Heartbreak of loss added to medical knowledge

In the Gazette this week we highlight a story from the history of medicine, which drove forward progress.

It is a very personal story, which was first highlighted on local news blog: ‘Hebrides Writer, (http://www.hebrideswriter.com/) but the story also has a much wider significance to society and is also well known among Islanders of a certain generation.

Given that in July the UK will also celebrate the 70th birthday of the NHS, this story is indeed apt to be given centre stage.

Story of Alex Dan

It is the story of Alex Dan Smith, a 15-year-old from Breasclete, who drank weed-killer by accident and underwent the first lung transplant in Europe in a bid to save his life. Alex Dan was one of a family of nine. He was my father’s youngest brother.

The story begins on a day early in May – the 8th, to be precise.

I’m going to tell this story largely as it was told to me, by my father, retired GP John Smith – who was in his final year of medical school at the time – and I’m just going to let it run.

“It was a Wednesday,” he said.

“My father’s van had a routine of going into Stornoway with finished tweeds to a few of the small producer mills and then taking more tweeds back out to the weavers to do.

“That day, Kenny my brother was driving the van. By this time he was involved with my father in the contracting business and he used to pick up the tweeds at 5 o’clock, then go round to the Lewis Hotel, park the van in front of the Lewis Hotel and go in for a beer.

“Alex Dan, who was in the hostel in Stornoway, used to sidle down to the van every week and hang about till Kenny came out of the pub and he would cadge a half crown off him for extra pocket money. He was on third year in the Nicolson, and staying in the hostel.

UNLABELLED WEED KILLER

“He sat in the van to wait for Kenny, because the van was always open, and saw a bottle of brown stuff in the locker which he thought was Coca Cola. It was in a big lemonade bottle – an unlabelled lemonade bottle – and looked like Coca Cola.

“And he took a mouthful of it. But it was fairly nasty so he spat most of it out. Then to put the taste out of his mouth he went and bought a poke of chips which of course meant that his stomach absorbed the poison. He had swallowed a mouthful of paraquat weedkiller.”

Before going to the Lewis for his pint, Kenny had run an errand for a neighbour. He had picked up a bottle of paraquat at a local store to take back with him to Breasclete, and had of course left it sitting in the van.

Alex Dan told Kenny what had happened and then, after they learned of it in the hostel and told the doctors, he was admitted to hospital.

“Dr Greig in the hospital realised that he might be in serious trouble and arranged for him to go to the Royal Infirmary in Edinburgh and my father went off with him.”

They went to Edinburgh by air ambulance on May 10th.

“He was in hospital for a week in Edinburgh and it was the following Friday afternoon – ten days later – that I got a call in the City Hospital, Aberdeen, which no longer exists.

“I was at a tutorial and I got a call from Edinburgh Royal Infirmary to say that I was required in Edinburgh immediately, and I was taken in a taxi from Aberdeen on Friday night.

“I got there at 9 o’clock and had a meeting with the doctors and my father, because the doctors had suggested to my father that they might try a lung transplant to save his life, but my father wasn’t sure about the ethics of transplant surgery and wanted to talk to me before giving his consent.

“From what I was told I realised that he had no chance at all without the transplant and I said to my father, ‘we have to give him this chance’, and he said, ‘fine’.

The lung Alex Dan would receive came from an 18-year-old girl, Anne Main, whose parents had actually met with my grandfather in the Free Presbyterian manse in Edinburgh, where he had been staying with the minister, Rev Donald Campbell.

My father recalled: “A lung became available a few days later and it was transplanted on the Wednesday. I went back to Aberdeen on the Monday but returned to Edinburgh on the following Saturday for the day to see him. A very nice friend had lent me his car. That was the last time I saw him.

“He was half propped up on a bed. The room was shut off for infection but his face was turned to us and he waved to us. He looked okay, he was smiling.”

At first, the operation had seemed to go well. The newspapers printed happy updates. quoting my grandfather saying, “I found him looking well and he was smiling quite happily. He was very fresh and bright, and he seems to be making good progress”.

CONDITION DETERIORATED

But his condition began to deteriorate after a week.

“Unfortunately the paraquat was still in his blood and damaged the transplanted lung as well,” my father explained.

“So the lesson for the doctors was, when anybody drinks paraquat, you have to filter their blood to get it out of their blood as quickly as possible.”

The situation soon became extremely serious and my grandfather made a phone call home to Breasclete. One of my aunts, Chirsty Mairi, remembers it.

Very quietly, she said: “My father phoned in the afternoon and told my mother to take somebody in. He said, ‘You need to take somebody in with you because this is nearly over’.

“Every phone call that came, my uncle Angus, my mother’s brother, was answering it.”

The call came.

“He said, ‘That’s it over’ – and he put his arms round her and started crying.”

MEMORIES OF ALEX DAN AND HOW THE FAMILY MARKED THE ANNIVERSARY OF HIS PASSING

The date of Alex Dan’s passing was May 28th, 1968.

My father recalls the funeral: “My father was standing at the head of the grave, I was standing at the feet, and I stood back and the manager of the store where the paraquat was bought walked up and looked at my father straight in the eye and said, ‘Finlay, I accept full responsibility for the boy’s death’.

“My father said, ‘That’s alright’.

“That night, I said to my father, ‘We could sue them for a million pounds’.

“His response was, ‘We won’t be suing anybody. That will not bring the boy back – and anyway we have enough to manage’. And that was that, end of debate, as far as he was concerned.

“But the doctors in Edinburgh were mad that he wouldn’t sue because the whole thing was so reckless.

My father admitted that “some of us struggled for years” with what had happened – but that their parents remained “magnanimous and greatly supported in their Christian faith in accepting God’s will”.

The story of the man who had asked Kenny to buy the weedkiller is an example of this. He had sent a message to the family home after Alex Dan died, to ask if he could come to see them.

“He came up to the house and stood in the kitchen sobbing, because he was scared of going in to talk to my mother. He stood there until she called to him from the sitting room and said, ‘Come in, come in, you don’t need to be afraid of anybody here – we don’t blame you in any way’.

ANNIVERSARY

Alex Dan had five sisters and three brothers. They are, in order of seniority: Chirsty Mairi, Iain (my father), Margaret (Peggy), Kenny, Norman, Dolina (Dolag), then came Alex Dan, followed by Catherine and Mary Ann. They will all be gathering at the family home in Breasclete this week to remember their brother.

It has been a difficult few weeks and they all have their own memories, although what stands out for some is a strange inability to remember what happened after the event. Dolag said: “I don’t remember. Maybe these things are totally blocked off.”

Chirsty Mairi remembers Alex Dan’s fascination with his brother’s medical books.

She said: “Iain was going to be a doctor, so he was going to be a vet, because that was a step above him, that was more difficult.

“He used to read Iain’s medical books and Iain would ask him questions and he would be answering them all.”

Chirsty Mairi also remembered: “The night my father was being interviewed on the Scottish news, we didn’t have a telly and our neighbour invited us down to her house so we could see him.”

The family have kept an archive of all the correspondence about Alex Dan in an old suitcase of my grandfather’s – the one he used for the Communions.

Where there was once a toilet bag, pyjamas, fresh collar and clean underwear, there is now a large bundle of newspaper cuttings, press photographs and sympathy cards.

Looking through them makes for very emotional reading. No matter how well you think you know the story, and how ready for it you are, the yellowed newspaper pages and the tabloid headlines – “LUNG BOY IS DEAD” – will catch you out.

There was one reporter who got particularly close to the story, Lorna Blackie of The Express, and she is remembered fondly by the family. She followed every twist and turn.

She even came to the funeral and can be seen clearly in one of the Express pictures of the procession, rather glamorous in a white coat.

Perhaps the most difficult aspect to comprehend, of this whole tragic story, is that when my granny – Alex Dan’s mother – saw that picture in the paper, she said: “That is what I saw in my sleep.”