15
There were around thirty-seven trillion cells in each of Joaquín Aldama’s patients. He himself had as many, though he didn’t dwell on this fact too often. A single defective cell in a trillion was all it took for a cancer. Given these odds, which only increased with longevity, it was hardly remarkable that the disease should exist and flourish in a world that was teeming with geriatrics. What surprised him was stepping out into the street and seeing so many healthy people. Good health wasn’t a state of peace and harmony with the environment, as naturopathic quack healers proclaimed. In fact, it was quite the opposite—a fleeting victory over chaos, a balancing act on a tightrope stretched over an abyss of turmoil. The “health” touted on TV was the opium of a century of narcissists, an effective illusion for marketing vitamins, salads, and activewear, but useless for understanding the body’s relationship to the world. Just like the plague and tuberculosis in other eras, cancer revealed this “natural balance” to be a gargantuan sham, the missing clothes of an emperor not only naked but wasting away. Like people, the cells of the human body were obedient subjects, but sometimes a young rebel broke away from the established order and reproduced; once its offspring were legion, they became a threat to the empire, and the oncologist and surgeon were called in to quash the insurrection. Thirty-seven trillion cells, for instance, answered to the name Ramón Martínez, and among them lived a band of renegades—millions, regrettably, in his left lung, despite the glossectomy and massive intravenous doses of blistering chemotherapy delivered in two-week cycles.
Now it was time, Aldama thought, to move on to experimental chemo and daily radiation. He regretted having to resort to such harsh treatment, but he had no choice. The patient’s life and that of a promising study were both on the line. Ramón’s genome could become the Rosetta stone of oncology, the key to deciphering the grammar of cancer, its internal logic.
Along with the pulmonary metastases, the institute had discovered an unprecedented mutation in the FOX01 rhabdomyoblast gene. The gene normally functioned, among other things, as a fatty tissue regulator and tumor suppressor. Aldama suspected that this defective variety of FOX01 was involved as much in the Martínez family’s predisposition to obesity as in the mysterious genesis of that childhood tumor.
The discovery would merit a privileged place in international medical journals. What should the article’s title be? “FOX01 Mutations: A Common Link between Obesity and Alveolar Rhabdomyosarcoma”? He needed to come up with something punchier, more concise. “Obesity and Cancer: Genetic Correlations”? Maybe. He was confident that the publication would make a splash in Mexican newspapers, with dumbed-down headlines like “Mexican Doctor Discovers Cause of Cancer in Fat Gene,” or “Love Handles and Tumors: The Secret Connection.”
Emboldened by these high hopes, Aldama emailed the country’s most renowned geneticist, inviting him to collaborate with him and Luis Ramírez: “We’re almost certain that this sarcoma is related to the expression of a specific insulin-like growth factor,” he wrote. He outlined his request that the researcher analyze the genome of various cell lines, signing off with a dramatic flourish: “This is by far the most fascinating case I have ever seen, and I think it merits a first-rate study by distinguished scientists such as yourself.”
Aldama was well aware of the gossip that circulated in the institute’s halls: that his enthusiasm was a product of Alzheimer’s disease; that in the absence of a lover, he was seeking a Nobel Prize; that Dr. Quixote and his pathologist Sancho Panza were riding their feeble hypotheses through the uncharted realm of genomic science. He didn’t care about the rumors. He believed that if envy were a virus, it would be herpes—common and opportunistic; fatal for the weak, but innocuous to the strong.
16
Paulina thought she was the only one in the family taking the news seriously that her father’s cancer had spread. According to her mom, the doctor had been optimistic, but Paulina found that impossible to believe. All the websites she’d visited concurred that the prognosis for a metastatic sarcoma was very bleak. She wished she could go along to his appointments with her father, to confront the doctor with the questions her mother was unable to answer.
The anxiety, which felt so much like hunger, drove her to eat more compulsively than ever. She put on the pounds as quickly as her father lost them. Her friends tried to persuade her to trade cupcakes for carrots and chocolate for jicamas, but such light, nutritious snacks did little to relieve the stress overwhelming her.
The rest of Paulina’s classmates, indifferent to her family strife, spared no time in making her the butt of their jokes, which until then had mostly been directed at her classmate Genaro, otherwise known as Porky the Brave.
The cure for her addiction came in the form of an accident at school. During a math class with the feckless Velociraptor—given this nickname for the way he flexed his arms with his head thrust forward—Paulina was gripped by a tremendous craving for carbs. That morning, she had neglected to restock her backpack with candy, and had nothing to tide her over until recess, when she could buy herself a chilaquile sandwich in the cafeteria. She daydreamed about the glorious medley of crusty bread, shredded and fried tortillas, salsa, chicken, and sour cream, glancing constantly at the clock as the Velociraptor jabbered on about obtuse angles in front of the blackboard.
She considered rounding out her lunch with a chocolate muffin and a spicy fruit lollipop. It seemed like a good idea to save half the muffin until school got out, so her hunger wouldn’t torment her again on the long bus ride home, where Elodia would have prepared the afternoon meal.
Five minutes before the end of class, Paulina took out the exact change for the sandwich and muffin. She wanted to leave the classroom right away, to beat the lines in the cafeteria. Clutching the change in her left fist, she noted her homework down in her planner, and began putting her things away in her backpack.
When the bell rang, Paulina tried to spring to her feet, but due to an error in her calculation of her own girth, she got wedged in the gap between her desk and her chair, lost her balance, and fell to the floor with a crash. The chair landed on top of her, she got whacked on the head by her notebook, and her pencil case clattered onto the floor, scattering her pens and pencils beneath the desks.
“What’s going on back there?” the Velociraptor asked, as a chorus of laughter celebrated the incident.
Paulina tried to get up, but her forty pounds of excess weight, the desk pinning her to the floor, and the fact that her free hand had been rendered useless by the change it was clutching, all made this impossible.
Genaro made a show of his alleged courage and rushed to Paulina’s aid before her best friend Leonora could make her way over from across the room. They helped Paulina to her feet and picked up her scattered pencils and notebooks. Leonora stayed behind with her once the classroom had emptied.
“Did you hurt yourself badly?”
“No, just on the shoulder,” Paulina said, nursing her injury.
“Do you want to go to the infirmary? I’ll go with you.”
“No, I’m fine.”
“Let’s go eat, I’ll buy you whatever you want,” Leonora suggested in an attempt to console her.
The clatter of her fall and her classmates’ mocking laughter still reverberated deep inside Paulina. She tried to hold back the tears welling up in her eyes.
“I’m not hungry,” she answered.
17
Elodia burst into the study, waking Ramón from an impromptu siesta.
“Señor! Help me with Benito, he’s gotten out of his cage,” she said in alarm.
Ramón leapt up with such haste that he felt dizzy and had to lean on his chair so as not to fall. He signaled to Elodia to help him walk. Linking arms like a pair of octogenarian sweethearts, they hurried outside. They found Benito perched on a branch in the ash tree overlooking the garden.
Would you look at that? thought Ramón, brimming with pride at Benito’s feat. If I’d known you we
re so wily, I’d have named you after the cartel boss, what do they call him? El Chapo, Joaquín “el Chapo” Guzmán. Although you’d be “El Chapo” Martínez, obviously. You’re family now.
“Come on, now, Benito, if you come down, I’ll give you a treat!” shouted Elodia. “Want some tomato? Come down and get it.”
Leave him alone, Ramón said inwardly. He’ll come down soon.
The parrot looked delighted. He was perched on a thick, gnarled branch that was much more suitable for his claws than the flimsy canary perch where he spent his days. His lime-green feathers contrasted sharply with the ash tree’s dark leaves.
Elodia was getting impatient. “I’ll go fetch the garden hose, that’ll teach him,” she said under her breath with fascist determination.
Ramón intercepted her, urging her to calm down with a pontifical gesture.
Don’t worry, Benito, I’ll get this woman under control.
“You wouldn’t believe the fright I got when I heard him cussing, and I turn around and what do I see? His cage is empty.”
Ramón would have liked to know what Benito had squawked to celebrate his escape. At that moment the parrot was silent, studying them curiously.
“Shall I call the fire brigade?”
Don’t talk such first-world nonsense, thought Ramón, shaking his head calmly from one side to the other. He pointed toward the kitchen and pretended to eat an egg-shaped vegetable.
“A tomato?”
Yes. Slice it up, thought Ramón, as he mimed his request.
Elodia followed his instructions precisely. She came back out with a plate of tomato chunks to offer Benito, lifting the plate up to the tree with both hands like an Aztec priest making an offering of a human heart to the gods.
Benito inspected the tomato curiously but didn’t stir from his branch. Ramón approached Elodia, asked her to hand him the tomato, and urged her to leave him alone with the parrot. Once she had left the garden, Ramón went and sat down, and rested the plate on the table next to the open door of the cage.
I’m not going to pressure you. You clearly wanted out of that fucking cage. You figured out how it worked. You practiced. I salute you. You have every right to stay up there, but I’ll tell you this, Benito. It won’t be easy. There are lots of cats in the neighborhood. If you don’t watch your ass, they could beat the crap out of you at any moment. They won’t think twice about it, you’ll have to be careful. And another thing: the cold. You have no idea how much the temperature drops out here. And you’re from the jungle, you won’t be able to handle it. I’m telling you now, so it won’t be a nasty surprise. Think about it. Soon they’ll bring me the money from the watch, and then I’ll buy you that cage I promised you. Hell, do you want a girlfriend? I’ll have them buy you one. The prettiest one around, nice and affectionate. What do you say? I’ll have some cash in my pocket, you should take advantage. The clock’s ticking. The other day I felt so beat up I went for my gun. I was about to pull the trigger, but I talked myself down. You have to wait for the right moment. That’s why I’m telling you, if you come down here and hang on for a week at the most, then you’ll see … a luxury pad, an old lady all to yourself. I’ll understand if you turn down my offer. I sure as hell know what it’s like to be shut in all day. And that’s not all: the hunger, the nausea, the fucking pain, and the shaky legs. They keep telling me to be patient. But what for? I won’t be able to do what I want. I’ll just be a burden to my family. Me, I need to be in court. I need to be negotiating. When I was twenty, I worked for Villanueva in the Department of Labor. One day, he took me to lunch at the Bellinghausen, in the Zona Rosa. That was the first time I ever sat at a table with a white linen cloth and napkins. I felt like a king. Bring the young man a filet mignon, Villanueva told the waiter. It was exquisite. As soon as I could afford it, I went back to that same restaurant for a filet mignon. I ate there so many times, and I’ll never be able to go back. Do you have any idea what it’s like to live with the knowledge that you’ll never eat another filet mignon at the Bellinghausen? There’s no hope for me. But in your case, it’s different: Check out this tomato. Doesn’t it look tasty?
Despite the appetizing bait, Benito flitted from branch to branch until he reached the top of the tree, where he belted out a jubilant, “Son of a bitch!”
Ramón smiled with a mixture of pride and bitterness, envy and melancholy. Gazing up toward the sky where Benito was perched, he pictured the view of himself from those heights and felt dwarfed by the scene, far too small to spend so much money on doctors and medicines, too small for so much exhaustion and pain; he felt freed from the burden of being himself.
Then he imagined the landscape Benito could see: a forest of water towers, antennas, and high-rise buildings, wrapped in that dense cloud of dust and fumes they called smog—the name as ugly as what it described—which robbed the city of its most beautiful view: the volcanoes Popocatépetl and Iztaccíhuatl, the warrior with his smoking torch and the sleeping woman, the pair of lovers who sexed up the horizon. As a child, Ramón had often dreamed of climbing the volcanoes, touching the snow, peering into Popocatépetl’s crater and catching a glimpse of the orange core of the earth. Ramón had lost the volcanoes just as he’d lost his innocence: without even noticing, many years before.
A gust of wind made the branches quiver, and soon there was a muffled thud in the bushes. Benito had fallen out of the tree. Ramón leapt up from his chair and hurried to pick him up in the front of his poncho. The parrot was so dazed that he didn’t resist.
Back in his cage, Benito scarfed up the tomato; it had been several hours since he’d eaten a thing. To prevent another escape, Ramón secured the door with a wire knot. In less than a week, he promised the parrot, I’m going to get you a better cage.
18
“I don’t feel like talking today,” Teresa said, at the beginning of her session with her analyst.
“Why not?”
“I’m tired. But it’s not just that. I was thinking on my way here that maybe two sessions a week is too much.” She paused for a moment to reminisce. “I don’t feel like I did back when I was seeing Ruffatto four days a week.” Juan Luis Ruffatto was an Argentine psychoanalyst in exile, renowned for his vast erudition and the psychedelic retreats he ran in the new age mecca of Malinalco. “Back then, I really needed to talk and get it all out of my system, figure out what I’d done in the black hole between the divorce and my cancer. And the tough thing was realizing, after so much effort, that none of that talking had done any good.”
“Well,” her analyst interrupted, “I think that had a lot to do with Ruffatto and the fact that he wanted to sleep with you.”
“Yes, but back then I really wanted an orthodox kind of analysis, and I ended up so shaken by the experience. When you suggested having two sessions a week, I wasn’t sure, but then I thought, Okay, she’s not just my therapist, she’s my supervisor, too, and we have a lot to work on. And it’s worked out. But now it’s been, how long? Seven years?” Her analyst nodded. “I’ve grown a lot as a psychoanalyst, with your help, of course. I feel more confident with my patients every day, except for the few exceptions we’ve talked about. I feel like your supervision has helped me get over my insecurities as an analyst, but when it comes to my own therapy, I think … I don’t know. I’ve been on the couch almost thirty years now. Even though I’ve more or less come to terms with myself and my decision to live alone, I’m still unsatisfied. At a certain point, doesn’t it start to seem like a delusion?”
“The entire symbolic order can be seen as a delusion.”
“Exactly,” Teresa replied, “and sometimes I’d like to live more in the Imaginary, identify with my images of other people, get to know them and listen to them.”
“Don’t you get to know your patients? Don’t you listen to them?”
“No, that’s just what depresses me. I don’t. Whenever I’m in a session, I spend the whole time trying to interpret the underlying messages, trying to connect what the
patient says to what they’ve said before, or to what Freud wrote in such and such a book, or to whatever I happen to be studying at the time. What I mean is, I analyze my patients without listening to them. Obviously, I listen, but too actively. It’s like I’m interrupting them the whole time in my head. And when I’m alone, the same thing happens. I can only be at peace with myself when I smoke pot, but the rest of the time I’m analyzing myself, and it obviously has to do with our sessions.”
“How long have you felt this way?”
“I’ve been thinking … since I started seeing Ramón, the one who lost his tongue. It’s amazing to see such a strong, vain, outgoing man suddenly reduced to nothing. His silence transformed him. I asked him if he feels like he has a phantom organ, but he just complains about the discomfort. It’s typical for a patriarchal subject like him: life is all about working hard, being in control, feeling comfort or pleasure, or being angry. He doesn’t understand what it means to be sick and in pain. Suddenly he doesn’t know who he is. He’s always having out-of-body experiences. He dreams about floating, touching the ceiling, looking down on his head and his sleeping body, and he’s afraid that if he wakes up, he’ll fall down and hit his head. He’s detached from his body. I was thinking, that must be why monks take a vow of silence. The Buddhists, the Carthusians, the Trappists. Silence distances you from the flesh. Don’t you think it’s a paradox that something as invisible as speech should be precisely what keeps us tied to the body? The other day in therapy he started by writing about pollution, the air quality index, and the ozone layer. He’s obsessed with the air quality in the city. He asks his daughter to check the government web page every day, to see how bad the smog’s going to be. I think it’s also a way of bonding with her. She’s tried to teach him to use the Internet, but he’s not interested. It’s like he associates technology with his mortality, with his own planned obsolescence.”
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