Nay, falter not--tis an assured good
To seek the noblest--'tis your only good
Now you have seen it; for that higher vision
Poisons all meaner choice for evermore.
15 December, 1910. My last day in Old England was spent in seeing one or two old friends who had previously been missed. Oxford, my old home and the City of Spires, was left about 11 am. in very dirty weather. In the afternoon it was a privilege to be at Salisbury Square for a part of the prayer meeting, and also to meet several missionaries. The last night was spent at the Honorary Secretary's house at Hampstead. Here I had the pleasure of meeting Mr. C. going back to China. It was a great privilege to see and stay with the new Honorary Secretary and really to know him.
16 December, 1910. The morning broke wet and gloomy. I went along to Paddington to meet mother, etc. Sunshine and rain attended our way, and I felt that that was but a picture of what was felt--the brightness of the future and the knowledge that at last one's life purpose was to be fulfilled--and sadness at parting from dear ones one might never see again. They all came aboard and we looked over the vessel. Then at 1.30 p.m. the final farewell was said, and the tender went back to land amid much waving o handkerchiefs, but some sorrow of heart. It is a long, long look forward, but we are in His hands. He will bring us back again or we shall meet in His Presence--we can leave all to Him. Telegrams were brought on board later. It was a great joy to think that some were thinking of me as I left the dear old country. But that very first evening I felt the first qualms of mal-de-mer! As soon as this came on all thoughts of friends at home--in fact, everything--were banished!
17 and 18 December, 1910, were spent in my bunk, doing nothing, eating nothing, saying nothing, thinking nothing. After that things began to mend, and on the 19th I began to appreciate my surroundings. We get over fully 180 miles per diem. We C.M.S. party are quite a jolly lot and have a good time together.
20 December, 1910. Such a sunset into the sea, followed by a beautiful after-glow--glorious climax to a perfect day--blue sky, warm sun, and cool breeze. What a change from the wet and rain of December in England The Marconi system keeps us supplied each day with the most important news of the world. Gibraltar was a stunning sight, the great rock standing out of the see. We went on shore. I was struck by the cosmopolitan nature of the people; the turkeys being driven along through the streets and sold at the door-ways for Christmas; and that there was a collecting box for foreign missions in the English cathedral! Saw banana and orange trees growing for the first time.
At Marseilles he was chiefly struck by the predominance of the drinking saloons; "though," he adds, "not one did I see sufficiently inviting to go into had I needed refreshment."
They were in the Mediterranean for Christmas. He wrote:--
26 December, 1910. Too bright and warm for Christmas Day, which, by the way, is on a Sunday. How one felt it being away from home, but one was reminded in hymn and verse of the real meaning of our joy. Games were put off till Monday, and life then became quite lively with sports and amusements. Never in my life have I seen such a beautiful sky at night, a veritable star-spangled banner.
He went ashore at Port Said also, the chief delight of which was the getting on land once again, and the most remarkable thing the bargaining capabilities of the shopkeepers!
31 December, 1910. Thoughts of the past and future. I felt that it is only as we are filled with the Person of Christ that u-c can exert the least influence on others. I must during the New Year seek to know and realize Him more fully--and my new work will then be done as He would have it done. The last few moments of the Old Year were spent in prayer in my cabin.
1 January, 1911. The first act of the New Year was to meet together at the Lord's Table and begin it in communion with Him. Reached Aden New Year's Day afternoon, and here we transhipped to SS. "Salsette." I had letters from Bombay confirming my destination to Peshawar.
3-5 January, 1911. A storm, which upset the equilibrium of the boat and also my own I could not even sleep, but--6 January, 1911, brought us into Bombay Harbour. Several hours that night I had been awake thinking much of the new day and life so soon to begin. What a welcome we received I am glad that I landed in India on the anniversary of "the feast of the Epiphany." I much enjoyed my three days in Bombay, seeing much and meeting many. Talked in the evening of student days and work.
9 January, 1911. I gave a short talk to about 250 Hindu boys in the school, on "I am the Way, the Truth, and the Life." My first bit of work in India. That evening I left for the Punjab.
He gives his impressions of the interesting sights passed in his journey up-country
The flat plains with their mud villages; the land being irrigated by bullocks which drew up the water from wells; the bare open pasture-land stretches with cattle feeding; the stone quarries; the great fort at Gwalior perched on the top of a sheer precipice and an old Buddhist tope passed near Sanchi, said to date back to 250 B.C.
Then Agra, where he spent a night and a day, and met many old friends. He describes the Fort and the Pearl Mosque, "while across the river could be seen the Taj shining in all the splendour of the bright sunshine." He continues:--While at Agra I had the opportunity of seeing and hearing some thing of the Mohammedan Mohurram Festival, and I saw the flimsy, gaudy models of the tomb of Hassan and Hussein. Nearing Lahore I could see in the distance the snow-capped mountains of Kashmir, while the gorge near Attock and the bridge there over the Indus were quite inspiring. And now begins my life work.
Although Starr's diary speaks for itself, and gives a full account of his impressions as a new-corner, yet something must here be said of the beginnings of the hospital to which he came.
The present hospital was built in 1906, and opened in 1907, but the work of the Peshawar Medical Mission had been commenced ten years before in rude native quarters in the heart of the city. These quarters were anything but suitable for a hospital--any one who knows in even a small measure what "the heart" of an eastern city is like, can guess that--but work was carried on there during all those years in a serai, or courtyard, hired for the purpose. A letter written in February, 1898, says: "The medical work was unconsciously opened, on 12 January, 1898, by a man from Ghazni, some two hundred miles beyond the frontier, who walked into the courtyard and asked for treatment. His interview with the medical missionary was the opening ceremony, although things were hardly straight, and there had not as yet been even a notice-board placed outside the courtyard in the main thoroughfare, to inform the public that it was now a hospital! "It was Dr. Arthur Lankester who started the medical mission work in Peshawar in 1898, who planned and built the present splendid hospital, and worked so successfully for seventeen years in Peshawar, until May, 1914, when he resigned that work to take up important government work.
The present hospital is an imposing building, well planned and laid out, standing on rising ground outside one of the chief gates of the walled city, and on the main road down which the camel caravans come from the Khyber Pass into Pehsawar. [The caravans bring dried fruits and silks, furs and carpets, from Kabul, Bokhara, and central Asia, for trade with British India--but they bring patients too.] From the point of view of the work it will be seen that the situation is ideal. On the road level is the whole out-patient block, on the terrace above are the walls and serai for the in-patients, and also the operating theatre and store rooms; while on a higher plane still stand the houses of the Indian assistants, and hidden by shady trees and rose hedges, in their own gardens are the bungalows of the English staff. Above the hospital stands a huge round tower or tomb, said to be the oldest thing in Peshawar, and it certainly is quite famous. It was once used as a smallpox hospital, and once as the mess of a regiment of the Guides, who had a bath, a fire-place, and a good wood flooring put in, making it double storeyed and quite habitable. The local folk believe that the place is without doubt haunted by the old pir, or "holy man," who is said to be buried there; but his ghost has, unfortunately, never been encountered! [During the spring of 1918, as all the bungalows in Peshawar were full, an English family made this old tomb their home. They were both happy and comfortable in it, but we fear the merry shouts of the three little children will have driven off the shades of the holy old pir beyond recall.]
On the extreme right of the compound is another smaller tower, octagonal in shape, and beginning to fall into decay. Rumour says there were once four of these, one at each corner of the central structure.
The out-patient block on the lowest level consists of a fine large men's waiting hall, a dispensary, consulting room, small theatre for septic cases, and men's and women's dressing rooms. Beyond is a hostel for the Indian boys in training.
Up a flight of steps, on the second terrace, are the wards; these are two-storeyed, built round a court yard, where a fountain plays in the centre. To the right are the office, lecture room, and theatre; the drug, clothes, wool, and oil store rooms, and the small but well-fitted laboratory. Beyond these, on a level with the square in which are the wards, is the serai. This is a one-storeyed courtyard, with a number of small rooms running round it on three sides, and a shady tree in the centre. These are the "family wards." Here a patient can live with his whole family during his stay in hospital; the patient has a bed in one of the little rooms, and is fed and clothed by the hospital, while the relatives of the patient treat the hospital as a kind of hotel, going to and from the city or the bazaar as they like in the day-time, and sleeping with the patient to look after him by night. This disarms suspicion, gives them confidence, and makes the Pathan feel at home, for he is there living under conditions not unlike those in his own home. Incidentally, it brings a larger number of people under the influence of the hospital and within earshot of the Gospel. The serai is one of the most interesting spots in Peshawar, for there one finds representatives of most of the Pathan tribes of the frontier, and of many distant districts in Afghanistan. Then, too, it not infrequently happens that a man will find himself in the serai of the hospital lying next to the enemy he has tried to kill. Here they must keep the peace until both get out again!
Out-patients are seen, and operations performed, on every day of the week except Sunday, throughout the year. Christmas Day, Good Friday, and Easter Monday are the only whole holidays, and on those days the in-patients must be treated and the round done as usual. The hospital is never shut, though, partly due to the very severe heat of the summer months, and partly to the doctor's absence on his six weeks' holiday during a part of that time, the work then slackens considerably. The spring is far the busiest time, before the great heat prevents the camel caravans from coming down from Afghanistan and Central Asia into British India. The hospital is registered as having one hundred beds, but during the month of March there are generally thirty to forty more in-patients than there is really room for. Our accommodation is, however, elastic, and beds are hired and put in rows in the veranda when the wards are full up. The one hundred beds are all supported by parishes, Sunday schools, or private subscribers at home. There is no government grant to aid the work, which is entirely kept up by subscription. Even the hospital clothes are all sent out from home, made by friends according to Pathan style and pattern. [Fourteen to twenty yards is required for a single pair of pyjamas!]
And the people? They are blackguards, but they are men. Cruel and lawless, treacherous and suspicious, they yet will trust you when they know you, and have a sense of honour of their own always able to see a joke even against themselves, and with tremendous pluck, one cannot but be greatly attracted by them.
Dr. Lankester writes:--
They are highlanders, with the grit and physique of high and the time will assuredly come some day when the Master shall work in them the change which only He could have wrought in the clans of our own Scotland, who were once no less lawless, no less cruel, and certainly were and are no less courageous. They belong to many different tribes; they live by trade if possible--if not, by fighting and by loot; and it is a case of every man (or at least every family) for himself.
The following story was told the writer by an officer, and is given here to show a trait in the character of a Pathan---his love of a fight for its own sake. A sepoy in a Pathan regiment was given six months' leave. It was at the time of the Tirah Campaign--and after, when medals and rewards were given to those who had fought in it, this sepoy who had returned from leave went to his coming officer demanding a medal, saying that his brothers-in-arms had received them while he had not. He persisted that he had fought in the campaign, and when the colonel told him that as he had been away on leave at the time that was impossible, he replied: "But I fought on the other side with my tribe while I was at home!" He had returned to the regiment at the expiration of his leave, fully expecting a medal in recognition of his having taken part in the fighting, although it had been on the wrong side.
A week after he reached his destination Starr writes:--
Very soon after my arrival in Peshawar I became greatly interested in the mixture of races which comprise the people who come daily to the city and to the hospital. They come from all quarters, but the transfrontier folk are the most interesting. With magnificent physique and fearless courage, they command admiration. Yet these people do things which to us are horrible, and the number of people we see with bullet-wounds and sword-cuts is an evidence of their manner of life. What would you say when a very respectable intelligent man speaks of shooting down an enemy in cold blood, in a similar way to that in which we might speak of reading a book? or to the man who will not let his wife have a needful operation when she is longing for it? A case illustrating the latter was that of a young woman very ill, but who might have been completely cured by an operation. Her husband, an Adamkhel, took the trouble to bring her from some distance to us, but w1 we pointed out that they must stay two weeks in hospital while she recovered, he looked at her as if weighing the point, and then said to us, before the woman: "No, it is not worth it. she is now thin and weak. I paid less than a hundred rupees for her--I can easily afford another wife, but I cannot spare two weeks to stay here so near the harvest." No persuasion on our part would alter his decision, so she had to go away unrelieved.
How one longs to get near them and find out what they think and feel; to lead them to the Christ, the only One Who can give them a better mind. Yet how hopeless it seems without a gift of tongues," for they speak several strange languages and dialects. I believe Urdu, Punjabi, Pushtu, and Persian--and by a helpless newcomer like me, English--are all daily talked in our hospital.
In the spring of 1915, and again in 1917, a large party of men from the borders of Russian Turkestan came to the hospital, all requiring treatment or operation. They could only speak their own language--no one in the hospital could understand them; so they brought one of their number, who knew a very little Pushtu, as an interpreter. They had come a distance of two to three hundred miles most were hernia cases, and all eventually went back cured. These people cannot come often or easily, as the Amir does not like them travelling down through his country.
It was Dr. A. Lankester and his colleague, Dr. R. Cox, with whom Starr first worked in Peshawar. Dr. Cox was transferred to Bannu in 1912, to carry on there after the tragic death of Drs. Pennell and Barnett. And it is he who, after the equally tragic death of Dr. Starr just six years later, in the same month of March, returned to take up the work in Peshawar in which he was formerly engaged. [Dr. Barnett died 20 March, 1912. Dr. Pennell died 23 March, 1912. Dr. Starr was killed on 17 March, 1918.]
To return to Starr's diary on his arrival in Peshawar from Bombay. On 13 January, 1911, he continues:--
My first day at Peshawar I was introduced to the hospital and its grounds, and to the staff at 9 am. After the morning prayers with the hospital assistants (who are all Christians) comes the round of the wards, followed by in-patient dressings. The out-patients were assembled at 11 am, in the very spacious waiting hall, which would do credit to an English hospital. Here a short address was given, and then all were seen separately in the consulting room adjoining, and were admitted, dressed, or given medicine, as the case might be. This till 2 p.m., and after lunch any operation cases still waiting were done. The theatre is a beauty, as good as any one could wish, and splendidly equipped. Alter tea I saw the mission college, which is a fine building in the Mall, and began to realize what a lovely spot Peshawar can be. The English flowers are a joy already. I just praised God for sending me to Peshawar. So ended my first day--one of many new things. (On the same day he writes:) There are some very interesting cases in the hospital just how. One a man who had his thigh shattered by a bullet--he is a Zakhakhel--the tribe whom we fought just lately. The sheep-skin treatment had been applied to him. I had heard of this at home.
This "treatment," commonly used by the Pathan for any large or serious wound, must be described to be understood, but seen and smelt to be appreciated. One, or sometimes two, goats are killed and flayed, their skins being wrapped as they are, and while still warm, round and next to the body of the patient. The idea is that the life of the animal thus killed for the purpose passes into the sick man, giving him new life. The result is not always what is intended, as in the heat of summer this application is liable to become very foul and cause the wound to go septic; in winter, however, it has sometimes acted well in helping to keep the patient warm. The removal of the impromptu "dressing," if bound over the wound itself, may be a somewhat trying proceeding, both to the patient and to the operator, especially if the latter has a highly developed nasal organ.
One case which impressed itself on the writer for all time was that of a young girl of 15 who was brought to hospital at midday in June when the thermometer stood at 118° in the shade. Her father's enemy, failing to get an opportunity to shoot him, had shot his daughter by way of revenge, and the father in evident distress had brought her a four days' journey to us. Her arm and shoulder had been badly smashed by the bullets, and the "skin treatment" had been immediately applied by the anxious relatives. The skins of two goats were bound round next to her body, while a cock, killed and cut in half, was tied, feathers and all, over the gaping wound. Needless to say, the wound was for a long time thoroughly septic, though in time it healed satisfactorily.
The diary continues:--
14 January, 1911. I experienced a new sensation, a slight earthquake shock. The weather was wet, like a November day at home, but without the fog. I began language study with my munshi.
15 January, 1911. Sunday. My first visit to the city, and most interesting it is. We went along the Caravan Road to the city gate, where a string of camels--a caravan, I suppose--was just leaving the city for the hills. The mission church is a splendid structure, white outside, and built and decorated in truly eastern style, both outside and in.
There are fine carved screens of the famous Peshawar "pinjara" work, and a deep font for baptism by immersion. The east end is carpeted with rugs, and Persian carpets over the tesselated pavement, and a. curtain divides the women of the congregation from the men. Of course I understood nothing of the service. I had lunch and tea, with the Lankesters. but both meals were disturbed by two emergency cases coming into hospital. One had to be for immediate operation. The man with the bullet wound died this morning. His story is as follows:--He had had a blood feud with another man for a very long time, till finally No. 2 paid a third man a thousand rupees to pay off his feud by killing No. 1. So he shot No. 1, our patient, at close quarters through the thigh. But No. 1, while lying on the ground, wounded, shot his enemy No. 2 and killed him, at which he was supremely happy, though he himself died in our hospital in the end.
We are seldom without one or more bullet-wound cases in the hospital. These are sometimes clue to the reckless way the people handle firearms, an extraordinary instance of which was the case of a woman whose hands were shattered by an explosion. Both hands had to be amputated, and she was very sad, until a generous English lady who heard of the case, after coming to see her for herself, gave the money to buy her an elaborate artificial arm. After this she became quite famous, and we heard that her village was known as "the village of the woman who bears the English arm"!
Carelessness, however, causes fewer victims than the blood-feuds, which exist all over the country beyond the British border, and are kept up from generation to generation, it being a point of honour to do so. Sometimes it is between two members of one family; sometimes between two clans or tribes. Such cases of bullet wounds, due to feuds, are continually being brought to hospital to be mended up, only to return to the fray with fresh zest. They recur over and over again, the only difference being that the blood-feud is started in one instance by the theft of a goat, in another by that of a woman, or of money, or again by an imaginary injustice or insult. It is a point of honour to keep up this vendetta, even to the extirpation of whole families. Even the women are not left altogether out of it. Failing a man, they must take their turn at upholding the honour of the family. An authentic case is that of an old woman who went to the Zenana mission hospital for treatment; "for," she said, "you must make me well. I have myself killed fourteen men, and there is one left whom I must slay. Then I shall die content." The women often resort to poison, but many can use a rifle with the men. The Pathan women are not behind the men in pluck. One who was to have an operation asked that she might have it if possible without chloroform, so that the husband might see how brave she could be. "I am an Afridi," she remarked, with as much pride in her nationality as a British schoolboy takes in his.
And plucky the Afghan women need to be, for though they have not to bear with the evils of the purdah system, and are free compared to their Mohammedan sisters of the plains, they have to put up with a good deal. "The result of the operation must be satisfactory," said a Kukikhel tribesman one day, as he consulted with the doctor about his wife; "for I paid as much as 200 rupees for her, and she is still of value." Immorality on the part of a wife, even if only suspected, is severely punished by the husband, who frequently cuts off the woman's nose. The disgrace is considered a worse evil than the disfigurement, and it is not uncommon for a woman to come alone to hospital to show her flat face and ask if we will undertake to make her a new nose. If the doctor has never had to perform this operation at home, he will certainly be called upon at some time or other to do it if on the frontier.
A woman was one day admitted whose pluck deserves mention. She fell off a roof, sustaining a complete compound dislocation of the right ankle, besides two or three deep gashes in each leg. Seeing from the scars that the wounds had all been sewn up, Starr, through an interpreter, asked her who did it. "I did it myself; my man was away fighting," she promptly replied, and her husband who had come with her assured us that it was so. She had waited eight months till her husband could bring her down to hospital to have her leg properly mended. Women sometimes come whose husbands are at the front in some Pathan regiment, and some wear the medals gained by their men in former frontier campaigns and given by the British Government.
A man one day displayed his forehead with a long even scar across it. When asked how that came, he told us it was a sword-cut, that his sister had pulled hairs from her own head and stitched it up for him with a darning needle; and it had healed perfectly, This shows the character which is developed in these transfrontier highland women--and certainly they vie with the men in common grit
To return to Starr's diary, which is largely about the people whom he came across. On January 16 he writes:--
One of the richest leading Mohammedans of Peshawar was also in hospital when I arrived. He was in a special ward, always guarded by from four to six armed men. He went out yesterday, and has written to Dr. Lankester saving how grateful he is, and acknowledging too the spirit which is behind and prompts our work. He enclosed 17--one pound a da and four extra. This man is very popular here, but when he suggested coming to the mission hospital a great demonstration was made against it out side his house. A deputation waited on him offering him a thou sand rupees to get a doctor from anywhere, and another thousand for him to put up wherever he liked and yet against all wishes and popular feeling in the city he came here. This incident is suggestive of the fact that it is, as a rule, the local city people who are less friendly and trust us less than those who come from beyond the border. It is not that 'familiarity breeds contempt," as might at first be supposed, but rather that the transfrontier folk have come a considerable, often a very great, distance, [Sometimes as much as 400 miles] and having already expended time and trouble, they are consequently willing to submit to whatever treatment or operation is advised, and are quite glad to take up their abode in the serai of the hospital. The local people object to staving in when their homes are near, for they do not understand the necessity for nursing, and as they live among their relatives they are sometimes afraid of what will be said if they are known to attend the mission hospital. They often go the round of the various hospitals and Indian dispensaries in the city
January 18. Thursday is "Shrine Day "(or Ziarat pa wraz, in Pushtu), when all the little wayside shrines and ziarats, the graves of pirs or so-called "holy men," are illuminated by means of tiny lights. There is one tomb in Peshawar which is nine yards long. As the saint was said to grow after his death, his tomb had to he correspondingly lengthened to fit, until Government, it is said, suggested that he should not grow any more, as the tomb was creeping across the public road On this night I saw two women worshipping at a little shrine--an incongruous picture, this, right opposite the C.M.S hospital and among the English residents.
Starr's diary from now on is mainly filled with notes on the operations he did, the cases he saw, and the Urdu study he was trying to fit in. An average day would be spent thus: Hospital work till two or three o'clock, two hours off for tennis or cycling, language study for two hours in the evening, followed by letters or any work of his own.
Once a week he would be present at the Anjurnan, a preaching hail in one of the main streets of the city, where in the evenings open-air talks were given to the people who collect, by any of the Pushtu speaking Indian Christians.
On 7 February, 1911, he writes:--
About seventy were present at the Anjuman to-night, and listened very attentively.
February 20. The hospital is beginning to get very busy; to-day a man came with a chit (letter of recommendation) which had been given him by a man in the streets of Kabul, saying: "Ask for Dr. Cock [Meaning Cox.] of Mission Hospital near Dubgari Gate"; and in this way he had found us.
February 26. Sunday. At the morning service in the mission church one of our hospital servants was baptized, after going through a long period of testing. One realized how much more it means to he marked with the cross before the whole assembled congregation.
February 27. An awful case--the like of which one never sees in England. A small child 6 years old, whose arm was now gangrenous to the shoulder, due to native treatment. It had been a simple fracture in the first place. Another fracture brought in the same day, but not so bad, had been treated with a poultice--a mixture of milk, salt, and cowdung.
March 3. A case, fractured femur in a long-Liston splint, had taken off his splint in the night, and rubbed ghi (clarified butter) and salt over the fracture! How can one expect them to get well!
He valued the medical conference, which was held twice during his seven years' service, as a time of meeting with other medical men from different parts of the Frontier and Punjab; for, as he says: "On the Frontier here one is rather isolated from those who work in the Punjab; indeed one is apt to feel we are not so much a part of India as of Central Asia!"
March 7. I take it as a high privilege, so early in my carerr, to meet these older medical missionaries. I have got an insight, too, into the problems of medical mission work in India. I met Dr. Pennell, etc., etc.
March 26. I cycled with--to Jamrud, at the foot of the Khyber Pass. The fort looks like a great grey battleship on the bare plain, with the still barer hills behind. There is a small Christian community living in the serai there who do the clean of the place. It is indeed the farthest outpost of Christianity, on the very border of Afghanistan. (In old days there was a mission dispensary as far up the pass as Lundi Kotal, but this is no longer allowed.) I was most struck by their cleanliness end cheerfulness, though they do all the dirty work.
March 27. 380 out-patients to-day, Hospital quite full. Little time for Urdu.
April 8. Started collecting materials for pathological room. Watched the military tattoo in the cricket field.
April, 10. Nearly 400 out-patients. Certainly work enough for all. A bit tired.
April 13. We took a census of all in-patients. There are ninety-four in the hospital, of whom sixty-four are transfrontier. We are less full than we were.
April 19. My first visit to Akora, our out-station. I went with Dr. Lankester, who gave an address to the assembled people, and then work began. They thronged and pressed round us as we sat, and we worked as hard as ever we could till 2 p.m. It was a long, tiring, but very interesting day. The streets of Akora are narrow and odorous--it is quite a native town with no English residents. We only have the dispensary open once a week, on the cattle-market day. It would be impossible to get over more often. On our way home we had quite an adventure. A man trying to drive his cow off the railway line was knocked down by the train. We got the train stopped (easier out here than at home!). Went back and found him with a compound fracture of leg; put up the fracture, using the legs of my camera stand as a splint. They answered splendidly--and then we brought him on with us back to hospital.
Starr was to help at the Srinagar C.M.S. hospital for the summer of 1911.
He left for Kashmir on May 12, bicycling in.
The whole journey has been one of the most wonderful rides in my life, not only for the beauty but for the variety of mountain scenery; the twenty-six mile run down from Muree to Kohala without touching one's pedals is the finest run I have ever had The quaint modes of travel that one sees! In Peshawar camels and bullock-carts, and of course tum-tums, [Small native dog-cart.] in Muree rickshaws and dandies, [Carrying-chair.] on the Kashmir road ekkas, tongas, [Springless native cart.] motors, ponies, and vehicles of all sorts; while the house-boats and straw-roofed dunga boats on the lakes and river Jhelum are the most peaceful and picturesque of all.
I thought the scenery beyond description, the fine bridge over the Jhelum at Domel, and the road from thereon cut out of the side of the steep cliff, on the right bank of the liver all the way in to Baramulla, at the opening of the "Happy Valley." The road rises several hundred feet above the river, and is altogether a wonderful engineering feat. The birds and trees of Kashmir remind me more of England than of India.
May 19 was his first day in the Srinagar hospital, where Drs. Ernest Neve and Rawlence were working.
May 20. Went with Dr. Neve to visit the leper asylum on the banks of the Dal Lake, where there were over 150 lepers in various stages of the disease. Some looked ghastly with fingers and toes missing, or stumps for hands--others appeared hardly touched. The lake was too beautiful for words, so still, the cool green waterways with willow trees and weed on either side, and then the open stretch of rippling water enclosed by the cloud-topped hills. The reflections and colours were perfect, and reminded me in parts of the river at Oxford. We were paddled along in a small flat-bottomed boat by several boatmen.
May 21. Sunday. My birthday. We climbed the Takht, a hill a thousand feet high, rising up almost alone on the plain, in Srinagar itself. It is surrounded by a quaint old Hindu temple; dome-shaped, built of stone, and 1400 years old. A magnificent view of Srinagar, the lake and the valley, and the distant snows from the top.
May 29. I did my first two cataracts, and ten operations in all.
June 2. I spoke at the weekly mission prayer meeting on The Fellowship of His Sufferings."
June 17. On the way to the leper asylum saw a poor woman fished out who was drowned. I stopped, but nothing could then be done for her.
June 20. Watched the regatta of Mr. Tyndale-Biscoe's schoolboys. Avery pretty and quite unique sight--eight boats, the crews dressed in their different colours, rowing, paddling, and purposely upsetting! Showing what can be done even with the Kashmiri Brahman.
June 22. Coronation Day service. I helped to superintend the distribution of a feast to the hospital patients a lantern service for the lepers on the life of Christ followed, and last a bonfire. The Takht was illuminated--a very effective sight.
June 29. Biggest day so far. 237 new cases, and 402 out patients in all, twenty major and ninety-three minor operations. During the week we have had 900 new cases, 800 old, eighty major operations, and over 200 minor. This is of course their busy season up here, but there are always three doctors here for it.
In July and August he was on holiday, which he spent in Sonamarg, at the head of the beautiful Sindh Valley, alone until joined by Dr. Turner, of the Dera Ismail Khan hospital.
This beats anything I have ever seen (lie wrote of Sonamarg) the rolling green slopes of the marg, the stretches of dark fir forest, the towering rock peaks and the wild flowers above all, the glaciers and the indescribable grandeur and solitude of the mountains. Up here I had one of my worst migraine (headache) attacks, which, though they come seldom, knock me out rather badly.
After a further short spell of work in Srinagar, he returned to Peshawar in the autumn. The road had been broken by many land-slips, and he had to wade across the Hurroo River, the water over his knees, while his cycle was carried over on a coolie's head. He went in for his language examination before the end of the first year, and failed the first time, which was a great disappointment to him, although he had had comparatively little time for study, and no language leave.
October 21. The Chief Commissioner did us the honour of coming over the hospital and seemed quite interested; the General of the Division, etc., were with him.
October 29. Went to Charsadda for the day with Lankester. This is our biggest out-station, which was opened only this year. An assistant lives here, so it is always open.
Charsadda is a large town on the banks of the Swat River, twenty miles from Peshawar. Already there are 150 to 200 patients daily. The drive out is very pretty--one crosses over no less than five bridges of boats.
December 28. A party of Australian cadets, on their way round seeing India, came to Peshawar, and to-day to our hospital. They were most interested in everything. A case yesterday of a poor Haji returning from a pilgrimage to Mecca to his home in far-off Turkestan. He got his foot crushed by the train at Pindi, and has had it amputated here.
December 31. So the year ends My first in India. What a year of experiences--new of every kind; new friends, new surroundings, new work, new language, new peoples, new difficulties, and new enjoyments. This first year, or rather a part of a year, has been one of impression rather than of expression. To a newcomer many things appear so strange, especially in the upside-down East, and ways and practices are not at all what we expect. To a new man there are some trials in separation from home when those at home need your help, but the sacrifice is a small one to make for Christ and these people. I wish more young men could know the joy of the life and work out here, then they would not hold back.
He expresses most nearly what he felt, though he had then been hut a short time in India, in the words of St. Paul, which he quotes on one occasion as the entry in his diary:--
Even the sacrifice of my life I count as nothing if only I may finish my earthly course, and be faithful to the duty which the Lord Jesus Christ has entrusted to me of proclaiming as of supreme importance the good news of God's grace.
Just seven years later an English padri expressed the same thought in more modern language, when, speaking of Starr's death, he said: "I think if it had happened to me, and if I could have known before hand, I should have funked--I think several of us I would; but I honestly think if Starr had known beforehand, there would have been no thought of shirking; he would have been quite glad to give his life thus, if he knew God had asked of him." Starr meant it when he once said: "If the service of God is worth anything, it is worth everything"; for he had that reckless faith that makes no calculations as to how much of time, money, or personality God shall have. "God does not ask much of you"--was a phrase repeated sometimes in an address; then softly after a pause he would add: "but He asks all." His was not that common enough religion possessed by the majority of Christian folk, which most unfortunately is mistaken for Christianity. Certain it is that this reckless faith which stakes all for God results in that sense that nothing can hurt--that nothing, even death itself, "really matters," because it but brings us back to God. This is perhaps in practical form what Christ calls His legacy: "My peace, which I leave with you."
The year 1912 was well in advance of all previous years for numbers. In this year he was able to arrange some classes for the assistants to help them to know more about their medical work, and so to take a keener interest in it. He also took on the small Sunday class composed of the children of the married assistants, and so began his first work in Urdu, though he could not yet speak freely.
This is a strongly entrenched Mohammedan district; most of our patients are quite uneducated, very ignorant, and entirely under the power of mullahs. From the artistic point of view they are always interesting, and many extremely so from the medical side. We wish they were as interested in our message as we are in them! As education and contact with the West spreads, how ever, prejudice is being removed; and some day, we, or those who come after, will see the fruit of many years. This is still the time of ploughing and sowing.
The following story gives an idea of the power the mullahs have over the common people. A young man was brought to our hospital by his father, brother, and friends. His leg was badly smashed up by a bullet through the thigh, and he had had severe h His friends knew as well as we that the only thing to save his life was to amputate the leg, and he himself was willing for this. After having agreed to it, they decided it must not be done till the mullah of their village had given per mission, so two men went off back to their place to get the necessary leave. We explained the danger of the delay, suggesting that the operation be done while the men were away; but they would not hear of this. Secondary haemorrhage again occurred, and the friends returned with the permission for amputation only in time to take the patient out of hospital in a dying condition.
If a patient is obviously dying, his friends generally wish to take him out, so that, if possible, he may die at his home. Many think it is unlucky to die in hospital.
Sometimes we lose cases who would otherwise get well, through the relatives getting a sudden scare that the patient is worse, when they frequently clear off without permission.
1 January, 1912. I saw the Proclamation Parade--a very pretty sight, the long line of troops and the background of hills interspersed with snowy peaks. All Peshawar seemed to be there. I passed a number of Turkestanis returning from the pilgrimage, or Haj. They were of Mongolian type and like the Ladakhi in dress. I thought if these men will go so far for a dead prophet, how much more would they do for a living saviour if they knew and understood.
January 2. A woman at out-patients to-day with an interesting story. Her husband is in Tirah and cannot move from his village because of a blood-feud. He is to be sent to Australia by the Government, as his life is not safe, and he is quite an important person. Even the woman herself is scarcely safe but she has got safely down to us, her sister bringing her.
January 16. I found a man with his bandage and dressing off and both wrapped up in his dirty turban, while his wound was exposed. He said he only wanted to see it
January 24. Played footer after hospital with the boys and shot a goal.
February 6. There was a good crowd at the Anjuman to night, nearly 100. They were attracted by a Christian fakir, who has been travelling on foot all over India and Burma for the past twenty years. He certa.inly speaks well.
February 7. Operated on a man who had bad a lead bullet over an inch long in his foot for two years.
February 8. While Cox was operating on a very young baby, its mother sat outside the theatre brandishing a huge carving-knife to keep off the evil eye! It is a common custom for a woman to carry a large knife, dagger, or sickle about with the baby for forty days from its birth, to frighten off the evil spirits which might otherwise harm the child. So they often come up to out-patients, a knife in one hand and a small baby in the other! Another quaint custom to do with babies is that for the first three months of life they are kept firmly tied up--"to keep them," they say, "from getting tired." A length of cloth and stout cord is bound round the child, whose arms and legs are thus kept straight, and the whole of its small person as stiff as a board. They are undone occasionally
February 21. Had a young man brought in who had had both eyes gouged out and one thumb cut off by his friends, because they wanted his field, and so did he! And next day a bad bullet-wound case----a man who had been shot from the roof at close range; one bullet bad gone clean through his shoulder, and the big wound in his thigh was full of debris and clot.
March 1. Went down to the city to see the holi procession, one of the chief religious shows of the Hindus, of whom there are a number living in the city. I was guided by some Hindu students from the college. In the procession boys were dressed up to represent various Hindu gods. I get little time for medical reading. To-day I gave a class on bacteria and showed the boys specimens under the microscope.
March 16. A heavy day. The spring rush is on. Dr. Lankester was at this time on furlough, and Drs. Cox and Starr carrying on the hospital work. Looking back on the events of the next few days, he writes:--
Whilst all appeared to be going well, there happened one of those events, in the providence of God, but so inscrutable to us, the tragedy at Bannu. Peshawar being the nearest C.M.S. station, was called upon to render help. I went as soon as the news reached us, only to hear that Dr. Barnett had passed away, and they were just returning from the cemetery when I arrived. Dr. Pennell was in a very serious condition, but I was allowed to sit with him for half an hour. Cox arrived the following day. Hospital was very full, especially of cataracts: we went round the wards and helped. Sister Fagg was splendid: that night we all stayed in the drawing-room till midnight, and prayed. Just as the reveille sounded at 6.30 in the morning Pennell died. The news quickly spread, and soon we had a great crowd in thecom pound. Over a thousand must have seen him lying in state dressed in the Pathan clothes he loved to wear. The funeral was the same evening, all Bannu attending. The most awful day in all my memory.
When Dr. Pennell died, both at Bannu and Peshawar the work was at its height, for March is the busiest month of the year. There was some difficulty in providing for the two stations, as five of the senior medical men of the C.M.S. were then at home. It was decided that Dr. Cox should go to Bannu, and Turner and Starr to Peshawar, and between the three of them the two stations should be carried on during the summer. But in Easter week, while in Bannu, Starr managed to come out with scarlet fever, and although not in the least ill, had to be isolated for several weeks. This was an added difficulty, ending in his staying on to work in Bannu until his summer leave. The work there gave them all much anxious thought, and Starr much new experience.
On July 14 he left Bannu for his needed holiday, driving for thirteen hours and a half by night to Kohat to avoid the great heat, and reaching Peshawar next day. On his journey from Peshawar he had driven over to Bannu via the steep Kohat Pass to save time, taking the ninety miles in two days. The Kohat Pass he describes as wilder than the Khyber, and very grand: "A border road where every mud-house is a walled fort and every man carries a rifle." It was strange that at the time of the tragedy in Bannu, Peshawar was called to render help; and just six years later, when the Peshawar mission was stricken, it was Dr. Cox whom Bannu gave up to return to his old work, and who is now carrying on in Starr's place.
From Peshawar he left with two friends on a tour up the beautiful Khagan Valley, camping by night Or putting up in a rest-house, and marching by day along the bare hill-side, on through pine forest, till they were out of the heat and in the cold bracing atmosphere of the mountains. By 8 a.m. on August 5 they were at the top of the pass, 13,700 feet above sea level. A panorama of snowy peaks met their view, the 28,000 feet of "K. 2," and straight to the East the 26,700 feet of the famous Nanga Parbat. "The morning light caught the peaks, lighting them up till they seemed to present all colours." Starr was rewarded by a perfect photograph, one of his most prized enlargements. Unfortunately, as the baggage mules came down the slope, one slipped over the edge into the torrent below and was carried away and drowned. Its load was recovered later. A list of the books read on this holiday give a sidelight on Starr's love of reading and his old habit of self-education through all kinds of instructive literature. They were: Prescott's "Conquest of Mexico," Dickens' "Dombey and Son," Bousinne's "Memoirs of Napoleon," De Quincey's "Confessions of an Opium Eater," and the "Confessions of St. Augustine."
On September 14 he was back in Peshawar, glad, as he says, to get back to work, and soon in the thick of it.
7 October, 1912. A man came up on Saturday, but went away again. To-day he returned, this time bringing seven six-foot Kabulis with him. Three of them stayed in the theatre, and saw me crush the stone, which took less than ten minutes. They were greatly delighted, and say they are going to take it to the Amir. They have come down from Kabul, 190 miles, mainly to back up their friend. To-day another young fellow bought both a Pushtu and a Persian gospel.
October 12. To-day a feeble old man came in at 7 a.m.; an abdominal case. I operated, Turner giving the anaesthetic.
Took an hour. He began to improve by 10.30. Took it out of me a great deal.
November 1. Dr. Lankester returned; Turner left same week.
November 23. Repaired the nose of a young fellow, making a new bridge to it. It had been cut off by his enemy in revenge.
November 26. An interesting case--a man stabbed through the thigh; he refused operation, but I think he may live.
November 20. Another poor fellow, an Afridi, who had been stabbed in the eye, but he would not let me operate to remove the eye.
December 24. Whistled carols to myself in bed. We have had twenty minor operations in two days.
December 31. Sat up with Dr. Lankester to see the old year out and the new in,
The year 1913 was less chequered than 1912 had been, though as regards work it beat all records. In the former, Starr had worked at Bannu and Srinagar hospitals, as well as at Peshawar, where he belonged; and in this year he for shorter periods helped at Shikarpur and Quetta. "I have now seen all but one, and helped iii all but two, of our main mission hospitals," he writes.
It was a difficult year from many points of view. One could feel a dead weight of opposition, produced no doubt by the Balkan War, and fanned by false newspaper reports. The chief event of the year in the annals of the mission was the visit of the house surgeon educated Christian, who had already worked about ten years on the frontier--to his home in Nuristan, after an absence of thirty years.
Dr. Robertson (later Sir George Robertson), British Agent in Gilgit, had found him when he was quite a little boy, and brought him down in 1895 or 1896, on his return from the expedition to Kafristan, The boy was educated at the Batala High School, and then took his medical course at Agra. He is the only Kafir Christian. This visit to his home was made possible by some of his relatives coming to the hospital for treatment, his own brother being among the number. He thus again got into touch with his family, and though it was a perilous under taking for a Christian to venture into the heart of Afghanistan, he nevertheless returned with them. On one occasion he was brought before a public assembly where he was being cross-questioned about his beliefs, and was even in danger of losing his life, when an Afghan present protested, saying: "This man is a good man--it was in his hospital at Peshawar that I was cured." This turned the tables, and he was allowed to depart. In many other places on his journeyings he was knocked about badly, but he was kept from actual hurt and returned safely to Peshawar, after being away five months. That he should be the only Kafir Christian is peculiarly sad, when it is remembered that at one time the people of Kafris tan were not Mohammedans. This tribe actually asked that missionaries might be sent to teach them of Christianity; they even petitioned that they should be taken over by the British, but Kafristan was ceded to the Amir, and thus the way into it was definitely blocked to any Britisher. The people were then forced to accept the faith of Mohammed, and the country was renamed by the Mussulmans "Nuristan," or "The land of light."
On 3 January, 1913, Starr writes:--
I did ten operations, and was kept going all day. I have had twenty major operations in two days. Dr. Lankester left for Bannu.
January 6. Went out to see the Khan of Lundi's son. Back to find the out-patient hall quite full I
January 31. Did four hernias straight off--a heavy day for January.
February 24. Left for Shikarpur.
"Shikarpur" needs some explanation!
Seth Hiranand, a wealthy banker of Shikarpur (a large town in Sindh), for some years had been paying the fares of poor people who had cataract to Quetta, that there they might be operated on in the C.M.S. hospital by Dr. Holland. One day the thought struck him, Why should not Dr. Holland come to Shikarpur and operate on the poor there? He accordingly, as an experiment, invited Dr. Holland to come down for ten days, and thus the work was begun in quite a small way. The agreement was then made that the Seth should put up permanent buildings, while the doctor would undertake to come for six weeks annually for the next five years. The next year, therefore, the Seth opened an eye hospital in Shikarpur, building opposite his own house a block comprising two theatres, with consulting and dressing rooms. This has since been opened annually for from four to eight weeks, and has become so well known that patients have come from as great a distance as the Arabian coast. The work is carried on, under Dr. Holland, by as many of the mission doctors as can be spared from the different stations, with the occasional extra help of one or more R.A.MC. officers. The Seth pays the extra cost of food for the patients and for all their friends who accompany them. The size to which the work has grown may be gathered from the fact that on 24 January, 1916, the food supply for the one day was estimated at fourteen maunds (or 1120 lbs., half a ton) of rice and eight maunds (or 640 lbs.) of ata, the common brown flour which the poorer people use.
The wards are empty white-washed offices at the back of the Seth's house, and open straw-roofed sheds are put up ad libitum in the grounds, till all are somewhere and somehow housed. The weather at that time of year is almost invariably fine, so that an open-air life is both healthy and pleasant. The English staff is housed in an adjacent bungalow which is lent for the occasion. If the wards are "elementary," the nursing is still more so, and yet the work is completely successful. A few days' numbers give some idea of the amount accomplished. Starr helped at Shikarpur in 1913, 1914, 1915, 1916, and 1917, the last time accompanied by his wife.
Of 1913, his first year, he writes:--
March 10. 123 operations, and 450 out-patients. Of the 123 operations seventy-three were for cataract.
March 11. Sixty operations.
Starr records that he did thirty-seven cataracts during the morning, and that many hernias had to be turned away. He left that night to return to Peshawar, feeling that "Shikarpur stood for work, enjoyment, and valuable experience combined."
In 1914 he records:--January 12. Sixty-nine operations, 240 out-patients.
January 15. Seventy-four operations, and only two doctors present for this day's work
January 17. 100 operations, of which many were hernias. January 26. 114 operations, and 706 out-patients. February 2. 129 operations--our record day so far! The round now took a full two hours; we were frequently operating all day till dark, and were all very tired at the end of it and very cheery.
By 1916 the work had grown to such proportions that on January 24, the record day of that year, 166 operations were performed, and 747 out-patients were seen by a staff of three doctors, two nurses, and their Indian helpers. Readers who, like the writer, have worked in "Moorfields," or some other well-known eye hospital in the homeland, may find the above figures hard to believe; hut they are taken from carefully kept records and are absolute fact.
Starr returned from Shikarpur on March 14, just in time for the second medical conference, which began that day.
March 18. An old white-haired man came to out-patients, who had had both eyes operated on for cataract by Dr. Pennell. He came to know if we could give him special spectacles or do anything to enable him to use his rifle, as he wanted to kill the man who had killed his son. He himself had numerous bullet w about neck and head, and a bullet in his chest I do not think I have seen a more pathetic case of this awful blood-feud system.
April 4. Nazir Ullah left for Kafristan.
May 19. Did a goitre and several major operations by myself. Getting hot; feel rather washed out.
June 11. A poor fellow brought to the hospital with gangrene of arm, shot five days ago through the forearm. No less than four goat-skins had been applied. There is no hope for him, as the gangrene has spread over his chest.
June 17. Had a narrow squeak cycling through the city, which was very crowded. I was knocked off by a horse, which rolled over me. However, no harm done, except to my cycle.
In July he went to help for a short time at Quetta, and on to Kashmir for his holiday. He cycled all the way in, as he had the first year; but this is a very different thing in the fierce heat of July as compared to the more temperate warmth of May. This year he and the same two friends of the previous year's holiday explored the Lidder, thought by many to be the most beautiful of all the valleys of Kashmir, though among so much beauty it is indeed hard to choose. They went on to the Kolahoi Glacier and over the Yamher Pass into the Sindh valley to Sonamarg; but as he did the same tour over again in 1917 with his wife, the fuller description which it warrants will be found later. By September he was back at work, and on October 8 writes:---
I am beginning to get abreast of arrears of work, for the drug and dressing indents are made up and sent off, and the instruments in use or in stock throughout the hospital listed and checked.
On October 11, while Dr. Lankester was away, he took his second Urdu examination, but under some difficulty. The grammar paper was in the morning, and at midday, as soon as it was over, he was called to see an accident case in the city. He arranged that the man should be brought in for operation that afternoon, and took his second paper during the afternoon. He was sent for, however, at the close, and rushed off to find the man was unconscious. The patient stopped breathing before the operation could be begun, and, he adds: "In spite of artificial respiration for just on an hour, I could get no result." No wonder he ended the day with a bad, headache, although lie passed the examination!
On 24 November, 1913, the new Sister for the hospital, Miss Lilian Wade, arrived from England. She was the daughter of the Rev. T. Russell Wade, who was for forty-seven years a missionary of the C.M.S. in India. Though he spent many of his years in Kashmir and the Punjab, he had come out first of all for Peshawar in 1863, and lived and worked there during his first few years, not wholly without adventure in those early days. It was therefore especially suitable that Miss Wade should be sent to Peshawar; and with reference to her coming Starr wrote:--
The nursing of our patients is one of the most difficult problems of all--in fact, there is no nursing in the proper sense of the word. Things are naturally very different from home, and the training of our men and boy assistants is, in my opinion, one of the most trying and yet most essential parts of our work. One has sometimes been disappointed after trying one's utmost, and per haps performing a difficult operation, to find a patient has slipped through one's fingers through inefficient nursing. The Indian lad may be keen to be a doctor or dispenser, but the actual work of nursing he somewhat despises, little realizing how much depends on it. Almost the whole time I have been here we have had no nurse, and the prospect of having one is very welcome.
Not many days after her arrival he felt that she would be a help to him in other ways beside the work; but it was not till February of 1915 that they became engaged.
At the beginning of 1914 he again went to Shikarpur. He writes
In January I had the pleasure and privilege of going again to help Dr. Holland for, in all, five weeks. It was very hard work, but very delightful. We worked from 8 am, to 8 p.m., with only short intervals for meals. I thought that this year there could not be nearly so many patients; but instead, all previous records were broken--as many as 120 operations being performed in one day. Several other days there were over a hundred operations, while on one day we saw seven hundred out-patients. These were all actually seen by one or another of the three doctors. Not least important, as many as eight gospel addresses were given in one day as the people collected, and in all some 1500 gospel portions were sold.
By February 11 he was back in Peshawar, and on March 7 he performed the difficult operation of laminectomy on a young man who had fallen off a ladder and injured his spine. In April he went for a short visit to the Dera Ismail Khan hospital, and found the journey there rather a unique experience. A bridge was broken; so leaving his vehicle, he and other passengers were towed up the river for some hours and were then rowed and punted across the various streams. They drove through other streams, in one place almost upsetting by sticking in a sand-hole in the river-bed. Owing to heavy rain and the rapid rising of the Indus, about five miles of land were under water. "We passed a herd of camels; several had fallen into the river, but managed to get out." He was there for Easter Sunday, April 12, and next day they were all horrified to hear the tragic news that Major----and Captains B----and H----had been shot on the Sunday evening while sitting outside the mess at Tank, not many miles off. It was, as he wrote, "a most serious business."
In May, 1914, Starr, though a junior of little over three years' standing, had to take over the entire charge of the hospital from Dr. Lankester. He wrote:--
Having now worked with him for nearly four years, I feel his going very much. It is a great blow, too, to the medical mission after his seventeen years' work here.
Starr remained in charge from this time until his death in March, 1918. He had the valuable help, more than once for considerable periods of time, of Dr. Janet Vaughan, also of Dr. Richardson for a year and a half, and of Dr. Lavy, of Baghdad, for 1915. The English nursing staff consisted of Miss L. A. Wade (from the end of 1913) and Miss F. M. Clarke (from the beginning of 1916). But Starr greatly felt the need of a medical man who should be permanently located to Peshawar as his colleague in the work, to share the tremendous responsibility which he felt so keenly. As a friend later said of him: "It has made him older than the years warrant." If it is true that "the only work a man does is the giving out of his life upon other lives, nothing else counts as work at all," then Starr knew what work meant, for he threw his whole soul into it, and found life too short for all there was to do. In the spring of 1913 he wrote:--
During the greater part of this last winter we had the very valuable help of Dr. Janet Vaughan. It may be wondered why there is need for a lady doctor in this hospital when we have already a well-staffed Zenana mission hospital in the city, besides the two separate civil hospitals for men and women. The facts are that the transfrontier people, who make up the majority of our patients, are not purdah as regards their women, who often will not go into the Zenana hospital. They come with their husbands or brothers as helpers, and as these cannot stay with them in a purdah hospital, a great number of them come to us. We cannot turn them away, although we have no special wards or arrangements for them. In the case of small children, both parents, and often other relatives, insist on staying in with the little patient, and this is why the serai (or family wards) is the ideal mode of accommodation for them. Then, again, we have a few rooms upstairs for Hindu women patients. These come in with their whole families, as being Hindus they have their own cooking arrangements. We only "cater" for patients, and the cost of their food is on an average two and a half pence per head per day.
At the end of 1913 he wrote:--
I am still struggling with my first language. Would that people could realize how difficult it is to carry on medical work with no reserve forces. It means that men never get real time to devote themselves to the language. I have not been able to even begin Pushtu, the language of the majority of our patients. This year we have beaten all records, and had 350 more in-patients than in any previous year. The help of Dr. Janet Vaughan has made it just possible for me to carry on the work when I have been alone. Having now worked in all but two of our hospitals, it has been a most valuable apprenticeship for me; but in some ways I feel I am not reaching my personal or hospital ideals. If Christ is not first in my life, He will be last.
The knowledge gained in those early years, when as a boy he studied and practised chemistry, now came in most usefully. He taught and superintended the dispensers, made up a small pharmacopoeia which he found fitted the work in the hospital, and on many occasions was able to help and advise other doctors who had not spent the years he had at that particular branch of medicine.
An important part of the doctor's work is the upkeep of the buildings and superintending of repairs. Starr was ever on the look for improvements, and in 1915 had the walls of all the wards redone with good English washing distemper, a cool green in colour: this was a tremendous improvement, not only in appearance, but from a sanitary point of view. Solignum (a brown stain) was applied to the wood-work of all the hospital buildings to check the ravages of the white ants. "The out break of the European war in August, 1914, came as a great shock to all, and we realized that it would sooner or later seriously affect our hospital work." Starr's business qualities and methodical ways enabled him to cope with this serious difficulty.
Not only did he keep things going, but an achievement which is well worthy of note is the fact that in the four years in which he was in charge, in spite of the fact that it was war-time, he wiped off the debt of Rs 4000 which lay on the hospital when he took over charge. It will be seen that this was no light task, for less money was coming into the hospital funds through private patients than heretofore, since it was impossible for one doctor to take private cases and run the work of the hospital; while the expenditure was increased, as, owing to the war, drugs, dressings, and other stock had enormously gone up in cost.
He feared that the income of the hospital would inevitably be decreased, but bed-supporters and friends at home "carried on" in such a splendid way that all such fears proved to be groundless. The increase in the cost of drugs, etc., and the delay in obtaining them which every hospital felt, were not the only difficulties at Peshawar which resulted from the war as time went on. The boys of the staff, one after another, left for war-work, attracted by the chance of experience and adventure and by the salaries Government were offering--very large in comparison with what they had been receiving in mission employ. They easily obtained posts as dressers and compounders for Indian hospital units, and some are still working in Mesopotamia. It was a pleasure to see how acceptable these Christian lads proved themselves, for in almost every case they had come to the mission hospital and received all their training there; so those at Peshawar felt that by setting them free for war-work they were in a small way doing their bit. A novel encouragement was the interest that during these years many of the English soldiers, who were stationed at Peshawar, took in the hospital. Parties constantly came to see over it, brought by one or another of the men who had been before; others gave us real help by working the magic lantern at the hospital services; and others again who knew a little Pushtu enjoyed chatting with the patients as much as the patients did with them. Some British N.C.O.'s are together supporting a bed in a mission hospital, while a corporal, before leaving Peshawar, gave his savings and his bicycle "for the use of the hospital." The special help that some of these men rendered at the time of the doctor's death will never be forgotten.
In October, 1915, came the doctor's wedding, from the hospital, about which one who was present remarked that it was the most original one he had ever seen The beautiful oriental mission church in the city was filled with the many English and Indian guests, and had been decorated with white oleander and aloe-bells and arches of tall date-palms. After an eight days' honeymoon in the hills, Starr and his wife were both back at their work in the hospital, for, as the doctor wrote home with his usual enthusiasm, "we are comrades and fellow-workers, besides all the rest!"
During the winter of 1915 they were a large and merry party, for the Rev. (now Bishop) J. H. Linton and his family, obliged to leave their work in Persia owing to the war, had joined them. The winter was full of happy work, but broken by the sad death on the eve of Christmas of the wife of Dr. Lavy, Starr's colleague in the hospital.
Each autumn, before the winter's work begins, a convention is held at Sialkot by the missionaries of the American and Scotch societies, at which large numbers of Indian Christians of every class and rank meet together. Not only are the meetings and the addresses a help to all who attend them, but the sight of such a large body of Christians--sometimes as many as three thousand---gathered together in one place for one purpose, is a stimulus in itself. The wonderful organization and the quiet calm which pervade the place speak wonders for the workers, and reveal the spirit underlying the work. Starr arranged that the members of his hospital staff should attend this great gathering, and he and they were there in September of 1915, 1916, and 1917. He wrote of it as "The Keswick of North India," and greatly valued the opportunity for refreshment which it brought, the friendships formed there, and not least, the unity among the different divisions of the Christian Church in the mission field, which it showed.
Owing to serious thefts in the hospital in the previous year, the doctor felt in 1915 that he could not leave the hospital for his full six weeks' leave at one time. They had arranged to leave Peshawar on the first of July, but on the night before another theft occurred, which, from its humorous side, is worth mentioning. Very early in the morning hospital servants came to rouse the doctor, who was sleeping on the roof of his bungalow, to say that the strong brass padlocks of certain store rooms had been cut through and that various things had been stolen. He hurried down to find that a large store of bandages had been taken, and among other things the box containing the specimen skeleton used for instructing the junior hospital staff. An unwary thief had not observed that one or two of the bandages had unwound and caught on the rose hedge in his hasty retreat, and these showed the line of his path through the garden and over the wall. The doctor was soon over the wall also, and there lay scattered the valuable bones! The polished mahogany case into which they were fitted had convinced the thieves that the contents were of great value, and their chagrin must have been great when they found it contained human bones. It was an amusing sight to see the doctor, the cook, and the gardener, who both had followed him, returning in triumph bearing the recovered trophies. During Starr's last four years on no less than eight occasions serious thefts occurred in the hospital. It is a Pathan's pride to he a smart thief, and in the art of thieving in particular "practice makes perfect." Leaving on the first of July, Starr was back at Peshawar on the first of August, but a good deal had been accomplished in the month. Both the doctor and his wife were athletic, and to them mountain climbing was an ideal holiday. An adequate description of Kashmir cannot be attempted here, but in their summer leave in three successive years, 1915-16-17, they managed to see more of it than many accomplish in a longer time, enjoying the free camp life and the beauty of mountain, lake, and valley to the full. One year it was to the five lakes between Sonamarg and Hararnuk, mountain tarns lying half hidden at the foot of dark rocky peaks and fed by mysterious glaciers, whose white snouts almost over hung the d blue water below. The next year up the Nauboog and Wardwãn valleys and over the fifteen-thousand-foot pass by the Shisha Nag (glass like) lake into the Lidder Valley. A friend who accompanied them on this tour writes: "I can see in my mind now both of them suitably rigged out in khaki, and always accompanied by Murphy, their little khaki-coloured dog, steadily climbing the steep mountain-side to the snow-level, over ground carpeted with edelweiss, blue gentian, and other alpine flowers in profusion---and no more supremely happy trio than they ever existed!" Another writes later to one of that trio "A picture comes before my mind of you both, walking down the road from Kashmir, so happy and so sunburned and well, offering us milk and buns when we were all held up by a landslip. You were just going back refreshed to your work in the Peshawar heat, and I thought to myself how splendid to work shoulder to shoulder as they do."
The summer of 1917 saw them--a party of five in all--climbing over the snout of the Kolahoi glacier, and on to a shoulder above from which the four-mile-long ice river could be seen below, while the great north peak of the mountain towered up behind, its almost eighteen thousand feet of dark rock and dazzling snowfield standing up into a cloudless blue sky. Memories of such holidays can never be forgotten, for they were true recreation, above all things suited to re-create body, mind, and soul for the next year's strenuous work in the plains below.
In 1916 a large section of country to the north and north-west of Peshawar was under strict military blockade, owing to the Mohmand rising, so no patients came from those districts for some time. This considerably lessened the number of out patients, and yet, owing to the shortage of staff, the winters of 1916 and 1917 were increasingly busy. There are indeed few better places for practice in surgery than a frontier hospital. The following statistics for 1917 show the amount accomplished, and give some idea of the variety and scope of the operative work. This was the last complete year of Starr's life, and for most of it he was alone.
Total number of in-patients 1409
Total number of out-patients 32,217
Of which men numbered 21,941
And women and children 10,276
Major operations in the year 793
Minor operations in the year 1654
Of the major operations, cataracts numbered 318; nearly 100 more than in 1916.
Other major operations were amputations, largely due to septic bullet wounds; stones; diseased-bone cases; tubercular glands; goitres; and abdominals, including hernias.
Starr, writing only a few weeks before his death, of the work during 1917, says:--
The spring of 1917 was, I think, the busiest I have known, especially for cataract operations. By May we had done two hundred, which is as many as in a whole ordinary year. Professionally the work is intensely interesting, and it was very happy in many ways. Some of the patients are extremely grateful, not always those who have had the most difficult and successful operations performed. One specially grateful case was a man from Kabul, with an old-standing ununited fracture of arm, which was cured very successfully by a four-inch transplant of bone from his leg to his arm by one of the newer methods. As far as possible, with so limited a staff, we have tried to keep our work Lip to modern requirements. The patients still come from very long distances to the hospital and are almost entirely surgical cases. The actual number of major operations performed in 1917 was 793, fully a hundred more than in 1916. Of these 318 were for cataract--that is, eighty more than the previous highest record. Medical cases will not, as a rule, stay long enough in hospital to be really improved. Once a week during the winter, and sometimes during the summer, we have a lantern address in one of the wards on the life of Christ, which is greatly appreciated, and sometimes intelligent questions are asked. Owing to my being alone, no new work has been undertaken during the year, and no itineration has been possible, nor have I been able to visit Charsadda more than three or four times during the year.
During the winter of this year a case was in the hospital whose striking story shows, not only the lack of morals which exists among the Pathans, but the very small value they put on human life.
A rich Pathan, head of his family and well known on that part of the frontier, was brought to our hospital with three severe bullet wounds. He told us their history himself. He had fallen in love with his aunt, who was not young, but very beautiful. He sent to ask her to come and live with him, but she replied that she was afraid of her son's anger, otherwise she would come. Upon this the man sent and killed her son, and then repeated the invitation. This time the lady replied that she was yet more afraid of his two sons, so dared not come. Our friend killed both of his own sons and again sent for her. This time she replied that if he could treat his own sons thus, what might he not do to her? She knew what that answer would mean, so went to two friends to plan for his death. These hired assassins laid wait for him near the road into Peshawar on the day when they knew he would be coming into the city to receive payment which was due to him, and shot at him from behind the rocks. He was brought to our hospital, and the would-be assassins were caught. When, however, they were accused of shooting in British territory, they cleverly replied that they, when they fired their rifles, were on the rocky hill-side beyond the road which marks the boundary, but the man they shot was, when the bullets reached him, in British territory, being on the high road!
A word must be said about the cataracts. These are mostly old folk, men and women, who have heard in their far-off homes in the mountains of the fame of the Angrezi Hakim (English doctor) who can give "new eyes." Perhaps they have met some one who has had his sight restored, so they are determined to have a try toot To them a journey on camel or pony back down from beyond Kabul, the capital of Afghanistan--190 miles from Peshawar---is a perilous undertaking How many weeks will it take to get there? How long will they be detained? What will be done to them? Will their herds and lands be safe from plunder in the absence of their husbands or Sons who must go to take them? And when all is accomplished, will it be of any use? All these questions have to be faced, and for old people, who for many years have never left their homes in the mountains, it is indeed no light matter. Even the journey is not always with out adventure, for there are only two days of the seven when the Khyber Pass is guaranteed safe for travellers: it is then guarded by men of the frontier tribes, who on the other five days may themselves be the raiders; and by the Khyber Rifles on the British side of the border. But they do come, and eventually arrive at the big gates of the mission hospital. They are seen in turn and admitted; next morning something is dropped in their eyes--something is in a moment done to those eyes of which they are hardly aware, and they are asked to count how many fingers the doctor is holding up! [The operation for cataract is almost invariably done under cocaine.] This done, darkness again, and several days of suspense till the bandages are finally removed, the eyes are tested, and the patient eagerly tries to see what he can see. Cataract cases are usually grateful; to get back their sight to them means everything. There is no better employment for the blind man in the East than to follow Bartimeus of old, and sit by the way-side begging. This occupation, by the way, has been known to be very remunerative. Another cataract case, not an old man, but a wee boy of 6. His father, who had been blind for twenty-two years, brought his little son, who was blind also, to the hospital. Both had double cataract--the man having become blind when he was 8 years old, and his little son at 3. They had come from Lughman, away in the heart of Afghanis tan, where they had met a man whose eyes had been operated on in this hospital. Both got back their sight, and it was pretty to watch the little child running about laughing with delight and catching at any brightly coloured objects which attracted him. Our results show that during 1917 the number of cataract cases which were unsuccessful was only two per cent. Because such a large proportion of them are completely successful, their faith in the doctor is extraordinary, and many quite hopeless cases are brought to him. Their disappointment, when they are told that it is quite too late and nothing can be done, is often pathetic, and "It is fifteen years since I saw the face of my son, but they told me you would give new eyes," is perhaps the answer. Spectacles are greatly treasured, and if considered too valuable to be worn, are triumphantly carried off wrapped up in the mysterious folds of their garments. If the case has to be entered as unsuccessful, it is not always the doctor's fault I More than one has been known to undo the bandage shortly after the operation, for if he has "new eyes" he does not see why he may not use them. Again, to hasten recovery they some times apply their own treatment on the top of the doctor's. Before they come to hospital they have probably visited a ziarat, or "holy man's" shrine. There the rascal in charge has applied some charm or treatment to work an imaginary cure, and got what return he could out of them.
One patient who, after visiting various famous ziarats, came on to the mission hospital as a last resort, and actually brought a little of the "holy earth" from a shrine with him, wrapped up in a twist of cloth. The day after his eyes had both been operated upon, he quietly removed pad and bandage popped some of the "holy earth "into his eyes, and bandaged them again to the best of his ability. Needless to say both eyes were lost--and the old man wondered why. So much for cataracts.
Bites, too, abound. Most of these are camel bites, and these, as those who have had the dressing of them well know, mean extremely nasty wounds, owing to the curious side-ways movement of the camel's jaws. Dog bites, mule or donkey bites, and, sad to relate, "lady bites," are all common enough. Stone is very prevalent, and often occurs in quite tiny children. In the "Lancet" of 9 August, 1913, there is a photograph of a vesical calculus stone weighing a full six ounces; its length was four inches and a half, breadth two and a half, and circumference six and a half. The operation was performed by Drs. Holland and Starr at Shikarpur, and the patient was a young man of 18.
Amputation is due to malpraxis, as well as bullet wounds. A boy of 12, only son of a devoted father, who was a rich landowner and lived only twelve miles away, was brought to hospital with his arm so gangrenous that immediate amputation was necessary, and that only gave him a sporting chance to live. It was at first a simple fracture, the result of a fall, but the barber--who is usually the surgeon as well--had applied home-made splints of wood, bound as tightly as possible to the arm, and these had not been loosened since the accident eight days previously. The child had suffered agonies, and was brought to us at this stage as a last resort. He died of tetanus (lockjaw) three days later; the result of infection introduced before he reached the hospital. The poor father was broken-hearted, but came up to the bungalow to thank the doctor once again for what he had done for his boy.
These are types of the cases met with only too frequently in the mission hospital. That is the quality--the statistics given show the quantity. Here is the actual operation list taken at random of a single day in the busy season:--
1. B. Ward No. 3. Double cataract.
2. Serai 5. Left cataract.
3. Edwardes Ward No. 5. Left cataract.
4. Serai 1. Double cataract.
5. Serai 2. Double cataract.
6. Serai 28. Double cataract.
7. Serai 21. Iridectomy and Peritomy.
8. Serai 2. Glaucoma.
9. Serai 4. Entropion.
10. Serai 32. Hernia.
11. Serai 1. Hernia.
12. J. Ward 18. Contracted knee.
13. E. Ward 12. Tumour.
14. E. Ward 7. Tubercule of Tarsi.
15. J. Ward 1. Tubercular disease of foot.
16. Serai 32. Calculus.
17. Serai 34. Calculus.
18. Serai 36. Haemorrhoids.
19. E. Ward 1. Urethral fistula.
20. Raban Ward 5. Urethral fistula.
And so the days are filled with work, or over-work, as the case may be. Never let a man think that any surgeon takes up medical mission work because he cannot get a better job! Professional efficiency does not necessarily mean professional celebrity The scope of work in mission hospitals requires the best men, equipped in every way--and it gets them. No brilliant talents will there be wasted, for the practice is excellent; and besides, the highest and the best is too low and too poor for the Master's royal service. There is no romance about the work, and the routine may seem dull and monotonous at times, although the cases vary so much that there can be no sameness in the work itself. The people for whom the work is carried on are probably black guards--though attractive ones at that. And they do not want the Gospel (few folk ever do!)--though they need it, and do not know their need. All this is, however, beside the point, in the face of "the marching orders," Christ's last command--and, as the old Scotch woman put it, "There is no slippin' out from under yon." If the remuneration appears. small, it is in reality great, for it comprises the joy of service in this life, and the Master's "Well done!" in the world to come. So much did Starr realize the comparative value of the work and its reward, that he copied and underlined a quotation which reads: "I regard self-sacrifice as getting something for nothing."
Of so-called spiritual results little can be said, for what is apparent is no gauge in this matter. In the last four years four men have come out for Christ as inquirers in Peshawar. Of these, two--one a Pathan and one a Hindu--have remained true; one has recanted to Mohammedanism, and one who had not even been baptized was killed by his own father because of his new faith. The mass movements towards Christianity in the Punjab and other parts of India are indeed wonderful, but it is not so on the frontier: there no one comes out for Christ except at the risk of his life. All these four became inquirers in one way or other through the hospital.
Starr was a great believer in prayer. To be able to go to God at any time is such a privilege," he wrote to a friend in 1905; "I find it so helpful in examinations, in everything."
It was mentioned that he had but two illnesses during his seven years in India, but one curious incident must be recorded which throws a side-light on his practical use of prayer. On 20 October, 1916, a case was admitted to hospital with a gland in the groin, requiring operation. The man said that he came from a village close by, and this naturally raised no suspicions. Not till the doctor started to operate did he realize that it was uncommonly like a plague bubo. Later the man owned to having come from Rawalpindi, where there were at that time some cases of plague, though his home was in the near village. Starr finished the operation, but by the next day there was a similar swelling under his arm, and he was by then feeling very unwell. He and his wife applied what local treatment seemed best, wired for the plague prophylactic serum--and prayed about the matter. The next day the tenderness and swelling had lessened considerably, and before the serum arrived on the third day by passenger train the lump had almost vanished, and the doctor felt himself again. This is merely given as a reminder that the days of miracles are not wholly passed; for his medical knowledge and common-sense convinced Starr that the infection was directly due to the plague case. He regarded prayer as the active side of telepathy. "It is foolish to be afraid of making our ties too spiritual, as if so we could lose any genuine love" (Emerson), he quoted in a letter to his wife:
I have always believed in what lies behind those words, 'the communion of saints.'" On one occasion he was thinking much of a certain friend (this with him meant prayer); later he heard that his friend had on that day been led to give himself to God. At another time another friend was much on his mind, though at the time he did not know why. So he prayed for her, and even wrote to her, and heard afterwards that on that same day she had died at her post in China. It may seem strange that the day on which Vernon Starr died was the special day on which the medical mission work in Peshawar is remembered by the members of the Nurses Missionary League, and a letter was later received which was written on the 17th of March by its secretary, which said: "Our prayers are to-day for Peshawar, and our thoughts naturally turn to you." There is no mistaking the fact that "Prayer changes things."
But it must not be supposed that Starr was unpractical or a dreamer. He was an able surgeon, and, as an old and revered friend wrote: "From the first I was struck with his quiet confidence in his professional ability, and with his industry and Christian character." He was essentially practical and punctual. Quick and ever on the alert, he would run up and down the garden path between home and hospital, and on sharp frosty winter mornings it was refreshing to see the dresser boys all on the trot after the little white-coated Doctor Sahib, caught by his brisk spirit and cheery ways.
Even in the long hot afternoon of a June day, when the thermometer outside stood at 118 or more degrees in the shade, and others rested, Starr would spend the time in his study at language or clearing off business letters, and be even-tempered and as cheery as ever at the end of it. He stood the hot weather wonderfully well and never had fever seri ously, though he wisely dosed himself with quinine when it seemed advisable. He made various changes in the routine of the hospital; so an ordinary day's work, as it was during the last two or three years of his time there, may here be given in detail.
8 a.m. Breakfast.
8.30 a.m. Hospital prayers taken by the doctor, at which he gave a short Bible lesson. Once a week there was intercession for the war, remembering by name the members of the Peshawar hospital who were serving at the front.
9 a.m. The round of the wards, with a bedside clinic on any especially interesting or instructive case, if time and opportunity permitted. Dressing of cataracts was done on the round by the doctor himself.
10.15 a.m. After the round, the in-patients' dressings were done, superintended by the sister and the house surgeon, and meanwhile the doctor would be operating on any cataracts and clean eye cases that had been admitted the day before. A short talk, given by the Indian padri or one of the hospital assistants who could speak Pushtu, might be going on in one or other of the large wards at this time.
11.15 a.m. A bell is rung throughout the hospital, for it is time for the out-patient services. On the men's side the patients have been gradually collecting in the large hall just inside the hospital gates, and on the women's side in a room in the out-patient block, but opening on one side of the main building. Starr latterly gave the address to the men as often as possible himself; but with so much on Ins hands, he found it hard to make time for the Pushtu preparation for it. Some miracle of healing would be very simply explained, and the reason for the existence of the mission hospital plainly shown. The men listened quietly, generally attentively, and neither disturbance nor argument ever occurred.
11.30 a.m. to 1.30 p.m., approximately, out-patients were seen. On busy days this took much longer, for it is a case of going on till the work is done. All would be seen in turn, given an out patient ticket and treated, or admitted if the case was serious or required operation. Minor operations would be done straight away in the second theatre, in the out-patient block.
1.30--2.30 p.m. The staff had time off for their lunch.
2.30--4 p.m., or later, was spent in operating. On busy days they were not finished till five o'clock or even after. One of the dressers would come on duty from four o'clock for the evening work, and to see after the bad cases. Soon after 4.30, if the doctor had finished giving out drugs, interviewing patients' relatives, and all the extras and interruptions that take up so much time, he then got up to the house for his tea, and then out for some recreation, perhaps a cycle ride or game of tennis.
6 p.m. The Indian house surgeon, and sometimes the doctor, would do the evening round.
6.30 p.m. Pushtu study with his munshi for an hour or so. But his work was not done yet, for if his address was to be ready for the staff prayers next morning, he must prepare it after dinner; and that, too, was his only spare time to answer any necessary letters, balance his accounts to date, and do any other job that might be waiting.
An R.A.M.C. officer writes: "It was my privilege to know Dr. Starr and to see a little of his work while stationed in the Peshawar division during the last year of his life. Few can realize the ceaseless daily toil connected with such work, and fewer still know with what spirit it was there carried on. Hundreds relieved of pain, cured of their diseases, shown by example and teaching what the life of a true Christian consists of; and then in the evenings often hours of office work connected with the hospital administration, preparation of statistics and records of cases, requisitions for medical stores, correspondence about patients, and letters to supporters and the friends of the hospital---work which in any hospital at home would fall to some clerk or subordinate. It was endless work, from early morning till late at night. Single-handed (owing to the war) he must treat all the medical and surgical cases of a large hospital himself, do all the major operations. (generally without skilled assistance), supervise the half-trained native assistants, maintain discipline and pay the wages of every subordinate and servant in the hospital, keep accurate accounts of every detail expended or received, write up records, etc., and alone bear all the anxiety and responsibility for the place. This was Dr. Starr's work and more, for in addition to his work for the body he never allowed it to obscure his work for the soul. Public prayers before starting the morning's work, and whenever opportunity arose a short prayer before a serious operation, . . . and on Sundays sometimes a sermon or help at the mission church in Peshawar or at some outlying station. Always over-worked, often tired, yet always optimistic and cheerful. A cheerful giving up of home and friends, of the position and income he could have attained anywhere as a skilful and experienced surgeon, and of its opportunities for laying by something for the future. A cheerful giving up of time and skill and of every particle of energy for the work he loved. He gave up all he had, and at last his life, cheerful to the end.
"The work of medical missions on the north-west frontier cannot be too highly praised. They reach and influence people far beyond our frontier, who could never even be approached in other ways. They have had a real influence in making the wild border tribes better disposed towards the British, and there fore less ready to listen to paid agitators sent broad cast by our enemies, and are preparing the way for the future spread of Christianity amongst them." [Many other officials, both civil and military, who have them selves seen it, have borne similar witness to the meaning of medical missions, and the power they are on the north-west frontier.]
Saturday, March 16, was the last occasion on which Starr took the men's Pushtu out-patient service, while his wife addressed the women. On the same day the latter in a letter home wrote: "Only yester day my husband removed five pieces of lead-bullet from one man's leg, and the end of a knife several inches in length from another man's shoulder. Both had been in some time, and both were the result of fights. The hospital is over-full, and we are as busy as we are happy, which is saying a good deal!"
On the next morning, Sunday, which chanced to be St. Patrick's Day, the blow fell.