pressureâs fine. Some of the things Iâve found might be due to it, like being short of breath, being tired, fast pulse, tiny bit of ankle swelling, but Iâm pretty sure your heart failure is under control.â
âThatâs good,â Sonny said. âI am relieved, Iâll admit it.â He drew in a deep breath.
âNumbness in your feet and fingers, and headaches donât go with that condition, though.â
âI see.â Sonny nodded.
âDoctor OâReilly, did you notice how smooth Sonnyâs tongue is?â
âI did,â said OâReilly, âand his conjunctivaeâre pale too.â
Barry nodded. âAnd I can feel your spleen, Sonny. Thatâs an organ under your ribs on the left that normally gets rid of old, tired red blood cells.â
Sonny forced a smile. âI feel like an old tired blood cell myself these days,â he said.
âAnd,â Barry said, âyouâve lost your knee and ankle jerks, and you didnât feel the vibration when I put a tuning fork on your insteps and ankles.â
The door opened. âCan I come in yet?â Maggie was carrying a tray. âTea and plum cake,â she said. âFor when youâve finished, Doctors.â
âCome ahead,â OâReilly said. âDoctor Lavertyâs going to tell us what he thinks is wrong and what we need to do next.â
âYour tickerâs under control, but Iâm almost certain you have thin blood. The trick is going to be to find the exact cause. Thereâs quite a few to choose from, although even now I can make a pretty good guess at which one it is.â
âCan you fix it, Doctor, dear?â Maggie asked.
âWeâll have to get some blood tests to be certain of what we need to treat.â
OâReilly hoped that a painful bone marrow biopsy and an uncomfortable gastric fractional test meal could be avoided.
Barry continued, âBut yes. I think so. Now my dad likes to say, âNever make a promise if youâre not sure you can keep it.â Iâm not promising you Iâm right.â
Good lad, OâReilly thought.
âWe understand,â Maggie said. âWeâll leave being infallible to your man with the pointy hat in the Vatican.â
Barry smiled. âThank you.â
âExcuse me,â OâReilly asked, âand Iâm not interfering, just asking, wouldnât it be simpler to ask Doctor Gerry Nelson, the haematologist at the Royal, to see Sonny?â
Sonny coughed. âNow look here. Iâm sorry, sir, but Iâm only seeing you two medical men under protest. I hate hospitals. I insist the young doctor look after me here.â Then Sonnyâs stiff posture and superior tone gave way and he looked at Barry. âPlease, Doctor Laverty.â His supplicant manner would have softened Pharaohâs hard heart.
Barry stopped writing out the lab requisition forms and smiled. âI can spare you a consultation with another doctor for now, Sonny, but I canât do the blood tests here. And you shouldnât be driving in your state. You could pass out behind the wheel. Iâll arrange for an ambulance to take you down to Bangor hospital tomorrow, have the blood work done. Weâll have the results next week and Iâll pop out to give them to you.â He handed the forms to Maggie.
OâReilly nodded his approval.
âIâm pretty sure with the right treatment we can get rid of your tiredness and shortness of breath. Iâm sorry, but I donât think I can fix your feet and fingers. Once a nerve is damaged Iâm sorry, but thatâs it. Itâs gone for good. But I reckon we can stop it getting any worse. Iâm working,â he said, âwith a diagnosis of pernicious anaemia, failure of production of red blood cells because of the bodyâs inability to absorb vitamin B12 through the gut.â
âPernicious?â said
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