Barry squeezed her arm. “Maggie, Jasper was bound and determined to get out of that car, you couldn’t have stopped him. And we could barely see the noses on our faces that morning. There’s no way you could have found Jasper. We’d have more likely lost you too, and then where would Sonny be?”
“You’re right. I know you are, but I still feel bad. Mind you, I’ve heard of dogs missing for weeks and still turning up.”
“That’s the spirit, Maggie. Now I’d better go and see my patient. Come back soon so I can explain to both of you what’s going on.”
“I will,” she said. “I’ll get you that towel and I’ll get the kettle on too. I’ve a wheen of buttermilk scones. I had a half notion Doctor O’Reilly was trying to avoid my plum cake last time he was here so I’ve made something else.”
Barry sighed at the prospect. In his experience, Maggie’s scones were only marginally less rock-like than her plum cake. He let himself into the lounge, where in the grate a welcoming coal fire burned, giving off a pleasing warmth as if to cock a snook at the sounds of the windowpanes rattling and the wind howling over the chimney pots. A polished brass coal scuttle reflected the light from a small chandelier.
Sonny, wearing a tartan dressing gown, was teed up in front of the hearth on a sofa that was flanked by two armchairs. General Montgomery was curled up asleep at his feet. Sonny’s hair was neatly brushed and he managed a small smile. He was very pale. “Please forgive me for receiving you lying down, Doctor Laverty,” he said. “I’m still so weak.” He gasped.
And short of breath. “Perfectly all right, Sonny. I understand,” Barry said. “Have you noticed anything new since we were here last Friday?” He stood beside Sonny and took his pulse.
Sonny shook his head. “Only that now I understand a bit about what ails me I’ve been able to keep my temper under control. For that I am very grateful.” He motioned to an armchair. “Unless you need to examine me?”
Barry shook his head. “Your pulse is one hundred and I don’t expect much else will have changed.” One hundred wasn’t bad considering what Barry knew from the lab results. He took the armchair beside Sonny’s head. “I have your results and I’ll explain in more detail as soon as Maggie comes in, but they look promising.”
“Thank you, Doctor. That’s one less concern, I hope.” Sonny looked at a framed photo of a group of dogs on a table beside the sofa. He sighed. “I worry about Jasper. Please thank Doctor O’Reilly for leading that search party. I’ve phoned Mister Bishop to thank him too.”
“I’m sorry they didn’t find Jasper,” Barry said, knowing full well there was no point mouthing trite platitudes about “not giving up hope” to Sonny. “Some of my patients have told me in the last couple of days that they’re looking for him round where they live and neighbour is asking neighbour to join in and do the same. I’ve even had a couple of calls from folks in Helen’s Bay and Holywood asking how they could help, so I’ve told them to do the same thing. We’ll soon have half of North Down keeping an eye out.”
Sonny sighed. “We do live in a wonderful place,” he said. “People still care.” He smiled.
“And we care about you, Doctor Laverty,” Maggie said as she came in and handed him a dry towel. “It’s been in the hot press,” she said, “and that’s over the hot water boiler so the towel’s nice and warm, so it is.”
“Thank you, Maggie,” Barry said, accepting the towel and drying his face, neck, and hair.
Maggie laughed. “I thought that would happen,” she said. “Your mop looks like a hay rick after a windy day.”
Barry, conscious of a tuft that always refused to lie down, rubbed his hand over his crown to try to flatten his hair.
“Here,” Maggie said. “Here’s a new comb, and don’t be shy using it in front of other people…”
Barry was. Public personal grooming had been distinctly frowned upon at Campbell College when he was a boy, and old habits died hard.
“All the youngsters do ever since Kookie on Seventy-Seven Sunset Strip on the telly did it.” She sat in the other armchair.
“Thank you,” Barry said, and combed his hair. “Now.” He opened his bag and pulled out several pink sheets of paper. “I’ve got all your tests so I’ll explain what they mean and what we’ll do next.”
“We’d be grateful, Doctor,” Sonny said.
Barry read from the first form. “The lab measured your haemoglobin level. That’s stuff in the red blood cells. Its job is to carry oxygen. Normally it’s fourteen point eight grams per hundred millilitres. Yours is six.”
“Six?” Sonny whistled. “That’s very low.”
Barry had wanted to make that point clearly so he’d used exact numbers, but the rest of the blood indices were difficult to explain in detail so he had determined to avoid using confusing figures and ratios. “It is, and so is your total red cell count. The technical term for red cells is corpuscles. Your body, and it’s mostly the bone marrow that does it, isn’t producing enough red cells.”
“I see.”
“And there’s another thing. Immature red cells are much bigger than healthy mature ones. And each young one carries more haemoglobin than an older one. The pathologists have defined certain ratios about haemaglobin content and size of the immature and mature cells, and yours meet all the criteria for immaturity. It’s like a factory that is short of raw materials and turning out half-finished products. Your bone marrow’s trying to cope in the same way by releasing immature cells too soon.”
Sonny managed a weak smile. “Immature cells? And it’s those cells, or rather the lack of mature ones, that are making me feel as old as Methuselah. I understand.”
Barry chuckled, admiring the man’s resilience. “Do you know, Mister Houston,” Barry said, “when I first met you, you were living in your car and—I hope you’ll forgive me—I thought you were—”
“Astray in the head?” Sonny chuckled. “So did everybody else except your senior colleague, Doctor O’Reilly. He is a very sage man.” Sonny became more serious. “Fact is I’ve never much worried about what other people think of me.”
“I think you are a very self-sufficient person who knows his own mind and has a very dry sense of humour.”
“Oh, he knows his own mind, all right,” said Maggie with a sharp cackle. “You might call it self-sufficiency. There’s some might call it stubbornness. But I love the old eejit anyway.”
“Thank you, Maggie, dear, and thank you, Doctor. If you don’t mind me saying, for a young man you are beginning to show a little of the sagacity of Doctor O’Reilly himself.”
Barry smiled. “Thank you.”
“So your ratios,” Sonny said, “have given you a diagnosis?”
“Not entirely,” Barry said. “The ratios allow us to make intelligent inferences about the nature of the anaemia and possible causes, but the lab people also spread blood on microscope slides and use special dyes, it’s called making a smear, so they can actually examine the individual cells and identify them for exactly what they are.”
“I’d like to see one of those smears,” Sonny said. “The whole thing sounds a bit like my old trade of archaeology. You suspect something by inference then you dig down layer by layer until you find what you’re looking for…” he smiled again, “or as is often the case, you don’t find it.”
“In your situation I think we’re getting close,” Barry said.
“You just let Doctor Laverty get you all better, you ould goat,” Maggie said, and the fondness in her voice was palpable. “Go on, Doctor, dear.”
“The report says that among the red cells are ones called normoblasts and others called megaloblasts. ‘Blast’ means an early cell that’s starting to develop and ‘megalo’ means—”
“Of exaggerated size, like in megalodon, a giant prehistoric shark,” Sonny said. “And that’s a big immature red cell. I understand, and please forgive me for interrupting.”
“And as far as I know there are only two possible causes.” He laughed
. “Well, there is a third, but unless you are a miracle of science, Sonny Houston, I don’t think it applies.”
“Anything’s possible with Sonny,” she said. “What’s the third cause, Doctor, dear?”
“Macrocytic—which is a fancy way of saying overly large-celled—anaemia due to … pregnancy.”
Maggie exploded into her cackly laughter and Sonny smiled. “I am not that self-sufficient, Doctor Laverty.”
“Away on, Doctor. You’re the quare one for a gag, so you are. And you’re too soft a man to be making jokes if you didn’t think you could fix my Sonny, and that’s a great relief, so it is. I’ll leave you and him to collogue away and I’ll go and get a cup of tea for til have in our hands and some of them fresh-baked scones.”
Barry’s pleasure at being described a “soft” man, which he knew meant gentle, wrestled with his horror at the thought of tackling her tea and baking. And it was too late to refuse. He said to Sonny, “My best guess, and it’s not really a guess, is that yours is due to, as I told you before, pernicious anaemia, because a chemical is missing from your stomach’s gastric juices. The chemical is called ‘intrinsic factor.’ We believe the body needs the intrinsic factor to combine with the vitamin B12 before they can both be absorbed. The only other possible cause is that your lower gut is inherently unable to absorb the vitamin, even if the B12 is combined with intrinsic factor.”
“Most interesting,” Sonny asked. “If it is pernicious anaemia, how would I have got it?”
“We don’t know what triggers it, but for some reason your body starts producing antibodies. Do you know what antibodies are?”
“I’ve read a bit about the immune system,” Sonny said. “They’re manufactured to attack foreign proteins like bacteria.”
“Correct, but in this case they attack the cells in your stomach that produce the very necessary intrinsic factor. None of it, no B12 absorption.”
Sonny nodded. “In military terms,” he said, “I’m producing a fifth column, a bunch of traitors attacking their own from within.”
“Very good analogy.”
“So how do we counterattack?”
“We may need a bit more…” Barry decided to stay with the military model, “intelligence.” He hesitated. He knew the textbooks recommended doing a bone marrow biopsy and a gastric juice analysis to see exactly what was happening at the site of production of blood cells. The biopsy was a painful procedure, and while the gastric juice analysis was not painful, it was thoroughly unpleasant. Much as he disliked it, Barry knew he must seek specialist advice. “I’m going to ask Doctor Nelson at the Royal to see you. He specialises in blood disorders. He may need to bring you in for a couple of days for some more tests that I can’t do here.”
Sonny stretched out a skinny hand and grabbed Barry’s arm. “Please, Doctor Laverty,” he said, and there was pleading in his eyes, “not a hospital. They terrify me. Stubborn I may be, but in this case, it comes from fear, plain and simple.” He firmly clutched Barry’s arm. It was the grasp of a terrified man.
“Please, Doctor.” Sonny’s voice was level as he tried to retain his dignity.
“All right,” Barry said, “I have to go to Belfast tomorrow. Doctor Nelson was one of my teachers. I’ll go and see him, take the results we already have, and see what he says.”
“Would you? I’d be eternally grateful.”
“A few more days before we move ahead is neither here nor there,” Barry said. “I am sure that once treatment is started we’ll have your blood better in no time.” Barry nodded as Maggie came in and set a tray on the table.
“You’ll take tea, Doctor. Milk and sugar?” she said. “And please excuse my fingers, but I’ll butter you a scone too.”
“Please,” Barry said, regarding the coming cup with the enthusiasm he was sure Socrates had had for the flask of lethal hemlock. Maggie was a firm believer in strong tea. As if to mark his discomfort, a mighty gust outside rattled the panes and blew a puff of coal smoke into the room.
“Tut,” said Maggie, “see that oul chimney? We always get blow-downs when the wind’s in the northeast.” She gave Barry his cup, with a buttered scone balanced on the saucer. “Get that into you, sir, and there’s more of everything, so there is, if you’d like seconds before you go out again into that lot.”
Barry, with memories still fresh of Maggie’s petrified plum cakes, said to himself, Go on, it won’t kill you, and took a bite from the warm-from-the-oven scone. His eyes widened. No. Couldn’t be. The thing dissolved in his mouth, the delicious melted butter heavier by far then the fluffy confection. He swallowed. “That’s delicious, Maggie,” he said, working hard to keep the surprise from his voice.
“Aye, well,” she said, “I’d like to take credit, but it’s not my recipe. Kinky taught me how to make ones like that. My own have more body.”
Barry could believe that, but said nothing.
Sonny, accepting his tea and scone, said, “Doctor Laverty’s going to consult with a colleague in Belfast and he’s sure between them they can put me right.”
Maggie bent and kissed the top of his head. “And I’ll be dead pleased til have my ould Sonny back. Now if we could just get Jasper too.”
Sonny said, “I agree, but to be fair to our doctors, fixing patients is their job. They’ve already done their very best for us. Thank you, Doctor.”
Barry smiled. He glowed inwardly from the satisfaction of having nearly made a difficult diagnosis without having to involve a specialist until the very end, and for being as comfortable as was O’Reilly in turning his efforts to trying to solve other problems for the villagers. He took a deep swallow from his teacup. Despite a spoonful of sugar it was bitter as gall. Socrates, Barry thought, if given the choice between Maggie’s stewed tea and poison, would probably have chosen the hemlock.
12
The Fool of Love
“Les sanglots longs des violons d’automne blessent mon coeur d’une langueur monotone.” Barry was sitting at his usual table near the door in a little upstairs restaurant on Belfast’s Arthur Street, rereading Sue’s letter. The airmail had arrived two days ago, and Barry had decided that reading it again, here in the Causerie, was a most pleasurable way of killing time until Jack Mills and Helen Hewitt arrived.
The lines on the thin blue airmail paper, bearing the slightest whiff of her favourite perfume, continued, “You may remember reading Chanson d’automne by Paul Verlaine at school…” He did indeed. In his last year at school, back in 1957, every pupil in the upper fifth form in Northern Ireland had to read, among other required French material, a slim tome entitled French Verse: From Villon to Verlaine. French Literature was one part of the national exams that had to be passed to qualify him to attend medical school.
He read on, knowing what was coming next and wriggling in anticipation. “I’m being grounded in French poetry as part of my exchange training,” she’d written, “except in my case while there are no long sobs of violins, and it’s winter not autumn today, my heart is wounded. Truly wounded. I’m missing you so very much, my dear darling. Seeing you during the holidays was wonderful.”
Barry smiled. It was a warm feeling to be missed by someone you loved and to be told so poetically too. She went on with happy chitchat about what she was up to, that she’d bought an antique plat à barbe, an ornate dish like a soup plate but with a notch taken out of the rim so the thing could be fitted round the customer’s neck while the Provençal barber shaved him. Apparently her father collected them. She went on, “You said in your last letter that Fingal will give you a week off in February. Any idea which one yet? If you can let me know I’ll ask for time off, say, Thursday, Friday, and Monday. That would give us five whole wonderful days together and leave you two to travel.” Barry had asked Fingal last night and he’d agreed to let Barry have Wednesday the 8th until Tuesday the 15th, provided Fitzpatrick was fully back in harness and Nonie was available. Five whole days with Sue.
Barry knew what was coming in the n
ext paragraph, but like a small boy saving a favourite Bassett’s Liquorice Allsort to be savoured last, he set the letter down and looked round the familiar room. It was well lit at this hour by two large high windows in the far wall. Of the fourteen tables with crisp white napery, shining cutlery and glasses, eight others were occupied—mostly, he assumed, by the staff of local businesses on nearby Anne Street and the Cornmarket. The hum of conversation was muted, but a man’s voice could be heard for a moment. “—and we’ve been having hell’s delight getting ten-bore cartridges from Ely-Kynoch.” He probably worked at Braddell’s, the gunsmith’s.
Barry returned to the letter.
“I know it’s naughty,” she had written, and his breath caught in his throat, “but I’ve found a delightful pension on the Rue Saint-Saëns no distance from Le Vieux Port…” The first time Barry had read as far as this he’d assumed she’d found the hotel room for him. He’d forgotten what a right-to-the-point young woman Sue Nolan was. “We are practically man and wife, will be within a few weeks, my GP put me on the pill four months ago, and anyway who do we know in Marseille? Let me know the dates and I’ll book us in. The French understand these things.” He swallowed. In just thirteen days he’d be holding her, kissing her—and more. He squeezed his elbows into his sides. Much more.
“Here y’are, Doctor Laverty.” The waitress, a motherly woman who treated her regulars like family, had greeted him like a long-lost friend when he’d arrived. He and Jack had been coming here even before they had qualified. Now she set a pint of Guinness on the tabletop. Barry knew Peggy McCarthy well. He knew she lived up in Turf Lodge with her husband, Aidan, and a Siamese cat named Maeve. Their four kids were grown now and gone south, scattered all over the Republic, but she had eight grandchildren she doted on. “And I brung some wee menus.”
“I’ll come back when your friends arrive, and see you, sir? When it comes til your grub, order something strengthening. You’ve no more meat on you than a wren’s shin.” She went away, shaking her head, to attend to another table.