An Irish Country Doctor (25 page)

She smiled.

"Kinky, could Julie MacAteer be working for the Bishops?" 

Kinky's small black eyes narrowed. "Aye, so." 

"Could we find out?"

"On Monday I'll be going to the Women's Union. Mrs. Bishop's a member."

"Could you ask her?"

"I will, so."

"Good. What kind of woman is Mrs. Bishop anyway?" 

"She's no oil painting but she's a decent soul. What she sees in Ulster's answer to Adolf Hitler is beyond me. I suppose she didn't want to end up as one of nature's unclaimed treasures." 

"She must have been pretty hard up to take him." Mrs. Kincaid's chins wobbled as she chuckled and said, "Hard up? Maybe for a husband, but she'd inherited a parcel of money from her father. Adolf didn't have two pennies to put on the eyes of a corpse before he married her." 

"Interesting," said Barry, finishing his tea. He heard the front doorbell.

"I'll see who that is," said Kinky.

"It's all right, Kinky. I'll go." It might just be my first patient, Barry thought, looking at his watch. "I've plenty of time before I've to get ready." 

"Aye, so," said Kinky, as the bell jangled again. "You're just like himself when he started here. Raring to go like an angel of mercy on roller skates."

As he left the lounge he saw her smile like a mother whose youngster has just won a Sunday-school prize.

A large, familiar-looking woman stood on the step. She wore a straw hat and a floral-patterned dress with the dimensions of a small bell tent. Barry noticed her white court shoes, over the edges of which the flesh of her ankles drooped. "Doctor Laverty?"

"Yes."

"Could I have a wee word?"

"Certainly, Mrs . . . ?"

"Sloan. Cissie Sloan. I'm one of the tonics." Her voice was coarse and rasping.

"Come into the surgery." Barry stood aside to let her squeeze past. She was the one who'd been wearing her stays when O'Reilly had tried to inject her with vitamin B12. "What can I do for you?" He closed the door and went to the swivel chair.

She perched her bulk on the patients' chair. "Cold in here," she said.

Barry was surprised that she felt cold as the room was overly warm.

"I feel the cold something chronic."

"Do you? Is that why you came?"

She shook her head. "I've been under Doctor O'Reilly for six months, and he's doing me no good."

Barry controlled his smile despite his mental picture of the gargantuan Mrs. Sloan being mounted by an enthusiastic, but clearly outclassed Doctor F. F. O'Reilly.

"I come for a second opinion. He's away, isn't he?" 

"Yes." News travelled so fast in Ballybucklebo, Barry thought, that it must practically attain the speed of light. 

"Donal Donnelly's my nephew. Him and his dog and Doctor O'Reilly's away to Belfast. Donal told me. The day you come here, Doctor O'Reilly said you was the youngest doctor that ever won a prize for the learning."

"Well, I-"

"So I want you to tell me what's wrong with me."

"I'll try. Can you give me a few clues?"

She pushed herself back into the uneven chair, folded her meaty arms, and grunted. "I thought you were an expert. Finding out's your job."

"I know, but I do have to take your history, perhaps examine you." 

"Ask away then."

Barry, with great patience and with growing concern that the consultation would make him late for Patricia, managed to mine a few nuggets of clinically relevant information from the slag heap of Cissie's detailed reminiscences; reminiscences delivered in a husky, drearily slow monotone. "I first took poorly on a Thursday. No. No. I'm wrong. It was the Wednesday that Donal's other dog died. The one with the wee short tail. . . So I said to Aggie, that's Aggie Arbuckle that was . . . now she's Mehaffey. Married to Hughie, him that's Maggie MacCorkle's second cousin . . . on the mother's side . . . Anyway, Doctor O'Reilly says to me . . . you know what he's like . . . you'd think he was Jehovah giving out the Commandments to Moses . . . he says to me, 'You're run down, Cissie. You need a tonic' And here's me taking the tonic every six weeks for six months and I'm no better--" 

"Right, Mrs. Sloan." Barry finally managed to stem the tide. Let's see if I've got this right. You've been tired for six months and it's getting worse?"

"Aye."

"You feel the cold?"

"I do."

"Muscle cramps?"

"Desperate. In my legs. And you'll not believe this, Doctor. I've been putting on weight."

"Never," said Barry, inwardly congratulating himself for being able to keep a straight face. "Has any of your hair fallen out?"

"How did you know that?"

Barry ignored her question but asked, "Are you constipated?" 

"Constipated? I've been like an egg-bound hen for months"-- she dropped her voice to a whisper--"and I haven't seen my monthlies since January."

Barry tapped his pen against his teeth, leant forward, and peered at her face. Her eyebrows stopped about two-thirds of the way to the corner of her eyes. Her complexion was pasty yellow, and there were puffy bags beneath both eyes.

"Let me have a look at your neck." He stood and moved behind her chair. "It's all right, I'm not going to strangle you," he reassured her, as he placed his fingers over the front of her throat. Underneath the fat he could feel a solid, rubbery mass. Barry stepped back. She was right. She wasn't simply tired. She had all the classical manifestations of an underactive thyroid gland. Fingal had missed the diagnosis.

"What do you think, Doctor?"

Barry coughed. He was unsure how to answer her honestly and at the same time preserve O'Reilly's professional reputation. "I'm not sure," he said. "We'll need to arrange a test at the hospital." 

"The hospital?"

"I'm afraid so."

"Have I cancer?"

Barry flinched. It was possible, but her thyroid gland was smooth, not hard and craggy. "I don't think so." He saw her relax. "I think your thyroid is a bit underactive."

"Why'd O'Reilly not do the test?"

"Urn . . ." Lord. The truth was that he'd probably been in a hurry and had missed the diagnosis. "It's new. I only heard about it this year."

"See. I was right to come and see you."

"But if the test shows what I think it'll show, we'll need Doctor O'Reilly to prescribe your treatment. He's much more experienced than I am." Two weeks, Barry thought, it had taken only two weeks for him to start bending the truth, but he couldn't let O'Reilly down. "Would you like me to explain to you about the thyroid and the test?"

She shook her head. "Not at all. I'd not understand a word. Just you fix it up. You can tell me when you get the results." 

"I'll go and make a phone call," he said. "Wait here." The laboratory was still open when Barry phoned. Yes, they'd arrange for her to have a radioactive iodine uptake test. Could he fill out a requisition and ask her to bring it with her to the metabolic laboratory at ten o'clock on Monday morning? "Here," he said, handing her the form. "Monday morning at the Royal. Go to the information desk. They'll show you how to get to the lab." 

"Thank you, Doctor Laverty, sir." She rose and left. 

"My pleasure," he said, and he meant it. He had been worried about being left all on his own, but unless something dramatic happened between now and half past six when he would leave to pick Up Patricia, he would be quite happy to feel just a little smug.

The Best Laid Plans of Mice and Men

Barry took one last look in the mirror. He probably hadn't needed to shave for a second time that day. He winced as the Old Spice aftershave stung. He brushed his hair, knowing that it was a futile gesture. Before long the tuft would be sticking up again like the crown of a broken hat, but at least he'd tried. He tied a half Windsor knot in his Queen's University tie. He glanced down. His shoes were newly polished and his corduroys pressed. He silently thanked Mrs Kin . . . no, Kinky.

He ran downstairs and into the lounge. Before he collected his sports jacket from where it hung on the back of a chair, he pulled out his wallet. One thing about being so damn busy, it didn't leave much time for spending money. He had almost thirty-five pounds.

Plenty.

He slipped into his jacket. "You behave yourself, Lady Macbeth. The white cat, who lay on the hearth rug, opened one eye.

"I'm off," he said.

The telephone began ringing as he cleared the last stair. He hesitated. O'Reilly had said to let Kinky take care of any calls. He lifted the receiver. "Hello?"

"I want to speak to Doctor O'Reilly."

"I'm sorry. He's in Belfast."

"Is that young Laverty?"

"It's Doctor Laverty, yes. Who's speaking?" He could overhear a conversation at the other end of the line: "O'Reilly's away." "I want to see O'Reilly." "You can't. You'll have to make do with Laverty."

He snorted and raised his eyes to the heavens at Kinky, who had appeared from her kitchen.

"Are you still there, Laverty?"

"Yes."

"This is Mrs. Fotheringham. It's very urgent." 

"I see."

"I want you to come at once. The major's been taken ill. Very ill." 

"What seems to be the trouble?" He glanced at his watch. Six fifteen.

"It's his neck. He's got a terrible pain in his neck." 

He is a terrible pain in the neck, Barry thought. "Could it wait until the morning?"

"I want him seen now."

Barry knew he couldn't justify sending for an ambulance for a man with a stiff neck. "Very well," he said. "I'll be right over." 

"Don't be long." The line went dead.

Barry replaced the receiver. "It's all right, Kinky. Major Fotheringham has a stiff neck. I'll just nip round there. It's almost on my way."

"Why don't you telephone your wee girl? Tell her you might be I late?" 

"I will." He lifted the phone and dialled. Damn it, the line was engaged. "Busy," he said. "I'd better get my bag." 

"You run on, Doctor, and don't you worry. I'll take care of things here. What's her number?"

"Kinnegar 657334." Barry charged into the surgery, grabbed his bag, and started to head for the kitchen. He stopped. Although Brunhilde was parked in the lane, he'd be damned if he was going near Arthur Guinness. He turned and left by the front door.

Gravel crunched underfoot as, bag in hand, Barry left the parked Volkswagen and walked to the house with the imitation coach lamps in the porch. Mrs. Fotheringham opened the door. She was wearing low-heeled, laced, brown brogues, thick lisle stockings, and a two-piece jacket and skirt of tweed Heather Mixture. An amethyst formed the head of a silver thistle brooch in her left lapel. Around her neck hung a single strand of pearls.

"Mrs. Fotheringham."

"Come in, Laverty. The major's in the drawing room." Her tone was haughty.

Barry followed her. He was amused by her changed attitude. The last time he had been here she had fawned over O'Reilly; now she was treating Barry like an underling. Mrs. Fotheringham must have clear views on the caste structure of Ballybucklebo. She was certainly dressed like the wife of a Scottish laird, and her "drawing room" was an upper-crust term for what most people called the lounge. "Laverty's here, dear," she announced, moving aside to let Barry precede her into a spacious room.

A fireplace, on the mantel of which stood an ornate ormolu clock, was flanked by two antimacassar-covered armchairs. Barry was disappointed not to see a potted aspidistra in a corner. The clock said six thirty-five. He'd better get a move on. "Major Fotheringham," Barry said to his patient, who lay on a long sofa between the armchairs. "How are you?"

The major put a limp hand to the left side of his neck, between the jawline and the top of an immaculately tied cravat. "It's my neck," he said.

"What seems to be the trouble?"

"It's awfully stiff."

"When did the stiffness start?"

"This morning, so we thought we'd better ask Doctor O'Reilly to visit before it got too late."

In case he might want to do another all-night test, Barry thought. "Were you doing anything when the stiffness started?" he asked. 

"He was carrying stepladders," Mrs. Fotheringham said. "I told him to wait for the gardener, but not my husband." She sniffed. 

"You've probably just strained it." Barry laid the back of his right hand on the major's forehead. Meningitis was one serious cause of neck stiffness. But if such were the case, the patient would have a fever, and the major's skin was cool and dry. "Could you sit up and take off your cravat?"

Mrs. Fotheringham moved forward to help her husband and i blocked Barry's view of the clock on the mantel. He reached out and took the man's wrist. It wouldn't hurt to take his pulse, and it gave Barry an excuse to consult his watch. Six thirty-seven and the pulse rate was normal. "Fine," he said. "Excuse me, Mrs. Fotheringham." Barry moved past her. "Just look into my eyes," he said to the major. Both pupils were the same size. No early clues of increased pressure inside the head there. "Show me where the stiffness is worst."

"It hurts when I try to put my chin on my chest. Mostly on the left."

Barry put a hand on the side of the major's neck. He could feel the tension in the sternocleidomastoid, the strap of muscle that runs from the clavicle to the base of the skull. It was probably a simple sprain or more probably torticollis, spasm of the muscle which was frequently a manifestation of hysteria. He could see the clock. Twenty to seven. "You've got a wry neck, Major Fotheringham." He saw Mrs. Fotheringham's shoulders tense, her lips purse.