It was July 1988 when I took the Hippocratic Oath. I was dressed in a jumper despite the high temperature. I reflected on my experiences up until then… Six years of torture, slaving away behind university desks and in university clinics, countless nights studying into the early hours of the morning, a stomach ulcer and indescribable days of anxiety. But medicine is a difficult art and taking the oath on that hot day it would be a lie to say I didn’t feel moved. But I can’t say I felt happy due to that special quality of universities: their ability to saps the joy out of you.
It was the month of July and suddenly the words Rural Clinical Placement flashed across my mind…
I don’t know of any other scientists who are forced to transfer to a post in the countryside at short notice in order to continue their training and then find work afterwards. Nor can I understand why the village inhabitants have not thrown up their arms in protest before now in demand of better care than some terrified graduate doctor who has never made a single independent decision concerning a patient up until placement time.
After my exasperation at just one more example of the unjust handling of the honest villagers – and somewhat idealizing my fears – I came to a decision: I would not enter a rural placement just like that, straight out of medical school! I registered for a specialization, thus justifying the deferment of my rural placement, and began a year’s specialization in Pathology at the Vostanio Hospital in Mytilini on the island of Lesvos.
It was perhaps one of the best years of my life as well as being one of the most tiring of course. Following a prefectural decision we found ourselves working 15 nights a month and transporting emergencies – for no extra pay of course – on the Aegean Sea with 10 Beaufort winds. It is to this year that I owe my human-dynamo character as a doctor, the varicose veins in my right leg, my familiarity with the local island dialect, its people and cuisine and the pleasure of the wonderful colours at sunset and dawn.
The year flowed by marked by intensity, sleepless nights, stress and the joy of first successes. However as the year came to an end the words Rural Clinical Placement lit up in my mind once again…
Now I had but one choice: Mytilini, but where?
Wherever! By then I knew many people on the island.
When the placement card from the Ministry of Health arrived it bore the name of an remote surgery in the Plomari Mountains and I didn’t think anything of it at the time. I accepted and, of course, being the soul applicant for that location it was mine! The previous doctor in the placement before me was a military doctor and after some time he had broken down…
(Note: The selection of rural placements for doctors who apply is done by a process of points connected to waiting time, level of qualifications, marital status and the existence of children and of course sheer force of luck.)
I set out one Sunday morning from Mytilini Town to see where I would be, where I would stay and what I would need. I was accompanied by my boyfriend of the time who was a local and the first thing that made an impression on me was the fact that he had never been up there.
The journey to Palaiohori in the Plomari Mountains from Mytilini Town is two hours, of which a large section is quite difficult because after Plomari it is a winding ascent along a rocky dirt road.
“Back to nature!” I yelled in an effort to draw courage. The village appeared on a turn in the road perched on a mountain-side full of olive trees and at the bottom was the deep blue of the sea. In the central square of the village there were three cafés full of men sitting drinking ouzo. Church had finished and chitchat and conversation began in the cafés. We parked haphazardly and went into one of the cafés to inquire.
“Good morning”, I said. “I’m your new doctor, who should I talk to?”. Suddenly silence fell and I felt many pairs of curious eyes turned in my direction. I remember only too well the doubt, disappointment and even dismissal in their glance. The truth is that my blond ponytail, tracksuit and the pink panther on my shirt -not to mention being only 26- were not very convincing.
“We will let the mayor know”, said the café owner. “Do you want a glass of ouzo?”.
What could I say? That I had a stomachache?
“Sure”, my boyfriend agreed and gave me a meaningful nudge. Needless to say that by the time the mayor arrived the ouzo had started to take effect and when I finally saw the doctor’s surgery and the waiting room I was starting to feel a bit faint.
The surgery was at the edge of the village right opposite the graveyard! It was a two-floor house that had been donated by the owner for use by the village doctor with the surgery downstairs and living space upstairs. It was an old stone house which had unfortunately been fitted with aluminum windows and doors. All the doors on the buildings around opened curiously and inquisitive women appeared to see what was going on. My final despairing discovery was the lack of central heating. On the first floor there was an amazing cast-iron stove in the kitchen which operated with wood. But I had never even lit a fire and the only experience I had of heating was radiators.
I settled in bringing only the bare essentials taking into account that the route to the nearest health centre was often cut off during the winter months when the rains caused landslides. On such occasions electricity and, from time to time, water were cut off. I suddenly realised that I was in the middle of nowhere, responsible for three villages with no other help to call on but God’s and perhaps sometimes not even that… I had taken on an experience not just of medicine but in the management of crises.
I closed the door on the first night and looked out from the balcony at the sea and the rising moon and decided I was talking rubbish. Where would I find crises? On the mountain?
When I went down on the first day to open up the surgery there was not a soul around so I turned to cleaning the space. Some romantic emigrant headed for Australia had donated some dentist’s equipment; a sterilizing oven and some surgical tools which lay abandoned collecting rust. I was trying to clean the surgical tools at least when suddenly a woman dressed from head to foot in black appeared at the door with a sunken face.
“Good morning. Do you remember me?” She said.
“Do I know you?” I asked.
“Of course. I came to the hospital with diarrhea. My name is Soultana. You were there the night they brought me”.
The conversation developed very warmly and needless to say that the woman’s experience proved to be my salvation as the news spread through the village that I was a doctor from a hospital.
The days passed marked by measuring blood pressure and glucose levels, fights because I refused to prescribe medicines which were unnecessary and strange discussions about medicine and illness. Then the olive harvest began and with it the accidents. The retaining walls of the olive groves perched vertically on the mountain left little room for movement and the fact that the majority of the inhabitants were elderly meant falls were inevitable.
The village emptied in the morning and there was not a soul about. Everyone returned in the afternoon and made their way to the surgery with high blood pressure, for medicine or whatever else, and then off they went to drink in the cafés.
I felt awkward being a young woman; it was difficult for the men to sit and let me examine them…when they finally made it to the surgery; and the women could be manipulative. On the other hand my colleagues around the island were of the belief that the countryside doctor simply wrote prescriptions and many had transformed their surgery into commercial pharmacies without encountering any major objections. Things were difficult…
Even crossing the central square proved to be a challenge as I felt the weight of all the curious eyes. I have to confess that I started to follow the example of the local women and took the side streets around it.
Then suddenly after dealing with a particular accident I started to ask if the villagers had been vaccinated against tetanus. I prepared the vaccinations and asked them all to come by the surgery to be vaccinated. Silence. No one came except the children who would have come anyway.
In the meantime I trained Angeliki, the daughter of a field policeman, who acted as a nurse for me.
“We’ll go to the cafés and vaccinate them there”, I told her one day.
“Are you crazy?” she said. “They will beat us off!”.
“We will give it a try and see what happens”, I answered.
Our entrance to the café caused a stir and was followed by the usual offer of ouzo (ouzo from morning to night, I was in danger of becoming an alcoholic!)
“Sleeves up for your vaccinations”, I told them.
They stiffened and glanced at each other; ouzo glasses were raised once more, the cigarette tips glowed afresh but they sucked down the smoke thoughtfully.
“Are you scared?” I said. “You have to do it. Why die for nothing?”.
“You’re overdoing it”, mumbled Angeliki next to me, but the teacher had already rolled up his sleeve.
I bless him to this day for that action which was stoically followed by all the others. I confess that I felt awkward at the time and up in the air faced with the resistance.
The next event further increased my kudos in the village, but in a strange way. It was first light and the hurried knocks at the door didn’t bode well. A panicked face appeared.
“Come quick. The child’s being badly slapped!”
I took my bag and followed her along the footpaths. At the entrance to a house the old mother of the village was holding a child of 3 or 4 years old upside down by its feet like a butcher’s carcass muttering some incomprehensible words while slapping the toddler till it rocked like a pendulum.
“What’s going on?” I asked.
“He’s got convulsions”, was the answer.
“And what is he doing upside down?”
“She’s banishing the fever”, they told me.
I don’t know how I managed to pry the child from her hands who was burning with a fever, nor how I wet him in the bath, I understood what the problem was and immediately gave him anti-fever medicine in a din of women demanding to know why. In the meantime the entire village had gathered round to see what was going on. At this point the village mother stood in the middle of the sitting room and said majestically: “It is not my fault if he dies!”.
What I heard next left me amazed. The child could not speak very well because he had a sore swollen ear and throat; I had seen many inflammations but nothing quite like this.
“What happened?” I asked.
“His ear hurt”, they told me. “So we gave him mouse oil”.
“What’s that?” I asked surprised.
The explanation left me aghast and panicked: When they found mice nests they collected all the baby mice and after killing them preserved them in a jar with oil. They used this oil to heal wounds and such like.
I was lost for words. I tried explaining to the child’s mother that he was in danger of blood poisoning and that the wishes and charms of the village mother (who had made a dramatic exit in the meantime) would do no good and that the fever was causing the spasms, which were also a consequence of the poison. The child was taken to the hospital where he was treated by excellent ear, nose and throat specialists and narrowly escaped blood poisoning.
I didn’t hear of the mouse oil again and I like to think that they stopped using it from that moment and that it is no longer made. What I regret is that I didn’t keep a record somewhere of all that medical folk wisdom, some dangerous and some beneficial. There were elderly men and women who had an answer for every problem, some preserve or ingredient.
Winter was tough and difficult with the north winds raging over the house and the graveyard at nights. I learnt how to light the wood stove having nearly choked to death from the smoke initially, much to the amusement of the rest of the village. I learnt to enjoy potatoes baked in the embers and keep the cat company that purred at the window. I accustomed myself to drinking ouzo at 5 in the morning and 10 at night with a midday ouzo break. I regularly scanned the sky to see if it would bring rain for the crops, which was something which had never crossed my mind before. I experienced kidding (in the sense of birthing goats) and learnt the importance of these animals for local families. Finally I learnt to speak strangely and lovingly like the inhabitants of Mytilini, and why not? I found my home in this village, me, an Athenian without anywhere to truly call home.
Chrysa Botsi
Athens, 24th August 2005
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