Cynric Temple-Camp - The Quick and the Dead: True stories of life and death from a New Zealand pathologist

CONTENTS

Royalties from the sale of this book are pledged to the Palmerston North Rescue Helicopter. We live in a relatively far-flung and sparsely peopled country where access in an emergency can be difficult. The familiar beat of the helicopters of this magnificent service never fails to make us look up and wonder what has happened and upon what errand of mercy they are embarking. And when we do so it is with gratitude and also pride, too, for they are our people and it is our service. It is therefore fitting that these, our community stories of the quick and the dead, are devoted as a tribute to their ceaseless vigil.

In memory of Jason Chase.

The dead teach the living.

CONTENTS

Hold off the earth a while

Till I have caught her once more in mine arms.

Laertes as he leaps into Ophelias grave to embrace her body.

Now pile your dust upon the Quick and the Dead.

William Shakespeare, Hamlet 5.1 233235

So I hear youre a pathologist?

People often look at me uneasily as they say this. Perhaps they sense that, through me, the Horsemen of the Apocalypse are already circling them. Theyre right, but those deathly horses have nothing to do with me. Theyre always there, continually circling us all. I am only there to help pick up the pieces after they have visited.

People imagine the job of a pathologist is only to crudely carve up the dead, but its not true. We spend most of our lives investigating, diagnosing and helping the quick, as the Bible calls people yet alive. Doctors are no different from anyone else: we have different personalities. Some prefer personal contact with their patients and administering care to the living: they are, rightly, the front-room boys and girls of medicine.

Thats not me.

From early on in my career, I decided I prefer the kind of hard science that pathologists are involved with observation, testing, the gathering of evidence, making deductions. Pathologists are the back-room boys and girls, searching for the scientific answers to the questions posed by disease and death.

When I was not even a year out from finishing my stint as a house surgeon and the ink on my diploma was barely dry, I landed a job as a general practitioner looking after the families of Rhodesian Air Force personnel. I was 24 years old and shaving once a day more from hope than need.

On my first day, I presented myself to Richard, the principal medical officer at New Sarum Air Force Station. He consulted his notes, and looked up at me speculatively from where he was sitting formally behind his desk. You can take over Mrs Bezuidenhout, he said. Itll be good for you. Besides, weve all had our turn with her. Bloody woman!

I narrowed my eyes.

Why, Richard? Whats wrong with Mrs Bezuidenhout?

Its Sir to you, not Richard. Or Squadron Leader. I dont mind which.

He looked more amused than annoyed that I had given him the opportunity to pull rank on me, and for good reason. He had only been a year or two ahead of me at medical school and wasnt even a specialist.

Shes completely loco, he said. Shes convinced her baby just stops breathing. Shes always barging into the base hospital and disrupting our days work schedule. She does it several times a week, in fact. And four times now in the middle of the night, Ive rushed around to carry out an emergency resuscitation only to find a healthy boy sleeping peacefully. Shes also got the civilian ambulance crews out a couple of times and now theyve complained to the Base Commander. Hes ordered me to sort her out, the bloody fool. Dont know what he thinks I can do about it.

A broad smile crossed his face.

So Im telling you that you can do it. He pointed at my chest. Thats how the military works.

It was supposed to be a hospital pass no pun intended but my interest was piqued. I was curious to meet the infant James Bezuidenhout and see whether I could spot something that my colleagues had missed. I didnt have to wait long for the opportunity, or much longer after that for another, and another.

Within a week, I too had had enough of panicked calls late at night. Each time, I examined the boy and found him normal in every way. I eventually had him tightly wrapped in a towel and pinned down by a nurse while I drew blood from his jugular vein, his mother looking on with her big, round eyes filled with horror and accusation.

She maintained the same intense stare as I explained to her that Jamess blood tests were all reassuringly normal. She made me feel distinctly uneasy. I wondered whether perhaps I should send her to a psychiatrist. I just didnt know what to do.

So it went for several months. James kept breathing as he always had and, far from dying, he met all his milestones, growing as any normal child should. It was a relief when I was deployed to the Forward Airfield at Kariba in the Zambezi Valley for a couple of weeks. Even the bush war seemed preferable to meeting Mrs Bezuidenhouts baleful glare, day after day.

I hardly gave her a passing thought until my tour in the bush was over. But her name soon came up when I was doing a debrief with the elderly GP who had been called up to locum for me while I was away.

Its all over with Mrs Bezuidenhout, he said. Its all sorted out.

Oh! I said. Has she emigrated?

I had secretly been longing for this to happen. It was the only solution I could imagine.

No. She came in to see me with young James. I took one look as she came through the door and said: Young lady, you have got severe thyrotoxicosis. You need treatment right now.

Thyrotoxicosis? I replied faintly.

Yes, he said, grinning. Graves disease. Youll remember that from your textbooks, wont you? And you will have noticed her bulging eyes. She has typical thyroid exophthalmos.

Thyroid exophthalmos. Bulging eyes! It all fitted. And all this time I thought she was just staring angrily at me.

I started her on treatment and shes fine now, he continued. Shes sleeping well and no more high anxiety, thank God. Thats all this whole saga was ever about. There never was anything wrong with her young lad, of course. Thyrotoxicosis makes you highly anxious, as you know, and James had just become the entire focus of her disease anxiety.

I missed it completely. I sat there and stared at him. I felt a complete and useless idiot.

The grandfatherly old-timer slapped me on the back.

Never mind, young fella. Youll learn the tricks soon enough. Always look at the whole story the whole family and not just the single symptom the patient is complaining of and one day, youll become a fine GP.

Maybe he was right, maybe he wasnt. I decided then and there that general practice wasnt for me. I think I always knew it, anyway, even as a medical student: I just didnt have the right stuff for that sort of job. Now Im older, I still feel terrible I got it so wrong. I found Sheila Bezuidenhout to be a lovely lady once her runaway thyroid gland was tamed and I got to know her better. Inexplicably, she still stuck loyally to me as her GP of choice, despite my shameful failure to spot her diagnosis. Thats more than I would have done.

No, I decided, I wasnt going to be a GP. I was going to get into a laboratory and become a pathologist. There would be no more Mrs Bezuidenhouts to bother me there.

I would do it just as soon as I could.

* * *

I did eventually become a pathologist, with a laboratory and a mortuary.

Wandering the laboratory one day soon after I had begun, I bumped into Colin Wilson, one of our surgeons. He was clearly on a mission.