Does She Still Need Me? Will She Still Feed Me?

One of the questions in Sir Paul's ditty isn't a question for me, though: if I'm out 'til quarter to three, I'm certain that whether or not the door is locked will be way, way down on my list of concerns.

I'm sixty-freaking-four years old today. How did that happen?

Predictable YouTube drop-in:

Erin go Thud, Part Three and Last

(Click the following links to see:
Part 1, or
Part 2.)

View northward from the Seaview B&B, Friday, 13 August, 2010.
This was the only photo I took that day -- a shame, really, since it was a spectacularly-clear day -- since we had a lot of other things to think about.

The morning of Friday the 13th was abysmal. Diane was in pain, since the prescription painkillers she had finally been given the night before had worn off, we each had virtually no sleep at all, we were afraid that we wouldn't be able to even go home (let alone follow our month's itinerary) as planned -- but, most of all, we were in a major medical situation in a country (the UK) that was foreign to the foreign country (the Republic of Ireland) in which our home base was.

We hadn't a clue as to what to do. So we cast about for information, and the best, quickest help we received was from our friend Lady Rosse back in Birr. She immediately contacted her own health-care providers with our questions, and kept us up-to-the minute with frequent e-mail messages and telephone calls. By mid-morning she had determined what we should do: as soon as we could, return to the Republic and go to the nearest Regional Hospital to Birr, one in Tullamore (only about half an hour by car north of Birr -- but about five hours away from where we were in Northern Ireland.) We shouldn't wait for a "fracture clinic," we shouldn't apply for an appointment with an orthopedist -- we should just get to Tullamore.

Just that information alone put us so much more at ease that it is hard to describe -- the pain and the anxiety were still there, but the feeling of being lost and totally ignorant was gone. And we have Lady Rosse to thank for that.

The remainder of the day was more or less adrenaline-free. We had to wait until the following day to try to drive south, since Diane's cast was still curing and travel was not advisable. She spent the day resting in Mabel Dunlop's spare bedroom, and I spent it driving around gathering various medical supplies.

Primary among the supplies I needed to get was a bottle of the pain medication that had been prescribed at the hospital in Coleraine the night before. I found a little pharmacy ("chemist's shop") in nearby Bushmills. The young lady to whom I passed my slip of paper looked at it, then at me, and asked a question in a language that had only a passing similarity to any English I am used to. Turns out that the Ulster brogue is far more like Scottish than it is like most Irish dialects, and I was baffled. We actually needed an interpreter (a very amused stock clerk) to communicate. We got our business done, but the poor young lady was irritated and I was embarrassed to my toes.

Given all of that, it wasn't until I got out to the rental car with my little bag that I realized: I hadn't paid for the pills! I went back in to pay... and was rewarded by a warm smile from my linguistic antagonist. It was a prescription. There is no charge for that.

Heading out of Antrim: serene farmland on a Saturday morning.

The following morning was clear and bright and augured well (and truly, as it turns out.) After our fourth great Ulster fry breakfast from Mabel, we set out southward for the Republic and for Tullamore.

At the Bernish viewpoint, just north of the border along the A1 motorway. Why the crutches are not attached to a human, and why the human is not in the picture in this isolated spot, will be left to the speculation of the viewer.

The drive south was very easy, facilitated by long stretches of brand-new "motorways" -- multi-lane divided highways -- in both Northern Ireland and the Republic. Our route took us through Belfast, around Dublin, and then rapidly into County Offaly in the heart of the island.

Suspension bridge over the Boyne on the Republic's M1 motorway.

We arrived at the Tullamore hospital at about three in the afternoon on this Saturday, steeled to endure yet another long, long wait in an understaffed emergency room. Ireland, like the UK, has "socialized medicine," after all, so we just figured we were in for a dose of the same medicine we endured up in Coleraine.

Not at all.

We were in and out in an hour, and considerably happier on the "out" than the "in." Inake ("triage") was quick, efficient, and friendly. The wait in a nearly-empty A&E waiting room was mere miniutes, and the physician who saw Diane was -- probably just by extraordinarily lucky chance -- a retired orthopedist who was just helping out on that Saturday afternoon.

Emergency department, Tullamore Regional Hospital, Co. Offaly, 14 August 2010.

After a quick study of the x-rays we had brought with us from Northern Ireland, he saw that the bone chips in Diane's ankle were very old, that there was no bone injury involved, and that the "box" (as he called her cast) was doing far more harm than good. He hacked off her cast in minutes (meanwhile carrying on a charming chatter about all manner of things), told Diane that the best thing she could do to facilitate healing of her sprain was to walk on it as much as she could tolerate, and sent us on our way.

It was as though a slab the size of the Clonfinlough Stone had been taken off the tops of our heads. We would be able to fly home when the time came. We would not be immobile for the remainder of our stay in Ireland.

There were still concerns and regrets, of course: concern primarily about Diane's pain. That would continue throughout the rest of the stay, helped a lot by some painkillers and by a lot of her own stubborn determination, but strong enough to eliminate a couple of major excursions we had planned (which were replaced by adventures we hadn't planned, so no net loss!) Derry was out on this trip, as was a return to the Connemara Pony Show, but that only reinforces our determination to make at least one more trip to the island, somehow, some way.

We were almost giddy when we finally rolled through the castle gates that evening, and up to the Bothy's door. Our plans had taken a major hit, but not our prospects.

"Home," inside the Bothy, 2010.

Coda: Trying to draw any conclusion about the benefits or ills of "socialized medicine" based on our experience with Diane's ankle injury would be silly. For one thing, each experience -- the negative one in Coleraine and the positive one in Tullamore -- was anecdotal and the product of a unique constellation of surrounding circumstances. Our feelings about the two hospitals could easily have been reversed. What if the major auto accident had taken place on Saturday afternoon in Tullamore instead of Thursday afternoon in Coleraine? What if the retired orthopedist had been helping out in the North instead of the South? Everything would have been different.

What is lastingly alien about both medical experiences, though, is that neither one of them included any financial stop along the way to treatment. We only recently received a small invoice from Tullamore (after a bit of fumbling on their part about where to send the bill), and have yet to hear anything from Coleraine. Our impression is that, in both countries, actually billing patients for medical care is so unusual that people "on the ground" in A&E facilities just don't think about it much, so bills can be very late in arriving, if ever.

We'll see. I still check my mailbox every day for a bill from Coleraine, but I'm not going to call them and ask them where it is.

Nymansay eucryphia near the Bothy on the Evening of Great Relief.

=========================================================

Erin go Thud, Part Two

(Continued from here.)

Last photo from Thursday, August 12 -- probably taken at just about the instant of the "thud" of the title.

I ran as quickly as I could from the clifftop back to the stile (slipping only once in a pile of sheep poop, Brian -- and I still have the stain on my MBTs as a souvenir). Diane, sitting on the ground between the two Germans, wasn't in tears but looked like she could bite through a shillelagh, so irritated with herself she was for falling. The German fellow and I lifted her so her arms supported her on our shoulders, and we hopped along after the German woman. She had found an old gate about 20 yards along the road from the stile, which we all managed to force open. After we got Diane in the back seat of the car, they took their leave.

We were only a few kilometers from our Bed and Breakfast, so we hurried back there so I could ask our hostess, Mabel Dunlop, where the nearest emergency clinic was. She directed us to the Causeway Hospital in Coleraine, about ten miles away.

We arrived at the "A&E" (for "accident and emergency" department) at around 4pm on a pretty, sunny afternoon. We left nine hours later, in the dark and the rain and a gloom punctuated only by the occasional weird feminine voice on our Garmin GPS device. The time in between isn't one I'd wish on anybody, especially not on the two of us by describing it in any great detail, so here it is in telegraphic fashion:

The emergency department was grossly understaffed and appallingly overloaded with clients. There was evidently just one physician on duty for the entire night, and, just before we arrived, several victims of a bad auto accident had been brought in. We sat in the waiting room with an increasingly large crowd of others seeking care for about six hours, but at no time saw or heard the kind of agitation one might expect. That resigned calm might have been due to the many large signs warning of "zero tolerance" for "harassment of staff" and the frequent appearance of PSNI walking swiftly through the place, belts a-bristle with all manner of police equipment. Shortly after we were called in to the rooms of the treatment area, we heard the triage nurse announce to the waiting room that anyone who could go home probably should do that and come back the next day -- and, again, we heard no grumbling, just the shuffling of feet as many left.

Once inside the A&E, Diane explained to the physician -- a very young, apparently calm fellow -- that in addition to extreme pain, she was concerned that she might have damaged her prosthetic knee joint in that leg as well. He immediately ordered x-rays of knee and ankle. Upon studying those about an hour later, he said that he saw no immediately obvious evidence of damage to the knee, but did see a number of bone chips in the ankle. Since he was not an orthopedist, he did the prudent thing: ordered a plaster cast on the leg from foot to just below the knee, and told us to consult an orthopedist as soon as we returned to the Republic.

While the cast was being put on, the head nurse gave us more bad news: if the cast stayed on, we might not be able to fly home. (It turns out that she may have been wrong about that, but it certainly would have made things a lot more complicated, and not just in the air.) She told us that we would have to find a "fracture clinic" near where we were staying in the Republic, and they would make decisions about when the cast could come off and arrange things with our airline. While we weren't due to fly back for almost another month, she thought the cast might still be necessary then and perhaps another couple of weeks beyond that.

Casting a pall on our prospects.

Meanwhile, poor Diane had been in a lot of pain for hours. While we were in the waiting room, not only could she not be given any medication, but they weren't even allowed to give us any ice to apply to the ankle. At one point, I drove into Coleraine and bought a sack of ice in a Tesco grocery store. Back in the emergency waiting room, after having rigged an ice pack for Diane, we passed the rest of the bag around.

At about 1am, she outfitted Diane with a pair of light metal crutches, helped us to our car, and sent us on our way into the night with the admonition that the cast shouldn't even touch a hard floor for 36 hours, until it was completely set.

Gloom.

Not only did the rest of the trip seem in wreckage, but we might not even be able to go home in time for school to start -- and to relieve Adam of an already too-long stewardship of Ft. Harrington.

And we hadn't a clue about what to do when we finally would be able to drive the four or five hours back to Birr. After an uncomfortable wee hours back at the Bed and Breakfast, we did two things. We arranged with Mabel to take a spare room in her house (our reservation was only through the night of the accident, and the three en-suite rooms of the B&B were already spoken for on the next night).

And we called Lady Rosse.

(To be continued.)

Erin go Thud, Part One

180-degree Panorama at the Giant's Causeway, County Antrim. Please click on any image -- but especially this one -- to see it in a larger size.

No matter how pleasant a town is otherwise, the sight of razor wire with six-inch blades atop a six-foot high stone wall around your hotel's parking lot will tend to put a damper on your enthusiasm. So will shuttered storefronts and grim, gray faces, but that was Armagh, and that was two days in the past and forgotten when we woke up on Thursday, August 12th. We were to spend most of this day among happy people and inspiring natural grandeur.

We had arrived at the Seaview bed and breakfast near the Giant's Causeway on the north coast of County Antrim the previous evening after a glorious afternoon's drive north from Armagh. Our plan for the twelfth was to be as tourist-y as we could and visit the area's three big draws: the Causeway, the ruins of Dunluce Castle, and the Carrick-a-Rede Rope Bridge. (And they are big draws: a little Googling shows that together they attract more than a million visitors per year, and the busiest month is August.)

I was a little anxious that morning, concerned about how my back would hold up with all the walking we had planned. For several months before we started our trip, I had been suffering from increasingly severe back pain and sciatica. About a month before we embarked, though, I had started wearing a pair of MBT shoes, and they had a dramatic effect on my back pain, almost completely eliminating it. There's a little problem with them, though: the reverse curvature of the soles puts a thick amount of material between one's arch and the ground, making them a little wobbly left-right and seem to increase the potential of twisting an ankle. Some of the terrain we planned to walk on this day would be particularly rough -- the head nurse in the emergency room would later tell us that they see a large number of badly sprained or broken ankles during tourist season because of it -- but I decided to wear them anyway, thinking that I needed to prevent the return of the back pain, which would put a damper on the rest of our vacation.

Diane (in yellow) navigates the Causeway.

We tackled the Giant's Causeway, the most heavily-visited of the three, first. Our strategy was to arrive early, before the shuttle vans started running from the visitors' centre down to the otherworldly hexagonal stone pillars. It worked; there were a few people there when we arrived, but nothing like the massive crowds that would be there later on in the day. The walk down was only about a kilometer, and my wobbly shoes carried me down easily. The Causeway itself presented a challenge, slippery and uneven, but I was very careful and negotiated its unevenness easily.

At the Giant's Causeway on a blustery August morning.

We spent a good couple of hours at the Causeway, marveling not only at the geology but also the sheer beauty of the north Antrim coast, and by the time we were ready to leave, the shuttle vans had begun their day and we were able to ride back up the hill to the visitors' centre. From there we drove westward along the coast to Dunluce Castle, where we arrived at about midday when the August throng of tourists (including us, of course) was starting to make itself evident.

Part of Dunluce Castle's ruins.

The castle's ruins are impressive, the coast it perches on is astonishing, and the surrounding terrain, while steep in places, presented no problems to my MBTs. By the time we had finished touring and exploring the old rockpile, it was going on two o'clock, though, and my legs were a little wobbly from the day's unaccustomed amount of walking.

Sherwood at a Dunluce picture window.

We doubled back along the coast, past the Causeway and our B&B, to the parking lot for the Carrick-a-Rede Rope Bridge. By that time, the full onslaught of tourism was under way, though, and the lot was jammed. We decided to postpone an amble across the famous rope suspension bridge until the next morning, Friday the 13th, and spend the rest of the afternoon exploring the great stretches of dramatic coastline instead, away from the crowds.

Along the north Antrim coast.

One place off a narrow side road looked especially promising for photography, a bluff at the far side of a sheep pasture which I figured would present a great view of surf pounding against rocks at the base of the cliff. We parked near a stile across the fence to the pasture. I gathered my camera stuff, but Diane decided to wait in the car. She was a bit tired, and was happy to listen to music on her iPod and watch the view from the comfort of the passenger seat, so I set out over the stile on my own.

The stile.

The last step down into the meadow was a very high one, but I managed it just fine. The fifty yards across the meadow to the cliff top was rough, as any soft surface trod by ungulates will be, but carefully watching my step brought me to the cliff top without problem. The view was every bit as spectacular as I had hoped. I looked around, planning the individual frames that would later go together in a Photoshopped panorama. When I had twisted around to my far left, though, rapid motion at vision's periphery caught my attention. I turned quickly to look back the way I had come from and saw two people at the stile, waving energetically at me. I started to wave back, but then saw that they weren't waving a greeting, they were gesturing for me to come back.

And then I saw Diane's head between them, just above the top of the knee-high grass.

She had decided to follow me to the cliff after all, but, distracted by the beauty of the scene and her music, she hadn't noticed the stile's last deep step. She had fallen badly, hitting the ground forcefully and awkwardly on her right ankle and knee, and could not get up. She was in excruciating pain.

(To be continued.)