As the last layer was removed, Fingal sniffed at it. Nothing out of the ordinary. Gas gangrene had a characteristic stench and was always a fear when a wound became infected. He saw the gauze was spotted brown from a tiny amount of old blood, but also there were streaks of yellow and that meant pus. Infection. Damn it all, the man should have had sulpha.
Fingal bent to examine the stumps. Both were swollen, red, and no doubt would be hot to the touch and painful. But it would serve no useful purpose to cause more pain to confirm a diagnosis that was plain as the nose on Henson’s face. The injured fingers were exhibiting the classic signs of acute inflammation: tumour, swelling; rubor, redness; calor, heat; and dolor, pain. Fingal looked at the wrist and shook his head. A thin red line extended from Henson’s wrist to halfway along the forearm. Lymphangitis. The infection was spreading. “Just want to have a feel in your armpit,” he said, and slipped a hand under Henson’s bed jacket. He began to palpate. Nothing out of the ordinary. He’d not expected there to be. The axillary lymph nodes would be the last defence, a string of redoubts, across the path of the invading forces of infection marching up the lymphatic channels. The spearhead of their advance was still in the forearm. When the nodes were involved they would be enlarged and feel rubbery to his fingers, but they would slow up the bacteria—for a while.
Once the nodes were overwhelmed, the microorganisms would have access to the patient’s bloodstream and cause septicaemia—often called blood poisoning—and, frequently, death.
“All right,” he said, “I’m afraid you’ve got a bit of wound infection, Henson. Can we get our hands on some sulphanilamide or sulphapyridine, Sister?”
“Yes, sir.” Somehow she sounded doubtful. Why?
“Good.” He put a reassuring hand on Henson’s shoulder. “We’ll have you right as rain in no time.”
“Please, sir. Please.”
I hope we can effect a cure, he thought, but it still doesn’t solve the problem of the man’s future. “I think,” Fingal said, “we should leave the hand open to the air.”
Sister nodded, clearly approving, and, the Lord knew, she’d managed more wounds than Fingal had had hot dinners. She said, “Thank you, Lieutenant-Commander. My nurses will see to the patient, but if you can spare a moment…?” She inclined her head toward her office.
Fingal frowned. What? Had he done something wrong? Damn it, he had a mile to walk to get home to Alverstoke and to Deirdre, and he really wanted to get started. He said, “I’ll pop in and see you tomorrow, Henson. I hope you’ll be on the mend by then.”
“Thank you, sir.” With his uninjured hand Henson grabbed Fingal’s arm. “You’ve got to fix it.”
Fingal unclasped Henson’s hand. “I’ll do my very best,” he said. “I promise.”
Sister was already heading for her office and Fingal followed. Whatever was on her mind, he wanted to get it sorted out.
“Sit down, Fingal,” she said.
“Thanks, Elizabeth.” After nearly six weeks of working together, they were on Christian name terms out of the hearing of other staff. “What’s wrong?”
“Surgeon Commander Fraser doesn’t believe in sulphas. He is convinced that the only guaranteed treatment for limb wound infection is immediate amputation.” She pursed her lips. “I thought you should know.”
“But that’s palpable nonsense. Sulphas have been accepted as routine treatment for infection for almost five years now. Ever since President Roosevelt’s son was cured of a strep throat back in ’36. It was written up in Time and reported worldwide, for God’s sake.”
“I know. I know. But that’s not good enough as far as Surgeon Commander Fraser’s concerned. Last year he had two patients die in spite of having been given massive doses of sulpha. He’s only interested in saving lives, not limbs. And he’s the chief of surgery.”
“I’m interesting in saving lives too. But amputation? That’s bloody barbaric. I suppose he uses rum as an anaesthetic too, just like Nelson’s surgeons.”
“No. He’ll use an anaesthetist, but I’m afraid it’s true about his treatment of choice.”
“But…” There was no hope of a one-handed man staying in the service. “Henson desperately wants to make the navy his career. He’s a very bright young man and his instructor told me the lad has a real future as a gunner in the navy.” Fingal’s shoulders sagged. He felt his spirits sink.
Sister Blenkinsop nodded, tutted, and grimaced. Then a very small smile flitted across her angular face. “How would you feel about a bit of subterfuge?”
Fingal frowned. “How?”
“The Zymotic block.”
“The fever isolation wards?”
She nodded. “We still use them for contagious cases. Look, so far all that is recorded is that Henson has a temperature and rapid pulse. Signs of fever. Commander Fraser is only interested in things he can operate on…”
A trait common to many surgeons, Fingal thought. When all you have is a hammer, everything looks like a nail. He had a vivid picture of Fraser’s standard opening of the abdomen with a flourish of his scalpel like the coup de grace of an expert swordsman.
“I suggest you make a note that you think Henson is coming down with something infectious, like measles perhaps, something that could sweep through this ward, and have him transferred to the—”
“Zymotic block. Brilliant, Elizabeth.”
“It’s not entirely without risk to you. If Fraser finds out…”
Fingal laughed. “What the hell’s he going to do to a younger doctor who made an honest mistake? Court-martial me? Have me drummed out of the service? Hanged at the yardarm? Keelhauled? Elizabeth, you are a genius.”
She dismissed his comment with a wave of her hand. “If you’re happy, I’ll phone over to your opposite number over there. Surgeon Lieutenant Imrie. He’s a decent chap, and when I explain I’m sure he’ll play along. If your sulpha works. They don’t always, you know.”
“We’ll be sure in thirty-six hours.” Fingal felt his spirits rise. “Damn it, Elizabeth, I’ve been using sulphas since ’36. I’ve lost count of the sore throats, ear infections, urinary infections I’ve treated in general practice with them.”
“I believe you, Fingal. And I want it to work too. And once it has, you can report back to Fraser that Henson’s hand’s well healed. That’s all he’s interested in, and that you’ll arrange for Henson’s discharge and follow up. It’s a fair stretch of the legs to the Zymotic block, along the arcade, then down a path that runs diagonally behind Saint Luke’s and past the back of the Medical Officers’ Mess. The old designers weren’t stupid. They wanted to keep infectious cases well away from the rest of the hospital. Commander Fraser is not one for hiking. If the sulpha works, I’m sure Fraser will never find out.”
“It’ll work.”
“And if it doesn’t?”
Fingal shook his head. “There’s no need to jump the gun. Either the drug will work or the lymphangitis will spread and his fever won’t break. If that happens, Henson will need an amputation, but at least he’ll have been given a chance and it still won’t have put his life in jeopardy.”
“And what about you?”
“Me?” He remembered Fraser snapping, “I’ll expect my orders to be obeyed in future.”
“You’ll have to bring Henson back here. Face Fraser.”
“That won’t be easy, I agree,” said Fingal. “You remember getting the fighter pilot to East Grinstead?”
She smiled. “Best thing that could have happened to him, even if Commander Fraser wasn’t pleased.”
“Not pleased? That’s putting it mildly. I tried to discuss Henson with Fraser yesterday. No go, so I asked for Angus Mahaddie’s counsel about how to make sure Henson could stay in gunnery school.”
“And?”
“Fraser has lodged a complaint with Angus, my departmental head, about the burned pilot, and has made it clear that anaesthesia is not to interfere with surgical patients again.”
“And he is w
ithin his rights. An anaesthetist has no authority over a surgeon,” she said.
“Bloody departmental chain of command. Ordinarily Angus would outrank Fraser, but some civilian practices have crept into the medical side of the navy.”
“And that’s usually all to the good.”
“Not in this case.”
“But despite that warning, you’re still willing to chance it?”
Fingal didn’t hesitate. “Henson’s hand, his future, are a damned sight more important than any bottle Fraser can give me.” He saw her smiling at him and realised that she too was taking a risk, and nursing here at Haslar was her career. “I’m putting all my money on the sulpha,” he said, “and if I’m wrong, it’ll be all my fault, because, Elizabeth, I, as a medic, officially outrank you as a nurse, and if the worse comes to the worst, you can let it be known that you had no choice but to lodge a protest and then obey. Isn’t that true?”
She looked him right in the eye and paused.
“Isn’t that true?”
“Fingal O’Reilly, when this lunatic war is over and you go back to your peacetime practice, you’ll have some of the luckiest patients in Ulster.”
He blushed.
“I mean it,” she said. “Now if you’ll just write the orders for Henson’s transfer, I’ll call Surgeon Lieutenant Imrie. Make sure he’ll start the sulpha M&B 693, sulphapyridine and give Henson aspirin to bring his temperature down as soon as our man arrives.” She handed him the chart.
Fingal was chuckling as he wrote.
“All set,” she said when she returned. “I’ll get a wheelchair and an SBA to take him now.” She frowned, then said, “You told me he wants to make the navy his career?”
“Absolutely.”
“And you know our job is to get men back to their units as soon as possible. I reckon if the RAF’ll let a bloke with two tin legs fly Hurricanes in battle?” Her left eyelid drooped and opened and she grinned.
“Douglas Bader.”
“Mmmm. I reckon the navy’ll be happy to have a slightly damaged but highly skilled gunner back.”
He said, “I’m sure a call from me to Henson’s divisional officer would carry enough weight. I’m not a mere lieutenant now but an experienced senior medical officer with the cuff rings to prove it. We’ll not bother Angus unless it becomes a court of last appeal situation.” Fingal stood, gave her a quick peck on the cheek, and said, “Sister Elizabeth Blenkinsop, I love yah, and Henson will love you more.”
“Leading Seaman Henson will never know,” she said, “because no one will tell him what we’ve done. But he seems such a nice young man, and I hate to see anyone’s dreams shattered. It’s up to your sulpha now, Doctor, and I hope to God it works.”
31
A Bargain Dog Never Bites
O’Reilly, with Arthur at his heel, heard the swing door close behind him. The Duck was its comfortingly familiar self: tobacco smoke, beer fumes, laughter, dimly lit. He waited for his eyes to adjust so he could spot Barry. Snatches of conversation ebbed and flowed. “Glentoran over Linfield?” That was Gerry Shanks talking to his friend Charlie Gorman. “Away off and feel your head. Glentoran couldn’t beat the skin off a rice pudding.”
“I see them Yanks has let off another atom bomb in Nevada the day.” O’Reilly recognized Helen’s father, Alan Hewitt, and wondered if the lass was busy getting ready for her date tonight with Jack Mills.
“And you mark my words. You mark my words.” An index finger was jabbed on the bar top for emphasis. “It’s them bombs that’s buggering up our weather over here, so it is.” That was the dour Mister Coffin, the undertaker.
Faces turned to the newcomer and all conversation stopped as, to a man, the room said, “Evening, Doctor. How’s about ye?”
“Evening all,” O’Reilly said, spotting Barry at the bar, holding a nearly full pint. O’Reilly moved to join him. “Pint, please, Willie.”
“Right you are, sir.” And Willie Dunleavy immediately got a pint of Guinness on the pour. “Arthur?”
“He’ll get his Smithwick’s a bit later.” O’Reilly looked round. The noise level of the place, now greetings had been exchanged, had returned to normal Saturday-afternoon levels. The room was packed. Not even much room to stand at the bar. He frowned, then he noticed Donal Donnelly sitting with Dapper Frew and beckoning. “Just a minute, Donal,” O’Reilly called, and turned to Barry. “How are you, lad?”
Barry shrugged. “I went down to the yacht club. Your old recipe of keeping yourself busy helped. I’m still worried, but if it can’t be cured it has to be endured.” He smiled. “I’m going to try to take your advice, believe there’s nothing to worry about—and hope to hell you’re right.”
“Good for you, and”—he inclined his head to Donal’s table—“whatever Donal wants to tell us might just prove to be a little more of a distraction for you. Are you up to it?”
“Of course I am, Fingal. I’m not sick,” Barry said with an amused smile. “How’d the bird count go?”
“Great afternoon out on the lough. Lars was in excellent form.”
“Your pint, Doctor,” Willie said, handing O’Reilly his drink.
“Ta, Willie. And we’re going to sit with Donal. Bring over Arthur’s Smithwick’s like a good fellah.” O’Reilly turned to Barry. “Doctor Laverty will settle with you later.”
Barry grunted, but smiled and said, “Cheaper than the five-pound bet I’d have been very happy to lose at Christmas.”
“Just be happy by Christmas and for tonight. Come on, Barry, let’s see what’s on Donal’s mind.” O’Reilly moved ahead like a dreadnought through a fleet of corvettes and shouldered his way to where Donal and Dapper were sitting.
“Evening, Doctors.” Councillor Bertie Bishop was at a table nearby with a stranger. “This here’s a friend of mine from Belfast, Ernie Ramsey. He’s with the Belfast Chamber of Commerce.”
“How do you do?” Barry said.
O’Reilly grinned. Barry’s public school education was shining through. Even after all these years of hearing that greeting, O’Reilly still wanted to ask, “How do you do what?”
“Rightly, sir. Grand altogether.”
“Welcome to Ballybucklebo,” O’Reilly said.
The man smiled.
“I’ll not hold youse up, Doctors,” Bertie said. “Away you on and sit with Dapper and Donal. I hear he’s getting some kind of rare Australian dogs?”
“News to me,” said O’Reilly with a straight face, keeping his promise to Donal not to let on that he was in on the secret. “I’m sure he’ll tell us all about them. Enjoy your evening.” He led Barry to Donal’s table.
Two other men were standing there finishing pints. “Shuey and Sammy’s just leaving, so they are,” Donal said, “so if youse would like til sit with Dapper and me, sirs, we could have a bit of craic.”
Barry said, “How’s the knee, Shuey?” Barry was treating the ninety-year-old for osteoarthritis.
“I’m still getting about, so I am, but I reckon your man Roger Bannister—”
O’Reilly could remember the excitement when the young physician had broken the four-minute-mile barrier twelve years ago, at the time considered an impossible feat. If Bannister had had Sergeant Livingstone on his tail, he might have gone even faster.
“I reckon thon boy could outrun me now, so he could,” Shuey said.
Everyone in the company laughed.
Sammy, Shuey’s sixty-seven-year-old son, said, “Youse can laugh now, so yiz can. But you should have seen my da fifty years ago. Even when he was forty, he was still the best runner with the South Down Beagles, and you’ve til be bloody fit to run cross-country behind a pack of beagles chasing a hare, so you do. That ould saying ‘He runs like a hare’ isn’t because hares are members of the snail family.”
While there was a general muttering of assent, O’Reilly wondered if all the exercise—Shuey had been a shepherd and a keen oarsman as well—was the source of his longevity, and if the beagling cou
ld have been the cause of his arthritic knee.
“Take it easy, the pair of youse,” Donal said.
“Fair enough, Donal,” said Shuey, and leant on his son’s arm. “Good night all.”
O’Reilly and Barry sat. “Under,” O’Reilly said, and Arthur lay down beneath the table. “Sláinte.” O’Reilly drank, savouring the bitter taste.
Donal said in a low voice, “The cat’s out of the bag now about the Woolamarroo quokka dogs. Wee Colin told a wheen of his friends at school and they told their mammies and daddies, and now everybody knows.”
“Bertie Bishop certainly does,” O’Reilly said.
“’Scuse me.” Willie had come over with Arthur’s bowl.
Barry paid and said, “So what’s the next step?”
“Everybody knows Donal will be getting them on December the tenth,” Dapper said. “Now,” he lowered his voice, “til avoid any suspicions, like, Bluebird’ll come and lodge with me when prospective buyers come over so she doesn’t give the game away when people start taking her pups.”
Mary Dunleavy’s Chihuahua, Brian Boru, the unwanted sire, wandered over and stopped at the table.
Donal, to O’Reilly’s surprise, leant down and patted the wee dog’s head. “Good boy.” He straightened up. “No point bearing a grudge.” His voice was barely audible over the pub’s din. “The wee man was just doing what comes natural. And if our scheme works, and we make a bundle, he’s the one responsible. Bloody good thing he’s a long-haired Mexican. Makes the pups look less like greyhounds. In fact, them funny-looking craytures are like no dogs I’ve ever seen in my whole puff, so they’re not.”
Brian Boru disappeared under the table to see his friend Arthur, and the sounds of lapping doubled.
“I thought at first it was a disaster,” Donal said, “but it’s looking better now. Just goes til show that it’s a sick wind that blows nobody any good.”
“Ill wind, Donal,” O’Reilly said.