Cutting for Stone

by Abraham Verghese

  “I don't suppose he can do much about that now,” Matron said, and gave the man a nod. He gathered his crowbars and gunnysacks and led his animal away.

  “I was thinking,” Hema said, her voice hoarse. “That inscription should read, ‘Died at the hands of a surgeon. Now safe in the arms of Jesus.’ “

  “Hema!” Matron protested. “Custody of the tongue.”

  “No, really,” Hema said. “A rich man's faults are covered with money, but a surgeon's faults are covered with earth.”

  “Sister Mary Joseph Praise is covered in the soil of the land she came to love,” Matron said, hoping to put a stop to this kind of talk.

  “Put there by a surgeon,” said Hema who had to have the last word.

  “Who has now left the country,” Matron said.

  They turned to look at her, mouths open.

  Matron said, apologetically, “I got a call from the British Consulate. That's why I was late. From what I can piece together, Stone went to the Kenyan border, then to Nairobi, don't ask me how. He's in bad shape. Drink, I presume. The man was crazed.”

  “He's not hurt or anything?” Ghosh said.

  “As best as I can tell he's in one piece. I made a trunk call to Mr. Elihu Harris just now. Yes, I got Harris involved. They have a big mission in Kenya. If he sobers up, Harris thinks Stone could work there. Or if he doesn't want that, Eli can arrange for him to go to America.”

  “But what about his books, and his things?” Ghosh said. “Should we send them on to him?”

  “I imagine he'll write for his books and specimens once he is settled,” Matron said.

  The news both annoyed and pleased Hema. It meant Stone had abandoned the children, and that he'd given up any claims on them. She wished he'd signed a paper to that effect. She still felt uneasy. A man who made his name at Missing, whose lover was buried at Missing, and whose children were being raised at Missing, might not be able to cut the Missing cord that easily. “The crookedness of the serpent is still straight enough to slide through the snake hole,” Hema said.

  “He's no serpent,” Ghosh said sharply, contradicting Hema. She was too astonished to reply. “He is my friend,” Ghosh continued in a tone that dared anyone to disagree. “Let's not forget what a valuable colleague he was all these years, the great service he gave to Missing, the lives he saved. He's no serpent.” He spun on his heels and walked off.

  Ghosh's words pricked Hema's conscience. She couldn't assume that he was to feel everything she felt. Not if she cared for him. Ghosh was his own man, had been all along.

  She gazed at Ghosh's receding back and was frightened. She'd never worried particularly about Ghosh's feelings, but now, at the graveside, she felt like a young girl who, while drawing water at the well, meets a handsome stranger—a once-in-a-lifetime opportunity—but she ruins it by saying the wrong thing.

  CHAPTER 16

  Bride for a Year

  THE MILK COW WAS HEMA'S FOLLY, but once the first cream-rich mouthful slid down her throat there was no going back, even if Ghosh had taken away the reason for a cow.

  “Are you joking, Hema? You can't give cow's milk to newborn babies!”

  “Who says so?” she said, but without conviction.

  “ I do,” he said. “Besides, they've been thriving on formula for weeks. They are staying on formula.”

  After his sharp words at Sister's graveside, she'd felt a terrible premonition that he would leave Missing, but in the ensuing days he had proved true to her, returning to sleep on the sofa. The calm, methodical way he'd approached Shiva's problem was a side of him she hadn't appreciated. On the wall by the door he'd taped a paper that graphed the waning and disappearance of those terrifying episodes of apnea. Hema would never have had the confidence to say what he said one evening— that the night watch was over.

  He'd been sleeping on the sofa since the day she summoned him, and now she didn't want him to leave—his snoring was a sound she'd come to depend on. But she couldn't resist arguing with him now and then; it was an old reflex. She thought of it as her way of being affectionate.

  They didn't take the anklet off Shiva's foot, even though it was no longer needed. The sound had become part of Shiva, and to remove it felt akin to taking away his voice.

  In the early morning a stone bell heralded the procession of cow, calf, and Asrat, the milkman, up the driveway. The cowbell was tonally related to the chime of Shiva's anklet. Asrat charged more for bringing the milk factory to the house, but by milking under Rosina's or Almaz's watchful eye, there was no question of the milk being watered down.

  By the time Hema rose, the house was suffused with the scent of boiling milk. She took to adding more and more milk to her morning coffee. Soon when Hema heard the cowbell, her mouth watered, just as if she were one of Professor Pavlov's mutts. Her morning “coffee” grew to two tumblers, and she had another two glasses during the day, more milk than coffee, loving the way the buttery flavor lingered on her tongue. Unlike the buffalo milk of her childhood, this milk was made so very tasty by the highland grass on which the cow fed.

  When Asrat, whose bovine equanimity Hema believed came from having his cows sleep inside his hut at night, said one morning, “If only madam would buy corn feed, the milk would be so thick a spoon would stand up in it,” she didn't hesitate. Soon a coolie arrived with ten sacks on a handcart stamped ROCKEFELLER FOUNDATION and NOT FOR RESALE. “The best investment I've ever made,” Hema said a few days later, smacking her lips like a schoolgirl. “Corn makes all the difference.”

  “Hardly a controlled experiment, given the bias you introduced by paying for the corn,” Ghosh said.

  Asrat tethered the animals behind the kitchen, the calf just out of reach of its mother's udders, while he delivered what milk remained to other homes. The cow and calf called to each other with such soothing and auspicious sounds. Hema remembered her mother saying, “A cow carries the universe in its body, Brahma in the horns, Agni in the brow, Indra in the head …”

  The calf's call for its mother was nothing like the cry of her twins, but the emotion was identical. In her years as an obstetrician, Hema had never thought too much about a newborn's cry, never paused to consider the frequency that made a baby's tongue and lips quiver like a reed. It was such a helpless, urgent sound, but hitherto its importance lay in what it signaled: a successful labor, a live birth. Only when it was absent was it noteworthy. But now, when her newborns, her Shiva and Marion, cried, it was like no other earthly sound. It summoned her from sleep's catacombs and brought shushing noises to her throat as she rushed to the incubator. It was a personal call—her babies wanted her!

  She remembered a phenomenon she'd experienced for years when she was about to fall asleep: a sense that someone was calling her name. Now she told herself it had been her unborn twins telling her they were coming.

  There were other noises she became attuned to in her new-mother state. The thwack of wet cloth on the washing stone. The clothesline sagging with diapers (banners to fecundity) and raising a flapping alarm before a rain squall, sending Almaz and Rosina racing outside. The glass-harp notes of feeding bottles clinking together in the boiling water. Rosina's singing, her constant chatter. Almaz clanging pots and pans … these sounds were the chorale of Hema's contentment.

  A Maharashtrian astrologer, on a tour of East Africa, came to the house over Ghosh's objections. Hema paid for him to read the children's fortunes. With his spectacles and fountain pens in his shirt pocket, he looked like a young railway clerk. After recording the exact time of the twins’ births, he wanted the parents’ birth dates. Hema gave hers and then volunteered Ghosh's, throwing Ghosh a warning look. The astrol oger consulted his tables and his calculations filled one side of a foolscap paper. At last he said, “Impossible.” He looked nervously at Hema, but avoided Ghosh's eyes. He capped his pen, put away his papers, and while an astonished Hema looked on, he made for the door. “Whatever is their destiny,” he said, “you can be sure it's linked to the father.�
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  Ghosh caught up with him at the gate. He declined Ghosh's offer of money. With a mournful expression he intoned, “Doctor saab, I'm afraid you cannot be the father.” Ghosh pretended to be deeply troubled by this news. Ghosh reported back to Hema, but she wasn't half as amused as he was. It left her fearful, as if the man had somehow predicted Thomas Stone's return.

  The next day Ghosh found Hema squatting, cupping rice flour in her fist and drawing a rangoli—an elaborate decorative pattern—on the wooden floor just outside her bedroom, taking pains that the lines were uninterrupted, so the evil spirits could not pass. Above the door frame to the bedroom, Hema hung a mask of a bearded devil with bloodshot eyes, his tongue sticking out—a further deflection of the evil eye. It became part of her morning ritual along with the playing of “Suprabhatam” on the Grundig, a version sung by M. S. Subbulakshmi. The chant's hiccuping syncopation evoked for Ghosh the sound of women sweeping the front yard around the banyan tree in the early mornings in Madras and the dhobi ringing his bicycle bell. “Suprabhatam” was what radio stations used to begin their daily broadcast, and as a student, Ghosh had heard the words of “Suprabhatam” on the lips of dying patients. It amused him that he had to come to Ethiopia to learn exactly what it was: an invocation and a wake-up call for Lord Venkateswara.

  Ghosh noticed that Hema's bedroom closet was now a shrine dominated by the symbol of Shiva: a tall lingam. In addition to the little brass statues of Ganesh, Lakshmi, and Muruga, now came a sinister-looking ebony carving of the indecipherable Lord Venkateswara, as well as a ceramic Immaculate Heart of the Virgin Mary and a ceramic crucified Christ, blood welling out of the nail holes. Ghosh held his tongue.

  Without fanfare and quite unexpectedly, Ghosh had become Missing's surgeon. Though he was no Thomas Stone, he had now handled several acute abdomens (his stomach fluttering just like the first time) and dealt with stab wounds and major fractures and even put in a chest tube for trauma. A woman in the labor and delivery room had suddenly developed airway obstruction. Ghosh ran in and cut high in the neck, opening the cricothyroid membrane; the aspirate sound of air rushing in was its own reward, as was the sight of the patient's lips turning from deep blue to pink. Later that day, under better lighting in the operating theater, he did his first thyroidectomy Operating Theater 3 was now a familiar place, but still fraught with danger. Nothing was routine for him.

  On the day the twins turned two months old, Ghosh was in mid-surgery when the probationer poked her head in to say that Hema urgently needed him. Ghosh was removing a foot so destroyed by chronic infection that it had become a weeping, oozing stump. The boy had traveled alone from his village near Axum, a voyage of several days, to beg Ghosh to cut off the offending part. “It has stuck to my body for three years,” he said, pointing to the foot that was four times the size of his other foot and shapeless, with toes barely visible.

  Madura foot was found wherever people habitually walked barefoot, but the town of Madurai, not far from Madras, had the dubious honor of lending its name to this disease. No place ever came off well when a disease was named after it: Delhi belly, Baghdad blues, Turkey trots. Madura foot began when a field-worker stepped on a large thorn or nail. Their livelihood gave them no choice but to keep walking, and slowly a fungus overran the foot, invaded bone, tendon, and muscle. Nothing short of amputation would help.

  Encouraged by the old surgical saw “Any idiot can amputate a leg,” Ghosh had decided to proceed. If he hesitated, it was because the rest of the saying went “but it takes a skilled surgeon to save one.” Still there was no saving this foot.

  The boy was the first patient Ghosh had ever seen who sang and clapped his way into the theater, overjoyed at having surgery. Ghosh cut through skin above the ankle, leaving a flap at the back to cover the stump. He tied off the blood vessels and sawed through the bone and heard the thump of the foot landing in the bucket. It was at this point that the probationer delivered her summons.

  Ghosh covered the wound with a damp sterile towel, and he ran home, tearing off his mask and cap, imagining the worst.

  He burst into Hema's bedroom, breathless. “What is it?”

  Hema, in a silk sari, had spread rice out on the floor. In Sanskrit letters, shed spelled out the boys’ names in the grains. Shiva was in her arms, and Rosina held Marion. Hema had assembled a few Indian women, who were glaring at him in disapproval.

  “The post came,” Hema said. “We forgot to do the nama-karanum, Ghosh. Naming ceremony. Should be on the eleventh day, but you can also do it on the sixteenth day. We have not done it on either of those two days, but in my mother's letter she says as long as I do it as soon as I get her aerogram we are all right.”

  “You made me leave an operation for this?” He was furious. It was on his lips to say, How can you subscribe to all this witchcraft?

  “Look,” Hema hissed, embarrassed by his behavior, “the father is supposed to whisper the child's name into its ear. If you don't want to do it, I'll call someone else.”

  That word—”father”—changed everything. He felt a thrill. He quickly whispered “Marion” and then “Shiva” into each tiny ear, kissed each child, then kissed Hema on the cheek before she could pull away, saying “Bye, Mama,” scandalizing Hema's guests before he raced back to the theater to fashion the flap over the stump.

  THE TWINS WEREN'T EASY to tell apart but for the anklet which Hema had kept on Shiva as a talisman. While Shiva was peaceful, quiet, Marion tended to furrow his eyebrows in concentration when Ghosh carried him, as if trying to reconcile the strange man with the curious sounds he made. Shiva was slightly smaller, and his skull still bore the marks of Stone's attempts at extraction; he fussed only when he heard Marion crying, as if to show solidarity.

  By twelve weeks, the twins had gained weight, their cries were lusty their movements vigorous. They clenched their fists against their chests, and now and then they stretched out their arms and focused on their hands with cross-eyed wonder.

  If they didn't show awareness of each other, Hema believed it was because they thought they were one. When they were bottle-fed, one in Rosina's arms, the other in Hema's or Ghosh's, it helped greatly for them to be within earshot, heads or limbs touching; if they took one twin to another room, they both became fussy

  At five months, the boys had a riot of black curly hair. They had Stone's close-set eyes, which made them appear hypervigilant, examining their surroundings like clinicians. Their irises, depending on the light, were a very light brown or a dark blue. The forehead, round and generous, and the perfect Cupid's bow of the lip was all Sister Mary Joseph Praise. They were, Hema thought, much more beautiful than Glaxo babies, and there were two of them. And they were hers.

  To his delight, Ghosh had the magic touch when it came to putting them to sleep. He supported one child on each forearm, their cheeks against his shoulder while their feet rested on the shelf of his belly. He would circumnavigate Hema's living room, bobbing and swaying. For lack of lullabies, he reached into his repertoire of bawdy verse. One night Matron took Ghosh aside and said: “Your limericks are usurping my prayers.” Ghosh pictured Matron on her knees reciting:

  There was a man from Madras

  Whose balls were made out of brass

  In stormy weather

  They clanged together

  And sparks came out of his arse.

  “I'm sorry, Matron.”

  “It can hardly be good for them to hear these things at such a tender age.”

  GHOSH COULD BARELY REMEMBER what his life was like before the twins arrived. When they snuggled in his arms, smiled, or pressed their wet chins against him he felt his heart would burst with pride. Marion and Shiva; now he could not imagine any better names. Of late his shoulders ached and his hands were numb when the mamithus lifted the sleeping boys from his arms.

  Since he started sleeping on Hema's sofa, he'd not had a twinge of discomfort when he peed.

  Hema regained some of her old manner. At times he missed
their sparring. Had he pursued her all these years precisely because she was so unattainable? What if she had agreed to marry him as soon as he arrived in Ethiopia? Would his passion have survived? Everyone needed an obsession, and in the last eight years, shed given him his, and for that perhaps he should be grateful.

  Many a night, after putting the boys to bed, he had to return to finish up at the hospital. Not one drop of beer had touched his lips since his first night on Hema's sofa. On Hema's narrow couch he slept peacefully and woke refreshed.

  Living under the same roof, Ghosh discovered that Hema chewed khat. It began during the night vigils with Shiva and it had helped her through her shift. Her bookmark was soon ahead of his in Middlemarch, and she was on Zola before he was done. She tried to hide the khat from him, and when he mentioned it, he found it touching how flustered she became. “I don't know what you're talking about,” she said.

  So he didn't bring it up again, though he knew when he saw her knitting late into the night, or when she waited up for him and was chattier than Rosina, that she had probably had a little chew before he arrived. Adid, the always smiling merchant she had seen on the plane coming back from Aden and whose company they both enjoyed, brought her the leaves.

  As for Ghosh, proximity to Hema was his drug. He brushed against her when he lowered the sleeping babies into the crib that replaced the incubator. He was encouraged when she didn't turn around and snap at him. He gazed at her while sipping his morning coffee as she wrote out shopping lists for him, or consulted with Almaz about the plans for the day. One day she saw him looking.

  “What? I look horrible first thing in the morning. Is that it?”

  “No. You look the opposite of horrible.”

  She blushed. “Shaddap,” she said, but the glow in her face did not fade.

  One evening at dinner, he said, more to himself than to her, “I wonder what has become of Thomas Stone.”