Cutting For Stone Part 24

"Come on, Genet. Don't talk that way," I said. "Unless you want to have your neck stretched." Even before the coup, it was heresy to speak against His Majesty. People went to the gallows for less. After the coup, you had to be ten times more careful.

"I don't care. I hate him. You can tell anyone you want." She stormed off.

WHEN THE SCHOOL TERM drew to a close, Rosina dropped a bombsh.e.l.l. She asked for leave to return to the north of the country, to Asmara, the heart of Eritrea. She wanted to take Genet with her to meet her family and to meet Zemui's parents. Hema feared she wouldn't return, and so she recruited Almaz and Gebrew to try to talk Rosina out of it, or have her go alone, but Rosina was adamant. In the end, Genet solved the problem. "No matter what," she told Hema, "I'll be back. But I do want to see my relatives."

When their taxi to the bus depot pulled away, Genet waved happily; she'd been so excited about the three-day journey, and she could talk of nothing else. But for me (and for Hema) it was heartbreaking. That very night, the wind picked up, the leaves were swishing and rustling, and by morning a squall arrived, heralding the long rains.

NOW THAT I WAS about to turn thirteen, I was aware that for Matron, Bach.e.l.li, and Ghosh, and for Missing Hospital, the rainy season meant the croup, diphtheria, and measles season. There was no letup in the work.

One morning, as I went down to the gate, umbrella in hand, I saw a woman coming up the hill to Missing, rivulets of water pouring off her umbrella. She looked frightened. I recognized her; she worked in one of the bars in the cinder-block buildings opposite Missing. Some mornings I saw her looking much as she did now, a plain and pleasant face, wearing a homely cotton skirt and top. Id also seen her at night, her hair teased out, wearing heels, jewelry, elegant clothes, and looking glamorous.

She asked me for directions. Her name was Tsige, I learned later. I heard the muted, glottic, honking cough coming from the infant slung to her back in a shama, papoose fashion. It was a sound like the cry of a gander, and for that reason, I bypa.s.sed Casualty and took Tsige directly to the croup room. The croup room was at other times the diarrhea/ dehydration room. A lab bench ran along the four walls, its surface covered with red rubber sheets. A curtain rod at head height circled the room and intravenous bottles were suspended from this. In a pinch, Missing could resuscitate up to sixteen or even twenty infants packed side by side on that bench.

The baby's eyes were screwed shut, the fingers curled, the tiny translucent nails leaving marks in the palm. The rise and fall of the little chest seemed too fast for a four-month-old. The nurse found a scalp vein and hooked up an intravenous drip. Ghosh arrived and quickly examined the little fellow. He let me listen with his stethoscope: it seemed impossible for such a tiny chest to be so full of squeaks, whistles, wheezes, and rattles. Over the left side, the heartbeat was so rapid I couldn't imagine how such a pace could be sustained. "You see these bowed legs, the lumpy bossing of the forehead?" Ghosh said. "And the hot-cross-bun pattern on the top of the skull? These are the stigmata of rickets."

"Stigmata" in my religion cla.s.s at LT&C meant the nail wounds, the cuts from the crown of thorns, the gash made by the spear of Longinus in Christ's flesh. But Ghosh used the word to mean the flesh signs of a disease. In the Piazza he had once pointed out the stigmata of congenital syphilis in a listless boy who was squatting on the sidewalk: "Saddle nose, cloudy eyes, peg-shaped incisor teeth ..." I read about the other stigmata of syphilis: mulberry molars, saber-shinned tibias, and deafness.

All the infants in the croup room appeared related because they all had the stigmata of rickets to a greater or lesser degree. They were wizened, bug-eyed, with big foreheads.

Ghosh put the child in the crude oxygen tent fashioned out of a plastic sheet. "The croup following measles, on top of malnutrition, on top of rickets," he said to me under his breath. "It's the cascade of catastrophes."

Ghosh took Tsige aside, his Amharic surprisingly fluent as he explained what was going on. He cautioned her to keep breast-feeding "no matter what you hear from anyone else." When Tsige said the child was hardly sucking, he said, "Still, it will comfort him because he will know you are there. You're a good mother. This is hard." Tsige tried to kiss Ghosh's hand when he left, but he'd have none of it.

"I'll try to check on this baby later," Ghosh said on his way out. "We have a vasectomy tonight. Dr. Cooper from the American Emba.s.sy is coming to learn. Would you bring over a sterilized vasectomy pack from the operating theater? And plug in the sterilizer in my quarters?"

I stayed in the croup room with Tsige, because I sensed that she had no one else. Her infant looked no better. I thought of the shops on Churchill Road and how I'd seen tourists stop there, thinking it was a flower shop or flower market, only to find that the "flowers" were wreaths. Then they noticed the shoe-box-size coffins, just for infants.

Tears streamed down Tsige's face-she could see her baby was the sickest one there. The other mothers withdrew as if she were bad luck. At one point I held her hand. I searched for words of comfort but realized I didn't need any. When her baby began grunting with each breath, Tsige cried on my shoulder. I wished Genet were with me-whatever she was doing in Asmara surely couldn't be as meaningful as this. Genet said she wanted to be a doctor-for a smart kid growing up at Missing, perhaps it seemed inevitable. And yet Genet had an aversion to the hospital and had no interest in following Ghosh or Hema around. Even if she were in Addis, I couldn't see her sitting here with Tsige.

AT THREE THAT AFTERNOON, Tsige's child died. It had been like watching a slow drowning. The effort of breathing ultimately proved too much for that tiny chest.

At once the staff nurse ran out in the rain to the main hospital, just as she'd been instructed to do. She gestured for me to follow, but I stayed put. A parent's grief needed a scapegoat, and parents were occasionally moved to violence, to exacting retribution on those who'd tried to help. I knew I had nothing to fear from Tsige.

Half an hour later, Tsige held the shrouded body in her arms, ready for his voyage home. Belatedly, the other mothers gathered around Tsige. They raised their mouths to the heavens, the veins on their necks forming cords. Lulululululu, they cried, hoping their lament might weave some protection around their infants.

I walked with Tsige to the gate. There she turned to me, her eyes full of pain. We held each other's gaze for what seemed like a long time. She bowed, then carried her bundle away. I felt so sad for her. Her baby's suffering had ended, but hers had just begun.

DR. COOPER ARRIVED promptly at eight that evening in an emba.s.sy staff car, just as the patient, a Polish gentlemen, pulled up in his Kombi.

Ghosh had learned the technique of vasectomy as an intern, and he'd learned directly from Jhaver in India, whom he spoke of as "the maestro of male nut clipping who is personally responsible for millions of people not being here." The operation was a novelty in Ethiopia, and now expatriate men, particularly Catholics, came to Ghosh in increasing numbers for an operation that was uncommon or unavailable in their countries.

"I have a proposition for you Dr. Cooper. I shall teach you the vasectomy, and once you are proficient, you can pay me back by doing a vasectomy on a VIP patient."

"Do I know him?" Cooper asked.

"You are talking to him," Ghosh said. "So you see I have a vested interest in seeing you are superbly trained. My a.s.sistant, Marion, will help me judge your skills. Marion, not a word to Hema-you either, Cooper-about my plans, please."

Cooper had a stiff brush cut and overlapping square teeth that looked like Chiclets. His American accent was sharp, jarring to the ear, but offset by the way he drawled out his words, by his relaxed, affable manner, as if he'd never had an unpleasant moment in his life and did not expect to.

"See one, do one, teach one. Raaaiyt, old buddy?" Cooper said.

"Indeed, yes," Ghosh said. "It is easy to do, but harder than it looks. Some preliminaries, Dr. Cooper. I tell the patient to use an enema the night before, because nothing makes them more tense than being constipated. Warm milk and honey mixed together and put into an enema bag held shoulder high is what I recommend."

"Does it work?"

"Does it work? Let me put it this way: if the patient happens to be drinking a whiskey and soda, it'll suck the gla.s.s right out of his hand."

"Gotcha," said Cooper.

"I also ask the patient to take a warm bath beforehand. It relaxes him." He added sotto voce, "And it improves my olfactory experience, you know?"

The patient hadn't said a word thus far. He was, Ghosh had told me, a consultant to the Economic Commission for Africa, an expert on population control who happened to be the father of five girls. He didn't mind all the attention.

"We can't finish if we don't start, so we better start, yes? Marion, the heater please?" I'd already turned on the electric heater under the table. "Here is the first caveat. If you don't want the s.c.r.o.t.u.m to shrivel up, and the b.a.l.l.s to retract to the armpit, the room has to be really warm. Now, the second caveat is relaxation. Very important. A barbiturate or narcotic might help. I recommend an ounce of Johnny Walker Red or Black. I'm not particular. A wonderful relaxant. And yes, you might give one to the patient, too."

Cooper's laugh rolled leisurely out of his mouth, like the great banks of clouds that spilled over the Entoto Mountains.

I hoped Cooper was paying attention. I'd seen it before: when the patient's private parts were first exposed, even when the room was warm, the scrotal skin-the dartos muscle-would wrinkle and shrink, and the cremaster muscle would tug the testis up. Then, after a good swallow of whiskey (by the patient), which was served only at this point and not before, the sac unfurled.

Both surgeons were gloved, and Ghosh cleaned the area thoroughly and then draped sterile towels to frame the field. "Another tip, Dr. Cooper. Even though it's a simple operation, mustn't allow any bleeding. Do you know what a brinjal looks like, Dr. Cooper?"

"I don't believe I do, no sir," Cooper said.

"Aubergine? ... Melanzana?...Eggplant?"

Cooper recognized the last word.

"Well, if you don't meticulously control bleeding, you'll have an eggplant. Or two. And you know what we call that complication, Cooper. We call it the b.l.o.o.d.y-brinjal-and-b.u.g.g.e.r-all. Which is also what they fed us for five years in my medical-school hostel."

I served the patient his Johnny Walker, which he downed in one gulp.

I loved a.s.sisting Ghosh. Ever since he treated me as if I were old enough to learn and understand, I took my role very seriously. I was thrilled to have Cooper there watching.

Ghosh, on the patient's right, rooted with his thumb and index finger at the top right of the s.c.r.o.t.u.m, just where it joined the body. "You feel all the wiry things-lymph vessels, arteries, nerves, and whatnot? Well, the vas deferens is in that lot, and with practice you can tell it apart from all the other wires. It has the largest wall-to-lumen ratio of any tubular structure in the body, believe it or not. Here it is. A whiplike structure. Put your finger behind mine."

Cooper rooted around, and said, "Got it. The vas. Yup."

"Now, push the vas forward from the back with the tip of your index finger, fix it like this against the pulp of your finger so that it doesn't slip away."

Ghosh's instructions to Cooper were similar to what he said to me when I a.s.sisted him. He loved to teach, and in Cooper, he had the kind of student he deserved. If he dazzled Cooper with his polished delivery, it was because he'd practiced it on me. Practicing medicine and teaching medicine were completely connected for Ghosh. When there was no one to instruct, he suffered. But that was rare. He would happily teach a probationer, or even a family member-whoever happened to be around.

"I use Adrenalin with my local anesthetic to keep the bleeding minimal. And don't be stingy." He emptied a five-cc syringe of local into the tissue that his index finger pushed forward. "Any less than that and he'll have pain and the b.a.l.l.s will go to the armpit. You'll have to call a chest surgeon to bring them down. Now ... see how my index finger still has the vas stretched over it? I make a tiny cut in the scrotal skin. I keep pushing on the vas, pushing it forward ... and ... there! When I can see it in the wound, I use an Allis to grab the vas."

He pulled out a short length of pale, white, wormlike tissue. "I put a mosquito clip here and here ... and then I cut between the clips. I remove a two-centimeter segment. Ideally you'd send it to pathology. That way if his wife gets pregnant a year from now, you can show the patient the pathology report and he'll know it's not because you didn't do your job but because a third party did his job better. I don't send it to pathology for the simple reason that we don't have a pathologist. But for a while, there was a pathologist at the American Emba.s.sy clinic in Beirut. I'd do the vasectomies for the American staff and send him these little pieces I cut out. The man did the pathology for all the American emba.s.sies in East and West Africa. He kept sending back reports that my specimens were inadequate: though he thought he saw some uroepi -thelial tissue, he couldn't be certain it was the vas. 'It's the vas,' I wrote to him each time. 'What other uroepithelial tissue could I have cut out? Call it the vas.' But he kept complaining: 'Cannot be certain. Not enough tissue.' It was starting to annoy me, you know? So finally, I sent him a pair of sheep's b.a.l.l.s. I put them in formalin and sent them off in the same diplomatic pouch. With a note: 'Is this enough tissue?' Never had a problem with him after that."

Cooper hee-hawed, his mask sucking in and out.

"Now, I tie off the cut ends with catgut. And then I tell the patient, 'No communication with wife allowed for the next ninety days.' "

Ghosh turned to face the patient, and repeated the sentence. The patient nodded. "Okay, you can communicate, say 'Good morning, darling,' and all that, but no s.e.x for three months." The patient grinned. "Okay, you can have s.e.x, but you must wear a condom."

"I use interruptus," the patient said, speaking for the first time in a heavy East European accent.

"You use what? Interruptus? Pull and pray? Good G.o.d, man! No wonder you have five kids! It's n.o.ble of you to try to get off the train at an earlier station, but it's unreliable. No sir. Interrupt the interruptus, man, unless you want to reach your half dozen this year." The patient looked embarra.s.sed. "You know what we call young men who use coitus interruptus?" Ghosh said.

The population expert shook his head.

"We call them Father! Daddy. Pater. Pappa. Pre. No sir, I have done the interrupting for you. Give me three months and you can tell your missus that she is not to worry because you will be shooting blanks, and there will be no more interruptions and you will be staying for dessert, coffee, and cigars."

CHAPTER 31.

The Dominion of the Flesh

WITH GENET AND ROSINA AWAY, our quarters felt empty. I missed Genet terribly. Hema and I both worried that wed never see her again. She'd promised to call, and write, but three weeks had gone by and wed yet to hear from her. That year, 1968, we had torrential rains; the Blue Nile and Awash had spilled their banks, causing flooding. The babbling brook behind Missing looked like a river. In Addis, the populace was bottled up indoors so that a lull in the rain released the scent of stifled humanity, dung fires, and clothes that refused to dry. The ivy raced up the drainpipes and found c.h.i.n.ks in walls, while the tadpoles hurried into croaking frogs before their limbs were fully formed. No child I knew was ever tempted to turn its face to the sky and catch raindrops on the tongue, not when you lived and breathed water.

Now that Shiva and I were teenagers, looking ahead to our fourteenth birthday, I kept expecting something to feel different. I tried to stay busy, but all I could think about was Genet and what she might be up to in Asmara. I hoped she was homebound, miserable, and missing me. Without Genet as a witness, nothing I did was meaningful.

LATE ON A TUESDAY EVENING, I watched Ghosh in Operating Theater 3 as he removed a gallbladder. When he was done, we swung by the surgical ward to see Etien, a diplomat from Ivory Coast, a man we knew socially, who'd suddenly developed a bowel obstruction. In surgery, Ghosh had found an obstructing rectal cancer which he was forced to resect. It was a big and challenging operation, and I knew Ghosh was hopeful for a cure. But he was forced to create a colostomy on the belly wall. "Etien's very depressed," Ghosh said. "Not about the cancer, but over his colostomy. He can't accept the idea of waste coming out from an opening in his abdomen."

Etien had the sheet over his head. When Ghosh examined him, and then said the colostomy looked beautiful, tears welled up in Etien's big eyes. He wouldn't look down there. All he said was "Who will marry me now?"

Ghosh was surprisingly firm. "Etien, that's not the part of your body I cut off, the marrying part. You'll find a woman who loves you, and you'll explain it to her. If she loves you for yourself, you'll both be glad that you are alive." Ghosh's facial expression brooked no argument, but then he softened. "Etien, imagine if all humans were born with their a.n.u.s on the belly and that's where everyone's waste emerged. Then imagine if someone said they were going to operate on you and reroute your bowel so it opened behind you, between your b.u.t.tock cheeks, somewhere where you couldn't see it except in a mirror, and where you could hardly reach it or easily keep it clean ..." It took a few seconds, but then Etien smiled. He dabbed his eyes. He ventured a glance down at his colostomy. It was a small step in the right direction.

Ghosh had one more patient to see. He told me to go on home so I wouldn't be late for dinner.

The rain began to come down hard and I had no umbrella. I walked under the sheltered walkways connecting the theater to Casualty and Casualty to the male ward. Where the walkway ended, I dashed across a short gap, leaping over a puddle to arrive at the nurses' quarters. I rarely explored this female warren. It looked deserted. If I went up the long outer balcony and down the stairs at the other end ... well, I'd still get soaked, but I'd be fifty yards closer to home before I had to dash out into the rain. I hoped Adam's wife, the keeper of the virgins, with that big cross around her neck, didn't see me, because she would chase me out.

Upstairs, the doors of the individual nurses' rooms opened onto the shared veranda. They must have all been in the dining room, otherwise they would have been lined up against the veranda railing, teasing out their hair, painting their nails, sewing, and chatting.

I heard music from the corner room that had once been my mother's. I'd been up here a few times, but just like her grave, this wasn't a place where I felt her presence. The strangeness of the music, the beat, were what pulled me closer. Guitars and drums in a driving rhythm repeated a musical refrain first in one register, then another. Of late some Ethiopian music adopted a Western sound, with horns, snare drums, and a repeating electric guitar riff that took the place of the m.u.f.fled strings of the krar and the hand clapping. But this wasn't Ethiopian music, and not just because the words were English (albeit an English I couldn't quite understand). This was radically different, like a new color in the rainbow.

The door was open a crack.

She stood barefoot in the center of the room, her back to me. A white slip exposed her shoulders and ended at the back of her knees. Her head went from side to side, and her long, straight hair, conked with chemicals, followed as if welded to her skull. Her hips were driven by the ba.s.s line, while her upraised right hand kept the melody. Her left hand must have been pressed to her belly, because the elbow jutted out like the handle of a teacup. The music had entered her; it lubricated her joints, softened her bones and flesh to produce this gyrating, fluid, and sensual movement.

She turned. Her eyes were closed and her face was tilted up. The lower lip was twisted, as if it had been split and had healed out of alignment.

I knew that lip, that faintly pockmarked face, though now the pocks textured the skin and exaggerated her cheekbones. It was the body I didn't recognize. She'd been a student probationer forever, until Matron, taking pity on her, gave her a new t.i.tle, Staff Probationer, which transformed her. From being on the long-term plan, a perpetual student, she became an instructor for incoming probationers. In the cla.s.sroom, with textbooks that she knew by heart, she could both drive facts into the probationers' heads and demonstrate that it was possible to keep them there, by the manner in which she regurgitated her material, never looking at the text.

Normally she wore her hair pulled off her forehead and neck and gathered into a top bun so tight that it arched her eyebrows. When she crowned this with the winged nurse's cap, it looked as if she'd inverted an ice-cream cone on her head.

Other than her precarious hairdo, I'd always thought of the Staff Probationer as plain. At school, I knew girls who were neither ugly nor beautiful but who saw themselves one way or the other, and that conviction made it come true. Heidi Enqvist was gorgeous, but alas not in her own eyes, and so she lacked the mystery and allure of Rita Vartanian, who despite her overbite and prominent nose managed to make Heidi envious.

The probationer was of the Heidi mold. I think that's why she made herself a willing prisoner of a stiff, starched uniform and adopted an unsmiling expression to go with it. The only ident.i.ty she had was that of being in the nursing profession; in her own eyes, and in the light of the world, she thought she was n.o.body. Id always felt the probationer's discomfort around us. But then she was shy around everybody.

But I could see now that there was more to her than nursing. The uniform concealed a body full of curves, like the figures Shiva used to draw, and the body moved in ways that would have made a harem dancer jealous.

Her eyes were closed. Were she to see me she'd be startled, embarra.s.sed, and probably furious. I was about to step back when, to my surprise, she stepped forward and pulled me in by my hand, as if a phrase in the song was my cue. She kicked the door shut. The music was louder and more intense inside the room.

She had me taking little steps in time to the beat, moving my body this way and that. I was embarra.s.sed at first. I wanted to laugh or say something clever, the way an adult would. But her expression and the throbbing beat made me feel anything but dancing would have been like talking in church. My steps became effortless. I imitated her, my shoulders moving in the opposite direction from my hips. My hands drew figures in the air. The trick was not to think. My body felt segmented, and each segment answered the call of a particular instrument. The pattern of our steps felt inevitable.

Just when I mastered that, she pulled me to her, my cheek against her neck, my chest against her b.r.e.a.s.t.s, separated from them by the thinnest of materials. I'd never danced before, certainly not like this. I breathed in her perfume and her sweat. She squeezed, taking my breath away, as if to make our two bodies one. She guided my arm so that it was around her, my hand over her sacrum, and I held her close. We never stopped moving. She led.

I antic.i.p.ated her every step, clueless as to where that knowledge came from. We spun, then surged this way, then that, like one organism. I thought of Genet. Emboldened, I led and she followed. I pressed against the soft flesh where her legs came together only because she pressed, too, grinding her hips into me. Blood surged to my face, to my arms, into my stomach, my groin. The world had fallen away. I was in an elaborate dialogue with her.

The music wouldn't stop, and I never wanted it to stop, and just when I thought that, it faded. The American announcer's lazy drawl was so unlike the crisp formal tones of the BBC. "Well, well," he said. "My, my. Umm, hmmm," as if hed seen us carrying on. "Have you ever heard anything quite like that? This is the Rock of East Africa. East Africa's Big 14. Armed Forces Radio Service, Asmara." It wasn't a station that I knew existed. I knew of a huge American military presence, a listening post, I'd heard it called, just outside of Asmara in Kagnew. Who knew they had something we could listen to?

We were still pressed together, holding the world at bay. She gazed into my eyes, I didn't know if she was about to cry or laugh. All I knew was that I'd have cried with her, or laughed or got down on all fours and pretended to be Koochooloo if she asked.

"You're so beautiful," I said, surprising myself.

She gasped. My words seem to ripple through her. Had I said the wrong thing? Her lips quivered; her eyes shone. She was expressing joy. I'd said the right thing.

She lowered her face, brought that lip with the puckered scar and the bulges on either side close to mine. Her mouth overlapped mine, forming a seal. The silliest image entered my mind, and it was that of connecting one garden hose to another. What flowed across wasn't water, but her tongue. This time, unlike in the pantry with Genet, I received her tongue eagerly. It was so very exciting. I put my hand behind her head. I pressed my body to her, feeling every atom in me come to a point.

I pulled away once to look at her and say, "You're so beautiful," because it was a magical phrase, one I knew I should use often, but only if I believed it to be true. I don't know how long we were coupled by our mouths, but it came most naturally, as if I were satisfying a hunger. I didn't realize this potential existed in me. It carried me forward. Whatever was next, I didn't know, but my body knew. I trusted my body. I was ready.

Suddenly, she stepped away. She held me at arm's length. She sat on the edge of the bed. She was crying. Something had happened about which my body had failed to inform me. Or perhaps there was a rule, an etiquette, that I'd failed to observe. I eyed the door, measuring my escape.

"Can you ever forgive me?" she said. "Your mother shouldn't have died. Maybe if I told someone she was sick, they could've helped her."

This was astonishing. I could feel the hair on the back of my neck rise. I'd entirely forgotten this was my mother's room. I couldn't picture Sister Mary Joseph Praise in here, certainly not with a poster of Venice on the wall, and on another wall a black-and-white poster of a white singer, his pelvis thrust forward at the microphone stand which hed pulled toward him, his face contorted with the effort of singing. I looked back to the Staff Probationer.

"I didn't know how sick she was." She hiccuped through her tears, just like a baby.

"It's all right," I said, feeling as if someone else gave me those words.

"Say you forgive me."

"I will if you stop crying. Please."

"Say it."

"I forgive you."

She only cried louder. Someone would hear. I didn't think I was supposed to be in this room. And I certainly wasn't supposed to make her cry.