An Irish Country Doctor (28 page)

"I told him not to be silly ... I wish I hadn't." Barry could see the lines in the textbook, word for word, the ones he'd memorized before his finals: "and headache may be so abrupt in onset as to make the patient think he has been struck." Christ. "Go on." O'Reilly produced a penlight and bent to examine the major's eyes. Barry knew, he just knew, that one pupil would be widely dilated and would not respond by constricting when O'Reilly directed the thin beam under the eyelid. Barry held his breath. "Then he boked. Grabbed his head and . . ." Her sobs came in gusts.

"Right pupil's fixed," said O'Reilly.

Barry exhaled. He didn't need O'Reilly to demonstrate that there were no muscle reflexes in the patient's left arm or leg, or that when a key was scraped along the sole of his left foot the great toe would curl upwards--the so-called Babinski sign--not down as was normal. Major Fotheringham had suffered an intracranial haemorrhage. And his stiff neck last night had been the earliest sign. O'Reilly stood, moved to the end of the bed, took Mrs. Fotheringham by one arm, and led her to a velvet-covered, button-back armchair. "Sit down."

She sat and looked up silently at O'Reilly.

"I'm afraid your husband's had a kind of stroke."

She crossed her arms in front of her stomach and rocked back and forth, all the while making little keening noises. And if I'd not been in a rush, hadn't been so busy congratulating myself for catching O'Reilly out about Cissie Sloan's thyroid disease . . . Barry's thoughts were interrupted when O'Reilly said, "I'm sorry Doctor Laverty didn't make the diagnosis last night." Barry stiffened. He couldn't believe that O'Reilly was trying to -- an old naval expression that his dad was fond of came to mind -- keep his own yardarm clear.

"But I doubt if anyone could have." O'Reilly stared at Barry and nodded once, almost imperceptibly.

"I know. He was very nice." She forced a tiny smile. Barry half accepted O'Reilly's unspoken reassurance, but inwardly he shrank. "Nice" wasn't good enough. What O'Reilly had said, and Barry blessed the older man for his support, would have been true if last night's examination had been thorough, if he had tested the reflexes and found them to be normal. But that hadn't happened. "Right," said O'Reilly. "We'll have to get him to the Royal." 

"Is he going to die?" Mrs. Fotheringham asked. O'Reilly nodded his shaggy head. "I'll not lie to you. He could." Barry was only too aware of the statistics. At least half the number of patients like Fotheringham would not recover. Mrs. Fotheringham yelped and stuffed a fist into her mouth. "He could live but be paralysed."

"Oh, my God."

"But until the specialists have done a test called a lumbar puncture, maybe take special X-rays, we'll not know what's caused it." Maybe it's just a bleeding aneurysm, Barry thought, and heard O'Reilly echo the idea.

"If it's just a leak from a thin-walled blood vessel, they can usually operate. Some patients make a complete recovery." 

"Really?" Barry saw hope in her eyes.

"Yes. But I won't make any promises."

Her eyes dulled again. She took a deep breath, stood, and exhaled. "Thank you, Doctor O'Reilly, for telling me the truth." O'Reilly grunted. "Doctor Laverty, could you phone for the ambulance?"

"Right." Barry rummaged in an inside pocket for a notebook where he kept important telephone numbers. When he opened the book at random, he found himself staring at Patricia's number. As if he needed to be reminded why he had slipped up so badly last night. "I'll go and see to it," he said.

The Compleat Angler

"I wonder where Lady Macbeth is?" O'Reilly remarked, walking directly to the sideboard in the upstairs lounge. Barry neither knew nor cared.

"Get that into you," said O'Reilly, handing Barry a cut-glass tumbler of Irish whiskey.

"I'd rather have a sherry." Or perhaps some hemlock, Barry thought. It had been more than an hour since Major Fotheringham's intracranial bleeding had been diagnosed and he and his wife dispatched to the Royal. O'Reilly had driven back home. They had exchanged few words.

"That's a medicinal whiskey. Sit down, drink up, and shut up." Barry sat. The Irish was peat-flavoured, sharp on his tongue. O'Reilly fired up his briar, took a pull from his own glass, lowered himself into the other armchair, looked Barry straight in the eye, and said, "I'm disappointed."

Barry flinched. He wasn't surprised that O'Reilly felt he'd been let down, but did he have to be so blunt about it? Of course he did. That was the mark of the man. And the damnable thing was that he was right to be upset. "There's no point making excuses. So I won't."

"Excuses? What for?"

"Come on, Fingal. I told you I was in a hurry last night. I didn't do a complete neurological examination."

"And if you had, what do you think it would have shown?" 

"Enough so that I could have got him to a hospital before the bleeding into his head got any worse."

"Maybe, but what did his wife say?"

"What do you mean?"

"Everything blew up this morning. Hours after you were there." 

"But-"

"If he'd had a decent bleed last night, don't you think it would have been as plain as the nose on your face? A second-year student could have seen what was wrong. But he hadn't bled and it wasn't plain."

"I was wrong last night."

"And that's why I'm disappointed."

"Because I didn't do my job right?"

O'Reilly stood and loomed over Barry. "No, you buck eejit. You knew your patient's history of malingering. You went to see him, and you didn't have to. You put him before yourself, and there was no need to. I know how much you wanted to see that wee girl. You could have been late for your big date."

"I was."

"You didn't have to be. I told you Kinky could have handled things. Fotheringham would have been no worse off if you hadn't been conscientious enough to go last night and we'd not gone out there 'til this morning."

"It's still no excuse."

"Christ, man. Who do you think you are? Sir William Osier? Hippocrates? Jesus Christ All-fornicating-Mighty?" 

"No. But doctors have certain responsibilities." 

"You're a sanctimonious young--"

"I don't have to take this." Barry started to rise, but the pressure from the hand that O'Reilly had clamped onto Barry's shoulder forced him back into his seat.

"By God, you do. Listen, what makes you think you're the only physician to make mistakes? Do you think missing Cissie Sloan's buggered-up thyroid and the Galvin baby's hypospadias are the only bollocks I've ever made?"

"Well, I-"

"Of course not. And not living up to your own personal standards last night may seem like the end of the world to you. It's not. You'll make mistakes. Even when you've done absolutely everything right, you'll still ask yourself questions when somebody falls off the perch in spite of you. But none of us is the Pope in Rome speaking
ex cathedra
."

"What?"

"
Ex cathedra
. That's when your man's being infallible. You're beating the holy bejasus out of yourself because you think you should be infallible. That's why I'm disappointed. You should know better than that." O'Reilly released Barry's shoulder and stepped back. "Let up, boy. Go easy on yourself." Barry looked up at the big man. The hint of a smile was at the corner of his lips as he said, "How long have you been here?"

"Two weeks."

"That's long enough for me. I've told you, Laverty, you've the makings of a damn good GP. But you'll never last if you insist on taking everything to heart."

"I still think I could've done a better job." 

"Yes," said O'Reilly levelly, "you could, but you recognize it and that's to your credit. What happened can't be helped. Learn from it, and put it behind you."

Barry could not honestly say that he felt as if a weight had been lifted from his shoulders, but somehow the pressure seemed to be less.

A huge grin erupted on O'Reilly's face, and Barry had to smile back.

"Good man, Barry." O'Reilly finished his whiskey. "Do you know what I do when this bloody place gets to be like the seventh circle of Dante's Inferno?" He crossed to the sideboard and refilled his glass. Barry resisted the temptation to say, "get pissed." 

"I don't know."

"I take old Arthur down to Strangford Lough." 

"To go wildfowling?"

"That's the excuse, but the ducks don't really matter. Nothing like a day in the open air, away from whatever the hell you do for a living to give you a chance to get your mind straightened out." 

"I used to go fishing."

O'Reilly looked at his watch. "It's only two o'clock. Why don't you grab your rod and head down to His Lordship's? There'll probably be a good trout rise this evening. And there's still the odd salmon in the Bucklebo River."

"I'd like that, Fingal."

"So finish your whiskey. Kinky'll make you some sandwiches. Off you go. Forget about Fotheringham. Forget about your broken heart. Girls are like buses. There's always another one along soon." 

"Do you believe that?"

"No," said O'Reilly, "but there's no reason you shouldn't." 

"I see."

"I'll look after the shop, and Barry, would you do me a favour?" 

"Of course."

"Take Arthur Guinness with you. He loves a day down at the river."

Barry, rod in hand, wicker creel half-full of Kinky's ham sandwiches slung over his shoulder, and hip waders buckled to his belt, let himself out through the back door. At least if the dog had a go at Barry's leg, this time he was well dressed for the occasion. "Here, Arthur."

The big dog, tail going at thirteen to the dozen, lolloped from his doghouse, poised ready to mount Barry's leg, hesitated, sniffed the rubber boots, and turned away with a look of disdain. "Heel."

Arthur looked at Barry, seemed to be having some difficulty making up his mind, and sat.

"Don't sit. Heel. Heel, you great lummox." That's what O'Reilly called his dog. To Barry's surprise the big Labrador rose and stood behind Barry's left leg. He kept his muzzle there as Barry walked the length of the garden and into the lane. Barry opened Brunhilde's back door. "Get in."

"Aarff," said Arthur, obeying immediately. Barry shut the door, climbed in, and drove off. He followed O'Reilly's instructions. Out of Ballybucklebo and along the shore road. He was just about to pass Maggie's cottage when he saw her, sitting in a canvas-and wood deck chair surrounded by Sonny's dogs. He braked and wound down the window.

"How are you today, Miss MacCorkle?" He noticed she had fresh snap-dragons in her hatband.

"Is it yourself, Doctor dear?"

"Doctor O'Reilly saw Sonny last night. He's on the mend." Maggie said, "I should hope so. Then he can come and take these flea-ridden beasts away." But her words were out of place with the way she fondled a dog's head and grinned toothlessly. "How does General Montgomery like having the dogs about the place?"

She cackled. "You'd not believe it. The ould General's made up with Sonny's spaniel. They're best friends just like David and Jonathan now, so they are." She rose and strolled over to the car. "Is that Arthur you have in there?"

"It is."

"Keep him in. The General's got used to having Sonny's ones here, but I don't think he'd take too kindly to Doctor O'Reilly's big lad."

"I'll be running on anyway. Just wanted to let you know about Sonny."

"Huh." She scratched her cheek. "He's on the mend?" 

"Very much so."

"I suppose we should be grateful."

"I am." At least, Barry thought, some of them do recover. "I wonder did the pneumonia cure his stubborn streak?" 

"Now that I couldn't tell, Miss MacCorkle."

"If it did, it would be like the day Himself turned the water into wine. An honest-to-God miracle."

Barry laughed. "We'll have to wait and see."

"Is that a rod in the motorcar?"

"It is."

"Well, if you're going fishing, go on with you, and thanks for dropping by."

"My pleasure." Barry put the Volkswagen into gear and pulled away.

He drove past a red-brick gatehouse that stood guard over two high wrought-iron gates, each bearing the crest of the marquis of Ballybucklebo. A long drive led to the Big House with its Georgian facade and ornate planters ablaze with nasturtiums and pansies. At the head of an immaculately manicured lawn, the topiarist's work on five evergreens was clearly visible, although Barry had some difficulty determining whether one was meant to be a horse, a rabbit, or a ruptured duck.

O'Reilly had said that the first fork to the right led to the river-- a rutted lane that disappeared beneath huge elms. The car jolted along. Arthur gave voice to a series of excited yips. Tree branches scraped the windows until, leaving the small wood behind, Barry found himself in a broad meadow. The path crossed the field and led to what must be the banks of the Bucklebo, where willows, some drooping silvered foliage, others polled and knobby-headed, wandered in a meandering line, presumably, Barry thought, following the curves of the stream.

The lane petered out. Barry parked and lifted his gear from the car. Arthur leapt out and began to quarter the ground ahead of Barry, running to the left, then to the right, nose to the ground, tail thrashing. Barry followed the dog through knee-high grass until he could see up ahead the waters of the Bucklebo. He lengthened his stride, clumsy in the waders.