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The Berge Istra, A Sad But True Story
In 1971 I was chief surgeon on the P&O liner Orcades. It was coming home from Australia. 24 hours out of Freemantle in the middle of the night was summoned to the Radio Room for an urgent medical consultation with the ship’s unnamed commander. He was his chief electrician, repairing the wiring on one of the ship’s boilers; he received a severe shock (the ship was running on 480 volts) and was catapulted backwards and fell at least 20 feet. He was still alive, but the captain feared he was dying and needed more help than he and his crew could provide.
It quickly became apparent that he was in great pain, and the commander needed advice on the appropriate dose and frequency of morphine, which the ship carried in its medical supplies. The nature of the pain indicated an injury to the chest wall, front and back, and possible damage to the vertebrae in the lower thoracic and upper lumbar regions. The two most pressing concerns were that he was peeing blood and getting paler and sicker by the hour. This strongly suggested internal damage to at least one kidney and possible internal bleeding due to injury to other organs such as the liver or spleen. He probably needed surgery and would definitely need blood soon, both ships were at least 2 days from land in any direction. There is a widely held myth that anything serious that goes wrong on a ship can be fixed by sending in a helicopter, it’s rubbish today and it certainly was in 1972. The range of the helicopter is quite short, at only 2-3 hours sailing most ships were out of range unless hugging the coast. We found out the name of the ship, she was called Berge Istra, but our Lloyd’s list had no information about her.
She was a monster, a huge long green monster. As she came alongside, our relative sizes became clear. We were a large passenger ship, 28,000 tons give or take, but we could have been a lifeboat for this one; it turned out to be the largest ship on the planet at the time. In an incredibly short time they had launched a small looking little red lifeboat, strapped the injured man into a stretcher named after their designer Anderson, and secured him as tightly as possible. The lifeboat capsized twice in quick succession.
We had our patient on board and were taking him to the hospital when the first problem arose. Like his ship, he was huge. So huge that he was too long for our hospital beds, he was 6 feet 8 inches tall. We made him comfortable on one bed while the Ship Carpenter cut off the leg of the other bed. He was as pale as a ghost, but he could speak and his English was good, although his nationality was Swedish. His pulse was thin and rapid, his blood pressure low, and every time he passed urine he was in agony due to blood clots in his urine. On closer inspection it appeared that the lower left rib had ruptured into the left kidney, more ominously it appeared that his spleen had ruptured as well. His stomach was taut, exquisitely sensitive, and the muscle hardened to a light touch. This was probably due to blood in the peritoneal cavity, but could indicate a ruptured bowel.
All in all, his chances of reaching Durban didn’t look very bright and the first priority was to get him some blood and keep his pain under control. It wasn’t easy on a passenger steamer at this time, we couldn’t carry blood supplies and the blood substitutes available at the time weren’t very good. The cross-matching was primitive, done with a series of blotting papers, a methodology devised by Nor that ultimately saved the Swede from the Norwegian ship. There was a small book about the blood types of crew members who were prepared to donate blood in case of emergency.
After the second pint, he really started to improve. His blood pressure stabilized, his heart rate finally started to drop below one hundred, his temperature dropped, and perhaps most importantly, he started to think he could make it. With 24 hours to go, his condition worsened. We really thought we were going to have to operate this time. We gave him a large dose of morphine and sedation to knock him out and those of the religious mind said a prayer, another pint was forced out of the only crew member with the correct blood type. So he made it to Durban, where an ambulance and a surgical team were waiting for him. In fact, it was even more damaged than we thought. Both kidneys were injured, his liver capsule was torn and leaking internally, and yes, his spleen was ruptured. His spleen and 1/3 of his left kidney were removed and another 6 liters of blood was given, but he pulled through and was back on Berge Istra within 3 months.
For several years he sent me Christmas cards with little details about his life, at that time I was a family doctor and one morning I was listening to the radio while on my visits reporting the tragic loss of one of the largest ships. in the world, yes, you guessed it, Berge Istra. She went down with the loss of all hands in the South China Sea. It was later revealed that the cause was probably insufficient clearance of the cargo spaces from flammable gases before loading the full cargo of iron ore in Japan. There was an explosion that ruptured the hull and she sank like a stone. They rang the Lutine bell at Lloyds of London.
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