Vital Signs

by Robin Cook

  Tristan reached out and gripped her hand. “No one can ever say we didn’t try,” he said.

  After the group had been resting for a half hour, they were disturbed by a distant droning noise that rapidly escalated. Having been sensitized by their recent ordeal, everyone looked at each other in puzzled consternation. The sound not only got louder, but it developed a peculiar concussive, pulsating quality.

  Finally Tristan recognized it.

  “It’s a helicopter,” Tristan cried. “Get under the trees!”

  They had barely darted beneath the branches when a large military helicopter thundered overhead, heading directly out to sea in the direction that the patrol boat had disappeared.

  Emerging from the foliage, they stared at the aircraft, which was already a mere pinprick against the pale blue sky.

  “Do you think they saw us?” Marissa asked.

  “Nah!” Tristan said. “But I’m surprised they didn’t see all this Hong Kong money spread out on the sand.”

  When everyone felt rested from the cold swim, they started across the marshlands. Assuming Tse knew where he was going, the other three fell in behind him. At first all they had to do was traverse swampy grass, but eventually they had to ford some deeper streams.

  “Any crocs around this part of the world?” Tristan asked nervously when he was up to his waist, holding his partially dried money belt over his head.

  “No crocodiles,” Bentley said. “But we do have snakes.”

  “What next?” Marissa asked sarcastically.

  But they didn’t see any snakes. They did encounter more than a few insects. As they approached the heavily wooded higher ground, the mosquitoes came in swarms. For Marissa, this was a new fear. She asked Tse about malaria and dengue fever.

  “There is always some malaria,” Tse said. “But dengue fever I’m not familiar with.”

  “Never mind,” Marissa said. There were just so many things she could worry about at once. “I suppose I should look on the bright side of things. We were lucky to get off the junk. Thank God for the Communist patrol boat.”

  “That’s the attitude,” Tristan said.

  “And at least we still have our watches,” Marissa added.

  Tristan laughed, happy to hear that in spite of all that had happened, Marissa was capable of humor.

  “Did you recognize the Caucasian man in the front of the powerboat?” Marissa asked Tristan. “He was the other man throwing chum overboard when Wendy died.”

  “I’d vaguely recognized him,” Tristan said. “From back when I worked for FCA.”

  Reaching the edge of the marsh, they next climbed up through thick vegetation. Vines hung down from the branches of the trees. It was slow going. It took some effort just to go a hundred yards. Then the trees suddenly ended at the edge of a rice paddy.

  “I recognize where we are,” Tse said. “There is a small farming village ahead. Perhaps we should go there and get some food.”

  “How will we get food?” Tristan asked. “Will they take credit cards?”

  “We’ll use your money,” Tse said.

  “They’ll take Hong Kong dollars?” Tristan questioned.

  “Absolutely,” Tse said. “There is a black market for Hong Kong dollars throughout the Guangdong Province.”

  “Do we have to worry about the authorities in this village?” Tristan asked.

  “No,” Tse said. “There will be no police. Only in Shigi will there be police.”

  Turning to Bentley, Tristan asked: “What do you see as our major problem being in the PRC? After all, we have visas.”

  “Only two things,” Bentley said. “You have no entry stamp and no entry documents. Everyone must have a Baggage Declaration form. That is the form you must surrender when you leave the PRC.”

  “But no one will hassle us while we’re here?” Tristan asked. “I thought the first walloper we came across would nab us.”

  Everyone looked at Tristan curiously. “What’s the matter?” he asked.

  “What’s a walloper?” Marissa asked.

  “A policeman,” Tristan said. “Am I the only one who speaks English around here?”

  Ignoring Tristan, Marissa addressed Bentley. “So we only have to be concerned about leaving the PRC?” she asked.

  “I believe so,” Bentley said. “Foreign travel has become reasonably commonplace in China, especially in Guangdong Province. So no one should bother you. But without some help, you probably will not be able to cross back into Hong Kong or Macao. Without a Baggage Declaration and also without the usual things a tourist carries, like a camera, you’ll be considered smugglers and put in jail.”

  “At least we’ll be safe,” Tristan joked. “Since we don’t have anything to worry about currently, let’s go to that village and get some tucker.”

  “Food!” Marissa translated for the others.

  Tse had been right. The villagers were eager to obtain the Hong Kong dollars. For what Tristan thought was a piddling amount, he treated all four to dry clothes and a hearty meal. Except for the rice, Marissa and Tristan did not recognize the food.

  During the meal Marissa was reminded of Wendy’s comment that people in the PRC liked to stare. While they ate, it seemed as if everyone in the entire village came to gawk at the four strangers eating in the village common room.

  When they had finished their meal, Tristan turned to Tse. “Do you have any suggestions for us as to how to get out of the PRC? Maybe you know how we could get a couple of these Baggage Declaration forms?”

  “I have never seen such a form,” Tse said. “And if you do not have one, I’m afraid it will be a problem for you. Our government requires forms for everything, and our officials are of a suspicious nature. But I don’t think you should go to the border. I think it would be best for you to go to Guangzhou. I know there is an American consulate. I’ve visited it in an effort to get medical books.”

  “That sounds like good advice to me,” Marissa said.

  Tristan nodded. “I wonder if there is an Aussie consulate as well.”

  “If not, I’m sure we can talk the American consul into helping you too,” Marissa said.

  “How do we go about getting to Guangzhou?” Tristan asked. “I suppose it is a long walk from here.”

  Tse flashed a smile. “A very long walk,” he agreed. “But it is not such a long walk to the next town, which is larger than this village. Chiang and I stayed one night in the town, and I know they have a medical dispensary similar to the one where I work. I imagine they have transportation to Shigi, where the district hospital is located. From there we can go to Forshan, which is a big city.”

  “That sounds good to me,” Tristan said. “What do you think, Marissa?”

  “Sounds almost too good to be true,” Marissa said. “I like the idea of having a U.S. official deal with the Communist bureaucracy. As Tse says, it’s a much better idea than going to the border and trying our luck. With everything that has happened, I don’t feel very lucky.”

  “What about you, Bentley?” Tristan asked.

  “I think I will go back via Macao,” Bentley said. “I have a hui shen jing, which entitles me multiple visa-free entries into the PRC. I shouldn’t have much trouble. Maybe a short delay; but I’ll go with you as far as Forshan.”

  The walk from the tiny village to the next town took only about an hour. First they passed by small plots of vegetables, then through rice paddies being worked by peasants with water buffalo. Whenever any peasants spotted them, they stopped and stared until the strange group passed from view. Marissa imagined they made for a curious sight: two gweilos and all four dressed in ill-fitting clothing.

  Entering the town, Tse conversed briefly with a man pushing a wheelbarrow. During the entire conversation, the peasant didn’t take his eyes off Marissa.

  “He says the dispensary is just a little way ahead,” Tse reported.

  Most of the buildings in the town were either wood or brick, but the health clinic was a concrete w
hitewashed structure with a roof made of sunbaked tile. They entered through a low door. Both Tristan and Bentley had to duck to get in.

  The first room was a waiting room. It was filled mainly with older women, a few accompanied by young children. One middle-aged man had a cast on his leg.

  “Please,” Tse said. “If you would wait here I will introduce myself to the doctor.”

  There was no space on the crude wooden benches that circled the room’s periphery, so Marissa, Tristan, and Bentley stood. None of those waiting uttered a single word. They merely gawked at the trio as if they were extraterrestrial beings. The children were especially curious.

  “Now I know how cinema stars feel,” Tristan said.

  Tse reappeared, escorted by a tall, gaunt Chinese man dressed in a short-sleeved Western-style shirt.

  “This is Dr. Chen Chi-Li,” Tse said. He then introduced Chi-Li to Marissa, Tristan, and Bentley.

  Chi-Li bowed. Then he smiled, revealing large, yellow teeth. He spoke quickly in guttural Cantonese.

  “He welcomes you to his clinic,” Tse said. “He thinks it is an honor to have an American and an Australian doctor visit. He asks if you would care to see his facility.”

  “What about the transportation?” Tristan asked.

  “The clinic has a van,” Tse said. “The van will take us to Shigi. From Shigi he said that we can take a bus to Forshan, then a train to Guangzhou.”

  “How much will he charge for the van?” Tristan asked.

  “There will be no charge,” Tse said. “We will go with several patients being sent to the district hospital.”

  “Fine,” Tristan said. “Let’s see the bugger’s clinic.”

  With Chi-Li and Tse leading, the group toured the clinic. The rooms were essentially bare except for crude furniture here and there. The procedure room was especially stark, with a rusted steel table, a porcelain sink, and one ancient glass cabinet full of instruments.

  Seeing that Marissa seemed interested in the instrument cabinet, Chi-Li went over and opened the door for her.

  Marissa winced when she looked into a tin of nondisposable needles that had become dull from overuse. It made her realize how much she took for granted in her office and at the Boston Memorial. As her eyes wandered to the upper shelf, she saw packages of vaccines, including a cholera vaccine made in the United States. Then she noticed some vials of BCG. She remembered Tse’s having mentioned their use in tuberculosis inoculations. Marissa was curious about BCG, particularly since it had never been proven to be effective in the United States. She reached into the cabinet and lifted one of the vials. Reading the label, she discovered it had been made in France.

  “Ask Chi-Li if he sees much tuberculosis,” Marissa asked as she replaced the BCG vial. She glanced at the other contents of the cabinet while Tse spoke with the man.

  “He sees about the same as I,” Tse reported.

  Marissa closed the cabinet door. “Ask him if he ever sees TB as a female problem,” she asked. She watched Chi-Li’s face as Tse translated. There was always the chance she could hit on something unexpected. But Chi-Li’s expression reflected a negative response to the question. Tse translated that Chi-Li had seen nothing of the kind.

  Leaving the procedure room, they walked into an examining room. A female patient was sitting on a chair in the corner. She stood and bowed as the group entered.

  Marissa bowed back, sorry to have intruded. Suddenly Marissa stopped. In the center of the room was a relatively modern examining table, complete with stainless steel stirrups.

  Seeing the table brought back all the unpleasant procedures she’d endured over the last year in the course of her fertility treatments. She was surprised to see such a modern piece of equipment at the clinic; nearly everything else she’d seen was quite dated and rudimentary.

  Stepping over to the table, Marissa absently fingered one of the stirrups. “How did this examining table get here?” she asked.

  “The same way all the other equipment got here,” Tse said. “Most of the rural health clinics have such a table.”

  Marissa nodded as if she understood. But she didn’t. Of all the pieces of modern equipment to be sent to rural clinics, it seemed strange for them to choose an examining table with stirrups. But having read of the bureaucratic mismanagement problems of Communist governments, she assumed this was just another case in point.

  “We use such a table frequently,” Tse said. “Birth control has been given a high priority by the government.”

  “I see,” Marissa said. She was about to walk on when she looked back at the table. She was puzzled. “What type of birth control do you favor?” she asked. “Intrauterine devices?”

  “No,” Tse said.

  “Diaphragms?” Marissa asked, even though she knew they couldn’t use diaphragms since they were too expensive and not effective enough. Yet why a table equipped for internal exams?

  “We use sterilization,” Tse said. “After one child the woman is often sterilized. Sometimes we perform sterilization even before the woman has a child if there is a request or if the woman should not have a child.”

  Tristan called to Marissa from the next room, but Marissa ignored him. Although she had remembered hearing that sterilization was used for birth-control in the PRC, she hated to hear a doctor speaking so coldly about it. She wondered who got to make the decision of who could bear a child and who couldn’t. The issue offended her feminist sensibilities.

  “How do you sterilize these women?” she asked.

  “We cannulate the fallopian tubes,” Tse said matter-of-factly.

  “Under anesthesia?” Marissa asked.

  “No need for anesthesia,” Tse said.

  “How can that be?” Marissa asked. She knew that to cannulate the fallopian tubes, the cervix had to be dilated, and dilating the cervix was excruciatingly painful.

  “It is easy for us rural doctors,” Tse explained. “We use a very small catheter with a wire guide. It is done by feel. We do not need to see. It is not painful for the patient.”

  “Marissa!” Tristan called. He had come back to the threshold of the examining room. “Come out here and see the garden. They grow their own medicines!”

  But Marissa waved Tristan away. She stared at Tse, her mind racing. “Can Chi-Li perform this technique as well?” she asked.

  “I’m sure,” Tse said. “All rural doctors are taught it.”

  “Once you cannulate the fallopian tube,” Marissa said, “what do you use to sterilize?”

  “Usually a caustic herbal solution,” Tse said. “It is like a kind of pepper.”

  Tristan left the doorway and approached Marissa. “What’s the matter, luv?” he asked. “You look like you’ve just seen a ghost.”

  Without saying a word, Marissa hurried back to the procedure room and walked up to the cabinet. She studied the shelf of vaccines.

  Tristan followed her, wondering what she was thinking. “Marissa,” he said, as he reached out and grabbed her shoulders, swinging her around to face him. “Are you okay?”

  “I’m fine,” Marissa said. “Tristan, I think I just figured it all out. All of a sudden I think I understand—and if I’m right, the truth is much worse than we imagined.”

  The health clinic van took the four of them to Shigi and dropped them off at the Shigi bus station. Since there was frequent service to Forshan, they had only a short wait. During the trip, Marissa sat next to Tristan while Bentley sat with Tse.

  “I’ve never seen anybody spit more than these Chinese,” Tristan said to make conversation. It was true. At any given moment someone on the bus was either preparing to spit or was in the process of spitting out the window. “What the hell is wrong with these blokes?”

  “It’s a national pastime,” Bentley said, hearing Tristan’s comment. “You see it all over China.”

  “It’s disgusting,” Tristan said. “It reminds me of that foolish American game of baseball.”

  Everyone on the bus seemed to be b
usy talking except Marissa and Tristan. Tristan had finally given up after Marissa persisted in meeting his every question with only one-word replies. She seemed to be deep in thought.

  Suddenly she turned to him. “Do you know the pH indicator phenol red?”

  “Vaguely,” Tristan said, surprised by her sudden inquiry.

  “When does it turn red?” Marissa asked. “In an acidic or an alkaline solution?”

  “I think alkaline,” Tristan said. “In an acid solution it’s clear.”

  “I thought so,” Marissa said. Then she lapsed back into silence.

  They rode for another mile. Finally, Tristan could no longer contain his curiosity. “What’s with you, Marissa?” he asked.

  “Why won’t you tell me what you’re thinking?”

  “I will,” Marissa said. “But not yet. We have to get out of the PRC. There are a couple of things I have to check to be sure first.”

  From Forshan they were able to get hard seats on a train to Guangzhou. Bentley and Tse left them at the Forshan bus station.

  By the time they got to Guangzhou it was dark. They took a taxi from the train station. On the recommendation of the driver, they went to the White Swan Hotel. During the short trip both Marissa and Tristan remarked that the city looked more Western than they’d expected, although even at night the bicycles far outnumbered the motor vehicles in the streets.

  The hotel turned out to be a surprise as well. The lobby was impressive, with a waterfall. The rooms had all the modern conveniences, including TVs, refrigerators and, more importantly, direct-dial telephones. They booked a suite with two bedrooms and a view over the Pearl River.

  Marissa was exhausted. She eyed the bed with longing, hoping that she would at last get a good night’s rest. But even before bed, what she was interested in most was the telephone. After calculating the time on the East Coast of the United States, she decided to put off her call for a few hours. She knew it wouldn’t help to wake Cyrill Dubchek from his sleep.

  “They have a Western-style restaurant,” Tristan said with excitement, coming into Marissa’s bedroom with the hotel directory in his hand. “What do you say to a nice big steak!”