The eminent surgeon whose constructive life was marred by political interference

IN AT THE DEEP END REMINISCENCES OF A MALTESE SURGEON

Author: Carmel Lino Cutajar Publisher: Allied Publications, 2014 Extent: 375pp

In this autobiography, the eminent Maltese surgeon Lino Cutajar describes his life against the backdrop of the social, cultural and historical development of Malta as well against the backdrop of the amazing progress in the fields of medicine and surgery.

In simple language he tells of his childhood in wartime Sliema, his studies at the Lyceum, then at the Medical School, his marriage to Irene nee Cassar (the daughter of wine entrepreneur of Marsovin fame) and then his studies in the London during the time of the Swinging Sixties.

Then, once back in Malta, he gets caught up, against his will, in the war imposed by the Labour government and the medical profession.

In 1976 the Medical School celebrated its 300th anniversary with celebrations and speeches.

The small stone that started the avalanche was a minor issue: in June an issue cropped up regarding what takes place when a TMO in the Gozo Hospital goes out on leave. The Department of Health ordered that a TMO from Malta replaces the Gozo one. The Malta TMOs refused to obey. One of them, Dr Alfred Gatt, was ordered to go to Gozo. He refused but eventually went to Gozo to deal with an urgent case. When he returned from Gozo, he was sacked. All the other TMOs promptly resigned. They held their meetings at Lino Cutajar’s house which became a sort of HQ for them.

So far, MAM had not been involved. When it did, it urged the TMOs to return to work. Meanwhile, government came up with a better package for the TMOs and they all accepted and returned to work, including Dr Alfred Gatt. But this was the lull before the storm.

There had been an earlier precedent: in 1956 the Medical Officers Union was set up by a dynamic person, Dr Censu Tabone, and a strike was ordered. Dom Mintoff, at that time prime minister, wanted to bring in foreign doctors to break the doctors’ strike, but Governor Robert Laycock vetoed it. Mintoff never forgot.

In May-June 1977, an issue cropped up. There was a recurrent shortage of junior doctors in the health service. After the obligatory two years practice after graduation, almost all doctors chose to resign, either to do private practice or to go abroad.

The government decided to impose heavy fines on those doctors who did not conclude their two years of service after graduation.

This could have been accepted by MAM, but the government then introduced another amendment that stated that it would be the minister, and not the Medical Council, to issue warrants to foreign doctors.

This was anathema to MAM and at a general meeting called at the Astra Hotel it was unanimously decided to reject this proposal. A limited strike was called for on 2 June.

On 3 June all doctors were stopped from entering hospital and those already inside like Dr Cutajar were ordered to leave. Foreign doctors were brought in from Libya. At one point, Minister Danny Cremona caused a commotion by hurling insults at the doctors. The doctors’ lock-out was intended by the government as a show of strength on the part of the Mintoff government (there were other industrial actions at the time). On 4 June Parliament was convened with urgency and a law was passed that prohibited doctors who stood by the MAM directives from working even in the private hospitals.

The exams for final year medical students were cancelled and the students were airlifted to the UK to take their exams there. The British Medical Council suspended recognition of Malta’s medical degree.

Some people may have expected Dr Cutajar to side with the government: after all, he had saved Dom Mintoff’s life when he hit his head while out on a horse. And his wife’s family was known as Mintoff supporters. But he sided with the doctors.

Tension continued to rise. One Saturday in July he was due to operate at the Blue Sisters Hospital on a patient suffering from cancer. Midway through that operation, the matron entered and told him there was an elderly British patient who had fractured his wrist and asked if he could set it. But while this second operation was about to begin, the same matron entered with a slip of paper in her hand telling him he must leave the hospital immediately. Parliament, meeting on Saturday, had decided that doctors on strike would be barred from working in private hospitals. They had to perform the operation on the petrified patient in the private clinic under local anaesthesia.

Then he happened to meet an American working in the oil industry in Libya who needed an operation on haemorrhoids. By the time the date for this operation came around, the doctors were out of hospital. Speaking at the Astra Hotel with his friend, anaesthetist Dr J Darmanin Demajo (Dede) the latter came up with a suggestion to do the operation, which required general anaesthesia, in the patient’s own home.

Lino went for it. The operation was carried out in an apartment in St George’s Park with the wife taking pictures of everything and was successful and uneventful.

This sparked off an avalanche of requests for private operations in homes (on one occasion, with chickens peeping through the door). Another memorable occasion was the operation on a young man who was suffering from gallstones and who had not been treated well at the hospital. Now this was a staunch pro-government family. The operation was successful.

Meanwhile in Malta the tension mounted. Doctors were very supportive to each other but then funds ran out. Many doctors, including Lino, decided to go abroad. His intention was to go to the UK, given he had studied there.

But on 7 November he had a call from a representative of an American company, the Whittaker Corporation, which was operating three state-of-the art hospitals in Saudi Arabia and who, to cut it short, offered him a job. The government got wind of this representative’s mission in Malta and declared him persona non grata. But nevertheless, Lino and a number of Maltese doctors, took up the offer and went, at first on their own, later joined by their families.

The rest of the book is an enjoyable account of Lino’s sojourn in the Arabian desert, the excursions in the Red Sea and the fantastic scenery of the Asir mountains. He also tells of the many interesting persons he met.

The book is dedicated to Irene, his wife, who features in many episodes but who died suddenly before the book was published.

The book, in its chatty format mentions many people. It is a pity there is no Index with the names that are mentioned.