All in a Doctor's Day

Memoirs of an Irish Country Practice

Lucia Gannon

• Publisher: Gill Books
• Year: 2019
• ISBN:
  9780717183289
• Topic: Social Sciences
• Subtopic: Social Science Biographies
• Index: Social Sciences

The story of a village, a doctor and her patients.

Arriving in the small village of Killenaule, Co. Tipperary – husband and children in tow – Dr Lucia Gannon was a blow-in determined to build a practice that would provide solace for the sick, worried and confused.

Journey with her as she builds a life in this tight-knit community. Meet the wily pensioner trying to pass an eye exam to continue her career as a dangerous driver; the lonely widower who needs someone to take the time to listen; the stressed teenager coping with an eating disorder and the frightened elderly woman who doesn't want to leave her home.

Discover what it means to be the one people bring their problems to – problems that are not always medical, but still require discretion, kindness and a willingness to provide a listening ear to those on the tricky journey of life.

CHAPTER ONE

THE BEST-LAID PLANS

One dark Sunday in February 1998, I slipped out of bed and made my way to the bathroom across the hall. At thirty-eight weeks pregnant, this had become a frequent nocturnal activity, one that I could almost carry out in my sleep, but that night, or morning – it was too dark to tell – I was wide awake. My baby’s kicking and wriggling had woken me, as if suggesting that it was no longer happy within that cramped space. I had no pain and no contractions, but at that moment I realised that my waters had broken and that my intuition was right. My baby did need to be born.

In the dim bathroom light, I stared at my reflection in the mirror. A tired, drawn and pale face stared back. ‘I know this is not what you had planned for today,’ I said to my reflection, in as kind and reassuring a voice as I could muster, ‘but by this evening you will have your baby. And everything will be alright.’ I was officially on maternity leave from the busy GP practice that I shared with my husband, Liam, and was looking forward to the birth of our third child. I placed my hand on my swollen abdomen and spoke just as softly to my baby. ‘You’ll be out soon. Just another couple of hours.’

Just then, I heard the house telephone ring in the bedroom. My husband’s sleepy voice answered it. ‘Yes, this is Doctor Meagher,’ he said. ‘Who am I speaking to?’

The rest of the house was silent apart from the odd creak of timber and the rain that had started to fall on the Velux window over my head. Further down the hall, our two children, Joseph and Ailshe, were still asleep. I resisted the urge to go to their rooms and check on them. We would have to wake them soon enough. I knew what I needed: I needed whoever was on the phone to stop talking, I needed someone to mind my children and I needed Liam to get me to the hospital.

When I re-entered the bedroom Liam was sitting up in bed. ‘Have you tried your own doctor?’ he was saying into the phone, rolling his eyes and giving me an apologetic look. ‘OK, OK. I understand. If you really think you need to be seen early, come to the house at about eight-thirty, before I leave to start the morning surgery. I will see you then.’

I slipped back into bed. It was not yet six o’clock on that dark and windy February morning. I waited for Liam to finish his conversation, trying to formulate a plan for the day. Liam sat back against the pillows and sighed deeply, covering the mouthpiece with his hand, while still listening. Whatever the person on the other end was saying, I could tell that they were being pretty insistent.

‘OK,’ Liam said, with an undisguised air of resignation. ‘Just let me take down the directions and I will be out as soon as I can.’

I tapped him on the shoulder. Pointing at my swollen belly, I shook my head and mouthed a silent ‘hospital’.

He gave me a puzzled look. My baby was to be born by planned caesarean section the following day, Tuesday, 10 February, the same birthday as my grandmother, not Monday, 9 February. For a split second, Liam looked as if he was about to remind me of this and point out that I had mixed up my dates, but then swiftly changed his mind. I was not one to raise false alarms. He turned his attention back to the phone. ‘I’m very sorry,’ he said. ‘From what you have told me so far, you do not need a doctor right now. You can call your own doctor later and arrange to see him. I’m afraid my wife is in labour and I need to get her to the hospital.’

I had never heard him speak so firmly to a patient, especially someone he did not know, but there was no way either of us could see a patient that morning: they would all have to wait for another day, see another doctor, or go to the hospital. We did not have a replacement doctor for the surgery for emergency situations such as this, nor did I have a doctor to replace me while I was on leave, which is why I had continued to see a reduced number of patients until two days earlier, when I’d finally decided to leave my consulting room and not return until after my baby was born and I felt well enough to do so. I knew our colleagues in the neighbouring villages of Ballingarry and Fethard were aware of our situation and were on standby to see any patients who needed attention. That was the only emergency plan we had.

Liam had told a white lie to the person at the other end of the telephone: I was not actually in labour, but I needed to get to the hospital without delay, because my baby was breech. For the last four months of pregnancy, my son (although I did not know at that time whether I would give birth to a boy or a girl) had positioned himself with his head nestled under my ribs and nothing I could say or do would persuade him to turn himself around. That was the reason for the planned caesarean section, but because the fluid that protects the baby was draining away, there was a risk of his umbilical cord becoming squashed against the muscular wall of the womb, depriving him of oxygen, so the section could not be delayed.

Both Liam and I knew the risks associated with a breech delivery. We had both worked in obstetrics and paediatrics during our GP training in the UK and had intubated and resuscitated perfectly formed, healthy-looking babies, who had become deprived of oxygen during such a delivery. And of course, all doctors know that medical people make the worst patients, that they attract complications like electrons to protons, the negative to the positive, or, at least, that is the common perception. That morning, all these possibilities remained present but unspoken. However, they were not fears – they were merely facts. We had been blessed with two healthy children and were both confident that this time would be the same.

My bag was packed, there was petrol in the car, but the previous night my childminder had called to say that she was ill and would not be back to work for the foreseeable future. I needed a plan before I woke Ailshe and Joseph from their slumber, where they remained, as yet unaware of the impending disturbance to their routine. Coming up with such a plan was not easy. Liam and I had only been living in Killenaule for a couple of years, since we had taken on the GP practice. We did not have a network of people whom we could call on in emergency situations, but I had made one friend and it was to her that my thoughts turned at that time.

Judith and I had crossed paths one day about a year earlier, as she was manoeuvring her toddler son and three-year-old daughter out of the local shop. It might have been her Northern Irish accent, which singled her out as another person who did not fully belong in this South Tipperary village, that drew me to her. It might have been that her bright and chatty daughter, Gráinne, was the same age as Ailshe and went to the same playschool in the neighbouring town of Fethard, or it may have been that the light blue summer sundress she was wearing that day, as she and her children enjoyed messy ice-cream cones, gave her a carefree air, making me sense that this was a person at ease in the world, with the capacity to find joy in the ordinary. As luck would have it, I was walking in her direction and we fell into easy conversation, two blow-in, migrant mothers, tentatively putting down roots in what we hoped was fertile soil. Before we parted, we had already made arrangements to meet again and so we embarked on a friendship that would enhance many a high point, sustain me through many a crisis and accompany me on a path that would have appeared dull and lacklustre without her. However, even though all of that was still to come, I knew, at that early stage, that I could count on her, even if, as now, it was only six o’clock in the morning and she was not expecting a call from me.

Ailshe appeared at the bedroom door, a sleepy four-year-old who knew, even in a house where phones rang and children migrated in and out of beds at all hours of the night, that morning was a bit more active than usual.

‘I’m afraid I have to go to the hospital today and not tomorrow,’ I said. Ailshe was a girl who did not like surprises, especially if they entailed separation from her mother. I was rarely parted from herself and Joseph, and as I knew this separation would be for more than a few nights, I had prepared them both as best I could. One afternoon, a few weeks earlier, I had asked them what they would miss most when I was away. Almost immediately they had both replied that it would be my bedtime reading. The next day we had picked out some of their favourite books, and in the following weeks, while I had rested in the afternoons, too tired and slow to do anything else, I had recorded myself reading as many excerpts as I could on an old-fashioned cassette recorder. It was no hardship for me. I did not need an excuse to read, especially when the books they had picked included The Secret Garden, Watership Down and other classics that I was only discovering as an adult.

Despite suggestions from well-meaning friends and relatives that my children were ‘too attached’, that I was causing them to become too dependent on me, I did not believe that, as I could observe the signs of their developing independence. Besides, I believed that it was easier to set sail from a safe harbour than to try to begin a journey on a stormy sea and I tried to provide this harbour while I could. At least, that was what I hoped I was doing. That was what the books I chose to read would have me believe I was doing: Rosalind Miles’s The Children We Deserve, D.W. Winnicott’s Home is Where We Start From, and Penelope Leach’s Children First, are just some of the well-thumbed volumes that still line my bookshelves, mementoes of early motherhood and my striving to do the right thing. Of course, I only read what I wanted to hear and avoided any self-professed expert or guru who might recommend strict schedules, exacting routines or separation from my children.

‘Your voice sounds funny,’ Ailshe had said when I had played some of the cassette back to her, ‘but I still know it is you.’ I reminded her now that she could listen to these stories any time she liked and that before she knew it, I would be back home with a new baby brother or sister. She dressed herself in an orange skirt and purple top of her own choosing, indicating to me that she was ready to face the day.

Joseph followed, also fully dressed, his face a mixture of concern and anticipation. At six years of age, he already carried the responsibility of being the eldest child. With him, I had made more mistakes, struggled with more uncertainties and worried more about doing things exactly right, but it was also with him that I had first experienced that overwhelming love for my own child and a realisation that my life would never be the same again. As he left for Judith’s home with his dad and his sister, his schoolbag over one shoulder, a box of Weetabix tucked under his other arm, I reminded myself that despite his mature and confident demeanour, he would not be fully convinced that all was well in the world until I was back home again.

Fifteen minutes later, they returned. ‘The Fennellys are all either drugged or dead,’ Liam said, referring to Judith and her family, when he came back with Joseph and Ailshe trailing behind him, looking forlorn and worried. ‘I have been ringing and ringing and pounding on the door, but there is not a stir from inside. Even though both cars are in the yard.’

I did not know how anyone could sleep so soundly. I seemed to hear every leaf falling and every branch creaking throughout the night and woke with the slightest provocation. I assumed it was from years of broken sleep as a junior doctor. I knew Liam would have done all he could to wake them: unlike me, he knew when to ask for help and did not consider it a personal failure to do so.

‘I’m afraid ye will just have to come with us,’ Liam said to the two worried faces. ‘They might let ye wait in the hospital foyer and then come up to see the baby before I bring ye back home. Ye might even be back in time for school,’ he joked.

I wasn’t in the mood for humour. Then I remembered that about a week earlier, while I’d waited for Joseph at the school gate, a mother called Deirdre had offered to do the school run and to help out with the kids anytime if I was stuck. I appreciated her kindness and knew her offer was genuine so I’d thanked her and said I would keep her in mind, never thinking that I would have to take her up on her offer. Now, I reminded Liam about that offer, adding that I really did not like to impose on her.

‘She wouldn’t have offered if she didn’t mean it,’ Liam replied, in his usual matter-of-fact manner, and without further discussion, without consideration of the ‘coulds’ or ‘shoulds’, he turned to the kids. ‘OK, guys, let’s go again. As usual, Mum has another plan.’

When he returned, almost half an hour later, he was alone and looked relieved. ‘You would think she was expecting them,’ he said. ‘No problem at all. I didn’t even need to explain: she just took them in and told me I’d better get going.

Getting to the hospital was the easiest problem to solve that morning, and once we did, our baby, Liam Junior, was born, pink and healthy, weighing over eight pounds. I was alive and well, if a bit stiff and sore. As soon as I could, I put him to my breast and he suckled as if he knew instinctively that his life depended on it. I had breastfed both Joseph and Ailshe well into toddlerhood. This was not a common practice in Ireland in the early 90s, when Joseph was born, and while it was probably a little more acceptable in theory in 1998, there were still lots of people who felt uncomfortable with the idea that babies were breastfed, especially babies over six months of age, so it was not something I advertised although I did not deny it or try to justify it.

Even as a qualified GP who had worked extensively in obstetrics and paediatrics, I had had no knowledge of breastfeeding when I had my first baby. It was not a topic that was included in textbooks or lectures and in the hospitals in which I’d worked in the UK, during my four years of GP training, I rarely saw mothers breastfeeding successfully. The calls I would get from the postnatal ward were usually from experienced midwives, who informed me that the mothers were having difficulty, that they did not have enough milk and that the babies were hungry. I was usually asked to give my imprimatur to a ‘top-up’ of formula milk, to help them over this hump. Not knowing any better, I took my cue from them and gave it. I did not know at the time that this was the worst thing I could have done, that a single top-up feed could result in the end of the breastfeeding relationship for these mothers and babies and that what they needed was encouragement and support from someone with knowledge of the breastfeeding process. I only learned that later, when I had my own children. This had been a steep learning curve for me, but once I was convinced that breastfeeding was the best thing to do, I was determined to succeed.

In those pre-internet and pre-Amazon days, finding relevant information was a challenge, but I was fortunate to discover a copy of Sheila Kitzinger’s The Experience of Breastfeeding in a small bookshop, a book that opened the door to a very different way of mothering and childcare than what I had been exposed to as a junior doctor. Armed with this new knowledge, I became my own expert, so that by the time I gave birth to Liam Jnr, I was determined not to let anyone endanger my breastfeeding efforts. While in hospital with my new baby, I guarded him with the tenacity of a lioness, never letting him out of my sight and feeding him at every available opportunity, making sure that no one would give him a top-up. That was all I could do. I could not think about the fact that I would have no one to help me manage the house and the children when I got home: Liam had returned to work the day after Liam Jnr was born. He had no choice. It was not possible to find a replacement doctor and someone needed to provide care for our patients. I could not think about who would take care of me and my children. All of that would sort itself out, I hoped. I tried to convince myself that what mattered was that my baby was well and healthy. That we had another little miracle that should not be taken for granted.

Liam told me not to worry, that he would sort something out and I had to believe that he would. On the day after my caesarean section, I awoke from a nap to find two of my eight sisters, Marian and Treasa, sitting by my bed. ‘We can stay a few days,’ Marian said, ‘so you needn’t worry for now. And Liam just told us before we left that he might have found someone to mind the kids.’

I cried tears of relief in response to their kindness. As a doctor, I was not used to asking for help. I was usually the one offering it, but now, I let my sisters’ concern envelop me. It felt nice, like a thick, warm fog that shielded me temporarily from the world – a world I had no wish to face just then.

Later that day I rang my home. A young woman answered the phone, and told me her name was Denise. I explained who I was and thanked her for coming to mind the children at such short notice. ‘It’s no bother,’ she replied, as if she had known me all my life. I remember thinking that her voice sounded kind and confident and I tried to imagine what she looked like, but I was too tired and fell into an uneasy sleep. By the time I came home from hospital, Denise was well on the way to winning the affection of our two sceptical children. She seemed to instinctively understand Ailshe’s need for planning and Joseph’s preference to be left to do his own thing. With her help, order was restored: laundry was done, dinners were cooked and I got back to my bedtime reading routine. Only from then on, our reading group contained one extra pair of little ears.

As spring turned to summer, my thoughts returned to getting back to work and to the ever-increasing list that Bridget, the practice secretary, was compiling, the list of the people who wanted an appointment with the ‘Lady Doctor’, as soon as she was back from maternity leave.

CHAPTER TWO

‘THE HILLS OF KILLENAULE’

At some point in the months after our youngest child’s birth, Liam and Bridget moved to work in the new surgery that we had built on a greenfield site on the outskirts of the village. The move had been delayed due to difficulties in getting an electricity pole erected: I had given up asking Liam when it would happen, as he didn’t have an answer. Eventually, it did happen, but there was no fanfare to mark the date, there were no politicians cutting ribbons, there was no cheese and wine reception with photographs for the local paper. Liam and Bridget simply left the Health Board premises they had been working in on a Friday evenin...

Table of contents

• Cover
• Title Page
• Author’s Note
• Dedication
• Contents
• Prologue: With Gracious Acceptance
• Chapter One: The Best-Laid Plans
• Chapter Two: ‘The Hills of Killenaule’
• Chapter Three: The Hill House
• Chapter Four: A Good Teacher
• Chapter Five: Safety-Netting
• Chapter Six: The Gift of Friendship
• Chapter Seven: Learning a New Language
• Chapter Eight: Divided Loyalties
• Chapter Nine: ‘Doing a Locum’
• Chapter Ten: The Art of Saying No
• Chapter Eleven: A Delicate Matter
• Chapter Twelve: Spread a Little Happiness
• Chapter Thirteen: A Broken Promise
• Chapter Fourteen: Unfinished Stories
• Chapter Fifteen: An Uncomfortable Situation
• Chapter Sixteen: This Mortal Coil
• Chapter Seventeen: Coming to Terms
• Chapter Eighteen: The Bare Necessities
• Chapter Nineteen: Practice Makes Perfect
• Chapter Twenty: A Bad Patient
• Chapter Twenty-one: Back on Track
• Chapter Twenty-two: Ireland’s Fittest Family
• Chapter Twenty-three: A Time to Remember
• Acknowledgements
• Copyright
• About the Author
• About Gill Books