by Dr James Knight
The Lake
Dr Cuthwyn Lake was only the third Black general surgeon to operate on our people. The first was Dr Noel Margetson and the second was Dr Ivor Heath. Dr William Joseph was the first specialist obstetrician and gynaecologist. So recently did they practice, that there are those of us here who knew all four of those doctors. Those of our regional and local physicians and surgeons who had been exceptionally privileged to study abroad, and decided to return to take care of their own, were the ones who began significant care for our people, more than a century after the abolition of slavery. Imagine the work that was before them.
Our nurses worked hard alongside them too. They were even the operating theatre assistants. As a matter of fact, there are nurses with us today, who worked with all four of them.
That’s when we began seeing less and less people with Goiter; less and less men struggling to walk, with their legs wide apart, carrying around huge hydroceles; less and less of our women labouring with abdomens distended by huge uterine fibroids and ovarian cysts; less and less deaths in child birth; less people dying from ruptured appendices, because they were accustomed to simply drinking Epson Salts or ‘salt purge’ when they had abdominal pains. Thanks to Doctors Margetson, Heath, Joseph and Lake, people here in their forties probably know nothing of such phenomena.
A colleague and good friend of Dr Lake, was Dr Cuthbert Sebastian of St Kitts, a son of an Antiguan from Johnson’s Point. He was a surgeon who became superintendent of the hospital in St Kitts, then Chief medical Officer, then Governor General of St Kitts and Nevis. In 2002, a book of his was published, titled One Hundred Years of Medicine in St Kitts. Except for the names and a few other changes, he could have been speaking of Antigua or any of our regional territories.
Because during slavery, there were doctors for the plantations. Of course, there was healthcare for the planter class. But also, they had to make sure that enslaved people who were still able-bodied, remained healthy enough for intense labour on the plantations. That was the life blood of their business; the source of their wealth. Surgeons were also useful for amputating a foot now and then of a recaptured repeat runaway slave.
But the moment that slavery was abolished, even though we remained on the plantation as labourers, we were no longer anyone’s property, and were therefore no one’s responsibility. Our bush medicines were what we had to rely on for more than a century after Abolition. We get a good insight into those years when we read the words of the Antiguan working man,Papa Sammy, in the book To Shoot Hard Labour, a book that I insist should be compulsory reading for every secondary school student in this country.
I first met Dr Lake in January of 1990. I saw him walking in the city and greeted him. He recognized me from published pictures. We spoke briefly. Myself and another who graduated in Cuba in 1989, were awaiting registration and licensing, and it was taking some time for various reasons, though another, who graduated in 1987, had gone through the process before.
He said to me that he could not help us with that process, but once that was done, we simply needed to report to duty at the hospital, and he would sort everything else out. At the beginning of March 1990, we presented ourselves to him at Holberton Hospital. I had the fortune of beginning my Holberton experience at the operation theatre with the man himself, along with Dr Ramamuthi Bekal. It was a two-man team of professional excellence and great personality.
Dr Bekal was a peaceful and kindly soul. He was wise, compassionate, empathetic, and ever willing to work. Dr Lake was a level-headed leader. He was reasonable and considerate, and displayed wisdom and significant general knowledge. I enjoyed our conversations. There was an absence of the complexes, phobias and prejudices that so many take to their graves – or perhaps, that take so many to their graves.
A short while into working with Dr Lake, I felt comfortable enough to ask him how was it that he was so close to Prime Minister V. C. Bird, yet the hospital often lacked even some basics. In typical Anguillan twang, he replied; “ You see man, you have to understand the politician”. Then he proceeded to explain that a basketball court in the village drew more attention than a bit of equipment in the hospital.
Fortunately, we have come a very long way since, but unfortunately, we still prioritize the spectacular and sensational, over the organizational or programmatic necessities in healthcare.
Dr Lake was also one of many of us who believed that it would have been much wiser to create a new hospital by restoration,renovation and addition of buildings at the Holberton site, given that location’s almost infinite room for expansion.
On a personal note, I must mention this insightful man’s influence on my professional development. A couple of years into my job at Holberton, I was being encouraged by senior colleagues to take up a position as a District Medical Officer, which was becoming vacant. That would have allowed me greater opportunity for private practice. Dr Lake said that he was reluctant in writing me a letter of reference, because he thought that staying longer at the hospital and working in the various departments would be an invaluable professional experience.
Well, it was. I worked at Holberton for just short of six years, and that is what gave me the confidence to apply to the Barbuda Council in 1997, to be the first to live and work there as the island’s resident doctor. Also, when some members of the nursing staff in Barbuda became bitter and troublesome because my case management was obliging them to work full eight-hour shifts, good old Matron Laurel Davis, a retiree from Holberton, said my response reminded her of Dr Lake. He, a man once nicknamed Brutus by nurses, maintained such good humour, such a pleasant countenance and demeanor, handling himself with such civility and humility, as to charm his detractors. So much so, that at the time of his forced departure from the job, many were among his greatest supporters and defenders. He had earned the admiration of consultants, caregivers, clerks, cooks, carpenters and cleaners.
Dr Lake performed surgery from the head to the toe, in an era when we had little knowledge of, let alone access to, the various surgical specialties. But he didn’t just know the human body; he understood and appreciated humanity. He was the type of person to see the period of the COVID pandemic as others should have seen it; a time for feeling greater sensitivity to human need, rather than seeing greater opportunity for human greed.
So when it seemed that we might have needed an additional facility for Covid-19 patients, it was indeed appropriate to name that facility for Dr Cuthwyn Lake.
For many years, true to his name, he was like that grand, smooth and steady body of water, a great repository of knowledge as nutrients, calmly and respectfully nourishing his environment, encouraging continued growth of good professional practice and abiding humility. We saw that in Dr Lake.
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