Admittedly, I did not look like a doctor. For one thing, I had just spent ten days on the Nile in a felucca with eight fellow travellers. (Feluccas are primitive sailing boats that look romantic in travel brochures but seem less so on closer acquaintance.) Then, when we reached Luxor, I was struck by one of those acute shopping disorders that afflict tourists, and bought a pair of baggy cotton trousers with broad black and yellow stripes. I wore these for the rest of the journey, so that by the time we boarded the overnight train from Aswan to Cairo I looked like a dishevelled bumble bee.
‘Is there a doctor on the train?’
The message came over the public address system, first in Arabic, then in French and finally in English. Aswan was a couple of hours behind us. I felt a strong desire to deny my profession, but in the past two weeks I had already attended almost everyone in my group for the usual unpleasant ailments that go with so-called ‘adventure travel’, and they all knew what I did for a living. Lurching along the corridor towards the back of the train, I found an edgy Egyptian guide attached to a party of French tourists. Judging by their dress and demeanour, they had spent considerably more on their trip than we had on ours. They raised eyebrows at my ridiculous appearance, but allowed me to enter the compartment where I met the patient, a ten-year-old boy. He was accompanied by a male guardian who could have been an uncle or perhaps a private tutor. Both guardian and boy were pale and sweaty. In the guardian’s case it was no doubt from anxiety. The boy, however, had a thin racing pulse and the rigid abdomen that indicates peritonitis. I knew the likeliest cause was a burst appendix.
I explained that that the child needed urgent surgery. This provoked a frightening response. The Egyptian guide lost the few vestiges of restraint that had held her panic in check and began to shout at me. I persisted, saying that the train would need to make an unscheduled halt at Luxor to let him and his guardian go to the hospital there. At this news the guardian practically passed out, while the guide dismissed my advice completely, saying that the hospitals were bad in Luxor and the child would be much safer waiting until we reached Cairo in about eighteen hours. I said as calmly as I could that he might die within eighteen hours, and that it was beyond belief that a town the size of Luxor would not have a surgeon who could remove an appendix competently.
Various members of the French party then came in to ask for proof that I really was a doctor. Close to losing my own temper, I managed to say witheringly: ‘Je suis desolé, mais je ne porte pas mes diplômes en vacances’ (‘I’m sorry, but I don’t carry my certificates on holiday’). With bad grace, two of the French tourists finally agreed that they would discuss the matter with the guard and then dismissed me. I returned to my own carriage. I had barely finished narrating the story to my own tour party and our Dutch guide, when another announcement came over the public address system. This time it was only in French, inquiring if there was a French doctor on the train. The stress was emphatically on the word ‘français’.
I leapt up. This time, fortunately, our guide offered to come with me. He had displayed his equanimity already on the trip in various ways. I also knew that he spoke better French than me, as well as some Arabic. When we reached the boy’s compartment we found, not surprisingly, that no French doctors had appeared, but a French nurse from another tour party had identified herself. She was, mercifully, an operating theatre nurse who must have seen hundreds of similar cases. Her elegance and fragrance also appeared to give her more professional authority than I had managed to convey.
Through a series of diplomatic negotiations, it was agreed that I would re-examine the boy under the appraising eyes of the French nurse. I did so. She indicated with a nod that, beneath my carnival outfit and uncouth appearance, I did seem to be a doctor, and that the signs I had elicited were grave. I supplied my name and work address to two of the more imperious Frenchmen at their request. I was unclear whether they wanted it for insurance purposes, or with the intention of suing me if I turned out to have caused them any inconvenience. Then I left.
For about six months I heard nothing, but eventually received a letter from the boy’s parents in France, offering their thanks. Their son had had an emergency operation in Luxor, and had been transferred to Cairo for postoperative care, where they had joined him. His recovery had been slow and complicated, but he was now quite well. An episode that threatened to turn from farce to tragedy had ended up as one of the few occasions in my career when I can say with almost absolute certainty that I saved a life.