Cutting for Stone

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Cutting for Stone Page 8

by Abraham Verghese


  Within the boundaries of his irrational logic, this was a rational decision. Doing the wrong thing to do the right thing, as Sister Mary Joseph Praise might have said.

  To a shocked and horrified Matron, the man who sat between Sister Mary Joseph Praise's legs didn't resemble their fierce, shy, and exceedingly competent Thomas Stone. This man had nothing in common with Thomas Stone, FRCS, author of The Expedient Operator. His place had been taken by this desperate, agitated fellow who did not look like a Fellow of the Royal College of Surgeons, but rather someone for whom the letters FRCS could mean (as Dr. Ghosh often claimed they did) “Farting Round the Country-Side.”

  Stone, animated now, consumed by a sense of mission, propped Munro Kerr's Operative Obstetrics open, cookery-book fashion, on the down slope of Sister Mary Joseph Praise's protuberant belly. “Damn it, Hemlatha, you picked a hell of a time to be away,” he said aloud, feeling his courage return.

  Two blasphemies, Matron noted. “Custody of the tongue,” she murmured under her breath. She took her own pulse because despite her faith in the Lord she was anxious about the heart flutter that had turned up in the last year like a surprise guest. Her heart was skipping beats now and she felt faint.

  The strange instruments that Stone had requested and that Matron dug up from an old supply closet refused to be tamed by his hands. “Where the devil is Ghosh?” he shouted, because Ghosh often pitched in to help Hema with abortions and tubal ligations, and, as a jack-of-all-trades, he had more experience with a women's reproductive anatomy than Stone. Matron once again sent a runner over to Ghosh's bungalow, more to placate Stone than with any faith that Ghosh was back. Perhaps she would have done better to send the maid to inquire at the Blue Nile Bar or its vicinity for the banya doctor. But even an inebriated Ghosh could counsel Stone that what he was about to do was not the act of an expedient surgeon but an idiotic one, and that his decision was wrong, his logic illogical. Matron felt this pregnancy, this birth, was somehow her fault—some inattention on her part had resulted in this. Still, she also assumed in the face of torrential bleeding that the child was long dead. Had she believed for a moment that the child was alive (she knew nothing about twins), she would have intervened.

  Stone cocked his head from side to side, trying to match Munro Kerr's illustrations of instruments—Smellie scissors, Braun's cranioclast, Jar-dine's cephalotribe—with the objects he juggled in his hand. His tools were distant cousins of the ones depicted in the book, but clearly designed for the same sinister purpose.

  With two Jacobs clamps, he grabbed the oval of my brother's scalp. “I see you in the depths, burrowing creature! Damn you for torturing Mary,” he muttered. Then, using scissors, he cut the skin between the two clamps and gave the intruder its first introduction to pain.

  His next move was to try to put the cephalotribe—the skull crusher— on the head. This awkward medieval instrument had three separate pieces. The middle was a spear meant to go deep into the brain, cutting a big opening in the skull as it did so. Flanking it were two forcepslike structures to clamp to the outside of the skull. Once all three pieces were in place, their stems interlocked to form a single handle with convenient finger indentations. Stone would be able to crush and grip the skull so it wouldn't slide away. Out would come the intruder.

  It was cool in the operating theater, but sweat from his brow trickled into his eyes and wet his mask.

  He tried to drive the spear in.

  (The child, my brother, Shiva, sheltered for eight months and already hurting from the cut of scissors on his scalp, cried out in the womb. I pulled him to safety as the spear slid over the skull.)

  Stone decided it would be easier if he first applied the outer two blades of the cephalotribe, then dragged the head within reach, and then inserted the spear. His hands were clumsy in this awkward space. Matron shuddered at the damage he might be doing to Sister Mary Joseph Praise's tissues and to the baby as he jammed each piece past an ear until, finally, he had the skull in his grasp, or thought he did.

  Matron was close to dropping. “It is the duty of the nurse to assist and anticipate the doctor's every need.” Wasn't this what she herself preached to her probationers? But it was all wrong, all wrong, and she didn't know how to begin to turn it around. She was sorry she ever dug out the instruments. A humane obstetrician invented these instruments for mothers with the most desperate needs, not for desperate physicians. A fool with a tool is still a fool. In Stone's hands the instruments had taken over, and they were doing the thinking for him. Matron knew that nothing good could ever come out of that.

  CHAPTER 5

  Last Moments

  AT THE VERY LAST SECOND, just as she braced for the plane to smash into the water, Dr. Hemlatha saw the ocean give way to dry scrubland.

  And before she could digest this, the plane flared to a touchdown over shimmering asphalt, squealing its tires, wiggling its tail, and, when it bled off its speed, scampering down the runway like a dog unleashed.

  The passengers’ relief turned to bewilderment and embarrassment, for the most godless among them had prayed for divine intervention.

  The plane stopped, but the pilot continued arguing with the tower while dragging on a cigarette, even though he had made a big point of turning on the NO SMOKING light after they landed.

  The little boy whimpered, and Hema rocked him with an adeptness she didn't know she possessed. “I'm going to put a tiny, tiny bandage on your leg, okay? Then the hurt will be all gone.” The young Armenian somehow found a cane, and the two of them fashioned a splint.

  When the throb of the engine ceased, Hema felt the silence within the cabin press on her eardrums. The pilot looked around, a smirk on his face, as if he were curious to see how his passengers had held up. Almost as an afterthought, he said, “We are stopping to pick up some bagg-aje and some Very Important People. This is Djibouti!” He smiled and showed his bad teeth. “They did not give me permission to land unless it is emergency. So I make an engine failure.” He shrugged as if modesty prevented him from accepting their accolades.

  Hemlatha was startled to hear her own voice shatter the silence.

  “Baggage? You bloody mercenary. What do you think we are? Goats? You just shut down an engine and drop out of the sky like that and stop in Djibouti? No warning? Nothing?”

  Perhaps she should have been grateful to him, happy to be alive, but in the hierarchy of her emotions, anger was always trumps.

  “Bloody?” the pilot said, turning red. “Bloody?” he said, clambering out of the cockpit, white knees knocking under his safari shorts, as he struggled free.

  He stood before her, huffing from the effort. He seemed to take far more exception to “bloody” than “mercenary.” His contempt for this Indian woman was greater than his anger. But he had raised his hand. “I will offload you here, insolent woman, if you don't like it.” Later he would claim that he had raised his hand merely as a gesture, with no intent to strike her—God forbid that he, a gentleman, a Frenchman, would strike a woman.

  But it was too late, because Hemlatha felt her limbs move as if by their own volition, fueled by anger and indignation. She felt as if she were observing the actions of a stranger, of a Hemlatha who had not previously existed. The new Hemlatha, whose license on life had just been renewed and its purpose defined, came to her feet. She was as tall as the pilot. She could see the tiny feeder vessel in the starburst on his left cheek. She pushed her glasses up on her forehead and met him eyeball to eyeball.

  The man squirmed. He saw she was beautiful. He fancied himself a lady's man, and he wondered if he'd blown the opportunity to have drinks with her at the Ghion Hotel that evening. Only now did he notice the people huddled over the whimpering boy. Only now did he notice the father's rage, and the clenched fists of some of the other passengers who had lined up behind her.

  What a specimen, Hema thought as she studied him. Spider angiomas all over his exposed skin. Eyes tinged with jaundice. No doubt his breasts are enlarged, his a
rmpits hairless, and his testes shriveled to the size of walnuts—all because his liver no longer detoxifies the estrogen a male normally produces. And the stale juniper-berry breath. Ah yes, she thought, coming to a diagnosis beyond cirrhosis: a gin-soaked colonial resisting the reality of postcolonial Africa. If in India they still are cowed by all of you, it is from long habit. But there are no such rules on an Ethiopian plane.

  She felt her rage boil over, and it was directed not just at him but at all men, every man who in the Government General Hospital in India had pushed her around, taken her for granted, punished her for being a woman, played with her hours and her schedule, transferred her here and there without so much as a please or by-your-leave.

  Her proximity to him, her encroachment of sacred bawana space, rattled him, distracted him. But his hand was still up there. And now, as if he just noticed it, he moved the hand, not to strike her, he would claim, but as if to determine whether it really was his hand and to see if it still answered to his commands.

  The upraised hand was insult enough, but when Hema saw it start to move, she reacted in a manner that made her blush when she recalled it later.

  Hemlatha's fingers shot up the pilot's shorts and locked around his testicles, only his underwear intervening. There was an ease to her movements which surprised her, and an ease to the way the gap between her thumbs and index fingers allowed passage for the spermatic cords that connected balls to body. Years later she would think that what she did was conditioned by her surroundings, by the propensity in East Africa for shiftas and other criminals to lop off their victims’ testicles. When in Rome…

  Her eyes burned like a martyr's. Sweat changed the pottu on her forehead from a dot to an exclamation mark. She had worn a cotton sari for the heat, and earlier, when she had been seated, she had hiked it to her knees—modesty be damned—and now that she was standing it stayed that way, outlining her thighs. Sweat glistened on her upper lip as she squeezed to extract the same measure of distress and fear the Frenchman had caused her.

  “Listen, sweetie,” she said (deciding that there was indeed testicular atrophy and also trying to recall tunica albugineae, and tunica something else, and vas deferens, of course, and that craggy thingy at the back, whatsitcalled … epididymis!). She saw his shoulders sag and the color drain out of his face as if she'd opened the spigot below. Dampness quite different from sweat appeared on his forehead. “At least your syphilis isn't far advanced because you can feel testicular pain, huh?” His upraised hand came floating down and then hesitantly, almost lovingly rested on her forearm, pleading with her not to increase the pressure. A cathedral of silence descended on the plane.

  “Are you listening now?” she said (thinking that she didn't really want to know a man's anatomy this way). “Are we talking as equals? … My life in your hands and now your family jewels in mine? You think you can terrify people like that? That little boy broke his leg because of your stunt.”

  She turned her head toward the other passengers but, keeping her eye on Frenchie's face, said, “Anybody have a sharp knife? Or a Gillette?”

  The rustle she heard might just have been the cremaster muscles of all the males on board involuntarily reeling their dangling sperm factories back up to shelter.

  “We were unauthorized … I had to …,” the pilot wheezed.

  “Take your wallet out right now and pay for this child,” Hema said, because she didn't believe in IOUs.

  When he fumbled with the notes, the young Armenian grabbed the wallet and handed it to the boy's father.

  One of the Yemenis, finding his voice, let out a stream of profanities, wagging his finger in the pilot's face.

  Hema said, “Now, you refund the plane tickets for the boy and his parents. And you get us back in the air very soon, … otherwise, you will not only be a eunuch, but I will personally petition the Emperor to make sure that even a job as a camel driver, let alone flying khat, will be much too good for you.”

  They heard the cargo door open and sharp exclamations from the coolies milling around outside.

  The Frenchman, his eyeballs sinking in their sockets, nodded mutely. France had colonized Djibouti and parts of Somalia, and they had even jockeyed with the English in India before settling for a foothold in Pon di cherry But on this steamy afternoon, one brown soul who would never be the same again, and who had Malayalis, Armenians, Greeks, and Yemenis backing her, showed she was free.

  “Well, how can one be sane in hot weather?” Hemlatha said to no one in particular, letting go and making for the outside to wash her hands, stifling her laughter.

  CHAPTER 6

  My Abyssinia

  HEMA FIXED HER EYES on the ground below, watching for the transition of brown scrub and desert into steep escarpment announcing the lush, mountainous plateau of Ethiopia. Yes, she thought. This is my home now. My Abyssinia, which sounded to her so much more romantic than “Ethiopia.”

  The country was in essence a mountain massif that rose from the three deserts of Somaliland, Danakil, and Sudan. Even now Hema felt a bit like a David Livingstone or an Evelyn Waugh exploring this ancient civilization, this stronghold of Christianity which, until Mussolini's invasion in ‘35, was the only African nation never to be colonized. Waugh, in his dispatches to the London Times and in his book, referred to His Majesty Haile Selassie the First as “Highly Salacious,” seeing cowardice in the Emperor's leaving the country in the face of Mussolini's advance. Hema's reading of Waugh was that he couldn't accept the notion of African royalty. He couldn't accept that the bloodlines of Emperor Haile Selassie, extending back as they did to the Queen of Sheba and King Solomon, made the Windsors or the Romanovs look like carpetbaggers. She didn't think much of Waugh or his book.

  The new passengers who climbed aboard at Djibouti were Somalis or Djiboutians (and really, she thought, what difference was there between the two, other than a line drawn on a map by some Western cartographer). They chewed khat and smoked 555s and despite their doleful, muddy eyes they were happy. Crammed into the plane, which by now was altogether too familiar to Hema, was khat, great bales of it being hauled back to Addis Ababa. It was all very strange, since khat usually traveled in the opposite direction: grown in Ethiopia, around Harrar, and exported by rail to Djibouti and then by air to Aden. That lucrative khat trade route was responsible for the birth of Ethiopian Airlines. She overheard that some problem with the railway and road transport, as well as the urgent need for large quantities of khat for a wedding, prompted this reverse export and the unscheduled stop. Khat had to be chewed within a day or so of its harvest, or else it lost its potency Hema pictured the Somali, Yemeni, and Sudanese merchants in the tiny souks that anchored every street and byway, and the owners of the bigger shops of the Merkato in Addis Ababa, eyeing their Tissot watches, snapping at their shop boys as they waited for this shipment. She pictured the wedding guests with mouths too parched to spit, but spitting and cursing all the same, telling one another that the bride was uglier than they remembered, and the big mole on her neck must mean shed also inherited the miserliness of her father.

  Hema imagined telling her mother about the pilot business. It made Hema laugh, which made the Somali sitting opposite her, one of the newcomers, smile.

  Madras had been hot and humid for the three weeks that Hema was there, but it was heaven compared with Aden. Her parents’ three-room house in the neighborhood of Mylapore, very near the temple, had seemed spacious to her as a girl, but on this visit if felt claustrophobic. Though she regularly sent her parents bank drafts, shed been dismayed to find no improvements in the house since her last visit. The interior paint had peeled to form abstract patterns while the kitchen, blackened with smoke, resembled a darkroom. The narrow street outside which rarely saw a car was now a noisy thoroughfare, and the compound wall showed no trace of whitewash but instead was the color of the earth on which it stood. Only the garden had benefited from the passage of time with the bougainvillea hiding the house from the street. The two mango trees h
ad become huge and heavy with fruit. One was an Alphonso and the other a hybrid with flesh that felt rubbery at first bite but then melted in the mouth like ice cream.

  The sole decoration in the living room was, as it had always been, the Glaxo powdered-milk calendar hanging on a nail. The overfed blue-eyed Caucasian baby had never grown up. The caption read “Glaxo Builds Bonny Babies.” It was enough to make any breast-feeding mother feel guilty that she was starving her infant. As a child Hema had barely registered the Glaxo baby. Now the calendar drew her eye and her ire. What an insidious presence that brat had been in her life. An interloper with a false message. Hema took down the calendar, but the pale rectangle on the wall called attention to itself in a way the baby never had. No doubt once Hema left, another Glaxo baby would find its way back there.

  During her brief vacation, Hema had the house painted and ceiling fans installed. Sathyamurthy, the father of her old childhood nemesis, Velu, peered over the fence as workmen carried in a Western-style commode to be cemented over the footpads of the Indian toilet. He sniggered and shook his head. “It's not for me, you old coot,” Hema said in English. “My mother's hips are bad.” And Sathyamurthy answered in the only English phrase he knew, “Goddamn China, kiss me Eisenhower!” He smiled and waved, and she waved back.

  THE SOMALI ACROSS FROM HER wore a shiny blue polyester shirt and a gold watch that swung on his stick wrist. His toes, protruding from sandals, glowed like polished ebony. He looked familiar to Hema. Now, he bowed, grinned, and displayed his fingers as if bidding at an auction as he said, “Three kids, two shots, one night!”

 

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