An Irish Country Love Story (7 page)

“Great,” Barry said as he slowed down to stop beside the gate at the end of the path. “Now let's go and see the patient.”

*   *   *

From up in the Ballybucklebo Hills, the distant waters of Belfast Lough should have been visible, but the swirling snow blotted out everything. O'Reilly remembered walking along this path two summers ago when Barry had kicked a cloud of downy seeds like miniature parachutes from a goat's-beard weed growing between two paving stones. It was impossible even to make out the path now.

When they reached the doorstep, a loud chorus of barking came from Sonny's dogs. The flap of the letterbox halfway up the front door opened. O'Reilly bent and looked into a pair of eyes peering out.

“Who's there?”

“It's me and the doctors, dear,” Maggie called. “We're getting foundered out here. Open up and let us in, like a good man.”

“I thought you were going shopping. Meddling old woman. Go away. Go away.”

“Sonny, for goodness' sakes—” Maggie fumbled with her house key.

“No. Go-a-way. I told you, I neither need nor want a doctor.”

She managed to get the door unlocked, but when she tried to push it open, it was stopped by a door chain.

O'Reilly took a deep breath. “Sonny Houston,” he roared. “It's Doctor O'Reilly. I'm worried about you. Open up. Now.”

Nothing but the barking of dogs.

“Sonny, put the silly beasts in the kitchen and open the door.”

“Don't want to, Maggie.”

“Sonny, for the love of God, it's freezing out here.”

“All right. Wait a wee minute.”

O'Reilly saw the door being shut. The sounds of barking receded. An inside door slammed. Barry looked at O'Reilly, who shrugged and tried the front door. It swung open.

“Come on on in,” Maggie said. “He'll be putting the dogs away.” She led, followed by Barry.

O'Reilly brought up the rear and shut the door. Kicking off his Wellingtons and taking off his overcoat, he quickly took in the black-and-white photos of Petra on the hall wall. Sonny had been there on an archaeological dig in the 1930s. His oar, with the names of his Cambridge college's rowing eight in gold on the blade, hung nearby.

At the far end of the hall the kitchen door stood resolutely shut.

“I'll kill the ould goat,” Maggie said, then raised her voice. “Sonny, would you come away to hell out of there? Nobody's going to hurt you.”

“Don't want to. Shan't.” He sounded like a petulant child. “Leave me alone. And this door's locked now.”

This was more than stubbornness. Sonny Houston was behaving irrationally. But why?

“You two, into the lounge,” O'Reilly said. “Leave this to me.”

Maggie opened a door ahead and to Barry's right.

He followed her.

“Bring the ould eejit into the parlour when you've got him til stop acting the maggot, Doctor,” she called.

“Now, Sonny,” O'Reilly said, keeping his voice low, steady, “it's Doctor O'Reilly and I want you to open this door.”

“Och, no. Go away.” But Sonny's voice had lost much of its earlier hectoring tone.

“Sonny, I'm big enough to break down this door, you know that, but I don't want to.”

No other sound but barking dogs.

O'Reilly took a deep breath. “Sonny, I really do want you to come out.” O'Reilly let an edge creep into his voice. “Either that or I'll arrange a consultation with a psychiatrist friend of mine in Belfast at Purdysburn as soon as the ambulance can get here to take you there.” O'Reilly knew full well the terrible stigma such a consultation would bring. Clearly, Sonny was not so deranged as to be unable to make a rational choice.

The door crept open. Sonny slipped through, keeping the barking, yelping dogs in the kitchen, then closed the door and turned to face O'Reilly.

The man's usually well-brushed iron-grey hair was untidy and there was an egg stain on his woollen cardigan. He wore neither collar nor tie. His face, which usually had a slatey-blue tinge because of his heart failure, was alabaster pale and twisted into a scowl.

“Come on,” O'Reilly said. “Maggie and Doctor Laverty are waiting for us in the lounge.”

“Oh, all right.” Sonny shuffled along beside O'Reilly.

When they arrived Maggie tutted and managed a smile. “There you are, you silly ould fool. You've had me worried sick. My heart's been in my mouth, so it has.” She shoved a huge one-eared, one-eyed ginger cat off an armchair. “And you, General Sir Bernard Law Montgomery, get away to hell out of that and let your betters sit down.”

The scowl vanished and Sonny hung his head. “I'm sorry, dear, but I don't know what all the fuss is about.” He inhaled. “It's just a touch of the collywobbles and I do not wish to be poked and prodded—” He stopped and gasped.

O'Reilly said, “I've brought young Doctor Laverty with me. He's going to look after your case.” He nodded a go-ahead at Barry.

“Hello, Sonny,” Barry said. “Not feeling so hot? Doctor O'Reilly tells me that among other things you get short of breath.”

Sonny nodded. “I'd like,” he said and pulled in a shallow breath, “I'd like to sit down.”

Barry stepped forward, took him by the elbow, and helped the man into the armchair recently vacated by General Sir Bernard Law Montgomery.

“Thank you,” he said, plucking a tuft of cat hair from the chair and turning a slightly accusing eye on Maggie.

“I'm sure youse doctors would like peace and quiet til look him over, so you will. Now, you do as you're bid, Sonny Houston. I'll go and get my hat and coat off, and I'll put on the kettle and cut a few slices of my plum cake.”

O'Reilly's heart sank at the prospect of having to face Maggie's overstewed tea. He had once described it as being fit only for stripping paint off a destroyer, and her cake as tough enough to patch a shell hole in the same ship.

“Now, Sonny,” O'Reilly and Barry said in unison.

“I have agreed to be examined, Doctors, and you have told me that Doctor Laverty has that privilege. Very well, Doctor. I'll submit to your ministrations.”

“Fair enough,” said O'Reilly, sitting in another armchair. “I'm just going to sit here, both legs the same length.” He hoped Barry'd not be blinded by Sonny's mild heart failure. While it certainly caused shortness of breath, so did other things.

Barry draped his overcoat on a chair, set his bag on the floor, and took out his stethoscope. “This won't take long, Sonny,” Barry said, picking up the man's wrist. O'Reilly watched his partner's head nodding as he counted the heartbeats. “Your pulse is nice and regular and running at ninety beats per minute.”

All right. A bit fast, and compatible with heart failure—or a host of other things.

“Look up,” Barry asked, and pulled down Sonny's lower eyelid.

O'Reilly could see that it was pale pink when it should have been scarlet because of the blood cells in the capillaries that lay just beneath the conjunctiva, the transparent membrane lining the eyelid and covering the eyeball. That was a sure sign of anaemia, the marker of a family of blood diseases often overlooked by the sufferer until it became severe. Then other people began to notice how weak, breathless, short-tempered, and forgetful their loved one had become. O'Reilly thought back to his own father's blood disorder in 1936.

“Stick out your tongue, please.”

It looked smooth and red raw. Oh-ho. This was beginning to add up. There were few causes of that sign.

O'Reilly waited as Barry quickly completed his examination, stuffed his stethoscope into his jacket pocket, and began explaining his findings to his patient. “I think I've a pretty good idea of what your trouble is, Sonny, and it's not your ticker. Your lung bases were clear, your heart rate's not irregular, blood pressure's fine. Some of the things I've found might be due to it, like being short of breath, being tired, fast pulse, tiny bit of ankle swelling, but I'm pretty sure your heart failure is under control.”

“That's good,” Sonny said. “I am relieved, I'll admit it.” He drew in a deep breath.

“Numbness in your feet and fingers, and headaches don't go with that condition, though.”

“I see.” Sonny nodded.

“Doctor O'Reilly, did you notice how smooth Sonny's tongue is?”

“I did,” said O'Reilly, “and his conjunctivae're pale too.”

Barry nodded. “And I can feel your spleen, Sonny. That's an organ under your ribs on the left that normally gets rid of old, tired red blood cells.”

Sonny forced a smile. “I feel like an old tired blood cell myself these days,” he said.

“And,” Barry said, “you've lost your knee and ankle jerks, and you didn't feel the vibration when I put a tuning fork on your insteps and ankles.”

The door opened. “Can I come in yet?” Maggie was carrying a tray. “Tea and plum cake,” she said. “For when you've finished, Doctors.”

“Come ahead,” O'Reilly said. “Doctor Laverty's going to tell us what he thinks is wrong and what we need to do next.”

“Your ticker's under control, but I'm almost certain you have thin blood. The trick is going to be to find the exact cause. There's quite a few to choose from, although even now I can make a pretty good guess at which one it is.”

“Can you fix it, Doctor, dear?” Maggie asked.

“We'll have to get some blood tests to be certain of what we need to treat.”

O'Reilly hoped that a painful bone marrow biopsy and an uncomfortable gastric fractional test meal could be avoided.

Barry continued, “But yes. I think so. Now my dad likes to say, ‘Never make a promise if you're not sure you can keep it.' I'm not promising you I'm right.”

Good lad, O'Reilly thought.

“We understand,” Maggie said. “We'll leave being infallible to your man with the pointy hat in the Vatican.”

Barry smiled. “Thank you.”

“Excuse me,” O'Reilly asked, “and I'm not interfering, just asking, wouldn't it be simpler to ask Doctor Gerry Nelson, the haematologist at the Royal, to see Sonny?”

Sonny coughed. “Now look here. I'm sorry, sir, but I'm only seeing you two medical men under protest. I hate hospitals. I insist the young doctor look after me here.” Then Sonny's stiff posture and superior tone gave way and he looked at Barry. “Please, Doctor Laverty.” His supplicant manner would have softened Pharaoh's hard heart.

Barry stopped writing out the lab requisition forms and smiled. “I can spare you a consultation with another doctor for now, Sonny, but I can't do the blood tests here. And you shouldn't be driving in your state. You could pass out behind the wheel. I'll arrange for an ambulance to take you down to Bangor hospital tomorrow, have the blood work done. We'll have the results next week and I'll pop out to give them to you.” He handed the forms to Maggie.

O'Reilly nodded his approval.

“I'm pretty sure with the right treatment we can get rid of your tiredness and shortness of breath. I'm sorry, but I don't think I can fix your feet and fingers. Once a nerve is damaged I'm sorry, but that's it. It's gone for good. But I reckon we can stop it getting any worse. I'm working,” he said, “with a diagnosis of pernicious anaemia, failure of production of red blood cells because of the body's inability to absorb vitamin B12 through the gut.”

“Pernicious?” said Maggie. “I don't like the sound of that.”

“It was called pernicious in 1800-and-something when it was first described,” Barry said. “Now, don't be scared when I tell you that back then doctors could make the diagnosis but had no idea how to treat it. The patients died, I'm afraid.”

“Boys-a-dear.” Maggie jammed a fist against her lips and stared at Sonny.

Barry hurried to add, “But in 1920, doctors found a cure.” He decided against telling Maggie and Sonny that before vitamin B12 had been identified and synthesised in the 1950s, the cure had been to eat raw liver every day.

“Hallelloolyah, that's a relief,” she said, clearly reassured.

O'Reilly chuckled at the Ulster pronunciation with the extra “lool” syllable.

“Thank you, Doctor,” Sonny said. “I am reassured by your findings, and—” He hesitated. “I'm sorry, Maggie, for yelling at you, and you doctors for my being bloody-minded. I don't know what came over me.”

O'Reilly was relieved they did not have to consider dementia any longer. “No need. Being grumpy's caused by the disease too.”

Maggie, who must have popped in her false teeth when she was in the kitchen, grinned so widely her hooked nose almost met her chin. “There, you ould goat,” she said. “You're forgiven for barging at me, going up one side and down the other this morning, and you and your ‘I don't want no doctors.' Buck eejit.” But she bent and kissed him—and the room was filled with forgiveness and love.

She pointed to the tray. “Now, sirs, tea and cake.”

“That would be really lovely, Maggie,” O'Reilly said, “but the snow is still falling thick and fast out there and we must get back to Number One.”

Barry picked up his coat and bag. “The ambulance will be here for you tomorrow and I'll call round to give you the results next week.” He followed O'Reilly, who was making for the door. “We'll see ourselves out,” O'Reilly said as he hauled on his boots. He was proud of Barry for having worked out a difficult clinical problem, and nearly as proud of himself for gracefully avoiding Maggie's tea and cake.

On the way to the car through the continuing blizzard, O'Reilly said, “It's downhill on the way home. I'll drive.” He got in. “Well done, Barry,” he said, manoeuvering the big car away from the kerb. “I was getting worried. It was looking like Sonny might have a blood disorder. I have very personal reasons for fearing them. My father died of leukaemia in 1936. But pernicious anaemia is much less serious.”