Jack Preger's Clinic at Cossipore, Calcutta


On each night leading up to this, his last, he did not know that his youngest son Jack had overheard his fervent prayers to be healed. Mercifully, neither was he aware that the Jewish faith he had so dutifully instilled in his son had fallen away from him, like a leaf from a tree, six years before.

        Tonight, although slow and troubled, their walk back together from the synagogue had given no indication of the events now to follow. His heart condition, born of rheumatic fever as a child, had already occasioned one coronary attack. In a few minutes, would come the second.

        As the first cruel pains gripped, he realised this was the end, and that all his prayers had gone unheeded, unanswered. Death was imminent, unthinkable, and now, despite his deep and enduring faith, terrifying. He fought the inevitability with energy engendered by fear as waves of blackness relentlessly engulfed him.

        The family gathered round the local doctor, still breathless from his rush to the house,
as he began his examination. Finally, he shook his bowed head slowly, lacking the courage to look up into their anxious faces.

        Harold Louis Preger, aged just 52, was dead.

        Jack Preger looked down at the silent lips which had uttered those ceaseless prayers night after night in vain. If he had lost his faith years before for no apparent reason, it was now justified. In the lifeless form of his father below him, the existence of a loving compassionate Creator was conclusively negated.

        His heart knew no meaning, his grief, no solace.


        The first thing I remember about Cossipore is the dust.

        It was the time of year for it - with the soaking monsoon now over, day after day of clear skies and long hours of sunshine had dried the silted mud to brittle flakes. The passage of wheels, hooves and feet, plus a gusting wind had done the rest. Cossipore in particular, seemed to be a dust magnet, and it clung to branches, sills and souls. Jack's arrival at the clinic turned many heads, like a sudden strong breeze in a field of flowers, and he returned broad smiles, banter and goodwill amongst the staff, both local and foreign. Whilst he entered into private consultation with his group of Indian doctors, I watched the familiar pattern of care repeating itself here, just as I had seen on my first visit to the Middleton Row clinic on the pavement, several years before.

         This was indeed a deluxe version as he had indicated, and the clinic was set back from, rather than actually on the pavement. In addition, most of it was shaded by tarpaulins, with only the occasional splash of now hot sunshine spilling through. And sure enough, at the far end, two latrines smiled out from door-less enclosures, and attracted a steady flow of men women and children, who squatted there quite immodestly.  Several hundred patients waited in various sections of the clinic, either to be seen, to be treated, or to receive medication, and if deemed necessary, food and money too. Entering among the mini- multitude patiently enduring the passage of the hours, I sensed the same familiar acceptance, as if I was almost a trusted member of their collective families, my white face being automatically interpreted as belonging to Jack's medical fraternity, and all the deep respect which it engendered.

         With this fellowship came subtle but meaningful communication; nods and little salutes from the men, and lingering glances from the women and children. In the latter case, dark eyes dared to hold your gaze and return your smile, then turned to share this simple excitement with those around them, hands covering mouths to conceal what had become grins of delight.

        I knew from previous experience what had brought all these people here, and that some would have travelled for two or even more days from outlying areas to reach this stretch of urban pavement. Others would be from Calcutta proper, living in slums, under bridges, inside drainage pipes, or on the streets. Many would have life-threatening conditions such as TB, malaria, malignancies, heart disease and leprosy. There would also be a wide spectrum reflecting every other aspect of tropical medicine, as well as injuries caused by accidents of all kinds. Here, they knew they would be treated completely free, whatever religion they belonged to, or whatever illness they suffered. Where necessary, they would be sent for X-rays and laboratory investigations, or to specific hospitals for special treatment or surgery, but I knew also that, paradoxically, some other hospitals with limited supplies of medication, actually sent patients to Jack's kerbside practice for treatment.

        Jack, now wearing spectacles and stethoscope, was still in deep discussion with the other doctors at the far end of the clinic, but rose suddenly, looking over the top of his wire frames across the sea of faces, then made his way slowly towards me, stopping to speak to patients that he obviously knew. One elderly man pulled out a scrap of paper to show him, and he nodded assertively, pointing to his group of doctors, and patting the old chap reassuringly on the shoulder.

         "You're lucky" he said, as he approached, pulling off his glasses, and stabbing them into his shirt pocket. "I can spare a few hours this afternoon, so you can get on with your interrogation"

         I followed him across the road and we perched on the side of the jeep, in the shade. From where we sat we could observe the Cossipore clinic in its entirety, occasionally completely obscured by dust when a heavy vehicle passed by. A tantalising smell - a blend of fragrant tea, Indian confectionery, and burning charcoal wafted out from an adjacent tiny shop, and sat with us. I produced my tape recorder, which seemed to be eating the Indian batteries at an alarming rate.

         "I shouldn't really be taking time off" he reflected, staring intently at his life on the other side of the rutted street, "But I'm trying to play more the role of an organiser and director, rather than being involved in every day to day aspect. Now I act as a consultant to the doctors, and follow up the most difficult cases with them. We've just decided to send another patient down to Vellore in South India for heart surgery. This chap has had rheumatic heart disease since a child, and surgery is his only chance. It's costly - about 80,000 Rupees - that's roughly £1600 -just for the operation, but it should save his life."

He peered through another cloud of dust newly created by a passing lorry, and added: "It's the same medical condition which killed my father"

         "How old were you then?" I asked

         "Twenty two"

         "Were you with him the time?" I dared ask.

         "Yes, the two of us had returned that evening from the synagogue, although he had no idea I'd lost my faith years before."

         "Was it an easy death?"

         Jack stared at the ground and shook his head.

          "No, it was terrible. He feared death, and he fought it" he said, still staring at the dust. "It was a terrible time for me too" he added.

        He fell silent for a while, and said: "Let's head into town shall we?"

        I rose, and automatically headed towards the jeep’s passenger door, but Jack remained still.

        "I'm afraid the jeep's used strictly for company business, so to speak" he clarified, and added with a chuckle, "Not for joy rides with visiting friends"

        I should have known better - not content with living in the humblest surroundings. Jack refuses the convenience of using any of his organisation's facilities or equipment for his personal use. Attempts by those closest to him to and persuade him that it might even benefit the organisation by saving his energy and benefiting his health, were in always vain.

        "So let's take the tram" I suggested, but Jack was already shaking his head energetically.

        "No - no way you'll ever get me on a tram" he said resolutely. "No way. I never use them – too damned crowded and too many pickpockets for my liking" he insisted, demonstrating the stubborn resolve which had permitted him to achieve so much in his life - and also get himself into so much trouble with local authorities.

         "Not at this time of day surely?" I countered, anxious to have a ride in Jack's company on Calcutta's historic public transport.

         "We can get on at Belgatchia terminus, it's not far, and it will be almost empty until we get into the city" I reasoned, seeing some sign of capitulation in Jack's amused smile at my childish desire, but he remained silent.

         "And as a very special, once in a lifetime favour, for a visiting friend, I would really enjoy it" I concluded.

         The smile broadened at my emotional blackmail.

         "Oh all right" he said, like a father suddenly giving in to a son's incessant supplications for an ice cream. "But if I get my wallet nicked, you can cough up the damage, OK?" he joked

        "Agreed" I laughed, knowing very well that Jack's Spartan lifestyle caused him to carry little more than the equivalent of a few dollars.

        "Besides, trams are an environmentally compatible form of transport" I added, blowing my nose, and noticing in astonishment the pitch-black contents
now contained in my handkerchief.
Once again came the question - how had Jack survived in this pollution for so many years?

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