An Irish Doctor in Love and at Sea (25 page)

“And if it is, what can youse doctors do?” His gaze was set on O'Reilly's eyes. “It'll break Lorna's heart if the baby dies.”

“It won't come to that.” O'Reilly managed a reassuring smile and said, “But we can do nothing for a while. We have to let the baby grow more. I'll not pretend it'll not be a worry, but things have come on in leaps and bounds since I was a young man in Dublin getting my training. There'll be more tests, then the experts at RMH—and they are experts—will decide what to do.” He put a hand on Reggie's arm. “It really is difficult to explain because there's a lot of, ‘If it's A we'll have to do B, or if it's not A we'll wait, and if it's C we'll do D.'” He met Reggie's gaze. “Can you understand what I'm trying to say?”

The farmer frowned. “Aye. I think so. It's like when the soil experts come down from the agricultural school and take samples. There's no point asking them what to do until they have the samples analysed. I think that's what you're trying til say, sir.”

O'Reilly nodded. “We'll be doing the next tests in about three weeks and we'll have a much better idea then. Can you trust us until then, Reggie?”

O'Reilly was shaken when Reggie Kearney stopped his needles' clacking, held out a big callused hand, and said, “We'd trust you with our lives, Doctor O'Reilly.”

O'Reilly seized the hand. He swallowed and said very quietly, “Thank you, Reggie. Thank you very much.”

“Aye,” said Reggie, “and I believe when you first explained to Lorna about them Rhesus monkeys, she told you we followed the Good Book?” He let go of O'Reilly's hand.

“She did.”

“So, no harm til you, Doctor, of course we trust you, but, well, we'll also put our faith in the Lord.” The words were said with a sincerity that moved O'Reilly, himself not a religious man.

He pondered for a while, seeking the right reply, then said, “You do that, Reggie. You do that, and here on earth us doctors, who are not gods, will be grateful for all the help we can get.”

“It's really none of my business, Mister Kearney,” the marquis said, “but I feel sure your faith, both in the Almighty and in your doctors, will not be misplaced, and I wish you and your wife and your new baby when it arrives the very best of everything.”

“That's very decent of you, sir.”

“And with your permission, if Doctor O'Reilly will notify me of the birth, I'd like to give the child a christening present as a small token of my thanks for an excellent afternoon's sport and for letting me into your confidence.”

It seemed the offer had rendered Reggie Kearney speechless.

And that, O'Reilly thought, is typical of John MacNeill, twenty-seventh Marquis of Ballybucklebo. A gentleman of the old school. Considerate to a fault of other people's feelings. No wonder the poor man was in knots about which of his staff and possessions to let go.

 

18

So Much Been Owed By So Many to So Few

“This is Pilot Officer Dennison. DFC, Hurricane pilot, 229 Squadron,” Sister Blenkinsop said. Her voice cracked. “He's nineteen and a half.”

No wonder they were called “fighter boys,” Fingal thought. The poor lad was little more than a child and, with a Distinguished Flying Cross, already decorated for gallantry.

“He's had a quarter grain of morphine and hot sweet tea about two hours ago and, as you can see, we've got him under a shock cage.”

Fingal looked at the face on the pillow. It was unrecognisable as that of a brave young man. More like a piece of raw beef punctuated by two staring blue eyes with constricted pupils. The rest of the bed was humped up with the blankets covering a wire half-cylinder inside which were lit rows of incandescent bulbs. The shock cage. The heat from the bulbs was believed to be therapeutic. His arms lay on either side of the cage and Fingal could see that the airman's hands were not burned. That was something to be grateful for.

“The triage officer who has examined him says that apart from the patient's face and a couple of minor cuts and bruises, he's okay. No broken bones.”

“What happened?” Fingal asked. “I didn't think there'd been any raids today.”

“He was sent up to find a lone German reconnaissance plane, got shot down over Bognor Regis, bailed out, and was brought here,” Sister said. “We've been told that one petrol tank in the Hurricane fighter is in the nose of the aircraft, immediately in front of the cockpit. And I'm afraid,” said Sister quietly, “there's no fire wall between the tank and the pilot.”

Fingal shuddered and bit back a curse. Perpetually burdened with a vivid imagination, he could picture the pilot frantically trying to get out of his blazing aircraft. It wasn't a great leap to picture
Warspite
sustaining a torpedo hit or heavy bomb damage, and fire spreading down to the medical distribution station where Fingal would be working again in four or five months. He realised that while he could face the possibility of death, he was mortally terrified of being burned.

Sister, perhaps more inured to such cases, continued quite placidly. “His pulse is very rapid at one hundred and twenty, and his blood pressure is only one hundred over sixty.”

The man was in shock, no wonder, and he could die from it. “We have plasma available?”

“I've sent for some.”

“First thing,” Fingal said, “is to give him some intravenously, then we'll have to take him to theatre, get his face cleaned up and treated. Have we sent for Surgeon Commander Fraser?”

“We have.”

“Right,” said Fingal. “I'll set up the infusion as soon as the plasma arrives. Meantime, we'll premed him with atropine one-hundredth of a grain. It's too soon after the morphine to give him any more narcotic.” He wondered what the best anaesthetic would be. One thing was for sure—there was no question of trying to put a mask over that ruined face.

*   *   *

“Good for you for getting plasma into the boy,” Angus said as two SBAs lifted the burned pilot from a stretcher onto the table in the underground theatre and hung a glass bottle one-third full of the straw-coloured blood plasma, whole blood from which the red cells had been removed, on a pole attached to the table. “And now I'm going to teach you to use a thing called a Flagg's can.”

“All right.”

“Just so. Come over here and I'll tell you about it before the surgeon arrives.” Angus led Fingal to the head of the table where a strange-looking device lay on a towel on a trolley top. It was simply a small cylindrical metal can. Its screwed-on lid was perforated in several places and a single red rubber tube came out through a larger hole in the lid's centre. The tube was joined to a narrower one. Fingal frowned. It looked pretty primitive, and he said as much to Angus.

“Eh, I agree. No one,” said Angus, “in their right mind would use this thing if he had a Boyle's machine handy and a supply of endotracheal tubes. But, in wartime, who knows what will be available where?”

“True.”

“And of course, with the situation our young flyer is in, this is the perfect application.” Angus glanced over to where Phillip Dennison lay beneath the shock cage and exchanged a concerned glance with Fingal. “An American called P. J. Flagg invented the can and tube device and he showed it to Professor Macintosh, who taught me in Oxford.

“Professor Macintosh found he couldn't get his hands on any endotracheal tubes when he was helping with an international brigade during the Spanish Civil War and dealing with some pretty bad facial injuries. So he rigged up a can using a Tate and Lyle syrup tin just like Doctor Flagg had shown him how and, hey presto, it worked.”

Fingal said nothing, his attention suddenly pulled away several hundred miles and several years—to Dublin in 1936 and Kitty O'Hallorhan, who'd left him to go and work in an orphanage in Tenerife during the Spanish Civil War. He needn't deny it to himself. He'd been in love with her then. The past didn't disappear just because now his Deirdre filled his heart.

“Fingal?”

“Right. Sorry, sir. I was paying attention. Your mention of Spain just got me thinking of something, well someone, actually. But I heard you. How exactly does the thing work?”

“There's a sponge inside the can. You drop ether through the holes in the lid and introduce the narrow tube into one nostril and on down into the trachea. The patient's own breathing draws room air and ether into his lungs, and that's it. You're going to use it on this case.”

“All right.”

“Don't sound so dubious,” he said sternly. “One day you and your patients may bless P. J. Flagg, laddie.”

“Are you ready for me?” Surgeon Commander Fraser called, striding into the room. “I haven't got all day.”

“Eh, not altogether,” Angus said, “but if you'll go and wash your hands like a good wee surgeon man.”

Fingal had to struggle to hide a grin. No one was going to ride roughshod over the little Scotsman.

Fraser did not try to hide his scowl, but he said nothing and, turning on his heel, strode out of the room.

“Here.” Angus handed Fingal a loaded hypodermic syringe. “Sodium pentothal. Give it intravenously for induction, and stick the needle into the intravenous line. It'll save you looking for another vein to puncture.”

Fingal did.

“Ordinarily,” Angus said, “the drooping and closing of his eyelids would give us a pretty good idea that he was going under, but the poor bastard hasn't got any. Christ.”

Fingal was surprised, because never before had he heard Angus Mahaddie swear or blaspheme.

“I hate burns. Hate them.”

Fingal nodded and thought, So do I, and I fear them. “Can't we do anything?”

“Not much here, but there's a New Zealander, chap called Archibald McIndoe, working at the Queen Victoria Hospital in East Grinstead, who's doing wonders for burn cases. He calls his technique ‘plastic surgery.' You'll see what we can do here when—” He lowered his voice. “—the monarch of the glen goes into action. Our job is to keep the patient asleep.” He looked at the man's pupils, squeezed the skin of his forearm. No response.

“Right,” he said, handing Fingal the can. “There's ether on the sponge. Start feeding the tube up his right nostril.”

Fingal did as he was instructed. “It's stuck.”

“Just so,” said Angus. “It can be awkward finding the entrance to the trachea, but there's a trick. I'm going to tell you what to do, but you're going to do it. You learn by doing, not being lectured at.” Angus moved forward. “Let me hold the can. An SBA can do that for you if you're on your own. Now be gentle, but use your hand to tip his head back. Now pull his mouth open.”

Fingal stared into the open mouth and saw the tube at the back.

“Use this laryngoscope.”

Fingal accepted the instrument, which allowed him to pull the tongue forward and directly observe the vocal cords.

“Take a pair of Magill's forceps.” Fingal did. “Now grab the tube and manoeuvre it where you want it to go.”

To Fingal's delight, the thing slipped easily into the trachea.

“Now, advance it, and Bob's your uncle.”

“And,” said Fingal, completing the lines, “Fanny's your aunt. Thanks, Angus.” He straightened up.

“About time,” said the gowned and gloved surgeon. “Now, out of my way, you two.”

Fingal moved to his place at the head of the table.

“Right,” said Fraser. “Cleansing. I'll need ether-soap and saline, Sister.”

As Fingal attended to his patient's anaesthetic needs by periodically adding more ether, he admired the gentleness with which the surgeon cleaned the charred tissue away.

“In sequence, Sister, give me swabs soaked in first one percent aqueous gentian violet, next ten percent silver nitrate, and then fifteen percent tannic acid.”

Fingal watched as the surgeon successively applied the solutions with the care of a master painting a portrait. Once the tannic acid had been applied, a black coagulum began to form.

“Saline-soaked patches for the eyes,” Commander Fraser said, beginning to strip off his gloves, leaving the task to his minions. “We'll keep him on Collingwood Ward for three days, they know the postoperative routine in these cases, then ship him to the nearest receiving hospital.”

Fingal remembered what Angus had said about plastic surgery. “Excuse me, sir.”

The Surgeon Commander stopped with his left glove still half on. “What?”

“Could we perhaps arrange for him to go to East Grinstead? It's an RAF unit and Captain Mahaddie says Mister McIndoe—”

“I believe I said the nearest hospital.”

“But—”

“Lieutenant. When I want your advice, I'll tell you what it is.” And with that, Commander Fraser swept from the theatre.

Fingal, cheeks scarlet, breath stuck in his throat, managed to make a growling noise. But he wasn't angry because he'd been insulted. His ire was on behalf of a nineteen-year-old patient who, because of a senior's arrogance, was going to be deprived of the opportunity of a chance of having his missing eyelids replaced. “Angus, I—”

The captain put his hand on Fingal's arm. “Bide a wee, laddie. Take a deep breath and see about waking your patient up. Dinna fash yourself about where this young man's going.” His gaze bored into Fingal's eyes. “But we'll not discuss that here.” He smiled at the nursing sister, the VAD, and the SBAs.

Fingal understood. As usual, Angus had something up his sleeve but did not wish to discuss it in front of the staff. Nor had he used his superior rank to challenge the commander in front of them. That was entirely ethical—and prudent, given Fraser's short temper, to which Fingal had already been exposed. Fingal nodded and started to remove the tube of the Flagg's apparatus. He cocked his head and looked at his senior. This man's a superb teacher, Fingal thought, and not only of technical skills. I could do a lot worse than try to emulate his apparent willingness to do whatever was necessary to achieve better care for his patients. Fingal grinned. “Fair enough,” he said. “I'll not get…” He couldn't bring himself to say “fashed” in case Angus thought Fingal was imitating him. “I'll not get too worried.”