Rosamund Kendal was born in Cape Town where she then went to school and University. After completing her MBChB, she did her internship at Tygerberg hospital and then community service amidst the gang warfare of Mitchells’ Plain. Following the community service, she went back to Tygerberg and took up a registrar post in Internal medicine. At that time the hospital was severely understaffed and, as registrars, they were working ridiculous hours- often in the region of two thirty-six-hour shifts a week. Also, most of what Rosie was dealing with was HIV and TB, so most of her patients were dying. The combination of long hours and emotionally draining work took its toll on her and she started losing her passion for medicine (really forgetting why she studied medicine in the first place). She also didn’t like who she was becoming and found that she was shutting off emotionally in an attempt to deal with what she was experiencing. Then she decided to do something ‘just for her’ and went back to do her MA (Creative Writing) at UCT. Rosie's first novel was an adaptation of her thesis for the Masters.
She hasn’t been able to decide whether she prefers being a freelance writer or a general practitioner, so she’s come to a compromise and does both part-time.
Rachael called in her next patient, a young man dressed in overalls who walked into casualty with a limp. He told her that he had been bitten by a snake.
‘A snake? Did you say a snake?’ Rachael asked, hoping that she had heard incorrectly. She had never had to treat a snake bite before.
She had never even seen a snake bite before. In fact, the only snakes that she had ever had any contact with had been safely behind glass at the reptile park. ‘Where did it bite you?’ she asked.
‘In the garden. I was busy gardening.’
‘No, I meant where on your body did it bite you?’
The man lifted his trouser leg to reveal a swollen, red lower leg.
The puncture mark was visible at the centre of the swelling. Rachael looked around casualty for Dr Ribbentrop; her knowledge was far too limited to manage a snake bite on her own. She caught sight of him leading an extended Indian family into one of the free cubicles.
‘I’m just going to speak to one of the other doctors quickly,’ she explained to the patient.
As she was walking away she vaguely remembered learning that one should always ask snake-bite victims what kind of snake had bitten them, or at least what it had looked like. She went back and asked the patient, glad that she had remembered to do so before she spoke to Dr Ribbentrop so that she would be able to give him an answer when he asked her. Engrossed in self-congratulation, she was only partially aware of the patient opening an old cooler box in response to her question. The slate-grey snake inside, obviously desperate for freedom, flung itself from the cooler box as soon as the lid had been lifted and headed straight in Rachael’s direction.
Rachael screamed. It was a scream so primal that it was partially out of her mouth before she actually registered why she was screaming.
She jumped backwards onto the examination bed, a feat that she would never have been able to perform without the presence of a hissing reptile to incite her, and continued her screaming from the relative safety of one metre above ground. Sister Naidoo was also screaming now, and started running in the opposite direction to the snake, and the large Indian family that Dr Ribbentrop had been on the verge of seeing had spread itself out in various panic-stricken directions. Only Dr Ribbentrop seemed calm. Rachael watched the snake slither over the grey linoleum floor, on which she had been standing a few seconds earlier, and make its way beneath one of the casualty cupboards.
‘Right, could we please have some calm in here!’ Dr Ribbentrop shouted. ‘It’s only a bloody snake.’
Startled anew by his voice, Rachael abruptly closed her mouth and clamped off her screaming. The casualty unit was in chaos.
Rachael’s patient had tried to jump up onto the examination bed next to her but, because of his lame leg, had fallen and was now lying on the floor below Rachael, trying to drag himself in the direction of the exit. Sister Naidoo was standing on the sisters’ desk with a fork in one hand and a letter opener in the other (Rachael couldn’t imagine that either would be particularly effective against a snake, since both were rather close-proximity weapons). The sick child who belonged to the extended family, and whom Dr Ribbentrop had been about to put onto a nebuliser for asthma, had pulled the nebuliser from the wall when his mother grabbed him to escape. The child was clinging desperately to the disconnected mask, inhaling ineffectively through it, while oxygen was escaping into the room. The asthmatic child’s father had managed to pull himself up into one of the large stainless steel sinks at the back of casualty. Unfortunately, the sink already contained a bloodied delivery set that had been used for a birth earlier in the day, and the placenta from the same birth.
‘My God, my shattered nerves,’ he wailed, realising what he was standing in. He extricated himself from the bloody mess, shaking pieces of placenta from his trousers. ‘My shattered nerves,’ he reiterated. ‘I think I’m going to have a heart attack. I can feel the poking starting in my chest. I need something to calm me down.’
He reached into the breast pocket of his shirt with shaking hands and pulled out a single cigarette and a lighter.
The next few seconds seemed to Rachael to unfold in slow motion. She heard Dr Ribbentrop screaming something at the man. She heard his shout a split second later, just before the very loud bang. The explosion, as the leaking oxygen combusted, was almighty. Luckily, the gas had been on a very low flow rate.
Sister Naidoo sprang from the desk, dropped her fork and letter opener and, with extraordinary presence of mind, grabbed the fire extinguisher from the wall behind her. Remarkably, it was still working. The fire was quickly put out, but by the time Sister Naidoo had gained control of the fire extinguisher the room was covered in a thick layer of white foam. The mother, now resembling a bedraggled snowman, grabbed her asthmatic child and ran from casualty. The father followed, leaving behind him a trail of placenta-specked froth. The snake was nowhere to be seen.
It took Rachael and Sister Naidoo and Dr Ribbentrop and one of the porters and the hospital cleaner two hours to create some sort of order from the mess.
‘It was a Mozambican spitting cobra, an m’fezi,’ Dr Ribbentrop said to Rachael matter-of-factly afterwards. ‘I’ve sent your patient through to the snake-bite unit.’
‘Oh, fantastic,’ Rachael said, relieved that she no longer had to manage the patient. She should have known that snake bites would be sent to a special unit. It was probably somewhere in Durban; perhaps the patient had even been airlifted there.
‘Down the corridor and to the left,’ Dr Ribbentrop continued.
‘You can go see your patient there.’
Rachael’s heart didn’t just sink, it plummeted. She still had no clue how to treat the snake bite and she was far too embarrassed to ask Dr Ribbentrop now. From the way he had looked at her while he was wiping fire-extinguisher foam from the casualty floor, she got the distinct impression that he blamed her entirely for the huge casualty fiasco. She would have to hope that there was a sister in the snake-bite unit who could give her some advice. She turned around and was about to walk away when she remembered the snake. It had disappeared beneath the cupboard but had not subsequently reappeared.
‘What about the snake?’ she asked Dr Ribbentrop, momentarily too concerned about being bitten to worry about what he thought of her. ‘Will you get someone in to remove it?’
‘The m’fezi is a shy snake; it won’t attack unless it’s cornered,’ he answered impatiently. He was still wiping foam from his hair. ‘They can spit, though,’ he continued, a small smile starting to flicker at the corner of his mouth. ‘According to some records they can spit from a distance of up to two metres with incredible accuracy. They usually hide in rock crevices … or any other dark place,’ he said, looking pointedly at the bottom of the cupboard. Rachael made her way as quickly as possible from casualty to the snake-bite unit.
The Handbook of Trauma (proudly published in the United States of America) informed Rachael that she should administer antivenom as soon as possible in order to treat the bite. When she asked the sister in the unit for antivenom, the sister looked at her as though she had asked for cocaine.
‘For that bite?’ the sister asked. Rachael nodded hesitantly. ‘We’ll have to order some from Pretoria,’ the sister continued doubtfully.
‘Don’t you usually treat with antivenom?’ Rachael asked, beginning to doubt her trauma handbook. The sister shook her head. Obviously, they did things differently in America. Since she didn’t possess a South African trauma book (she made a mental note to buy one as soon as possible), Rachael had no option but to swallow her pride and go ask Dr Ribbentrop for help. She walked back to casualty, carefully avoiding the cupboard, and asked Dr Ribbentrop if he could help her manage the patient. Contrary to what she had expected, he wasn’t at all irritated with her. While they walked back to the snake-bite unit together, he gave her a quick tutorial on the management of snake bites.
‘Ninety-eight per cent of snake bites aren’t fatal,’ he reassured her. ‘Giving antivenom is usually more dangerous than the bite itself.’
By the time Rachael got back to casualty after treating her snakebite victim, Seema, the rather aloof Indian intern, had arrived and was getting ready to take over from her. Rachael handed over her patients to Seema and then lingered in the unit for a while, listening to the sisters and staff singing. It amazed her that they managed to harmonise together, without an instrument to guide them. It also amazed her how much energy they seemed to be able to muster for their singing after working a full twelve-hour shift. She was so exhausted she was sure that if she tried to sing all that would emerge would be a tired whimper. She felt something wet her ankle and bent down to wipe it off. As she did so, she felt another squirt, this time on the back of her neck. She was looking up at the ceiling to see where the water was dripping from when she realised that what she had felt had not been a drip. It had been a distinct spray.
Dr Ribbentrop’s words played through her mind like somethingfrom a horror movie: spitting cobras could aim from two metres. She screamed and clambered onto the nearest examination bed, something she was by now getting good at. The singing stopped abruptly and Rachael waited for the sisters to start running out of casualty, or at least to climb to places of safety, but they remained where they were – and started laughing. Something was not right.
Rachael slowly turned to look behind her. One of the community service doctors was standing with a dental syringe and needle in his hand, laughing.
‘I’m sorry,’ he spluttered. ‘Dr Ribbentrop told me what happened and I couldn’t let the opportunity slip. I’m really sorry.’
He exploded into a fresh bout of guffaws, which rather threw in doubt the sincerity of his apology. Rachael didn’t know whether to laugh or cry or shout at the doctor. Before she could make up her mind, he extended his hand in greeting.
‘Shane Pillay,’ he said.
He has nice eyes, Rachael noticed. Under different circumstances, she probably would have thought him quite good-looking. She decided to join in the laughter.
2008. Karma Suture. Jacana Media
2010. The Angina Monologues. Jacana Media
2012. The Murder of Norman Ware. Jacana Media