by Cary Groner
Alex stirred, groaned, and pulled back the curtain. She scowled out into the room with fright-wig hair. “Time?”
Peter felt for his watch, which was buried amid the wallet, keys, water bottle, and other stuff on the crate that served as his bedside table.
“Seven-thirty,” he said. “It’s late.”
She briefly surveyed the room, then lay back down and pulled the covers over her head. One arm snaked out and drew the curtain closed.
Peter didn’t want to get up, but he did. Alex and Devi would be hungry. He dressed and put on his scuffed shoes. In the confusion of arrival the previous evening they hadn’t turned the heater up high enough, and the place was cold. He went over to it and rotated the dial, then went out to pee.
The outhouse was built of planks, with a tin roof, but between the chilly air and the ample ventilation, at least it didn’t stink. There was just a hole in the ground with a place on each side to put your feet if you needed to squat. When Peter had finished, he hung a roll of toilet paper on a nail and went back inside.
Alex pulled back her curtain again, as if she’d hoped the previous viewing had been a hallucination. “Good fucking God,” she said.
“You’re being punished for your father’s sins,” Peter said. “It’s very Greek.”
“I wouldn’t mind Greek if we were in Greece.”
Devi cried out, babbling something in Nepali, and Alex shook her and said her name. She rolled over and buried her face in Alex’s flank. Peter rooted through the food bag to see what he could cook. The heater was ticking, but so far it wasn’t helping much.
Alex lifted Devi’s arm off her, then pulled on a sweater and a jacket. She grabbed her pants from the foot of the bed and put them on under the covers. She got up, slipped on her socks and shoes, then headed outside.
“Fuck!” echoed in from the outhouse in back, and Peter briefly wondered if the Nepali family had heard it too. He decided he didn’t care and got water heating for oatmeal. Devi stirred again and mumbled. Soon Alex returned, her teeth chattering.
“This country is a real confidence builder,” she said, hopping up and down near the heater to try to get warm. “Just when I think I’m starting to get it, it turns out I don’t know shit.”
“You’ll be intimately acquainted with shit by the time we leave here,” he said. “What happened?”
“I’m trying to squat over the thing, but it’s so cold I can’t even relax enough to go,” she said. “And then I missed the hole, and I’m thinking, they’re going to find me out here frozen to the ground by a pee icicle.”
Devi rolled over sleepily and sat up. She rubbed her eyes and looked around. “Hey, not bad,” she exclaimed, smiling. “We’ve even got our own water!”
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An hour later they met Ian at the clinic for the official passing of the baton. He was a good-looking, affable Kiwi of about thirty who’d finished his residency the previous year and had signed on with Phwoof so he could get in some mountaineering before starting a full-time practice back home in New Zealand.
The Nepali nurse—a short, broad, fierce-looking woman named Banhi—busied herself with some paperwork as Ian walked them through the clinic, which took up two rooms on the bottom floor of a concrete building. One was an office and exam room; the other served as the triage and waiting room. Both had windows to the street made of old-fashioned opaque security glass with wire mesh cast inside it. It was chilly.
“Looking forward to going home?” Peter asked.
“Can’t begin to tell you.”
“What’s Wellington like?” Alex asked. She’d been watching Ian quite closely.
“Splendid,” he said. “It’s all built on hills around the most beautiful harbor. If you’re up there in the evening, with the sun going down over Cook Strait and the city lights coming on … It’s just …” He looked about ready to weep at the prospect of seeing it again.
“It sounds wonderful,” Alex said. She had acquired a kind of glow. “I’d love to see it someday.”
Peter and Devi both stared at her, then glanced at each other, then looked back at her. Holy shit, Peter thought. He’d seen her flirt before, but this time she was doing it right in front of Devi. He hoped there wasn’t about to be some sort of blowup.
Ian seemed to notice too. “Of course,” he stammered. “I mean, you’re always welcome to come visit if you … um, you know …”
“Turn eighteen,” Peter offered, helpfully.
Alex shot him a look, then smiled at Ian. “Thank you,” she said. “I might. Visit, I mean. And turn eighteen.”
Ian handed Peter the keys, wished them luck, and started off down the street. His step was so buoyant he looked as if he might break into spontaneous, ecstatic dance, twirling from the light poles like Gene Kelly in Singin’ in the Rain.
Devi turned to Alex and crossed her arms over her chest. “My, my,” she said.
Alex blushed. “I’m sorry,” she said.
“You are such a hussy!”
“I know,” Alex said, “and I really, really apologize. But you have to admit …”
“Well, he was pretty gorgeous,” said Devi. She uncrossed her arms, then Alex hugged her and mumbled something in her ear. Devi smiled, then laughed.
They strolled through the clinic again and took stock. The waiting room had one old poster taped onto the concrete wall—the usual kitten hanging by its front claws from the usual branch, with the usual “Hang in there, baby!” printed over the top—but with translations written freehand underneath in both Nepali and Tibetan. The tape was old and yellow, and the poster had started to peel off the wall.
A dozen or so blue metal folding chairs with white paint spattered on them were arrayed haphazardly around the room, and in the center stood a low wooden table that looked as if it had fallen off a truck and broken into pieces, then been reconstructed by a four-year-old using chewing gum and vomit. It held a tattered copy of Newsweek Asia, a slightly more recent Bollywood magazine, and a thick wad of Kleenex that was suspiciously yellow in the center. Peter kicked it onto the floor, then kicked it again, to the side of the room. When Devi went to pick it up he told her not to touch it, and he was serious.
In the office–exam room–lab there were a few boxes of latex gloves, assorted syringes, an old mercury thermometer in an alcohol container, cotton swabs, a handful of surgical masks, and a pressure cooker on a hot plate that apparently served as an autoclave.
When Peter opened the fridge, though, he could barely believe his eyes. There were the usual antibiotics and painkillers, but there was also a huge supply of second- and third-line TB drugs, better stuff than they’d had at the main clinic in town. He turned to the nurse.
“Banhi, where did these come from?”
She turned to look and made a dismissive gesture. “We getting some things,” she said vaguely.
“Getting how?” Peter asked.
She eyed him coolly. “Just getting,” she said. “Not necessary knowing everything.”
Peter looked at Alex and Devi, who appeared as astonished as he was at this blatant insolence. He felt his temper rising. “In this case, I’d like to know,” he said as evenly as possible.
She responded by closing the ledger, throwing on her coat, and stalking out without even glancing back at him. The steel front door slammed behind her.
“What the hell was that?” Peter asked. “Are we dealing with some sort of Mafia here?”
“I don’t think the Mafia’s too interested in Nepal,” Devi said.
“Well what, then?”
“Don’t have a stroke, Dad.”
“She’s obviously a bitch,” said Devi.
“Probably been talking to Mina about you,” Alex added. She stretched out on the exam table. It was built of plywood and two-by-fours, and had a thin vinyl pad on it that appeared to be stuffed with animal hair, some of which was coming out at the seams. “It’s like lying on a dead goat,” she said.
Peter was still fuming.
He sat down on the stool and rested his chin on his hands. “I was one of the best cardiologists in California,” he said.
“Or maybe a dead yak,” Alex said. “A black yak, whacked by the little-known Nepali Cosa Nostra.”
“Smacked in the back by a Mafia hack,” said Devi.
“I was supposed to speak at a colloquium at Stanford last week, in fact,” Peter continued, ignoring them. “I would have become pals with the new dean of the medical school, and as a result you would be starting next fall on a full ride.”
“Dream on, Dad.” She turned to Devi. “I’ve seen this syndrome once or twice before with him. You might want to take a seat.”
Devi sat on the table by Alex’s feet.
“In your first year you would write a memoir of your experiences called Alexandra on the Farm, which due to its tastefully suggestive and inspiring content would quickly land you a place on Oprah and become an international bestseller,” Peter said.
“The farm?” asked Devi.
“Stanford’s nickname,” said Alex.
“There are animals there?”
“Extremely well-bred ones.”
“The film rights would sell for three million dollars,” Peter continued, ignoring them, “and you would be played by … um … Who would be playing you?”
Alex spoke with only a hint of sarcasm. “Keira Knightley, I expect.”
“Fair enough. Of course, sooner or later Keira would want to meet me. Just, you know, to express her appreciation for what a great job I’d done raising you and all. Dinner and drinks, a long walk on the beach. Nothing fancy.”
Alex looked at him a little askance. “I’m pretty sure Keira Knightley has a boyfriend.”
“She does?”
“God, Dad, don’t you ever read?”
FIFTEEN
Several Tibetan monasteries had been rebuilt near Boudhanath after the destruction by the Chinese across the border. People still routinely fled from Tibet across the high passes, and Peter was seeing a lot of frostbite. He was usually able to save fingers, but sometimes the refugees’ toes would turn gangrenous and require amputation. For that, he gave them bus fare and sent them into Kathmandu, to Franz.
Alex’s Nepali had become serviceable, and she and Devi worked together with the Tibetans so Alex could get closer to fluency in Tibetan too. Alex and Devi were tireless, putting in ten-hour days every day but Sunday, and soon acquired a devoted following among the children.
One night after work, Devi cooked momos, Tibetan dumplings stuffed with ginger, lamb, and garlic. Alex picked up a calendar and realized they’d forgotten Christmas—missed it by five days, in fact. She wanted a tree, but Peter had no idea where to find one without poaching it. They did have a green marker, though, so they drew a tree on an empty rice bag and tacked it to the wall. Peter told them they’d open presents the next night, on New Year’s Eve.
The heater wasn’t really up to the task, given the drafty window and the concrete floor, and they were always cold. Peter found a shop that had a thick rug, big enough to cover the entire floor, with a good pad for underneath.
On New Year’s Eve he brought the rug home. They moved their stuff into the yard, unrolled the rug, then brought everything back in. The girls were delighted and promptly stretched out on it, luxuriating in the thick fibers and cooing their approval. The room felt warmer immediately, just by having their feet shielded from the heat-sucking concrete floor.
Peter decided to give the girls some time to themselves, so he walked down the road and called Franz, who picked up on the second ring.
“Home alone on New Year’s?” Peter asked. “Serves you right for banishing us to the outlands; we could have kept you company.”
“I’m not alone,” said Franz.
“Oh, you’re right, I can hear the cat. I expect that’s the closest you’re getting to pussy tonight, boss.”
“Fuck you, American doctor.”
Peter smiled. “What’s the news at court? Any chance Duke Bahadur will be mollified by spring?”
“I’m taking care of his girls for him, gratis, thanks to you.”
“Well, you old whore.”
“Everyone he touches ends up as some kind of whore, apparently. He has even more connections than I knew.”
“Meaning what, exactly?”
“He’s still pissed at you, so I’ve got a feeling you’re going to find out,” said Franz. “Oh, and by the way, that girl you sprang? She’s already back with him, and she is HIV-positive.”
Peter felt the holiday cheer bleed right out of him. “I’m sorry to hear that,” he said feebly.
“Happy New Year, Dr. Do-gooder,” said Franz, then hung up.
Peter had been trying not to think about futility, but it had acquired such multifarious manifestations it had become impossible to ignore. Recurring trachoma, because you could treat the patient but you could never kill all the flies. Kids dead from diarrhea, because you could give them antibiotics but you couldn’t clean up the rivers. Endemic TB, because for every case you treated there were ten that never came to a clinic, that lived with it and died with it, while the bacteria just kept evolving resistance. For that matter, a kind but stubborn lama who could have had his heart repaired but who preferred to stay at the monastery and meditate. Peter could see why docs burned out here; it was like medical Whac-a-Mole. For every case he hammered, ten more sprang up that he couldn’t do anything about. There was no end to it, no sense of having finished or accomplished anything. It was starting to feel corrosive, as if it might burn its way through his skin and begin consuming him from the inside.
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He scheduled visits at a couple of the monasteries up the hill and took stock of his paltry supplies. Stuffed into the old leather doctor’s bag that had belonged to his father was a stethoscope; a thermometer; a Ziploc full of latex gloves; a speculum; a couple of dozen sterile-wrapped syringes; an otoscope; and his favorite reflex hammer, gift of Bollixall Pharma, with its titanium handle and orange rubber head. Medications from the clinic stock—ampicillin, sulfa, Cipro, cortisone (injectable and inhalable, for anything from anaphylactic shock to asthma), albuterol, insulin, and a few other things. And of course the amazing array of TB drugs.
Peter hadn’t thought of his father in a long time, but the bag brought the old curmudgeon to mind. Peter and his sister had grown up in Jackson, Mississippi, where their father was a dermatologist. Even though his father was otherwise embarrassingly conservative, as a young man in the late 1950s he’d raised eyebrows by being one of the first white physicians in town to accept black patients.
“Once you learn something about skin, you’d have to be an idiot to think it makes any difference between people other than maybe in melanoma,” he told his son, when Peter was about ten. “And if that’s your metric, they’re superior to us.”
Holding the old leather bag now, Peter felt more fondness for his father than he had in some time, and wondered if his father too had felt his work was futile. Mississippi in those days had almost as much poverty as Nepal did now, and he must have wrestled with some of the same issues.
The jeep had only a canvas top, and the morning they left, it was cold as they careened through the mud on terrible roads. Devi was excited about seeing other Tibetans, though—or as she put it in her blunt way, Tibetans who weren’t afraid to be Tibetan, as her mother was.
They drove through the front gate of the monastery and found their liaison, a robust, red-cheeked nun who showed them to a small room where they would treat the other anis.
The room, like the whole building, was unheated. It was furnished simply with a cot, a chair, a small writing table, and a shrine with water bowls, lamps, and photos of the Dalai Lama. Down in the valley the days did warm up; it might be thirty degrees in the morning, but it would hit the mid-fifties by afternoon. Up at elevations like this, it stayed cooler. Having a row of butter lamps and three people crammed into the room helped, though. It was more than a matter of comfort; Pe
ter liked his patients to feel safe, and it always seemed that they were more relaxed and talked more easily if they were in a warm place.
Alex and Devi unpacked the various kits. Devi was worried that the anis might balk at being examined by a male doctor, but the abbot, Lama Yeshe, had assured the nuns that there was no misconduct in this and encouraged them to keep themselves well.
Soon the first ani appeared, a broad-hipped woman in her late thirties. She’d had recurrent diarrhea ever since leaving Tibet. Peter asked about it, and the nun said there was no blood in it, and that between bouts she felt all right, though a little weak. Without access to a real lab, Peter had to treat empirically, so he gave her Flagyl and figured that would likely take care of whatever she’d picked up.
The second nun was much older, possibly in her seventies, and had a skin rash over her lower back, buttocks, and legs. It wasn’t clear what was causing it, but it didn’t appear to be serious. Peter suggested she try to bathe every day with gentle soap, then gave her a big tube of cortisone cream.
Next came Ani Dawa, a pretty but tough-looking young woman in her twenties. She’d had a hacking cough for three months. Peter did his best to listen through her three or four layers of clothing but finally had to ask, through Devi, if she would mind paring down a bit. Ani Dawa laughed and unwrapped herself, leaving in place just the T-shirt that served as her bottom layer.