A Dublin Student Doctor

  “There are professors of medicine.”

  “And how many do research?”

  “I don’t know.” And I don’t care. Fingal uncrossed his legs and rubbed his thighs with the palms of his hands. I’d never get interested in research, he thought. I like people.

  “Here at Trinity, medical research is done by Professor Bigger in bacteriology, Professor Jamieson in anatomy, Professor Fearon in biochemistry, and a few other basic scientists. Not very impressive.”

  “But I want to look after people, not laboratory rats.” For God’s sake listen to me. Hear what I’m saying. Try to understand.

  “Fingal, you’re only eighteen—”

  “I’ll be nineteen next month and I’m sorry, but why shouldn’t a nineteen-year-old know what he wants?” He knew he was letting a sarcastic edge creep into his voice.

  “Youth,” Father said, and shook his head. “I’ve been around the groves of academe all my adult life. It is what I have tried to groom my sons for.” He frowned. “Poor Lars. I don’t think he’d have done very well,” his smile reappeared, “but you, Fingal, you have exactly what it takes. Trust me.” He leant forward and stared into Fingal’s eyes. “You are special, Fingal O’Reilly. I’m a professor. Professors can make a difference too—but not in a small village like old Doctor O’Malley. In the whole world. Look at Einstein’s work. He was awarded the Nobel Prize six years ago. Who can predict where his discoveries will lead—but you could be at the forefront of making new ones. You could go on and become a dean, a vice chancellor, because the subject of the future is—” Father’s eyes shone.

  “Nuclear physics. I know.” Fingal’s shoulders drooped. He rolled his eyes. He said, “But I’ve told you, God knows how many times—”

  “Mind your language.”

  “Oh, bugger my language. I’m not doing nuclear physics.” Fingal got to his feet.

  Father pursed his lips. “Sit down.”

  Fingal shook his head. “What is so terrible about medicine?”

  “Nothing, but it’s not the best you can do.” He stood and folded his arms. “It is the duty of every father to guide, yes, and if necessary force his children, particularly his sons, to do what they are best suited for—”

  “And,” Fingal knew his voice was rising, “for me that’s medicine—not bloody nuclear physics. Can’t you understand? For God’s sake, Father, Queen Victoria died seven years before I was born. The old Irish tradition, first son gets the farm, second son into the church, third son Colonial civil service, stupidest son into the army, exactly as father dictates, those days are over. My friends have been able to choose their careers. Why in hell can’t I?”

  Father did not look remotely persuaded. He said, “Calm down and sit down.”

  “No.”

  “I can’t force you to sit, Fingal—”

  “No, you can’t—” Fingal hesitated. If he carried on like this he might cause an irreparable rift.

  “And I obviously can’t force you to study nuclear physics.”

  “Good.” Fingal smiled weakly. Thank the Lord he hadn’t said what he wanted to say—that Father couldn’t force him to achieve the goals Father hadn’t achieved in his life. “I’m sorry,” he said, “I came very close to losing my temper.” It wouldn’t hurt to offer the olive branch.

  “I can’t make you study nuclear physics, yet,” Father said very quietly, “but I will not finance your medical studies. Perhaps when you’ve had time to give the matter due consideration we can reopen it. Students can enroll in April as well as in October. Six months really won’t make much difference considering how long it takes to get a first-class Ph.D.”

  “What?” Fingal heard blood pounding in his ears, felt his fists clenching and unclenching. His breath came in shallow gasps. He felt the tip of his nose blanch. That was, and had been since he was sixteen, a sure sign that his temper was about to erupt. “No,” he yelled. “No.”

  From somewhere inside a tiny voice told him, Control yourself. Get out of here. He’s your father. He’s wrong, but as Ma often taught, “Least said, soonest mended.” “Thank you, Father. Thank you very much,” Fingal said, trying to keep the sarcasm out of his voice, “I’m sure I’ll find something useful to do between now and then.”

  3

  I Feared It Might Injure the Brain

  Something useful? O’Reilly was thoughtful as he stepped down from the ambulance into the brightly lit bay outside the Royal Victoria Hospital’s casualty department. Young Fingal had found something very useful to do. He had, literally, run away to sea.

  O’Reilly walked to the back of the vehicle and waited for the attendants. They’d gone to bring hospital orderlies to load Donal onto a trolley then take him inside. O’Reilly and Kitty would follow. If they’d been relatives they’d have been told to stay in the waiting room, but as members of their professions they’d go with Donal. And O’Reilly would not be a doctor today if it hadn’t been for Lars and Ma, bless them both. Despite his bravado with Father, a young Fingal O’Reilly had thought things pretty hopeless after that morning discussion in 1927. He had stood in the dining room beside Ma and across from where Lars sat.

  “Well?” she had asked, reaching up a hand to him, a faint smile on her lips, but tiny wrinkles on her forehead.

  Fingal shook his head.

  Her smile faded, the furrows deepened. “I’m so sorry, dear,” she said. “I’m not sure what to advise. I had hoped after I’d had a word with your father—” She sighed. “Tell Fingal what you’ve been saying to me, Lars.”

  Lars pushed his chair back from the table and stroked his dark moustache. He cocked his head to one side. “I have a suggestion—”

  “If it’s to do what Father wants, don’t bother,” Fingal snapped, and immediately regretted it. “I’m sorry,” he said. “Go on, Lars, I’m listening.”

  Lars looked at Ma. “Once Fingal has—and I hesitate to use the term—but once he has ‘declared war’ with Father, he won’t be able to live here. He’ll have to find a job and move into lodgings.”

  “I might be able to manage a little money,” said Ma, “but—”

  “Thanks, Ma. I understand. Go on, Lars. I’m listening.” Fingal felt a lump in his throat. Ma simply could not have the resources to support him for the five-year medical course.

  “It seems to me that you’d be able to save fastest if you had a job that gave you free board and lodge and no opportunity to spend.”

  After the interview with Father, the rising temper, and the disappointment, Fingal was in no mood for pie-in-the-sky suggestions. “I’d get that in the Mountjoy Gaol. But the wages are poor.”

  Lars lowered his head and regarded Fingal from under a set of bushy eyebrows. “Don’t be facetious, Fingal, I’m trying to help.”

  “I’m sorry.”

  “How would you fancy going to sea?”

  “Going to—?”

  O’Reilly felt a hand on his shoulder that pulled him back to the present. “Excuse me, Doc. Could youse move back a wee ways?”

  “Sorry, Alfie.” O’Reilly stood aside to let the driver open the back doors, but his thoughts were soon back to 1927.

  That suggestion by Lars and the twenty pounds Ma had given him from her own private nest egg had certainly opened the door for the young Fingal O’Reilly. He had enjoyed his three years at sea in the merchant navy.

  When he’d joined the Royal Naval Reserve in 1930, he’d spent another year at sea, this time on the British battlecruiser HMS Tiger as part of his training. He had made money in the peacetime auxillary branch of the British Navy and he’d made a good friend. A young sub-lieutenant named Tom Laverty. The Lord does move in a mysterious way, thought Fingal as the traffic noises rose to a crescendo on the Grosvenor Road outside the Royal Victoria Hospital. That Tom Laverty was the father of the young Barry who was now O’Reilly’s assistant.

  It had been a condition of RNR service that members would be called up for active duty in the event of hostilities, but
it was only eleven years after the end of the Great War and he’d thought the risk small. The great powers had not seemed belligerent in 1930. The United States was following a policy of isolationism. The Fascist Mussolini in Italy seemed like a peaceful chap whose intention was to get the trains to run on time. Adolf Hitler couldn’t even take his seat in the German Riechstag because he was an Austrian national. And Ramsay MacDonald, the British prime minister, was too busy trying to deal with the aftereffects of the Great Depression of 1929.

  And Fingal O’Reilly had a lot more pressing business in mind. The sea had made him grow up, but he’d never wavered from his determination to be a doctor. As soon as he had saved enough he’d, in the naval parlance of the day, swallowed the anchor in ’31 and enrolled at Trinity College Dublin. He might not have been as polished as some of his classmates—the sea could do that. Dealing with seamen didn’t call for drawing room etiquette.

  But at least he knew enough now to say, “Thanks, lads,” to the ambulance crew as they handed Donal over to the hospital staff and prepared to depart. “Safe home.”

  Kitty climbed out. “No change for the worse, Fingal,” she said. “Pulse, blood pressure fine. He’s still asleep, but he’ll wake up if you call his name.”

  He took her arm and followed the orderlies as they wheeled Donal to the ambulance room, a part of casualty where patients were seen and assessed. The lights were bright, the floor tiled. The room was divided into cubicles that could be screened by closing curtains, and each contained an examining couch.

  The smells were ones he’d known for more than thirty years, and those in Belfast differed not one jot from the ones he’d first encountered in Sir Patrick Dun’s, a Dublin teaching hospital. He was barely aware of the niffs of disinfectant, floor polish, vomit. Sounds of retching came from behind curtains.

  Donal was wheeled into the nearest cubicle, where a nurse would record his pulse, blood pressure, respiratory rate, and level of consciousness before a doctor came.

  O’Reilly stopped near the front of the room at a tall desk that looked like something out of a Dickensian counting house. A young woman house officer leant against it. Her blue eyes behind rimless spectacles had dark bags beneath. He knew the hours these youngsters worked, could still recall the breaking dawns of his own junior years.

  “I’m Doctor O’Reilly. I’ve come with the man with the concussion,” he said, “and this is—”

  “Hello, Sister O’Hallorhan,” the young woman said. “I’ve just done three months on ward 21.”

  “Doctor Fleming,” Kitty said. “Good evening.”

  The house officer pulled out a lined four-by-eight card. “I’ll have to get a few details, Doctor O’Reilly.”

  “I’ll give you them in a tick,” said O’Reilly, turning to Kitty. “Why don’t you go and sit down? Or head home? I’m going to wait until I see Donal settled.”

  He felt Kitty squeeze his arm. “I know you’re worried.”

  “Och, not really,” he said, “but—”

  “I know you, O’Reilly. I still remember you sitting up all night with a patient when you were a student.”

  “Sergeant Paddy Keogh. Pneumonia. I remember him too.” He smiled. “I just want to be able to tell Julie that Donal’s fine.”

  “I understand.” She looked down the room. “There’s nothing for me to do,” she said, “and the staff won’t like having an off-duty sister breathing down their necks, but would you like me to stay and keep you company?”

  O’Reilly shook his head. “Head home.” He’d like to have kissed her, but not here. He lowered his voice. “You and I have to go shopping in the next week. I hear tell Sharman D. Neill’s do a nice line in rings.”

  “I know,” she said, and smiled. “I’ll look forward to that, but I will run on now,” she said. “I might see you tomorrow if you’re still here at the hospital. I’ll be on the ward in the morning.”

  “We’ll see,” he said, “but I hope Donal’s well enough that I’ll be able to get home soon.”

  “Good night, Fingal. Look after yourself—and Donal.” She turned and left. It wasn’t a long walk home and the hospital grounds were well lit.

  O’Reilly turned to the house officer and gave her Donal’s details.

  He heard a voice behind him. “Doctor O’Reilly?”

  He turned. “Yes?”

  “I’m Mister Rajat Gupta, neurosurgery senior registrar.” He held out a hand. O’Reilly shook it and appraised the young East Asian. His hair was glossy black, his eyes deep set and mahogany brown. His grip was firm. As the man’s title was Mister, not Doctor, he had already passed the Fellowship examinations of the Royal College of Surgeons. It was one of the peculiarities of the British and Irish system of medical titles. Being a fully qualified general surgeon was a prerequisite for training as a brain surgeon.

  “Thank you for coming,” O’Reilly said. “It’s probably just concussion, but I’m a country GP and there’s no harm getting an opinion from an expert.”

  Mister Gupta smiled. “A trainee expert.”

  “You’d be surprised,” O’Reilly said, “by how little brain surgery I practice.”

  “I understand.”

  “Donal Donnelly’s in there.” O’Reilly indicated the cubicle.

  “Come in.” The senior registrar held back the curtain and O’Reilly followed.

  Donal lay on the trolley taking short, shallow breaths.

  “Donal, wake up, you lazy bugg— so-and-so,” O’Reilly said, moderating his language for the student nurse who was taking the patient’s blood pressure.

  Donal muttered something but did not open his eyes.

  O’Reilly noticed the pallor of Donal’s cheeks, that his breathing was shallow. “What’s his pulse rate, Nurse?”

  “One hundred, Doctor, but it’s strong. His temperature is only ninety-three degrees.”

  O’Reilly was sure his own pulse had speeded up. Donal’s condition had worsened, not dramatically, but he was concerned. “Mister Gupta?”

  O’Reilly waited patiently until the senior registrar finished his neurological assessment. “I’m sorry,” he said, “but your patient has a mild cerebral contusion. Nothing terrible, but I want him on the neurosurgical ward.”

  “Fair enough.” Donal would not be going to the observation ward where he’d have spent the night if it looked as though he had suffered only a mild concussion.

  Mister Gupta frowned. “I think there’s a bit of relatively mild bruising of the cerebral cortex, but I can’t completely exclude compression, squeezing of the brain because of bleeding.”

  “Go on.” O’Reilly folded his arms across his chest and stroked his chin.

  “He’s got a bruise over his right temporal bone. That could mean a skull fracture and a possible tear to the—”

  “Middle meningeal artery. Damnation.”

  Mister Gupta said, “I hope it’s not, but to be on the safe side I’m going to arrange skull X-rays, the routine blood work and cross match in case he needs a transfusion, and we’ll do an ultrasound once we get him admitted to ward 21. Unless you have some questions, Doctor O’Reilly, I’m going to get those tests ordered.”

  O’Reilly nodded. “Thank you, Mister Gupta.” This young man clearly had everything under control and Donal was in good hands. O’Reilly looked at the unconscious face of Donal Donnelly, his freckles standing out against his pallid skin, the tips of his buckteeth barely visible. God, O’Reilly thought, he looks so young. He dropped into a chair beside the trolley and waited until the curtains parted and Mister Gupta reappeared. “Everything’s organised, and I’ve had a word with Mister Greer. He’s at home. He agrees with our plan—”

  O’Reilly was flattered by the “our.”

  “He says to say hello.”

  “We were students together,” O’Reilly said.

  “And to call him if things get worse. Your patient might need surgery if they do.”

  “A craniotomy?”

  Mister Gupta nodde
d. “Perhaps. If it’s only a small bleed I can do a burr hole under local, drill through the skull, and let the blood out, but if it’s a bigger bleed or doesn’t stop, Mister Greer will remove more bone, drain the clot, and tie off the artery.” He smiled. “I honestly don’t think either will be necessary.”

  “Jesus,” O’Reilly said softly, “I hope you’re right. When I was a student, the mortality rate from brain surgery was fifty percent.”

  The senior registrar smiled. “We’ve come a long way, sir, and your friend Mister Greer is one of the people who’s brought us to where we are today.”

  It was hard to imagine today’s pillar of the medical establishment as the irresponsible young Charlie Greer of O’Reilly’s student days. He shook his head. “How long before you’ll have the tests done?” He took another look at Donal.

  “About an hour.”

  “And you’re sure—as sure as any of us can be—that Donal’s not going to get worse?”

  “Pretty sure.” Mister Gupta stepped aside for two orderlies.

  “All right if we take your man here ’til ward 21, sir?”

  “Please,” said Mister Gupta.

  “Right,” said the first orderly to his mate, “take you that end, oul’ hand, and away we go.” The rubber-tyred wheels squeaked as the trolley began to move. “Thon axle could use a wee taste of oil,” he remarked.

  O’Reilly put his hand on Donal’s clammy arm. “You’re going to be all right, Donal,” he said quietly, and hoped he was right.

  4

  A Memory of Yesterday’s Pleasures

  O’Reilly carried a tray bearing a plate of steak and kidney, brussels sprouts, mashed potatoes, and a slice of apple pie. Its filling would taste like wallpaper paste, but he’d eaten a lot worse at sea and it could be a while before there was any further prospect of food.

  He sat under pale yellow arches. The cafeteria had been built under two wards and was known as “the Caves.” Smells of floor polish competed with an attar of boiled cabbage. A steady hum of conversation nearly drowned the clatter of serving spoons. He chewed a piece of steak and worried about Donal. Everything was under control. Mister Gupta clearly was competent. It would serve no purpose for Fingal to sit by Donal’s bedside and he’d been in practice long enough to know that worrying never changed a damn thing. But head injuries were unpredictable.