'I thought as much. That lying bastard told me I couldn't use the car this morning 'cos the alternator needs fixing. Just wait till the bum gets home for his lunch!'
I picture the little man, innocent for once, coming home to this welcome: 'Warren says there's no such thing as an alternator in a bloody motorcar!'
Dr Sadd was not long for this world, let alone the service. After his dismissal, his wife left him and returned to Australia with the boys. He went into private practice in a small town near Salisbury but, not surprisingly, did not prosper. Soon after, I heard that he had crashed his car in South Africa and killed himself.
5 - Back to School
After a year at Umvuma I saw the post of medical superintendent at Sinoia advertised. This was another general hospital like Marandellas but larger. I was beginning to feel the limitations of the little backwater of Umvuma, not least in the direction of marital prospects. The Scottish sisters from Marandellas had called on me on their way to Bulawayo, sat outside the Falcon and declared they would go mad in a week in this place. I had my work to keep me occupied but I was human too. So, with 'the cries of unsatisfied love', I applied and was accepted for Sinoia.
There were three or four doctors there, including a consultant physician. It was a busy hospital and emergencies came thick and fast. I thought I was doing fairly well, when an old doctor (then a part-timer) drew me aside one day and told me he thought I needed more surgical training. What is more, he had written to the secretary for health (in Rhodesia/Zimbabwe this means the permanent secretary) expressing the same opinion. This was a shock and a blow to my pride, as surgery was my strongest suit and my leading interest.
The secretary came down, had a chat with my colleagues and another one with me. In the event, I agreed to go back to school again at Umtali, the main hospital of the eastern province of Manicaland; incidentally taking two steps down the promotional ladder to simple GMO again. As I was not a married man, that was the least of my disappointments.
Umtali was a hospital the size of Gwelo and had three specialists. Henry, the surgeon, was a South African of French extraction with the stern, dark looks of a South American dictator and an authoritarian manner to match, best described by one sister (white, of course) as, 'God has entered the ward!' Ian, the superintendent, was an orthopaedic surgeon, a tall, dour Scot, who was 'not one to suffer fools gladly', as they say: which I have always regarded as an ominous expression. Ivor, the physician, was a Rhodesian, like David Taylor; and that was all they had in common. Ivor was a tall, dark man of Welsh extraction and excitable temperament, who would throw the notes across the ward at the slightest provocation - with or without the clip-boards. He had a saving sense of humour - at least, he laughed as heartily at my jokes as he cursed my shortcomings.
At Gwelo, I had worked exclusively with ladies and gentlemen: at Umtali, I was to get the abrasive treatment. Which was the more efficacious, I have never been able to decide.
And at Umtali, I met up again with Jimmy Lennon, the schoolmaster from Liverpool. He had now moved from Brown's Hotel to digs. I asked him to share house with me, and he gladly accepted. We were to have a happy year together, the period of my tutelage at Umtali. Jimmy had had a sad life. He first came to Rhodesia during the war, under the Empire Air Training Scheme, based at Gwelo, and met and married a Rhodesian girl. He took her home to England with him, found a teaching post in a Liverpool suburb and a house in Wirral, 'over the water', not a very convenient arrangement. He returned home on his first day, after a long journey by bus and train, to find his Rhodesian wife, now deprived of servants, sitting weeping in the dark, and no supper ready. They struggled on for as long as they could before Jimmy decided his wife was a little tropical flower, plucked from its native soil and unlikely to flourish in the unkinder latitudes of Mersey. He found a post in Rhodesia and took her home again, Kathleen (though, in fact, her name was Rosemary).
They had three children, but the marriage still did not prosper. Jimmy went home on leave to England alone and on his return found that his wife had left him, taking the children, and gone off with a communist: adding insult to injury as far as Jimmy, a devout Catholic, was concerned. Moreover, through some sort of influence, she had got him transferred to Wankie, the remotest and hottest part of the country, in the hottest month, October - the 'suicide month'. (This part of the story seems to require further explanation.) For Jimmy, it was the lowest point in his life: he told me how he cried himself to sleep at night and wished he would never wake again. Or rather one of the lowest points. The second came just before he joined me at Umtali, when his two daughters were killed in a car crash.
He would get to Salisbury when he could to see his children. His wife seems to have got her hands on his money for he was very poor. He told me how he would hitch a lift down to Bulawayo in the guard's van (300 miles), and the same to Salisbury (another 300 miles), and back, over a week-end. Finally, his wife divorced him - a position Jimmy, for religious reasons, never recognised, despite the advice of more 'advanced' priests of his church to the contrary. To complete his desolation, the communist was expelled from the country, and took Jimmy's family with him.
I was introduced early to Henry's style after an operation one night. Their teaching method there was not very good. Henry and Ian did all the operations, even the minor ones: the GMOs gave the anaesthetic and learned what they could by watching the masters. This was still useful to me: I had had my hands on already and could learn much by watching; but it was no good for tiros, and to do them justice, before I left, they were beginning to change it for more practical methods.
I had prepared a case of ruptured ectopic for Henry - or thought I had. I had needled the abdomen and got blood. Thinking to kill two birds with one stone, I sent this blood to the lab for the usual business, including matching stored blood for transfusion. When Henry arrived, I gave the anaesthetic and watched him as best I could while still watching the patient.
After the op, in the changing room, instead of changing, Henry sat sombrely in a chair. I was about to change when he stopped me with a question.
'What was the trouble about that woman's blood tonight?' he asked in the tone of a Victorian headmaster on ‘your record this term’.
'I don't understand.'
'That I can well imagine.'
He paused, then continued: 'How did you obtain the blood you sent for grouping and cross-matching?'
'I sent the paracentesis specimen.'
'And did you expect that specimen to clot?'
I wasn't sure, so said nothing. Besides, I have always considered the Socratic method unneccesarily patronising.
'Of course, it wouldn't bloody clot!' shouted Henry, unable to contain his natural choler any longer in the cold judicial manner which did not suit him. 'And how was the man going to group and cross-match the blood if the specimen didn't clot?'
What he meant was, the technician had to test both cells and serum, which would only separate in a clotted specimen. The blood I sent had already clotted in the abdomen, and was simply a kind of soup, which would never settle out. This, Henry could have explained in two sentences, as above. But that was not his style: his style was the rhetorical style.
'First prrinciples man!' he bellowed, rolling his 'r's' like a Dutchman, which he was not, although he came from the Orange Free State. By now he was pacing up and down like Hitler on one of those days his generals used to hate. 'I'm talking about first prrinciples! Not your bloody Brritish Medical Journal wrritten by intellectual twits and show-offs, trrying to get ahead in the rrat-rrace!' (I agreed with him about the British Medical Journal, or rather, for practical value, preferred the more basic publication, Tropical Doctor; but this did not seem the occasion for discussing the various merits of the medical press.) 'I'm talking about the things you were supposed to learn as a medical student!'
Well, that covered a multitude of forgotten lessons, and I was not going to learn them from Henry that night. I had to sit down and work them out
next day, which I suppose is one way of teaching.
Next, I got it from Ian. Admittedly, a shameful case on my part. A young soldier came to outpatients who had lost his nerve about military operations - the bush war was spreading further, and had now reached all the eastern districts. I had no idea how to deal with this case. I knew nothing of Moran's theories of the 'anatomy of courage', as indicated before, though his book was obtainable then. I had heard of cases of airmen involved in crashes, who were sent straight up again, before they lost their nerve. This was, of course, inapplicable in the present case, which I would have seen if I had given the matter more thought. But on the spur of the moment, I told him about this method and suggested he try and carry on.
Fortunately for the lad (if not for me), the case reached Ian's ears: most things did. He sent a message for me to await him in his office. When he came in, he berated me at the top of his voice. At least, he told me what I should have done: namely, put the poor fellow off duty on tranquillisers; for which I was grateful, if not for the way he said it. I felt like asking him if this was his usual way of addressing his colleagues - the short answer to that was 'yes', as far as the GMOs were concerned, and I later learned I had shared the dubious honour with his own son-in-law; but I lacked the necessary confidence and missed the opportunity.
At least I was not lacking in cold courage, and decided to have it out with Henry, who had given me the rough treatment more than once. I arranged a meeting with him.
'Yes, Warren,' he smiled, as soon as we were alone. 'What can I do for you?' He could be charming when he wanted: he was unfailingly charming with women, and I have to say he was kindness itself to children.
'Mr Denard,' I began, falteringly. 'I am afraid that you bully me sometimes.'
He said it was entirely unintentional, and asked me to give an example.
'Well, the first time was the case of that ectopic, when I sent the paracentesis specimen to the lab. I thought the way you spoke to me then was not very friendly.'
'Please understand, old chap,' he pleaded. 'I do not claim to be a gynaecologist.'
This was pure flannel, and Henry knew it. A brilliant career in politics awaited him any time he chose to take it up.
There was more pleasantry of a similar sort, and the meeting ended on a friendly note - as they say in Belfast.
Two days later, he was as bad as ever again.
I have already mentioned Ivor's discus-throwing performances. I was rapidly becoming the whipping boy of the hospital.
I can joke about it now, but at the time it caused me some distress, and I even lost sleep over it. Jimmy was most indignant, being a fiery Irish type himself, and was all for having a word with Ian about it, who was a personal friend of his, but I restrained him. He did not know Henry, but took the opportunity to observe him at a wedding reception. He came to some Celtic intuitive conclusion, and assured me: 'You’ll get nowhere with that man, Warren. He’s made of concrete.’
Of course, it would have been better to catch them on the wing, so to speak, in the middle of their rages, with a sharp protest; but I lacked the confidence.
In time they softened towards me. As men get to know one another, mutual confidence grows, and I am glad to say it did in this case. Before my time was up, I was enjoying good relations with them, which endured after I left.
Moreover, I was not guiltless of these crimes myself. I bullied the nurses, especially the Africans, whose cultural respect for authority impeded them from protesting. (Henry, of all people, reproved me for never saying 'please' and 'thank-you' to them; and I can’t say he wasn't justified.) This is the cowardice of the bully, who always senses the soft target - and leaves the other kind alone. This was true of my tormentors, and it was true of me. Once I bullied a sister, a Zulu girl of delicate beauty, as sensitive as a gazelle. She burst out in tearful protest at the end of the ward round. I led her outside and apologised profusely, promising her (and myself, inwardly) it would never happen again. I hope I kept my promise.
Jimmy was a great champion of the Africans, and, indeed, the poor the world over. He was much troubled by some statistic that most of the wealth of Britain was owned by ten thousand people, but admitted the strength of my argument that the important thing was that nobody should go without.
We took a holiday at Kariba over Christmas. At breakfast one day, Jimmy was dilating on the miserable wages of the African waiters. He called one over.
'How much do they pay you at this place, my friend?'
'Sah?'
'How much money do you get every month? Malini?'
'Thirty dollars, sah.'
'And how many children do you have?'
'Five, sah.'
'Listen to that, Warren! How do they expect a man to support a wife and five children on thirty dollars a month?'
The waiter went away. He spoke to other waiters, and a delegation of waiters approached the manager. (Shades of me and the latrine boys of Ghana!) The result was the manager granted them a rise of five dollars a month - miserable enough at that.
The revolution spread, and after we left, the hotel managers were no doubt asking one another, who was the funny little man who looked like Father Christmas, who had been stirring up the waiters that festive season?
Towards the end of my time at Umtali, we were joined by a young doctor from Argentina, who shared house with me and Jimmy. His wife was to follow him later. This was Carlos.
Jimmy soon found reason to reprove Carlos, who had spoken of the 'stupidity' of the Africans.
'Carlos, you must realise that that is a very offensive word to Africans. Besides, they are not stupid. Just because they are different from you, does not mean they are stupid.'
'But they are stupid, Jimmy.'
'Carlos, did you hear what I said? These people are your patients, and you will never be a good doctor unless you learn to respect your patients.'
'Yes, Jimmy. You are like my father. You look like my father, Jimmy.'
'I am not your father. I am just thinking of your good, Carlos.'
'Yes, Jimmy. You are my father.'
One day, Carlos came running into the sitting room with a soapstone head some man at the door was trying to sell him.
'Look at this head, Jimmy! It only costs ten dollars.'
Jimmy rose from his seat, went to the door and closed it in the face of the pedlar outside. He returned and spoke to Carlos.
'Now, Carlos. Just because that man asks you ten dollars for that thing, does not mean it is worth ten dollars. Ten dollars is a lot of money in this country.'
'Yes, Jimmy. You are my father.'
'I am not your father,' replied Jimmy, taking the head and leading Carlos by the elbow to the door. 'Come with me.'
Jimmy opened the door and said to the man outside: 'Now, my friend, how much are you asking for this head?'
'Ten dollars, sah.'
'Ten dollars!' retorted Jimmy. 'Tell me, my friend, which school did you go to?'
The man was taken aback, but, in true African fashion, quickly concealed it. 'St Michael's mission, sah.'
'St Michael's mission!' exclaimed Jimmy, who had taught in, or knew, nearly every school in the country. 'That's Father Flanagan's school, isn't it?'
'Yessah.'
'I know him well. And what would Father Flanagan say if he knew you were going around the country robbing people?'
'Yessah.'
'What?'
'No, sah.'
'He'd give you a good hiding, wouldn't he? Maningi shaya?'
'No, sah.'
'What?'
'Yessah.'
'So how much do you want for this head?'
'Nine dollars, sah.'
'Did you hear what I said? Do you want me to write to Father Flanagan?'
'Yessah.'
'What?'
'No, sah.'
In the end Jimmy got the head for two dollars.
About this time (early 1975), we got our first war casualties. The first three were sho
t by a white farmer on his own land when he thought they looked suspicious and they refused to stop when he called them. The country was getting very trigger-happy and nervous. Soon the notorious Amnesty and Indemnity Act came out, waiving prosecution in cases of action against 'suspected terrorists', which Mugabe found very convenient in his turn, and which remains on the statute books to this day.
The three men had been shot in the abdomen - the worst cases to deal with. Even head and chest shots were easier: they either died on the spot or required comparatively simple surgery. Limb shots had their own problems, but were still simpler than abdominal shots, which were like firing a bullet through a television set: there was so much to damage, and sometimes so hard to get at.
Henry had been involved with the Lumpa troubles in Zambia, a decade earlier. Ian had spent busy holidays with the ski-slope surgeons of Austria, where he would have learnt much about injuries. Certainly, they were both on top of modern war surgery, and in the next few months I was to learn much from them - and use it within a couple of years myself, as the war spread until it involved the whole country.
These three cases they tackled between them, swiftly, expertly and successfully, working in two theatres at a time. Then an even bigger order, when an African bus ran over a land mine, and Henry and Ian did eight rapid amputations between them in an afternoon.
Why the guerrillas (I shall use the BBC term as the most neutral: though I questioned its accuracy at the time), why they planted mines in the tribal areas, where the most likely victims were going to be African buses and other vehicles, I do not know; except to try to exclude the security forces. I asked an African doctor about it, who was sympathetic to the nationalist cause, and he simply said: 'the people accept it'.
Life went on despite these dark clouds. One night a man of about fifty was brought in. A leopard had taken his eye out. This turned out to be an occupational injury. The man was a leopard-killer. He went about his business with a knobkerrie, hanging about the affected kraal until the intruder appeared. On this occasion, the man took the opportunity to announce his retirement, while he had one eye to guide him through his old age.
Across the Wide Zambezi: A Doctor's Life in Africa Page 24