“Can I wash my hands in the sink?”
“Aye, certainly,” Kieran said, eyeing the scalpel blade, which was clearly visible through the transparent packaging.
Barry washed his hands and shook most of the water off. He didn’t bother drying them. He didn’t need dry hands, and he didn’t want to waste the prewrapped sterile towel in the bag.
“Can you give me a wee hand, Ethel?”
“Yes, sir, and here’s your nice clean soup plate,” she said, crossing the linoleum-covered floor.
“Just set it on the table beside Kieran.” Barry noticed how the plate’s glaze glistened in the rays from the single overhead sixty-watt bulb. When Ethel said “clean,” she meant thoroughly scrubbed. Her housing might be verging on being a slum, but it would not stop Ethel O’Hagan being a tidy housekeeper. “Kieran, hold your hand over the bowl, and Ethel, unscrew the top of that bottle . . .” He nodded to indicate the Dettol. “Now pour some over Kieran’s thumb.”
She did, and Barry’s eyes were stung by the strong fumes of the disinfectant. “Right, Ethel, one last job. Can you open the package the scalpel’s in?”
She looked puzzled.
“Take each side between your one finger and thumb, and pull.”
She followed his instructions, and Barry had no difficulty removing the surgical knife. “Now, Kieran,” he said, “I’m going to cut a wee window in the nail.” Before Kieran could object, Barry seized the thumb in the ring of his own left thumb and index finger and used the pointed scalpel blade to cut a small rectangle in the nail over the bruise. In a second the piece of now free nail was lifted and dropped in the bowl, and the dark old blood beneath welled up and dripped over the side of Kieran’s thumb.
Kieran whistled, then said, “Boys-a-boys, that’s powerful. The throbbing’s stopped already.”
“It’s because the pressure’s been relieved.”
“Just like a safety valve on an engine,” Kieran said wide-eyed, and whistled on the intake of breath. “Modern science is a wonderful . . . a wonderful . . . thing.”
“Hold your thumb there.” Barry wrapped it in a cotton swab and used the adhesive Sellotape to bind the swab in place. “A week or so and it’ll be good as gold . . . but you’ll probably eventually lose the nail, and it’ll be a while before a new one grows back.”
“Och, well,” said Kieran, “sure I’ll just ask Santa for a new one for Christmas.” And he laughed.
“I’ll wash the soup plate,” Ethel said, as the kettle started to whistle on the stove. “Are you sure, Doctor, you’ll not have a wee cup?”
Barry shook his head. “I’ll just wash my hands again and be running along. I’ve another call to make.”
“No rest for the wicked, eh, Doc?” Kieran asked.
“None,” Barry said, drying his hands on the towel Ethel offered. Then he shrugged into his coat. “Can you bring him in tomorrow, Ethel, if the weather’s warmer, and I’ll change the dressing?”
“Aye.”
“Good. Now you two enjoy your tea. I’ll see myself out.” And so saying, Barry left the cosy kitchen and walked down the chill hall and out through the front door into the teeth of a blast that must have started its life somewhere north of Spitsbergen.
His next call was six doors down, and on a warmer day he would have enjoyed the chance to stretch his legs and take in the atmosphere of the neighbourhood. Today, though, he hurried, the wind pushing at his back. The narrow street usually echoed with the high-pitched cries of children at play: boys in short pants swinging on ropes tied to the lamppost; boys noisily trundling old, tyreless bicycle wheels along the road, guiding them with bent pieces of wire and rolling along with roller skates clamped to the soles of their boots; girls skipping rope, chanting, “One potato, two potato, three potato, four . . .”; others hopping over the hopscotch squares that were chalked on the paving stones. But not today. It was far too cold.
Barry stopped at Number 31, knocked, and waited, stamping his feet, his shoulders turned to the wind.
O’Reilly had made the first call here ten days ago to see the tenant’s nine-year-old son. The little lad had been one of the many cases of upper respiratory infection in the village. Barry had visited four days ago, and young Sammy had seemed to be well on the mend. But today Kinky said the mother felt he’d had some kind of relapse.
The door was eventually opened by a woman he knew to be twenty-eight. But the dark rings under her eyes, her complete lack of any makeup, and her barely combed, lank brown hair made her look at least forty. It was a shame, because Eileen Lindsay was usually a pretty young woman, and, O’Reilly had told Barry, she had shown courage and independence when her husband scarpered to England two years ago. “Come in, Doctor Laverty.” Her voice was listless, and she stifled a yawn, brushing back a few strands of hair with the same hand she’d used to cover her mouth.
Barry followed Eileen into the hall, where his nostrils were assailed by the smell of boiled cabbage.
“Thanks for coming, Doctor Laverty.” She stepped aside to let him into a hall that was an identical twin of the one he had just left—and equally chilly. “Sorry to drag you out on a day like today.” She closed the front door. “Sammy’s upstairs. I don’t like this rash he took last night.”
Barry looked at the bags under her eyes. “And were you up with him all night, Eileen?”
She nodded.
“Why didn’t you send for me?”
“Och, sure, but it was only a wee rash. No need for the pair of us to lose a night’s sleep, and you might have had something important to do, like delivering a baby or something.”
Barry shook his head. Countryfolk. “That was considerate of you, Eileen, but if you are worried about anything you should call.”
“Go on, Doctor, sure I told you it’s only a wee rash.”
It was the wrong time of the year for most of the diseases of childhood that were usually accompanied by rashes, but with the history of an earlier chest infection Barry was already halfway to formulating a diagnosis.
“Let’s go and have a look at him,” he said, “but next time call. Please.”
“I will,” she said, but he knew by the tone of her voice that she would not.
Barry followed her up a narrow uncarpeted staircase onto a landing and into a small bedroom where there was barely room to move between a single bed and a set of bunk beds. “The tribe usually all sleep in here, but I’ve Mary and Willy in with me while Sammy’s sick,” she said.
Barry knew that Eileen had three children, and that she did a remarkable job rearing her little family on her pay as a shifter at the Belfast linen mills. It was hard physical work, running up and down between the thundering looms replacing empty bobbins with full ones. A lot of millworkers developed hearing loss from the constant assault of the thunder of the machinery on their unprotected ears.
Sammy lay in the single bed. He was a tousled-haired boy, and Barry could see at first glance how his head lay on the pillow, hardly moving, and how the lad’s blue eyes were dull. “How are you, Sammy?”
His voice was soft and slow. “My knees and ankles is achy, Doctor, and I’ve bumps all over me like a seed potato.”
“Is that so?” Barry smiled at the image. “Seedy spuddy knees? Is that what I’ve to call you? Like your other fella, ‘Skinnymalink melodeon legs, big banana feet’?” Barry tossed his head from side to side as he chanted the words of a favourite children’s taunt for someone with long thin legs.
“Away on, Doctor Laverty. Away on and feel your head.” Sammy managed a weak smile. “My legs isn’t that skinny.”
“I’m only pulling your leg,” Barry said, admiring the child’s spunk. He sat on the edge of the bed and took the boy’s pulse, noting also that the skin was cool and dry and that the pulse rate was normal. He turned to Eileen. “How’s Sammy’s chest been, Eileen?”
“Grand for the last two or three days, so it has. I was going to let him go back to school, but . . .” He saw her shrug and the
way her lips pursed.
It didn’t take a genius to know what she was thinking. She had had to stay at home to nurse him. The effect on the family finances would be noticeable. At the first visit O’Reilly had given her a certificate, which Barry had renewed and would again renew today, but the pittance paid by the state was a great deal less than her wages would have been. Barry sighed. It was frustrating; maybe, after he’d got on with the technical doctoring, he could try to think of a way to help out a bit. That’s what O’Reilly would do. “Let’s have a listen. Sit up, Sam,” he said.
The boy sat, with a bit of help from Barry supporting his shoulders. Barry lifted his pyjama jacket. There was no sign of a rash on the boy’s skin. Another clue. The chest was moving easily; the respiratory rate was normal. “Deep breaths.” Barry listened through his stethoscope, moving it from lung base to lung base. No rustling, no cracklings, just the gentle sounds of air moving in and out of the lungs. Good. “Now,” said Barry, “lie down, Sammy, and roll over onto your tummy.”
The boy did as he was told. He smiled at Eileen and nodded his head toward the door. Little lads could get embarrassed when their pants were pulled down, even in front of their own mothers.
Her eyes widened but she withdrew.
Barry eased the pants of the boy’s pyjamas down, and as he expected saw the hives of what his textbook referred to as an “urticarial rash” on the buttocks and backs of the thighs and calves. In a day or two, if his diagnosis was right, the hives would have been replaced by dark, flat purplish areas, the classical “petechial rash.”
It came as no surprise to note that both knees and both ankles were slightly swollen. That, taken in conjunction with the nature of the rash, pretty well nailed things down.
Sammy had a condition that often followed upper respiratory infection in children, Henoch-Schönlein purpura. In most cases it was self-limiting and cleared up without treatment, although it could take several weeks or even months before the signs and symptoms disappeared completely. Barry pulled up the lad’s pyjama bottoms. “You can roll over, Sammy.
“Now, young Sam, you’re going to have to stay in bed for a while.”
“No school?”
Barry shook his head. “Not until after the Christmas holidays.”
“Wheeker. Christmas Day’s seventeen days away, and school doesn’t start until after New Year. I’m going to get a brave long holiday, so I am.” Sammy’s smile was very wide, but it faded. “Does that mean I’m ferocious sick, like?”
Barry saw the concern in the little boy’s eyes. It was strange that during his training it had never occurred to him that children could worry as much as adults. He looked for simple words to explain to the boy what ailed him and realized that he’d have enough difficulty trying to explain it to an adult. Henoch-Schönlein purpura was an autoimmune disease, an ill-understood group of conditions like rheumatoid arthritis, dermatomyositis, and lupus erythematosus in which the body mysteriously began to attack itself.
Barry hoped he could get away with confidently expressed reassurance. “You’ll be fine,” he said. “Do you play soccer?”
“Aye. I do that. I’m a right-winger, so I am.”
“Well,” said Barry, “you’ll be out there scoring goals again in no time. Just like Stanley Matthews.” The Blackpool player was the most famous soccer player of his day. Barry wasn’t much of a sports fan, but he did understand the power of the familiar when someone needed reassurance. Somehow his being able to trot out the player’s name would persuade Sammy that Barry was also an initiate into the soccer fans’ world and hence to be trusted.
“Wheeker,” Sammy said with a grin. “Just like Stan the man.”
“But you’ll have to do exactly what your mammy says for a while.”
The lad’s face fell.
It was going to be a boring few weeks for the child, and that could make things hard on his mother. And God knows, Eileen didn’t need any more grief than she already had. He hesitated but then decided to reinforce the message. “And if you don’t obey your mam, Sammy, maybe Santa won’t come.”
“Huh,” said Sammy, “it won’t make a wheen of difference this year anyhow.”
“Oh?”
“Nah. Mammy says poor oul’ Santa’s a bit short of the do-re-mi this year, so me and my brother and sister’ve to go easy on what we ask him for.”
Barry could understand why Santa might be a bit hard up. With the lad needing to stay in bed longer, Santa’s budget was going to be cut even closer to the bone if Eileen couldn’t go back to work. Barry had been proud of his ability to make a confident medical diagnosis of what ailed the lad, but now he wished O’Reilly was here. He would be bound to have a solution to Eileen’s financial woes.
Barry stood. “You listen to your mammy, Sam, like a good lad, and I’ll be back to see you in a day or so.”
He was rewarded with a big smile.
“And don’t you worry about Santa; I’m sure he’ll come.”
“Too true he will.” Barry was struck by the absolute confidence in the boy’s voice. “Me and Mary and Willy have a way to help him out.”
“Good for you.” Barry moved to the door. “I’ll see you in a day or two, Sammy.”
As Barry went downstairs, he heard the boy call, “Bye-bye, Doctor Laverty.”
“In here, Doctor.”
He heard Eileen’s voice coming from a room across the hall. She would be waiting for him in the front parlour. He went into her best room. It was carpeted. Eileen stood beside the mantelpiece. Two bamboo-framed armchairs faced a small grate. He noticed in one glance that the coal fire was set, but not lit, and one of Eileen’s nylons was laddered.
She must have seen where his gaze had gone. She blushed, looked down, and said, “Wouldn’t you know it, a new pair, right out of the package, so they were, and one of Sonny Houston’s dogs jumped on me in the village yesterday. Poor Sonny felt awful. Was halfway to insisting he buy me a new pair, but, well . . .” Barry could see the pride and resolve lift her chin a little higher. “Anyway, I’m sorry the fire’s not lit, Doctor, on such a cold day as this . . .”
Barry understood why. Stockings and coal cost money.
“I’m saving the fire up for the week before Christmas when the kiddies send their letters to Santa.”
Barry could vividly remember being a child and laboriously writing a letter of wishes to Santa to be burnt in the living room fire so the charred paper, with the words still readable, would be wafted up the flue and directly, at least according to his parents, to Santa’s workshop at the North Pole. Which reminded him, it was about time he dropped his folks a note. “I hear Saint Nick’s a bit hard up this year, Eileen,” he said.
“He is, but look, sir.” She lifted a tea caddy from the mantle and handed it to him. He noticed it bore a picture of the 1947 wedding of Princess Elizabeth to a lesser Greek prince, Philip. “Open it.”
To his surprise Barry found it full of ten-shilling notes.
“See,” she said with a shy pride, holding out her hand so he could return the caddy. “I’ve been putting away ten bob as often as I can from my wages so the kiddies won’t go short on Christmas Day. I’ve nearly fifteen pounds in there.”
“Good for you, Eileen.”
She used the back of her wrist to shove a few strands of hair off her forehead. “It’s not much between the three of them, but I will be able to get them some wee things. Just to unwrap on Christmas Day, like.”
Barry coughed. He felt a tightness in his throat. It was humbling to see how she was exerting herself for her family. Dear God, but he had to admire the woman. Putting some small savings away for little luxuries for her children, but neglecting her own needs. He glanced at the laddered stocking again. Unbidden, his hand went into his pants pocket looking for a pound note. Then he pictured the scene if he tried to give it to her. She’d stand ramrod stiff, scowl at him, and say haughtily, “The Lindsays don’t accept charity.” Damn it, just like the meanness of her State allo
wance, it was something he was powerless to do anything about. Still, he could explain to her what was wrong with her son, perhaps give her some small comfort. He smiled, hoping she would find that reassuring.
“About Sammy . . .”
“Yes, Doctor?”
“He’s got a condition that we often see after coughs and colds. It’s got a German name as long as your arm—”
“Och, sure, don’t you bother your head telling me it, Doctor. I’d only forget.”
“It’s a miracle I remember it myself sometimes. But never mind the name, Sammy’s going to be alright.”
“Thank God for that,” she said. “I’ve enough on my plate without a really sick one to nurse.” There was a tear at the corner of one eye. “He’s a very good wee lad, so he is.”
“He’ll be right as rain,” Barry said, “and there’re usually no lasting problems once the patient gets better.” He saw no reason to worry her that occasionally a child would bleed from the bowel or develop kidney failure. Such complications were extremely rare. “But if he complains of a sore tummy or if you notice any blood in his urine, call me at once.”
“I will, Doctor.”
“And Eileen?” His gaze held hers. “I mean at once.”
“Yes, sir.”
“And I’ll pop in and see him in a day or two.”
“Thank you, Doctor.” She replaced the caddy on the mantelpiece and turned back. Barry realized she wanted to ask him something else. He could sense her worry and wondered if he’d not explained Sammy’s condition well enough.
Finally she asked, “How long is he likely to be in bed?”
She hadn’t wanted to ask. Most mothers in Ballybucklebo were able to stay home with their children. But Eileen would be worried sick about how she was to make her living and remain home with her sick son. It could be a month, even more, before the little fellow was recovered. He took a deep breath. “It can be a few weeks, Eileen.”
Barry heard her sharp intake of breath. “How long’s a few?’ ”