The Strength of Bone

by Lucie Wilk

  Iris reaches over and places her hand over the bones and sinews of her mother’s hand. She squeezes it gently. “You should eat, Mama. It’s getting cold.”

  Chapter 7

  Henry arrives at the hospital while most are still asleep. He enters the office, finds it empty and is mildly disappointed in this. After he hangs his backpack over his lab coat, he leaves the office and makes his way down the dark hallway to one of the smaller wards, to where he had been painting the previous morning. As he navigates the hallway, he sees a figure in a stiff, A-line dress approaching from the opposite direction. She comes closer and he sees her shape and posture, hears the way her feet fall with a sound that is both proud and angry. He knows it is Iris. “Doctor,” she murmurs in greeting as they pass each other. She looks down as they pass. “Good morning, Sister Iris.” He says this to her although it is not really morning; it is still a long way till sunrise. But he feels as if he needs to share a normal greeting, to make this encounter in the dark, late hours of the night less strange.

  When he reaches the ward that has been partially painted, he sees that some of the walls are wet and the supplies have been recently cleaned. He stands in the room of slumbering bodies and smells the wet paint. This has been happening sporadically. Walls painted in his absence.

  So the nocturnal painter is Iris. Iris, who fixes him with such a stern stare, who watches his patient-care decisions with undisguised disapproval, who often takes pains to avoid his presence altogether when they share care of the ward. It is she who is spending the quiet hours of her overnight shifts painting the walls. He has suspected this for some time but has tried to ignore the clues.

  Despite his certainty that it is her, he has yet to say anything to her, or to thank her. He takes care to arrive at the same time each morning, so as not to catch her in the act. He looks away when she surreptitiously rubs a bit of paint off her hand or arm. He prefers the secrecy and the cleanliness of the silence by which they go about their tasks toward a common goal. He senses a fragile burgeoning friendship somewhere in the vacuum of their interactions, which makes him cautious and anxious; he doesn’t want to risk acknowledging it, he doesn’t want to risk trampling it with his clumsiness, his large awkward ways.

  But perhaps he is just imagining it, this fresh green bud of friendship. Perhaps it is just a common desire, a silent pact to improve the conditions for these patients. Nothing more than that.

  Today he enters the ward, nods to her sitting there at the desk, puts some new blankets on the desk in front of her, and leaves the office to begin painting. As he turns away and leaves the room, he senses her reaching toward the three new blankets sitting folded on the desk, feeling the coarse cotton, knowing what to do with them.

  Henry moves his painting supplies to the TB ward. He has finished the corridor now. It glows in the early light as though the walls are lit from within. A few hospital staff shuffle down the corridor past him, blink in the brightness of it, having emerged from a shadowy room, their eyes adjusting in sharp spears of pain. They eye his tray, roller, and paint can dubiously, give him a wide berth. He enters the TB ward where patients lie in still bundles in the semi-darkness. As he sets up, he hears an exchange of rooster crows from beyond the windows and some patients begin to shift in their cots. A few heads lift up from the beds and spot Henry, track him as he moves in the shadows. They have no doubt heard about the painting doctor and now here he is, about to leave his mark on their ward.

  Henry opens the can of yellow paint and breathes in the familiar smell. He welcomes it as he stirs the paint with a wooden stick. It is the clean smell of change.

  When he reaches for a patient’s wrist to take a pulse in the same ward a few hours later, the patient looks away, twists his arm deftly out of Henry’s grasp. When Henry reaches for him again, the man releases a shout: a short, sharp burst of warning. Henry stands in front of him, puzzled. He looks across the ward and there is Iris, watching. She sighs heavily; he can see her chest rise and fall from here, so many beds away. She weaves toward him between the beds like a boat tacking toward the shore. When Iris stands beside him, he reaches once more for the patient’s arm and again it is pulled from his grasp. The man, sitting heavily on his cot, looks down at Henry’s feet. Iris speaks in brisk Chichewa; Henry can hear the no-nonsense tone in her voice. The man mumbles a reply and then lies down on his bed, pulls his sheet over top of himself in a weak attempt to cover up, to hide. Iris translates:

  “He’s afraid of you.” Right now, Henry is grateful for her matter-of-factness, her inability to mince words.

  “Afraid.”

  “Yes.”

  “Why.”

  “He thinks you are an impostor. He thinks you are not a real doctor.”

  Henry says nothing but lifts the bell of his stethoscope up and stares at it as though it will speak on his behalf.

  “Because you paint the walls. This is why he worries.”

  Henry says nothing still, then reaches for the man’s wrist again. This time the patient does not pull away, but stares darkly at Henry as he allows the touch, he allows the press of the doctor’s stethoscope to his chest while he takes quick and shallow breaths.

  “Tell him what he needs to hear,” Henry mutters and then listens as the man’s breath slows while Iris speaks.

  *

  There are the sounds again. The funeral wails, the ululations—rising, falling, rising. Like the waves of grief itself. But only the women. Why only the women? Why can’t the men participate, shed their grief along with their women? Perhaps they can, perhaps they do somewhere else, in some other way. Their job here in the hospital seems to be to disappear, and to allow their women to grieve unrepressed.

  Henry presses himself against the wall as the gurney, pushed solemnly by the men and followed by the crowd of wailing women, moves past him down the hallway. The body—long and narrow under the sheet—has been draped as usual, with a white sheet emblazoned with a red cross. He wonders if it is one of his.

  Henry’s first experience with death was on the medical wards. “Check the pupils for reactivity,” the senior medical resident had said, yawning, for it was 4 am when he received his lesson in pronouncing death. “Feel for a pulse in a big artery, like the carotid. Auscultate for breaths and for heart sounds.” She’d turned to face him then, away from the body on the bed whose mouth still gaped open, whose eyes were not quite closed. “It’s all a silly formality, making us do this. The nurses know perfectly well when a patient is dead.” And then she’d led him out of the room. Following her out, he had brushed open the curtain that divided the dead patient’s bed from her roommate. The woman stared back at him from her pillow with an expression he has ever since tried to forget.

  He didn’t know then what loss feels like.

  Now he knows that loss is having the lower half of his lungs fill with something thick and immoveable so he can never again take a satisfying breath. He wanted to do all sorts of things when Emma died: throw himself down on the ground. Pound his fists. Scream until his throat ached. Release the violence.

  But he kept silent.

  Here where he stands pressed up against the wall long after the gurney has passed, silence makes no sense. You have to make noise, you have to yell and complain. You have to be outraged. Your voice has to follow the soul, up and up and up. And as he watches the procession disappear around the corner the women’s wails echo even more, reiterated by the corners, the long halls, the maze of this place that contributes to the fury. Yes, he thinks. Make noise. Make it matter.

  *

  Henry is stretching up, reaching the highest recesses of the walls with his roller on an extension pole, when Ellison comes into the TB ward. He stands behind Henry for a few minutes and watches him. Then he clears his throat and shifts noisily. Henry turns around, sees him, and smiles. “Hey there,” he says.

  Ellison nods. Tilts his head toward the
hallway. “Can we chat?”

  Henry wraps up his tools and follows Ellison’s broad shoulders out of the ward and into the hall. Ellison stands off to the side, touches a hand to the wall, and then leans up against the yellow. “You’ve been hard at work,” he says, folding his arms across his chest.

  “Yes. No more dingy grey.” Henry looks down at his hands that are chafed and calloused. The sight of them pleases him. He adds, “There were years of grime on the those walls. Nice to cover it up, start fresh.”

  Ellison looks down the hall. “I’ll bet,” he says. He shifts position, shoves his hands in his trouser pockets. “Listen. I’ve been asked to share some concerns with you. About all this.” He waves a hand out, gesturing vaguely around them. “What is all this, mate?”

  “I’m just doing what should have been done years ago.”

  “Well, that may be, but … ” Ellison pauses then continues. “We’re just not sure what you’re trying to do here. You’re

  trained as a physician, not an interior decorator, for Chrissake.”

  “I’m just trying to improve the lot for these people,” says Henry, “by doing whatever it takes.”

  “Well, frankly, it’s bizarre. And you’re scaring the patients.”

  “Scaring them?” Henry thinks of the patient who pulled away.

  Ellison sighs. “They think you’re lost. They think the real you’s been kidnapped and an impostor is in your place. Or worse—that you’re possessed. They’re nervous to be treated by a man who’s only pretending to be a doctor. And who can blame them? To be honest, I’m starting to wonder myself.”

  “It’s cleaner now. Less dark. Less depressing.”

  “I’d hazard a guess that it being depressing here has nothing to do with what colour the wall is. C’mon, man. Think. When you come in here fighting for your life, does it matter whether you’re staring at a yellow wall, or a grey one? It could be purple, for Chrissake. You’re dying. And maybe, just maybe, one of these white guys will drop his paintbrush and turn around and help you.”

  Henry studies Ellison’s implacable face. “Have you noticed the new supplies coming in? I’ve managed to convince a few organizations to be more generous with us. More drugs, blankets, gloves.”

  Ellison twists his mouth. “That’s great, mate. But again: not your job.” He sweeps his hand around again. “You’re not God, Bryce. You’re not here to wave a wand and—ta-da! A whole new, better place. One thing at a time, man. One thing at a time. Focus on what you’re best at. What you’re trained to do. This,” he gestures to the yellow wall, “is a waste of your very expensive education.”

  Ellison places a large, warm hand on Henry’s shoulder.

  “Let’s head back to the ward, eh? Painting smock off, lab coat on. Let’s try to help these poor sods. Get them better.” He steers Henry down along the hall and Henry walks.

  *

  Henry’s mother often brought him to her workplace after picking him up from school. He would follow her down elevator shafts and through long corridors all the way to her subterranean lab. She was a medical pathologist and her lab smelled of harsh things. A pungent, eye-stinging smell of formalin and other fixatives. She never showed him a body. She showed him parts, though. Tiny slices of flesh, frozen then carved by a delicate knife into transparent slivers one cell thick. Human tissue viewed under the microscope was beautiful—cotton-candy swirls of pink studded with blue and purple gems. Like a painting. He would have liked to enlarge them, frame them and hang them on his wall they were that beautiful. They were slices of a secret life.

  Down in his mother’s lab, he learned all about this microscopic universe of hustle and bustle, how well-mannered and coordinated it all was, each cell doggedly contributing, pumping out messages, receiving others, obeying instructions. All these were acts of pure altruism, down to the cell’s own programmed death. This cellular world was a sliver of nirvana, each single act in harmony with every other.

  It was his mother’s job to look for war deep down in the tissue. And she found it. Rogue cells which as a boy he imagined as pirates. His eyelashes brushed against the lenses of the microscope while she told him what he was looking at. The idea of such a tiny battlefield frightened him. Pirates, hiding in the body. Lawless and brutal. Greedy and mercenary. They slashed through the nirvana, ruthlessly sought immortality. They refused to die. And in this Peter Pan quest, they brought the whole organism to its knees.

  Under the microscope they looked disturbed; somehow their gluttony was visible through the magnified lens—their cytoplasm bloated, their mitochondria crooked. They even took more stain; they soaked up the pigment like blood. These were the cells that ballooned into a tumefied, disorganized mass, or they attacked their own trusting neighbours. Even as a child he could pick out the slides that contained pathology: the swirling pink slashed and pockmarked, the chaotic spill of purple-celled armies, row upon threatening row of them all squinting their single-nucleus eyes and turning them on the pink cells bleeding cytoplasm, the red cells punctured and deflated and eviscerating, the ferrous stain of waste and cellular rubble. Henry gripped the microscope with small cold hands and stared down at these scenes.

  He would lie in bed after coming home from his mother’s lab, close his eyes and see that advancing army and wonder if there was a dissenter in his own ranks, waiting quietly in an organ, plotting an uprising. An irrational seed.

  Chapter 8

  Henry feels a tug on his sleeve. He looks down and sees a boy—short, dark, slender—staring up at him with an urgency he doesn’t often see in this place. It is the urgency, not the boy delivering it, that catches his attention.

  “Yes? What is it?” He tries—albeit a weak effort—to hide his impatience. He bothers less and less these days with hiding this sort of thing.

  The boy stammers but manages to get out that there is a very sick patient in another ward.

  “Where?”

  “This way, Doctor.” The boy limps off and Henry follows. The nurse whom he abandons in the middle of the ward watches them leave, not a smudge of curiosity on her face.

  Henry hears the patient as he turns the corner into the ward. The woman —young—another one too damn young—breathes as though underwater. She is surrounded by the usual mass of sick patients, no hospital staff. The boy points needlessly to the patient in trouble, then bows his head and ducks out of the ward. Henry mutters, “Need a crash cart.” As though there were one to retrieve. He scans the room anyway, hoping to see its familiar red bulk. Nothing. He represses the urge to say, “Call a code blue” to the space where there should be people—nurses and other doctors—milling, trying to organize their rising panic into something productive. He moves over to the patient. He grabs her arm—slippery with sweat—feels for a radial pulse, then reaches for the shallow groove in her neck and under her jaw where the carotid pulse should be, then shoves aside a wet sheet to feel in her groin for the femoral pulse. Nothing. Pulseless. Fingers cold, nail beds blue. The woman’s underwater breathing sounds have stopped. When did they stop? Couldn’t have been more than a minute ago.

  Feeling a rising energy and nowhere for it to go, he crosses his hands over the woman’s sternum and plunges down. Pump. Pump. Pump. There is a nurse—over by the clean utilities. “Get me some oxygen, and an endotracheal tube—#7, and a laryngoscope. A clean one.” He hears his voice—hoarse, tight with the excitement of this attack on impending death. Crack. Crack. The ribs break beneath his hands as he compresses again. Pump. Pump. Pump. He stops for a moment to feel for a pulse. Nothing. He grabs the oxygen mask from the nurse, fits it over the woman’s mouth, pulls her jaw forward, opens the valve on the tank. “Continue the CPR,” he says to the nurse and she stares at the woman’s chest, puts her hands over her sternum and leans forward, unsure. Henry moves the mask aside and picks up the laryngoscope. He snaps open the blade, tilts the woman’s head back, slides the blade into
her mouth and uses it to push the bulk of her tongue over. The light shines down on her tonsils, then on her esophagus, then on the reedy, white triangle of her larynx. He passes the thick plastic endotracheal tube through it and into her trachea, removes the laryngoscope, and attaches the oxygen supply to the blunt end of the tube that now sticks out of the woman’s mouth. He compresses the black bag, squeezes some air into the tube. The woman’s chest rises with each compression.

  Henry looks at the nurse—Maria, he thinks her name is. “Let’s take her to the ICU.”

  Euphoria moves through him like a current of energy. He has been shaken awake. He forgot how it feels. He looks over at Maria and she smiles back—shy, tentative. They transfer the patient to a gurney and then push the gurney, weave it squeaking through the beds, run it along the hallway. They rush. People shuffle out of their way. Orderlies hold open doors. They ride this tide of urgency and it carries them all the way to the intensive care unit.

  *

  Jakob tells his mother later about the woman that he saw in the ward he was cleaning, how he had noticed her struggling with her breath, and how no one else seemed to notice, or didn’t care. And he knew she was going to die. He told her how he ran over to another ward and summoned Dr. Bryce. And then how Dr. Bryce did some wonderful things and saved her all by himself.