An Irish Country Christmas (4 page)

He could make out lights from the farmhouse up ahead. One was shining through an unshuttered upstairs window. A single glass-encased bulb burned above the front door. The shutters were closed over the downstairs windows, and only errant rays crept through the chinks where the panels didn’t quite meet.

He parked the car outside the front door. He’d not be sorry to get inside, and the sooner he left the car the sooner that’s where he’d be. He grabbed his black bag and got out.

“Get away to hell out of that,” he said sharply to the border collie that appeared from the darkness and crouched, belly low to the ground, lip curled, throat quivering, as it snarled.

“Go on. Away to hell.” O’Reilly strode past the dog and was about
to hammer on the door when it was thrown open by a large thirtyish woman who wore a calico pinafore and fluffy carpet slippers. He could see a little girl, thumb in mouth, peeping round the hem of her dress.

“Come in, Doctor O’Reilly.” She stepped back and pushed the little girl away. “Run you away on and play with your brother.”

The little girl, thumb still in her mouth, walked across the floor. O’Reilly noticed how she turned her left toes in. She stopped from time to time to stare at him with the biggest blue eyes he had ever seen. He winked at her, crossed the threshold into a spacious kitchen with a tiled floor, and said, “And what’s the trouble with Liam, Molly?” He started to shrug off his coat. The room was stifling from the heat coming from a cast iron range in the corner of the kitchen. “Kinky said you sounded upset.”

“I’m better now,” she said. “I lost the bap when I seen Liam lying there out in the barn. I tried for to lift him, but he’s a big man and I couldn’t budge him so I ran in here and phoned.” She held one fist in her other hand and, resting her chin on top, pursed her lips and stared at the floor. Then she looked O’Reilly in the eye. “I thought he was dead, so I did.”

O’Reilly stopped with this coat sleeves halfway down his arms. “Is he in the barn yet?”

“No.” She raised her eyes to the ceiling above. “He’s in bed up there. By the time I was off the phone and heading back to the barn, Liam was on his way here.”

O’Reilly finished taking off his coat. “Can you tell me exactly what happened?”

“For the life of me, Doctor, I don’t know. We’d brung the cattle in out of the snow. Liam was getting a bale from the hayloft. I’d my back turned to him. I heard a thump, turned round, and there he was . . . out like a light. I couldn’t rouse him, so like I said, I phoned you.”

“Ma-aa . . .” The four-year-old came in through the kitchen door. “Ma, Johnny’s just shit his pants.”

“Just wait a wee minute, Jenny. Mammy’s busy.”

“Liam got back here under his own steam?”

“Aye. He wanted me to phone back and tell you not to bother coming.”

Typical of countryfolk not wanting to put anyone to trouble, O’Reilly thought, “It’s all right, Molly. Liam’s in your room, is he?”

“Aye.”

“Ma-aa . . . he’s shit himself.”

“Mother of God, go and get your brother into the bathroom. I’ll be along in a wee minute, so I will.”

“I’ll find my own way up there. You see to the kids.”

“Thanks, Doctor.” She stepped across to the four-year-old, grabbed her by the hand, frowned, and said, “I’ve told you before, don’t you say shit.”

“It’s what Daddy says, so it is . . .”

The debate was continuing as O’Reilly left the kitchen, climbed a flight of stairs, went along a landing, and let himself into a bedroom where on one side of a double bed Liam Gillespie lay propped up on a couple of pillows on top of the eiderdown. “Come on in, Doc. I’m sorry we’d to trouble you on a night like this.”

Liam was indeed, as Molly had said, a big man. O’Reilly guessed he’d be about six and a half feet tall and would weigh a good fourteen stone. He looked pale and was sweating.

“It’s no trouble, Liam.” O’Reilly sat on the edge of the bed. “What happened?”

“I was stupid. I was lifting down a bale of hay from the hayloft, and I slipped and fell, so I did.”

“Hit your head, did you?” O’Reilly peered at the man’s eyes, noticing that both of the pupils were the same size.

“Divil the bit. No. I hit my ribs, here on the left . . .” He pointed to just above where his shirt disappeared beneath the thick leather belt that held up his moleskin trousers. “I must have hit myself a ferocious dunder, for I passed out. I don’t know how long I was out for.”

“Can’t have been very long. You were heading back here by the time Molly phoned me.”

“Right enough. So it was only a wee short turn I took?”

“Did you pass out before or after you fell?” O’Reilly reached for Liam’s wrist and took his pulse. The skin was clammy.

“After. I remember hitting the corner of a workbench. The pain was ferocious in my ribs for a wee second, and then I was coming to lying on the floor.”

The man’s pulse was rapid and thready. “Still sore in your side?”

“Aye. But I can thole it.”

“Let’s have a look.” O’Reilly had long ago learnt of the stoicism of many of the countryfolk. If one of the important diagnostic symptoms of any condition was pain, having a man like Liam Gillespie say he could put up with it did not necessarily mean that the pain was not severe. Fourteen stone falling on the corner of a bench would probably have cracked a rib or two, and of more consequence the spleen lay beneath the lower left ribs.

Liam started to pull his shirt out of the waistband of his trousers, but then flinched, sucked air between his teeth, and gasped, “Ah, Jesus.”

“Sore?”

“Bloody right.”

“Here, let me.” O’Reilly unbuckled the man’s belt, unbuttoned his shirt, then pulled out the faded blue shirt. There was a bruise as big as a soup plate. O’Reilly stood to face the patient. “This may hurt a wee bit, Liam.” He put the flat of one hand on top of the bruise and slipped the other hand under the man’s chest. Liam whimpered when O’Reilly squeezed, and he felt a grating sensation. “Sorry about that. You’ve a rib or two bust there.”

Liam nodded but did not speak. His forehead glistened in the light from the overhead bulb.

Pain could certainly make a man sweat, and O’Reilly had no difficulty being empathic with anyone with broken ribs. A bloody great boot from an opposing forward had caved in three of his own ribs during a rugby game years ago, and he could still remember the grating pain every time he took a deep breath.

He also remembered vividly another game when a player had taken a thumping, gone to the sidelines to rest for a few minutes, come back
to play out the rest of the game—and collapsed in the dressing room. He’d had a ruptured spleen.

Were Liam’s broken ribs alone sufficient to account for his rapid, thready pulse? O’Reilly shook his head. He moved one hand beneath Liam’s ribcage on the left side and tried to depress the muscles of the abdominal wall. They were stiff as a board and unyielding. “Am I hurting you, Liam?”

“By Jesus, you are, Doc.” Liam’s words had difficulty getting past his clenched teeth.

O’Reilly lifted his hand gently away. “Can you stand up?”

“I can try.” He started to swing his legs over the side of the bed.

O’Reilly waited, hoping the man would succeed. If Liam couldn’t make it under his own steam, O’Reilly wasn’t sure he was strong enough to carry the two hundred-pound man downstairs. O’Reilly was sure the man had a ruptured spleen. The giveaway was his pallor and rapid pulse, along with the rigidity of the abdominal muscles caused almost certainly by blood in the peritoneal cavity. And there was no guarantee that the bleeding from the damaged organ would stop. Death from haemorrhagic shock was a real risk.

“Jesus, Doc,” Liam said, “I’m weak as a baby.” He breathed in short gasps.

“We’ve to get you downstairs.” O’Reilly lifted Liam’s right arm and draped it around his own left shoulder. “Come on. I’ll oxter-cog you.”

A ruptured spleen had to be treated at once by surgical removal of the damaged organ. That meant Liam must be taken to the nearest hospital, and it was unlikely that an ambulance, with the necessary attendants to carry him out to the vehicle, could get here in under four hours—if at all with the snow on the roads. If O’Reilly was right, Liam could bleed to death in less time.

God, he weighed a ton, but he was doing his best to help. Together they made it to the top of the stairs when Liam gasped, “Can we . . . rest for . . . a wee . . . minute?”

O’Reilly himself was panting, and each indrawn breath burnt his lungs. He coughed. Maybe there was some truth in what Barry and
young doctors like him were saying about tobacco smoking being bad for your health. “Can . . . can you manage a bit more, Liam?”

Obviously too weak to speak, Liam nodded.

O’Reilly steadied them by putting his hand on the banister and slowly descending, one step at a time. An ornamental wooden bench stood in the hall below. O’Reilly debated sitting Liam down on it so they both could rest but decided against it. He might not get the man back on his feet again. “Come on, Liam . . . almost there,” he said, as they reached the hall. He was more than supporting the man now. Liam’s legs were limp, and his feet dragged.

In the kitchen Molly looked up from a sink where she was rinsing a pair of boy’s short pants and underpants. “Jesus, Mary, and Joseph.”

“It’s all right, Molly. If you could just . . . open the back door, the back door of the car, and then go and get . . . a couple of blankets . . .” O’Reilly heard his chest wheezing.

She hurried to the door, threw it open, and ran outside.

O’Reilly felt the chill and saw snowflakes being blown inside.

“I’ll get the blankets.” She dashed past him, leaving behind her a trail of wet footprints on the tiles.

O’Reilly hauled in one last deep breath, pursed his lips, and forced himself to march ahead, through the kitchen, out the door, and through the lying snow and the once more flying flakes that reflected the rays of light coming from the bulb above the back door. Liam’s head lolled against O’Reilly’s shoulder.

Thank Christ Molly had opened the Rover’s back door. It took his last reserves, but O’Reilly managed to stuff Liam into the back of the car. He stood, hands on the roof, ignoring the chill in them, head bent, mouth gaping as he pulled in lungful after lungful. He could only nod when Molly appeared with blankets, but by the time she had tucked them around Liam, O’Reilly was able to speak.

“You stay with Liam for a minute. I’ve to make a phone call.”

“The phone’s in the kitchen.”

He didn’t reply but headed straight back to the house, picked up the phone, and dialed the Casualty Department of the Royal Victoria Hospital.

“Hello. Who’s that? Registrar on duty? Great. Listen, I need an ambulance sent to the Holywood Arches on the outskirts of Belfast. I’ll need six units of O-positive blood and . . . I beg your pardon? Who do I think I am?” He could feel the blood draining from the tip of his nose. He knew he should be polite, but Liam Gillespie could die if he wasn’t treated soon. “Son. I don’t
think
I’m anybody. I bloody well
know
who I am. I’m Doctor—did you get that, son?—
Doctor
Fingal Flahertie O’Reilly from Ballybucklebo. I’m at a farm at the arse end of nowhere up in the Ballybucklebo Hills, and I have a patient with a ruptured spleen. That’s right. No, I don’t want the ambulance here. I’ve the patient in the back of my car, and I’ll have him at the Arches by the time the ambulance gets there . . . You’re not sure you can arrange that? You’re too junior to order an ambulance on your own authority? Jesus. Who’s your boss tonight? . . . Sir Donald Cromie?” Sometimes, O’Reilly thought, honey catches more flies than vinegar. He lowered his voice from its quarterdeck-at-sea-in-a-gale level and gently said, “Well look, son, you give old Numb Nuts . . . that’s right, Numb Nuts . . . he and I played rugby together years ago . . . give him a call right away, tell him who phoned and why, and I’ll be surprised if the ambulance isn’t waiting for me at the Arches . . . You will do that? Good lad.”

O’Reilly hung up and looked round for his overcoat. He’d have a quick word with Molly, tell her what was going on, send her back to her kids. Then he’d drive up to the Holywood Arches and make sure Liam was safely transferred to the ambulance and transfused if necessary.

O’Reilly lifted the coat from the peg and paused as a sudden gust whirled fresh flakes in through the open door. He’d better get a move on. If it started to drift up on the country roads, even the Rover could have difficulty getting through, and he wasn’t sure how long Liam could live if they got stuck. O’Reilly’s jaw muscles tightened. By God, Liam Gillespie was going to survive for the rest of his natural span if Fingal O’Reilly had anything to do about it.

He hauled his coat on, strode to the door, and headed back to the Rover.

“Go in and get warm, Molly.”

He climbed in, started the engine, and waited as Molly dropped a small kiss on Liam’s forehead.

“Go on,” O’Reilly said. “He’ll be fine. I have to go.” The second Molly shut the back door he put the car in gear, hunched his shoulders when the tyres spun for a moment before gripping the icy mud of the farmyard, and then relaxed as the big car lurched forward.

As the car jolted down the farm lane, occasional snowflakes dancing in the beams of the headlights, he chided himself for taking things so personally. He’d done everything possible for Liam—more by driving him. If the weather conspired to frustrate his efforts and he did lose his patient, it would hardly be his fault. Every doctor should bloody well know that.

O’Reilly stopped at the gate and unlatched it. Then he wrenched it open so forcibly that he bent the top bar. Lose Liam? A few weeks before Christmas? He snorted, and his breath clouds made a little smoke screen.

“Hang on,” he called to the backseat as he drove through the gate and onto the road. The gate would just have to stay open. Getting Liam to the ambulance was a damn sight more important than a few stray beasts—and anyway weren’t they in the byre?

The going was easier on the road. He’d get through all right so he could stop worrying and concentrate on his driving, and if all went according to plan, O’Reilly grinned, he’d be back at Number 1 Main Street in a couple of hours. His tummy rumbled. He hoped Mrs. Kincaid would keep him something decent to eat. Of course she would, unless young Laverty, who should be home by now, had scoffed the lot.