[The following passage is from Paul Brand’s Pain: The Gift Nobody Wants, 1988. Paul Brand was the son of English missionaries working in India. His parents wanted him to go into medicine, but his father’s untrained but effective methods in dealing with the guinea worm parasite put him off the idea. There was too much blood and pus for his liking. He left his parents for England at the age of nine to acquire a more formal education, and didn’t return to India until after the war. The life-changing experience below occurred in 1937 during his training for work as a missionary builder. Brand went on to develop new, innovative techniques for hand surgery, as well as to revolutionize our understanding of why leprosy causes disfigurement and the loss of limbs.]
I fleetingly wondered whether I had made a mistake choosing against medical school. Had I wasted the last five years in the building trade? Yet surely I dare not discard all that training and start over in a new profession. Putting my doubts aside, I finished the term at Livingstone and enrolled in a preparatory course at the Missionary Training Colony, my final step before returning to India as a missionary builder.
A quintessentially British institution, the Colony combined the rigours of Sparta, the ideals of Queen Victoria, and the jolly teamwork of the Boy Scouts. The founder, who had lived in rural Ethiopia, determined that his charges would emerge from the Colony equipped to survive in any corner of the Empire. We slept in long wooden huts with single-thickness walls that stood no chance against English weather. Every morning before daybreak, in rain, sleet, or snow, we jogged in formation to a park, underwent a regimen of calisthenics, then returned to take a cold bath (the Colony disdained such luxuries as warm water). We repaired our own shoes, cut each other’s hair, prepared our own meals. Summers, we went on six-hundred-mile treks through the Welsh and Scottish countryside, pulling supplies behind us in a wagon-wheel cart.
The two-year Colony course also included a stint at a charity hospital, and it was here that my interest in medicine finally drove me to action. One night as I was working in the emergency room, ambulance attendants wheeled in a beautiful young woman, unconscious. The hospital staff lurched into their controlled-panic response to a trauma patient: a nurse dashed down a corridor for a bottle of blood while a doctor fumbled with the transfusion apparatus. Glancing at my white dresser’s coat, he thrust a blood pressure cuff in my direction.
I could not get a reading, nor could I detect the faintest flicker of a pulse on the woman’s wrist. Her skin had an unearthly paleness, a sign of internal hemorrhaging, and her brownish hair seemed jet-black in contrast to her thin-lipped, parchment face. In the glare of hospital lights she looked like an alabaster saint from a cathedral. As the doctor searched her chest with his stethoscope, I noticed that even her nipples had whitened. Only a few freckles stood out against the pallor. She did not seem to be breathing, and I felt certain she was dead.
Just then the nurse arrived with a bottle of blood. The doctor punctured the woman’s vein with a large needle and fastened the bottle high on a metal stand so that the increased pressure from elevation would force the blood faster into her body. The staff told me to keep watch over the emptying bottle while they scurried of to cross-match her blood type and get more blood.
Nothing in my memory can compare to the excitement of what happened next. Alone in the room, nervous and frightened in the presence of death, I held the woman’s cold, damp wrist. Suddenly I felt the slight press of a pulse. Or did I? Was it my own pulse that I felt? I searched again. It was definitely there, a faint, rhythmic tremor against my middle finger.
The next bottle of blood arrived. A spot of pink appeared like a drop of watercolour on her cheek and began to spread into a full flush. Her lips darkened pink, then red, and her body quivered with a kind of sighing breath. A third bottle was connected. My own heart pounding, I watched a drama unfold. Her eyelids fluttered and began to part. She took a deep breath, then another. She squinted at first, then blinked a few times, her pupils constricting in reaction to the bright lights. At last she looked straight at me and, to my amazement, she spoke. “Water. Water, please,” she said in a soft raspy voice. “I’m thirsty.” I ran to get some water.
That young woman entered my life for only an hour or so, but the experience transformed me. No one had told me medicine could do this! I had seen a corpse resurrected. By the end of my first year at Missionary Training Colony, I was incurably in love with medicine. I swallowed my pride, resigned from the Colony, and in 1937 enrolled in medical school at University College Hospital, London.
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