Across the Wide Zambezi: A Doctor's Life in Africa by Warren Durrant Read Free Book Online

edge of the
gangway, wailing bitterly.
    'Who is that woman, Emilia?'
    'That is the rival.'
    'Who?'
    'The rival. The junior wife.'
     
    At the end of the Saturday morning
clinic one day, a crabby little old woman was brought in by her crabby little
old husband. She had a lump in her groin, which I recognised as a hernia. It
had been there three days and could not be pushed back. This was a strangulated
inguinal hernia. I suspected the lump contained gangrenous bowel, which would
need a resection (which means cutting out the bad section and joining the rest
up again). Otherwise, the little woman was going to die a lingering and painful
death.
    Once more I went to get the book out. On
the famous shelf in my office lay two or three surgical books, as Des had said.
I selected one of them.
    Classical scholars recognise two
approaches to science: the Greek approach, occupying itself with theory and
leaving the grubby practical stuff to low fellows like carpenters and Romans;
and the Roman approach itself, which gets down to the nitty gritty. My first
selected book (which shall be nameless) belonged to the Grecian category.
    After a learned dissertation on the subject
of gangrenous bowel, the writer concluded with the lordly words: 'the many
methods of operation are sufficiently well known as to require no further
rehearsal in these pages'.
    'Marvellous!' I thought (and probably
shouted: soliloquy is not unknown in the jungle). ''And here I am a hundred
miles up in the bush!'
    Fortunately, my second choice was the
Roman kind (Scottish, actually, which is the same thing) - the redoubtable
Professor Grey Turner. Quickly seeing that Professor Turner meant business, I took
him home with me and studied him over lunch.
    Of the 'many methods' known to the
Grecian gentleman (if he kept them to himself) Professor Grey Turner knew only
one - a good honest method, which was unfortunately the most pedantic and
time-consuming, as you might expect...but that's enough cracks about the Scots!
Anyway, after I returned to the theatre I removed four inches of gangrenous
bowel. The operation lasted four hours - and a spinal anaesthetic lasts an hour
and a half.
    I realised this when the little woman
started grunting. Happily, we were able to keep her comfortable with local and
morphine.
    We got her back to the ward in good
condition, with the regulation collection of tubes, and strict instructions for
NIL BY MOUTH.
    Then I went home for supper. After a
couple of hours at the club, I looked in on her on my way home. To my horror I
found the little woman had pulled all these tubes either up or out. Moreover,
her husband was bending over her, shovelling fufu down her throat (which
is cassava mash, slightly less stiff than cement), demanding angrily, what sort
of hospital was this, where they left the patients to starve?
    The fact that the little old woman made
a good recovery on this post-operative regime will be of interest to
physiologists.
     
    One afternoon, an old man brought in his
son, a lad of about sixteen, whom I found on a stretcher. He had been ill for a
week and three days ago had developed abdominal pain and become much worse. He
was hiccupping and his cheeks were sunken. When I felt his abdomen, it was
board-like. In England I would have diagnosed a perforated peptic ulcer.
    I opened the abdomen but found no ulcer.
In despair, I closed the abdomen and started antibiotics. Later that evening
the lad died.
    I wrote about this case to Howell, but
received no reply. I expect Howell was past correspondence by then, if he was
still alive: when I returned from West Africa, he was dead. At the end of my
letter, as an afterthought, I mentioned typhoid.
    Few British surgeons who had not worked
in the Third World would have made the diagnosis. Howell had served in the
Middle East in the Second World War, so might have guessed. The answer arrived
in an article on the subject in the West African Medical Journal.
    Well, I had got the two main clues,