When I'm 64

At an age when most people think of retirement, Dr John Millard left behind his prosperous consultancy and the family he adores for a new life treating tuberculosis in the Transvaal. Was he inspired by altruism, or was his decision essentially selfish? His daughter, Rosie Millard, writes here about his transformation and the sometimes painful consequences, while on page 18 other men and women discuss what compelled them to start all over again. Photograph by Ian Berry
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I first learned of my father's love affair with South Africa in 1974. I was nine and a half, and 'When Will I See You Again?' by the Three Degrees was on the radio. My three siblings and I were in the back of the family Cortina. My mother turned round from the front seat. "We're going to South Africa next week," she said quite casually, "for a year."

And so we did. My elder sister, brother and the dachshund were dispatched to boarding schools and friends; my younger sister and I were to go with our parents. My mother was to be our teacher. She packed the rudiments of the school's curriculum, plus an Oxfam project on the Third World and the entire Little House on the Prairie series by Laura Ingalls Wilder, a literary phenomenon with which I was to become fixated.

My parents are both doctors, which I remember thinking was quite weird. Indeed, in those days my mother Rosemary was something of an exception. In a photograph from her first year working at Bart's, in 1957, she is one of only three women sitting alongside rows of tweedy-looking chaps (including my father). Legs elegantly crossed at the ankle, she is looking intelligent and ever so slightly smug, as well she might for a first-class honours student.

But it was she, the clever one, who relinquished her job in cancer research at the Marsden Hospital. "I was fed up with it," she later told me, "and your father wanted to go to South Africa."

My father, John, had a sabbatical year from his position as a chest physician in Tooting. Like all the family initiatives - barge holidays, or walking up Snowdon in the rain - this jaunt was his idea. He had been offered a year's work at the Jane Furse Memorial Hospital, a 300-bed hospital founded in 1921 by Michael Furse, the Anglican Bishop of Pretoria. The hospital - named after his only child who had died of scarlet fever - is in the high veldt, the vast grasslands of the Transvaal - those impoverished heartlands where a large proportion of the black population are forced to live.

Jane Furse was different from south London. It was exciting medicine: my father left behind cancer-ridden geriatrics and entered a glossily traumatic world stalked by Victorian diseases - TB, typhoid, malnutrition. The lifestyle was shockingly new. Our cosy suburban family existence became a foray into the mysteries of boiled milk, green mambas in the garden, and no television. And so started a life-long pattern for us all.

On our return to England, my father advertised in medical journals for other doctors to go out. Over the years, legions of applicants turned up. Nervous young men wearing Hush Puppies and thin, intense women with crosses around their necks and corduroy skirts, would appear just before Sunday lunch and spend the rest of the day talking about South Africa in general and Jane Furse in particular. We, in the meantime, would fall about with boredom.

Twenty-two years have now gone by, and my father is 64, but he is back at Jane Furse. He should have been readying himself for the retirement two-step of Gardening and Grandchildren. But for three, or possibly five years, he has slipped the noose, left the charms of south London, his wife and family, to realise a final ambition: the setting up of a tuberculosis aid programme for the million or so people who live in the 9,500 square kilometres of the Southern District around Jane Furse.

Of course, this time it's different. The four children are all grown up, working, married. My grandparents are dead. My father counts his blessings. "I'm lucky," he said, before leaving. "I've no responsibilities here. I'm healthy, you're all healthy and, fortunately, your mother will let me go." And, rather than go with him, like last time, my mother has stayed at home.

"I hate Jane Furse," she muttered at the time. "I'm too old for it. I haven't got your father's stamina. But, if I don't let him go, he might turn round to me at the age of 80 and accuse me of not letting him go. I have to let him do this, to get it out of his system," she says. "If he hadn't gone, he would have been very wistful. And I don't think he would have ever got over it. I don't know how he would have coped with normal retirement."

My father bought an Apple Mac and taught himself to use it. He stocked up on relevant texts and khaki shirts. He had a tortuous correspondence, firstly with the old South African government, and then the new one. Countless people rang to say goodbye. My mother padded around behind him, vacillating between wanting to go too, and not wishing to talk about it at all. It was like seeing a student go off to travel the world.

When he finally left, everyone said their farewells quite happily and agreed it was absolutely the best thing. No-one broke down in tears and wailed down the road. The family's not like that. But now we feel dislocated. Our family home, the old centre, has lost its gravitational pull. No car- washing on Sundays, no disastrous barbecues, no gardening. A man comes and does the garden, but it's not the same. I realise how friends of mine feel who have lost a parent.

"But you'll all come out to visit me, that's the thing," he says. And, just as we were forced to walk up Snowdon in his wake, it has now become a dogged pilgrimage to Jan Smuts Airport. Every four months on average, one or more of us finds ourselves walking round its Emmenthal architecture and smelling the peculiar smell that is the atmosphere of South Africa.

So now it's the middle of the South African winter, and I'm sitting with my father having breakfast at the kitchen table. It's 6.30 in the morning. We're living a diurnal existence. Up with the dawn, down with the dusk. It's too cold to do anything else. The table is regulation plastic and stamped ACW/174/PYG in large black letters, as is the refrigerator. The floor is old lino. The bedrooms are furnished with hospital iron bedsteads. It's another world from the house in Britain, with its long silk curtains, soft carpets, and walled, wisteria-clad garden.

We're living on chicken stew and yams, tinned fruit and tap water - when it works. The only reference that says this is the modern world is a photograph of President Nelson Mandela, and that's on a newspaper I have brought from Britain. But none of this bothers my father. He is his usual cheery self, rushing about in a half-walk-half-run, tossing his keys in the air, loving it.

Which is not the same for Rosemary, whose visits are conducted through what one might politely term gritted teeth. Oh, she misses him, but her joy at seeing him is mixed with apprehension for the domestic horrors she encounters visiting Jane Furse. On her first trip in June, the water supply collapsed and there was a power cut for over 36 hours, leaving the house in total darkness and without heat, lashed with freezing rain, while in the operating room the babies were delivered by candlelight.

Now my father and I clamber up into a white truck and bump out of the hospital compound. We're taking some TB patients to a small village 15 miles away. The sun has come up over the improbably named Lulu mountains. The veldt, interspersed by small dusty bushes and the odd telegraph pole, stretches for miles around. I sneak a look at my father as we bounce along in the truck.

"Look at the view!" he says, gesturing across the streaked windscreen. "Just look at that." He laughs. "I sometimes think I should have come back here earlier." He speaks with the relief of someone who has at last got his own way.

The project my father is embarking on will require thousands of miles of travel and hours of bureaucracy. It will take him three or more years to set up, and there is no guarantee it won't all collapse when he leaves. TB is not a high-priority disease, even though it accounts for 80 per cent of communicable diseases in South Africa, and the rate is expected to double in the next 10 years. A recent report by The World Health Organisation indicated that drug resistance is mounting. TB represents "a disease more terrifying than Aids or the Ebola virus", concludes the WHO.

Yet it is curable, and the project John Millard is setting up could make a difference. The scheme was honed in the slums of Madras in the 1950s by Dr Wallace Fox. In some excitement, my father waves a copy of the Lancet at me. The article tells how Fox developed a system of directly observed medication for TB sufferers, who must undergo a long process of taking their pills every day in order to get better. Fox discovered that, if you supervised the patient every day, the medicine worked - a 70 per cent success rate compared to 40 per cent without the system. This is what my father is setting up in the Transvaal, using four hospitals, each with their own TB wards, nurses and patients. After each patient is discharged, a local person is found to supervise the crucial months of follow-up care.

What a way to end a successful career, my friends tell me! To set up a system which will run on and on, and cure thousands of people of the region's worst illness, particularly now that Aids is being linked with TB. And I nod with pride, pleased that my father does something more useful than play endless rounds of golf. But then, in the evenings, I call my mother, and it's sadness I feel.

My mother hovers about the house in London, sitting in its lovely, airy rooms playing the piano. She fills her days and nights with choir practice, art lectures and grandchildren. She's thinking of doing a Master's degree; she's visiting relations and travelling the world. She scoffs at people who suggest her rightful place is by her husband's side; she demands her own satisfaction in life. Yet Jane Furse has been somewhat of a thorn in her side. Oh, of course she loved going out in the 1970's. But things haven't always been easy. Five years ago, while my father was off on a brief fact-finding jaunt to Jane Furse, a man climbed over her garden wall, walked into the kitchen and, wielding a kitchen knife and demanding cash, proceeded to blindfold my mother and shut her up in the cellar. She was written up in the local paper as a "terrified pensioner", which amused her greatly.

But it's clear she's bored and lonely without her lifelong partner. My mother is still in love with my father. When he's away, she still opens the wardrobe, like a young woman, and touches the blue, pink and white rows of his shirts, to remind herself of him. She is very loyal, but she knows the hospital in the Transvaal is a rival.

"He's interested in what I do, of course," she admits, "but it's only a polite interest. He seems more, well, alive, when he's at Jane Furse. I never had his drive, even at medical school. I was a gifted student, but I think my career suffered because of his single-mindedness. I held back: I didn't want him to feel I was the clever one."

John Millard had wanted to be a doctor since he wasseven. According to his sister, Josephine, he worked hard at it, scratching away through the night on a blackboard and easel in his room: "I used to go to sleep hearing him."

He first went to Africa in 1950, when he was 17. He had won a place on the Schoolboys' Africa Tour from the South African Aid to Britain Fund. Left-over cash from the fund, set up during the War, was used by Prime Minister Clement Atlee to send upstanding young men to Africa. Atlee himself saw the boys off on their four-month trip, which went straight down the continent from Benghazi in Libya to the Cape of Good Hope. Atlee is pictured leading a group of clean-cut youths down the garden steps at Number 10. The schoolboys are all sporting furiously correct side-partings, their eager, polished faces belying the dearth of opportunities denied by the past decade of war. For my father, this was his first trip overseas, and a moment when he glimpsed a possibility for his future.

It's not easy having devoted your life to doctoring, but particularly at that moment when you have to give it up to retire. And a hospital doctor feels it worst. A long-time friend of my father's, Sir John Batten, the retired chest physician, says: "Unlike GPs, you don't know your patients as friends, so at one stroke you lose all your professional friends, plus the impact of medical students. Some doctors just don't prepare for it. Some have no interests outside medicine. I know quite a few doctors who have dwindled since retiring. Some don't live for very long afterwards."

Now we are in the hospital library and my father is giving three other doctors an impromptu lecture on a particular patient with suspected TB. The few medical books on the shelves are hopelessly out of date, and so are all the journals. There is no light box, so my father is holding the X-ray up to the window. The lungs in the photograph look foggy, with thin, white webs; but the delicate dance of clavicle and collar-bone still stand out, framing the diseased chest with elegant curves.

"You can see here the high bronchial tumour," starts my father, pointing with his pen. Then: "My God! There goes a cockroach!" he says suddenly, laughing as the insect marches doggedly across the wall. Outside, it's a typical, South African winter's day. Chilly sunshine pours down from a bright, blue sky, hitting the brown, fronded leaves of the jacaranda trees. Lamps, strung up on cables, swing gently between the trees.

"It's better than shutting oneself up in an old people's home," he ruminates later. "Yes, what I'm doing is selfish. Perhaps. Who can say whether what you do is for yourself or for some greater need? Is it better to go or to stay? I came to the conclusion it was better to go. It's a risk, but it's a good time to take a risk."

To which my mother, far away, says, "I'm looking forward to having our retirement years together. I'm just deferring it for a few years."

Perhaps when you've wanted to do something from the age of seven, giving up simply isn't an option. Perhaps it postpones the realities of age, which doctors see all too clearly before them.

"Everyone worries about getting old," says my father in his familiar, comforting manner, the way he spoke when I failed my French O-Level and he told me that he had failed his, too. "I'm not trying to hide that. I just think this is a more worthwhile thing to try. To set up a viable TB programme and make it stick: it's more worthwhile."

Than what? Being with your family, your home, your life? He is irritatingly impossible to rattle. "I have you all here with me. I have the hospital. I have my work." What then, if anything, does it hurt to leave behind? "My garden," he says slowly.

Outside the window, the harsh wind is sucking up the sand and the dirt, and the ibises are flying home to roost in the tall eucalyptus trees. "That could be the thing I miss the most," he adds. And in his garden in south London, the lavender bushes blow in a soft wind and we all sit and wait

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