The degradation of Josip BrozBMJ 1996; 313 doi: http://dx.doi.org/10.1136/bmj.313.7069.1409 (Published 30 November 1996) Cite this as: BMJ 1996;313:1409
- Paul Aurora
Josip Broz lived in a small children's home on the edge of town. The staff pitied him, for not only had he been born with the ugliest of deformities, but fate had orphaned him at a young age. His mother died giving birth to him; his father, unable to cope, took solace in whisky and met his destiny in a road accident a few months later. Josip's sister, unprepared for the sudden responsibility, abandoned him to the children's home, where he received more sympathy than affection. Josip had his revenge on the staff when the war came, for while they lost their homes and their children Josip stayed in his own bed, and apart from the cold and the occasional journalist, his life did not change.
The war was bloody even by local standards, and by the time it was over the town had been gutted. Then the foreigners arrived driving bright new Land Cruisers, wearing crisp white suits, their wallets bulging. The people were ecstatic.
“Thank God you've come. You've no idea how much we need your money. The school's been levelled, the children are wearing rags, they even stole the generator from the children's home.
The foreigners were curt. “We've come for Josip Broz.”
Josip had his first ever ride in an aeroplane accompanied by smiling, doting strangers, asking him questions that he could not understand. Arriving at the hospital was even more intimidating for here were more people than he had ever seen before and all of them interested in him.
“Turn him around a bit, love,” shouted the photographers to the nurse. “Show us his ugly side.” The nurse refused, feeling embarrassed for them, so they sneaked behind her and took the pictures anyway.
The chief executive called a press conference.
“Josip has come to one of the best specialist units in the world and will receive the most detailed corrective surgery Western medicine can offer. By treating Josip, we are showing the world what good will and cooperation can achieve.” The surgeon looked less sure but happily answered gruesome questions about the surgery.
The press were beside themselves. “Tragic Josip saved by NHS” rattled the headlines. “Your favourite newspaper leads the campaign to rescue Europe's most desperate tots.” The photographs were a hit, sales went up, and donations flooded in.
The ward staff were unsure what to do with Josip at first, and there were a few false starts. The speech therapist did her best, but she could not speak his language and had little idea of how much he could understand. The physiotherapist got him a new chair. The nurses felt more than a little uncomfortable, but they were professional as well as humane, and within a week Josip had stopped crying and was eating again.
Informed consent was a bit of a problem as Josip understood so little. One of the newspapers had flown Josip's sister to Britain, but she visited the ward only once and now was untraceable. The hospital contacted his children's home and then telephoned his government. “Sure,” said a government official. “Do whatever you want. Keep him.” They ignored the last sentence, the forms were completed, and the surgery went ahead.
The days after the operation were difficult, no more than expected, but Josip still needed ventilation, inotropes, and lots of blood. The bills went to the charity, which was astounded that a single intensive care bed could cost as much as rebuilding a small school. But this was what it had raised the money for and it could hardly stop now. The bills were paid.
Easter came and Josip was still on the ward. By now he was used to the staff and had definite favourites, and the staff in turn were fond of him. The surgery had gone reasonably well, and his deformities looked a little better, but the miracle transformation predicted by the tabloids had failed to appear, and they had transferred their attentions to another child. The charity was in a panic, for the money it had raised (a huge sum, it thought) was all gone, and the trust administrators were getting insistent. It had tried to raise more money, but with the support of the newspapers gone it found it impossible, and eventually it gave in. The charity told the surgeon, who cancelled the second operation, and the staff started packing.
A bemused Josip Broz was wheeled out of the ward, along the corridor where the gaping photographers once stood, and on to an aeroplane for the second time in his life. The baffled staff at his old children's home put him back in his old bed, put his old bottle back in his mouth, and carried on with their jobs. It was difficult for them not to resent Josip, especially when they thought of the still missing generator, but they were professional as well as humane, and within a week Josip had stopped crying and had started eating again.
This is fiction, of course, for all charities know what they are doing, no trust would put free publicity above the interests of a child, and our newspapers are the best in the world. But if you have a lot of money to spare, and are looking to spend it wisely, remember the story of Josip Broz. You can buy a lot of vaccine with a suitcase full of money.—PAUL AURORA is a paediatric registrar with experience of working in former Yugoslavia and in several British teaching hospitals. This story is based on several children he has seen and is not a description of a single child.