The Crooked Path

by Irma Joubert

  “Mr. Pistorius, what exactly do you want me to do?”

  “Oh, if you could address us on the dreaded disease—no longer than about forty-five minutes, please, then there should be ample time for questions—we would highly appreciate it.”

  “A forty-five-minute information session!” Lettie gasped. “Mr. Pistorius, I’m a doctor, I’m not—”

  “My deepest gratitude, Dr. Louw, for the years you’ve been a pillar of the community. We appreciate—”

  “No, no, I think you’re confusing me with my father. He’s retired, so—”

  “Well, thank you once again, Dr. Louw. Good bye.”

  Slowly Lettie replaced the receiver. “Shall I send in the next patient?” Mrs. Roux asked from the doorway.

  “Yes, send him in,” Lettie said, dazed.

  That night when the girls had gone to bed, she said to Marco, “Your principal asked me today to deliver a lecture on infantile paralysis during an information session.”

  He smiled, amused. “How long did he take to ask you that?”

  “My word, the man is pompous! I’m sure he wasn’t that bad when I was at school. But worst of all, I didn’t agree to do it, he just presumed I would. I really can’t do it, Marco. I’ll call him tomorrow and tell him—”

  “Of course you can do it, Aletta,” Marco said calmly. His smile reached his eyes. “You should hear him tie himself in knots when he speaks English!”

  “Marco!” she scolded. “Why haven’t you told the poor man you understand Afrikaans? Put him out of his misery?”

  Marco laughed. “He can do with a little practice,” he said.

  “Oh goodness, you two,” Lettie said the next Sunday afternoon as she and her friends were making salad in the kitchen. “I know how to take care of people’s health issues. But speak in front of all those people! Klara and Annabel can do it, yes. Or you, Pérsomi, you do it every day in court. But I really don’t know if I want to do it.”

  “I know how you feel,” Christine said. “I could never do it. Why can’t Fanus Coetzer do it? Or your dad, or Yusuf Ismail?”

  “My dad isn’t up-to-date with the latest developments. He’s a full-time oupa these days,” Lettie said, shaking her head.

  “I wouldn’t trust Dr. Coetzer after five in the afternoon,” Pérsomi said tactfully, “and Yusuf won’t be allowed to enter the school hall. I think it’s very important that people get the right information, and I think you’re the person to do it, Lettie.”

  “Well, that’s it then. A good thing you’re so smart,” Christine said. “Why don’t you ask De Wet to help you? Of the lot of us, he’s the one who knows best how to address an audience.”

  Lettie smiled. It was heartening to witness Christine’s blind faith in her husband’s abilities. Pérsomi could also help me, she thought. She’s making a name for herself as the best litigator in the district. Or I could ask my husband. Marco has no problem speaking to a large group of people.

  “Start by telling the people what infantile paralysis is and where it comes from,” Marco suggested when she began to work on her lecture.

  “I want to keep it as short as possible. I only want to say what is absolutely necessary,” Lettie explained.

  “The people are there to be informed,” he said. “You have the knowledge, Lettie. I think you owe it to your audience to give them the facts as fully as possible.”

  “Go on to explain the symptoms,” Marco said, “so they will recognize the disease, then tell them what the treatment entails.”

  “It’s not quite that simple,” Lettie said worriedly. “The symptoms resemble those of ordinary flu, and there’s no treatment.” She shook her head. “There’s already such hysteria around the disease, I can’t tell people that!”

  “You have to be honest, Aletta,” Marco said seriously. “But you can offer them hope by telling them about the progress being made in medical research.”

  “They’ll know that. It’s been all over the papers and the news.”

  “Not everyone reads the papers or listens to the news on the radio,” he said calmly. “Let me help you write your lecture.”

  “You’ll have to write it in Afrikaans. Bushveld folk don’t understand English,” she said.

  “No, you’re going to write it, in Afrikaans. I’ll just be lending a hand.”

  On the appointed Monday night Lettie dressed with care. She gave extra attention to her makeup. “If you know you look good, it gives you confidence,” Pérsomi had said the day before.

  She stepped back and inspected herself in the full-length mirror. Isabella appeared in the doorway behind her, fresh from her bath and in her pajamas, her dark hair neatly brushed. “You look pretty, Mommy,” she said.

  “Your mommy is beautiful, and tonight she’ll show everyone she’s not only the best doctor, but also an orator of note.” Marco put two-year-old Leonora on the double bed and began to dry her hair with a towel.

  “Marco, don’t tease, my nerves are shot,” Lettie said.

  “Mommy looks pretty, Mommy looks pretty,” Leonora echoed her older sister, squirming out of her father’s grasp.

  “Come, you’re going to Oupa and Ouma now. Mommy and Papa are going to the school,” Marco said.

  “Are you going to sing, Papa?” Isabella asked.

  “No, Mommy is giving a talk,” Marco replied, and gathered them in his arms. “Lock the door, Lettie, please?”

  There was a sizable audience in the hall, chiefly parents and grandparents anxious to protect their children against the dreaded disease. They’re here to learn. They’re scared, Lettie realized. Marco was right, I can help them.

  But when she found herself on the stage after the meeting had been opened with a long prayer, in which the reverend pleaded with the Lord to keep the children safe, after the headmaster’s verbose welcome, and after various procedural arrangements had been announced by the mayor, Lettie stood looking out over a sea of faces. For a moment she panicked, then she remembered Marco’s advice. “Take a deep breath and look them in the eye.”

  She took a deep breath. “Infantile paralysis, or poliomyelitis, is an acute viral infection, an inflammation of the gray matter in the spinal column, that is easily spread from one person to the next, orally or through contact with fecal matter. Poor personal hygiene and contaminated water contribute to the increase in reported cases.”

  She felt herself grow calmer. The audience looked back at her impassively. “That’s why washing our hands is so important, and boiling our drinking water when we’re not sure how clean it is,” she ad-libbed.

  The audience remained unresponsive.

  She looked down at her notes. “The first clinical description of infantile paralysis was provided by the English doctor Michael Underwood in 1789. Later, the disease was known as Heine-Medin disease because of the work of doctors Jakob Heine and Karl Oskar Medin in the 1840s and 1890s respectively. The polio virus was isolated by Karl Landsteiner in 1908.

  “The disease later became known as infantile paralysis because it affects mainly children,” she continued. “Though infantile paralysis, or poliomyelitis, has been endemic for thousands of years, epidemics were unheard of until the nineteenth century. It has become one of the most feared children’s diseases of the twentieth century.”

  The next time she looked up from her notes, she looked for Marco. He was smiling and nodding encouragingly. He thinks I’m doing okay. He’s proud of me.

  She continued more confidently. “Polio causes no symptoms in people with natural immunity—and that’s ninety percent of patients—although those patients can spread the virus.”

  Lettie remembered that Marco had told her to use her hands. She raised her hand and pointed at her lips. “The polio virus enters the body through the mouth and attacks the first cells it finds, those in the throat, for instance, or the mucous membranes in the intestines. That is why the first symptoms are a sore throat or an upset stomach, and of course a high temperature—the body’s way of fi
ghting the virus.”

  She looked down at her notes again. “In about three percent of cases the virus ends up in the central nervous system, and the patient may contract nonparalytic aseptic meningitis, which leads to severe headache, backache, fever, vomiting, and lethargy. In only one percent of cases”—Lettie was careful to stress the word—“the virus destroys the motor neurons, which leads to muscle weakness and paralysis.

  “The incubation period averages six to twenty days, but it could be shorter or longer.”

  She glanced up at her audience. The people were gazing at her, attentive now. Here and there someone was frowning or nodding anxiously.

  She took a sip of water, and her eyes sought out Marco’s. She was getting to the worst part now. He was smiling and nodding. Next to him sat Christine and Pérsomi. Christine smiled at her, but Pérsomi was listening attentively.

  “There is no cure for poliomyelitis,” Lettie said as emphatically as possible. “Treatment merely serves to relieve some of the symptoms, like pain, and to prevent complications, like infections in the weakened muscles. Exercises and an improved diet are prescribed to restore as much function as possible to the affected muscles. Long-term rehabilitation includes physical therapy, braces to prevent deformity or fractures in weakened limbs, corrective shoes, and sometimes orthopedic surgery.

  “In case of paralysis of the respiratory muscles, an iron lung is used to help the patients until they are able to breathe independently again, usually about two weeks from the onset of the paralysis.”

  A hand went up in the audience. “Yes?” Lettie asked.

  “Can you please explain what an iron lung is?”

  “An iron lung is a kind of cylinder in which the patient is placed so that only the head remains free,” Lettie tried to explain. “It pressurizes the patient’s chest, forcing out air. Then the pressure is relieved and the lungs are inflated again. Almost like doing artificial respiration with one’s hands.”

  Another hand went up. “Is there an iron lung in our hospital?” a man in the third row asked.

  “Oh no, it’s a very expensive and highly specialized piece of equipment,” Lettie replied. “The nearest iron lung is at the Johannesburg Children’s Hospital.”

  “And without it a child with breathing problems will die?” the same man asked.

  “It’s possible, yes.” Lettie nodded. “Without the iron lung the patient can suffocate, or contract pneumonia. Five to ten percent of patients who contract the paralytic form of the disease develop respiratory problems, and about four percent of those don’t survive. Usually only an arm or a leg is affected, sometimes both arms or legs. But at the first signs of further paralysis the child is taken to Johannesburg by ambulance.”

  Another hand went up. “Is there no other treatment?” a lady in the front row asked.

  “Other long-term treatment includes hydrotherapy, massage, and passive exercise,” Lettie replied. “There’s a lady in Australia doing research on various kinds of physical therapy, but the results have not been published.”

  “What are the chances of a child with a slight degree of infantile paralysis recovering completely?” another lady asked.

  “The paralysis is often temporary,” Lettie replied. “Nerve impulses are sometimes restored after a month, and complete recovery might occur in six to eight months. Muscles have the ability to recover completely, even if half the original motor neurons have been lost. But if the affected nerve has been completely destroyed, it can’t be regenerated. Paralysis that remains after a year is usually permanent.

  “The good news,” Lettie said, folding up her notes, “is that scientists have developed several vaccines that are currently being tested to fight the polio virus worldwide. I hope that in about three years our children will all have been vaccinated, which will protect them the same way the vaccination against smallpox does.”

  “But this doesn’t help us in the next three years,” someone said loudly from the middle of the audience.

  “No,” Lettie agreed, “but it’s hope for the future.”

  When they drove back to her parents’ home to pick up the girls, Marco said, “I was very proud of you tonight, Aletta. I know it wasn’t easy, but you did a really great job.”

  “I’m glad you think I was okay,” Lettie said with a smile. “One thing I can tell you: I’d rather do ten complicated operations than get back on a stage to speak to so many people again!”

  Early in February 1955, Leonora woke one morning feeling out of sorts. “She feels warm,” Marco said worriedly.

  An icy fear gripped Lettie. She laid her palm on Leonora’s forehead. Steady, she told herself, every parent expects the worst at the slightest sign of a sniffle. But for the first time she was able to put herself in the shoes of a parent entering her surgery with a sick child.

  The child’s skin was warm under her cool hand. “Her temperature is slightly raised. It’s not serious. I don’t think it’s anything much,” Lettie said.

  “Are you sure?” Marco asked.

  She saw her own anxiety in her husband’s eyes. She reached out with her hand and gently stroked his cheek. “I’ll ask my dad to keep an eye on her today, but I really don’t think there’s anything to worry about.”

  But all morning fear kept gnawing at her. She phoned home twice. “She’s not well, but she’s asleep now,” her mom said. “Daddy agrees it’s just a touch of flu. There’s no need to worry.”

  And when she picked up the girls just after one, her dad said, “No, Lettie, it’s just old-fashioned flu. In a day or two she’ll be herself again.”

  She got up a few times during the night to check on the child. Leonora was still warm, but her condition didn’t seem serious. Marco also returned a few times, saying, “She’s warm and restless, but she’s asleep.”

  The fever stayed around for three days, not growing worse, but not improving either. “Just keep her quiet,” Lettie told her parents. “We don’t want to take any chances.”

  When she fetched the girls in the afternoon of the fourth day, her mom said, “Leonora is definitely getting better. She even ate something today. We kept her quiet, but Daddy says in a day or two she’ll be as right as rain.”

  Relieved, Lettie drove home. “No,” she told Marco that evening, “I don’t think we should give her a proper bath. I’ll just give her a sponge bath. Let’s wait until her temperature is normal before we bathe her again.”

  She got up in the night to make sure the child was okay. Leonora was still warm, but she seemed to be sleeping more peacefully. “She’s getting better,” she whispered to Marco.

  The next morning Lettie was up early. She made porridge and coffee, and sandwiches for Marco and herself. After a while Isabella woke up and came into the kitchen, bleary-eyed. “Leonora is still asleep,” she said and got up on a stool to eat her milk and rusks.

  “Still?” Marco asked when he joined them in the kitchen, freshly showered and neatly dressed.

  “Yes,” Lettie said. “Would you like some porridge?”

  Leonora began to cry in the bedroom. “I’ll go,” Marco said and got to his feet.

  He hurried down the passage.

  “Wait, Isabella, don’t stir your porridge with the sugar spoon. Look, now there’s porridge on the spoon. Mommy will give you another—”

  “Lettie?” Marco was standing in the doorway. His voice sounded strange.

  Lettie turned.

  Their child was limp in his arms.

  Tears were rolling down his cheeks.

  “She can’t stand,” he said.

  chapter

  FOURTEEN

  She can’t stand.”

  The words entered through Lettie’s ears and reverberated in her mind.

  The words cut through her.

  “. . . can’t stand . . .”

  The words cut her to pieces.

  Her legs gave way, and she sank down on the nearest chair.

  “Mommy?” her eldest said.

&nbs
p; “. . . can’t stand . . .”

  Then the meaning got through to her.

  Marco was still in the doorway, the child sobbing in his arms. She got up, her mouth parched.

  She took three steps to reach her husband and child, three endless steps.

  She reached out and took Leonora from Marco. She was warmer than an hour before. She clasped the child to her bosom. “There, there, my darling, there, there.”

  “Is it . . . ?” Marco asked, his voice raw.

  Lettie acted on instinct. She ran her fingers over the child’s left leg. “Can you feel that?” she asked.

  The child nodded.

  Lettie tapped gently on the knee. The natural reflexes were missing. “Can you tell Mommy where it hurts?” she asked.

  “My legs hurt,” the child sobbed. “And my head.”

  Lettie looked up into her husband’s dark, anxious eyes, brimming with tears. She nodded slowly. “Probably, yes.”

  He took the child from her again, carefully, gently clasping her to his chest. “Papa’s little princess, Papa’s beautiful little girl,” he said over and over in Italian.

  “Don’t cry, Papa,” the child replied in Italian. “It’s not so bad.”

  “Leonora,” Marco said softly.

  Lettie drew a deep breath and forced the words past the large lump in her throat. “I think we should take her directly to Johannesburg,” she said.

  Marco looked up and nodded. “Yes,” he said, his voice stronger now. “But let’s first say a prayer.”

  “Mommy?” Isabella’s small voice jolted Lettie back to reality.

  She looked down. Her eldest daughter’s face was filled with alarm, her eyes fearful, her lips trembling. Lettie picked her up and wrapped her arms around the child. “Leonora is ill. Papa is going to say a prayer for her,” Lettie said.

  “Okay,” said Isabella.

  Marco knelt, his youngest still in his arms. Lettie knelt beside him, her arms protectively around their eldest daughter.

  Marco began to pray, deeply, earnestly, in his mother tongue. Lettie bowed her head. She didn’t understand everything, but she felt a deep sense of peace settle over her.