An Irish Doctor in Love and at Sea
The ting, ting, ting of the firing bells was followed instantly by the blasts from all eight of Warspite’s great guns.
His world dissolved into a maëlstrom of deafening basso sound, chest-crushing concussion, blinding light as tongues of dragons’ breath seared the air and clouds of mahogany cordite smoke blended with the darkest corners of the devilish night. Warspite, all thirty-two thousand tons of her, heeled to starboard.
And from astern Valiant and Barham were lit up for brilliant seconds in the blaze of their big guns.
All the while, the six-inchers raved away, lethal terriers barking and snarling at the Italian destroyers which were now beginning to appear. And as the huge barrels ran in onto the recoil mechanism, returned to position, and once more hurled their shells, Fingal saw what the missiles were doing. Shells burst brilliantly on the enemy ships and whole turrets and masses of debris were hurled high into the air to splash back into the uncaring pitch-dark sea. In minutes, the three enemy ships were glowing masses, burning from stem to stern.
“Stop it. Please stop it,” he whispered. Those ships were defeated. Italians were dying, drowning, being blown to fragments, roasted alive—the worst fate of all—or horribly maimed. It didn’t matter that they were the enemy. They were young men. He shook his fist at the B turret barrels. “Stop it,” he yelled. But as a tornado doesn’t heed a mere human’s plea to go away, the great gun ignored him and went on belching its message of hellfire.
To Fingal it seemed an eternity, but only ten minutes after the firing began, the order “Check, check, check,” was given. The main act of the Battle of Cape Matapan was over.
Fingal was chilled to the marrow. His ears whistled and rang. He was heartsore from the carnage he’d witnessed, and turning on his heel, headed for his station. There would be Italian survivors. During battles the big ships become floating hospitals for the injured—of both sides—just as Warspite had done at Narvik last April.
He descended the last companionway and rubbed his hands over his face, trying to dispel what he’d seen, yet hoping what he’d just witnessed might somehow help to shorten the war. May I and all those like me, he thought as he pulled open the heavy metal door, go home sooner to our loved ones. But what a waste. What a hideous awful waste.
45
It Is a Wise Father That Knows His Own Child
“Right,” said O’Reilly, bounding to his feet from a wooden chair as Barry appeared at the back door of the kitchen. “All done for the day?”
Barry slammed the door, cutting off a chilly blast from outside. He nodded and started to unbutton his overcoat. “Mother told me there’d be days like this. If I have to visit one more case of flu I’ll—I’ll spit. But yes, I’m done.” He stopped unbuttoning. “Fingal, why are you wearing your coat and gloves? It’s hot as hell in here with the range roaring away.”
“I know, but I’ve been waiting for you. Keep your coat on,” O’Reilly said, “I need your help. Come on.”
“Help with what?”
“I’ll explain in the car,” O’Reilly said, “but it’s not flu, I promise.”
“Bloody hell,” Barry muttered sotto voce, but said, “all right.”
The stiff northerly breeze was raw on O’Reilly’s cheeks as they crossed the back garden, a back garden quite devoid of Arthur, who was in the lounge, snug in front of the fire where he’d been all week during the cold snap.
“Hop in.” O’Reilly let himself into the Rover.
Barry did, and like a grand prix racing competitor O’Reilly took off as if from a Le Mans start.
“Lord, Fingal, where are we going? Is someone bleeding? What’s the rush?” Barry clung to the edges of his seat. “The roads are pretty icy, you know.”
“I’m used to them,” O’Reilly said as the back of the car slewed sideways and he straightened the Rover up. “You remember that Lorna Kearney was being discharged yesterday?”
“Yes. Is she okay?”
“She’s fine and so is the baby. Here.” He handed Barry a letter. “I got it this morning and I haven’t had a chance to get you to explain it to me fully. You read it aloud and I’ll try to tell you what it means to see if I’ve understood what I think I’ve learned. You can correct me if I’m wrong. I reckon I’m understanding this Rhesus business a lot better now. Fair enough?”
“You hauled me away from a warm kitchen and a chance to put my feet up after a very long afternoon of visiting coughing, feverish, tetchy customers, to explain a letter to you?” Barry shook his head.
“Sorry about that, but I’m in a hurry.”
“Why? There’s nothing urgent about a neonatal checkup.”
“Ah,” said O’Reilly with a grin, “but if we get it done quick we’ll have time to nip into the Duck before Kitty gets home.”
“Doctor O’Reilly,” Barry said past pursed lips, “sometimes I despair.”
O’Reilly ignored the lad’s irritation and reached out to tap the letter in his lap. “Skip the ‘Dear Doctor O’Reilly’ stuff and all the things we already know like her last period and her blood pressure. Just stick to the Rhesus stuff.”
“I want it known that I’m doing this under protest.” Barry began to read the report, “‘The results of the patient’s first amniocentesis showed that the optical density level was in the moderate zone on the prediction chart. It was decided to wait for two more weeks—’”
“I remember that.”
“‘A second uncomplicated amniocentesis was carried out on the morning of Wednesday December the seventh when the pregnancy was thirty-five weeks and five days. Results were received that day. The optical density of the fluid was reported as being point zero six—’”
“So Doctor Whitfield plotted that on the prediction chart and determined the severity?”
“Right. It showed that the level was almost in the severe zone.”
“She was nearly thirty-six weeks by then. Safer to deliver the baby than let the isoimmunisation get any worse. I’d try to get labour started.”
“And you’d be right again, that’s what they did, and—Jesus Murphy, Fingal, look out.”
O’Reilly had not quite judged his line into the crown of the hairpin bend where a lane led to the Donnellys’ cottage. This time, despite his best efforts, the car skidded sideways and just missed hitting the road embankment before he was able to get it back on course. “Nothing to worry about,” he said. “Go on.”
“Nothing to worry about? I thought I was going to be having a chat with Saint Peter. Slow down.”
O’Reilly said nothing.
Barry’s voice trembled as he read, “‘Labour was induced that afternoon by rupturing the membranes and giving intravenous oxytocin to stimulate uterine contractions. The normal delivery of a healthy female infant occurred at four sixteen on the morning of December the ninth.’”
“Sounds like a fair while,” O’Reilly said, accelerating onto a straight bit of road.
“The baby was clearly not in a hurry—unlike you,” Barry said. “Will you please slow down, Fingal? There’s plenty of time to get Lorna and the bairn seen to and get to the Duck.”
“Oh, very well.” O’Reilly let a few miles an hour bleed off the speedometer. “Happier now?”
“A bit, but I think I’d be happier still if I were driving.”
“If you were driving, then how would you read the letter?”
Fingal took a sidelong glance at Barry and saw the boy’s lips twitch into the faintest of smiles. “Please carry on, Doctor Laverty.”
“Right. ‘While induction was initially slow, the onset of the active phase of labour began at two P.M. on the ninth.’”
“That’s not so bad then.”
“Not bad at all. Perfectly normal for an oxytocin-induced labour.” Barry shuddered and said, “Did we just pass five men on skis hauling a sledge?”
“What are you on about?”
“I thought we just passed Scott’s last expedition on its way to the South Pole. Lord knows it’s c
old enough in here. Why isn’t the heater on?”
“Um,” O’Reilly said, feeling a little chastened. “It’s broken.”
“Well, get it fixed then.” And implied in Barry’s tone was “you buck eejit.”
O’Reilly was about to snap at Barry when he realised how out of character the young man’s irritation was. Sue Nolan would be home in four more days. Maybe Barry’s mood would take a turn for the better then. For now he was getting a fool’s pardon. “I will, but what else is in the report?”
“It goes on, ‘A sample of cord blood was taken at birth and a direct Coombs test—’”
“You’ve lost me.”
“Foetal red cells are mixed with an antibody that will stick to globulins, proteins, on cell surfaces. Anti-rhesus antibody is a globulin. If the baby’s red cells stick together, that’s proof that they have antibody attached to them. The test was positive, so the baby was affected just as the results of the two amniocenteses had predicted.”
“How badly affected?” O’Reilly knew that some wee ones were given exchange transfusions. Their own blood contained the breakdown product of the red cells, bilirubin, which caused severe effects like the neurological disorder kernicterus. The neonate’s blood was removed, taking the bilirubin with it, and replaced with fresh Rhesus-negative blood, which would not be attacked by any residual anti-Rhesus positive antibodies remaining in the baby’s circulation.
Barry managed a weak smile. “Clinically, according to the letter, she was mildly jaundiced but exhibiting no signs of any neurological disorder. The baby’s bilirubin measured on the same blood sample was less than three miligrams percent, which is below, and her haemoglobin was fifteen grams per one hundred millilitres, which is above the cutoffs for needing an exchange transfusion. They did put her under phototherapy lights for two days. The lights change the structure of the bilirubin and render it harmless.”
O’Reilly decelerated, indicated for a left turn, and pulled onto the lane to the Kearney’s farmhouse. “I read about that away back in 1958,” he said. “A Doctor Cremer published a paper in the Lancet.”
“Actually,” Barry said, “the effect of light was first noticed by a nursing sister at a hospital in Essex. She thought that sunlight was good for preemies and noticed that it improved jaundice in affected ones.”
“Discovery,” O’Reilly said, “favours the prepared mind. And there are no better prepared minds in medicine than good nurses’. Smart young doctors cotton on to that early in their careers.” He would have expected Barry to comment on the misphrasing of Louis Pasteur’s famous doctrine, or the observation about nurses, but given Barry’s mood O’Reilly was not surprised when the lad ignored the remarks and simply said, “And by yesterday the paediatricians were satisfied she would be fit for discharge.”
The car jounced and quivered.
“If you keep bouncing over ruts like that, you can add new springs as well as a new heater to your mechanic’s bill,” Barry said.
“Nonsense,” O’Reilly said. “The Rover company builds cars as tough as Sherman tanks.” He parked and sat back. “The hospital folks just want us to make sure baby’s being kept warm, is established on breast-feeding, not badly jaundiced, and that Lorna knows to take the babby to the follow-up clinic at RMH next Thursday. Come on then. Let’s get the job done.”
Reggie Kearney answered the door and ushered them in.
O’Reilly remembered the big living room from when he and the marquis had called in for a hot half-un after their day’s snipe shooting in October. He wondered how Lars was getting on sorting out John MacNeill’s affairs.
Even though the room was overly warm, O’Reilly moved to stand in front of the fire. He rubbed his hands and said, “Jes…” He remembered the Kearneys’ devoutness. “Brrrr. It’s bitter cold out today. I’m half foundered.” Barry was right about having the old Rover car’s heater fixed.
“Warm yourselves, Doctors,” Lorna said from where she sat in a comfy chair beside the hearth. “Doctor Whitfield told me to expect a visit.” A crib on rockers stood beside her chair and Reggie, her husband, stood beside her, one big hand on his wife’s shoulder.
Barry, whose nose was losing its blue tinge, moved to stand beside O’Reilly.
“You’ll be wanting til see wee Caroline,” Reggie said, pointing to the crib.
“First things first,” O’Reilly said. “How are you feeling, Lorna?”
“Ah, grand,” she said. “Grand altogether. Doctor Sproule give me the complete once-over just before I was discharged, so he did. He said for to tell you as far as he’s concerned I was A1 at Lloyds and not to worry because they’ll be seeing me next Thursday at the postpartum clinic.”
“Fair enough,” said O’Reilly. “If the specialists are satisfied we’ll forgo examining you. Agreed, Doctor Laverty?”
Barry nodded.
“And Caroline?” O’Reilly asked.
“She’s still a wee bit yellow, but they said that was to be expected.”
“And how’s she feeding?”
“Wee Caroline started breast-feeding six hours after she was born, and took to drinking every four hours like her daddy takes to his Guinness on a Friday night.” She laughed.
“I like my pint,” Reggie said, and chuckled. “We may be good Presbyterians, but we’re not teetotallers.”
“Good man-ma-da,” O’Reilly said, and thought, I’d go a pint myself. Definitely on the way home.
“The only trouble with four-hour feeds is wee Reggie Junior,” Lorna said. “I’m sleepy all the time, and Reggie still has a farm to run, so he has. The wee lad was going til get a bit neglected so he’s at his granny’s until I get better rested.”
“Good idea,” said O’Reilly. “And you’ll have your feet under you in no time.” He turned to Barry. “Doctor Laverty, you’ve had more recent experience with a lot of newborns than me. Would you do the honours?”
“Of course.” Barry stripped off his gloves, shoved them into his overcoat pockets, and said, “Mister Kearney, would you hold Caroline for me, please.”
O’Reilly watched as Reggie Kearney, all six feet of him, with shoulders like an ox, bent and, with infinite gentleness, lifted his tiny daughter from her crib. He held her tenderly as Barry began his examination by opening the baby’s cardigan and pulling up her nightie. Caroline objected.
“Nothing wrong with her lungs,” O’Reilly said with a smile as the little one’s screeches filled the room. He simply had to speak more loudly. “Boys-a-dear,” he said, “that’s a powerful bright cardigan she’s got on. Some of your handiwork, Reggie? Fair Isle, is it?”
“Aye,” said Reggie with pride in his voice, “it is. Fair Isle’s a tricky pattern, but not as tough as all the cable stitches in Arran knits. Anyroad, Lorna said the doctors wanted the wean to have woolly caps to wear all the time so I knit a clatter of them too.”
“The doctors advise that,” said O’Reilly, “because little ones can lose a powerful amount of heat through their heads and getting cold is very bad for babies, especially premature ones.”
“She’ll not get cold in this house,” Lorna said, rising, taking two big pieces of turf from a wicker basket and putting them on the fire before returning to her seat.
Barry straightened up. “You can dress her, please, Mister Kearney.”
O’Reilly was impressed by the nimbleness of Reggie’s fingers despite their looking as clumsy as sausages.
“A tiny bit of icterus, sorry, doctor talk. She’s still a wee bit yellow, but only from her belly button up, and none on her palms or soles. That’s very good.”
O’Reilly agreed. It was a rough rule of thumb used clinically to guess the severity of jaundice, but he and Barry had the reliable backup of the figures in the letter from RMH.
“Give her here, Reggie,” Lorna said. She had already unbuttoned her blouse.
Reggie bent and handed over his very vocal new daughter and in moments the room fell silent as she latched onto Lorna’s nipple and began
to feed.
Madonna and child, O’Reilly thought, and saw how Reggie was grinning and Barry, so grumpy on the drive out and strictly professional here, was standing, head tilted to one side, with a smile best described as dreamy. Mothers’ love had that effect. No wonder the great artists, da Vinci, Michelangelo, Raphael, Caravaggio, Rubens, Dali, had all rendered the subject. The moment seemed suspended in time. The warm room redolent with the earthy smell of turf, the intense concentration of the couple on the tiny child held in her mother’s arms. The four adults said nothing for several minutes until the steady ticking of a clock on the mantel reminded O’Reilly of the time.
“Reggie, do you mind the day his lordship and I dropped in?” O’Reilly said quietly.
“After you’d been at the snipe?”
“Aye. He said he’d like to give Caroline a christening present. Can I let him know that she has arrived?”
“Go right ahead, Doctor,” Reggie said, and immediately turned to Lorna. “I forgot to mention it to you, love. Clean slipped my mind in all the running back and forth to Belfast and wondering if this little one was going to be okay.”
“That’s all right, Reggie,” she said. “It’ll be a great honour. She’ll be getting baptised in January, and Doctor O’Reilly, we’d like you and Mrs. O’Reilly and Doctor Laverty and his young lady Miss Nolan to come. We hear she’ll be back from France for Christmas.”
“We’d be delighted,” O’Reilly said. “Just let us know the date. Doctor Laverty?”
“I’ll need to discuss it with Sue but I’m very flattered.”
O’Reilly said, “Right. I think that’s about it. I’ll let Miss Haggerty the midwife know you’re home, and she’ll pop in on Monday. See how you’re getting on. We need to be heading back. Come on, Doctor Laverty, and if we don’t see you before, have a very merry Christmas.”
“And to you, Doctors,” Reggie said, holding open the door. “And thanks for helping to see wee Caroline into this world. She had us worried a bit, but youse doctors knew the right specialists and they, with the good Lord’s help—”
“Och, say no more,” O’Reilly said. “I was lucky to have two young doctors who were right up to date and could advise me.” And, he thought, to show me that it is important for me and Barry and even old Ronald Fitzpatrick to keep up to date.