The Hospital in Buwambo

by Anne Vinton

  Not that Sylvia’s unruffled front in public was always kept up in private. On her third working day she performed six operations, two of a major nature. She stayed within call until all the patients had survived the first period of shock, prescribed their drugs and dosages and crawled off to bathe and sleep. Two hours later a night steward awoke her. Sister’s compliments, and a patient had been admitted who needed her attention. Coming out of a sleep that was sheer stupor, Sylvia heard her voice responding automatically, saying that she would come as quickly as possible. When the messenger had gone she clutched her head and sobbed impotently for a few minutes. Was this the way it went on? Was there never to be rest in this place? She didn’t mind the sweat any more, didn’t complain about the stickiness of the pillow after the first hour, the zooming of mosquitoes that had somehow gotten inside the net, the ants crawling along the far wall; all she wanted was to be allowed to sleep. She must tell Sister she had to sleep.

  But on the ward she asked quietly to be conducted to the new patient. A frightened, sixteen-year-old girl peered from over an immaculate sheet at her, her swollen, ungainly body telling its own story.

  “Your province, surely, Sister?” Sylvia smiled reassuringly at the girl and squeezed her hand.

  “I think it’s yours, Dr. Phillips, or I wouldn’t have called you,” Sister said tartly. “She needs help.”

  “Let’s see, shall we?”

  Behind screens Sylvia made her examination.

  “I see no reason why this girl shouldn’t do very nicely without help,” she said. “I know she’s young and is going to make a great deal of noise out of ignorance and fear, but she’s going to be much happier tomorrow if the child is born naturally tonight.”

  “I disagree,” Sister snapped.

  “Very well.” Sylvia kept her temper admirably. “One of us had better get some rest if the patients are not to suffer. You go to bed, Sister. I’ll be midwife.”

  “You’ll be no such thing!” Sister said angrily. “I was delivering babies when you were in socks!”

  “Then deliver this one.” Sylvia smiled. “You’ll get him about five o’clock. She’s having good contractions now.” The girl bellowed mightily, and all the ward stirred in protest. “Give her a pethidine injection—it’ll help,” was Sylvia’s final instruction, and she went back to bed knowing Sister would have her hands full for an hour or two at least.

  In the morning there was a seven-pound baby boy in the nursery already investigating his small thumb for nourishment. The mother slept soundly, her ordeal quickly forgotten in the personal satisfaction of having served her husband so well by giving him a man-child. Also she had by now realized that she was lying in a bed with white sheets around her, and food was brought when she needed it. There would be so much to talk about when she got back to her village.

  Dr. Kalengo, his expression inscrutable as always, shrewdly observed the blatant slave-driving that was going on under his nose. He had always stood in awe of Sister since the day he had arrived, five years ago, from Ibadan University. Kalengo was well overdue to present the thesis that would enable him to place the letters M.D. after his name, but he was a patient man and devoted to his Senior. Carroll treated him like a colleague and insisted the staff do likewise, and only on the rare occasions when he annoyed the superintendent was he fiercely reminded that he only held an inferior qualification and might never reach the M.D. Dr. Phillips had quickly assessed his true skill and knowledge, but Sister had treated him with rather more contempt than usual since Sylvia’s arrival. He was not at all happy about the condition of the girl whose leg had been deeply incised with a machete before the superintendent’s illness. She did not appear to respond to penicillin as did most patients. He suggested to Sister that they ask Dr. Phillips’ opinion, but was quickly snubbed.

  “Don’t be ridiculous!” Sister snorted. “This girl is Dr. Carroll’s patient and I have charge of her. She’s a bit slow, but she doesn’t moan, does she? She’s not in pain.”

  Sister’s statement was finality, but Kalengo, looking down at the girl, pondered on the question of whether or not to defy Sister and call in Dr. Phillips. But the new doctor had only just left the wards after an exhausting session, and if Sister would not let her rest, he must.

  The girl died quietly that same night.

  Kalengo read this news in the report that lay on the superintendent’s desk the following morning. A great sorrowing anger welled up inside him so that tears burned behind his eyes. The grimace that his face had become met Sister as she entered the office, closing the door pointedly behind her.

  “I thought you’d be upset,” she said sharply, “but there was nothing to be done about it. Dr. Carroll’s collapse came at an unfortunate time.”

  Kalengo had had time to control himself. He looked down at the report and unclipped his pen from his pocket.

  “You will not object if I add a note to the effect that I suggested we should call in Dr. Phillips, Sister?” he asked.

  “Do as you, please, of course,” snapped the woman, turning to the door. “As though a few hours would have made any difference! Anyway”—she added offhandedly—“I did call Dr. Phillips in. She was up all night with the girl.” There was such a note of satisfaction in this statement that Kalengo bridled immediately.

  “Dr. Phillips,” he roared, towering over the woman, “will be allowed to sleep until she is called on my authority!” He took a breath. “You hear—Sister?” he demanded.

  Sister opened the door somewhat nervously and looked back at him. He was putting his pen away, having added nothing.

  “I hear—sir,” she said, and made her escape.

  Kalengo wiped the sweat from his brow with shaking hands and smiled to himself.

  Sylvia hardly knew what to expect of David Carroll when he realized she was still at the hospital despite initial efforts to eliminate her. She expected shock and anger, certainly not calm acceptance of the fact.

  David Carroll strode back on duty after a week, looking a little more spare—otherwise none the worse for his attack. Sylvia found herself staring as he called to her politely to join him in his office.

  “This is it!” she told herself, already rehearsing the hot retorts she would make to him. She would stand no bullying nonsense, she decided. Having filled a breach and worked herself sick for a week she was at least entitled to an honorable discharge and some thanks, though she had no hopes of the latter.

  “Did I wish you good morning?” the superintendent looked up to ask.

  “Good morning, sir,” she replied cautiously. “I’m glad you are on your feet again.”

  “Thank you. So am I.” He looked down at the report before him. Without raising his eyes he continued, “I deliberately kept off my feet for the luxury of it. It was heaven.”

  Sylvia wondered what she might interpret from this somewhat ambiguous statement, and shifted from one foot to the other.

  “Tired?” he flashed at her. “Don’t deny it, you must be. You look it. You’ve done splendidly. Now when do you wish to be relieved?”

  “Oh—” Here it was. She smiled wryly. “May I leave all that to you, sir?”

  “As you wish. How about Friday, that’s tomorrow, for your day off, and every other Sunday? Will that suit you? You’ll be due for five days’ leave after three months, which gives you time to get to the coast for a breather and back. That works wonders for me, I fine, though I haven’t been able to get down for some time.”

  “You mean you want me to stay on?” Sylvia said, unable to believe her ears. “Are you sure you’re all right, Dr. Carroll?”

  He smiled, and she realized that the youthfulness she had noticed about him was due to the removal of his beard. His moustache he retained—neatly trimmed, however.

  “I must have appeared single-minded in my efforts to turn you back, Dr. Phillips,” he twinkled at her, “which, I hope, you do not find discreditable. However”—he sighed—“I have been temporarily removed from the scen
e and return to find you still here. You stay, Dr. Phillips, unless you, yourself, steer the bark of your fate away from this place. Now, would you kindly take rounds while I catch up on this?” He indicated the report.

  “Certainly.” Not knowing whether she was on her head or her heels, Sylvia joined Dr. Kalengo and Sister at the entrance to the women’s ward. She sailed on down the ward volunteering no information, and, biting back her fury, Sister followed one pace behind Kalengo.

  Sylvia had decided to spend her day off in bed, but as it had been a quiet night and she had been allowed to sleep like a log, she raised her head from the damp pillow and decided that a leisurely bath would indeed be a luxury. Her toilet arrangements since she had left the bungalow had been rather skimpy and laborious. The hospital had its own water tanks, but so far was not piped to serve the small bungalow where she was now accommodated. She had to carry water in a pail from outside. Whenever Gideon saw her he ran to help, but he had been so tied to his Dr. Carroll that she couldn’t in all fairness expect him to serve her also.

  On this morning Sylvia had the misfortune to bump into Carroll as she was carrying her third pailful back to her quarters. “What are you doing, Dr. Phillips?” he demanded.

  “I’m about to have a bath of sorts,” she replied, as lightly as possible.

  “But where’s your steward?”

  “Steward?”

  “You mean you haven’t a steward?” The old, familiar thunder stole over his countenance. “Kalengo!” he roared.

  “Oh, please,” Sylvia pleaded, “don’t blame Dr. Kalengo for anything else. I suppose I’m rather green and I do things rather than ask. It’s nobody’s fault but my own.”

  “Very well.” Carroll waved the nervous-looking Kalengo back into the hospital and took the pail of water from Sylvia. “I hope you don’t mind if I glance in your place while I’m here.”

  Sylvia said not, and stayed outside until Carroll emerged, looking thoughtful. She thought he was going off without speaking again, but suddenly he turned.

  “Dr. Phillips, there’s a lot to discuss. Please join me at dinner this evening. Eight o’clock suit you?”

  “Thank you. That will suit me very well, sir.”

  “Oh”—he scratched the back of his neck, and she could see the color mounting the column of his throat before he spoke—“evening dress will not be worn on this occasion.”

  She looked him full in the eyes, her flush matching his.

  “No,” she said levelly. “We’re not celebrating anything this time.”

  He retired while the honors were even, leaving her quivering unaccountably.

  She spent the afternoon in Buwambo village, finding the natives friendly and hospitable. Most of the families had had some dealings with the hospital, of which they were justly proud. Sylvia found herself admiring old operation scars and new babies, giving advice, and hearing weird and wonderful stories.

  Thoughtfully, Sylvia wended her way back to the hospital, feeling refreshed by the few hours of complete mental relaxation. A week ago the thought of existing in Nigeria’s bush-belt, with its heat and humidity, had frightened her, but after David Carroll’s collapse and her initiation into the running of Buwambo Hospital, she had ceased to be aware of the climate in the mental effort of keeping abreast of the work. Now she accepted the trickle of sweat at the base of her spine, the damp circle where her belt embraced her, the cool wetness of her nape.

  One could be content where one could work, she decided. But was there not a warm glow in her heart as she thought of working alongside one particular person? Loath to investigate further into the files of her neatly kept, immaculate mind, she furtively smoothed her short hair and emerged from the bush into the blinding glare of the hospital compound.

  She stood back in the doorway of her bungalow and gasped. It was hardly recognizable as the place she had left a couple of hours ago. Frilly curtains hung at the windows; a rattan chair and chaise longue had appeared, and the camp-bed she had been using had been changed for the superintendent’s own—which boasted an interior sprung mattress. A small writing table stood under the window and a plywood bookcase, empty at the moment, in the space between bed and wall.

  It’s home from home, Sylvia decided, still in wonderment.

  In the small inner room stood a hip-bath already filled with lavender-scented water.

  Asking no more questions Sylvia stripped and plunged into the bath. It was so pleasant to lie and soak that she dozed for a moment or two. When she shook herself awake the clothes she had discarded were gone from the chair upon which she had laid them: in their place were two large, sky-blue towels and her silk kimono.

  Her heart fluttering a little, Sylvia dried herself and went back into the living room. On a small bedside table stood a tea tray, with a curl of steam emanating from the pewter pot.

  I must be more careful, Sylvia decided, and lock my door. I’ll be getting a bad name in this place. Firstly I throw myself at Kelso Blaine, then David Carroll practically undresses me while I’m drunk and incapable, and now some Tom, Dick or Harry has seen me in my bath ... I couldn’t have less mystery if I was trying to strip myself of it!

  The tea, however, was hot, refreshing and most acceptable. Somewhere behind all this was the firm, kindly hand of the superintendent, she knew.

  Oh, Michael Hogan, you never suspected that life in Buwambo might appear good to one Sylvia Phillips, did you? Not in your wildest dreams!

  CHAPTER SEVEN

  Michael Hogan, full name Michael Eugene, though this fact he kept a secret whenever possible, was on that same date scrubbing up in the place Sylvia had so recently vacated, the washroom adjacent to the theater for general surgery in the hospital of St. Augustine. He was to be permitted to watch an operation performed by Dr. Ian MacAlpine, eminent surgeon and teacher.

  Mike had an unfortunate habit of calling everyone “Bud,” which went badly against the grain of discipline-conscious hospitals in the United Kingdom. That morning he had “budded” one of his examiners, which cost him censure, but—fortunately for him—not marks.

  “Gee, Bud,” he had exclaimed, “I could have done it on my head!”

  “Dr. Hogan”—the examining surgeon had said coldly—“you will call me sir, and a good surgeon will always keep his feet on the ground. Understand?”

  “Yes, sir!” Mike conceded humbly.

  Despite Hogan’s unfortunate shortcomings in etiquette, however, the examiners had liked his work. The fellow was going back to Africa, and as long as he didn’t have the nerve to show his face in their hospitals again they would pass him. Anyway, he was a pupil of Carroll’s. Remember Carroll? Clever chap!

  Feeling the shivers of uncertainty suffered by all post examinees, Mike had blown into St. Augustine’s thankful to have his mind taken from his morning’s work. The confidence he had felt at the time had now disappeared, and he mentally composed the cablegram that would inform Dave that he had failed again. But as he donned gown and cap he felt cheered. What more could he have done? A natural aptitude had been given sheen by the excellence of his tutor, and Dave had also coached him in written work, taught him how to present a phrase that—with the knowledge—could not fail to impress. Surely this time it must be a cinch to come through with colors flying and the precious little letters to add after his name.

  Quickly soaring up once more from his lunchtime slough, Mike looked affably around the washroom where a few students, himself and a theater sister were carefully scrubbing up.

  “A nice place you have here,” he observed, taking in the immaculate blue and white tiling, the tubular steel fitments and the shining perfection of everything. “You sure should see the flea-hole I worked in back in Buwambo.”

  “I hope you’ve brought no fleas here,” said the theater sister sharply, raising a faint titter from the students.

  “If you are Dr. Hogan,” she said tartly, “kindly keep well out of Dr. MacAlpine’s way in the theater. We‘re working, you know.”
r />   “This I must see,” Mike said enthusiastically. “Real hospital busy bees. Mother says thank you for having me!”

  Sister flounced out and the students looked at each other. Who was this westerner who could take on a senior sister like that and outsmart her?

  “Congratulations!” came a voice behind Mike.

  He spun around. A sleek, good-looking type was bending over the bowl he had just vacated.

  “You speaking to me?” Mike asked. “Have I had the pleasure?”

  “No. My name is Shale. Martin Shale. I heard you taking the micky out of Sister Venable. I’ve often wanted to do it myself but—”

  “You work here, Bud?” asked Mike.

  “Yes. I’m the anesthetist this afternoon. You might see some fun and games. The boss doesn’t always care for my methods and we have a barney right in the middle of a job.”

  “Anything to relieve the monotony, eh?” Mike smiled. “I once gave an intravenous while I was smoking a cigarette. You should have heard my boss! Of course, Buwambo isn’t quite St. Augustine’s, but we still observe a few things.”

  “I thought you mentioned Buwambo before,” Martin said. “That’s in Nigeria, isn’t it? You must be the bloke who appointed Sylvia?”

  “Right!” Mike agreed. “Of course this is her place, isn’t it, and you must all know her? Some woman!”

  “You’re telling me!” Martin agreed. “I ought to punch you on the nose for taking her away, Hogan!”

  “Oh, yeah?” Mike could see the other was smiling, but cautiously. “Did you know her well?”

  “Very well,” Martin said. “We were ...” he stopped, and Mike presumed indelicate things with a sense of distaste for the turn the conversation had taken. “Oh, well,” Martin continued with a sigh, “she’ll come to her senses, I’ve no doubt, after a while. If you see her before I do, tell her Martin’s waiting, will you?”