Adventures in Two Worlds

by A. J. Cronin

  On the following day we lost two of our patients. It was Hasan himself who sewed their shrouds, who in his hoarse and hollow voice read aloud a short passage from the Ramayana before their bodies, wrapped in sailcloth, with a weight at their feet, were cast overboard at midnight.

  No fresh cases developed. And a week later, in the sulphurous light of early dawn, we anchored off Colombo, the Cingalese port doctor and officials came aboard, all formalities were completed. Before the first of the passengers was awake, the yellow flag had been lowered and the sick men taken off to hospital. Several of the patients showed signs of having passed the crisis, but three, helpless and delirious, a mass of running sores, were carried to the lighter, like children, in the arms of Hasan. As we stood together, watching the flat launch bobbing towards the shore, I saw that the serang‘s dark cheeks were wet with tears.

  Our passage through the Bay of Bengal was brief and uneventful. I had barely time to recover myself, or to realise that the epidemic had been confined, before we had navigated the mud flats of the Hoogli and were anchored alongside the quay at Calcutta. A general celebration marked our arrival – sirens blowing, favours floating in the breeze, final rounds of drinks, the decks crowded with people waving and shouting greetings to friends meeting them on the dock. Suddenly, at my elbow, I heard the familiar shrilling of Miss Jope-Smith.

  ‘Oh, look, look, Ronnie. There’s that absurd creature again.’

  Once more I followed their united gaze. And there, again, down in the afterhold, knocking out the hatch battens to unload the baggage, his squat figure foreshortened from above, with long arms swinging, more ungainly than ever, was the object of their mirth – Hasan.

  The huntress from Cheltenham swung round, bent her wit, her fascinations upon me.

  ‘Where did you keep him all the voyage, Doctor dear? In a special cage?’

  Silence – a vision of the serang‘ s nobility rising before me.

  ‘Yes … in a way … it was a cage … But isn’t it queer, Miss Jope-Smith – the animals were all outside.’

  Though I kept my voice even, I thought that I should suffocate. Abruptly I turned away, went below to my cabin, and beat my clenched fists hard against the wooden bulkhead.

  Chapter Five

  Scotland again, and real Scots weather – sad contrast to the sunny skies and spicy breezes of the tropics. On the deserted little platform of Dundonald Junction I stood in the blinding wind and rain, wondering if I should take a cab. Economy denied the cab, dignity demanded it – not my own dignity, but that of my new position.

  At length I beckoned to the red-faced cabby in the long green coat, who, from beside the one flyblown four-wheeler that graced the station exit, had been considering me for the last three minutes with a stealthy, speculative eye.

  ‘How much to Tannochbrae village? Dr Cameron’s house.’

  Auld Geordie cautiously came over. None of your southern alacrity, none of that ‘Cab, sir!’ nonsense about Geordie. He knew his worth, did old Geordie Dewar, and never sold himself for less.

  ‘How much luggage have ye got?’ he parried, though the luggage was plainly seen – one portmanteau upon the pavement, and a small black Gladstone bag, a very new bag, which I gripped in my right hand. Then he added:

  ‘You’ll be Cameron’s new assistant, I’m thinkin’?’

  ‘Just so!’

  ‘Two shillings to you, then – Doctor.’

  He threw a cunning emphasis upon the title, but for all that I kept my head and said sternly:

  ‘I mean the short cut.’ I who had never been in Tannochbrae before! ‘Not the long way you proposed to wander round with me!’

  ‘As Goad’s my Maker …’ protested Geordie.

  A lively argument ensued, at the end of which a compromise – one shilling and ‘the price of a pint’ – was effected with expressions of good will on both sides.

  The portmanteau was slung upon the roof, old Geordie climbed rheumily upon the box, and I was rattled off along the stony moorland road.

  At the end of the voyage home, Captain Hamble had pressed me to remain with him on the Ranaganji, but at the same time had honestly advised me against lapsing into a routine which, to his knowledge, had turned many an eager and ambitious young man into a lazy and lackadaisical ship’s surgeon. The captain had been extremely kind to me and in Calcutta had taken me ashore many times to lunch at the Grand Hotel and to see the sights – the great temples and gilded palaces, the teeming bazaars where sacred cattle roamed and ravaged the stalls at will, the gorgeous botanical gardens filled with exotic birds and blossoms, the grisly burning ghats that lined the waters of the Hoogli. All this had fascinated me, had stirred within me a longing to record my impressions of so exciting a scene. Yet, I was fully aware of the sound sense in Hambles’ warning, and hearing from a classmate at the University that there was an assistantship vacant in Tannochbrae – ‘Not much, mind you … Regular country practice … and he’s a hard nut, old Cameron, though a rare good sort at heart’ – I had, not without reluctance, quitted my berth in the ship.

  So here I was, hunched in this mouldy four-wheeler, clattering down the cobbled street of a small West Highland village. Halfway down we swung to the right, into the drive of Arden House, a soundly built white stone dwelling with a coach house at the side and a semi-circular spread of lawn in front.

  The rain dripped miserably as I sprang up the front steps and rang the bell. After a minute, the door opened and the housekeeper, a thin, elderly woman, dressed entirely in black, confronted me. Her hair was tightly drawn, her person spotless, and in her bleak face was stamped authority mingled with a certain grudging humanity; she had the look, indeed, of one tempted terribly to smile, who guards perpetually against a single sign of levity, lest it ruin her self-esteem.

  For a few seconds she inspected me, my bag, my hat, even my boots; then, with a slight elevation of her brows, my luxurious background of horse and cab.

  ‘Ye’ve a cab!’ she observed severely, as though I had arrived in the state coach drawn by four cream horses. A pause. ‘ Well! I suppose you’d better come in. Don’t forget to wipe your feet.’

  I dutifully wiped my feet and ‘came in’, feeling that I had made a bad beginning.

  ‘The doctor’s out,’ she announced. ‘He’s fair run off his legs, poor man, since the last assistant left. Aah! He was no good, that one – no good ataaal!’ And with a faint shake of her head, as though, in her considered judgement, I would not prove much better, she left me marooned on the hearthrug.

  Somehow I had to smile. Then I glanced round the big, comfortable room – the dining-room, it was – with warm red curtains and red turkey carpet, a blazing coal fire, and furniture of sound mahogany. No aspidistra, thank God! A big bowl of apples on the sideboard, a full glass barrel of biscuits, and whisky in the square-cut decanter. No pictures, no photographs, but, of all things, three yellow violins hanging on the walls. A good – oh, a decent room to live in. I was warming myself pleasantly at the blaze when the door was flung open and Cameron came stamping in.

  ‘That’s right,’ said Cameron, without a handshake or a word of preamble, ‘warm your backside at the fire while I work myself to death outside. Dammit to hell! I thought Stirrock said ye would be here this mornin’. Janet! Janet!’ – at the pitch of his lungs – ‘For God’s sake bring in our tea.’

  He was a medium-sized, oldish man with a face beaten bright crimson by Scots weather and Scots whisky, and a pugnacious little grey imperial, now dewed with raindrops. He stooped slightly, so that his head had a forward, belligerent thrust. He wore gaiters, cord breeches, and a big, baggy tweed jacket of a nondescript, vaguely greenish colour, the side pockets stuffed to the bursting point with everything from an apple to a gum-elastic catheter. About him there hung invariably the odour of drugs, carbolic, and strong tobacco.

  Obtaining a good three-quarters of the fire, he inspected me sideways and asked abruptly:

  ‘Are ye strong? Sound in wind and
limb?’

  ‘I hope so!’

  ‘Married?’

  ‘Not yet.’

  ‘Thank God! Can ye play the fiddle?’

  ‘No!’

  ‘Neither can I – but I can make them bonny. Do ye smoke a pipe?’

  ‘I do!’

  ‘Humph! Do ye drink whisky?’

  My dander had been rising under this interrogation. I don’t like you, I thought, as I looked at the odd, unprofessional figure beside me, and I never will. I answered surlily:

  ‘I drink what I like, and when I like!’

  The spark of a smile gleamed in Cameron’s sardonic eye.

  ‘It might be worse,’ he murmured, and then: ‘Sit in and have your tea.’

  Janet had swiftly and silently set the table – cake, buns, toast, preserve, brown bread, home-baked scones, cheese, and bannocks – and now, with the big brown teapot, she brought in a huge dish of cold ham and poached eggs.

  ‘There’s no falderals in this house,’ Cameron explained briefly as he poured the tea – he had beautiful hands, I noticed, hard-skinned, yet supple. ‘ Breakfast, middle-day dinner, high tea, and supper – plain food and plenty. We work our assistant here, but – by your leave – we don’t starve him.’

  We were well through the meal when Janet came in with more hot water. Only then did she say impassively:

  ‘There’s a man been waiting this last half-hour – young Lachlan Mackenzie, him that has the steading up Inverbeg way. His bairn’s badly, he makes out.’

  Cameron arrested a piece of oatcake halfway to his mouth to let out his favourite oath:

  ‘Dammit to hell!’ he cried, ‘and me up at Inverbeg this mornin’ and passed his very door. Th’infernal eediot! I’ll wager the child’s been sick for days. Do they all think I’m made of steel?’ He checked himself. Then, with a sigh which seemed to let off all his boiling steam, he added in quite a different voice, ‘All right, Janet. All right. Let him come in here now.’

  In a moment Mackenzie stood in the doorway, cap in hand – a poor, shiftless-looking crofter, very much abashed by his surroundings, and terribly nervous under the doctor’s interrogating eye.

  ‘It’s the boy, Doctor,’ he muttered, twisting his cap. ‘The wife thinks it’s the croup.’

  ‘How long has he been poorly, Lachlan?’

  This friendly use of his name gave the young fellow confidence.

  ‘Two days, Doctor – but we didna’ think it was the croup …’

  ‘Ay, ay, Lachlan. The croup! Just so, just so,’ A pause. ‘How did ye get in?’

  ‘I just walkit in, Doctor – it’s not that far.’

  Not far! It was seven miles from Inverbeg to Tannochbrae. Cameron rubbed his cheek slowly.

  ‘All right, Lachlan man! Don’t you worry. Away with Janet now and have your tea while the gig’s bein’ got round.’

  Silence in the dining-room when he had gone. Cameron reflectively stirred his tea. Almost apologetically he said:

  ‘I can’t be hard on a poor devil like that. It’s a weakness I never seem to get over. He owes me for his wife’s last confinement – he’ll never pay it. But I’ll get out the gig, drive seven miles, see the child, drive seven miles back. And what do you think I’ll mark against him in the book? One and six – if I don’t forget. And what does it matter if I do forget? He’ll never pay me a red bawbee in any case. Oh, dammit to hell! What a life for a man who loves fiddles!’

  Silence again; then I ventured:

  ‘Shall I do the call?’

  Cameron took a long pull at his tea. The bright satire was back in his eye as he said:

  ‘That’s a braw wee black bag ye’ve got – ay, I see it on the sofa – brand-new and shiny, with your stethoscope and all the new contrivances inside, bonny and complete. No wonder ye’re fair itchin’ to use it.’ He looked me straight in the face. ‘All right! Ye can go. But let me warn you, my lad, in a practice like mine it’s not the bag that matters – it’s the man!’ He got up. ‘Do the call then, and I’ll do the surgery. Take some antitoxin with you to be safe. It’s on the right-hand shelf as you go in the back room. Here! I’ll show ye. I’m not wantin’ you to drive seven miles to find out that croup is liable to mean diphtheria.’

  The gig was waiting outside the front porch, with Lachlan already in the back, and Jamie, the groom, standing ready with the waterproof sheet. We set off through the wet, blustery night.

  In the village the rain fell heavily enough, but when we crossed the bridge and breasted the hill it broke upon us in torrents. The wind drove full into our teeth like a hurricane.

  Fifteen minutes, and I was half drenched; my hat saturated, trickles of water oozing down my neck, and my precious bag, which I held upon my knees, streaming like a wet seal. I wanted to curse the weather, the practice, and Cameron; but I shut my teeth and said nothing.

  It was bad, bad going. The road was dark, too, the gig lamps so blurred by a film of mud that Jamie had difficulty in keeping the horse upon the road. Away to the right, behind massed firs, were the lights of Darroch, vague, unfriendly; and to the left, lying like a great dark beast, the amorphous bulk of the Ardfillan Hills.

  We went on through the pitch blackness and the rain in silence. Then from ahead came the quick lapping of water against some hidden shore.

  ‘The loch!’ said Jamie, by way of explanation. They were the only words spoken during the journey.

  The unseen road wound now by this angry, unseen water. Then, three miles on, we bore sharply to the left and stopped finally at a small steading where a single illuminated window seemed some-how swamped and hopeless in the great void of sodden blackness.

  As we climbed out of the gig, Lachlan’s wife opened the door. She looked no more than a girl despite her clumsy sacking apron and uncouth brogues. A coil of hair fell carelessly down her neck, and her big eyes were dark and youthful against the anxious pallor of her face. She helped me out of my wet coat in silence; then, though she still said not a word, her worried eye indicated the kitchen bed. I walked over to it, my boots squelching on the stone-flagged floor.

  A little boy of three lay tossing under a single blanket, his brow damp with sweat, his face completely livid as he gasped for breath. I asked for a spoon, but did not use it; instead, with my finger I depressed the child’s tongue. Yes! The whole of the fauces covered with thick, greenish-white membrane. Laryngeal diphtheria!

  ‘I’ve made him some gruel, Doctor,’ the mother murmured, ‘ but he doesna’ … doesna’ seem to fancy it.’

  ‘He can’t swallow,’ I said.

  Because I was nervous my voice sounded unsympathetic, even harsh.

  ‘Is he bad, then, Doctor?’ she whispered, with a hand at her breast.

  Bad! I thought, with my fingers on the pulse. She doesn’t dream how bad he is! Bending down, I made a complete and careful examination. There was no doubt at all – the child was dying. What a horrible position, I thought again, that this should be my first case.

  I went to my bag, opened it, filled my big syringe with 8,000 units of antidiphtheritic serum. The child barely moaned as the needle sank into his thigh and the serum slowly filtered in. To gain time I went back to the fire. Jamie and Lachlan were in the room now, too, for it was the only warm place in the house. They stood together by the door. I could feel their eyes on me, watchful, expectant, together with the terrified eyes of the mother. I was the centre of that humble room. They looked to me to do something for the child.

  What was I to do? I knew very well what I should do. But I was afraid. I returned to the bed. If anything, the boy was worse. In half an hour, before the serum could act, he would be dead from obstruction of the windpipe. Another wave of fear came over me. I had to make up my mind, Now – at once – or it would be too late.

  Automatically I faced round. I felt myself so young, so utterly inept and inexperienced in the face of the great elemental forces which surged within the room. I said in a manner wholly unimpressive:

  ‘T
he boy has diphtheria. The membrane is blocking the larynx. There’s only one thing to do. Operate. Open the windpipe below the obstruction.’

  The mother wrung her hands, and screamed:

  ‘Oh, no, Doctor, no!’

  I turned to Jamie.

  ‘Lift the boy on to the table.’

  There was a second’s hesitation; then slowly Jamie went over and lifted the almost senseless child on to the scrubbed pine table. But at that Lachlan broke down.

  ‘I canna’ stand it! I canna’ stand it!’ he cried weakly, and looked around desperately for an excuse. ‘I’ll away and put the horse in the stable.’

  Blubbering, he rushed out.

  Now the mother had recovered herself. Pale as a ghost, her hands clenched fiercely, she looked at me.

  ‘Tell me what to do, and I’ll do it.’

  ‘Stand there and hold his head back tight!’

  I swabbed the skin of the child’s throat with iodine. I took a clean towel and laid it across those glazing eyes. The case was far beyond an anaesthetic; madness to think of using it. Jamie was holding the oil lamp near. Setting my teeth, I picked up the lancet. I made the incision with a steady hand, but I felt my legs trembling beneath me. A deep incision, but not deep enough. I must go deeper, deeper – go boldly in, yet watch all the time for the jugular vein. If I cut that vein …! I widened the incision, using the blunt end of the scalpel, searching desperately for the white cartilage of the trachea. The child, roused by pain, struggled like a fish in a strangling net. God! would I never find it? I was muddling hopelessly, messing about – I knew it – the child would die; they would say that I had killed him, I cursed myself in spirit. Beads of sweat broke out on my brow, as I remembered, suddenly, MacEwen’s fatal words: You will never be a surgeon.

  The child’s breathing was terrible now, thin, infrequent; the whole of his tiny thorax sucked and sobbed over each frightful, useless breath. The neck veins were engorged, the throat livid, the face blackening. Not a minute longer, I thought! He’s finished, and so am I. For one sickening instant I had a quick vision of all the operations I had known – of the cold, immaculate precision of the Infirmary theatre, and then, by frightful contrast, this struggling, desperate thing dying under my knife upon a kitchen table by the flare of an oil lamp, while the wind howled and stormed outside. Oh, God, I prayed, help me, help me now.