General Practice

A MEMORABLE PATIENT

BMJ 1995; 311 doi: https://doi.org/10.1136/bmj.311.7007.730 (Published 16 September 1995) Cite this as: BMJ 1995;311:730
  1. David Berger

    Of sea devils and things

    Elizabeth was 12 years old and nearing the end of her inpatient treatment for tuberculosis at the small government hospital in the Western Solomons. One day her grandfather, who had remained with her throughout her stay, drew my attention to a rash which had arisen on the front of her left thigh. The rash appeared vesicular and covered the whole of the thigh in a non-dermatomal distribution.

    “Perhaps this is a jellyfish sting,” I ventured. No, she had not been in the water. Elizabeth sucked on her lollipop and six pairs of eyes looked at me. I looked at the nurse for inspiration: “This is the mark of Tamalokolo, the sea devil,” she said in pidgin English. “Ah, so it is a jellyfish sting then.” “No, no, it's the mark of a devil, the sea devil.” The six pairs of eyes waited expectantly. I started to sweat. “Mostly,” she continued, “they fly through the air in a fiery form and strike people out in canoes, but Elizabeth was on the shore when she was struck. That can happen sometimes. If you see one and you lie down quietly in your canoe sometimes they don't see you and go away again.”

    Over the next week or two the rash got better of its own accord and Elizabeth remained as unconcerned as ever. Our visiting consultant physician drew a blank and as I recounted the story to all who would listen over the next few weeks I became more and more disenchanted with the sceptical, patronising corner that I was manoeuvring myself into. “How charming. How ingenuous. The mark of a sea devil—who would have thought it?” Gradually, the implicit superiority and arrogance of my stance became increasingly distasteful and, eventually, I stopped telling the story altogether.

    I think that Elizabeth has taught me two things. Firstly, just how much lighter and more harmonious it is to respect the beliefs of these gentle people than it is to set about them with the axe of rational cynicism. Secondly, I now know what to do the next time I am out in a canoe and see something fiery coming through the air towards me.—DAVID BERGER is senior medical officer in Gizo, Solomon Islands

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