The first patient at crew surgery was a seasoned rating with a handkerchief clasped to his jaw:
“Got a toothache, doc ... Been troubling me for ages, now ... ”
The lilting Welsh accent was straight from the valleys; I took to him immediately.
I had been evacuated to Breconshire in Wales with my cousin Eric, at the beginning of the war, when my father had joined up, and my mother had returned to work as a receptionist at the Savoy Hotel, a post she had held when she first met Dad. My earliest memories were of the farm in Llangammarch Wells, and the Pughs who ran it. Daffyd Pugh was a tall lean leathery man, out in all weathers tending his sheep and cattle, with the help of his nephew Danny and his two sheep-dogs, Spot and Flash; his wife, Bronwen, was a squat comfortable woman in a floral apron, always busy about the house. They both spoke with very strong accents, so that it was frequently difficult to tell whether they were speaking in English or Welsh. They had no children of their own, and Danny Thomas, a gangly spotty teenager, appeared to be their nearest relative. As we grew older, they seemed awkward and tongue-tied with us; nevertheless Eric and I could sense the strength of their love. We were the children they never had, the children they had yearned for.
The farm house was an ancient building with low ceilings, small windows, and smoke-blackened oak beams. On the ground floor, one entered from the front door straight into the living room/ kitchen, heated by an old-fashioned cooking range and an open fire; these burned all day long, summer and winter, giving off the pleasant smell of wood-smoke, and a formidable heat. Plates were displayed on the Welsh dresser, and flowers in vases decorated the room. The place was crammed with furniture: dinner table, chairs, stools and easy chairs, in addition to the large dresser; I still have vague recollections of Uncle Daffyd, hunched in a comfortable arm-chair, his feet on a stool, a pipe stuck in his mouth, his glasses perched on his nose, his face engrossed in a newspaper, while in the background came the competing sounds of the wireless and Auntie Bronwen.
A narrow uneven stairway led up to a landing on the first floor; off this were two bedrooms and a small bathroom. The large bedroom in the front was occupied by the Pughs, and I never passed through the door. At the back was the smaller, homely, but still comfortable room which served as our bedroom and play area. Eric was nine months older than I, much taller and more heavily built. We spent the war years and the first two or three post-war years in each other's company, and I thought of him as a brother. Though I was thoughtful and frequently buried in my books, and he was more physical, good at fighting and proficient at sports, yet we were always very close, almost inseparable. We played in our room with our toys: soldiers, farmer, dogs and farm animals. As I grew older, I would often read in bed when Eric had already dropped off to sleep, stopping only when the summer light faded. Sometimes, I would be woken by the noises of the night: the call of the night birds (some achingly lovely melodies, some harsher), the coughing of a fox, joined after a while by the barking of the dogs, the distressed shriek or squeak of a small animal pounced on by a night predator; the owl hooting later, perhaps in satisfaction. The moonlight penetrated our thin curtains, casting deep shadows. Eric lay on his side facing me, sleeping heavily, a blissful expression on his face.
Among the outbuildings was the sole toilet, a bit inconvenient in the winter, but no bother to us, who had grown up with it. Some chickens pecked in the yard, and a cockerel strutted among them and woke us at dawn with its crowing from the roof of the cow-shed. (Auntie Bronwen's duties included feeding the chickens and milking the cows.) Off the farm-yard, a little way up an overgrown track stood the large barn. Fields stretched towards the purples, greens and browns of the mountains.
When we were five, we joined the village school. Here they spoke Welsh, and I soon acquired a grasp of the language. I would lose most of my vocabulary soon after returning to Clapham at the end of the war; however I retained my Welsh accent until it was overlaid by a South London intonation in my early years at Clapham Grammar.
Eric and I, though we considered ourselves natives, were for many years treated like outsiders by the other children. We were suffered to join their games of marbles, milk-tops and football in the playground; my favourite activity, however, was wrestling, at which I was notably unsuccessful by virtue of my small stature and poor stamina. Time after time I had to be rescued by my much stronger, heavier cousin; yet always I would come back for more! The centre point of the village may have been the pub, but for Eric and me it was the general store. Here we could browse for hours, assessing the merchandise, surreptitiously examining the customers, eavesdropping on their conversations:
“I hear Megan Phillips has bought a new hat ...”
“There's posh for you ...”
We hardly paused at the post-office grille (even when there was no queue), not even to examine the official-looking posters (“Watch your speech; careless words kill ...”). The grocery section, with its display of tins and jars, the hams and cheeses that hung from the ceiling, was scarcely more riveting, though I sometimes stopped to watch the shop assistant finely slicing ham on a brightly polished white and chrome machine. For Eric, the centre-point of the establishment was the confectionery section: he would stand to gaze wistfully for seemingly hours at the tall jars of sweets, liquorice all-sorts, sherbets, candies, toffees and bars of chocolate. I, on the other hand, was drawn to the rack in the middle of the shop, which displayed newspapers, comics and children's books – they had the Beano, the Dandy, Film Fun, Radio Fun, and Rupert Bear Annuals, and I longed for them.
Most of our leisure time was spent “helping” on the farm. We would watch Uncle Daffyd move the sheep to a new field or to the pens. The two sheep dogs, Spot and Flash, had shining black and white coats; in outward appearance they were very alike; however they had totally different personalities: Flash, though fully grown, was the younger; he bounded about, expending his energy profligately, always happy, tail always wagging. Spot behaved much more maturely, was more thoughtful, was the natural leader of the pair. They worked the sheep as a team, taking their orders from the farmer's whistles, but Flash glancing frequently at his partner to check that he was in the right place at the right time. They moved together stealthily in a crouching crawl, their stomachs almost touching the ground; Uncle Daffyd placed his fingers in his mouth and gave a piercing whistle; immediately the dogs lay down and waited, while the sheep moved a few paces in a group; when one of the sheep strayed, Uncle Daffyd would whistle again, and Spot would effortlessly bring it into line with the group. Sometimes the farmer would point his walking-stick (he didn't use a shepherd's crook), when Flash was especially obtuse; the dog would respond, and the situation would be saved. Eventually, the sheep would enter the pen, and the farmer, who had positioned himself at the gate, closed and latched it; for a few moments discipline would be relaxed, as the dogs rushed over to us, tails wagging furiously, waiting to be petted, rolling over to be stroked, Spot vying with his younger brother to demonstrate his enthusiasm, loyalty and love.
The dogs used to lie by the fire in the living room at the end of the day, after they had been fed, heads down, one eye open, an occasional wag of the tail, hoping that the farmer, his wife, or one of us boys would give them some attention. Sometimes, Flash would make soft growling sounds in his sleep; he was having bad dreams. Next morning, when we got into Uncle Daffyd's old van to drive to another part of the farm, the sheep-dogs would race behind us; then one after the other they jumped over the tail-gate into the back of the van, where they kept Eric and me company until we reached our destination.
The cart-horse that was used to pull the plough and the hay-wain, was chestnut and white, sleek, well-groomed, but (especially to my eyes) massive; initially I was frightened of this giant who towered over me; however, I soon discovered that he was quite docile; he allowed me to sit on his broad back, grasping his mane, while he ambled slowly behind the farmer who held his reins. When Eric saw that it was safe, he took his turn.
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bsp; Danny was in charge of getting in the hay, after it had been cut and left to dry. I remember his lanky figure lazily but efficiently arranging it into equal piles with a pitch-fork, and then stringing these into bales; we helped him load the bundles onto the cart, sat on the top of the loaded cart, Danny leading the horse by the reins, and finally stood on top of the hay-stack in the barn, fielding the sheaves which Danny expertly propelled up to us with the pitch-fork, and treading them down neatly to keep the top level.
Occasionally, we had visits from our mothers, who at that time seemed rather shadowy figures. They took us for snacks at the local cafe (a lemonade and a piece of cake); they bought us presents in the village shop (for me always a handful of comics, or a small book; for Eric – sweets). My favourite activity with my mother was to be taken on the bus to the next town, where there was a cinema; here I first experienced the thrill of moving pictures, and began a love affair which endured through the whole of my childhood. I was gripped by Bette Davis, smoking through a long cigarette-holder, plotting to murder her husband; and convulsed with laughter at the antics of Will Hay as a provincial station-master; I could hardly bear, at the end of each performance, to find myself on the street in front of the cinema, in broad daylight with the dying rays of the sun still peeping over the roof-tops. After the war, I saw much more notable films, such as the Alan Ladd Classic Western, Shane, and the Gothic thriller, the Spiral Staircase (which causes my flesh to creep even now); however these early motion pictures made an equally lasting impression on me because they were the first. In spite of these undoubted treats, I was always secretly relieved, when, after a day or two, mother left, and we were alone again with our Auntie Bronwen and Uncle Daffyd. When the war finished, my worst fears were realised, and we were sent back to Clapham to our real parents. I continued to correspond with Auntie Bronwen at Christmas, even after Uncle Daffyd had died, but I never achieved my ambition of returning to Llangammarch Wells to visit them. However, I still get a stab of pleasure mingled with pain, at the musical cadences of a Welsh voice.
I looked: his teeth were yellow-brown stubs from a combination of tobacco and caries; the lower right premolar was loose, and he was pointing to this.
“I'll try and take it out, but I've never done a dental extraction before ... Sure you want me to go ahead with this?”
The sailor gave a lopsided grin, and nodded emphatically. I searched in the instrument cupboard, where there was a complete set of dental forceps; I selected a couple of instruments at random, boiled them up in the steriliser; I sat him under the light, tilted his head back, grabbed one pair of forceps, and began. Fortunately, Charlie Hardcastle had given me his one useful piece of advice, when I had started on the Koh-i-Noor:
“To extract a tooth, always push in first, then twist, and then pull.”
I followed his instructions, and the tooth came out sweetly. It was only later I remembered that I had omitted the local anaesthetic.
I struggled through the rest of my clinical workload, which fortunately was light.
“There's a passenger here at the hospital ... Injured his arm ...” Agatha Pitrose was on the phone, a trace of irritation in her voice. “Dr Hardcastle isn't answering. Could you come and have a look at him, Dr Scott? I'll have Joe Spall on hand, in case the patient needs an X-ray.”
I cursed Hardcastle under my breath. I was still feeling groggy.
“I'll be right over, Sister.”
Sister Pitrose seemed pleased to see me. She was in her early forties, a big hearty lady with a ruddy face and candid blue eyes. She had a reputation as a hard drinker and a heavy smoker, and was variously described as “hard as nails” and “tough as old boots”. Yet she had a soft heart. All who came in contact with her were drawn to her: the other sisters confided in her; the children's hostesses sought her out when they were in trouble; Joe Spall could be found in her cabin at midnight, drinking cocoa; even Charlie Hardcastle treated her with a grudging respect.
The patient, a First Class passenger in his mid-fifties, in white shirt, white linen trousers and a panama hat, was grimacing in pain; he supported his right fore-arm with his good hand. The pipe, clamped between his jaws, had gone out. He looked vaguely familiar, and I realized that I had previously seen him in the company of Christopher McFee, when he had got lost on the junior officers' deck. As I entered the cramped consulting room, Sister Pitrose handed me the thin folder, with the terse notes “James Hemmingway; date of birth – 16th January 1910.”
“Good afternoon, Mister er Hemmingway, I'm Dr Scott, assistant ship's surgeon ... Perhaps you can just tell me what happened ... Then I'll have a look at you.”
I learned that he'd been strolling along the sun-deck; the weather was picking up, and the ship was pitching and rolling a bit. He had lost his balance, and fallen onto his outstretched hand.
“Been damn painful ever since ... Haven't taken any pain-killers ... Wanted you to see it first ... Came straight here ... Didn't want the little woman to see, don't you know – she'd just have fretted ...”
With Sister's help, I eased the arm out of his shirt sleeve (“Save having to cut it out with scissors, Mr Hemmingway ...”).
“Now show me exactly where you feel the pain, sir ...”
There was a red area over the lower end of the right fore-arm, with some bruising but no obvious deformity; tenderness was maximal over the lower third of the radius, but there was none over the scaphoid bone. I didn't try stressing the bones (as I vaguely remembered from my student days that I should), in case I caused displacement of any fracture.
“We'll get an X-ray; but first I'll give you something for the pain ... Pethidine injection, please sister – 50 mg.”
She had it all prepared; I checked it, and she gave it into his buttock with a minimum of fuss. Without delay, we took him to the small room next door, where Joe Spall awaited with the rather ancient Siemens portable X-ray machine. (“Always take an X-ray,” I had been advised by central office. “Otherwise you risk litigation.”) The machine was aligned with a white stripe on the floor; the back of a chair with a second marker. We sat the patient on the chair.
Joe Spall had been a hospital orderly in the merchant navy for thirteen of his thirty years, and on the SS Koh-i-Noor since her maiden voyage three years ago. He was a tubby cockney, effeminate, neat, efficient, always ready with a smile and an apt phrase. He was the only one in the department who knew how to work the temperamental machine; now he positioned the patient's arm, checked the X-ray plate in its holder. Neither of us wore a lead apron; so I stood well back, while Joe turned a dial, pressed a button, and thumped the casing with his fist. We waited: the machine hummed gently to itself, and then stopped with a click. Joe took the plate to the dark-room to be developed, while I accompanied Mr Hemmingway back to the consulting room ...
I knocked on the door, and entered when invited to do so. The main light was back on. Joe had processed the film through the developing fluid, and was just removing it from the fixative, using what looked like wooden laundry tongs.
“Soon done, doc,” he greeted me cheerily. “'Fraid the old Siemens portable's a bit past 'er prime ... me brother Sid's a radiographer at a proper 'orspital ... The London in Whitechapel Road, near where I wus born ... amazing what some of them new machines can do ... Still I'd rather be 'ere wiv this old museum piece – yer can't beat the briney and the good ol' Koh-i-Noor.”
He clipped the X-ray film onto a washing-line, and allowed it to drip into the sink.
“We keeps a stock of a dozen films ... replenish 'em as we go ... often no X-rays taken on a whole trip, an' then we might use two or three next time round. Sister Pitrose keeps a check on it all ... Care to 'ave a butcher's – a look,” he asked after a couple of minutes, when it had stopped dripping. He popped it on an X-ray viewing box. I could just about distinguish the bones from the background – it was like looking through a blizzard.
“'Tis what we, in the business, calls a nebulogram,” he continued with a cheeky gri
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The only thing I could be sure of was that there was no displacement of any fracture of either radius or ulna; whether there actually was a fracture I couldn't ascertain!
“Thanks Joe. Can I borrow this for a few minutes?”
“Sure doc, but let's 'ave it back. I needs to dry it prop'ly.”
Armed with the film, I returned to the patient. He seemed much more comfortable: the pethidine was having its effect.
I held the film up to the light:
“Here's the fracture, Mr Hemmingway.” I pointed to a black line on the radius, which might have been a crack, but could equally have been an artefact. “The good news is that there's no displacement.”
Joe, who had been hovering, retrieved the X-ray and disappeared.
“Now we'll need to put the arm in plaster.”
The plaster trolley was ready, and Sister Pitrose wheeled it in. I cast my mind back to the Orthopaedic Firm of my medical school days. I applied stockinette from axilla to the finger-tips of the right arm; next, I immersed bandages impregnated with gypsum in a basin of water; with these, I bandaged the arm from the hand at the metacarpo-phalangeal joints to well above the elbow; there was an exothermic reaction as the Plaster of Paris dried, and it felt warm; I moulded the plaster with my hands, cocking up the wrist, abducting the thumb and bending the elbow, before it all solidified; I added a couple of extra layers of plaster to the outside to strengthen it, checked that it was not too tight, and that the patient could move his fingers; finally, I trimmed the stockinette; I waited for the plaster to set solid, before tapping it with my finger-tip – the resonant note confirmed that it had indeed set.
Death on the Koh-i-Noor (Edwin Scott Crime Trilogy Book 3) Page 7