The Strength of Bone

by Lucie Wilk

  The woman in the bed was nursing an infant. The baby was scrabbling for her breast, had not yet achieved a satisfactory latch and the woman winced as the baby’s mouth took hold.

  “I’m sorry,” said Henry to the boy.

  “She went in peace,” he replied. He licked the crumbs off the napkin stained with oil from the cake and looked at Henry.

  “That’s good.”

  “It’s okay,” said the boy.

  “Are you okay?”

  “I’m okay,” he said. And looked it.

  *

  Iris is overseeing the wards tonight; she is in the office flipping through a chart but thinking of other things when a man is brought in. When she sees the new patient wrestling with his caregivers, unwilling to lie down, when she sees his wild eyes, red and yellow, she calls in the doctor. This man cannot wait till morning.

  Dr. Bryce arrives within the half hour. She had hoped it wouldn’t be him. She had hoped for Dr. Kumwembe, or even a surgeon. Anyone but Dr. Bryce. But there he is, looking serious and determined, not yet knowing what is coming.

  Together they hold the man down; he has no family with him. A group of strangers found him outside a pub and dragged him in; he fought with them the whole way. “Probably poisoning,” they mutter to each other, staring down at him. It is a courtesy they are willing to provide: bringing him in. They’d want the same if they were the target. Once on the stretcher, the man still struggles. He looks around savagely at them all, not really seeing them. The strangers leave, exasperated. They don’t turn around when Iris says, “Zikomo.” Thank you.

  Dr. Bryce and Iris do the usual things: vital signs, obtain IV access. Once they have collected all the basic information, Dr. Bryce steps back from the patient. Iris joins him. They watch him; he has quieted now. He lies on his stretcher and stares up at the ceiling, then turns his head and looks at the empty space above the bodies in the ward. He is completely disoriented; he couldn’t state his name, or the place, or the correct date.

  “Could be meningitis. Malaria. HIV.”

  “All three, maybe,” adds Iris and she feels him nod beside her.

  She collects the blood and hands the tubes over to Dr. Bryce. There is no lab technician in the hospital at this time. He will go to the lab himself. She watches him walk down the hall toward the lab. He still has a limp. He is still injured. She turns away and returns to the ward.

  *

  Henry walks down the corridor of the hospital. The concrete floor dips and humps in places; it was laid down unevenly and smoothed over by hand. Like a sculpture. It exaggerates his limp. And he feels the pain in his leg, now. It aches each time his muscles clench around his femur. He is grateful that Ellison did not need to take him into the operating theatre. The fractures were well aligned, somehow. He thinks, again, about Alile and her touches, her listening, her handmade medicines. He imagines that under her care the bone fragments shifted, realigned like metal shavings do in response to a magnet. How else can it be explained? Some sort of random miracle?

  He walks and passes windows open to the air. The night-creatures are silent outside. He is now aware of silence, of the different types of it, as he moves through the world. Night brings a whole new kind. And a different one here than in the village. When he lies in his bed in his stark apartment he listens to it, feels the absence of sound in his bones. He knows that at some unperceived frequency the silence exists as movement; it resonates, it speaks. Nothing, he has learned, is completely empty.

  Henry reaches the lab and enters it. Here, the silence is broken by the quiet whirr of a fan someone left on. He sits down on the stool and wheels himself up to the workbench. He dons gloves and waits for a minute, feels the intermittent breeze on his back as the fan oscillates in the room. His hands are already sweaty under the latex when he picks up a tube of the man’s blood and draws out a small amount with a pipette. He drops a single drop of blood on the glass slide, then drops a single drop of oil overtop. He puts the slide under the microscope and leans over, peers through the eyepieces. His eyelashes brush the eyepieces when he blinks. A red blur. After some fiddling with the dials, the man’s red cells emerge out of the disorienting fog. There they are: malarial ring forms inhabiting the cells. Multiples within a cell. Everywhere. He has to search hard to find a normal red blood cell. There is one: a single plump and rosy cell amid the parasitic invasion. Henry pushes himself away from the table and continues to sit on the stool, waits for the brief passing of fanned air across his back, suffers the heat in between. Sweat is gathering under his shirt and his hands are soaked under the gloves. He peels them off and leaves them, inside out, on the counter beside the microscope.

  Malaria falciparum, no doubt. The worst kind. It goes to the blood, the liver, the brain. It brings a high risk of death, particularly when treated late.

  There is a small refrigerator humming quietly behind him. Inside are vials of blood, stored for running additional tests, or repeat tests. One of them, he knows, is marked: “Dr HB.” He is afraid of that vial of blood, of what it might show. Or worse, what it might not show. In this vial he would have to confront the frightening strength of his body, or the frightening strength of his mind. And he is not ready for that. He will probably never be ready for that.

  He thinks of the man on the ward, how brutalized he was by this illness. How his eyes looked: not human anymore, all red and yellow like a beast. He stands up and fans out his shirt, allowing some cool air between the cotton and his skin. He will do for this man what was done for him. Here is a chance to turn another life around, to clean up the mess.

  *

  The man died at sunrise.

  Iris and Dr. Bryce did what they could. They gave him fluid, antimalarials, antibiotics, all the usual resuscitative measures. At 5:55 am, Dr. Bryce looked at his watch. “Time of death,” he muttered, although they do not record such things in the medical notes. He wrote it down in his notes anyway: Time of Death: 5:55 am. Iris saw Dr. Bryce’s face: too blank. His eyes were too fixed. He went about his morning tasks too stiffly, he moved like he was wooden. At 6:30, before the morning staff were due to arrive, Iris approached Dr. Bryce where he stood staring at a bedside chart. “Shall we get some breakfast?” she asked. And he followed.

  *

  Now they sit across from each other in the canteen, sipping tea. She looks down into her cup, swirls the tea around inside.

  “Why did I recover?” He asks this while looking away, across the canteen at the empty tables and empty chairs. “I was as far gone as he was. Why did I respond? Why was I the lucky one?”

  Iris looks at him and struggles to contain her annoyance. Why should she have to explain something so obvious? Why, again, must she be the adult in a room full of children?

  “What do you know about luck? You’ve been making your own your whole life.” She tries not to sound too snappy, too impatient. She breathes and continues. “Good substrate. You have it. The strength, the ability to do whatever you want.” She waves a hand around. “Be a doctor. Travel to Malawi. Save lives. Be healthy. All these things.”

  He starts to respond: “We had the same illness, received the same medication … ” Iris shakes her head and cuts him off.

  “If you want to talk about luck, then yours started in the womb.” She thinks about the patient they tried to save. “His bad luck started at the same time. Bad substrate. Bad substrate means you can’t make luck. It is outside of you. You take what you get.” She looks down at her tea again. She tries to take a sip but her throat is too tight to manage it. She struggles to contain this, whatever is rising up inside her. But she cannot contain it; it overflows and the tears appear. She holds her fingers against her eyes and swallows the feeling down. Her throat is still so tight.

  “Let’s not talk about luck.” She finally manages.

  Henry looks at her. Nods.

  “Let’s talk about strength.
And love. You have both. You’ve had both all your life. That’s what got you through.”

  Henry looks out the window.

  They both look out there. Through the window, Iris can see a few sparse and stunted yellow grasses, trampled into the red dirt. Above this, laundry dries on a line. Behind the billowing sheets and fluttering gloves is the white-blue radiance of the sky.

  “Emma had those things. Strength and love.”

  Iris breathes before she speaks. “Your child.”

  He looks at her. “Yes.”

  “Then she had all anyone could have asked for.”

  His gaze has moved back to the window.

  “And you. You also have knowledge,” Iris continues. “You know what you are capable of. I hope you do. And you don’t believe that you will fail, do you?”

  Henry turns back to look at her, right in her eyes, which is something he rarely does. And she shares his gaze boldly, does not look away.

  “No.” He smiles. “No, I don’t believe that.”

  He reaches over now, and puts his big, warm hand over her small cold one and even then, she does not look away.

  *

  After breakfast, they part ways. Iris leaves for home and Henry walks the corridors back to the medical ward. He notes the point at which he passes from grey to yellow, and how he feels in doing so. No different, he admits to himself. He trails his fingers along the yellow wall, though, like he has seen children do. It feels good: the smooth, clean paint under his hands.

  He makes his rounds on his youngest patient first. The woman with the newborn. The baby has made it out of the intensive care unit and he sleeps, swaddled tightly in cloth, in the woman’s arms. Henry leans over and studies the infant’s face. Still too young to be out of the womb. His face is small and puckered, wizened like an old man’s. All the tubes are out, now. The baby is ready to take milk. Henry has already explained to the woman that breast milk is not allowed, to reduce the risk of the child contracting HIV. Here is something he can do: protect this child by preventing the infection in the first place. Together, he and the mother will keep this child healthy.

  The baby shifts and frees a tightly bundled fist before his face reddens and he releases a hearty squall. The woman clucks, nestles him close to her breast and he quiets again, chin up, fist loosened, face like a Buddha. The woman turns her own face up to Henry. Her gaze is steady, almost defiant. This is her son. Strong and healthy. Already a survivor.

  “Doctor, please.” She points at Henry, then points to her swaddled son. “Name.”

  Henry watches the newborn sleep. His tiny brow pinches in tight, then smoothes out. Eyebrows lift, then settle. Already rudimentary emotions are crossing his face, marring his natural state of bliss. But they are transient as clouds across a clear blue sky.

  “I don’t—” He starts to say, then thinks of the young man in the village, the game of bao they played. Ba-wo. El-eye-as. But Elias is one of our names, he thinks. Biblical. The infant shifts, his brow flickers, another cloud drifting across his consciousness. There is the hint of a smile on the child’s face.

  Juma.

  He says it with certainty.

  The woman smiles and Juma sleeps.

  Henry weaves between beds. Elias. Bao. Alile.

  He feels a pang of something that if he didn’t know any better could be grief.

  If he were to hitch a ride on the back of a pickup all the way to Mlele. If he were to walk down the hidden path all the way to where the huts begin, scattered in the flat red earth strategically, people standing around them like seeds in a game of bao. Would he feel like that—like he has walked into a game he does not see or understand? Would Alile stand at the threshold of her hut obeying unsaid rules? He gained entry by default. By being ill. This was the only way in and health forced him out. And now?

  He is foolish to want to believe more than he can. He is only capable of so much of the stuff.

  Belief.

  And yet.

  He tucks down beside his next patient who has a place on the floor. The man, knowing what is coming, obligingly sits up, leans forward and lifts the back of his shirt. Even before Henry can place his stethoscope on his back, the man is taking large, exaggerated breaths, as if to prove his fitness. Henry presses the diaphragm of the stethoscope onto his skin, between ribs, and listens. The air moves as it should, the exhale is long and soft like a sigh. Henry lets the stethoscope drop to his chest, pats the man on his shoulder.

  “All clear.”

  Iris pushes the heavy hospital door open and steps into the warmth of the morning sun. She joins the crowd of commuters but she is moving against the flow; most are going in toward the city and she is walking out toward home. She takes a tangerine from an offered tray and hands over a few kwacha to the vendor. She begins to peel the fruit and walks on the path beside the road, away from the hospital. The path takes her through a cluster of magnolia trees that are just green now, their blooms spent months ago. A mottling of bright sun and cool shade moves across her skin as she passes beneath the trees. She continues to peel the tangerine and breathes in the sharp citrus fragrance, feels the oiliness of the peel on her fingertips. Saliva bursts into her mouth in anticipation of the first piece of the fruit. This is the world revealed to her after a night shift. Everything is clearer, brighter, more striking and noteworthy.

  She continues along the path and out from the cover of the trees. In this wide open space, the sun can press its warmth down on her shoulders. She unpins her hat and pulls it off, crumples it in her hand and now the sun warms her head, a breeze flutters across her bare neck. She sees up ahead the familiar cluster of bougainvillaea bushes, their papery blooms vivid pink against the blue sky. Thin but generously adorned branches cascade over the wall, bow and bend to its shape, to the wind, to her passing hand which pulls them forward with her before they fall back, dropping into place behind her as she moves on. She tilts her face up, feels not the warmth of the sun pressing down but the cool weightlessness of the sky above and the space, all the space it offers her. Today, Iris can’t help but feel the open expanse of the sky as she moves up the hill and closer to it. She rarely looks there. She rarely looks up at the sky. The colour of it is like a clean pool of water and she thinks about it like that. That she is returning to water. This is why her movements are so fluid and effortless. This is why she feels lighter.

  Acknowledgements

  I owe an enormous amount of thanks to so many incredible people for their vital contributions to this collaborative project. This book would never have taken flight without them.

  To John Metcalf whose insight, wit and passion made the editing process a revelation.

  To Dan Wells, Tara Murphy, Kate Hargreaves and Chris Andrechek for their enthusiasm, diverse talents, intelligence and professionalism in bringing this book into the world in the best possible way.

  To Annabel Lyon for her mentorship, and her support of and belief in this project, and to Larissa Kostoff, Elle Wild and Zazie Todd for giving so generously of their time and advice.

  To Matthew Engelke for sharing his expertise on religion and traditional spiritual practices in the region, and to Elizabeth Hull for allowing me access to her research.

  To the students and faculty at the University of British Columbia Optional Residency MFA program for their thoughtful feedback and for creating such a nurturing environment in which to share early pages.

  To Descant, Prairie Fire and their fellow literary publications who, against all the odds, continue to support and encourage emerging Canadian writers.

  To the works of Rabindranath Tagore, Rumi, Malidoma Patrice Somé and Brian Morris which provided unique insights, perspectives and inspiration. I have excerpted from the collected works of Rumi for the section headings.

  To the wonderful families, and especially the children, of Nkudzi Bay for opening their hearts and
homes to me.

  To Linda, Lisa and Edna for their unfailing support and encouragement.

  To my amazing family: Peter and Donna, Tom and Richard, for being there with love, for cheering on each small success, and for being my very earliest readers.

  And always to Eric for his love, support and time to allow this book to be born, and for never doubting its successful gestation, and to Amber and Aidan who have been an inspiration just by being their beautiful selves and loving me back.

  About the Author

  Lucie Wilk grew up in Toronto and completed her medical training in Vancouver. Her short fiction has been nominated for the McClelland & Stewart Journey Prize Anthology, longlisted for a CBC Canada Writes literary prize, and has appeared in Descant, Prairie Fire and Shortfire Press. She is working toward an MFA in Creative Writing at the University of British Columbia. She practices medicine and lives with her husband and two children in London, UK.