An Irish Country Wedding Read Online Free

onset, concurrent bilious vomiting, previous history of groin aches — ”
    “Physical findings?”
    “Clammy skin and tachycardia and that’s all I know. Come on, Jack. Kinky’s fed you often enough when you’ve come down here. You know how she looks after O’Reilly and me. It would be like examining my own mother.”
    “Fair enough. You don’t need to anyway. It sounds like a strangulated hernia. Probably needs surgery,” Jack said. “Shoot her up to us and we’ll take care of examining her and doing any tests.”
    “I thought it might be a hernia,” Barry said, “but getting her to you in a rush is tricky.” It was gratifying to have his probable diagnosis confirmed by his friend who now had ten months of surgical training under his belt. Barry was happy to have the specialists take care of Kinky. She was family. It was the other referrals he’d had to make that were frustrating him.
    “How soon can you get her to the Royal?” Jack asked.
    With bowel obstructions, the sooner the constriction was removed the less was the likelihood of complications like gangrene of the bowel, perforation, peritonitis. Barry owed it to Kinky to move quickly, but— “I could run her up myself,” he said, “but O’Reilly’s not back from Belfast and if I do there’ll be no one here if there’s another emergency in the practice. She usually looks af ter the shop when the boss and I are both out. Makes not-so- urgent patients wait, gets an ambulance for the really sick ones and sends them to casualty.”
    “Not to worry. You’re at home?”
    “I am.”
    “I’ll get an ambulance down pronto.”
    “Fine.” Barry heard a distant low moan. “Jack, she’s having a lot of pain. Morphine?”
    “Better not, I’m afraid. Understanding the pain, where it’s felt, what makes it worse, what relieves it, it’s all part of making the fi nal diagnosis in folks with acute bellies. Painkillers muddy the wa ters. We’ve known that since fourth year, Barry.”
    “I know. I just thought — ” He bit off the words. He’d made the serious mistake of letting his concern for this special patient override what must be done. He also knew he hated to see Kinky suffering.
    “We’ve made an informed guess that it’s a hernia,” Jack said, “but at her age, what, fifty, fifty-five? You could get those symptoms from a lot more things. Crohn’s disease, ulcerative colitis — ”
    “I know, I know,” said Barry. “You can spare me the list, Jack. Just tell the ambulance to be quick and ask one of the attendants to keep her company on the drive up to Belfast. She’s in a lot of pain, and she’ll be terrified. She shouldn’t be left alone.”
    “Done, mate,” Jack said, “and I’ll talk to my boss, Sir Donald Cromie, at once. He’s here in outpatients. He teaches that severe belly pain is either ‘watching sick,’ meaning you can observe them, try nonsurgical treatment, and perhaps they’ll get better, or ‘opening sick,’ which means immediate surgery is indicated. And I’m sorry, Barry, but even sight unseen, your Kinky sounds pretty ‘opening sick’ to me. If he agrees, he’ll see her the minute she arrives on the ward. Save a bit of time.”
    “Thanks.” Barry was going to say good-bye, but remembered, “One last thing. Kinky’s hundreds of miles away from her family in County Cork. She’ll be all on her own at the hospital. I’ll have to let her folks know, but I’ll wait ’til I hear for sure what’s going on. Will you give me a call when you’ve seen her?”
    “Sure.”
    “Thanks, Jack,” Barry said. “I’d better go back and see how she’s doing.” And it won’t be well, he thought, but at least I can offer her a bit of comfort while we wait.

 
    3
    “Plain Cooking” Cannot Be Entrusted to “Plain Cooks”
    “What? You’ve sent Kinky to the Royal?” O’Reilly still had one arm in his wet raincoat as water from an April shower dripped onto the hall carpet. It was forty-five