I went back to the ranch before returning to England, where I decided to take off in an old Land Rover for some hunting. I was gone a couple of days. On my way back, I had a flat tire in a remote part of the ranch. The sun was going down, and a crescent moon had appeared. It would be dark in minutes. It was too late to look for wood for a fire. Camping until morning was out of the question. I didn’t like the idea of spending the night in the Land Rover, so I started changing the tire. As I began I could hear the heavy coughing sounds of lions out hunting. They were close and downwind. They were coming closer.
To keep myself company, and to perhaps help warn the lions away, I turned on the Land Rover’s shortwave radio. After dialing around for a moment, I picked up a news program. It turned out that the whole world was listening. Neil Armstrong and Buzz Aldrin were about to descend to the surface of the moon. As I looked around for a log to put under the Land Rover’s jack, I kept one ear on the lions and one on the radio. Glancing up at the moon, I could not fathom how far apart these two events were—me changing a tire while being circled by lions in the African bush, and two Americans about to land on the moon. I was in a place that had changed little in thousands of years. They would soon step onto a place where no one had ever been.
I got the tire changed and sat for a while in the Land Rover, listening to the radio as moonlight filled the cab. The lions came up and sniffed around the vehicle but lost interest and left. I started the engine and headed for home, wanting to make sure I was back before Philip was worried enough to send out a search party.
I still had a little time left. I discussed my medical school decision again with Philip and my mother, who once again counseled that I should think it over and do as I pleased. Feeling unready to go back—but knowing that I would—I decided on a final camping trip into the bush. I headed for the eastern edge of the ranch, near the border with Portuguese East Africa. I made camp on a wide part of the Nuanetsi River that we called Buffalo Bend. At around two in the morning, I heard what I thought must be machine-gun fire in the distance. Only the army and the rebel terrorists had machine guns. At dawn, a Rhodesian Army Land Rover with three uniformed soldiers in it pulled into my camp. They told me they’d engaged a band of terrorists as they came across the border in the night. The rest of their outfit were now tracking them up. We talked for a while, and I offered them coffee. As they were getting back in their vehicle, we saw an unexploded hand grenade in the back—the type with a handle and what looked like a tin can on the end. Chinese made. Whoever threw it had forgotten to unscrew the base and pull the cord. As they left, one of the soldiers said with a smirk, “Well, I expect they’ll get better at it.” Unfortunately, they did.
It was time to go back to medical school. Had I not, my life would have been different, and not just because I’d left medicine.
One of the section managers at Nuanetsi was an old man named Mee. He lived with his wife in a small house on the ranch. I was friends with Mrs. Mee, who was always kind to me. She told me once that she and Mr. Mee had a close marriage. She would get up every morning at four and make tea, and then the two of them would talk until Mr. Mee left for work at five. One night after my visit, there was a knock on their door. When Mr. Mee went to see who it was, he was pushed back into the house at the muzzle of a gun. He was made to watch as his wife was raped, mutilated, and then killed. Then he was tortured and shot. The bodies were left on the lawn.
Eventually, it became too dangerous for my parents to remain at Nuanetsi. They left with only the clothes on their backs, telling nobody they were going. My mother had a handful of diamonds. She sewed them into the hem of her coat, and they headed for the border. She and Philip would have to live on those diamonds for the rest of their lives.
Rhodesia had become an idea that belonged to another era. In April of 1980, the country would rename itself Zimbabwe. But it had ceased to be the country I had grown up in long before then. As I watched from afar, first while I completed medical school and then as I began a career that eventually took me even farther away from Africa, the violent change that my father had feared swept over Rhodesia.
The civil war escalated. The Rhodesian economy collapsed. Bank accounts had long been frozen. Now other investments and property were seized by the rebels. In the coming years, a rampant inflation spun out of control. There was a saying, not far wrong, that if you stopped in a bar for a beer, your second one would cost twice as much as the first. The government kept printing money, sometimes running out of paper. At its peak in November 2008, the rate of inflation was incomprehensible, estimated at 6,500,000,000,000,000,000,000 percent. It became difficult to carry the number of notes needed to buy a loaf of bread. I still have a one-hundred-trillion-dollar Zimbabwe bank note printed in 2009. It’s worthless.
Nuanetsi was appropriated without compensation by the new black government. It was handed over to the leader of one of the two rebel groups, Joshua Nkomo, who thus became the biggest private landowner in Africa. Nkomo had been a freedom fighter along with the current president of Zimbabwe, Robert Mugabe, who led a competing faction. It was an old story. Mugabe’s people were Shona; Nkomo’s Matabele. The two groups fought against the Rhodesian army, which was mostly black, and also against each other—as the Matabele and Shona had done forever. But now there was a twist. Mugabe was backed by the Chinese, Nkomo by the Russians. Like other struggles for independence in Africa, Rhodesia’s war of liberation was also a Communist proxy war for influence on the continent. In May 1978, fifty civilians were killed in a clash between Communist militants and the Rhodesian army.
Nkomo’s group was responsible for many atrocities. On September 3, 1978, they slaughtered a group of innocents in a way never seen before when they brought down an airliner with a Russian-made surface-to-air missile. The plane was on its way from Kariba to Salisbury, carrying fifty-six tourists on their way home from a holiday. Nkomo’s men were hiding in the bush not far from the Kariba airport when they launched the missile. Eighteen people survived the crash when the plane came down in a clearing in the bush. Five of the survivors went to a local village to ask for help. Upon returning to the crash site, they heard voices and automatic gunfire. The other survivors were being killed, including women, children, and infants. A young flight attendant was shot as she tried to protect her passengers. A baby was bayoneted through the head. Nkomo’s gang then looted the plane and the bodies. Three of the crash survivors who had remained at the aircraft avoided being killed by hiding in the bush. After a terrifying night in the cold, they were rescued by Rhodesian Army soldiers the next day, as were the five who had gone for help.
As horrific as this mindless act was, the response from the international community was almost as disturbing: silence. No elected leader, no country of the civilized or uncivilized world condemned the shoot-down and its blood-soaked aftermath. The lone voice of protest came from the Reverend John da Costa, the Anglican dean of Salisbury, who said from the pulpit, “This bestiality, worse than anything in recent history, stinks in the nostrils of heaven.”
And then it happened again. Nkomo’s group shot down a second airliner from Kariba on February 12, 1979. This time all fifty-nine civilians onboard died in the crash.
Zimbabwe today is a different country in more than name. Wildlife no longer roams free over private property. The mass slaughter of game animals by terrorists, poachers, and ordinary citizens faced with starvation has altered the nature of the bush. In Harare, a corrupt government continues to exploit and bankrupt its citizens. Little of what used to be still exists as it did. After I left Nuanetsi to return to medical school in 1969, I never saw the ranch again.
CHAPTER TEN
TIGER COUNTRY
Houseman jobs at St. Mary’s were eagerly sought after. The top surgical position was with Eastcott and Kenyon. When I graduated in early 1971, I got it and began a six-month rotation with that firm. Running the service was left entirely to the two housemen. The other houseman was Mike Hampton. Theoretically we c
overed for each other every other night, but that is not how it worked out. After a day’s operating, we worked late into the evening and then did ward rounds. After that, we had to get the patients ready for surgery the next day. We finished late each night and were always on call for our own patients.
One of the surgeries I got to perform early on was the removal of homografts, which were replaced with artificial grafts. I loved every minute and felt completely in my element. I had a room at the hospital, and all meals were provided. Although the total salary for the six months was less than $500, I had no expenses or outside responsibilities. I was as well off as I had ever been.
The hours were long. We never left the hospital. A lot was expected of us, especially from Eastcott. One night at around eleven p.m. I was on the mostly darkened ward checking on my patients. Through the shadows, I made out Mr. Eastcott by the door. I was not officially on duty, and I am not sure what he was doing in the hospital that late at night, but I went forward to greet him. As always, he was in a suit. I was in my white coat and white shirt.
“Ah,” he said, “it’s you, Jamieson. I didn’t recognize you without your tie. I thought it was a boy from the village.”
Eastcott was one of the court of examiners for the Royal College of Surgeons, which held exams twice a year, in the spring and in the autumn. The failure rate was about 80 percent. Eastcott once put his arm around a candidate who had done poorly and led him to a window overlooking a park. The trees had begun to leaf out after a long winter.
“Do you see those leaves?” Eastcott said.
“Oh, yes, sir.”
“Well, then,” said Eastcott, “come back again when those leaves fall off the tree.”
Eastcott always wanted to be knighted, but he never reached this goal. You either had to be politically connected or have a successful outcome with a royal patient to get a knighthood. Eastcott came onto the ward one day announcing that he had a royal patient. We were advised to be on our best behavior. The patient was the nanny of the Duke of Kent, who was being admitted for treatment for varicose veins. Eastcott insisted that everything go without a hitch, particularly since the Duke of Kent himself would be bringing her to the hospital on Sunday afternoon so she could be worked up for surgery the next day.
I was in the hospital as usual that weekend. On Sunday morning Eastcott called me to say his elderly mother, who was staying with him at his home in Upper Harley Street, had fallen down the stairs and now had blood in her urine. He asked me to order an emergency intravenous pyelogram to inspect her kidneys, which I did. Shortly after that, I got a call from Southampton regarding a man with a leaking abdominal aneurysm. We were the national referral center for this life-threatening emergency. I told them to send us the patient at once and phoned Eastcott. He said he had just caught his finger in a deck chair while folding it up and told me to ask Barry Thomas, the registrar, to operate instead. I did this and then alerted the emergency room that Eastcott’s mother would be coming in. The mere mention of Eastcott got everyone’s attention. The emergency room doctor on duty that day was a temporary replacement who wasn’t familiar with the emergency room staff or the way things worked in the hospital. He said he was just about to call me, because a boy had come in with acute appendicitis. Just about then Barry showed up to get ready for the aneurysm patient. We met in the emergency room and after examining the boy with appendicitis decided to operate right away.
While we were in the OR, the aneurysm patient arrived in the emergency department in extremis. They initiated a frantic series of blood transfusions and worked to revive him. In the middle of this chaos, the Duke of Kent—who should have gone to admissions—arrived with the nanny. As the duke stood there looking unconcerned about what was happening, the emergency room staff assumed that he must be Eastcott. The nanny was hustled off to radiology to have her kidneys looked at. The duke thought this was part of the normal preoperative workup for varicose veins.
Then Eastcott showed up.
He barged in front of everyone. As he waved his hands around, the staff noticed his bandaged finger. Thinking he had a minor injury and was nobody to be concerned with, they told him to sit down and wait his turn. Eventually it all got straightened out. I was happy to be unreachable in the OR as it was happening.
Eastcott never got his knighthood.
Eastcott had four daughters. If you were his houseman, you could expect to be called on from time to time to escort one of the daughters to some event. One day, Eastcott said that he had some tickets to the St. Mary’s annual ball and asked me if I would like to go. Since I was too poor to buy my own tickets, I was absolutely delighted by his offer and accepted. “Good!” he said, “then you can take my daughter.”
Despite what I’d heard, she was pleasant. We had an enjoyable evening. We did have to sit at Eastcott’s table during dinner, which was awkward since I was technically his guest. I sat to the right of Mrs. Eastcott; he sat on her left. After dinner everybody got up to dance, leaving me and dour Mrs. Eastcott sitting at the table. I thought I should be a gentleman, and I asked her if she cared to dance. She replied crossly that she did not believe in that sort of frivolous nonsense.
Any thought I might have given to this evening causing Eastcott to see me in a more generous light disappeared with his next invitation. Eastcott asked me to come to his house for a dinner party. I replied that I would be honored.
“Fine,” he said. “Come at six, and bring your white coat. You can serve the drinks.”
Part of my job was to assist Eastcott with his private patients in the Lindo Wing. He also operated at the King Edward VII Hospital for Officers, and I helped him there, too. He would pick me up in his Jaguar. When we were done, he drove me back. Eastcott had a reputation for being miserly. He always seemed to have left his wallet behind when he invited the junior staff to the pub across the street after rounds. He never paid anyone. for working with him on his private patients at weekends, as most of the other senior surgeons did with their housemen. So I was surprised when at the end of my six months he gave me a check for twenty pounds—at the time a magnificent sum to me. I showed the check around proudly until someone pointed out that it had not been signed.
This was a dilemma. With advice from my colleagues, I drafted a careful letter to Eastcott, in which I said that I was overwhelmed by his generosity and thoughtfulness but that he had forgotten to sign the check. I enclosed the check and said I’d be most grateful if he could remedy the oversight and send it back. I hoped this would end the matter. It did. The check never came back, and Eastcott never mentioned the letter.
Mr. Kenyon was more gregarious than his partner. Much as I admired Eastcott’s talent, I found it easier to get along with Kenyon. One day he called to ask if I could fly to Greece with him and his anesthetist that evening. I dug out my passport, threw a few things into a bag, and rushed to the airport, where they were waiting. On arriving in Athens, we went to the hospital to see the patient, a shipping magnate who had an abdominal aortic aneurysm. The operation was scheduled for the next day. We left the hotel early in the morning. Since nobody in Greece had replaced an aortic aneurysm before, we had many visitors coming in and out of the operating room, some in street clothes. There was no air-conditioning and it was hot, so the windows were open. Flies buzzed around as we worked.
The operation went well, and I was assigned to stay with the patient that night. In the morning, the man’s wife and family invited us onto his yacht. It was impressive, perhaps three hundred feet in length, with a full crew. We sailed to a private island to have a lunch at their villa. The boat had anchored a half mile off the beach, and the launch was put over to take us ashore. I decided to swim. I had only gone a hundred yards when I noticed that I was being accompanied by another boat from the yacht. I asked if there was a problem. One of the crewmen said that they were there to protect me from the “big fishes.” The American Sixth Fleet was on station nearby, and garbage had been dumped from the large warships. This attrac
ted sharks. At lunch I learned that there are forty-six different species of sharks in the Mediterranean, and that attacks do occur. I took the launch on the way back.
Some weeks later, when I was scrubbing for an operation, Kenyon came by and tucked an envelope into my back pocket. “The heavens have opened,” he said. After I finished the surgery, I found a large sum of money in the envelope.
Of the body’s great vessels, the aorta is primary. It’s roughly the diameter of a large garden hose. It comes off the left ventricle—the heart’s main pumping chamber—provides blood to the coronary arteries that supply the heart, and then ascends up and over the top of the heart in an arch before descending to take blood to the abdomen and lower extremities. The arteries that supply the upper body, including the head and arms, branch off from the aortic arch above the heart. Like the heart itself, this confluence of vital blood vessels is asymmetrical. On the left side, the left carotid and subclavian arteries come directly off the aorta and go to the head and arm. But on the right there is a single vessel, the brachiocephalic artery, which comes off the aorta for a short distance before branching into the right carotid and subclavian arteries.
I don’t know if there is a seat of the soul. But if there is, I believe it is here, where the vessels that sustain the mind and the brain meet the aortic arch. To operate near the aortic arch is to operate in a dangerous realm—tiger country. One small mistake and the patient can transition to heaven quickly.
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