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Home Features Jerome – a medical continuation of Matron!

Jerome – a medical continuation of Matron!

From British Honduras to Belize: one family’s drama – a novel written by the late Chrystel Lynwood Hyde Straughan

Chapter 22

It had been a time of great hope and excitement when, at thirty-two, Jerome had returned home to join the staff of the government hospital in 1960. The head of the now two-member professional staff of the surgery was completing the final few months of his contract before departing to greener pastures when Jerome had reported for duty, full of enthusiasm and plans to introduce a new era of “local”-flavoured service.

Significant progress had been made in the years he had been away. Matron had received formal appointment in 1950 as the first identifiably native person to hold that post. Nurse Pauline had returned to her home district in 1954 to head a larger and better equipped clinic, coincidentally in response to a request from her father to come home to assist in the care of her mother, who had been forced to pass her sewing over to her daughter Enid for health reasons.

Since leaving the district Pauline had spent a few long vacations working in the United States and had filed for a permanent resident visa, not with any intention of migrating but as a useful backup opportunity for income-earning should the need arise, confident that in three months she could earn the equivalent of a year’s salary at home, and nurses were in demand.

Overall physical and staff expansions, especially in the Children’s and Maternity wards, had taken place in response to pressing need; and the movement towards Independence that had been germinating in the psyche of people like Matron and others of her generation was catching on and finding expression by upcoming younger groupings. While the older heads were concerned with social and economic self-sufficiency as a step towards developing capability for managing our affairs, the younger element was seeking a political solution and allegedly soliciting support from neighbouring Hispanic republics sympathetic to their cause. Matron had regarded this as putting the cart before the horse, but took a live-and-let-live view of their methods, assuming their objectives to be the same.

Before retiring in 1959 at the mandatory age of fifty-five, she had seen the modest beginning of a nursing school and it became one of her highest priorities to support and promote the development of the institution as a member of its governing board, through the Nursing Association which had become a reality some years before, and as a private citizen.

Once her father’s will had been probated and she had received actual control of his estate, she had pursued a plan of sponsoring training in various fields among individuals she had identified as civic-minded and responsive to the needs of fellow-citizens; and supporting various organizations, such as the Black Cross Nurses who had dedicated themselves to altruistic pursuits. She accepted appointment to various voluntary boards and councils involved with oversight of government and non-government institutions such as the prisons, homes for the poor and indigent, orphanages etc., besides keeping personal contact with ex-patients all over the country. She was such a source of information for anyone seeking help or advice about a wide range of matters that many queries were answered with the suggestion to “try Matron.”

She paid the school fees of many a student with ability who was financially deprived, and was generous with contributions to many worthy causes, both individuals and groups. Her personal association with ex-patients and their grateful relatives had equipped her with contact to people who could facilitate ordinary citizens in solving everyday problems, and she was as generous with her time as she was shy of publicity.

Jerome benefited from her legacy of goodwill and continued her style of operation and her maxim of the patient always being the priority; and, as soon as he had full responsibility for the department when the Chief Surgical Officer had left office, he had called the staff together and outlined new procedures effective right away, joking with Mama about his appointment as Acting CSO of a one-surgeon department. Matron’s record of performance had been instrumental in creating trust from both staff and patients, who saw in him a continuation of the same commitment and empathy.

One of the first practices he had introduced was a ban on small talk on entry to the outer room of the theatre, applying to everyone including himself, the purpose of any talk being to convey information or to ask or answer relevant questions. The impression had sometimes been given, due to the way things had been done in the past, that the matter in hand was of secondary importance to the private concerns of those in authority; and his intention was to dispel that notion and direct strict attention to the work of the department.
He had next compiled a list of all pending surgeries with as much details as possible, both personal and case-specific, and introduced himself to each patient in seeking to create a rapport with them.

He had studied this list and prepared a time-table for completing the operations on the two-day weekly schedule for surgery, starting his day one hour earlier than was customary and having two one-hour breaks rather than one lasting two hours. Also, the decision was made to operate on Tuesdays and Thursdays, leaving Fridays and Saturdays free for routine and emergencies.

A personal touch he had introduced after a few months was to assign a nurse to escort each patient as far as the outer room of the theatre, as a way of providing reassurance of constant oversight and concern; and the value of this practice had had instant results, with feedback from patients and their families expressing appreciation.

People responded positively to his initiatives and he worked long hours to improve and upgrade the services provided not only by his department but by the hospital in general. His demeanour, although serious, was courteous, caring and respectful, especially of the elderly, with whom he was popular.

His commitment to his vocation was obvious, but what gave me personal satisfaction was detecting his enjoyment of the work, especially because of my awareness of the circumstances by which he had arrived at his career choice.

Of some concern to our family had been his detachment regarding Elena, of whom he had spoken not a word, not even to my mother. His time was spent between home and work, with occasional attendance at some sporting match. He ate at Mama’s on Wednesday nights and visited us after church on Sundays, often spending the rest of the day until he called in at the hospital before going home. Living in the family home afforded us access to the room and sports equipment downstairs, and Jerome spent many an hour there with Lloyd and Victor during his visits, often joined by Nigel.

On the matter of Elena, Mama had asked my opinion one day about something that was puzzling her. It seemed that Elena, who had continued her friendship with our family, had confided in her that her husband had become aware that she and Jerome had had an arrangement when he noticed the ring he had given her in her jewellery box and had asked about it. He had suggested she return it now that Jerome was back, but she, who was reluctant to approach him, had asked if Mama would help her out by delivering it. It was then that we had learnt that because she had not had the courage to write him right away, it had been after the birth of her first child that he had been told about her marriage. She had received a brief note of acknowledgement from him and nothing more.

On my advice Mama had put the ring in its case, wrapped it in plain tissue paper and handed it to Jerome with the comment that she had been asked to deliver it on Elena’s behalf; and all he had said was, “Thank you, Miss Eileen,” and put it in his pocket.

####

Things had progressed evenly at the hospital for the first years, during which Jerome’s changes had been accepted and formed part of a comfortable routine. One thing about him that had stood out was his unfailing courtesy to high and low alike. From earliest times in the service doctors were treated with great respect by staff and patients alike. Unfortunately, in many cases such treatment was not reciprocated, and many on the professional staff tended towards condescension and even arrogance and impatience with those below them and in need of their attention, while some were notorious for shouting at and insulting both patients and nurses.

Jerome, on the other hand, never raised his voice to anyone; and if the need for admonishment arose it was done with such grace that no offense was given. Colleagues who knew of our relationship would joke that Dr. St. John had “had a word” with them about this, that or the other when he had had occasion to call them aside and make any correction.

####

In his second year at the hospital a group of amateur performers from the regional university had presented a play and poetry readings to which Nigel and I had invited him. We had had aisle seats for the show and I had sat between him and Nigel, who had occupied the end seat. People kept coming in and just before the curtain rose, the head surgical nurse, Miss Newcombe, had arrived and was escorted to the seat next to him. After greeting each other he had introduced her to me, as, although we worked in the same hospital, we had very little contact with each other. Before long he had made the suggestion that they exchange seats so that the ladies would be flanked by the males, as she had come alone.

On several occasions after that, they had attended shows at the Bliss Auditorium together and by the end of that year had become a twosome. It had not lasted long, however, and she had been awarded a scholarship to study somewhere in the Caribbean; and Jerome had been credited with arranging her promotion out of the service.

The grapevine had it that she had brought it on herself by violating his ban on small talk in the surgical theatre area. At the end of a session in surgery she had asked whether he had obtained the tickets for a show they were planning to attend, which he had ignored. She had repeated the question at the next break and again it had been ignored. I was told that at the end of the day he had walked to his office and put the tickets in an envelope with a note saying he was not up to attending, but that she was welcome to take a friend.

She had been of the old school, which upheld as inviolate all the practices put in place by the colonial authorities and was in contempt of any innovations, so their relationship was regarded as a casualty of her resisting change.

####

Losing a patient was an experience every doctor has to face sooner or later, and Jerome was no exception. But the circumstances had been very traumatic for him as it could have been easily avoided. He had performed an appendectomy on a middle-aged patient whose appendix had ruptured on the table. He had prescribed antibiotics to ward off infection and the patient had been healing satisfactorily when one night before the fever had subsided completely the physician on duty had prescribed a new antibiotic without first ordering a test. The patient was found to be allergic to the new medication and when Jerome checked on him the following morning it had been too late to remedy the situation and he had passed away.

Jerome had made strong representation to the Chief Medical Officer that the offending physician should acknowledge his culpability and face serious consequences, but by the time he had taken action the offending officer had resigned suddenly and left the country.
Frustrated by the injustice connected with this incident, Jerome had instituted procedures for prevention of a recurrence by mandating that any change in a surgical patient’s recovery should be referred to him personally without delay, at any time of the day or night; and for this purpose always left a telephone number where he could be reached when leaving the hospital premises.

He went further and authorized that in the absence of senior personnel in charge any member of staff present was empowered to take the initiative to contact him; and in addition to all these safety measures it became his habit to show up at the hospital unexpectedly to check on his patients.

ooo0ooo

With Miss Newcombe’s absence, the Surgery unit was operating on short staff for several weeks when relief had come in the form of Mrs. Margaret Havers, a friend and colleague of Jerome from his days in the U.K.

He had given Mama the background to their friendship, describing her as a very proficient surgical nurse with whom he had become acquainted through her husband, a surgeon specialist under whom he had worked for a time after completing his studies. The Havers were very sociable and in the habit of befriending and entertaining students and visitors from the colonies. Wealthy and much older than his wife, Mr. Havers was a star in the surgical world, sharing a private practice with another eminent surgeon, while also teaching part-time at the University Hospital where Jerome had done his residency. Mrs. Havers, whose father was even wealthier than her husband, worked in his practice as well as at the same University Hospital.

Jerome said they were an idealistic couple who were sympathetic and supportive of Third World countries and put their money and interest in trying to help. Both had wanted children, but after a miscarriage she had been unable to conceive again, so they had busied themselves with their jobs and with charity and social work.

In conversation one day they had asked about his country and he had painted a realistic picture of our situation, stating how he proposed to contribute on his return home. She had promised that one day she would join him in his efforts, but he had not taken her seriously.
They had written to each other off and on since then, and one day he had received an offer from her to come and spend a year to assist him in his work. This had come at a time when he had been despairing about the obstacles he was facing with lack of sufficiently trained staff, which we were losing to the United States job market at a high rate, and saw her offer as a godsend. He had been pleasantly surprised when she had agreed to come right away and spend a year, free of cost, as a private citizen and not as part of any volunteer programme of the colonial government. So, there she was!

As an appointee of the Ministry of Overseas Development in the U.K., Jerome had been eligible for housing, which he had foregone, continuing to live at home; but now that Sister Havers was here, he had applied for and been granted one of the government buildings situated in the area of the old army barracks, which he had shared with her. Being an area of privilege catering mostly to expatriates, the local inhabitants had nicknamed it “South Africa.”

Jerome had told Mama what a shot in the arm it was to have Sister Havers’ presence in the theatre, describing it as being almost like working alongside a surgeon, so capable, knowledgeable and supportive was she; adding that the effect of her proficiency had been to upgrade the performance of those on the whole surgical team, who were inspired to greater efficiency by her example.

A feature of Jerome’s style from the day he reported for duty was an easy formality, expressed in according all members of staff their proper form of address and never lapsing into familiarity. I was either “Nurse” or “Mrs. Brandon” to him, while on the hospital compound, and he was “Doctor” or “Mr. St. John” to me, a practice upheld by Sister Havers also.

Her behaviour towards Jerome was so deferential and protective that it had aroused the resentment of other members of staff, especially a group referred to as “senior sisters,” as well as the recent trainees.

The senior sisters were so-called because they had been re-hired after retirement (at fifty-five years) to offset the continual shortage of nurses, many of whom had migrated to the United States, where the retirement age was sixty-two or even later, in pursuance of greater opportunity for a higher standard of living. They were referred to as the “SS” (for obvious reasons) or “Gestapo” due to their militance in upholding the old standards of the service, as against the younger staff members who were more interested in rights than in responsibilities.

(Chapter 23 in Friday’s issue of Amandala.)

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