The television series ER has nothing on the human dramas constantly unfolding in our own wards
I SUPPOSE the first Christmas that you spend working away from home is bound to be memorable.
Twenty years ago I was working as a medical intern in a county hospital in Northern Ireland. The hospital was run well, friendly and known for having a family atmosphere, so I was not surprised to find that I liked it.
What I had not expected was that I would fall in love with the town. One of the effects of The Troubles was to freeze the town in the past with quaint old shops, narrow quiet streets and unspoilt countryside nearby.
The people combined an old-fashioned courtesy with a very direct manner of speech, and I always thought they had an endearingly optimistic outlook.
On evenings off I would go to a red-fronted 400-year-old pub with "Big Jim", the radiology consultant. As we sat at the ancient wooden counter he would explain to me the peculiar delights of living in the North.
He had been a consultant in a leading London hospital, and he had left it behind him. "It's the nature in the people. That's what brought me home," he would say.
I had this in mind when I admitted a man in his mid-60s known to all as "Wee John". John came in several times a year, usually complaining of vague chest pains. I had been the receiving doctor on this occasion, and it soon became apparent that his dearest desire was to tell you whatever it was you wanted to hear.
"Do you smoke John?"
"Oh no. Never touch the dirty things . . ."
"Is the pain bad?"
"Ah, not too bad. Well, sometimes, but it could be worse. But then it's fierce."
I experienced a slightly surreal feeling after talking to Wee John for a few minutes, a will-o'-the-wisp feeling that all things were possible, or maybe none at all. So I did what everyone else had done and booked him in for three days' tests and observations.
"It's not right," said the Registrar, as he poured the post-ward-round coffee. "Wee John knows that if he says he has chest pain he'll get in for a few days. The tests are always normal."
The consultant looked a little uncomfortable. Wee John was a particular favourite of his.
"I suppose there could be better arrangements for a bit of respite care. But he gets lonely, and he does love the medical ward. He'll be back in for Christmas anyway, he always is," he said mildly.
We were interrupted by one of the porters who was carrying a Christmas tree and a bucket of sand. He told us to get out of the way as he had 23 of those things to stick up today and the head was lifting off him with a hangover. As I said, a family atmosphere.
The weather became frosty. Nurses donned Florence Nightingale capes and toured the wards in groups every night carol singing. Boxes of chocolates and biscuits appeared in and bottles of whiskey and brandy were donated.
One had to be careful here for the more sternly Christian consultants did not drink. In fact, one was rumoured to pour presents of hard spirits down the ward sinks, so many of the bottles were passed over to the Galway doctors, who would drink anything, and the rest were stored in the Res.
About a week before Christmas Day, the various ceasefires were declared and the town was getting busy. In the medical ward that night all was warm and peaceful.
Except that is, for the patient I had mentally christened "the Bull". He, like John, had come in with vague symptoms, but they couldn't have been more different types. The Bull was huge and surly.
Wee John approached me, "See him, he's a boozer. Spends all day in the pub. He's from near me. I think he's missing it."
In the office Brenda, the nurse in charge, had just obtained the Bull's blood results
"He's a boozer all right. He looks like he might blow."
I went out to see the Bull, but he was not on the ward. I then went out to the hall where I found him looking distinctly agitated. His eyes were wild as he turned to me and I could see that he was very close to developing delirium tremens.
And God knows what he saw when he looked at me for he roared: "Give it here you bowsy," and charged. Meaty hands grabbed my white coat.
He was astonishingly strong, especially for a man who had spent 20 years sitting on bar stools. As we wrestled like a two-man rugby scrum, I reflected that all they said about the strength of madness was true.
I was being manoeuvred towards the stairs when I noticed an ephemeral shape. For a fleeting second I thought that it was my guardian angel, then I saw that it was Wee John.
"Get help," I shouted and over the Bull's shoulder I saw John careering away. He reappeared with Big Jim. Jim took one look at the situation and promptly turned and ran towards the Res.
The situation was getting serious. It seemed likely that Bull would throw me down the stairs, as I already was losing my footing. This would be just about tolerable if he let go of me, but if he landed on top of me I would undoubtedly be killed. It had already seemed like hours as we grunted, wrestled and manoeuvred around the stairwell, but then I saw Jim and John racing towards me with a bottle of brandy, a bottle of stout and a tea cup.
I never saw a slicker surgical manoeuvre than the way Jim opened the brandy bottle, John held the cup and they filled it to the brim. It was stuck under the Bull's, sadly, ringless, nose. He stopped wrestling, put down his head and sank the brandy in a grateful gulp.
The transformation was miraculous. Wee John scuttled away and then returned with some nurses and the porter who gently escorted the Bull back to the ward. He meekly followed the stout bottle like a spaniel following a biscuit.
"Take a break," said Jim, "I'll sort him out with some valium and we'll dry him out. You're off for the evening."
I went and sat in the ward kitchen. Wee John sat beside me in respectful silence. I filled a tot of brandy each. Then John produced a packet of cigarettes and we sat and smoked the dirty things in silence.
What do you say to a man who has saved your life?
As it happened, I didn't have to say much. He started to tell me about how he had been living alone for many years on a small farm since his mother died. But when he mentioned the medical ward his face lit up.To him the medical ward represented a social life, a medical drama and a holiday.
"Is it nice here on Christmas day?" I asked him. "Oh, aye."
He was discharged a couple of days later, and everyone fully expected to see him again on Christmas Eve.
I drove home on Christmas Eve myself and returned on Boxing Day.
I met Brenda in the hall.
"Well, I asked jokingly, "how's Wee John? Was he in for the turkey?" She gave me a strange look.
"Oh, he was in all right. On Christmas Eve too. But he never got the dinner. He had a massive heart attack on Christmas morning. We couldn't revive him. He's dead."
• Pat Harrold is a GP practising in Co Tipperary
