The Berge Istra, a sad but true story
In 1971 I was chief surgeon on the P&O liner Orkney. I was coming home from Australian time. 24 hours out of Freemantle in the middle of the night there was a summons in the radio room for an urgent medical consultation with the captain of an unidentified ship. It was his chief electrician who had been repairing the electrical wiring on top of one of the ship’s boilers; he had been hit hard (the boat was running on 480 volts) and had been catapulted backwards and fallen at least 20 feet. He was still alive, but the Captain feared that he was dying and needed more help than he and his crew could provide.
It quickly became apparent that he was in a great deal of pain, and the captain needed advice on the proper dosage and frequency of morphine the ship was carrying in its medical supplies. The nature of the pain suggests injury to the anterior and posterior chest wall, and possible vertebral damage in the lower thoracic and upper lumbar region. The two most pressing concerns were that he was urinating blood and that every hour he grew paler and sicker. This strongly suggests internal injury 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 soon he would definitely need blood, both ships were a minimum of 2 days from land in either direction. There is a common myth that anything serious that goes wrong on a ship can be corrected by sending in a helicopter, this is nonsense now and certainly was in 1972. The range of a helicopter is quite small at only 2-3 hours. sailing, most ships were out of range unless they came close to shore. We had found out the name of the ship, it was called the Berge Istra, but our Lloyds list had no information on it.
She was a monster, a huge long green monster. As she got closer, our relative sizes became apparent. We were a big passenger ship, 28,000 tons or so, but we could have been a lifeboat for this one; she transcended that at the time she was the largest ship on the planet. In a surprisingly short time, they lowered a tiny-looking red lifeboat, strapped the injured man to a wraparound stretcher, named for its designer, Anderson, and secured him as tightly as possible. The lifeboat rocked at top speed.
We had our patient on board and took him to the hospital when the first problem arose. He, like his ship, was huge. So huge it was too long for our hospital beds, he was 6 feet 8 inches tall. We made him comfortable on one bed while the Ship’s Carpenter cut off the foot of the other bed. He was pale as a ghost, but he could speak and his English was good even though his nationality was Swedish. His pulse was thin and rapid, his blood pressure low and he was in agony every time he urinated due to blood clots in the urine. On closer examination it appeared that a lower left rib had been torn to the left kidney, more ominously it appeared that he also had a ruptured spleen. His abdomen was taut, exquisitely sensitive, and his muscle hardened at a light touch. This was probably due to blood in the peritoneal cavity, but could indicate intestinal rupture.
Overall, his chances of making it to Durban didn’t look too bright, and the first priority was to give him some blood and keep his pain as controlled as possible. This was not easy at the time on a passenger liner, we could not carry blood supplies and the blood substitutes available at the time were not very good. The cross comparison was primitive, done with a series of blotters, a methodology devised by a Norwegian, which ultimately saved a Swede from a Norwegian ship. There was a little book of blood groups of crew members who were prepared to donate blood in an emergency.
After the second pint it really started to improve. Her blood pressure stabilized, her pulse rate finally began to drop below a hundred, her temperature dropped and, perhaps most importantly, she began to think that she could make it. With 24 hours to go, her condition worsened. We really thought we were going to have to operate this time. We gave him a large dose of morphine and a sedative to knock him out and the religious believers prayed, he squeezed another half pint out of the only crew member with the correct blood group. So he arrived in Durban, where the ambulance and surgical team were waiting for him. In fact, he was even more damaged than we had thought. Both kidneys were injured, his liver capsule was torn and oozing internally, and yes, his spleen was ruptured. They removed his spleen and 1/3 of his left kidney and transfused another 6 pints of blood, but he made it and within 3 months he was back at the Berge Istra.
For a few years he would send me Christmas cards with little details of his life, at that time I was a family doctor and listening to the radio one morning while making my visits there was a news bulletin reporting the tragic loss of one of the largest ships. in the world, yes you guessed it, the Berge Istra. She had sunk with the loss of all hands in the South China Sea. It was later learned that the cause was likely inadequate cleaning of the holds of flammable gases before loading a full cargo of iron ore in Japan. There was an explosion that caused the hull to rupture and she sank like a stone. At Lloyds of London they classify the Lutine Bell.
