“Could I come and get you to show me Butch one day, Colin? When your arm’s better.”
“Aye, certainly, couldn’t he, Mammy?” Colin looked up at his mother.
“I’ll make you a cup of tea when you do, Doctor,” Connie said, clearly forcing a smile, then inclining her head toward Colin’s arm.
“Tell you what, Mammy, could you help Colin roll up his sleeve?”
“I think so.” Connie bent and unbuttoned Colin’s shirtsleeve. His eyes never left his mother’s face as she rolled the material one-third of the way up to where Colin supported the arm with his other hand.
“Now,” said Barry, “did that hurt, Colin?”
The boy shook his head.
“If Mammy holds your hand and you hold your elbow, I think we can get the sleeve up a bit more so I can see the sore bit. Just to look at.”
“Colin?” Connie asked. “Will we do what the doctor asks?”
Colin took a deep breath, and nodded.
“You’ll need to let go of it,” Barry said, and Colin obeyed. In no time Barry had carefully pushed the sleeve farther up. He could see that the forearm was bent out of its usual straight line into a curve. Another diagnostic sign. “Point to where it’s sorest, Colin.”
Colin’s index finger hovered over the crown of the curve, the place where a moment ago he’d been cradling it. Local bone tenderness. Sign four. That was enough to confirm Barry’s suspicions. He said, “I’m going to get a splint and bandages.”
“Is it,” Connie silently mouthed, “broken?”
“I think so.”
She sighed. “Thank God it’s not fractured, so it’s not.”
Barry had given up trying to explain that broken and fractured were the same thing. The entire population of Ulster, it seemed to him, was quite willing to accept a bone being broken, but the thought of a fracture filled them with dread. Perhaps because in pre-antibiotic days, compound fractures could become infected and gangrenous, and the limb would have to be amputated. Gangrene. For a moment Barry was distracted. If Kinky had a strangulated hernia, gangrene of the bowel was a risk. Concentrate, he told himself. Colin has a greenstick fracture where one side of the bone has cracked, but the opposite is intact. The same thing would happen to a young tree branch if you bent it far enough. The arm needed to be splinted to immobilise it and protect Colin from more pain. Later, in hospital, it would be set. “I’ll just be a minute,” he said. “Keep your arm still, Colin.”
Barry took what he needed from his bag. His movements were deliberate, but in a short time, with Connie’s help, he had put the forearm at right angles to the upper arm, thumb upward, palm toward the body, and had applied splints on the inner and outer sides of the forearm. “Now,” he said, “bandages to hold the splints, and a sling.” It was a good thing, he thought as he worked, that as a kid he’d been a Sea Scout and had passed his first-aid badge. This kind of splinting wasn’t taught at medical school but was left to volunteers trained by the Saint John’s Ambulance Brigade or to ambulance attendants, those who were usually first at the scene of any accident.
He stood, the job done. “How’s that, Colin?”
“All right, so it is.” The little lad wiped his nose along his right sleeve.
“Colin, use your hanky, for God’s sake,” Connie said.
Barry had a vivid image of one small boy in Belfast taunting another. “Hey, silver sleeves? Away on home. Your mammy wants ye.”
“Now, Connie,” said Barry, “can I use your phone?” He inclined his head to indicate she should follow.
“Aye, certainly. You be good for a wee minute, Colin.” She led Barry into the hall. “Thonder.” She pointed at a Bakelite receiver on a hall table. “Is it really bad, like?”
Barry shook his head. “Not really, but he’ll need to go to hospital for an X-ray to be sure the bones are broken, and if they are he’ll be given an anaesthetic so a surgeon can set the bone properly, pad the arm, and put on a plaster cast. Don’t give him anything to eat or drink. He’ll need to have an empty tummy for the anaesthetic and he’ll have to stay in tonight, but you’ll get him home tomorrow. The cast’ll be taken off in six weeks. Don’t be too worried. At his age kids heal perfectly.”
“Thank God for that.” She hesitated then asked, “We’ve no motorcar and my man won’t be home from work for hours. Will I take him now on the train or bus up to Belfast?”
Barry shook his head. “That’s what the country ambulance is for, but you’ll have to get him home yourself tomorrow.”
“Fair enough. I’m sure we can get a lift.”
“I’ll call for the ambulance. You go and keep Colin company. I’ll be in in a minute.”
Barry made the arrangements, went back into the parlour, and squatted beside Colin.
The little lad fixed Barry with an inquisitive glare. “Now what? Am I all fixed?”
Barry shook his head. “Did you ever go for a ride in an ambulance?”
“No,” said Colin, pulling back. “Don’t want to.”
“Be a pity if you miss it,” Barry said. “You could get the driver to go nee-naw on his siren.”
“Right enough?” Colin leant forward.
“I’ll bet you none of the boys in your class’ll have had an ambulance ride.”
“Aye.” Colin managed a weak smile.
Barry said, “You’ve bust your arm, Colin. You need a plaster of Paris cast to hold it steady until the bones knit, and when you get back to school—”
“You mean I’ve to be off, like?” Colin brightened.
“I do indeed. Until next Monday.”
“Wheeker,” Colin said, and his grin was from ear to ear. “I can play with Butch all I want. Teach him tricks, like.”
Barry chuckled. He knew that school was not Colin’s favourite pastime. “And when you get back all your friends can sign your cast.”
“Honest?”
“Cross my heart.” Barry did.
“All except Art O’Callaghan. He’s a right wee willick, so he is.”
“Colin,” Connie said.
Barry laughed, stood, and said, “When you get home, you tell your mammy if it still hurts or if your fingers swell up. And if Colin does, Connie, send for me. Sometimes if the arm swells a cast can get to be too tight and has to be split.” Barry headed for the door, turned, and said, “I’ll pop in later in the week, and I want to see Butch when I come.”
“Och,” said Colin, “could I not show him to you now?”
Barry shook his head. “Sorry,” he said. “I have to get back to Number One. Doctor O’Reilly’s making our tea.”
Connie said, “Because Mrs. Kincaid’s poorly.”
Barry shook his head. He should have known word would be out in the village by now.
“I know because Aggie Arbuthnot, her that’s Cissie Sloan’s cousin, was passing Doctor O’Reilly’s house a wee while back. She seen the ambulance and she said the attendants were putting Kinky in the back. Aggie popped in here to borrow some baking powder for to make biscuits before Colin took his purler.” She looked Barry in the eye. “It’s not serious with Mrs. Kincaid, is it, sir?”
He heard the concern in her voice and admired how Connie, who must be worried about Colin, could still find time to ask about Kinky. He knew Connie’s question wasn’t coming from idle curiosity. She cared. “I hope it’s not,” he said, “but you know I can’t tell you any more. Kinky’s family, but she’s also my patient.”
“I understand, Doctor, but if youse see her will you tell her I was asking about her?”
“I will, Connie.” He went into the hall. “Now, I really must be running on. Try not to fret about Colin. He’ll be fine,” he said, and let himself out.
As he strode rapidly back to Number One he hoped to God O’Reilly had heard about Kinky so they had a clear idea about what was happening to her. When it came to family and friends, doctors were no better at dealing with medical uncertainty than a mother dealing with a hurt child.
5<
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Make unto All People a Feast of Fat Things
“In the kitchen,” bawled O’Reilly in answer to Barry’s, “Where are you, Fingal?” He didn’t wait to take off his coat, but headed straight in the direction of O’Reilly’s roaring. The big man, stripped to his shirtsleeves, red braces crossed at his back, wrapped in one of Kinky’s floral aprons, sat peeling a potato. Despite his concern for Kinky, Barry had to stifle a laugh. A nearly empty glass of what he knew was Jameson’s whiskey sat on the table beside a saucepan of water.
“Before you ask,” O’Reilly said, “Cromie called. His examination and an X-ray have confirmed that Kinky has a strangulated inguinal hernia with a loop of jejunem trapped. The X-ray was quite clear. Classic concertina pattern.”
“Now we know exactly what’s wrong.” Barry felt himself relax. “Thank goodness it’s something treatable.”
“And your diagnosis was right,” said O’Reilly. “Good for you.”
Barry dipped his head and took a certain selfish pleasure from having been right. “A strangulated hernia’s not a great thing to have, but it could be worse. Much worse.”
“It could,” O’Reilly said. “Cromie asked me if I knew exactly when the pains had started, and I did, because you’d told me. He reckoned he’d time the onset of strangulation from when she started having pain at short intervals and vomiting. That gives him a start point of one thirty. He says he’ll try conservative treatment for a while.”
At least, Barry thought, part of that regimen was to give large doses of morphine. Finally she’d be getting relief from the pains.
“Cromie’s none too sanguine. Six hours from onset will soon be up—”
“And if the bowel doesn’t slip free by then, gangrene will set in.” Barry knew he’d been right to worry about that. This time being correct gave him no pleasure. None at all.
“So it is likely they will operate.” O’Reilly looked at his watch. “It’s five thirty now. They’ll go ahead at seven to give themselves half an hour’s leeway.” He dropped the peeled potato into the saucepan and grabbed another spud.
“Poor Kinky,” Barry said. A tube would have been passed through her nose and down into her stomach to remove gastric secretions and any toxins that might accumulate above the blockage. With an intravenous dripping saline into a vein, she’d be nursed head down, feet up in the hope the bowel might slip free. He could imagine the pain going on until the narcotic at last took effect. “At least we know what’s happening, and thank the Lord for morphine.”
“Indeed,” said O’Reilly. “Called after Morpheus—”
“Greek god of dreams,” Barry said.
“Son of Hypnos, the god of sleep,” parried O’Reilly, and with a flourish dropped another potato into the pot.
Barry smiled. This was a practised game between them now, Fingal spouting trivia and Barry rising to the bait like a trout to a fly to show he wasn’t entirely unlettered. Barry decided it wasn’t because of their lack of concern for Kinky, but rather relief at having had the uncertainty about her removed. Now that they knew the prognosis was good their emotional safety valves were blowing off steam.
“Cromie said he or Jack’ll let us know if they’ve decided to operate and they’ll phone us again once they’ve finished. I’ll give one of her sisters a call after dinner.”
“Decent of you, Fingal, and decent of the surgeons to keep us up to date,” Barry said, knowing full well that few consultants made time to keep referring GPs apprised of their patients’ progress.
“Cromie and I go back a long way. It’s not what you know, Barry. It’s who.”
“My father often says that,” Barry said.
“I learned it from him when we served on HMS Warspite, in the war.” O’Reilly held a lit match over a ring on the stovetop. The resultant loud pop and ring of bright blue flames made Barry flinch, but O’Reilly seemed unconcerned. “Grub,” he said, and blew out the match.
He put the saucepan of potatoes on the flames. “I’ve preheated the oven,” he said. “Fetch that pie.” He pointed to an oval Pyrex dish on a counter near Barry. “Put it on the counter here.” O’Reilly dipped a brush into a cup. “Egg yolk,” he said. “I’ve watched Kinky do this. Monkey see. Monkey do.” He painted the yolk on the pie crust.
“Mmm, I think that’s already been done, Fingal.”
O’Reilly grinned. “Bit more won’t hurt.” He set the brush aside then opened the oven door and popped the pie in. “Thirty minutes and everything’ll be done,” he said.
“Kinky told me twenty-five minutes at medium,” Barry said.
“Medium?” O’Reilly peered at the knurled wheel on the oven door. “I guessed that’d be about four hundred fifty. That’s what it’s at, and an extra five minutes won’t do it any harm. I like my crust nice and brown,” O’Reilly said.
Barry had a vague recollection of his mother using a setting of 350° to reheat already cooked food but decided to keep his counsel.
“Then at the start of the first dog watch, or if you prefer six o’clock, a feast fit for a couple of kings for us, lad.” He dropped his bantering tone. “And not long to wait after we’ve finished eating to hear what’s going to happen next in the Royal.”
Barry recognised what Fingal was doing. It was primitive, probably a throwback to when their ancestors wore skins, but by refusing to mention Kinky by name, O’Reilly, like Barry, was trying to pretend nothing was happening to her, or could.
O’Reilly untied his apron. “In the meantime,” he said, finishing the whiskey in one swallow, “I suggest we have a small libation, but unlike the ancient Greeks, refrain from pouring the sacrifice on the earth and use our throats instead.” He set the apron aside. “Come on. Upstairs to the lounge.”
“I’ll get out of my coat and I’ll be right up,” Barry said.
He hung his coat in the hall and was heading for the stairs when the doorbell rang. Now what? Barry opened the door to find Maggie MacCorkle smiling her toothless smile.
“Hello, Doctor dear,” she said. A limp daffodil adorned her hatband. “I’ll only keep you a wee minute, so I will.”
“Come in, Maggie.”
“Och, no. I’ll not be stopping.” She proffered a brown paper bag. “John McIlderry, him that works at City Hall, came out to bring Sonny some townland records, you know … the oul goat’s looking for a hill fort or a passage grave or some ancient ould thing near Ballybucklebo. You know what he’s like about his archaeology.” She raised her eyes to the heavens. “Anyways, John telt us Kinky was sick. He’d heard it from Cissie Sloan, so he had.”
Who’d heard it from Aggie Arbuthnot, Barry thought.
“Sonny reckoned, no harm to yiz, but you and himself might not be the greatest cooks. Sonny’s out in the motor—”
Barry leaned past Maggie and waved at Sonny, who was sitting in his parked 1954 Sunbeam-Talbot.
Sonny waved back.
“So we thought we’d bring youse this here cottage pie I’d made yesterday and had in the fridge.” She shook the parcel. “And I put in a couple of slices of my plum cake for afters.”
Barry accepted the bag. “That’s very kind,” he said, hoping, ungraciously he knew, that Maggie’s cottage pies were not as God-awful as her plum cake. “Thank you.”
“Is Kinky going to be all right, sir?” Maggie had lowered her voice.
“She’s in the Royal and she’s comfortable,” Barry said, knowing he sounded like an official hospital bulletin, “but that’s all I can say. Sorry, Maggie.”
“Och, aye. I know you’re like priests, you doctors. Have to keep things confidential, like.”
“That’s it, Maggie, but we’ll let her know you both were asking for her, and please thank Sonny.”
“You and himself just let us know if you need anything,” Maggie said, “and there’s no rush to get the pie dish back when you’ve done.” She turned, then called back over her shoulder, “Just drop it in some day you’re passing.”
“Right.” You
didn’t get people like Maggie and Sonny fussing over you when you worked in a teaching hospital, Barry thought as he trotted through to the kitchen to pop the bag in the fridge.
He heard a roar from upstairs.
“Are you coming tonight, Laverty?”
“Take your hurry in your hand,” he called back up and trotted to the staircase.
“Jameson or sherry?” O’Reilly was standing at the sideboard when Barry entered the room.
Barry hesitated then said, “Whiskey, please.”
O’Reilly, who already had his own glass refilled, poured and handed Barry his. “Who was that?”
“Maggie and Sonny with a cottage pie.”
O’Reilly nodded. “News travels,” he said. “Come and sit down.” He moved to an armchair, shooed Lady Macbeth out of the seat, sat, and made no objection when the little cat sprang into his lap and curled up in a purring ball.
Barry took the other chair. “Sláinte.” He sipped the smooth Irish whiskey.
“Cheers.” O’Reilly drank. “How’s Colin?”
“Greenstick. I splinted it and sent him to the Royal.”
“Good man.” O’Reilly scratched Lady Macbeth’s head. “And I’ll say again that you were absolutely right to send Kinky too so you’d be here if anybody needed one of us while I was out.” He frowned. “It’s dawned on me how much we’re going to miss having her here to answer the phone or doorbell.”
“We should be able to manage. One here, one out doing calls, like this afternoon.”
O’Reilly frowned. “I’m not so sure. What if both of us are out? Or take tomorrow. Someone must go and see Kinky.”
“She’d appreciate it if it’s you, Fingal.”
“I know. I’ll look in on Donal Donnelly too. See how he’s doing.”
Donal. With all the anxiety about Kinky, Barry had forgotten that Ballybucklebo’s arch-schemer had had a head injury last Saturday, been operated on that night for the removal of an intracranial blood clot, and was recovering well. “Say hello to him too.”
“I will.” O’Reilly paused. “Trouble is if you’re out on a visit—”