Across the Wide Zambezi: A Doctor's Life in Africa (45 page)

     Another consideration in favour of
my ‘doing it yourself’ was due to the national shortage of urologists. Urology
is a superspecialty, and if specialists are thin on the ground in Africa,
superspecialists are almost invisible: less than half-a-dozen urologists in the
whole country. So if I referred a prostate patient to the urologist in Bulawayo
he would be sent home with a catheter to wait as long as a year or more for
operation, and though most of them seemed to survive this otherwise unavoidable
expedient the inevitable infection did not do them much good.

     Then Percy said, what about
thyroids? Endemic goitre is common on the high plateau of Central Africa,
where, as in all high country, the soil is deficient in iodine. I had now got a
contract for Percy at the government hospital, and although he only operated in
the worst cases, he was soon doing one a week. But I never dared follow him in
this tricky operation, and when he left, the cases themselves fell off to their
previous number.

     The better answer here was
preventive, through iodised salt; but although available, it was four times the
price of plain salt.

One afternoon, at the end of a five-hour
session in the operating theatre, I began to feel ill. On my way out, they
called me to see a case on the wards. I had to lean on the end of the bed, I
felt so faint. When I got home, I felt so tired I thought I must be getting too
old for surgery - which has been proved to be as heavy on the heart as manual
labour, and not so healthy.

     I had supper, and was thinking of
an early bed, when I was called to the hospital again: a road traffic accident.
Fortunately, the patient did not need more than observation, as I had hardly
been able to drag myself to the ward, and on getting home, was only able to
stagger into bed. Terry became concerned.

     At eleven o’ clock, they rang me
for a caesar. I was only able to pick up the telephone: impossible to stand up.

     It was Friday night. By a piece of
administrative ineptitude, abysmal even for me, even though it was that golden
age when we had four doctors on the station, I had let the other three leave
for the week-end. Terry got on the line to the mine doctor, who was also alone.

     He came and saw and diagnosed - at
any rate, guessed - gave me a cocktail injection of all the things he had in
his bag, and then the good fellow did my caesar for me into the bargain. Before
dawn, Terry had to call him again for an appendix (not me). And he never even
put in a bill for his fees.

     Next day I felt slightly better,
but towards evening, I developed awful stomach pains - no diarrhoea or vomiting
- and felt feverish. Terry had started a four-hourly temperature chart, at the
suggestion of my colleague, the night before. A dreadful sleepless night was
succeeded by a stormy day. I found at last that Doloxene could control the
pain, but I still felt feverish.

     Then I had a good look at the temperature
chart. I saw something that every doctor or nurse in Africa would (and all
European ones should) recognise: a rising pattern like a step-ladder or
staircase. This meant only one thing: I knew I had typhoid fever.

     How I got it, I do not know. It was
the typhoid season: there were at least a dozen cases on the wards. Maybe I
hadn’t washed my hands often enough; a piece of unwashed fruit from the market.
My colleague from the mine agreed and started me on chloramphenicol.

     Fortunately, Stephan had only taken
one night - on Saturday he was back in time for a busy week-end.

     On Monday, the delayed diarrhoea
started. I feared for my family, and they put me in the mine hospital for a day
or two, until it went off. But I still did not feel well.

     It was three weeks before I had the
strength to take a turn up the hospital road, and that did for me for another
two weeks. My temperature rose every evening for most of five weeks.

     I was well enough to read. I
studied every morning: I studied whenever I could in Africa - more than I ever
did, before or since, after leaving the medical school. I had to. And in the
afternoon read
The Raj Quartet
- all through it. When I was weary of
reading, I picked up Poucher’s photos of the Lake District, and re-lived old
days on the hills.

     And after five weeks, as I said, I
was fit for work. It is good for us doctors to sample the diseases we deal in:
it shows us the patients’ point of view. And I was writing to people in
England: ‘It is at times like this that one appreciates the ‘modern age’ (pace
Evelyn Waugh). Fifty years ago you might have got this letter from my widow.’

Until he retired, Jock and I would share
a Sunday lunchtime drink on the veranda of the Nilton, or on cold, grey winter
days, in the lounge. On the latter occasions, Jock, who hated the cold, would
declare: ‘This weather reminds me of Manchester.’ (Where he had been an
assistant medical officer of health). ‘The most Gawd-forsaken place on earth!
I’d sooner sweep the streets of Bulawayo.’

     People would approach our table.
One was Mr Gonzo, a watch-mender, who had a little desk on the pavement in the
main street. He looked like Karl Marx, painted black. It was fatal to offer him
a drink. He would take a seat and call the waiter himself, who knew his order
(at any rate, for treats). An imported Scotch would arrive. Zimbabwe produced
its own whisky, which I had described to curious connoisseurs in England in
Thurberish terms as ‘a rough colonial blend, but you have to admire its
muscle’. It was good enough for me, at any rate, and as much as I could afford:
imported being about four times as much. More than once, I instructed the
waiter, ‘Mr Gonzo takes Gold Blend when he drinks with me.’

     Mr Gonzo (whose name means ‘mouse’
or ‘rat’, according to taste) would look pained and exclaim: ‘But you are my
doctor! Aren’t you thinking of my stomach?’

     I introduced him to Jock as a
‘watch-doctor’, a description which Mr Gonzo always reinforced: ‘A
watch-doctor, not a witch-doctor.’

     He demonstrated his political
incorrectness when I called him a bloated capitalist. ‘I am a poor man. I am
telling you the truth. I would not lie to you. I would lie to my wife; but you
are a man. That is another thing.’

     Once, when Jock had gone to the
toilet, a woman with a baby on her back, who had been modestly sipping a Coke
by herself at a nearby table, slipped over to me.

     ‘You remember me? You save my
baby.’

     I expressed pleasure at this news.

     ‘You cut me, and save my baby.’

     A caesar. She unfolded the little
fellow, and presented him for my inspection. Just before Jock returned, she
added:

     ‘You lack to fack me?’

     I explained that that was not our
usual fee. With a sly look at Jock, she gathered up her child and slipped back
to her place.

     ‘What was all that about?’

     Another day, a black man sat at a
nearby table by himself, looking about him in a rather agitated way. Presently,
he approached us.

     ‘Please can you tell me the way to
Belingwe?’

     ‘Sit down,’ invited Jock. ‘I can
tell you all about Belingwe.’

     He ordered the man a drink, and did
so. The man had something else on his mind.

     ‘I have just come from Ghana,’ he
said, rather breathlessly. ‘I had to put down at Lagos airport, and you’ll
never guess what happened to me there. I asked to go to the transit lounge. I
told them I was on my way to Zimbabwe. And do you know, they sent me to the
arrivals lounge, and when I tried to get back, they said I didn’t have a stamp
in my passport. I told them I wanted the transit lounge: I was going to
Zimbabwe, but they wouldn’t believe me. They threatened me with the police. In
the end, I had to pay fifty pound to get back into the transit lounge.’

     I glanced at Jock, who knew the
story of Terry’s and my adventure. ‘You were lucky it wasn’t Christmas,’ I said
to the man, and told him my tale.

I had only one difference with Jock, and
that was happily resolved. I report it to show the flip side of his admirably
independent spirit.

     As I have said, we took week-ends
in turn, which included a Saturday morning ward round, when we saw all the
patients, including the other doctor’s. (This was before the arrival of Stephan
and Charles, though we continued the practice with them.) I suspected
meningitis in a baby Jock had admitted the day before. Meningitis is difficult
to detect in babies, and the signs would not have been so pronounced at that
time. I performed a lumbar puncture and got cloudy fluid. A British student,
Sam, was with me at the time. I ordered treatment. The practised nurses were
better at getting a drip into the tiny veins of a baby than I was.

     On Monday, out of interest, I
looked at the baby again, to discover to my horror that Jock had discontinued
treament. I accosted him in the corridor.

     ‘I didn’t think that baby had
typhoid,’ said Jock The baby was on chloramphenicol, used in both diseases.

     ‘Typhoid!’ I exclaimed. ‘Didn’t you
read my notes?’ (Evidently not.) ‘Jock, that baby has meningitis.’

     ‘O, I didn’t think so.’

     ‘You should have seen it on
Saturday. Anyway, I did a lumbar puncture and got cloudy fluid.’

     ‘Was it really cloudy, or just
misty?’

     ‘Jock, normal spinal fluid looks
like tap water.’

     ‘O, I don’t know. Sometimes it can
look a bit misty.’

     ‘Ask Sam. He was with me.’

     ‘I’m not going to ask a medical
student,’ replied Jock, indignantly.

     ‘Anyway, the lab reported pus cells
and haemophilus bacteria.’

     ‘O, I wouldn’t go by the lab
report.’ (Which was produced by mere assistants.)

     This was terrible. Egoism is an
occupational disease in country doctors in Africa, almost a necessary evil: but
this was sheer pig-headedness.

     ‘Look, Jock,’ I challenged him. ‘If
I am wrong, it does not matter. If you are wrong, the kid will die.’

     This seemed to get through to him.
He gave me an indulgent smile - the cheeky blighter!

     ‘All right, Warren,’ he
condescended. ‘I’ll do it for you.’

     He resumed treatment. I had the
cheek myself to make sure, and the baby made a good recovery.

The best side of Jock (in which he was
backed up by Joyce) was his almost embarrassing charity to lame ducks. He had
two children of his own, but found time to adopt at least two others: an
African girl who became a matron in UK; another, a Coloured girl, he ‘found on
a rubbish dump’ in Bulawayo. ‘Where’s your mother?’ ‘She doesn’t want me.’ Jock
took her to her home and found it was true. ‘You can have her!’

     In the time I knew him, he gave
house-room to a demobbed young white soldier, who seemed a bit lost in his
mind, with nowhere to go, before he settled him somewhere; and likewise a
schizophrenic white girl, who became quite cheeky because Jock wouldn’t play
the piano to her - a thing, as I have said, he never did for anyone, as a rule.
‘You’re supposed to be entertaining me!’ He managed to dispose of her after a
week or two.

     All in all, there’s not much more
you can do for your fellow creatures than share your home with them.

     His individualism remained
unimpaired as long as I knew him. One day, he discovered one of his patients -
a young girl with typhoid - had been discharged by her mother. ‘Why did you let
her?’ protested Jock to the ward sister, in his petulant falsetto. It was not
unheard of for patients to do this (or parents), if they did not get better in
five minutes, to go to the witch-doctor.

     Here was a clear case for an appeal
to the magistrate, under the Child Protection Act. Magistrates and their acts
were not Jock’s style: Jock’s style was the citizen’s arrest.

     He got into his Audi and patrolled
the town like a police car, until he found the runaway pair in the main street.
He got out and ordered them into the back of the car, to the amusement of the
afternoon drinkers on the veranda of the Nilton.

     And his gallantry. Another time,
Terry and I were sitting on the balcony of the bottom house, when we saw a girl
running up to the hospital, screaming and beating herself with her hands. I
suspected another lunatic. I soon got a call to the hospital - to the private
wards (which were still in existence), to see Dr Scott. I found Jock sitting up
in bed, stripped to the waist, covered in bee-stings, which the nurses were
brushing off. I ordered Phenergan and pethidine.

     Jock had been driving up to the
hospital, when he saw the girl in a cloud of bees. African bees are the
fiercest and most dangerous on earth. He jumped out and told the girl to get
into the car. She did, and so did the bees, and soon Jock was in a worse case
than the girl. How and when he got to the hospital, I do not know, but the
girl, when I found her, was more comfortable than he was. He had shut the bees
in the car, and the police waited till evening (when bees are calmer), before
releasing them and recovering the vehicle.