“Thanks for coming, Doc—and Missus,” he gasped, then grimaced. “Byjizzis, that stings, and I’m foundered, so I am.” He was shivering.
O’Reilly set his bag on the end of the bed. He saw how flushed Willie John’s face was, although his lips were slate blue. His forehead was damp with sweat and he hardly needed a thermometer to tell that Willie John had a high fever. The man hacked, hawked, and spat into a hanky.
“Let me see that,” O’Reilly said. If, as O’Reilly suspected, his patient had pneumonia, it might be due to one of a number of different bacteria. The history of this sudden onset did not suggest tuberculosis. Staphylococcal pneumonia was accompanied by purulent and sometimes blood-stained sputum. The rare Friedländer’s pneumonia was caused by Klebsiella pneumoniae. O’Reilly remembered thinking as a student how ironic it had been that the self-same organism had killed its discoverer, Doctor Carl Friedländer. It produced sputum that was purulent, but with a greenish colour. Willie John’s had a rusty tinge. Almost certainly due to infection with the pneumococcus. Mind you, O’Reilly wasn’t going to be like ancient Chinese doctors who made their diagnoses entirely on an examination of the patient’s stool. One sputum sample wasn’t going to be conclusive. He would do another thorough examination of Willie John’s chest.
“Nurse,” he said as he fished his stethoscope out of his bag, “give me a hand, please.”
While Kitty took off her raincoat, O’Reilly felt Willie John’s pulse. Far too fast, at 120. “I need another listen in,” he said to the panting patient, who nodded weakly.
Kitty pulled back the bedclothes, removed the pillows, and supported Willie John with one arm while lifting his grey flannel nightshirt with her other hand. There was nothing out of the ordinary when O’Reilly inspected the chest, although the respiratory rate was far too fast. Nor did percussion reveal any dullness. He was not surprised. Even if Willie John were suffering from lobar pneumonia, it usually took twenty-four hours before those signs would appear. “Just breathe as normally as you can, please.” He moved the instrument’s bell over Willie John’s back, listening carefully to each inhalation and exhalation. Pretty much the same as this afternoon, but O’Reilly could persuade himself that the sounds of air entering and leaving the lungs were diminished over the left lower lobe. In the same position he could hear faint creakings like the sounds of boots in fresh snow. That was a pleural rub, caused when two layers of pleura, the membrane that envelops the lungs and lines the chest cavity, rubbing together were dry and inflamed.
For completeness, he examined the opposite side of the chest. No additional findings.
He straightened. “Let’s get him comfortable. I’ll give you a hand.” Together he and Kitty did that, and when her head neared his she whispered, “Left lower lobar pneumonia?”
“How do you know?”
“Don’t ever play poker. Your face is a study when you find what you’re looking for.” She grinned at him.
Damn it all, she was right. They’d been apart from almost thirty years before they’d met again two and a bit years ago, and yet she knew him better than anyone. They were a team. Hadn’t she been a great help with Colin Brown a couple of weeks ago? And together they’d delivered Doreen Duggan of a boy last year. Somewhere in the back of Fingal O’Reilly’s mind an idea began to form, but his patient needed attention now.
They lowered Willie John back onto his freshly fluffed pillows.
He managed a weak “Thanks.”
“How is he, Doctor?” Ruth asked.
“I’m afraid, Willie John, you have a touch of pneumonia as well as bronchitis.”
Willie John nodded.
“You’ll need oxygen and nursing, lots of fluids, painkillers and antibiotics. With a bit of luck, we’ll be getting you on the mend in a couple of days.”
“That’d be good, Doc. I feel God-awful right now, so I do. Dead peely-wally.”
“You’re very lucky Ruth was here, Willie John. She caught it early and you’re going to be fine.”
“You hear that, Willie John Andrews?” she said, flashing a wide grin at O’Reilly. “So none of that mouldering on about me fussin’ over you.”
“Och, hold yer tongue, woman.” But the look he gave his sister was gentle and full of gratitude.
“Now, Nurse O’Reilly, will you get one hundred milligrams of pethidine ready and five hundred thousand units of benzyl penicillin ready while I go and phone for the ambulance?”
“I will,” Kitty said, and headed for the medical bag.
“I’ll show you to the phone,” Ruth said.
By the time he’d made the arrangements and got back to the bedroom, Kitty was pulling down Willie John’s nightshirt and expertly rolling him onto his back before pulling up the bedclothes. A distinct smell of methylated spirits now filled the room. Rubber-capped bottles of medications, a bottle of spirits, a couple of used syringes, and some cotton wool balls lay on the dressing table.
Kitty gave him one of her most dazzling smiles. “I’ve not been nursing for more than thirty years for nothing,” she said. “Here’s the form you need to sign telling the hospital what medications the patient has been given. It’s filled out. And here’s a sick line for Willie John’s employers. All you have to do is sign it, Doctor.”
“Bless you,” said O’Reilly, and signed while Kitty put the gear back in the bag. That idea he’d begun to formulate was really taking shape, but it could wait until they got home. “We’ll wait until the ambulance gets here, then we’ll be off, Willie John. You try to sleep.” O’Reilly inclined his head to indicate that he, Kitty, and Ruth should leave the sickroom. Kitty would check the patient’s vital signs in fifteen minutes, but without the equipment in the ambulance that would be here in about half an hour, there was little more a doctor could do.
* * *
“Do you want to go back to the meeting, Fingal?” Kitty asked as she closed the Rover’s door.
O’Reilly shook his head. “I’ve said my piece. The vote’s being taken in camera, but the results will leak out. I’m sure someone will give us a ring and let us know what happened. I’m worried about how much influence Doran could have, but there’s nothing I could say that would sway that man.”
“Let’s go home, pet,” Kitty said. “He may have overplayed his hand.”
“I hope so, but…” O’Reilly inhaled. “Home it is.”
He turned the car, drove the short distance to the lane, and put the Rover in the garage. Together they crossed the back garden, went through the kitchen, warm and redolent of the ginger cake Kinky had baked for dessert that night, and along the hall. The front doorbell rang.
O’Reilly shrugged. “No rest for the wicked. You go on up. I’ll see to it.”
Bertie Bishop stood on the step. “Evening, Doctor. We just finished up there now.”
“Come in, Bertie,” O’Reilly said, guessing that the vote had been taken. And judging by the glum look on the councillor’s face, it might not be what O’Reilly wanted to hear. He closed the door. “We’ll go up to the lounge. Whatever you have to say, I want Kitty to hear, but give me your hat and coat.”
He preceded Bertie up the stairs.
“See who’s here,” he said to a kneeling Kitty, who was poking the fire.
“Bertie.” She stood and gave him a great smile. “Please have a seat.”
“Thanks, but I’ll not be staying. I just wanted til let youse know as quick as possible how things turned out.”
“Go on,” O’Reilly said.
“It’s not black and white. I’m sorry, but they rejected plan B, the bypass. Two thousand pounds is a good bit of dosh. Your man Dornan swayed the vote. He’s a very persuasive talker.”
“I’ve said it before, he’s a turd of the first magnitude. A miserable wizened-up toad of a man.” For a second O’Reilly even forgot about patient confidentiality and blurted, “How his wife puts up with him I’ve no idea. Before my fight with him—” O’Reilly could picture the scene, the jarring of his knuckl
es on the man’s chin, the venom in his voice as Doran yelled, “I’ll get you O’Reilly, you shite.” “—she was never out of my surgery. I couldn’t diagnose any physical cause for her constant headaches, backaches, tummy upset. Nor could the specialists I sent her to. Typical of a thoroughly unhappy wife. Thank God they’ve no children. Neither of them are my patients anymore since he and I fell out. Poor old Fitzpatrick looks after the Dorans now.”
“I’ll not say a word of that to anyone, Doctor.”
“Thank you, Bertie.”
“There’s an election coming and them councillors that’s not from Ballybucklebo don’t want the voters til think they’re not financially responsible.”
O’Reilly glanced at Kitty, who was biting her lower lip. He sighed.
“It’ll probably take too much legal work to run a road over church property, and again we’d have every Presbyterian voter agin us…”
“So they’ll recommend expropriation of my house?” O’Reilly felt a chill in his nose tip, a sure sign that he was becoming angry. “Bloody hell.”
“Not quite. Between you and Mister Robinson and what his lordship stressed again when it was just the council there, you’ve got them dead worried about what your lease might say.”
O’Reilly frowned. He hoped to God either John MacNeill or Mister Robinson could find a copy.
“So,” Bertie said, “they compromised. Kicked for touch. It was his lordship’s idea. I seconded it. We tabled the vote on expropriating your property, but judging by their comments it would have been four for and only three against. Alice Moloney’s on our side. The chairman only votes if it’s tied. The best we could persuade them to do was delay making a recommendation to the ministry for a month to give you time til produce that lease.” He shook his head. “We all voted for that. There’s sympathy for you, sir. It’s always a notion to get to know the enemy in politics so I asked Doran on the QT a bit later why he’d not opposed delaying. He said,” and Bertie’s grimace was fierce, “‘Sure won’t a month give the good doctor a bit longer to stew in his own juice?’ I seen the marquis’s face. He’d overheard.”
“Doran is a gobshite,” O’Reilly said.
“But it gives us a breather,” Kitty said. “We’ll just have to delay making the repairs, but we can manage.”
“By God, you’re right.” O’Reilly reckoned he felt like a condemned man who had just received a stay of execution. He might just get to keep Number One and put Doran in his box too. Old Doctor Phelim Corrigan’s adage back in Dublin in ‘36, “Never let the patients get the upper hand,” had applications under other circumstances and this was one of them.
“If what you said is right, they still may have to recommend plan B,” Bertie said. “And there’s more. I wish you’d been there. Alice Moloney said it was typical of you, Doctor, even though you probably had the most to lose and might have stayed til the end to make one last try. What did you do? A patient needed you and off you went at once. You should’ve heard the ‘hear, hears,’ from all but Doran, when she finished. She didn’t tell the other councillors, but her and me had a wee private chat after. She said she near cried when Kinky spoke. She’s round at my house now. Her and Flo’s starting a ‘save our doctor’s house’ petition, so they are.”
“A petition, is it? Jaysus Murphy. I’m very touched,” O’Reilly said.
“Aye,” said Bertie, “and if it gets enough signatures we’ll have a council who will have the Presbyterians agin them and all your patients too if they try til change this corner. I tell you I’d rather fight a campaign as a defender of two good people rather than as an ould Scrooge who was only interested in saving money.”
“Thank you, councillor. Kitty and I are most grateful for you letting us know at once,” O’Reilly said. “Now, we were just going to have a drink. I know I have you restricted to one pint a day because of your heart, but we could stretch the rules this once. Please join us?”
“Och, no thanks, Doctor. I’d best be getting home.”
“I’ll see you out then,” O’Reilly said, “and thanks again.”
* * *
“Here’s your whiskey,” Kitty said, lifting his glass from the sideboard.
“Thanks.” They took armchairs on either side of the fire while Lady Macbeth snoozed on the hearth rug. “Well,” he said, “it’s not exactly the outcome we wanted, but I think we’re in with a chance. I’ll get onto John and Mister Robinson in the morning. Leave them both in peace tonight. Even if they could produce the lease now we couldn’t do anything with it at nine thirty.”
Kitty took a sip from her brandy and stared into the fire. “I must say I’m touched by Alice getting up that petition. Looks like we might have a second string to our bow if the lease doesn’t help. Astute of Bertie recognising how the council’s stance on this might affect their chances of reelection.”
O’Reilly laughed. “In Bertie Bishop’s own words he ‘didn’t come down the Lagan on a soap bubble yesterday.’ He is one very shrewd politician of the street-fighter school. I’m very glad he’s on our side.”
“You know him better than I do, but I have to agree.”
“Actually,” O’Reilly said, “while it’s great to be getting help, there’s also the old notion that the Lord helps those that help themselves. I had a thought for our own plan B if we do lose Number One. And I’d hate that.”
“Me too, and we know it would break Kinky’s heart, but let’s hear.”
“It occurred to me when we were working together tonight.”
“I really enjoyed watching you, Fingal. I have done ever since I saw you care for that poor man Kevin Doherty when he was dying of rheumatic heart failure at Sir Patrick Dun’s in Dublin back in 1935.”
“And I appreciated your help then, and do you know it gave me a notion.” He looked into her eyes, and drank some whiskey. “I know how much you enjoyed the day out searching for Jasper, shopping together, having lunch in the Culloden a couple of weeks ago, dinner with the marquis.”
She frowned as if unsure where this was leading. “Of course, Fingal.” she said. “I always enjoy my time with you.”
“And begod, I enjoy my time with my bride of not so very long ago, and I’d like to enjoy more of it. The pair of us will be sixty soon. ‘Time’s wingèd chariot,’ and all that. Since Barry and now Ronald Fitzpatrick are working with me and the prospects are good for Nonie getting back to work in a couple of months, I’m going to have more time off than I’ve ever had before and I want to make the most of it,” with you, he thought, but wanted her to draw that conclusion herself. People were always more likely to embrace a new idea if they thought it was their notion.
“You’ve earned it,” she said, and sipped her brandy.
“The younger doctors today aren’t willing to work singlehanded anymore. They’re getting together in things called group practices and they have other professionals attached.”
“Midwives, physios, occupational therapists, health visitors,” she said. “Some even have professional administrators to fill in the forms. You’d like that.”
“I would indeed, and thanks for doing that at Willie John’s.”
“Doing a bit of nursing tonight was fun.”
“It always was with you, Kitty. Remember the day I met you at Sir Patrick Dun’s?” He remembered a pair of amazing amber-flecked grey eyes smiling at him.
She laughed. “The day I’d been told to wash the old men’s false teeth and I’d collected them all up in one basin. You helped me restore each set to its rightful owner.”
“Och,” said O’Reilly, “we all did foolish things, but you did turn out a first-class nurse, Sister O’Reilly, and a trained midwife to boot.” Now, he thought, give your little speech. “Kitty,” he said, “bear with me. I have a lot more free time, but you seem to be working harder than ever and coming home frazzled too many days.”
“Are you suggesting I should go part time? Quit? I’ll not quit.”
“I’d not expect you to. What
would you do all day? We’ve no kids or grandkids and you’re not cut out to sit at home being the country doctor’s wife, helping out with afternoon teas and charities. I know nursing’s an important part of your life, part of who Kitty O’Reilly is, but what would you think of changing jobs?”
She frowned. “Go on.”
“What if I was able to get a group practice started in the village? We already have three doctors taking call, and probably a fourth coming back. Nonie deserves her chance. Ballybucklebo has a health visitor who visits patients in their homes to promote healthy living, good nutrition, particularly among the children. And there’s Miss Hegarty, the midwife, and Colleen Brennan, the district nurse. I know you’re a highly trained neurosurgical nursing sister, but we’d need a nurse or two in the facility, perhaps a second health visitor, and you have the necessary nursing and midwifery experience to do that job.” He remembered the night she’d celebrated the arrival of the weekend: “No more committee meetings, no more commuting, no more Belfast rush hours…”
“And don’t forget the professional administrators to do all the paperwork.” She winked at him over the top of her glass.
He laughed. “We’d have to get a budget from the Ministry of Health to build it, take the money Lars says we’d get from the government if Number One is expropriated, build a new house. I could almost argue a case for not living over my work anymore, you having more time off.”
She rose and kissed him. “You are a sweet old bear worrying about me.” She kissed him more strongly and he felt the tip of her tongue. “I’m no angel, but neither am I a fool to rush in to where the heavenly host fear to tread. So I’ll not give you an answer tonight. Let me think on it.”
“All right,” he said, seeing this very much as a step in the right direction.
“And I’ll tell you one thing, if we do open such a practice…”
He read her mind. “Of course you can choose the curtains, but,” he pulled her onto his lap, “there will be roses in the waiting room.”
And Fingal O’Reilly had to wait for a long time until she’d stopped laughing and he could kiss his wife.