28
A Place for Everything
“Keep Mairead in bed and don’t let her eat or drink anything,” Barry said into the phone. “What? Gerry, don’t be daft. Of course I don’t mind coming out on a Saturday morning. I’m on call. I’ll be right over.” Barry put the phone down and headed up the stairs to where O’Reilly, Kitty, and Kinky were deep in conversation. He was impatient to be on his way to the Shanks’s, but knew important decisions were being made.
“I do be sure you are right, sir,” Kinky was saying, “only close friends and family in church, and you’ll both need to speak to Mister Robinson the Presbyterian minister about the ceremony, so. He may want to change the service.”
Kitty said, “I can’t see him going on about ‘the procreation of children— ’”
O’Reilly roared with laughter then said, “‘Then Abraham laughed and fell on his face and said in his heart, Shall a child be born unto him that is a hundred years old?’ Genesis 17:17. Come on, Kitty. I’m not quite a hundred yet.”
Kinky smiled and said, “No sir, but you are no spring chicken either, so.”
That teasing of her boss was more like the old Kinky, Barry thought. He looked at Kitty and wondered how she really felt. Would she have liked to have been the mother of their children? He’d never know and it was too late for that now.
“And I’d like the ‘obey’ bit taken out, Fingal,” Kitty said. “It is 1965.”
“Consider it done.” He reached over and touched her arm.
Kinky said, “That’s the decision about the service taken care of, but you still have to decide what you want to do for a reception.”
O’Reilly pursed his lips and said, “The whole village won’t mind not being invited to the church, but the do after’s a different matter. I’d prefer to keep it small, but—”
“Me too,” said Kitty. “The folks who’ve been to the ceremony, maybe a few others.”
“But then we have to think of the rest of the village,” O’Reilly said. “What happens if we invite Bertie and Flo Bishop, and Cissie Sloan because she’ll be playing the harmonium in church, but not Aggie Arbuthnot? We could put a lot of noses out of joint among the folks who think they should have been asked, but haven’t.” He looked up and noticed Barry standing in the doorway. “What do you think, Barry, about who we should ask to the reception?”
“You know the village a lot better than I, Fingal. All I can tell you is that I had a damn sight more fun at Seamus and Maureen Galvin’s going-away party in your back garden where the whole village was invited than I had at Bertie Bishop’s Boxing Day do, where the guest list was more select.” He had every reason to want completely to forget Bertie Bishop’s Boxing Day party.
“True.” O’Reilly scratched his chin, eyed Barry, and then turned to the women again. “Kinky? Kitty?”
“Excuse me,” Barry said. “That was Gerry Shanks on the phone. Mairead’s period’s two weeks late, and she fainted. I’m off to see her. Just wanted to let you know. Probably only a touch of what my old prof described as ‘Oh, pregnant women get that a lot,’ when he couldn’t make head nor tail of the not-very-specific symptoms of early pregnancy.” Barry didn’t like the sound of the faint, but there could be a simple explanation.
“Off you go. We’ll take care of things while you’re out.” O’Reilly turned back to Kinky. As he left, Barry heard, “Come on, Kinky, you’ve been here longer than any of us. Small crowd or free-for-all?” Fingal O’Reilly was certainly working hard at reminding Kinky Kincaid how important she was to him and Number One Main.
* * *
“Doctor Laverty,” said Gerry Shanks as he opened the door. He bent to two children who were peeping round his legs. “Angus. Siobhan. Run away on over to your auntie Gertie’s. Tell her Mammy’s poorly and needs you minded for a wee while. Go on. Daddy and Mammy has to see Doctor Laverty, so we have.”
Barry stood inside the hall and remembered that O’Reilly had delivered a breech-birth baby for Gertie Gorman last year.
“Here, Angus. Here’s sixpence,” said the boy’s father. “Buy you and your wee sister some dolly mixtures or midget gems.” He shooed his two children out.
Two shrill voices chorused, “Thank you for the sweeties, Daddy,” and the children ran off.
Gerry shut the door. “Good of you to come, sir.”
“Not at all, Gerry. Where’s Mairead?”
“In bed. Come on, I’ll show yiz, sir.”
Barry followed along a hall decorated with black-and-white photographs of rows of men in sports gear all looking purposefully at the camera. In each photo, the central seated figure, presumably the captain, held a soccer ball with the year’s date painted on it. Gerry, Barry remembered, was a keen supporter of the Glentoran Football Club.
“In here.” Gerry showed Barry into a tidy bedroom where Mairead lay covered with a pink candlewick bedspread on a double bed. “Hello, Doctor Laverty. Sorry to bring you. I’m feeling much better, so I am. I think I’m mending.”
“I’m glad to hear it, but seeing that I’m here I’d like to ask you a few questions. Examine you.”
“If you’ll excuse me, Doc, I’ll wait outside,” Gerry said.
It was customary for men to absent themselves when their wives were being examined.
“Put you the kettle on, Gerry,” Mairead said. “Doctor Laverty might like a wee cup of tea in his hand when he’s finished with me.”
Barry said, “Thank you, but let’s see to you first, Mairead.”
Barry studied her face. She was very pale. Tiny sweat beads stood out on her forehead. Her eyes were bright and focused. “So tell me what happened,” Barry asked, beginning to wonder, simply because of her pallor, if it was more than “Oh, pregnant women get that a lot.”
Her voice was firm, steady. “I was doing the ironing. I had the radio on. ‘Housewife’s Choice,’ you know, the program that plays requests? Them Beatles was doing ‘I Want to Hold Your Hand’ when I took this ferocious cutting stoon down in my right side. I let a roar out of me and the next thing I knew Gerry had me tucked up in bed and was patting my hand and saying, ‘Wake up, love.’ Then he said he was going for to get the doctor, so he was.”
Gerry hadn’t mentioned pain on the phone and one word, “cutting,” now took Barry’s attention. His text, Operative Obstetrics, observed that in cases of tubal pregnancy the pain was usually aching, but severe episodes, probably caused by blood dripping onto the peritoneum, were, he could picture the words, usually described as “cutting.” “So,” he said, “you were feeling fine and suddenly you got a pain and fainted?”
“Aye.”
“Tell me about the pain.”
“I’d not never had nothing like that in my life. Just like someone stuck a knife in me.”
“Can you show me where?”
She threw back the bedspread—she was fully dressed—and pointed to a spot on the right between the centre of her skirt waistband and her hip bone.
“Thank you. And have you been noticing anything else?”
“Like Gerry told you, Doctor, my monthlies are two weeks late.”
“What date?”
“I should have started on Friday the fourteenth of this here month, and you could set your watch by mine. Every twenty-eight days and the one before was on April seventeenth.”
Today was the thirtieth of May. That was slightly more than six weeks since her last period. Barry could imagine hearing Doctor Graham Harley, lecturer in obstetrics and gynaecology at the Royal Maternity Hospital, saying, “If you learn nothing else from me, remember this: Every woman is pregnant until proven otherwise. Even if they’ve not even missed a period. Then you’ll not make silly mistakes like ordering lower-back X-rays and irradiating an early embryo until you’re sure it’s safe.” Sound advice, and from the time Gerry had phoned, Barry had assumed that Mairead was pregnant. Now he must consider all the possible causes of her pain in the light of that assumption.
Even though it was early
she might have some more symptoms of pregnancy. “Any morning sickness? Sore breasts?”
“No, sir. Just the pain and the fainting, but I was sure I was up the spout. I was so excited. You know me and Gerry’s been trying for number three for a brave while. And here hadn’t it happened just like Doctor O’Reilly said it would if we just took our time. Now this? I hope to God there’s nothing wrong.” She managed a weak smile. “I’ve heard tell lots of pregnant women swoon.”
A few still did, but not in the numbers they used to, Barry thought, when women wore tightly laced corsets with whalebone stays. He didn’t comment. His text had remarked, Sudden faintness … is a characteristic symptom of ectopic pregnancy. If he’d known about the pain when Gerry had phoned, Barry would not have taken the other symptom so lightly, or spent as much time listening to Fingal’s wedding plans.
“Have you noticed any bleeding down below?” A small amount of vaginal bleeding could be a sign of impending miscarriage, but it too was associated with ectopic pregnancy.
She shook her head.
Bleeding wasn’t vital in order for him to make a working diagnosis. Barry was as certain as he could be on the three facts so far available that Mairead was pregnant and something untoward was happening. It could be a threatened miscarriage, but the absence of bleeding made that unlikely. With the pain in her right side, it might be a bowel condition like appendicitis and unrelated to the pregnancy. Or it could be a disease of the ovaries or Fallopian tubes, once again unrelated. But there, at the forefront of his thoughts, was a growing belief that she was pregnant, that the early embryo had failed to reach her uterus, and now was growing in her Fallopian tube. This condition could not continue. The greatest risk was that the tube would burst and the resulting haemorrhage would be lethal.
He reached over and took her wrist. “Your pulse is nearly normal,” he said. “Tiny bit fast at ninety-two, and I don’t think you’ve got a fever. You feel cool enough. Now, I just need to take your blood pressure and have a look at your belly and down below.”
Her blood pressure was normal, her abdomen not unduly tender when he palpated it. Barry turned his back, ostensibly to take rubber gloves from his bag, but also to give Mairead a moment of privacy to remove her knickers.
“Ready, Doctor,” she said.
He turned. She lay on her back, knees flexed, thighs parted. Barry squeezed some K-Y Jelly onto the first two fingers of his right hand. “I’ll be as gentle as I can,” he said, knowing that it was going to be impossible not to hurt her. He was looking for one last diagnostic sign. In so early a pregnancy, he probably couldn’t tell if the uterus had, under the influence of pregnancy hormones, become enlarged, nor would he be able to feel a distended tube if one did contain the fetal sac. The tube would be too soft and too small, but if there was blood on the sensitive peritoneum, his exploring fingers would produce what was graphically described as “yelling tenderness.”
They did.
Mairead shrieked and Barry rapidly withdrew his examining fingers, pulled down her skirt, and covered her with the bedclothes. “Sorry, Mairead,” he said, thinking what a hollow word it could be. “Sorry.” But that scream had clinched it in his mind. Mairead Shanks, who so desperately wanted a third child, almost certainly had a tubal pregnancy.
She took a series of deep breaths, blowing each out through partially closed lips.
Gerry rushed in. “What’s up?”
Barry said, “I’m sorry, Gerry. I was examining Mairead and touched a sensitive spot.”
“It’s all right, Doctor,” Mairead said. “I understand youse was only doing what youse had to. I’m over it now.” She took a huge breath. “Can youse tell us what’s wrong?”
Barry stripped off his glove. He stared at the floor and thought, Get on with it. It’s your job to break bad news. He sat on the bed and took Mairead’s hand. “I think you are pregnant,” he said.
“But it’s gone bad,” Mairead said. “I knew it.”
“I’m afraid so. I believe it’s not in the right place.”
“An ectopic, like?” she asked.
“How do you know about ectopics?”
“When I was still at school, a wee girl in my class, my best friend, got knocked up, so she did. But nobody knew until she collapsed in class and they had to rush her to the Royal for an operation, you know. They took out the tube with the pregnancy in it. She told me all about it when she came back to school.” She looked up at her husband. “It’s all right, Gerry. She got married two years later and has two lovely weans, so she has. This doesn’t mean I’ll not be able to have another, does it, Doctor Laverty?”
Barry marvelled at the stoicism and the optimism of his patient. “Women do get pregnant after tubal pregnancies,” he said, and reckoned that this was not the time to tell the Shankses that such patients did run a risk of having another ectopic in the remaining tube. “We’d better see about getting you to the hospital,” he said. He knew exactly what would have to be done to confirm his diagnosis, and the kind of surgery Mairead would almost certainly need. In another six weeks, he’d be learning to do that surgery. He was looking forward to that. “I’ll go and phone for the ambulance.”
Gerry bent and kissed his wife’s forehead. “It’s going to be all right, love, isn’t it, Doctor Laverty?”
And despite the uncertainties that surround ectopic pregnancies and any kind of major surgery, what else, Barry thought, could he say? “Of course it is, although I am pretty sure you’ll need an operation, Mairead.” He put a hand on her arm and stood. “I’ll wait until the ambulance comes.” If the bloody thing ruptured while they were waiting, there wasn’t much he could do, but he could ask the despatcher to make sure there were four pints of O-negative blood on board. Just in case. “So I’ll make that call, and if the kettle’s boiled, a cup of tea would really hit the spot, Gerry.”
29
Of Manners Gentle
“I must say,” said O’Reilly, pushing away a plate where only a couple of bones remained of what had been a lunch of cold poached salmon garnished with parsley, slices of lemon, and leaves of crisp iceberg lettuce from his vegetable garden, “since we finished the overflowing benificence of our neighbours yesterday, it is indeed a great relief to have Kinky back in her kitchen.” Even, he thought, if she is keeping her promise about cutting back on starch. Ordinarily there would have been a cold potato salad and her oh-so-creamy homemade mayonnaise. Och, well.
“It is that,” Barry said. “Doesn’t seem like nearly six weeks since her operation. She’s recovering very well.” He dislodged something with his little fingernail from between two teeth. “And she hasn’t forgotten how to cook.”
“It was absolutely delicious,” Sue Nolan said. “I wonder if she’d show me how she gets the fish so firm?”
“I would take pleasure in that, Miss Sue,” Kinky said, coming in from the hall. She set a tray on the table and started to clear. “It was my own mother-in-law showed me how when we lived at her house in Ring in County Cork. When you’re married to a fisherman you’d better learn how to cook fish, so.”
Interesting that Kinky would mention her past in front of Sue, O’Reilly thought, and the “Miss Sue” was a sure sign of acceptance too. Of course, Sue Nolan posed no threat, and Kinky was a good thirty years older than the schoolmistress. That age difference gave Kinky the right to be familiar and use the younger woman’s Christian name, but as she was accompanying Barry, there was a social gap, so Sue still must be accorded her title, “Miss.” Och, O’Reilly thought, the rules of etiquette, they’re so bloody archaic, but it pleased him enormously to watch Kinky being her friendly self and seeing how the colour had returned to her usually rosy cheeks. He knew she’d lost weight, but, like himself, she could afford to. He gave a small, wry smile. But it was a pity about the mayonnaise.
“Let me help,” Sue said, getting to her feet.
“Stay where you are for now,” Kinky said, “but thanks for the offer.” There was a clattering of plate
on plate. “I’d appreciate it if you’d come with me in a minute. The coffee’s ready and it would be a favour to me if you’d take this tray downstairs and the coffee up.” She smiled at Sue. “Climbing them stairs still does be an effort, so.”
“You, Kinky Kincaid,” said O’Reilly, “get your kitchen tidied and then take the rest of the day off. I’m going to Portaferry after coffee to see my brother. You’ll not mind giving Mrs. Kincaid a break, answering the phone, Sue, if Barry gets called out and you’re on your own?” He was curious to see how having yet another stranger doing her job would affect Kinky.
Sue said, “I’d be delighted. I’ve paperwork to do for the CSJ, so I won’t get bored if I am left on my own.”
Barry had told O’Reilly about Sue’s political work for civil rights. Like Barry, O’Reilly distanced himself from sectarian politics, treated everybody the same, but had said he thoroughly approved of Sue’s involvement.
“I’d be very grateful if you would, Miss Sue,” Kinky said. She looked straight at O’Reilly. “I have become used to having Helen do part of my duties during the week, and it is a load off not to have to be interrupted at my new job. Since we decided the reception is going to be in the back garden here I have a great deal of work to do arranging the food and drink, so, and a marquee. We’ll ask the Highlanders pipe band for the loan of theirs like we did for Seamus and Maureen Galvin’s going away last July.”
“We’re happy to leave that to you, but not this afternoon, Kinky,” O’Reilly said. “I want you to rest.”
“Wellll,” she said, “it does be the first Saturday in June, there’s always horse racing at Goodwood, and it’ll be on Grandstand on the telly.” She chuckled. “I might have a flutter with the bookie, Mister McArdle.”
“I saw how you did at Downpatrick,” O’Reilly said. “I could feel sorry for Willy.” And he wondered, as he often had, if Kinky’s being fey in any way influenced her remarkable successes at the betting.
“I’ve always loved the horses, so. My brother-in-law, Malachy Aherne, is very good with them. In fact, his name in the Irish is Ó Echtigerna, which means ‘grandson of the lord of the horses.’ I do believe his understanding of the animals rubbed off on me.”