In 1971 I was the senior surgeon on the P&O liner Orcades. It was coming home from Australia time. 24 hours out of Freemantle in the middle of the night there was a summons to the Radio Room for an urgent medical consultation with an unnamed ship’s master It was his Chief Electrician who had been repairing electrical wiring on top of one of the ship’s boilers; he had received a severe shock (the ship worked on 480 volts) and had been catapulted backwards and fallen at least 20 feet. He was still alive but the Captain feared he was dying and needed more assistance than he and his crew could provide.
It was quickly apparent that he was in a lot of pain, and the master needed advice on the appropriate dose and frequency of morphine that the ship was carrying in its medical supplies. The nature of the pain suggested chest wall injuries, front and back, and possible vertebral damage in the lower thoracic and upper lumbar region. The two most pressing worries were that he was peeing blood and getting paler and iller by the hour. This strongly suggested internal injury to at least one kidney and possible internal bleeding due to injury to other organs such as the liver or spleen. He probably needed surgery and he would soon definitely need blood, both ships were a minimum of 2 days from land in any direction. There is a commonly held myth that anything serious that goes wrong on a ship can be rectified by dispatching a helicopter, this is rubbish now and it was certainly rubbish in 1972. The range for a helicopter is quite small, with only 2-3 hours sailing most ships were out of range unless hugging the coast. We had found out the name of the ship, she was called the Berge Istra, but our Lloyds list did not have information on her.
She was a monster, a huge long green monster. As she came alongside our relative sizes became plain. We were a big passenger ship, 28,000 tons give or take, but we could have been a lifeboat for this one; it transpired that at that moment she was the biggest ship on the planet. In an amazingly short time, they had lowered a tiny looking little red lifeboat, strapped the injured man into a wrap around stretcher, named after its designer, Anderson, and secured him as tightly as possible. The lifeboat bobbed across in double quick time.
We had our patient on board and carried him to the hospital when the first problem presented itself. He, like his ship, was huge. So huge that he was too long for our hospital beds, he was 6ft 8in tall. We made him comfortable on one bed while the Ship’s Carpenter sawed off the foot of the other bed. He was pale as a ghost, but able to talk and his English was good though his nationality was Swedish. His pulse was thin and fast, his blood pressure low and he was in agony every time he urinated because of blood clots in the pee. On closer examination it seemed that a lower left rib had ripped into the left kidney, more ominously it looked like he had a ruptured spleen too. His abdomen was tense, exquisitely tender and the muscle hardened on light touch. This was probably due to blood in the peritoneal cavity but could indicate a ruptured bowel.
All in all his chances of reaching Durban did not look too bright, and the first priority was to give him some blood and keep his pain as controlled as possible. This was not easy at this time on a passenger liner, we could not carry stores of blood, and the blood substitutes available then were not much good. The cross matching was primitive, done with a series of blotting papers, a methodology devised by a Norwegian, which did in the end save a Swede from a Norwegian ship. There was a little book of blood groups of crew who were prepared to donate blood in emergency.
After the second pint he really did start to improve. His blood pressure stabilised, his pulse rate at last started dropping below a hundred, his temperature was down, and, perhaps most importantly, he began to think he might make it. With 24 hours to go his condition took a turn for the worse. We really did think we were going to have to operate this time. We gave him a large dose of morphine and a sedative to knock him out and those of a religious persuasion prayed, a further ½ pint was squeezed out of the only crew member with the correct blood group. So he made it to Durban where the ambulance and surgical team were waiting. He was in fact even more damaged than we had thought. Both kidneys were injured, his liver capsule was torn and oozing internally, and yes the spleen was ruptured. His spleen was removed and 1/3 of his left kidney and he was transfused a further 6 pints of blood but he made it and within 3 months was back on the Berge Istra.
For a few years he sent me Xmas Cards with little details of his life, by this time I was a family doctor and listening to the radio one morning while doing my visits there was a news bulletin reporting the tragic loss of one of the biggest ships in the world, yes you guessed it, the Berge Istra. She had gone down with the loss of all hands in the South China Sea. It later transpired that the cause was probably inadequate clearing of the holds of inflammable gasses before loading a full cargo of iron ore in Japan. There was an explosion causing a hull rupture and she had sunk like a stone. At Lloyds of London they rang the Lutine Bell.