A Dublin Student Doctor

  “Pack.” He took another gauze square and used it to grip the caecum. The smooth rubber of his gloves would have slid off the slippery bowel, but the rough gauze gave added traction. Slowly the organ emerged, and there it was. The appendix.

  Fingal blew out his breath. He hadn’t realised he’d been holding it and felt the dirty nurse swabbing his forehead. How did he feel inside? Certainly not as scared as he had at the start. Relief? There was that all right. He’d felt the same way when for the first time as a young deck officer he’d anchored the ship unsupervised.

  Sister had given Harry a Morrant Baker forceps and was offering one to Fingal. The instrument was designed to encircle the appendix without damaging it while it was still within the abdominal cavity. Harry applied his to one end while Fingal placed his where the organ joined the caecum. He then handed his to Harry who, by pulling on both, lifted the appendix and exposed its mesentery, a thin membrane through which the blood vessels ran. It took but a moment to clamp it and the vessels firmly and divide them. The appendix was free and ready to be removed.

  Fingal took a different set of forceps with ridged blades and, to facilitate its ligation and division, deliberately crushed the appendix close to the caecum, removed the forceps, and reapplied it above the crushed area to seal part of the organ that would be removed. Those days of suture duty and learning to tie knots paid off as he ligated the appendix at the crushed area then took a scalpel and divided it between the ligature and the clamp.

  Harry lifted the diseased organ and dumped it and the attached forceps into a stainless steel dish.

  Fingal heard the clatter of metal on metal. His feelings of triumph were pulled up short when Doctor Callaghan asked, “Going to be much longer? Mister Kinnear would be halfway through his third case by now.”

  “Not long,” Harry said. “Just have to suture the mesentery to secure the blood vessels, and bury the stump in the caecum.”

  “Let me know when you have. He’s been under for a fair while—”

  Fingal pursed his lips. He’d completely forgotten that a person called Seamus Farrelly lay under the towels. A childless married butcher who had been a keen hurler.

  “I’d like to start lightening the dose of chloroform.”

  “I’ll finish,” Harry said. “I’m quicker.”

  “Fine.” Fingal was happy for the houseman to speed things up and cheerfully assisted as Harry sutured the mesentery, put a purse string suture in the caecum around the base of the appendix, pushed the stump in, and tightened the loop before tying the knot.

  “Closing,” Harry said, pulling out the moistened swab Fingal had inserted into the belly to keep loose bowel out of the way.

  “Thanks,” the anaesthetist said.

  Fingal was happy to cut the stitches as Harry closed the wound.

  “Done,” Harry said, helping Sister put on the dressing. As she tied the last knot in the bandage the patient moaned.

  “That,” said Doctor Callaghan, “is close to the perfect anaesthetic. As the surgeon finishes, the patient is wide enough awake to be told the fee.”

  Fingal laughed in relief that the surgery was over. He was startled to hear a round of applause coming from the stands, looked over and saw his three friends clapping.

  Charlie Greer said, “Well done, Fingal.”

  Cromie added, “And we don’t give a hoot about your self-imposed monastic life of study. Tonight, boyo, Hilda and Fitzpatrick are on duty so we’re going to Davy Byrnes and the first pints are on you.”

  “I’m sorry to disappoint you lads,” Fingal said, “but go away on your own. I’ve work to do. I’ve got those Part I exams in December, remember?”

  “And you’ll destroy them,” Cromie said. “Utterly.”

  Fingal shook his head. “It’s all right for you lot. You’ve only all the clinical subjects to master for Finals Part Two in June. I have them on top of repeating Part One. And I’m not going to fail this time around.”

  “Fingal,” Charlie said. “One evening’s break won’t kill you. We’ve got our certificates of good standing in all the other clinical disciplines except the final three, midwifery, opthalmic surgery, and anaesthetics.”

  “That’s right,” Bob said. “And Mister Kinnear’s bound to issue our certificates for surgery in December.”

  “Three months away, but that certificate will be bugger all use to me if I fail Part One. I’m studying tonight.”

  “I think, gentlemen,” said Charlie, “we have run up against the immovable object.”

  “Pity,” said Bob.

  “Fraid so,” said Fingal. “I’m going to change, have my tea, and then work. See you lot at rounds tomorrow.” He strode into the surgeons’ dressing room. Eejits. But he smiled. They were good lads. They meant well.

  * * *

  Fingal had just settled at his desk in his bedsit at Sir Patrick Dun’s students’ quarters and opened his pathology textbook when he heard a knock at the door. Now who the hell was that? “Come in,” he roared. They’d better be quick, whoever it was. He didn’t need interruptions. He had twenty-six pages to read about the pathology of cancer of the lung.

  Bob Beresford stuck his head into the room. “And how is the great Lawson Tait tonight?”

  “Lawson Tait? What the hell are you on about, Beresford?” Fingal scowled. “I’m busy.”

  “Scottish surgeon,” Cromie said, pushing Bob inside and following, “who did the first appendicectomy in 1880. Clever lot, us Scots.”

  “I wonder,” said Fingal grimly, “if he was related to the Butcher of Grand Canal Street?”

  “Wasn’t your patient a butcher?” Charlie asked as he brought up the rear.

  “He is, but I am referring to myself,” Fingal said, “the student who killed his classmates because they wouldn’t let him study.” But he couldn’t really be angry with his friends.

  “We need your help,” Bob said. “And you’d never refuse to give your friends a hand. We know that.” The two large brown paper bags he set on Fingal’s desk clinked. “We’ve just come from Davy Byrnes.” Bob fished out a bottle of Guinness. “You couldn’t expect the three of us to put away another wheen of Mister Arthur Guinness’s best by ourselves, could you? And it’s not every day of the week that a pal does his first appendix.”

  “You lot are hopeless. Utterly bloody hopeless.” Fingal laughed. “All right. All right, come in. There’re glasses in the communal kitchen.”

  “No there’s not,” said Charlie, producing the tumblers. “Fill ’em up, Bob.”

  Bob rummaged in his pocket for a corkscrew.

  Cromie and Charlie squashed onto a two-seater settee.

  Bob opened the bottle with a distinct pop and poured. “We,” he said, “are here to toast you, Fingal, aren’t we, lads?”

  “Indeed,” said Charlie. “Pity it takes so long to pour stout.” He stood, moved to the fireplace, and stared at a row of picture postcards. “Mind if I take a look, Fingal?”

  “Go right ahead.”

  Charlie squinted then said, “That’s the Parthenon in the Athenian Acropolis, and those are the great pyramids, Cheops, Khefren—and buggered if I can remember the third, and that’s the Sphinx at Giza. Napoleon’s gunners made an awful mess of the poor old thing’s nose in 1798. So you’ve friends in Greece and Egypt?”

  “My folks,” Fingal said. “They decided to take an extended holiday this year. They send postcards to me and my brother. Keep us posted.” And Lars and I talk on the telephone once a month, he thought. It’s about time I gave him a ring.

  Charlie whistled. “Lucky them.”

  Fingal saw the sympathy in Bob’s look. He was the only one of the friends who knew the truth about Father’s illness. Bob had never mentioned it again since the night Fingal had told him, but always listened sympathetically if Fingal needed to talk.

  Fingal said, “They left in August on their grand tour. They had hoped to take the Arlberg Orient Express from Zurich to Budapest and on to Athens, but my fath
er felt crossing Nazi Germany would be dangerous. They went to Marseilles instead and took passage from there. They’ve decided to winter somewhere warm too.”

  “I think,” said Bob, passing a full glass to Fingal, “your dad was right to keep out of—what does Adolf call it? The Third Reich? In September he banned all Jews from public life. The maniac has just announced a program to build submarines—U-boats he called them. It’s got Winston Churchill’s knickers in a real twist. He’s been screaming in the British parliament that England must rearm.”

  “I wonder who the subs’ll be used against?” Fingal asked, thinking of his commitment to serve in the navy.

  “England,” said Cromie. “There could be a war. Churchill has a point.”

  “I sincerely hope,” said Bob, handing a glass to Charlie, “that you are both wrong.”

  “Your people had better not winter in Italy,” Cromie said. “Mussolini’s poised to invade Ethiopia. He’s a fascist and he has dreams of Empire too.”

  “And,” said Bob, “I had dreams of having a few quiet bevvies with our good friend Fingal O’Reilly tonight and for once not letting him worry about exams he’s bound to pass—”

  “I hope,” Fingal said.

  “Here.” Bob gave Cromie a Guinness. “And that’s enought blether too about the miserable state of the world. We can’t do much about it.” He pulled a silver flask from an inside pocket and opened its top. “Now,” he said, “who’ll propose a toast?”

  “Me,” said Cromie, lifting his glass. “In the immortal words of my Scottish forbears—”

  “I didn’t know you were descended from bears,” Charlie said. “Which one? The grizzly, Ursus horribilis, I’ll bet.” He held his arms crooked above his head, hands curled into claws, and made a ferocious growling noise.

  Fingal laughed.

  Bob chucked a cushion at Charlie, who dodged, but managed to spill some Guinness on Fingal. “Shut up, Greer,” Bob said, “and let Cromie finish.” He turned to Cromie. “The floor is yours.”

  Cromie bowed, then said, “To Fingal’s dextrous surgical fingers—”

  “Sorry to interrupt,” Bob said, “but would you consider being a surgeon, Fingal?”

  “I might,” Fingal said. “I just might. We’ll see.”

  “Just curious,” Bob said. “We’re all going to have to choose pretty soon.”

  That, thought Fingal, is pretty promising. Bob’s including himself in “all.”

  Bob said, “Carry on, Cromie.”

  Cromie pointed at Fingal. “To his forthcoming success in Finals Part One,” he swept an arm wide to encompass the room and intoned, “and to us four. As us Caledonians say, ‘Here’s to us. Wha’s like us? Damn few—and they’re mostly dead.’”

  Fingal had heard it before, but somehow the intense way Cromie had spoken struck a chord. Fingal was a lucky man to have these three stalwarts as friends. He lifted his glass and said, “I’ll drink to that, all of it. By God I will.”

  36

  Windy Night; a Rainy Morrow

  Fingal shivered. The windows in his room clattered as another gust of the rain-sodden mid-November gale smashed against the pane and a cold draught slipped past the ill-fitting sash. The rug over his legs barely kept the chill at bay. “Dublin in the winter? Bad as the bloody Bay of Biscay,” he muttered, rubbing his hands together and blowing on his fingers before he could turn the page of the book lying on the desk where he sat studying. A small paraffin heater burbled, giving off an acrid smell and precious little heat.

  For a moment he mistook a knock on his door for the rattling of the window. “Come in, and shut the door behind you,” Fingal called. He’d been at his books for two hours already this evening and would be grateful for a break.

  Charlie Greer, who had the room across the hall in the students’ quarters, came in, shut the door, and stood beside Fingal. Charlie was wearing a Paddy hat, raincoat, and carrying a hold-all. He must be going out somewhere.

  “Yes, Charlie?” Fingal asked.

  “Still at it? So our session here last month didn’t lead your stumbling feet off the paths of righteousness.” Charlie leant over and grunted. “The spleen.” He read the page heading from the 1935 edition of A Short Practice of Surgery by Bailey and Love. “Interesting, isn’t it?”

  Fingal said, “It is. I try to read about any new case we see, and Bob and I were on duty last night. Fellah with a ruptured spleen came in. I assisted Mister Kinnear and Doctor Ellerker at the splenectomy. They let me close the incision.”

  Charlie shivered and said, “It’s cold as a witch’s tit in here.” He asked, “Mind if I have a pew?”

  Fingal shrugged. Charlie, like all Irishmen, should be used to their miserable winters. There was no point complaining. Then Fingal smiled and said, “Park yourself.”

  The springs gave a twang as Charlie flopped onto the two-seater. He said, “I’m pretty sure I’m going to be a surgeon.” He grinned. “In the last five months we’ve removed sebaceous cysts, ingrowing toenails, repaired uncomplicated hernias, fixed abscesses, appendixes, varicose veins. I love working with my hands. I want to do more.”

  “I’ve enjoyed it too,” Fingal said, “but I think of it as training for general practice. Doctors in the country are still taking out appendixes on kitchen tables.”

  “And speaking of which—”

  “Kitchen tables?”

  “No, you goat.” Charlie shook his head. “Appendixes. The last time you took a break was when we descended on you with Guinness to celebrate you taking out your first one.”

  “No,” said Fingal, holding up a hand like a traffic policeman on point duty. “Oh no. Not again.” He turned in his chair and roared, “Bob and Cromie, if you’re lurking out there, go ’way to hell out of it.” He lowered his voice. “Charlie, I don’t mind chatting with you for a while, but tonight I still want to read the pathology of pancreatitis and the bacteriology of tuberculosis. And I was just finding out if removing the spleen was any good for cases of leukaemia.” He hoped so.

  Charlie chuckled. “Don’t worry. The lads aren’t here. I came by myself, and I can save you some reading. It’s been tried in the past for cases of leukaemia, but splenectomy has no curative value. It’s not done anymore.”

  “I see. Thanks.” Fingal wasn’t going to discuss his family’s affairs with Charlie, so would keep his disappointment to himself. “But I still have more studying to do tonight.”

  Charlie pushed his Paddy hat back and ran fingers through his red fringe.

  “You’re bound to pass.”

  Fingal shrugged. “I shouldn’t have missed so many classes.”

  “I wonder,” said Charlie, “if all those practices last season improved our game. I’ve been training on Thursdays, but you haven’t, and I reckon you outplayed me last Saturday.” He grinned. “Did Bob tell you?”

  “Tell me what?”

  “Doctor Murray and Mister Musgrave were at the match.”

  Fingal spun in his chair. “Seriously? The selectors?” Rugby, even at an international level, was an amateur game. The scouts were volunteers who themselves had long been associated with the sport. Since his first cap in 1927, Doctor P. F. Murray had collected eighteen more for Ireland. To Fingal, to any serious player, there could be no greater honour. Charlie’s news made Fingal quiver.

  Charlie nodded. “I reckon we both have a chance. The trial’s before Christmas. If we’ve been picked for it we’ll hear in the next week.”

  Fingal grunted. “My exam’s just before Christmas too.”

  “Fingal,” Charlie said quietly. “It’s a chance to be picked to play for your country.” He waited.

  Fingal said nothing.

  Finally Charlie broke the silence. “You know, the rest of the lads and I, we worry about you.”

  “I’m fine.” Fingal glanced at the page. It was time to get back to work, but Charlie was not to be put off.

  “You’re not the old Fingal. You’re more like Mister Badger in The Win
d in the Willows. You never leave your lair. It’s not healthy. The odd night getting your mind off the books wouldn’t hurt you.” Charlie picked up his hold-all, unzipped it, took out a boxing glove, and tossed it at Fingal.

  He caught it. “What the hell?” Without thinking he sniffed the scuffed leather and the memories came.

  “Bob says you told him you’d boxed in the navy. I’d often wondered where you got those lugs.”

  Fingal’s ears were thickened from his years in the ring at school and at sea. He laughed and nodded. “Aye, I did box a bit back then. See that?” He pointed to a scar under his left eye. “I got that in 1930 on board HMS Tiger. We were in Gibraltar. Referee stopped the fight early in the third.” He didn’t want to seem to be boasting to Charlie so didn’t mention how the bout had ended.

  “I go to the gym every Tuesday,” Charlie said, “skip, punch the bags, spar if I can get a partner. Helps keep me trim.”

  “I just play rugby on Saturdays,” Fingal said, “but I reckon I’m pretty fit.”

  “Physically,” Charlie said, “but, and I mean it, you’re not the old, hoist skeletal Gladys up in her knickers, stuff Fitzy’s stethoscope with cotton wool Fingal. There was a time you enjoyed playing practical jokes, took a jar with the lads, went to the flicks. We reckon the odd night out of this room away from those damn books wouldn’t hurt, and it doesn’t have to be a night in the boozer. You’re getting old before your time.” Charlie grinned and said, “We’ll be buying you a walking stick soon—old man.”

  Fingal roared with laughter. “Bugger you, Greer. Old man? Walking stick? If you’ve got a second pair of gloves in that bag I’ll show you who’s an old man.”

  “Will you, by God?” Charlie laughed. “Will you? Have you guttees?”

  “Gym shoes? I have.” Fingal cocked his head, looked at Charlie, then back to the surgical text. Surely he could afford a couple of hours? And Fingal O’Reilly could never resist a challenge.

  Charlie nodded at the hold-all. “I’ve three more gloves, spare trunks. Mine should fit you.”