A Dublin Student Doctor (27 page)

“Go on.”

“Lars and I talked things through on Friday then went wildfowling on Saturday morning. We left the shore and set off in his car for Belfast in plenty of time to catch the Dublin train and be with you that evening. His car broke down. I missed the train. Spent the night in Belfast with a friend. I’m sorry.”

She inclined her head. “Fingal, it’s all right. You did let me know, and we’ll be able to get together—”

“Mister O’Reilly. Nurse O’Halloran.” Sister Daly had come round the corner. “You two know the rules. You, Nurse. Back to the ward. At once. You’re late. I’ll speak with you later.”

Kitty fled.

Fingal sought for anything he could say to protect Kitty from the wrath of Sister, but she forestalled him.

“I warned you, Mister O’Reilly. I warned you when you started here. Doctor Micks will not be pleased.”

Was there any point pleading now? He shook his head. All he could do was say, “I am truly sorry.”

There was iron in her voice. “I’ve watched you since you started. You are gentle with your patients and you care—perhaps too much. You are developing good diagnostic skills. I’ve seen generations of students. I know how to judge them. One day, when you’ve grown up, you will make a fine physician.”

Fingal held his peace.

“I will think about you for the next two weeks and I will decide whether or not I believe my suggesting to Doctor Micks that an extra six months repeating this clerkship might help you achieve the maturity that you currently lack.”

“Thank you, Sister.”

“But you will not be seeing Nurse O’Hallorhan during that time. I shall arrange for her to be transferred to the children’s ward and I will be having a word with the lady superintendent to ensure Nurse O’Hallorhan is confined to barracks for the rest of March.”

24

And Great Was the Fall of It

“Are we certain we want to go ahead?” Charlie asked, sprawled in a chair in the students’ common room. He nodded to where Fitzpatrick had hung his white coat.

“Bloody right I am,” said Fingal. “In twenty minutes we’ve to be in the lecture theatre with Doctor Micks, the patient with valvular disease, and the learnèd professors of the Pilgrims. It’s a brilliant opportunity to prick Ronald Hercules’s balloon.”

“Hear him,” Cromie said, and ran a hand through his thin hair. “Hear him.”

“I know it’s what we’ve planned,” Charlie said, “but, Fingal, so far you’ve been on your best behaviour. It’d be a shame to spoil it just to put one over Fitzpatrick.”

In the last two weeks Fingal had done everything possible to appease Sister Daly and impress Doctor Micks. Today, with a bit of luck, Sister would agree not to report Fingal after all, and in one more week he’d get that certificate of good standing from Doctor Micks.

“I think the risk’s worth it,” Fingal said. “We’ve put up long enough with Fitzpatrick’s arrogance, his disregard for other people’s feelings.”

“But Charlie has a point,” Cromie said. “Our three months in psychiatry starts next month and we want you with us. And for the surgical dressership in July.”

“After Finals Part One,” Fingal said, looking straight at Bob Beresford. “We all have to pass in June.”

“Well, actually, no,” Bob said. “We don’t. As long as we have our certificates we can continue our clinical studies and repeat Part One six months later. The
Regulations
say so. I should know. God knows how many cracks I took at Intermediate Part Two.”

“And,” Fingal asked, “how many goes at Finals Part One were you thinking of having, Bob?” Fingal had had a heart-to-heart with Bob two weeks ago, but it clearly had been as much use as farting into a force-ten gale.

Bob reddened. “Well I—that is—”

“Haven’t been studying quite as hard as you might?”

Bob looked away, then smiled and said, “You all know I’m in no rush to qualify, which is why I have a suggestion to make about our plan for the downfall of Fitzpatrick.”

“Go on,” Charlie said, glancing at the coat again, “but I reckon if we all confess—if we have to—Micks won’t hold us all up.”

“I’ve a better idea. I know getting qualified as quickly as possible is important to you three.” Bob shrugged. “I’ve all the time in the world.” He lit up.

“What are you suggesting, Bob?”

“I don’t believe Doctor Micks is going to be too enthralled when we pull this off. We’ll embarrass Fitzy all right, but we’ll embarrass Doctor Micks too.”

“Come on,” Fingal said. “Our chief’s not going to treat us like schoolkids. He’ll see the funny side.”

“If he doesn’t?” Bob asked.

Silence.

“I’ll tell you,” Bob said. “We act as planned, but if Micks demands to know the perpetrator, I’ll be happy to own up.”

Fingal said, “A regular Sydney Carton, ‘It is a far, far better thing I do now—’”

“
Tale of Two Cities,
” Charlie muttered. “Dickens.”

“I’m not so sure I want you going to the guillotine for us, Bob.”

“Facing Doctor Micks is not facing beheading. He might let me off.” He hesitated then continued, “And you’re right, Fingal. I haven’t been working as hard as I should. I’m not sure repeating the medical clerkship would necessarily be a bad thing for me.”

Fingal said deliberately, “All right, but on one condition if the other lads agree.”

“Which is?” Bob asked, and blew a lazy smoke ring.

“Which is, Bob Saint John Beresford, you make a solemn promise here and now—”

“To what?” The smoke ring collapsed.

“To use the next three months to get stuck into the books and bloody well pass Part I with us. We’ll help, won’t we, lads?”

Both grinned and their heads nodded. “Indeed we will,” Charlie said.

Bob’s jaw dropped. “That’s blackmail.”

“Yes,” Fingal said with a grin, “but it’s in a good cause.” He held out his hand and eventually Bob shook it. “It’s a promise, Fingal Flahertie O’Reilly,” he said to the applause of the other two. “But you’re one crafty devil. You’re the Wily O’Reilly, by God.”

“Wily O’Reilly,” Cromie echoed. “I like that.”

“Och sure,” said Fingal as he stood and removed Fitzpatrick’s white coat from its hook. “Dat’s all right.”

*   *   *

Fingal and the rest stood round a trolley upon which lay a young man with sandy hair, blue eyes, and a narrow nose between plum-coloured cheeks. He was propped up on pillows and his pyjama jacket was unbuttoned.

The trolley was positioned head toward a blackboard, feet to the semicircular tiers of benches and the members of the Pilgrims. Fingal scanned the faces of the soberly dressed men. Victor Millington Synge, physician to Baggot Street Hospital and recently appointed King’s Professor of the Practice of Medicine at Trinity College, sat in the centre of the front row.

“Pilgrims, welcome to Sir Patrick Dun’s,” said Doctor Micks. “We’ve a full day arranged where you can visit our new facilities, observe a new surgical procedure, and, of course, the banquet in the Royal College of Physicians this evening. But first we’d like you to see our students in action. Mister SH here is used to his trips to Sir Patrick’s. He is a willing volunteer when we need to demonstrate his condition and has often been used as a case for our students to diagnose in the medical part of their Finals Part II practical exams. How often?” he asked the patient.

“I’ve bin an exam case turteen times, sir.” He grinned. “It’s a great day out for me. Gets me away from herself and the feckin’ chisellers. And the hospital gives me a grand lunch. And I’ve learned a fair bit of medical lingo.”

“Quite,” said Doctor Micks.

Fingal saw Professor Synge smiling broadly at Mister SH’s last remark. The professor was in his midfifties and bore a striking resemblance to the pictures of his famous uncle. His hair had receded as far back as his ears and from there a central patch of shiny pate was surrounded by a rim of hair. He wore spectacles and was paying attention as Doctor Micks said, “And the net result of his condition has been damage to the heart’s valves.”

Fingal glanced at his classmates. Hilda had been let in on the plot. She and the three others looked innocent. Fitzpatrick was staring eagerly at Doctor Micks, who said, “Here at Sir Patrick Dun’s we take pride in our students being well grounded in the finer points of cardiac auscultation.

“We have here today six typical, late-fourth-year Trinity students. I should like one to examine the patient.”

Fitzpatrick nearly tripped in his haste to step forward.

“Very well,” Doctor Micks said.

If the swelling of a pigeon chest was ever accompanied by an explosion, Fingal thought, the attendees would have been deafened.

The assembled professors leaned forward.

Fitzpatrick, a supercilious smile on his lips, fumbled in the pocket of his white coat, produced his stethoscope, plugged in the earpieces, stepped forward, and without a word to the patient clapped the instrument on his chest.

By the way Mister SH flinched, the bell must have been cold.

“There is a—” Fitzpatrick frowned, moved the bell a couple of inches. “There is a—” He blanched. Beads of sweat appeared on his forehead. He pulled out the earpieces, stuck a finger in each ear in turn, replaced the earpieces, stared at the bell, and put it on the patient’s chest. He remained immobile, then shook his head. “I can’t hear anything,” he said hoarsely. “Nothing. Nothing at all.”

Fingal didn’t dare look at the lads.

A muted murmuring arose from the audience.

“Well,” said Doctor Micks, “anyone can have an off day.”

“Excuse me,” Professor Synge asked. “May I see that stethoscope?”

Fitzpatrick crossed the well of the theatre and handed over the equipment in question.

Meanwhile Doctor Micks, with a scowl like thunder, said, “Miss Manwell, please.”

Hilda approached the patient. “Hello,” she said, “I’m going to examine you.”

“Ah sure, grand,” he said, “and such a pretty wee mott, yiz can be my doctor anytime.”

Hilda smiled and bent to her work.

Fingal snatched a glance at Professor Synge, who had removed the bell from Fitzpatrick’s stethoscope and was fishing up the rubber tubing with a narrow propelling pencil.

Hilda said, “I’m pretty sure I can hear an opening snap—” her brows knitted, “a low-pitched rumbling diastolic murmur, and—and presystolic accentuation.” She straightened and looked at Doctor Micks.

Fingal hoped she was right. He had learned that there were many combinations of sounds depending upon which valve or valves of the four in the heart and blood vessels were damaged.

The patient said, “You take the prize, miss. Dat’s w’at all the professors say.”

Doctor Micks smiled. “Well done, Miss Manwell. Very well done.” He addressed the audience. “I can assure you she is absolutely right, gentlemen.”

“That’s impressive, young woman,” Professor Synge said. “And Robert—”

Fingal realised he was addressing Doctor Micks.

“Don’t be too hard on the young man. It would be impossible to hear anything,” he held up the offending objects, “when the tubing of your stethoscope is stuffed with cotton wool.”

The laughter began slowly, but soon everybody was laughing—everybody but a red-faced Fitzpatrick.

Doctor Micks cleared his throat. “Very well. Now Mister O’Reilly?”

“Yes, sir.”

“You heard Miss Manwell. Those murmurs are diagnostic of?”

“Mitral stenosis, sir.”

“Sure it’s not mitral incompetence?”

“Yes, sir. The systolic murmur of that occurs when the ventricle contracts in systole, not when it relaxes in diastole.”

“Good.”

There was a small round of applause. Doctor Micks smiled and inclined his head to the audience.

“If you’ll excuse me, Robert?” Professor Synge said.

“Of course.”

“I think I can speak for all of the Pilgrims when I say we are impressed with your last two students and have sympathy for the first.”

There was a muttering of assent.

“You have every right to take pride not only in the skills of your students, but in their sense of humour. That’s only the second time I’ve seen the cotton wool trick. The first was when Edgar there,” he pointed at another Pilgrim, “did it to me in front of old Professor Purser.”

To a man, the Pilgrims chuckled.

“Thank you, Victor,” Doctor Micks said. “Most understanding.”

“I take it,” Professor Synge continued, “these youngsters are near the end of their clerkship?”

“They are,” Doctor Micks said. “They have one more week to go. Sister’s reports earlier today on them are all favourable.” He glanced at Fingal.

What? I love you, Sister Daly, Fingal thought. The minute I’m out of here I’m off to the ward to thank you.

“And unless one of them commits a felony in the next seven days they’ll all be getting their certificates of good standing.”

Fingal wasn’t sure—but had Doctor Micks actually winked at him?

“In view of Professor Synge’s intercession I shall ignore the recent—um, incident.”

“I’m delighted to hear it,” Professor Synge said. “It’s not so long ago we were students ourselves. Good luck to you all.” He looked at Fitzpatrick. “Don’t take it too hard, son. We all had a good laugh.”

The look Fitzpatrick gave O’Reilly might have been lethal. So what? Fitzpatrick had been punished and the dark cloud hanging over Fingal had blown away. He’d have no difficulty persuading the lads to head to the Bailey for a few pints.

He’d miss Saint Patrick’s Ward and Doctor Micks’s regular teaching sessions, but it was time to move on to new aspects of the trade. And they’d be back on the old ward with its black walls and painting of Saint Patrick and Oisín in July to start their surgery.

25

That Where Mystery Begins

“Life as a medical student,” observed Cromie, from his seat in Davy Byrnes pub, “as I have before remarked, is one of long periods of relaxation punctuated by short spells of intense horror.” He took a pull from his pint.

“Horror as in the Finals Part One exam in sixteen days,” Fingal said, swallowing a mouthful of Guinness then emitting a puff of smoke. He could afford Erinmore Flake these days. The better tobacco was pleasant and so was the restoration of diplomatic relations with Father.