When is medical evacuation justified?

Illness is a pain in the neck. Its arrival is always unwelcome, unsolicited, and an intrusion on the more pressing urgency of living. Only the most perverse individual could relish the experience. All the more inconvenient then when you are far from home.

“Not much of you, is there?” joked the avuncular physician as he cast an eye over my unclothed form on the examination couch. I had flown into London that morning, evacuated from west Africa, for investigations into marked loss of weight and a sky high sedimentation rate. The dark spectre of tuberculosis, AIDS, or metastatic malignancy loomed and I saw it reflected in the worried facial expressions of those about me. I, too, was naturally scared, for it could mark the end not only of my chosen career in the tropics but of my very life, neither of which I cared to countenance.

True, I had not been well for the previous three months and, although I had continued with a very full schedule of work, I had stopped running …