“Right,” said Angus Mahaddie, who was sitting beside Fingal. “I held your hand all day yesterday and for today’s first two cases. I’ve shown you how to give intravenous pentothal, insert an endotracheal tube, and connect it to the Boyle’s machine. I’ve pointed out the valves to operate, gasses to use, and how to tell if the anaesthetic is too shallow or too deep. I’ve hung back, not said a word to you about how you’ve been managing this case. Let me see you wake him up without my help, and if you manage that smoothly you’ll, in RAF parlance, have ‘gone solo,’ and be well on your way to becoming a useful anaesthetist.”
Fingal swallowed, but admitted to himself that with the Scotsman’s careful guidance he was feeling more comfortable and more confident when he administered an anaesthetic. He was proud of his achievement. He looked at his gear. Clamped to the sides of a trolley were cylinders for oxygen and the anaesthetic gases, all of which he could now identify and turn on and off and regulate their rate of delivery to the patient. Pipes from the cylinders led through flow meters and through a device for vaporising and mixing the gasses. Next a mechanical bellows delivered the nitrous oxide, oxygen, and ether mixture through one of a pair of black corrugated rubber hoses connected to a Magill tube in the patient’s trachea. The other hose removed carbon dioxide and the gasses as the patient exhaled.
He reduced the flow of nitrous oxide and ether and gradually opened more widely the one supplying oxygen so the level of anaesthesia would be less deep before he actually woke the patient up. In very short order the man began to move as he should—much to Fingal’s relief.
“Christ,” said the surgeon, “keep him still. I haven’t finished suturing yet, O’Reilly, and when you do bring him round, I don’t want him coughing and ripping out my stitches because of your ham-fisted anaesthetic.”
Fingal inhaled through his nose but, saying nothing, reopened the gas valves. The patient lay still. There was no thank you. Already Fingal had decided that the acerbic surgeon commander was the antithesis of the helpful and good-humoured Angus Mahaddie.
A few minutes later, “Now I’m finished,” the surgeon commander said. “Do try to get him awake quickly, O’Reilly. We don’t have all day before the next patient.” Fraser turned from the table and ripped off his rubber gloves. “Come on, Sister,” he yelled at the circulating nurse. “Stop daydreaming. Get my gown off.” He started dictating his operative notes to a clearly nervous young VAD clerk. “… external oblique fascia. Are you sure you can spell that, girl?”
The masked QARNNS sister who had been handling the instruments caught Fingal’s eye and raised her own to the heavens as if to say, bloody prima donna surgeons. In 1937 in the Rotunda Hospital the look of two shining eyes above a surgical mask had led him to ask a certain midwife, Deirdre Mawhinney, for a date. He smiled at the memory of those eyes.
Angus said quietly, “You’re doing fine, laddie. Now what should you do?”
“Shut off the gasses and ventilate lungs with carbon dioxide and oxygen.” Fingal spun the knurled wheels. “And give 5cc of coramine intravenously, sir, and get him extubated.” Fingal gave the injection.
As the patient’s eyelids fluttered, Fingal withdrew the endotracheal tube and held a rubber mask over the man’s nose and mouth.
“Well done, and now—”
Outside, the air raid sirens howled into rising and falling life, giving advance warning of incoming bombers somewhere in their vicinity. The police sounded the sirens for one minute when a red alert was given, meaning the planes were twelve minutes away. Thank God for radar and the system of plotting the tracks of enemy aircraft. It gave the defending air force and the potential victims of the bombing enough time to react. The racket did not mean Gosport would be the target, but precautions would already be under way, because the hospital would have been informed by telephone on the yellow alert—planes twenty-two minutes away. That would be eighty-eight miles for a squadron cruising at 240 miles per hour.
Down here in the cellar operating theatre, the orderlies began moving the patient onto a trolley. He’d not be going upstairs to the Admiral Collingwood Ward, but to a bed in the cellar air raid shelters. Even in the theatre, Fingal was aware of tramping feet in the corridors outside, and the cries of patients who’d be frightened or in pain as they were moved.
Every moveable patient was being brought down by the nursing and sick berth staff, helped by ambulatory patients, all under the watchful command of the ward master, a commissioned sick berth attendant. God help the poor bastards in traction who had to be left to their fate upstairs on the wards. Fingal felt for them as he had felt for the unprotected upper-deck crew on Warspite when she was being bombed or shelled. Perhaps the large painted red cross in the quadrangle might dissuade the German airmen from aiming at the hospital if Gosport was indeed the target. They’d not know until the raid was over and the unwavering note of the “All Clear” had been sounded. Then the patients would be taken back upstairs. There was bustle in the theatre.
“It’s going to be crowded in here if it’s a big raid,” Angus said. “They’ll be bringing in two more tables so three surgical teams can operate here, and the same in the other underground operating theatre.”
“Will it be crazy in here?” Fingal said, but even before he saw Angus shake his head, he knew it wouldn’t. Not really. More a form of orchestrated chaos. He’d seen how it worked on Warspite at Narvik.
“We have our moments. But we’re pretty well drilled,” the little captain said with a smile. “You’ll see. We’ve a highly developed system, just like the one afloat. The wounded are taken to a clearing centre and divided into those who can wait, those who need surgery at once, and those, God help them, who are beyond any help but hot sweet tea, morphine injections, and a visit from one of the chaplains.”
The sirens had long ceased their howling, replaced by the asynchronous beat of German aero engines. The buggers were coming in low. Staccato pounding of Portsmouth’s AA guns was punctuated by the far-distant crumps of exploding bombs. Fingal was pretty sure the dockyard several miles away was getting it again. Selfish as he knew it was, his immediate thought was, Rather Portsmouth than Fareham—where Deirdre would be settling in with Marge. He wondered what she’d be doing. If the sirens had gone off there, he hoped she’d be taking shelter as a precaution too.
“Here we go again,” said Angus Mahaddie. “There’ll be casualties arriving soon.” He glanced over at the surgeon, who was now complaining about something else to the VAD. Leave the poor child alone, Fingal thought.
“Aye,” Angus said, nodding to himself. “Just so. Sometimes I think some surgeons have what we in the Highlands would call ‘a very good conceit of themselves.’” He winked at Fingal. “You did very well, laddie. Pay him no heed.” He stretched. “We’ll not be doing the routine case for a while. That patient’ll have to wait until we’ve looked after the injured. Could you manage to drink a cuppa cha? It’ll be at least an hour before the first victims start arriving, and I’m parched.”
“I would like that,” Fingal said. It probably meant he’d be kept here well past five thirty by the inflow of casualties. Damn it. He shrugged. Couldn’t be helped. He’d known for years that when it came to patients they always came first.
“Aye,” said Angus, “and don’t worry. You’re a trainee. I’m sure we’ll be able to do without you for an hour. Come five o’clock I’ll manage on my own for a wee while. We can’t have you late for seeing the admiral, now, can we?”
The man was a mind reader.
* * *
It was a long walk to the admiral’s office from Fingal’s quarters in the medical officers’ mess. He’d headed there as soon as Angus Mahaddie had released him from the theatre so he could ensure his appearance was now all ship-shape and Bristol fashion, as the navy quaintly put it. Admiral Creaser had been clearly insistent upon proper dress, and there was no need to antagonise the man. Fingal strode along the cloisters under the ward blocks. A shortcut led up the centre of th
e quadrangle from the entrance to the hospital and along to the church, but it wasn’t called the Admiral’s Walk for nothing. A lieutenant would no more think of treading on those hallowed flagstones than flying to the moon in a submarine.
As Fingal walked, one thought kept step with his footfalls. What if he said no? What if Surgeon Rear Admiral Thomas Creaser RN flat-out said, “No.” Were there any arguments Fingal could advance, any appeal process? He shook his head. He’d no idea. He pursed his lips and, barely recognising what he was doing, crossed his fingers.
Memories of yesterday and getting Deirdre settled into Twiddy’s Cottage flooded back. Marge had welcomed her into the house like a long-lost daughter and Benbow, the sheepdog, had stirred from his shaggy heap by the fire to lick her hand and cover her with his long, wiry fur. He and Marge had watched as Deirdre handled the baby hedgehogs Riddle, Mee, and Ree with a childlike mixture of awe and gentleness. The two women had hit it off at once. “I think that you and I are going to get along famously,” Marge had said as she ordered Deirdre upstairs for a bath and a sleep before dinner while Fingal and Marge planted leeks in the Wilcoxsons’ tidy vegetable garden.
Deirdre coming downstairs after her rest had looked gorgeous. How much he’d wanted her.
And just when he thought he should have devised some way for them to be alone, Marge had made her astonishing pronouncement: “I’ve some utterly boring Parish Council meeting and I won’t be back until ten.”
And he of the huge appetite had barely noticed the pheasant and bottle of Pol Roger they’d had for dinner, but Deirdre’s kisses, her caresses, the violent urgency of their lovemaking, the languorous afterglow, and the reaffirmation of their love would be with him in every detail forever.
He left the cloisters and went along a corridor. If the interview went well they would have nearly three whole wonderful months to be together before he must go back to sea. But if it didn’t?
He halted in front of the door to the admiral’s office, straightened his tie, dusted off his coat, and as regulations demanded, tucked his cap under his arm. Before he knocked, Fingal remembered the conversation with Marjorie after she’d arrived home at five past ten last night. “I do hope you two have had a lovely evening.” She’d beamed and said, “I’m sure you have. I am married to a sailor, you know. It’s wonderful when he comes home.”
Fingal had swallowed, trying to think of a tactful reply, but she’d continued, “I was very happy to make myself scarce this evening, of course,” she said, “but we can’t be making a habit of it, can we? So do be a good boy and hurry up and get married.”
His knock was answered by a terse, “Come.”
He opened the door and stepped into the office. A fire burned in the central fireplace surmounted by the massive coat of arms.
“O’Reilly. Have a seat.” Surgeon Rear Admiral Creaser was seated behind his desk behind a stack of files and indicated the chair in front of it with an absent wave of his hand, the same chair Fingal had occupied last Thursday. “Glad to see you’ve taken my advice and are in the correct rig of the day. Good.”
Fingal took the chair and the small compliment as a good omen and a reminder of the admiral’s final words to him on Thursday: “I’ll see what I can do.”
“We’ll make this brief. I’m informed that the raid on Portsmouth is keeping us busy, and you’ll want to get back on duty, I’m sure.”
“Yes, sir.”
“I know why you’ve sought this interview.” The senior officer took a deep breath. “As I promised, I have spoken to the Admiralty.” His gaze fixed on Fingal. “I must explain this to you in some detail. I’m sorry, O’Reilly.”
He didn’t need to say one word more. How often had Fingal himself used “I’m sorry” as a prelude to bad news? But it would be impolitic to interrupt. He held his breath.
“Even in wartime, they expect you to wait until you are a lieutenant-commander.”
Fingal exhaled. Damn it. Damn it all to hell. It had been wonderful seeing her, but if they couldn’t live together, what was the point in Deirdre being here? He had brought his darling girl here for nothing, and subjected her to risk and danger along the way. His shoulders sagged and he stared at the desktop.
“It’s not all gloom and despondency,” the admiral said. “With your four years seniority as a lieutenant, I can ensure that you will be promoted at the earliest opportunity.”
A flicker of hope. Fingal raised his head and asked, “And when will that be, sir?”
“Promotions are granted twice a year. June and December.”
“December?” He heard his own voice rise in pitch. December? He was going back to sea in January. He felt an emotional thump as powerful as a hit by one of Warspite’s fifteen-inch shells.
“And become effective six months later.” The admiral steepled his fingers and looked at Fingal who, despite his disappointment, heard compassion in the senior officer’s voice, saw it in his eyes.
Fingal gritted his teeth, wanted to yell, demand that the rules be bent. He took a deep breath, struggled to control his temper, and asked, “And that’s final, sir? Nothing can be done?”
The admiral shook his head. “I am dreadfully sorry.”
For a moment Fingal simply stared at the desktop, then he said, “Thank you, sir.” What else could he say? Damn you, damn your regulations, and damn the whole bloody war? To what purpose? He merely rose. “I’d better be getting back, sir.”
“Carry on, O’Reilly, and try to bear up.”
Fingal didn’t reply. As was fitting, according to regulations, damn them, he stood at attention, replaced his cap, about turned, and marched to the door. As he let himself out his only thought was simply, How the hell am I going to tell Deirdre?
11
Never Look Long upon a Monkey
“I want advice from the pair of you,” said O’Reilly. Slouched in the swivel chair in the surgery, he eyed the two youngsters and adjusted his half-moon spectacles. He and Kitty had arrived home on Saturday night after their most satisfying week in Barcelona and it was his turn to take the surgery this Monday morning. He’d asked his juniors to come into the office before he started seeing patients.
“I reckon,” he said, “you, Barry, should know how to screen for Rhesus isoimmunisation, and you, Jenny, fresh out of working with Doctor Graham Harley, will be au fait with what’s being done for it at Royal Maternity.” He spun around to the rolltop desk, picked up an antenatal record, and swung back to his colleagues. “Kinky met Lorna Kearney last Thursday in the butcher’s. Lorna’s expecting and Kinky told her to get in here today to start her antenatal visits.” He pointed with the folder at the door. “She’s out there now.” He looked from one to the other. “I need your help on her case.”
“Fire away,” Barry said, and Jenny nodded.
“Obstetrics has moved along since I spent a year as a junior in Dublin’s Rotunda Maternity Hospital in the late ’30s,” O’Reilly said.
“I don’t imagine,” said Jenny, “there’d have been much call for midwifery skills on your battleship either.”
Barry laughed. “Sounds like a sketch from TV’s That Was the Week that Was. Naval medical officer says, ‘Push please, Wren Petty Officer Joan Jenkins.’ Then another, very cultured English voice says, ‘Number two and three batteries. Fire.’”
“Eejit.” O’Reilly shook his head. “It might have happened in Nelson’s navy. Some wives were permitted to go to sea. But modern WRENs didn’t in my day, although some did fly aircraft. And the order to the guns is ‘shoot,’ not ‘fire.’ Goes back to wooden ships too. Yelling ‘Fire’ on one tended to upset people.” He smiled at the two, each perched on one of the patients’ chairs. “Now stop acting the lig, Barry. I really do need your advice.”
“Aye aye, Commander.”
“Thank you. Now, I’ve read about potential Rhesus blood group incompatibility between mother and baby. But I’ve never seen a case since I came to practice here. We didn’t know what the devil it w
as back in the ’30s. Just that, tragically, some babies died in the uterus and were swollen and oedematous when they were stillborn. That was called hydrops foetalis, and it was rare, but if it did occur it happened in pregnancy after pregnancy in the same woman. The Catholic church forbade contraception and the poor craytures conceived again and again with no hope of ever having a live baby.”
“That’s ghastly,” Jenny said. “Sometimes I think religions, all run by men by the way, have a lot to answer for when it comes to what they do to women.”
O’Reilly decided to avoid that discussion for the moment and continued. “Some other babies turned yellow after birth, icterus gravis neonatorum, and some of those did survive, but many showed signs of cerebral irritation. We called it kernicterus. They died about a week after they were born. We’d no idea what caused any of it. It was damned frustrating, I can tell you.”
“We do still see the same cases now,” said Barry. “But we are getting better at managing them, because we understand the condition now.”
“But Fingal, you could hardly have been expected to know about it,” Jenny said. “The Rhesus factor wasn’t discovered until 1940, and I imagine that you’d have been too preoccupied with the results of the Battle of Britain and trying to win the war to be paying attention to current civilian medical research into blood groups.”
“You’d be right,” O’Reilly said. “Although patient-to-patient blood transfusion was being done, it was discouraged in ships at sea. A blood transfusion service was eventually set up at a hospital called Haslar near Portsmouth. I worked there in 1940, but the transfusion service came in after I’d left.”
Jenny said, “It was way before our time; I was only one.”
“And I was born that year,” Barry said.
“But I know about Lansteiner and Stetson,” said Jenny, glancing at Barry. “In 1940, they discovered that 83 percent of the human race shared proteins on their red blood cells with the Rhesus monkey, but that 17 percent did not. The first ones were said to be Rhesus positive and the others Rhesus negative. Now we know that a baby’s blood cells can get into the mother’s circulation, usually in a first pregnancy. Then in 1941—is that right, Barry? Was it just a year later…”