Review: Vivien Horler
A Wilder Life – Journey of an adventuring doctor, by Joan Louwrens (Jonathan Ball Publishers)
I’ve always thought that hairdressing and doctoring must be among the most portable jobs – you can do them anywhere. Dr Joan Louwrens thought so too (but without the hairstyling).*
As a GP you can work in a suburban practice, seeing colds and coughs and piles, and live a pretty regular life. Or you can travel the world, sometimes with children in tow, and have a series of adventures.
That’s what Dr Joan chose. It was usually interesting, sometimes terrifying, and she was often the only doctor for miles around. On occasion she was so far from “civilisation” or a “proper” hospital that the distance was measured in time rather than kilometres.
This was true of her stints on St Helena, Tristan da Cunha and Gough islands (although there was some medical back-up on St Helena).
She obviously has a thing for islands – as have I, which made this memoir so special for me. I have also had the privilege of visiting all three islands (Gough from aboard ship), as well as the Antarctic Peninsula, and the Australian outback, all places where Dr Joan has practised.
Her approach in these farflung places could be summed up by a quote she uses from one Squire Bill Widener, which was later repeated in Theodore Roosevelt’s 1913 autobiography: “Do what you can, with what you’ve got, where you are.” (A useful sentiment that could be applied by us all in a variety of circumstances.)
Dr Joan – that’s what her patients call her – graduated from the University of Cape Town in 1975, and at 27 was the acting senior medical officer on a vast sugar estate in Swaziland (now Eswatini), where her husband Pete was the agricultural engineer.
The first case she describes is of a man who had been run over by a tractor and seemed very dead. But she found a faint pulse, and he had a fighting chance of survival if she could get a drip up to hydrate him, given that he was almost certainly bleeding internally.
But the man was in a poor way and she couldn’t find a vein. Finding a vein is a basic medical skill, and she says she had never felt so helpless and incompetent.
Then someone behind her said: “Ma’am? Why don’t you stick it up his arse?”
The manager of part of the estate turned out to have been a medic in the Bush War in Rhodesia. He told her: “We only had a two-week training course but we did learn a few tricks. We saved lives rehydrating per rectum.”
She did this, and the patient made it alive to the nearest hospital.
Dr Joan said the former medic opened her path to adventure medicine. Teamwork and “making a plan” had worked. She muses: “Maybe, just maybe, I’m better suited to this… Apparently I thrive in problem-solving with minimal assets at my disposal.”
She adds: “Medicine should never be an adventure; medical practioners are trained to always know what to do or to work out a good solution. But it’s an imperfect world…”
What follows are some hair-raising stories, like that of the Kruger Park chef who got venom in his eyes from a spitting cobra (after her treatment he was fine), rabies cases, scorpion bites, catatonia, and a man who drank half a bottle of meths to get drunk.
In 1984, Pete died of metastases from a melanoma. He was 32; the couple’s daughters were four and five months.
Out of the ashes of her life – there was also a disastrous second marriage – Dr Joan took the post of the doctor on Tristan da Cunha for six months.
Tristan, a British Overseas Territory in the middle of the Atlantic between Cape Town and Rio, is between five and eight days away from Cape Town by sea. There is no air link.
On Tristan, if Dr Joan needed help, she had to head to the Radio Shack to contact Cape Town Radio, who could patch her through to a Mother City specialist, usually with questionable reception.
When one of the islanders developed a life-threatening jaundice condition caused by blocked bile ducts, Dr Joan knew he needed urgent surgery – surgery she was in no position to provide.
Cape Town was days away, but only when a ship was moored in James Bay. If there was no scheduled ship, you had to find one. She sent out a general SOS to all shipping channels, as a matter of life and death, for a ship ready to divert to the island and then Cape Town.
In appalling weather and sea conditions the first two ships to respond manged to collide with each other, and eschewing Tristan, headed to Cape Town for their own first aid.
A third ship declined to approach the island because of the dangerous conditions. Eventually Dr Joan approached the island’s administrator, asking that one of the Tristan Investment Company ships – that catch crayfish around the island and provide the bulk of its income – abandon its months-long secondment and take the patient to Cape Town without a full catch – a huge expense.
But the next day the fishing boat was there, the patient embarked and months later he was back on the island, fit and well.
By this time she was due to leave Tristan, and she realised: “My world had opened up to oceans and islands. I wanted to string them together with the trace of an albatross. Medical expertise could do this if I had the courage.”
And she did.
Many more adventures followed, including cruising to the Falklands, South Georgia and the Antactic Peninsula.
If this kind of thing appeals to you – and it certainly does to me – you’ll love this book. Generally I don’t review five-year-old books – it was first published in 2020 and reissued in 2023 – but this memoir was new to me and I gobbled it up.
Right at the end, Dr Joan comes home to Africa, which she acknowledges is a high-risk place, but her own.
“Adventure medicine has taken me through all seven continents, but my life’s adventures started, and will finish, here in Africa.”
A terrific read.
- I’m not knocking her hair…
End- afterall er adventuring, she’s back in Africa, or what when this book was first publishedin 2020, and reissued in 2023.