Clodagh Finn: Canoe travel, lamp-lit operations, snake bites — a witness to a lost world

The work of surgeon and later psychiatrist Patricia Horne, who died on October 29, is widely admired
Clodagh Finn: Canoe travel, lamp-lit operations, snake bites — a witness to a lost world

Patricia Horne: ‘You had to watch out for the crocodiles, so you didn’t put your feet or fingers into the water.’ Picture courtesy of Margaret Horne

It is said that a picture is worth a thousand words. This one of surgeon and later psychiatrist Patricia Horne, who died on October 29, opens a fascinating window into the life of the late Irish doctor, who performed operations in Africa in the 1950s under the light of kerosene lamps and without running water.

However, what it doesn’t communicate is the excitement of the man who repeatedly pointed to his head when Dr Horne stepped into the canoe. He told her that she had stitched it after he sustained horrific injuries when a branch of a tree clipped his scalp as he travelled under it in an open-topped vehicle.

You couldn’t know, either, that Dr Horne’s car is on another raft upriver. She didn’t travel with it in case it went down.

As she told historian Ida Milne, when travelling on rivers in Nigeria one always had to be careful: “You had to watch out for the crocodiles, so you didn’t put out your feet or fingers into the water.”

These and other vivid memories of working in Nigeria and Zambia in the late 1950s and later, in her 70s, in Zambia and Kenya, are captured in Ms Milne’s fascinating interview, which is part of the Royal Academy of Medicine in Ireland’s Living Medical History project, which is archived at the Royal College of Physicians of Ireland.

Dr Horne recalled the working conditions in Nsukka in Nigeria, where she was the only doctor in the hospital and worked 12-hour days to treat patients with tuberculosis and yaws, a chronic infection of the skin, bone, and cartilage.

Yaws was “absolutely awful, frightful”, she said. “They’d have sores all over the person and, if the mother had yaws on the face, the baby would pick it up.”

She also recalled her work in obstetrics, often made more difficult because pregnant women left it late to come into hospital.

“I’d say to them, ‘Why didn’t you come in sooner?’ ‘We were waiting for the next moon’. They counted their dates in 10 lunar months, which of course was longer than our nine months, with the result they all came in about 10 days too late.”

Dr Horne knew she had a difficult obstetric case if she saw a woman being carried in on a plank of wood because she was too ill to walk. 

It was “the same thing if you saw a man coming in on a bicycle or a plank of wood; you knew he had a fractured spine, usually from falling out of palm trees”.

She talked about treating snake-bites and the prohibitive cost of anti-venom medication, which was almost as expensive as the price of a house.

When Dr Horne returned to Africa in the 1990s, she witnessed the scourge of Aids. Her retirement in 1992 lasted just two years.

“It suddenly struck me: I have medical qualifications; what am I sitting here for?” she told journalist Sue Leonard in 1999, explaining her decision to work in a Zambian hospital run by the Missionary Sisters of the Holy Rosary.

When funds were running low, she’d send back “SOSs to Margaret”, her twin sister, who still lives in Ranelagh, and use the money she fundraised to buy drugs. She described seeing whole families dying of Aids-related TB.

“It was just terrible and the children would be dying of starvation too. I think that was the worst thing. There was nothing you could do for them. We didn’t have the drugs in those days.”

When she died last month, you might have expected to hear about it. Had she been a politician, for instance, the passing of this exceptional woman might have made a line on the evening news.

Graduating from UCD in 1955, she went to the Mater before working in Africa. When she came back in 1959, she was the first female surgical registrar of the Mater Hospital and then worked as a consultant psychiatrist in St Davnet’s Hospital in Monaghan. Under chief psychiatrist John Owens, Dr Horne was responsible for implementing the transfer of long-stay patients back into the community — another pioneering development.

Happily, it is not at all true to say that Dr Horne’s contribution is not remembered. Her work — and that of Margaret’s, who was a medical social worker — is widely admired.

Consultant obstetrician and gynaecologist Nóirín Russell remembers meeting the sisters a few years ago.

“They really stood out in my memory. Patricia... told me that her mother Delia [Moclair] was the first female assistant master at the National Maternity Hospital [NMH]. [Patricia’s grandfather, Patrick Moclair of Ballinree, Cashel, was one of the leaders of the Plan of Campaign in South Tipperary].

“When the master [Andrew Horne]’s son came home from war to work at NMH, they fell in love. She had to give up work when they married. I remember thinking that was incredible after all the work she had done to acquire the skills to become the assistant master.

“I mentioned to her that I held the same post as her mother did, a few years previously. Luckily, I was not expected to give up work when I got married.”

Patricia Horne also recounted the story of the birth of herself and her twin at their home in Merrion Square in central Dublin.

“Patricia was the second twin. Her sister Margaret said that, as the first twin, the only time she ever got peace to speak was the three-and-a-half hours she had before Patricia arrived.”

National Museum curator of military history Brenda Malone also recalls Patricia Horne — and her sister — with great fondness. In 2014, they donated their father Andrew Horne’s collection of wartime photographs to the museum.

Lt Andrew J Horne, 17th Stationary Hospital attached to the 29th Division in Gallipoli in 1915-16. Picture: National Museum of Ireland
Lt Andrew J Horne, 17th Stationary Hospital attached to the 29th Division in Gallipoli in 1915-16. Picture: National Museum of Ireland

Attendant to the Royal Army Medical Corps, Dr Andrew Horne was one of the last five officers to leave Gallipoli and his exceptional photographs of exploding shells, captured Turkish soldiers, and the evacuation of Gallipoli are of international significance. They are now part of the Recovered Voices exhibition at Collins Barracks in Dublin.

What is striking is that neither daughter spoke about themselves when they donated their father’s photographs.

“That is so often the case,” says Ms Malone. “They came to us with their father’s photographs because they wanted to honour him. They said nothing about themselves.”

Too often the stories of people who make such valuable contributions to this world simply disappear when they are gone.

Thankfully, that won’t happen in this case of Dr Patricia Horne because her words have been recorded by Ms Milne in a project that charts the enormous changes in medicine that have taken place over the last century.

One of those changes, highlighted by Dr Horne in 2013, provides ongoing food for thought.

“I wouldn’t have got into medicine now. I wouldn’t have had the points. We got in on our matriculation… but now it is all points. I wouldn’t have got in, no way.”

What a loss that would have been.

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