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The Berge Istra, A Sad But True Story

In 1971 I was senior surgeon on the P&O liner Orcades. It was time to come home from Australia. In the middle of the night there was a summons to the radio room for urgent medical advice with an unnamed ship’s master within 24 hours from Fremantle it was his chief electrician who was repairing electrical wiring on top of one of the ship’s boilers; He received a severe shock (the ship operated on 480 volts) and was knocked backwards and fell at least 20 feet. He was still alive but the captain feared he was dying and needed more help than he and his crew could provide.

It was quickly apparent that he was in a lot of pain, and needed the master’s advice on the appropriate dosage and frequency of the morphine the ship carried in his medical supplies. The nature of the pain suggests injury to the chest wall, front and back, and possible spinal damage in the lower thoracic and upper lumbar regions. The two most pressing concerns were that he was urinating blood and becoming faint and ill by the hour. 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 would definitely need blood soon, both ships were a minimum of 2 days away from land in any direction. There is a common myth that something seriously wrong with a ship can be fixed by sending in a helicopter, which is rubbish now and must have been rubbish in 1972. A helicopter’s range is quite short, only 2-3 hours. Most sailing ships were out of range until they hugged the coast. We found the name of the ship, she was called Barge Istra, but we didn’t have information on her in Lloyd’s List.

He was a monster, a huge long green monster. He plainly came across our relative sizes. We were a large passenger ship, give or take 28,000 tons, but we could have been a lifeboat for it; It appears that at that moment she was the largest ship on the planet. In a surprisingly short time, they lowered a small-looking red lifeboat, wrapped the injured man around the stretcher, whose designer was named Anderson, and secured him as tightly as possible. The lifeboat crossed in double-quick time.

We got our patient on board and rushed him to the hospital when the first problem appeared. He, like his ship, was huge. So huge that he was too tall for our hospital bed, he was 6 feet 8 inches tall. We made him comfortable in one bed while the ship’s carpenter sawed off the legs of another bed. He was pale as a ghost, but able to speak and his English was good although his nationality was Swedish. His pulse was thin and rapid, his blood pressure was low, and he was in pain while urinating due to blood clots in the urine. On closer examination it appeared that a lower left rib had ruptured into the left kidney, worse it appeared that he also had a ruptured spleen. Her stomach was taut, wonderfully tender and the muscles were tight to the light touch. This was probably due to blood in the peritoneal cavity but could indicate a ruptured bowel.

All in all his chances of reaching Durban were not very bright, and the first priority was to give him some blood and keep his pain under control as much as possible. It wasn’t easy on a passenger liner at this time, we couldn’t carry a blood supply, and blood substitutes weren’t very good then. Cross matching was primitive, done with a series of blotting papers, a method developed by a Norwegian, which ultimately saved a Swede from a Norwegian ship. The crew had a small book of blood groups ready to donate blood in case of emergency.

After the second pint he really started to improve. His blood pressure stabilized, his pulse rate finally began to drop below one hundred, his temperature dropped, and perhaps most importantly, he began to think he could make it. Within 24 hours, his condition took a turn for the worse. We really thought we had to manage this time. We gave him a large dose of morphine and a sedative to knock him out and another ½ pint was squeezed from the only crew member of the right blood type, who prayed for religious inspiration. So he arrived in Durban where the ambulance and surgical team were waiting. He actually suffered more than we thought. Both kidneys were injured, his liver capsule was torn and oozing internally and yes the spleen was ruptured. His spleen was removed and 1/3 of his left kidney and he was given another 6 pints of blood but he made it and was back on Barge Istra within 3 months.

Over the years he sent me Christmas cards with little details of his life, by which time I was a family doctor and was listening to the radio one morning during my visit when there was a news bulletin reporting the tragic loss of one of the largest ships. On earth, yes you guessed it, Berg Istra. He went down in the South China Sea with the loss of all hands. It was later revealed that the likely cause was insufficient clearance of flammable gases before loading a full cargo of iron ore to Japan. There was an explosion that caused a hull to burst and she sank like a stone. They rang the Luteen Bell at Lloyd’s of London.

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