Homage to Gaia

by James Lovelock

  My homecoming on 1 January 1983 marked the start of a new way of life—the feverish days of 1982 were over. Helen was joyous to have me home, and the first part of January was an unusually happy time. I soon found that I could do the five-mile round walk briskly and without pain or breathlessness, but in mid-January I grew aware that I had not yet escaped the consequences of ‘industrial action’ at King’s College Hospital: an abscess as large as an egg grew on the wound scar that ran down my chest. My physician arranged for me to have it drained at the North Devon Regional Hospital in Barnstaple and, in the mildly euphoric state engendered by the success of my bypass operation, I took this in my stride as a minor affair, and so it was. By the beginning of February, something more serious began to obtrude; I found that it took minutes to empty my bladder. I returned to Barnstaple hospital again for day surgery to enlarge what was assumed to be a small stricture—a side effect of the heart surgery—and I was not apprehensive, but when I came round from the anaesthetic I was aware of a great deal of pain. I imagined it was to be expected—the penis is a sensitive part, that is half its use. I thought it would soon pass, but it grew worse. A nurse appeared after an hour or so and gave me some tea to drink and said, ‘Try to pass water as soon as you can.’ I did try but nothing happened. I recall little from then until I found myself on a bed in a ward of the hospital in severe pain and the discomfort of retention. I tried to pee but it would not flow, and by 7 o’clock that evening, I was feeling desperate. I remember crouching on the floor next to my bed to ease the pain.

  After a while, the nursing staff noticed my misery and fetched a pair of interns. I should add that I had not yet realized the necessity of whingeing to get attention. As an Englishman, I suffered unnecessarily because of my stiff upper lip. A white woman doctor and a black surgeon came to my help. The woman gave me a sizeable injection of intravenous Valium, but it was without effect on the discomfort and pain. They then tried unsuccessfully to pass a catheter into my bladder. The Valium must have been working to some extent, because the pain of doing this was not as great as I thought it would be. The young surgeon was most solicitous and said, ‘I’ll give you an operation to fit a supra-pubic catheter as soon as I can, but you might have to wait another two hours, because I’ve two operations now to do, and one of them is an emergency appendectomy that cannot wait.’ They left me dazed, in pain and profound discomfort from an ever-extending bladder. Well meant but foolish offers of more tea from nurses I turned aside. Never can I recall time passing so slowly, and it was not until midnight that relief came. They took me to the operating theatre and the surgeon performed his work using a local anaesthetic. It seemed to take an age to cut through the layers of tissue over the bladder but at last he was through, cut a slit in the bladder wall, and inserted the catheter: the relief was incredible. In some ways, I found the discomfort of retention worse than pain. I remember thanking this young man profusely and then falling into a deep sleep and not awakening until the following morning.

  I was now in King George the Fifth ward. A modern form of open ward consisting of bays containing about six beds, three on each side, and dispersed along a corridor. It was better than single rooms, but nothing like the friendly atmosphere of the old Nightingale wards. Architects had fiddled again, and fiddled to no good, with Florence Nightingale’s design. I now suffered no pain or discomfort, and the supra-pubic catheter, with its pipe emerging from my abdomen, was doing its job. A nurse came and attached a leg-bag for me so that I could walk around. Helen and Margaret soon appeared, bringing with them my dressing gown, slippers, and razor. As soon as I had changed from the gown lent to me on arrival, I went with them to the canteen, where I tried to tell them what had happened, but did not really know myself. Later that day I saw the surgeon responsible for the disastrous dilatation and asked, ‘Whatever went wrong?’ ‘Nothing went wrong,’ he said. ‘You had the worst stricture I have ever seen. It went all the way from the glans to the neck of the bladder. I’ve no idea what caused it but you must have had a roaring urethritis.’ Oddly, it did not occur to me then to connect this disaster with the catheter used at King’s.

  In a few days, the oedema surrounding my urethra subsided, and I found that I could pee at a reasonable rate. The supra-pubic catheter was removed, and I prepared to go home, thinking, ‘This has been rough but now I can resume life again.’ The surgeon warned me that it would close up and would need dilating again, but the after effects would not be so severe as those I had just experienced. Within three weeks, the flow declined again to a few cubic centimetres a second, and I was back at Barnstaple. Sure enough, the second time was not as bad as the first and after an hour or so I could pee, although painfully. Every three weeks I was back in Barnstaple for more dilatation, but now after each of them the pain was worse and more prolonged. Margaret Sargent came to collect me from the hospital, and each time the sixty-mile journey over country roads was agonizing. I seemed to be taking antibiotics and codeine painkillers almost continuously. The year before I had almost enjoyed the dreamy but quite bearable threat of imminent death, but I now faced a painful decline that filled me with despair. I knew that I could not go on like this, but even so, I kept up my daily walks, no matter how hard they were to do.

  In between the painful excursions to Barnstaple, business kept on as usual. I travelled to London for meetings, and to America to maintain my obligations to my customers there. In April 1983 I visited New York at the invitation of the United Nations University and saw my friend, Walter Shearer, at the United Nations Building. There we discussed the plan for a meeting the following summer in Corsica. I vividly remember having to give a lecture on Gaia to the Sigma Xi Society, of which I am a member, in Washington. I was in severe pain during the introduction by the chairman of the meeting. When I rose to cross the floor, it intensified, and I fainted and fell on the floor. Within moments, I had staggered to my feet, and to the lectern. The audience seemed to think I had merely tripped on a cable. I looked at my lecture notes and saw only a dark blur with no words distinguishable. Somehow, on automatic pilot, I started my lecture, and after a few minutes could see my notes again. It seemed to go all right—audiences could be most tolerant. No one commented on the fraught beginning.

  Life from February until June 1983 was a nightmare of pain and despair. What I had hoped would be a cure at King’s College Hospital seemed to have worsened my affairs. Rescue came in a letter from a past colleague of my days with the Medical Research Council, David Pegg. He wrote asking if I would give an after-dinner speech at a conference in King’s College Cambridge on cryobiology. It seemed an occasion on which I could reminisce and tell stories about the Mill Hill Institute in the 1950s; it also gave me the opportunity to cry for help. I replied, saying that I would love to come, but warned that, because of my frequent visits to Barnstaple, I might not be in a position to do so. I asked him to recommend a first-rate urologist who might be able to cure my affliction. He replied promptly, recommending the surgeon Michael Bishop, who operated from the City Hospital in Nottingham. The next day I had a sympathetic letter from Mr Bishop, inviting me to go there to have the next operation performed by him in July.

  I took the train that goes cross-country from Exeter to Nottingham, and travelled from the station by taxi to the City Hospital—a large, multi-storey building occupying a sizeable area. Mr Bishop came to see me soon after I settled in the ward, and explained what he would try to do. It was surgery of the urethra—a urethrotomy—he said, and then explained that it was a careful and painstaking procedure, done using the magnified view of an endoscope, not the crude surgery done at Barnstaple. Here, blunt instruments had dilated my injured urethra—they had used thin stainless steel rods called bougies to expand the damaged tissue. I had my operation the next day, and learnt from Michael Bishop that the repeated attempts at dilatation in Barnstaple had produced a mess of broken tissues and blind passages. He had made some much-needed repair, but warned that I needed a great deal more before my urethra w
ould function properly again. It would not be necessary for me to make repeated journeys to Nottingham, as a skilful surgeon, Mr PI O’Boyle, practised at Taunton, in Somerset, much closer to where I lived. He would write to him and explain what I needed when my urethra began to close again. As the train drew away from Nottingham and passed through the flat industrial landscape of the Midlands and on towards the West Country and Devon, I felt a great sense of thankfulness. At last, it seemed that I was safe again. Michael Bishop did such a good job that there was a wonderfully long interval of eight weeks before it was necessary for me to go to Taunton.

  During that respite, I travelled to the United Nations University meeting on the island of Corsica. At Coombe Mill in early July 1983, the temperature rose, most unusually for England, into the nineties Fahrenheit and stayed there for most of the week. We were lucky to live in a mud-and-straw constructed house, a kind of English adobe—cob is the word Devonians use to describe it. The two-to-three-foot-thick walls keep a cool environment in hot weather and a warm one in winter. The heat capacity of all those tons of mud was such that its temperature could only slowly respond to that of the air at its surface, and it required weeks of torrid heat or freezing cold to change it from comfortable to unpleasant. The English climate, with its endless samples of weather—hot and cold, wet and dry—almost never tested it to its limit. Corsica, strangely, seemed cool after Devon, although the Mediterranean was heavenly to swim in, which I did on most days, from a rocky cove beneath the hotel where we were staying. The distinguished environmental scientist, William Clark, was my companion for much of the stay in Corsica, as well as my friend, Walter Shearer. As at all scientific meetings, the key things were said tête-à-tête at the restaurants in the evening, or during walks to and from the beach. I sometimes wonder why there are so many prepared talks at scientific meetings; we would do better to spend our time in private conversation.

  Eventually, in September, I knew I had to go to Taunton for more surgery. I arrived at Musgrove Park Hospital and went to Ward 3. It was a familiar old-fashioned ward, part of a temporary wartime hospital built in the 1940s, a series of huts angling from a boardwalk—ugly and well beyond its anticipated lifetime. Perfect, I thought, for a propaganda film by American private medicine to show how awful was the National Health Service and socialized medicine. In fact, the quality of the surgery and nursing care I received during the twenty-five or so visits I was to make there over the next thirteen years, could not have been bettered anywhere in the world. It was comforting to see, on a recent visit to Ward 3, a party of surgeons from the distinguished Mayo Clinic who had come to Taunton to learn about the pioneering techniques that my surgeon had developed. Unlike King’s College Hospital, the interior was warm, clean, and amazingly full of laughter. The domestics here were local women, and they seemed to know that they were an essential part of the hospital system. They took care of us and hastened our recovery; their friendly concern and help showed what should have been the conditions in Lonsdale ward.

  I first met Paddy O’Boyle in Ward 3 one Thursday morning in September 1983. I had not expected an immediate operation when I arrived there, and so had breakfasted before leaving home. ‘Never mind,’ said Paddy, ‘Over lunchtime I will have a look at your urethra by endoscopy and we’ll use an epidural anaesthetic’ A cheery Australian anaesthetist did the epidural as I waited on the operating table. Then my legs were set up on a stand, similar to that used for women in labour, and a blanket was set up between the surgeon and me. I wondered if this was to spare my feelings, but not so. The blanket slipped off during the surgery and Paddy asked the nurse to put it back. I said, ‘I don’t mind,’ to which he replied, ‘But I do.’ It was good to know that I had a sensitive surgeon. What he did was little more than endoscopy, to look at the extent of the damage and then decide on the repair that he would have to do. The endoscope, being somewhat large, automatically dilates the urethra anyway. Michael Bishop had done a fine job clearing up the worst of the ragged mess—the traumas of King’s College and Barnstaple together—but there was still a great deal to do. Paddy warned me that the incidental dilatation now done would last only a few weeks. I must prepare myself for a prolonged spell of urethral surgery. He said, ‘It will involve operations every week for quite a while. You will have to come here every Sunday afternoon and leave on the following Tuesday. Can you arrange your life to make this possible?’ After the previous miseries this seemed no great problem, and he started the long series of operations that eventually led to a partial cure. There was pain, but nothing like the agonies I had experienced at Barnstaple. The only bad times were when I experienced a proctalgia: this is a nearly intolerable pain in the inguinal region and it came on when there was, simultaneously, inflammation of the urethra and the bowel. It seemed to be a consequence of taking antibiotics to keep bladder infections at bay. My physician, Alan Edwards, gave me Temgesic tablets to ease the pain; these are fast-acting, tiny sublingual tablets of a synthetic opiate. They certainly did the trick, although with a pleasant side effect of a day’s excitement and euphoria. Not something to which I would want to become addicted but, again, it made me realize and understand better what appeals to the drug users whose daily lives are often bleak and cheerless. I have often wondered how much addiction is part of our personal programming: are those who lead normal lives in much danger of becoming addicted to drugs? After all, we rarely drink to excess when life is good. I was fortunate to be able to work in a laboratory attached to my home and I managed, during this period, my two visits a year to the United States and some to Europe.

  There were about five more visits like this to Taunton, where Paddy O’Boyle diligently repaired blind holes and other problems caused by the crude dilatations with stainless steel rods at Barnstaple. He tidied up my urethra to make it again a pipe, rather than something like an inverted river delta, but there was still scar tissue from the damage done earlier. The problem with scar tissue is that it contracts, and I needed relatively frequent operations to keep my urethra open. A less serious side effect was that I now had a curved penis when it was erect. Then came the day when he said, ‘I do not think there is much more I can do by urethrotomy, so we have to decide what the next option is. The main problem is the contraction of the scar tissue; it makes dilations every three weeks a necessity. After talking with my colleagues, I have decided that the most useful thing we can do is to make a short channel from your bladder to the inguinal region. In other words, to arrange for you an artificial urethra that would be similar in construction to that in most women. Next time you come to Taunton, prepare for a longer stay, perhaps ten days.’ With the thought that my penis would soon be redundant, celibacy seemed now not to matter quite so much. I resigned myself to this next ordeal. I must admit that, during this period, I became quite obsessed about trade unions, and cheered when the union leader Arthur Scargill lost his long battle over the mines.

  As I drove along the M5 on the way back to Musgrove Park Hospital, my mind was full of the consequences of my next operation. I nearly missed the turnoff, exit 26 for Wellington and Taunton. I do not much care for cars or driving them, but there is no other way to travel from Coombe Mill to Taunton. The welcome I received on arriving at Ward 3 was warmer than usual, and everyone there seemed to know that tomorrow’s surgery had profound consequences for me. I had for some time regarded the ward staff as almost a second family, and knew most of them well. A great deal of this strength and cohesion came from those most closely associated with it, especially from Sister Chant and the surgeon, Paddy O’Boyle. Sister Chant wore the dark blue dress of a hospital Sister, with its belt and silver buckle, and she wore it with authority. She wore it in a way that Florence Nightingale would have approved. She was no mere senior nursing officer, although that may now be her title. Doctrinal egalitarianism does not allow for honourable vocations, like nursing. I cannot imagine her, whatever the provocation, joining in a strike. In all of the fourteen years of visits to Ward 3, I have heard her rais
e her voice only twice. She did not need to. Whether by choice or by accident, the staff appropriate for Ward 3 seemed to gravitate there and to stay. Prominent amongst them was Robert Conway, also a quiet and powerful figure, whose striking appearance was part of the ward’s quality. The staff called it the grandfather’s ward, since most of the patients were over sixty and having some or all of their prostate gland removed.

  A strange incident occurred at this time. I had brought with me to read a book by the author, Richard Cowper, called The Road to Corlay, first published in 1978. I did not usually read books of this kind: it was science fantasy. To me, science was fantastic enough anyway, but Richard Cowper wrote so well that I have read and enjoyed immensely everything he has written. He had also written to me personally about a small story in my first book, Gaia. He was keen to use it after revision, and publish it as a short story, and sought my permission, which I gladly gave. I was looking forward to a good read, while I waited in the afternoon and evening before the next day, when I was to be partially converted in the female direction. I had reached page sixty when I was astonished to read: