In 1981 I spent a month at the Royal Hospital for Children in Bristol as a guest of their Professor of Child Health, Neville Butler. As part of my orientation to English medicine, Neville arranged for me to spend a day with an English GP making his weekly home visits to bed-ridden patients. In fact we never did make a day out of it. After visiting three elderly people, we retired to a pub for lunch and after a couple of pints, I decided that was that, got dropped back to the Hospital and made my boozy way home by bus.
I don't remember much about two of the patients but I'll never forget the last. It was about 11 in the morning of a crisp English summer's day. The operative word is crisp. We in the West Indies do not know what crisp is. We don't know what cold is. You cannot die from cold in the Caribbean. You can sleep outdoors, around the Savannah or in a doorway, quite well. Not comfortable but you can sleep. You cannot do that in jolly England. It's a question of life or death.
Sleep outdoors in England in winter and you dead. The rest of the year is barely better. Up to that time, the English summer of '81 was the coldest in memory. The West Indies team in England played their cricket bundled up in sweaters, hands under their armpits. Batsmen looked like penguins waddling out to the pitch. I was well bundled up too, in vest, long sleeve shirt, sweater and jacket. The Morris Minor was heated so we were snug and warm as we tootled along through the streets on our way to the Council flats on the outskirt of Bristol.
My GP driver was a typical shortish, bossy Englishman who probably had not bathed in two days but was competent, cheery and sympathetic to his patients and easy to like.
"I have a surprise for you," he said. "We are going to see a West Indian!"
We pulled into the Council Estate, got out of the car, met the community nurse and proceeded to walk up the stairs to the fifth floor. The nurse opened the door, "he's bedridden." We walked in. I don't remember much about the flat except that it was cold, "the heating is turned off, it's summertime," it was dark "electricity is expensive," said dryly by the nurse and the man in his bed, almost hidden by a pile of clothes and blankets, weakly calling out to us to come in.
My GP did his thing whilst the nurse pottered around checking that the gas stove was turned off and that there was clean linen etc, all the while asking about the delivery of food and was he taking his medication and so on.
I stared at the man in his bed. He must have been in his late 60s and had that pale ashen hue dark-skinned people get when they live in dark places and don't get enough sun.
He had got himself into a sitting position with the help of the nurse and a pillow placed behind his back. He sat very still, face expressionless, quiet but answering questions competently when asked. He had lost the use of his legs in an industrial accident and lived alone. He had no immediate family. There was a niece who lived "up north" and occasionally visited but she had three children and "times not so good." His accent was vaguely West Indian. "St Vincent" said the nurse.
"Dr Bratt is from the Caribbean, you know," my GP said jovially. There was little reaction. I could think of nothing to say. What could I ask? Was he well? Was he happy? Was he content with the treatment and care he was getting? Free? Was it worth it? Did he dream of the place he was born? Did he ever think of going back? What made him leave?
In 1985 I spent a week in St Vincent running a PAHO course on Oral Rehydration and Gastroenteritis for doctors and nurses. My hotel was on Front Street (at that time and perhaps still, Kingstown had three streets that ran parallel to the port, Front Street, Middle Street and Back Street). The upstairs window of the dining room overlooked the street and the harbour. The Tuesday night I looked out and noticed a large group of young, poorly dressed men jostling around underneath the window.
"What's happening? I asked my host.
"It's the banana ship. Comes in every Tuesday. The men come from all over the island to get work loading bananas. For most of them, that is it, so they need the work. Not all of them get hired for the night."
In the morning the ship was gone. So too were the young men.
He turned to me. "You from the West Indies?"
"Yes."
"Where from?"
"Trinidad."
And that was it. He turned his face away. We packed up and began to leave.
At the door I turned back and looked at him. He was gazing longingly at me. I wondered what he was thinking. He reached out his hand. I shook it. For a second I thought he was going to cry. I was going back. He was not. Then I turned away and we went to the pub.
I've often wondered about him. Did he ever leave Bristol? Go back to his warm little island in the sun?
Or did he spend the rest of his life on his back in a cold place, wrapped up in sweaters and blankets until his heart could take it no more and he sighed, maybe had a last lingering thought about his Mammy and the warm sea, and was gone.