Surgeon at Sea

Chapter Eight

The next morning my professional tranquillity was split like an old sail in a storm.

I had settled down in my cabin after breakfast to read _War and Peace,_ with which I first killed three or four cockroaches, when Easter came in. He showed me a new card trick and described the occasion when he was steward on a Greek tramp and had won from the skipper, an incorrigible but luckless gambler, as a final stake one night in the Mediterranean the exclusive services of his stout but agreeable wife until Gibraltar.

'There's something, Doctor,' Easter went on. 'One of the crew took queer in the night.'

'What's wrong with him?'

'Vomiting and suchlike. Shall I chase him up here?'

'I think we'd better pay a domiciliary visit.'

The patient was a young deckhand. He was lying on his bunk, holding his abdomen and groaning.

'Good morning,' I said briskly, taking his pulse. 'What's the trouble?'

'Aw, cripes! I got the bellyache something horrid.'

Just let me have a look at the-er, stomach.'

He stretched himself on his back. I reached out a hand and felt the right-hand quadrant of his abdomen. Immediately I felt as if I had eaten a bunch of safety-pins and they had all opened inside at once.

I dragged Easter outside the door and shut

'Easter,' I said hoarsely. 'This man has acute appendicitis.'

'Cor!'

'This is urgent. How far are we out of Santos?'

'About two days, the Mate reckons.'

'Well, we must make land before then and put the poor chap in hospital. I'll go up and see the Captain.'

Captain Hogg had just got out of his bath. He stood in his slippers with a towel round him, looking at me like Bligh offering Christian the cheese. I could appreciate that it was one of his gastric mornings.

'Well?'

'Er-good morning, sir.'

'Good morning!'

'Could you do twice the speed you are, sir?'

'What!'

He jumped so violently he shook drops of water from his chest on to the carpet.

'I mean-you see, sir, one of the crew has developed acute appendicitis. He will have to be operated on as soon as possible. I understand from the engineers that it is possible for the vessel to make a few more knots, and I thought…'

Captain Hogg sat down on the edge of his desk. He gave a sharp tug to his left ear, as though pulling the pin out of a Mills bomb.

'For every knot above the cruising speed of my ship,' he began quietly, 'the bill for fuel oil practically doubles itself. What do you think the Company would have to say? Eh?' He banged the desk. 'Operate, Doctor, operate!' he shouted. 'What do you think I pay you for?'

'Yes, sir,' I said.

I recognized at once that the Captain's advice on therapy had obvious drawbacks. In the first place, I had a meagre idea of how to remove an appendix. A medical qualification is like a marriage licence-it gives you official permission to go ahead, but it doesn't guarantee you know enough to tackle all the difficulties after the honeymoon. I had diligently attended the operating theatre in my hospital, but there were always so many students present whenever the surgeons removed an appendix that all I usually saw of the operation were the boils on the neck of the man in front of me.

The second difficulty was equipment. Although appendices have reportedly been removed by second mates with bent spoons and a bos'n's knife, I felt that my academic inhibitions made it impossible for me to operate skilfully with the products of an ironmonger's shop. Thirdly, there was professional assistance. Easter was an admirable character for whom I had a sincere admiration as a man of the world, but when it came to dabbling in clinical medicine he was as dangerous as an unlabelled bottle of strychnine.

I called him into my cabin.

'Easter,' I said earnestly, 'have you seen a case of acute appendicitis before?'

'Ho, yes, Doctor. Every time I eats pickles I'm reminded of it.'

'Pickles?'

'That's right, Doctor. I was on the Western Ocean run at the time. The old Doc was scared to operate, so he puts the patient in the ship's hospital and tells me to keep him on a light diet, see. That night I goes along and asks if there's anything he wants, like, before I turn in, and the patient says to me "Yes," he says, "I should like just a few pickles."

"Pickles!" I says. "You can't have no pickles! Don't be balmy! The Doctor would have me over the side if I was to give you pickles. We of the medical fraternity don't reckon pickles is a light diet. Not for 'arf a minute we don't." I says.'

'Well the next morning I brings him 'is breakfast-two poached eggs done special-and when I goes to shake him-Cor! He was cold to the touch. Them pickles was his last wish, Doctor, and I refused him. Sad, ain't it?'

'Quite so, Easter,' I said. 'Let's have a little less of your reminiscences and a little more action. We must operate on this man before sundown. Do you realize what that means? We must strip the hospital, scrub it out with antiseptic, rig up some lights and an operating table, and find some instruments from somewhere. Savvy?'

'Very good, Doctor. We of the fraternity always rises to the occasion, as they say.'

'Well, start rising.'

He hesitated.

'If might be so bold, Doctor…'

'Yes?'

'Perhaps it might make things go a little easier if you and me was to have a bit of the medical comforts to start with.'

I clapped him gratefully on the shoulder. 'Capital idea, Easter. Reach down the bottle from my locker.'

Rumours of my intended surgical assault spread through the ship faster than the news of a landfall. It was not only a pleasurable interruption to the tedium of the voyage but it had the attributes of mystery and originality as well. The crew hadn't had such fun since a boiler blew up off Panama.

I shut myself in my cabin and opened the text-book of surgery I had prudently included in my packing. Turning over the pages to appendicitis, I ran my finger down the print. I started to read the section headed 'operation.'

'The incision is made at McBurney's point,' it said. Oh God! What was McBurney's point? It sounded like a mountain in California.

There was a rap on the jalousie.

'Come in!'

I unlatched the door. It was the Chief Engineer.

'I heard about this wee party you're having, Doc,' he said affably. 'I reckoned you'd be needing some lights so's you can get a good squint at the innards. I can rig up a cargo cluster for you, if you're willing.'

'Thanks very much.'

He gave a grin.

'Of course, you won't mind me turning up to see the fun, Doc, will you? I reckon I ought to be there in case the lights go on the blink. You never can tell with these cargo clusters.'

'That'll be all right, Chief.'

'Thanks, Doc. Give us a shout when you want to stand-by.'

I opened the book again, and had read far enough to learn that the appendix may be in any of six positions when Hornbeam put his head round the door. He laughed loudly.

'Hello, Doc! Making you do a bit of work for a change?'

'That's what I'm here for,' I said casually.

'Reading it all up in the old almanac, I see,' he said genially.

I shut the heavy book with a bang and dropped it behind the bunk.

'One must refresh one's memory,' I said. 'Even Lord Lister had to do that sometimes.'

'What I came down for, Doc,' he went on, 'was to offer you a bit of a hand. I remember seeing one of these done in the war when I was trooping. Thought you might like me to hold the blood-bucket or something.'

I considered.

'All right,' I said. 'I'd be pleased to have someone with common-sense around. You won't faint, will you?'

'What, after all these years at sea? I'll come along later.'

I was still looking for my place in the surgery book when I saw Sparks in the doorway. He brushed aside a couple of imaginary companions and grinned at me.

'Yes?' I asked uninvitingly.

'I hear you're going to carve 'em up, Doc.'

'I am intending to operate, certainly.'

'Wouldn't mind if I watched, would you? I'm a bit of a photographer, and I'd like a few pictures to show the kids.' His grin widened. 'Makes a change from seagulls.'

'I don't think there'll be enough room for me and the patient if you come too.'

'Would you like to send a message to his mother?' he asked.

'No, I would not.'

'Haven't got a spot of gin handy, have you?'

'Not now. Later. I'm very busy.'

'All right, Doc. Have a good time.'

He went off, singing with his friends. But there had now collected outside the door a bunch of deckhands, led by the Bos'n with his cap respectfully in his hands.

'What the hell do you want?' I asked crossly.

'Sorry to disturb you, Doctor, only seeing as we're all pals of Erb's, we was thinking you'd let us come in, see, to 'ave a dekko. 'E says its all right wiv 'im, as long as we behaves decent.'

'Go away,' I said. 'Go away at once. All of you. Who do you think I am? A music-hall turn? I shall report you all to the Mate.'

I slammed the door and returned to the intricacies of appendectomy.

I found Easter in the hospital. He had dismantled the cabin furnishings and was on his knees scrubbing the deck, stripped to the waist.

'How's it going?' I asked.

'It's bloody 'ot.'

'What's the temperature?'

He got up and inspected the thermometer in the corner.

'Hundred and six,' he said.

'Can't you put the forced draught on?'

'Blows soot in.'

'Oh, all right. We'll have to put up with it I suppose. How have you got on with the operating table?'

He had a wooden trestle table along one bulkhead which he set up proudly. It left just enough room on either side for the pair of us.

'I got it off Chippy,' he said. 'He uses it for mixing the paints on.'

'It's better than nothing. If you scrub it hard enough it'll be reasonably sterile.'

As I spoke, two large, rusty drops fell from a pipe crossing the deckhead on the spot where the operation wound would be.

'Damnation! Can't you do anything to stop that?'

Easter shook his head.

'Been like it for years. It's a job for the shore engineers, that is.'

'Well, you'll have to fix up some sort of screen. Have we got any dressings and gloves, and so forth?'

'There was some in the locker. Seem to have been there since the war.'

'Get them sterilized in the galley. How about instruments? What have you found?'

Easter pulled two handfuls of metal objects from his trouser pockets.

'I've been on the scrounge,' he explained. 'I thought these would come in handy, like.'

I looked at his booty, which he spread on the table. There was a pair of pliers, two saloon forks, a packet of darning needles labelled 'A Sailor's Friend,' some paper-clips, a stiletto, a potato knife, a pair of tweezers, a surgical scalpel, and a uterine curette.

'You'd better sterilize the lot,' I said gloomily. 'Except the pliers. Shouldn't there be a set of surgical instruments on board?'

'They seem to have disappeared, Doctor.'

'You mean you flogged them?' He scratched his nose guiltily. 'There's nothing for it but to use what we've got,' I told him crossly. 'I damn well hope you get an appendix, too!'

I went out on deck. I needed some fresh air. The day was already becoming too much for me.

Outside the hospital I found Chippy. He was sitting on the deck with a hatch cover-a thick piece of wood about six feet by two used in rows to cover the hatches. He was polishing it carefully with emery paper.

'Hello, Chips,' I said. 'Getting everything shipshape for Santos?'

He looked up at me gloomily.

'He'll slide off this lovely,' he said.

'Who will?'

'Why-'im down there.' He pointed aft with his thumb. 'The poor bloke what's for the knife. Slide off it like a wet fish, he will,' he added with relish.

I was perplexed.

'What's he want to slide off a hatch cover for?' I asked.

'Why, when they buries 'im, of course.' He gave it another rub. 'Lot of work I've put in on this 'ere 'atch cover.'

'Now, look here, Chippy. What gives you the idea my patient's going to die?'

'Oh, they always does. I've seen five appendicitises at sea. 'Ad their time, every one of 'em. Over the wall they went on a 'atch cover.'

I stamped off in disgust. I felt I had been professionally insulted. I climbed the bridge ladder angrily to report the Carpenter's pessimism to one of the Mates. There I found the Second moodily sorting out flags.

'What ho, Doc,' he said. 'When's the carve-up?'

'In about an hour.'

'Think that ensign'll do?'

'Do? What for?'

'Why, in case-in case of accidents. To cover the body.'

'There isn't going to be any body, damn you!'

'Well, Father told us to take precautions. Means a lot of work for all hands, Doc. It'll be a shame if they're all disappointed now.'

I admit that they do give one an excellent funeral at sea. The properties are traditionally adapted from the ship's gear and the routine is prescribed as firmly as that for entering and leaving port. As soon as the body is available it is turned over to the bos'n, who sews it up in canvas with half a dozen firebars from the galley. For this he receives a bottle of whisky. Meanwhile, the carpenter has been polishing and attaching rope handles to a hatch cover, and the quartermasters have been pressing their best uniforms. The ceremony is held at sunset or sunrise on the same day, because ships spend most of their time in tropical waters and the performance might be marred by the corpse if it became aggressively high. The vessel stops, a rail is taken away from the side, and the ship's officers, including the abashed Doctor, line up with the Captain. Caps are removed, and at the appropriate moment the body is marched to the rails on the hatch cover by the quartermasters-who receive a bottle of whisky between them for their services-and smartly tipped overboard. The Mate, who has charge of all deck stores including flags, at the same time edges himself down to the rail and grabs the ensign-which costs the Company money-before it slips into the sea with its bundle. The ship then starts again and everybody goes off for an obituary peg.

'I should hate to spoil your fun,' I said coldly, 'but this patient is going to walk off the ship in Liverpool.'

I returned into the hospital, where Easter was boiling the instruments over a Primus stove.

'Everyone thinks there's going to be a funeral,' I said. 'I never heard such nonsense.'

'Ho, yes,' Easter remarked calmly. 'That's why I couldn't fit a screen under that there pipe as you said. Bos'n says he's got to keep all his spare canvas for the shroud.'

'But it's monstrous!'

Easter chuckled over the steaming instruments.

'Cor, I've seen some funny funerals at sea! Remember one we had in the Indian Ocean. Chinaman it was. Got knifed. Blimey, we pushed him overboard all right, but he wouldn't sink. Bobbed about like a buoy. The Old Man wasn't 'arf flummoxed. In the end we had to leave him to it. Couldn't pull him out again, could we? Probably still bobbing about somewhere, if the sharks ain't got him.'

'I'm going to see the patient,' I said sternly. 'Get everything ready in an hour's time.'

The patient was sitting in his cabin eating fish and chips and drinking a bottle of beer.

'What the devil's this!' I shouted. 'I thought I told you to have nothing by mouth?'

'Oh, sorry, Doc,' he said awkwardly. 'But seeing I was feeling so much better like, I thought I could do with a bit of grub.'

'Better, man! How dare you say you're better! That's for me to decide. You only think you're better. You've got an acute appendix inside you.'

He pulled a fish bone out of his mouth repentantly.

'There's just one thing, Doc,' he said respectfully. 'Do people often get this appendix taken out twice.'

'Twice? What do you mean?'

'Well, I had it taken out the first time in Birkenhead when I was six…'

I sprang at him and pulled up his shirt. A faint, white two-inch scar. I started to laugh.

'Not operating, Doctor? Why?' Captain Hogg demanded.

'I've charmed it away, sir,' I explained. 'A trick I learnt in infancy from a gypsy.'