoped she’d be happy to wait. She’d been almost as jubilant as he in April when he’d finally been able to tell her face-to-face about Paddy. He still remembered the soft way she’d looked at him and said gently, “You are a gentleman, Fingal O’Reilly, and I admire that,” then she’d kissed him and he could taste it yet.

  “And you’re seeing her this evening?” Ma opened her handbag and took out her purse. “Here,” she said, handing him a pound note, “buy her a nice tea.”

  He tried to give it back. “Ma, I can’t—”