Homage to Gaia (59 page)

I took the train that goes cross-country from Exeter to Nottingham, and travelled from the station by taxi to the City Hospital—a large, multi-storey building occupying a sizeable area. Mr Bishop came to see me soon after I settled in the ward, and explained what he would try to do. It was surgery of the urethra—a urethrotomy—he said, and then explained that it was a careful and painstaking procedure, done using the magnified view of an endoscope, not the crude surgery done at Barnstaple. Here, blunt instruments had dilated my
injured urethra—they had used thin stainless steel rods called bougies to expand the damaged tissue. I had my operation the next day, and learnt from Michael Bishop that the repeated attempts at dilatation in Barnstaple had produced a mess of broken tissues and blind passages. He had made some much-needed repair, but warned that I needed a great deal more before my urethra would function properly again. It would not be necessary for me to make repeated journeys to Nottingham, as a skilful surgeon, Mr PI O'Boyle, practised at Taunton, in Somerset, much closer to where I lived. He would write to him and explain what I needed when my urethra began to close again. As the train drew away from Nottingham and passed through the flat industrial landscape of the Midlands and on towards the West Country and Devon, I felt a great sense of thankfulness. At last, it seemed that I was safe again. Michael Bishop did such a good job that there was a wonderfully long interval of eight weeks before it was necessary for me to go to Taunton.

During that respite, I travelled to the United Nations University meeting on the island of Corsica. At Coombe Mill in early July 1983, the temperature rose, most unusually for England, into the nineties Fahrenheit and stayed there for most of the week. We were lucky to live in a mud-and-straw constructed house, a kind of English adobe—cob is the word Devonians use to describe it. The two-to-three-foot-thick walls keep a cool environment in hot weather and a warm one in winter. The heat capacity of all those tons of mud was such that its temperature could only slowly respond to that of the air at its surface, and it required weeks of torrid heat or freezing cold to change it from comfortable to unpleasant. The English climate, with its endless samples of weather—hot and cold, wet and dry—almost never tested it to its limit. Corsica, strangely, seemed cool after Devon, although the Mediterranean was heavenly to swim in, which I did on most days, from a rocky cove beneath the hotel where we were staying. The distinguished environmental scientist, William Clark, was my companion for much of the stay in Corsica, as well as my friend, Walter Shearer. As at all scientific meetings, the key things were said tête-à-tête at the restaurants in the evening, or during walks to and from the beach. I sometimes wonder why there are so many prepared talks at scientific meetings; we would do better to spend our time in private conversation.

Eventually, in September, I knew I had to go to Taunton for more surgery. I arrived at Musgrove Park Hospital and went to Ward 3. It
was a familiar old-fashioned ward, part of a temporary wartime hospital built in the 1940s, a series of huts angling from a boardwalk—ugly and well beyond its anticipated lifetime. Perfect, I thought, for a propaganda film by American private medicine to show how awful was the National Health Service and socialized medicine. In fact, the quality of the surgery and nursing care I received during the twenty-five or so visits I was to make there over the next thirteen years, could not have been bettered anywhere in the world. It was comforting to see, on a recent visit to Ward 3, a party of surgeons from the distinguished Mayo Clinic who had come to Taunton to learn about the pioneering techniques that my surgeon had developed. Unlike King's College Hospital, the interior was warm, clean, and amazingly full of laughter. The domestics here were local women, and they seemed to know that they were an essential part of the hospital system. They took care of us and hastened our recovery; their friendly concern and help showed what should have been the conditions in Lonsdale ward.

I first met Paddy O'Boyle in Ward 3 one Thursday morning in September 1983. I had not expected an immediate operation when I arrived there, and so had breakfasted before leaving home. ‘Never mind,' said Paddy, ‘Over lunchtime I will have a look at your urethra by endoscopy and we'll use an epidural anaesthetic' A cheery Australian anaesthetist did the epidural as I waited on the operating table. Then my legs were set up on a stand, similar to that used for women in labour, and a blanket was set up between the surgeon and me. I wondered if this was to spare my feelings, but not so. The blanket slipped off during the surgery and Paddy asked the nurse to put it back. I said, ‘I don't mind,' to which he replied, ‘But I do.' It was good to know that I had a sensitive surgeon. What he did was little more than endoscopy, to look at the extent of the damage and then decide on the repair that he would have to do. The endoscope, being somewhat large, automatically dilates the urethra anyway. Michael Bishop had done a fine job clearing up the worst of the ragged mess—the traumas of King's College and Barnstaple together—but there was still a great deal to do. Paddy warned me that the incidental dilatation now done would last only a few weeks. I must prepare myself for a prolonged spell of urethral surgery. He said, ‘It will involve operations every week for quite a while. You will have to come here every Sunday afternoon and leave on the following Tuesday. Can you arrange your life to make this possible?' After the
previous miseries this seemed no great problem, and he started the long series of operations that eventually led to a partial cure. There was pain, but nothing like the agonies I had experienced at Barnstaple. The only bad times were when I experienced a proctalgia: this is a nearly intolerable pain in the inguinal region and it came on when there was, simultaneously, inflammation of the urethra and the bowel. It seemed to be a consequence of taking antibiotics to keep bladder infections at bay. My physician, Alan Edwards, gave me Temgesic tablets to ease the pain; these are fast-acting, tiny sublingual tablets of a synthetic opiate. They certainly did the trick, although with a pleasant side effect of a day's excitement and euphoria. Not something to which I would want to become addicted but, again, it made me realize and understand better what appeals to the drug users whose daily lives are often bleak and cheerless. I have often wondered how much addiction is part of our personal programming: are those who lead normal lives in much danger of becoming addicted to drugs? After all, we rarely drink to excess when life is good. I was fortunate to be able to work in a laboratory attached to my home and I managed, during this period, my two visits a year to the United States and some to Europe.

There were about five more visits like this to Taunton, where Paddy O'Boyle diligently repaired blind holes and other problems caused by the crude dilatations with stainless steel rods at Barnstaple. He tidied up my urethra to make it again a pipe, rather than something like an inverted river delta, but there was still scar tissue from the damage done earlier. The problem with scar tissue is that it contracts, and I needed relatively frequent operations to keep my urethra open. A less serious side effect was that I now had a curved penis when it was erect. Then came the day when he said, ‘I do not think there is much more I can do by urethrotomy, so we have to decide what the next option is. The main problem is the contraction of the scar tissue; it makes dilations every three weeks a necessity. After talking with my colleagues, I have decided that the most useful thing we can do is to make a short channel from your bladder to the inguinal region. In other words, to arrange for you an artificial urethra that would be similar in construction to that in most women. Next time you come to Taunton, prepare for a longer stay, perhaps ten days.' With the thought that my penis would soon be redundant, celibacy seemed now not to matter quite so much. I resigned myself to this next ordeal. I must admit that, during this period, I became quite obsessed
about trade unions, and cheered when the union leader Arthur Scargill lost his long battle over the mines.

As I drove along the M5 on the way back to Musgrove Park Hospital, my mind was full of the consequences of my next operation. I nearly missed the turnoff, exit 26 for Wellington and Taunton. I do not much care for cars or driving them, but there is no other way to travel from Coombe Mill to Taunton. The welcome I received on arriving at Ward 3 was warmer than usual, and everyone there seemed to know that tomorrow's surgery had profound consequences for me. I had for some time regarded the ward staff as almost a second family, and knew most of them well. A great deal of this strength and cohesion came from those most closely associated with it, especially from Sister Chant and the surgeon, Paddy O'Boyle. Sister Chant wore the dark blue dress of a hospital Sister, with its belt and silver buckle, and she wore it with authority. She wore it in a way that Florence Nightingale would have approved. She was no mere senior nursing officer, although that may now be her title. Doctrinal egalitarianism does not allow for honourable vocations, like nursing. I cannot imagine her, whatever the provocation, joining in a strike. In all of the fourteen years of visits to Ward 3, I have heard her raise her voice only twice. She did not need to. Whether by choice or by accident, the staff appropriate for Ward 3 seemed to gravitate there and to stay. Prominent amongst them was Robert Conway, also a quiet and powerful figure, whose striking appearance was part of the ward's quality. The staff called it the grandfather's ward, since most of the patients were over sixty and having some or all of their prostate gland removed.

A strange incident occurred at this time. I had brought with me to read a book by the author, Richard Cowper, called
The
Road
to
Corlay
,
first published in 1978. I did not usually read books of this kind: it was science fantasy. To me, science was fantastic enough anyway, but Richard Cowper wrote so well that I have read and enjoyed immensely everything he has written. He had also written to me personally about a small story in my first book,
Gaia.
He was keen to use it after revision, and publish it as a short story, and sought my permission, which I gladly gave. I was looking forward to a good read, while I waited in the afternoon and evening before the next day, when I was to be partially converted in the female direction. I had reached page sixty when I was astonished to read:

Not bad for a coincidence: the year and month were wrong and Ward 3 was on the ground floor, but what a surprise to read, while preparing my mind for major surgery. Every week someone wins the lottery at comparable odds against, so coincidences like this must happen every so often. But just as the winner is happily amazed at the news of the win, so was I by this coincidence at such a time.

Next morning, which was Monday, I woke earlier than usual, and shaved and showered before anyone else was up, which would be about 5.45 am. I helped to take the morning teacups around the ward, went back to bed, and read again for a while. The tall figure of Robert Conway came up to me and said, ‘So you are for the big one this morning, Jim, and you are the first on the list and will be going along to the theatre at about 9 o'clock.' At about 8 they brought me two 10 mg Valium tablets as the favoured premedication of that time. Soon, it seemed, the porters came with their trolley, or what the Americans call a gurney, to take me to the theatre. They wheeled me along the short distance to the theatre, and in the anteroom the anaesthetist chatted to me as he prepared his intravenous cocktail of anaesthetic. He then inserted a cannula with a syringe port into a vein on my hand: this welcome invention saves repeated puncturing of veins to deliver doses of any drug or antibiotic. Soon, he injected his mixture into this device while we went on chatting and then suddenly I was away. I came to in the recovery room adjacent to the theatre, and soon I felt the familiar touch of tubing on my thigh and put my hand down to confirm it. Yes, there it was, a catheter tube leading from my penis. Strange, I thought, then Paddy came over and said in a matter-of-fact voice. ‘We decided after all not to do the big operation and just completed the urethrotomy.' I should have sung my praises to him there and then. Where would I have been in five years' time with nothing to bring to my second marriage but a withered member?

From now on visits dropped back to four weeks or so, but another problem arose: that of repeated bladder and kidney infections. A kidney scan and a kidney function test using radioactive technetium, soon revealed the damage done to my left kidney by the tractor accident at the beginning of 1982, and it looked as if it needed removing. Sister Chant told me that Paddy was one of those surgeons who operated only when it was wholly necessary. I had good reason to believe this, and I could see that he was loath to remove the damaged kidney and preferred to try to coax it back to life.

One day, whilst busy preparing a lecture that I had agreed to give in Vienna in a few weeks' time, Dr Lightfoot, the pathologist at Taunton, called. ‘Can you drop everything and come to Taunton at once?' he asked. ‘What, now, this afternoon?' ‘Yes, it is urgent that you do. Do you want us to send an ambulance to bring you in or can you drive?' ‘Oh, I'll drive in, but what's the fuss?' said I. ‘You have a
Pseudomonas
infection and it should be treated without delay.' Feeling as well as I was used to feeling, I chose to drive in to Taunton, having packed my pyjamas and dressing gown and other odds and ends.