The Hospital in Buwambo

by Anne Vinton

  “Sure, sure,” Mike agreed, as the senior surgeon bustled into the room, waving them all aside. “I’ll tell her that with pleasure.”

  Dr. MacAlpine was in one of his “stand no nonsense” moods. He missed Sylvia badly. His present pupil had ten thumbs, and his promised assistant hadn’t yet materialized. He also had the suggestion of an approaching migraine.

  “Dr. Shale,” he roared to his anesthetist, “the patient’s blue. Jig him up a bit.”

  Martin looked at the various dials beside him.

  “Everything reads all right, sir,” he said smoothly. “He’s fine.”

  “Fine! Fine, he says!” The surgeon stooped to lift the patient’s eyelid. “I like ‘em pink, Shale, and pink I’ll have ‘em, dials or no dials. Now give him more oxygen!”

  There was a furious little silence followed by the hiss of the oxygen mask.

  “We’ll now continue,” Dr. MacAlpine stated stiffly. “Will you come forward, Dr. Hogan, if you want to see the job done. If we can keep this fellow alive long enough”—he darted a scathing glance at the anesthetist—“he’ll walk on legs that match in future.”

  “You’re inserting a new ligament?” Mike asked, interested. “Yes, from the shoulder. The nuisance is in having to open two places. Trying for the patient. Double shock. Now...”

  Martin sat in a silent, sulky fury throughout the long afternoon. He would have liked to match wits with the surgeon, but no one got far with “Auld Reekie,” as MacAlpine was affectionately dubbed, and he could not afford to let himself go. His job was not worth a fig since he had failed in a diploma exam recently, and missed promotion. Life seemed to have recoiled on Martin of late, dating from Sylvia’s departure for foreign parts. He missed her more than he could say, though his vanity would not acknowledge love. Her serenity, her grace, her cool presence had had a narcotic effect on his emotions, soothing rather than rousing, but as necessary as sleep. Now he could never relax with anyone. Pressure made him irritable and sulky by turns. His popularity had dwindled since the breaking of the engagement. Though it had been a joint decision, Kay Waters was the one who had been hurt by it. She had wanted to marry him and raise a family, therefore she had wished to give up working. The idea of providing for a wife and possible children out of one salary stunned Martin. Others might do it. Let them. He wanted to do the best for himself, not be worse off by marriage.

  He saw now, clearly, that the ideal partnership was with Sylvia, who loved to work. Here would have been a physical gain and no financial loss. Impulsively, he had leaped in the wrong direction and so lost a gilded—if not a golden—fortune.

  But had he?

  Even Africa was not the end of the world—and wasn’t he sick to death of Augustine’s? If that lout, Hogan, could get work in Africa, why shouldn’t he? It was a prospect worth pursuing, especially with Sylvia in an escapable position at the end of it.

  “Dr. Shale!” Dr. MacAlpine was saying, with an exaggerated patient. “Would you mind joining in for a moment? I think the patient has expired!”

  Of course the patient hadn’t done any such thing. But “Auld Reekie” liked to make one jump and start like that if one chanced to wander.

  Feeling he had had a bad day, Martin found later that Sister had passed him a cup of cold tea into the bargain.

  Sylvia could not help but remember, as her dress caught on a rosebush, that other breathtaking episode in the moonlight, more than a week ago and seeming like a year. Tonight there was no moon and she was not leaving Buwambo. Gideon was her escort across the compound, boasting a new white suit with a high collar and bright buttons.

  Tonight she wore no froth of tulle, but a blue dress of broderie Anglaise with a demure coat. She had made sure of her appearance, however, and though there was no flash of diamonds about her, two pearl studs flattered her ears, leaving a warm, rested glow to flash only from her eyes.

  The superintendent was in white with a black tie, the accepted dinner dress in this part of the world. He hardly glanced at her, waving her to a chair and continuing to read an article. Gideon entered with the soup, serving with a flourish.

  “You must forgive me Dr. Phillips,” said Carroll, putting down the periodical almost regretfully. “I get so little time to keep abreast of my reading. That is a February issue. If you haven’t ordered your copy don’t bother. You’ll find a whole sheaf, filed, in my office. I see your MacAlpine’s holding forth in this one.”

  “Yes,” Sylvia acknowledged, vaguely disappointed that they were talking shop. “Dr. MacAlpine’s baby is orthopedics, but he’s had to foster it out. Do you find the article interesting?”

  “Theoretically—yes. In practice—no. You’ve done some orthopedic work?”

  “I spent three months with our Dr. Siegel, but I’m very humble about it.”

  “That’s the spirit. If you’d said you knew anything about anything after three months I’d have floored you. We’re doing an amputation tomorrow. I had the fellow brought in today for prepping. I wanted you to see a true, gangrenous limb. Do you faint?”

  “I never have.”

  “Keep a pad of ammonia handy, nevertheless. By the way, do you like this with your soup?”

  “Not particularly. Do you mind?”

  “I’m sorry. But as in future you’ll do your main eating here, you’ll have to learn to like it or lump it. Which brings me by a devious route to the present situation and you, Dr. Phillips. I’ve been making some inquiries, and nobody knows where—or if—you’ve had your meals for the past week.”

  “Oh, I picked up a snack here and there in the hospital. I ate a lot of fruit.”

  “Any enteritis?” he asked sharply.

  Sylvia didn’t answer.

  “In future I’ll vet everything you eat, if you don’t here. Luncheon and dinner you’ll take here, as Hogan did. Working days you’ll just drop in as you are, straight off the wards.”

  “Very good, sir,” she said, as he paused and Gideon whisked away the soup plates and reentered with curried mutton set in a circle of snowy rice.

  “Do you like your house now?” Carroll asked.

  “Oh, yes. I forgot to thank you.”

  “You’ll have the water in a day or two, then we’ll get you a larger tub.”

  “You’re very kind.”

  “Not at all. The more comfortable you are the more efficiently you’ll work. I have to consider these things. Owing to the smallness of your quarters, and the consequent lack of privacy, I have given you a blind houseboy. He’s a good lad and will guard you with his life. His name is Kadiri.”

  “I don’t really need a houseboy,” she protested.

  “Your position here merits a personal servant. He will bring you breakfast, tea, attend to your laundry and clean your shoes, et cetera. Watch your cigarettes if you smoke. Do you?”

  “No.”

  Carroll regarded her.

  “I really know very little about you,” he said thoughtfully.

  “When I first came you didn’t want to know. Remember?” she teased him.

  “Ah, yes. When you first came...” There was a somewhat pregnant silence. “Dr. Phillips, you. are here against all my early— er—intentions. Please discount also my early—frivolities, shall we say? In a certain playful, airy mood I may have appeared like a bull calf in the spring, but spring does not come to Africa, Dr. Phillips. I am no longer particularly young, and I can’t afford to be foolish. Do I make myself clear?”

  He looked positively aggressive in hiding his embarrassment. Gideon brought in raspberry jam tarts deluged in custard.

  “I understand you perfectly sir,” she said levelly. “I am much younger than I feel, and I was never given to foolishness. Pity as it may be, we’ll just have to work together.” And she smoothly changed the subject. For the rest of the meal they talked about impersonal topics.

  Sylvia crossed the compound without joy. She had not noticed her accompanying shadow until she groped for the key to her quarters.


  “Drat!” she exclaimed as it fell to the ground.

  “Permit me,” said a soft voice, and Sylvia bit back a scream. She had no flashlight.

  Deft fingers found the key in the dust and inserted it into the lock.

  “Shall I light the lamp for you?”

  “Please do,” Sylvia urged.

  Once light flooded all was reassuring. She saw a tallish figure wearing a white robe and a woolly cap lowering the mosquito netting and tucking it under the mattress on the bed.

  “Would you be Kadiri?” Sylvia asked.

  “That is so.” The steward had a soft, deep voice.

  “Will you like tea at this hour?”

  “What a luxury!” Sylvia beamed. And then she remembered that the lad could not see her encouraging smile. When he had lit the lamp for her, he, himself, was left in the dark world of blindness.

  A great pity welled up in her bosom.

  “Tea would be very nice, Kadiri,” she said gently. “Then I will go to bed. You, too, can go to bed.”

  Outside the crickets chorused and fireflies starred the bahama grass to splendor. The air cooled and the first rain of the season fell in a shower with drops that lashed on Sylvia’s small house like the racketing of pebbles thrown at a window. This was followed by a potpourri of scents rising like vapor to the nostrils, and delightfully sedative. The fertile earth drank greedily, and in the morning the red dust was again as dry as a bone—as though the rain had never been. It seemed hotter than ever.

  Sylvia had ignored the injunction to have a handy ammonia-soaked pad on this important morning, when, for the first time, she would be working alongside her senior.

  On this morning, however, she had thought for one dreadful moment that she must succumb to the most overpowering nausea she had ever experienced. The patient was wheeled in in the normal way by two orderlies. After that nothing about him remained normal. As he was transferred to the operating table Sylvia saw with horror that two or three portions of rotted flesh remained on the sheet covering the trolley.

  Sylvia felt her knees weaken. Carroll’s voice came from a long way off.

  “I can start without you, if you like.”

  From that moment sheer discipline came to the woman’s aid.

  “I’m ready,” she said quietly, but steadily.

  The crinkle of the blue eyes above the mask was sheer encouragement. Sister Kineton’s statuesque immobility by her instrument trolley was a challenge.

  “Why is it in this state?” Sylvia felt she had the right to ask. Surely Dr. MacAlpine had seen nothing quite like this in his long experience.

  “Ignorance, Dr. Phillips. To the remote villager we are a very limited concern. The medical units that periodically visit him can inoculate him against diseases and pull his teeth, but when he is sick unto death, no one mentions his name. I must have passed through this lad’s village a dozen times and I never knew of his predicament until his mother asked if I could remove the body. I had him brought to Buwambo village and billeted with Kushi Abimola, a widow with some nursing .experience. For a consideration Kushi takes a patient to prepare him for treatment. I have had Taki on penicillin for two weeks and gradually given him to believe that life is not over. Is he in good shape. Dr. Kalengo?”

  “Maintaining a fair pulse, sir.”

  “Right. We’ll proceed. Ready, Dr. Phillips?”

  “I think so, sir. I am the right side for you, I presume? I feel rather odd.”

  “Dr. Carroll operates left-handed,” Sister Kineton said sharply.

  “I’m sorry. I didn’t know.”

  Sylvia felt as though David Carroll had crossed a wide gulf in that crumb of information. He seemed withdrawn and touchy, his brows meeting, his keen blue eyes on the job.

  “Clamps!” he called.

  Sylvia nipped the arteries and veins in the severed, healthy flesh of the thigh. She had never been a messy worker, and the table was a picture of cleanliness long after the femur was sawn through.

  “How’s that?” Carroll asked after an exhausting two hours.

  “Will you stitch, Dr. Phillips, please? I have some sort of cramp.”

  Sylvia did so willingly, having marveled at the dexterity of the man in his left-handedness. She remarked to Sister, when the superintendent had gone to scrub up, that it was the first time she had worked with a left-handed surgeon.

  “But he’s not, really,” Sister said tartly. “He’s a right-handed surgeon who refused to be pensioned off. There aren’t many folk who could train their left hand to take over where the right left off, are there?” and she flounced out after the patient, leaving Sylvia intrigued. She remembered the white gloves Carroll wore on the wards, the peculiar way he held his knife at the table, between third and fourth fingers. How could she find out the full, true story? Obviously Sister would not pander to the newcomer’s curiosity, disliking the alien presence as she did. The superintendent was the last person to approach.

  Sylvia gleaned a little interesting information from Kadiri. He was about twenty-four years old, speaking and understanding English better than the other hospital stewards and servants. This was due to the fact that he was town bred, his father having been head steward in a government official’s household in Kaduna. Unfortunately for Kadiri, when he was sixteen and working as a kitchen-steward and wash-boy for a trader, he awoke one night to the smell of danger—robbers had broken into the house. Kadiri raised the alarm. The robbers fled with money and linen, and—waking his employer—Kadiri felt a stunning blow and fell to the ground. He didn’t know then that the club his master wielded had taken away his sight.

  “I was taken back to my father,” he told Sylvia. “Who would employ me? I also complain much at this time. I do not like to be blind. The government man’s wife say her brother made blind in big war, and she teach me to work without sight. For this lady Kadiri thanks his God many times. When I am twenty years Mr. Earnshaw tells me good news. He say maybe I have operation and see again; he say very good eye doctor is in Nigeria...”

  “This doctor’s name?” Sylvia queried.

  “Carroll, my lady. Him very good eye doctor, Mr. Earnshaw tells me. I come Buwambo to see Dr. Carroll, but I am too sad again. Dr. Carroll he say it is mistake. He say not operate on eyes. He laugh and say belly bigger place for knife, more room to make mistake. I do not understand for I am sad. But Dr. Carroll give me work and I stay four years in this place.”

  “Do you still think about getting your sight back, Kadiri?”

  The man shrugged.

  “I forget eyes,” he said philosophically. “I am happy. Soon I take wife. If it be God’s will I shall see her one day...” He left the rest unsaid.

  Sylvia puzzled all day on his words. Had she not heard of a Carroll in ophthalmic surgery, possibly quoted by some senior in St. Augustine’s? Had not this Carroll specialized, made a name for himself? It could all tie up.

  Finding the office empty that evening, Sylvia discovered the Lancet file and burrowed deep. Eventually she found what she was seeking in an old journal. It was an article headed, “New Steps in Ophthalmology,” and it went on to describe the methods used by one David George Carroll who was successfully specializing in Harley Street.

  Surely there couldn’t be two David George Carrolls in the same generation of surgeons? Further down the file Sylvia found an even more informative paragraph. This started:

  We regret to hear of the accident occurring to Dr. David George Carroll, M.D., F.R.C.S., F.B.O.A., the rising young ophthalmologist and surgeon who severed a ligament in his hand. It may well be that a promising career will be cut short. We wish Dr. Carroll...

  Sylvia raised her eyes to see the superintendent angrily regarding her from the doorway.

  “Dr. Phillips, dinner has been waiting for some time.”

  “I’m sorry, sir.” She tried jauntiness to cover her natural confusion. “I get so little time to catch up on my reading nowadays.”

  "Reading, or—prying?” he shot at h
er, placing the copies of the Lancet back in the file.

  “Both, if you like. You must admit it’s a bit of a strain knowing only half a tale.”

  “Wasn’t it curiosity that killed the cat?” he asked her, as they left the hospital side by side for the bungalow.

  “Maybe,” she retorted. “But what on earth was the cat curious about?”

  She saw he was smiling as they entered the lighted room, driving Gideon into a frenzy of activity.

  “Well,” he asked, as the minestrone soup was set before them. “What else do you want to know?”

  She decided to take him up on this.

  “My interest is mainly professional,” she told him. “I understand you did not regain the full use of your right hand?”

  He flexed his fingers somewhat ruefully and self consciously.

  “No. I could have made a better job of it myself, I often think. But no repining. All my life I had been more or less ambidextrous. I could write with both hands, and so forth. I knew my ophthalmic work was out, but that was all I would admit. I worked, practiced, satisfied a hospital commission, and here I am. May we now close the inquest?”

  “As you wish.” She ignored his bitterness. Had he not been probing an old wound for her benefit? “Before we quite finish with it may I very humbly ask something of you?”

  “Fire away,” he invited.

  “Please would you—teach me all you know about ophthalmic surgery? May I be your pupil? I—I think I have the right sort of touch...” She stopped, uncertain of his reception of the idea. Perhaps it was impertinent of her to suggest it. Was she not there to relieve the pressure of work on him? “I’m sorry,” she said quickly. “I get carried away about my job. Of course I can’t expect you to...”

  He tut-tutted her into silence, picked up her right hand and regarded it wryly.

  “Little hand,” he said caressingly, “if you have the courage and the skill, I’ll supply the knowledge.” He released it gently, and Sylvia thrilled at the tone of his voice, hardly knowing whether he was serious or not.