Q J Med 2003; 96: 693-694
© 2003 Association of Physicians
Coda |
The wrong trousers
Admittedly, I did not look like a doctor. For one thing, I had just spent ten days on the Nile in a felucca with eight fellow travellers. (Feluccas are primitive sailing boats that look highly romantic in travel brochures but lose much of their allure on closer acquaintance). For another, when we reached Luxor, I had been struck by one of those acute delusional shopping disorders that so often afflict tourists, and purchased a pair of baggy cotton trousers with broad black and yellow stripes. I wore these for the rest of the journey south, so that by the time we boarded the overnight train from Aswan to Cairo I looked more like a dishevelled and overgrown bumble bee than a doctor.‘Is there a doctor on the train?’ The message came over the public address system in Arabic, then French and then English. Aswan was a couple of hours behind us. I felt a strong a desire to deny my profession, but in the past two weeks I had already attended most of my fellow holidaymakers for the usual unpleasant ailments that go with so-called ‘adventure travel’, and they all knew what I did for a living. Wistfully, I recalled a consultant neurologist at my medical school who taught us exactly how to walk past a traffic accident on the other side of the street, but it was clear that on this occasion I could not put the teaching into practice.
Lurching along the corridor towards the back of the train, I found an edgy Egyptian guide attached to a party of French tourists who, judging by their dress and demeanour, had spent considerably more on their trip than we had on ours. They raised eyebrows at my ridiculous appearance, but allowed me to enter the compartment where I met the patient, a ten-year-old boy. He was accompanied by a male guardian who could have been an uncle or perhaps a private tutor. Both guardian and boy were pale and sweaty. In the guardian’s case it was no doubt from anxiety. The boy, however, had a thin racing pulse and a rigid abdomen.
I explained that the child had peritonitis and needed urgent surgery. This provoked a frightening response. The Egyptian guide lost the few vestiges of restraint that had held her panic in check, and began to shout at me. I persisted, saying that the train would need to make an unscheduled halt at Luxor to let him and his guardian go to the hospital there. At this news the guardian practically passed out, while the guide dismissed my advice completely, saying that the hospitals were bad in Luxor and the child would be much safer waiting until we reached Cairo in about eighteen hours. I said as calmly as I could that he might die within eighteen hours, and that it was beyond belief that a town the size of Luxor would not have a surgeon who could remove an appendix competently. Various members of the French party then came in to ask for proof that I really was a doctor. Close to losing my own temper, I managed to say witheringly: ‘Je suis desolé, mais je ne porte pas mes diplômes en vacances’.
With bad grace, two of the French tourists finally agreed that they would discuss the matter with the guard, and then dismissed me. I returned to my own carriage. I had barely finished narrating the story to my own tour party and our Dutch guide, when another announcement came over the public address system. This time it was only in French, inquiring if there was a French doctor on the train. The stress was emphatically on the word ‘français’.
I leapt up in disgust. This time, fortunately, our guide offered to come with me. He had displayed his equanimity already on the trip in various ways, and I knew that he spoke better French than me, as well as some Arabic. When we reached the boy’s compartment we found, not surprisingly, that no French doctors had appeared, but a French nurse from another tour party had identified herself. She was, mercifully, an operating theatre nurse who must have seen hundreds of cases of peritonitis. Her elegance and fragrance also appeared to give her more professional authority than I could muster.
Through a series of negotiations that would not have disgraced Castlereagh or Talleyrand, it was agreed that I would re-examine the boy under the appraising eyes of the French nurse. I did so, and with a regal nod she indicated to her compatriots that, beneath my carnival outfit and uncouth appearance, I did indeed seem to be a doctor, and that the signs I had elicited were grave. At this point my guide urged me to return to my own companions. ‘You have done your job as a doctor’, he said impressively, ‘and I will now do mine as your tour leader’. I supplied my name and surgery address to two of the more imperious Frenchmen at their request, unclear whether they wanted it for insurance purposes or with the intention of suing me if I turned out to have caused them any inconvenience. Then I left.
For about six months I heard nothing, but eventually received a letter from the boy’s parents in France, offering their thanks. Their son had had an emergency appendicectomy in Luxor, and had been transferred to Cairo for postoperative care, where they had joined him. His recovery had been slow and complicated, but he was now quite well.
Later that year, I pottered around the garden in my bumble-bee trousers a couple of times, but then I put them in the fancy dress box in the loft, together with the loin cloth and spear from Kenya, the fez and pointed slippers from Marrakesh, and the Nigerian tribal outfit. I have never worn them since.
CiteULike 
Connotea 
Del.icio.us What's this?
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||