Every year we competed against the other London teaching hospitals. St. Mary’s never lost. We also rowed at the big annual regatta at Henley, in Oxfordshire, that draws teams from all over the world. St. Mary’s owned a country estate nearby that had once belonged to a family named Fleming. Ian Fleming, the creator of James Bond, had grown up in it. St. Mary’s kept a few guest rooms in the old servants’ quarters above the stables, and during the regatta they were given to us. One year we won our class at Henley. This made us eligible to join the Leander Club, an old boys’ association for rowers that was considered a big honor. Members wore pink ties and socks. Unfortunately, there was an initiation fee that I couldn’t afford.
The professor of surgery when I came to St. Mary’s was a man named Bill Irvine. He was called Willie. Willie had a drinking problem. Everybody knew it. I used to go to watch him operate. It was unusual for him to be called in late, certainly after the cocktail hour, but I remember one evening when we had a leaking abdominal aneurysm, a serious emergency. Willie was summoned. When he arrived he was drunk. His registrar had to guide him through the operation, at times taking him by the hand to put a suture in the right place.
One time I’d been gone for a week to row in the regatta at Henley. When I got back, Willie asked where I’d been. When I told him, he sighed, “Ah,” he said. “To be at Henley sitting on the lawn beneath a tent drinking champagne.”
I also remember when a woman with a lump in her breast had come to see Willie. She was waiting for him in the examination room, having removed her top. Her husband was there with her. Willie came into the room, drunk, and stumbled forward. He caught himself by grabbing the woman’s breast. The husband looked at me.
“Is he drunk?” the man asked. “IS HE DRUNK?”
I stared at the floor.
Eventually they fired Willie, a difficult thing to do to a professor.
The wards at St. Mary’s were enormous, with tall windows and high ceilings. When the hospital was built, there was a theory that a large airspace helped reduce contagion. As we moved beyond our first years of medical school, these wards became our homes. The first things we learned were how to draw blood and how to take patient histories. Students rotated between different disciplines. Six months in obstetrics, followed by six months of internal medicine, and so on. When you were on the surgical rotation, you finished up your ward rounds by eight a.m. and then scrubbed in as a third or fourth assistant in the OR. You did little during a procedure, usually nothing more complicated than holding a retractor, sometimes for hours. Everyone ignored you unless the retractor moved.
When my surgical rotation came up, I was thrilled to be assigned to the Eastcott-Kenyon team, which was the most sought-after job. Eastcott was a legend, the most senior surgeon at St. Mary’s. Always impeccably turned out in a three-piece suit, he was taciturn and unforgiving, an intimidating mentor. But if he got behind you, your career could take off.
Eventually, I became closer to Kenyon—a slightly rotund man who was as affable and pleasant as Eastcott was standoffish. But I loved to watch Eastcott operate. He was precise and methodical, with no wasted moves. And he always worked in what surgeons call a clear field. When you cut someone, they bleed. But you can’t see through blood, and so you can’t operate unless you can stop the bleeding you’ve started. You have to tie off bleeding vessels and make sure you’re not cutting anything unnecessarily. This blood-free “hemostasis” is essential. And Eastcott was good at achieving hemostasis. He always worked in a clear field.
It was good to watch these two talented surgeons work—because I really did little else but observe and stay out of the way. Eastcott and Kenyon still used the technique of total-body hypothermia for carotid endarterectomies when I was a medical student. One of my jobs was to get up in the dark of the early morning and haul blocks of ice up to the operating theater in a sack. It didn’t take any skill, but I always made sure that I brought enough ice and got it there on time.
I rarely thought about anything other than my work as a medical student. I was friendly with the crew I rowed with and enjoyed the comradery. But I was always eager to get back to the hospital. Other than Brian Jennings, I didn’t have any close friends. Brian knew another student named Hamish, whose family owned a cottage on Loch Duich, on the west coast of Scotland near the Isle of Skye. In the summer a group of us went up there on holiday. The scenery was spectacular. Loch Duich is an arm of the sea. In places it’s flanked by mountains. It wasn’t like Africa, but it was a refreshing break from grimy London.
One morning Brian took a small dory out on the loch by himself. He never came back. Later, we found the boat overturned with no sign of him. The weather was not bad, though squalls sometimes blew up quickly on the loch and he could have got into trouble. We reported Brian missing to the one policeman in the nearest village, and he helped us organize a search. But there was no trace of Brian. Hamish phoned Brian’s parents. Of course, I thought of my stepbrother, David, and his disappearance. Brian was smart and sensitive, and medical school was demanding. Had he taken his own life? Gone off to take a new identity and start life over? There’d been no indication that he was upset about anything. It was a mystery. After a couple of days, we went back to London, taking our unanswered questions with us. Like David, Brian was never seen again.
In 1969, I was awarded the Anthony de Rothschild prize as St. Mary’s most promising surgical student. Rothschild, the head of the Rothschild banking family, was a patron of St. Mary’s, vice president of the medical school, and chairman of the board of governors from 1944 to 1957. He died in the Lindo Wing in 1961. His son, Evelyn—later Sir Evelyn—continued to support St. Mary’s, as did Rothschild’s widow, Yvonne. The Rothschild bank had funded Cecil Rhodes in the development of the British South Africa Company and the colonization of what became Rhodesia. The Rothschilds, whose family tree had branches extending across all of Europe, were one of the world’s wealthiest families.
I was delighted with the prize, which I don’t think had anything to do with my having come from Rhodesia. The Rothschilds had interests all over the world, and my background would have seemed ordinary to them. The prize included a cash award that I promptly spent to attend a meeting of the International Society for Transplantation in The Hague. There were thousands of people there, including many surgeons I had only read about. On my return to London, I was asked to write a report of the trip for St. Mary’s. The report found its way to Yvonne Rothschild, who, to my surprise, took an interest in who had benefited from her late husband’s generosity. Astonishingly, she asked to meet me.
This began a friendship that was to change my life over the next eight years. Yvonne was in her late sixties when I first met her. She spoke flawless English and French, as well as several other languages that I did not. She was lively and fascinating. Yvonne had fled France during World War II, hidden beneath a pile of hay in a horse cart. Now she lived at the family’s vast estate at Ascott, in Buckinghamshire, about an hour’s drive from London. Although Yvonne was Jewish, she was not observant and in fact loved to celebrate Christmas. To my amazement, I was invited that year. It would be the first of many holidays I spent with Yvonne.
I took the train up from London. I was met at the station by Hurley, the Rothschilds’ butler—though he seemed to be much more like a chief of staff. I suppose Hurley was his last name, and I never found out his first. He took my tattered suitcase, put it in the back of a Rolls-Royce, and we were away.
The main house at Ascott was a Tudor-style mansion of two hundred rooms. It was the centerpiece of an estate that sprawled over more than three thousand acres. I loved to explore the magnificent gardens surrounding the house, thrilled to be out of the city. The gardens had been built by Anthony’s father, Leopold de Rothschild, as a wedding present to his wife. There was a large greenhouse and a beautiful lake that had a swan on it. I later learned the swan had a nasty disposition and would attack you if you came too near. There was also a topiary sundial, and
close by it a memorial to Anthony’s brother, who had been killed in 1917 in the Battle of Mughar Ridge, fighting in Palestine against the Turks. Anthony had also been in the war and was wounded at Gallipoli.
Yvonne lived at Ascott with her mother, Sonia. The main house being far too big for them, they stayed instead in smaller quarters on the premises, in what they called “the cottage,” though it was bigger than any house I’d ever been in. There was no question of me staying with them in the cottage, though there was plenty of room. It would have been improper. So I was put in the main house and given free run of it. The house had a full staff by day, but in the evenings I was alone. It was incredible, filled with treasures. I remember a chess set in which the usual white and black pieces were instead made of solid silver and gold. I didn’t know anything about fine furniture, which was everywhere, but I recognized the names on the many paintings hung throughout the house. Renoir. Cézanne. Gainsborough. My favorite spot was the library, which was lined with leather-bound books to the ceiling. It was huge—bigger than Raigmore.
I’d walk down to the cottage every evening for a formal dinner with Yvonne and Sonia. Naturally, I was expected to be in black tie. I had a dinner jacket and trousers that had belonged to my father. I had loaned them to my brother to wear to a rugby dinner that must have got out of hand as the evening wore on, and they were a little the worse for wear afterward. Chris admitted to me that he had torn the trousers crawling through a hedge. Hurley took them away to press before dinner, holding them at arm’s length, saying, “I will do what I can, sir.”
At dinner, Yvonne insisted that we speak French—a language I hadn’t used much since Whitestone. She thought my accent was passable, though I understood the language far better than I could speak it. Meals at Ascott were always accompanied by wine, usually from the Rothschilds’ Lafite or Mouton wineries in Bordeaux. I must not have realized that these were among the finest and most expensive wines in the world, as I usually asked for beer instead. Yvonne made sure I got my beer, though I suspected she disapproved. She did tell me that she was relieved that I didn’t drink scotch. Apparently Winston Churchill had been a frequent guest when Anthony was alive and drank scotch all day long. Though he somehow never showed its effects at dinner, Yvonne wouldn’t serve him good wine in the belief it would be wasted on his already overtaxed palate.
After dinner I’d walk back to the main house, where Hurley would let me in and then leave. He was back the next morning with my breakfast on a silver tray and a newspaper he’d ironed to take out the creases. Before he left he drew a bath for me, using a thermometer to ensure the correct temperature.
I took every chance to visit Ascott—holidays, weekends when I could get away. I came to love Yvonne, who was like a second mother to me when my real one was half a world away. Soon Ascott began to feel like home, which was strange when I thought about my actual home in the heart of Africa. Ascott was another world, but one I eagerly embraced. I was only mildly surprised when one day Yvonne said that she’d like to adopt me. She never did, of course, but if she had, it would not have changed the direction of my life.
Yvonne’s son, Evelyn, would often appear for a short visit. He was always polite to me, though we never talked at length. I gathered that he was still something of a playboy then—into fast cars and racehorses. But he was also bright and accomplished. He ran the bank, eventually managed the queen’s finances, and spent a number of years as the editor of The Economist. Evelyn always stopped in for at least a couple of hours at Christmas, the big event of the year. Christmas lunch was usually at Yvonne’s daughter Renee’s house, a horse farm in nearby Tyringham. Renee had married an Olympic equestrian named Peter Robeson. After lunch we would sit in the drawing room and listen to the queen’s annual holiday speech.
Yvonne had a summer home in the south of France, in the mountains above Cannes. It was a converted abbey, and she sometimes took me there. We traveled by plane, invariably in coach—which I found amusing and endearing. The house and its gardens were lovely, and I could see the blue Mediterranean from my upstairs bedroom. We’d spend our days reading and relaxing. I always brought some work with me. Yvonne pointed out the driveway to the home of her nearest neighbor, Orson Welles. But I never saw him.
In my final years of medical school, I began to do temporary houseman jobs. This was an assignment given to senior students for a two-week period while an intern was ill or on leave. Although I had not yet graduated as a doctor, it was an accepted practice in a teaching hospital. To wear a long white coat and see patients and to be addressed as doctor was thrilling. I loved the work and rarely left the hospital. Medical students don’t work so hard today, and I don’t think they are nearly as single-minded about medicine. I don’t know if this is ultimately good or bad, but I do know what they’re missing: the passion that I felt coursing through me every minute that I spent becoming a doctor. I did not want to do anything else.
St. Mary’s was especially nice late at night, when it was silent. I liked to stand by myself on the second-floor balcony and gaze down at the marble floor of the great entryway. Looking out into the dark space, I’d think how much I loved it, all of it, and how much I looked forward to the coming day, when footsteps would echo in the entryway and the hospital awakened and I could meet someone new who needed me.
CHAPTER NINE
IN THE BUSH BENEATH THE MOON
In the third year of medical school, we were granted a three-month elective, during which we were encouraged to work at another hospital or in some medically related endeavor to broaden our experience. Most people went overseas. I went back to Rhodesia.
I found a cheap air ticket on a charter plane, which left from Nice. I took a train from London. Having no money for a hotel, I slept at the airport. Every hour or so, a policeman would roust me and I would move on to find another place. I was not much rested when the plane left in the morning. It was a Dakota, a propeller plane with a range of little more than fifteen hundred miles. We stopped to refuel at Cairo, Khartoum, Entebbe, and Ndola, before finally arriving at Johannesburg. The trip took two days as we flew along just below the clouds, through stomach-turning turbulence in the heat of the day. Many passengers were airsick, which only amplified the misery onboard.
I left the airport and found my way to the outskirts of Johannesburg, where I stood on the side of the road with my suitcase, hoping to hitch a ride. The silence on the road outside the city was a welcome shock. Rhodesia was still fifteen hundred miles away. I rode with several Afrikans farmers who were interested in my experiences in England. Finally, I was left on the road on the south bank of the Limpopo. I walked across the bridge into Rhodesia, looking at the crocodiles basking on the sandbanks below. I was home.
I arrived late at night at the Elephant and Castle Motel, on the road from Beitbridge to Fort Victoria. The hotel belonged to the Nuanetsi ranch, but the drive from the headquarters, about seventy miles, was not safe at night. My mother and Philip arrived early in the morning to pick me up. At that point I still hadn’t started doing any real clinical work at St. Mary’s—I was still waiting to fall in love with medicine. Being back in Africa made me question everything again. I told Philip and my mother that I was thinking of not going back to medical school. Shrewdly, they told me to do whatever I wanted to. I had hoped they’d argue with me and that I could be stubborn. Instead, they’d made me think—something that more often leads to a good decision than does an argument. I realized that of course I would be going back to London.
After a few days at the ranch, I went up to Salisbury—now Harare—where my godfather had arranged for me to join the Department of Health. I was to embark on a medical safari to examine the native population. The department provided a Land Rover, two medical orderlies, and a native ascari, or policeman. The ascari usually accompanied the DCs on their trips into the bush, and he knew what he was about.
I drove, and the ascari and one orderly rode in the cab with me, the other orderly in the Land Rover’s
open back with the equipment. We covered about twenty or thirty miles each day, then set up camp. Somehow word went out that a medical officer had arrived, and in the morning there would be a long line for the clinic. Everyone in the village came out, and each, in turn, had to be seen. I was expected to prescribe something for everybody, as they would be humiliated to be sent off with nothing. Naturally, there wasn’t anything wrong with most of the people I saw—the most common notation my orderly made in the record was NAD for “nothing abnormal discovered.” Nonetheless, I’d hand over some aspirin or a skin ointment and call the next case.
Some people were sick, however, including a few that I could not help except to tell them to get to a hospital if possible. Snakebites were a common issue. In some cases the affected limb had gone gangrenous. There were traumatic injuries from accidents or encounters with animals. I saw several people with leprosy. And there were serious, sometimes advanced cancers. I saw one woman with a tumor on her jaw so large that she could not close her mouth. I also stopped in to examine a young man with what was surely one of the world’s last cases of smallpox. He was covered in pustules. The villagers had wisely confined him alone in a hut, where he was being fed but was otherwise quarantined. I stayed on to care for him for several days. He survived.
Although unrest was spreading in Rhodesia, as yet it was not an all-out civil war. Most people still believed it would pass and Rhodesia would remain as it was. But there were certain places the ascari told me we could not go because it had become too dangerous. This was new. The dangers I’d grown up with had all been of the nonhuman variety.
These weeks were a remarkable interlude. By day I was a doctor—nobody I treated had any doubt. When we camped for the evening, I had little to do. I stretched my legs, washed, and changed, then had dinner, prepared by one of the orderlies, by the campfire. I would then make notes in my tent about the day’s activities. I paid particular attention to the various eye ailments I observed. I later wrote this up and published my first paper on the occurrence of eye disease among African villagers.
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