He gave Adam a quick tour of the clinic; there was a waiting room with two long wooden benches, some posters about breastfeeding, vaccinations and the correct use of condoms taped onto the bare walls. The treatment room had a table, a desk and a chair and was lined with wooden shelves crowded with medications, some of them covered with thick layers of dust. The whole place smelled like a bus station that had recently been doused with disinfectant.
He was astonished to find the clinic was equipped with a centrifuge and an X-ray machine. There was even a petrol generator for back-up. “There are power cuts all the time,” Bernard said.
He would be lodged with one of the families in the village, he said. Luis was Bernard’s acolyte and would also be his translator and informal assistant. He took him next door to meet him. Luis looked as if he was barely out of school even though he already had a braided, dimple-cheeked wife - Rosa - and two hijos, four and two.
The house he was to live in was much like the others in the village; it had whitewashed adobe walls and dirt floors. His room was sparse; there was a cot pushed against the wall, made up with a sheet and a light cotton blanket, and a window with wooden shutters.
“Where’s the remote for the air conditioner?” Adam said.
Bernard gave him a tight smile. “It’s on the DVD player next to the Swedish sound system.”
This is where his daughter gets her quick tongue, Adam thought.
Bernard asked if he would like to have dinner with him and Jamie, but Adam pleaded exhaustion. He couldn’t endure more of Jamie’s icy silence, and anyway he guessed Bernard might like to spend some time alone with his daughter.
Luis said that Rosa had made tamales but he didn’t make it to dinner. After Bernard left he collapsed onto the bed and was almost instantly asleep.
Chapter 28
He woke suddenly in the dark, with no idea where he was. He stared into the blackness, his heart hammering. He lay there for a long time, disoriented and a little frightened.
“What the hell am I doing here?” he said aloud.
He did not remember falling back to sleep, when he woke again it was still dark but he heard horses trotting past his window and someone slapping tortillas onto a griddle for breakfast. He tried to doze but the roosters crowing under his window made that impossible. Then he smelled the tortillas roasting and he remembered how hungry he was.
He stumbled into the dim, lantern-lit kitchen. There was a smoky wood fire and a few rickety wooden chairs. Luis and Rosa were already awake. Rosa put a stone bowl in front of him and he gratefully gulped down some watery beans and steaming tortillas. They were not at all like the ones he had eaten in Boston; they were rich and grainy like whole wheat pancakes. There was not even a spoon, he used the tortillas to scoop up the beans and dripped juice onto his jeans or onto the table. Afterwards there was a cup of warm milk flavoured with powdered coffee.
He ate with Luis. Rosa and the children would eat later, Luis told him, after they had left for the clinic.
After their rudimentary breakfast, Luis led the way to the clinica. It was just getting on for dawn and he could make out shadows moving about the village. There was movement around the SUV parked outside the clinica, Jamie was already dressed and was getting ready to leave. She had probably hoped to slip away before he appeared.
She said her goodbyes to Bernard and then came over - with some reluctance he thought - and held out her hand.
“Well good luck,” she said. “I have to be getting back. It was good to meet you.”
“Will I see you again?”
“Hopefully not.”
“I’m sorry.”
“Let’s not get into that.” She got into SUV. The window whirred down. “Oh, and watch out for yourself.”
“The witches?”
“Not just any witch. You have real competition now. Don’t let the Crow steal all your patients.”
“What’s the Crow?”
“You’ll find out soon enough.”
She spun the wheels, turned around and headed back down the dirt road towards San Cristobal. Adam watched her go with genuine regret. “You really screwed that up,” he said to himself and joined Bernard in the clinic for his first day as an angel of mercy.
Chapter 29
Santa Marta wasn’t the end of the world, but it wasn’t Beacon Hill either. There was an unreliable electrical supply and when it was working he discovered that everyone in the entire village had a television and kept it turned on at full volume from the moment they woke up until they went to bed.
Every morning the benches in the waiting room filled up with patients; there might be an old man with pneumonia, or a farmer with a self-inflicted machete wound that had become infected, and always and an endless troupe of exhausted women with crying babies or toddlers with diarrhoea. He was on call day and night, in that first week he treated a young woman who had burned both her arms trying to start a fire with petrol, and a young man who had fallen from his horse and broken his collarbone.
He hoped he would not be asked to treat anything much more serious. There was no CBC, no nurses to help him ventilate or take blood, not even a defibrillator. Any diagnosis was made without the benefit of a CT scan or a specialist paediatric physician; on the upside, if someone died he would not be sued, and there was no paperwork to file.
Bernard did not charge the villagers for his services, either in the church or the clinic, but sometimes people brought them vegetables, or a chicken, or some eggs, or they would help him repair something at the clinic or the church.
The local women all wore black woollen skirts with embroidered satin blouses. If the weather turned cold they put on shaggy woollen shawls, but winter or summer they wore open sandals on their feet. They carried the small children in a baby hammock on their backs. They called it a rebozo.
“Don’t take photographs, whatever you do,” Bernard had warned him. “They believe the camera can capture their soul.”
In Boston his patients always came to him; in Santa Marta he sometimes had to go to them, and Bernard kept two sorry looking nags for just this purpose. Adam hadn’t ridden a horse since college, but it was just one of an entire range of new skills he was required to learn.
One day a man came to the clinic begging for a doctor to come and visit his sick child. Adam got through his day’s patients and prepared to leave.
He and Luis saddled the horses and rode for a couple of hours to find his tiny edijo perched on a high bluff overlooking the valley. He wasn’t even sure it had a name, there were just a few adobe houses at the end of a long and dusty trail.
He had to stoop to get through the door. There was a blackened stove and a few cots around the walls. As his eyes grew accustomed to the gloom he became aware of a half dozen pairs of eyes staring back at him.
The mother of this little family looked as if she was not yet out of her teens. She kept her eyes downcast. Her husband looked even younger, just a boy himself, he had a jaunty red bandanna around his neck and jet-black hair hanging down to his shoulders. There were two other small children, only one of them old enough to stand.
The mother sat in the corner nursing her infant. She was trying to feed the child, but she lay listless in her arms. He made a quick examination. The baby was clearly dehydrated. She had had diarrhoea for three days, the mother said.
Not trusting his schoolboy Spanish he had Luis ask her how long the baby had been sick.
There was a brief consultation. “About three days,” he said. “Her uncle came, he’s a curandero, and he put the sickness into a chicken but now it’s come back.”
“Three days?” Adam said. “In three days a child can die. Tell them in future they should send for me first!’
“It is no good to get angry,” Luis said. “You will just frighten them. They don’t understand.”
Adam muttered an apology. Bernard had warned him not to let his frustrations get the better of him. “Tell them I think it’s just a gastric infection. Mal del
estómago. I’ll give her some fluids and rehydrate her, and perhaps we can try some antibiotics. Tell the mother her milk has dried up, it’s useless trying to feed her that way.”
He had brought some saline solution and a needle small enough for the child’s tiny veins. He suspended the intravenous bag from one of the wooden beams in the ceiling, adjusted the flow. It was so dark inside the little house he needed a flashlight to check the flow rate.
“She is asking if her baby will be all right.” Luis said.
“I think so,” he said, with more conviction than he felt. He smiled at the mother to try to reassure her.
* * *
Bernard was waiting for him on the veranda when he got back to the clinic. He slid from the horse, exhausted and saddle sore.
“How was it?”
“A baby with a gastric infection. I gave her some fluids and antibiotics. I think she’ll be okay.”
“You were gone two days. I was about to send out a search party.”
“I didn’t want to leave her.”
“Where did you sleep?”
“We had blankets, so Luis and I slept on the floor. It wasn’t so bad.”
“Did you ever consider snakes and scorpions?”
He shook his head. No, that had never occurred to him.
“Oh well, you’re back in one piece now.” He clapped him on the shoulder. “How are you feeling?”
“I’ll be all right after something to eat and a bit of sleep.”
“No time for that now, I’m afraid, the waiting room’s full. You have to get to work.”
Chapter 30
“Why don’t they come to us first?” Adam said that night as they ate their tamales and beans. “They gave the child to one of these curanderos.”
“What did he do for her?”
“He held a chicken over her then wrung its neck. It’s like being back in the Middle Ages.”
“He probably gave her some herbal medicine as well. Don’t be too harsh. Most of these curanderos are all right, they understand as much about pharmacology as you do, they know all the local plants and herbs and what they’re used for.”
“She was dehydrated. It was the intravenous therapy that saved her life. Can a curandero do that?”
“The healers were here before western medicine, Doctor Prescott. If it wasn’t for them the queue in the clinic every morning would be a lot longer.”
“It’s frustrating.”
“You’ve been in the country five minutes and already you’re trying to change things. You’re a typical conquistador.”
“If they won’t let me help them, then what am I doing here?”
“You are helping. But you have to remember there were shamans here before the Spanish. We had curanderos in Europe too, before the Inquisition stamped them out. Is that what you want to do? Imitate Guzman and his religious thought police?”
“We’ve come a long way since the Inquisition.”
“Have we? There are many things about western medicine that we can teach these people but there are also many things they can teach us. The shamans have been around for a very long time. How do you think they helped women give birth before you came along, how did they mend broken bones? Do not be too quick to judge whether your patients should always come to you first, Doctor Prescott.”
“Then why have a clinic here at all?”
“Because there are some things that the curanderos can’t heal, like dehydrated babies. I’ve watched you work, you’re a very skilful doctor; you’ve saved a lot of lives in the month that you’ve been here. But there’s other things, admit it, you don’t have a clue.”
“Such as?”
“Like depression. Like the woman who thought she had a frog in her stomach.”
“Well we don’t have too many of those in the ER in Boston.”
“That’s just semantics. There’s a lot of people in Boston who think they have a curse on them, they just use different words to describe it to their doctors. And what do the doctors do? Give them a prescription for a drug made from the same herbs, bark and roots the curanderos use, only they don’t put them in a fancy packet and charge fifty dollars a dose.”
Adam supposed that much was true. There was a big difference between the certainties of emergency medicine and the impotence of his peers in other branches of medicine.
“come on,” Bernard said, ‘you’ve had a long day. Let’s see if Rosa will make us some of her truly terrible coffee. Perhaps I have a little Irish whisky hidden away that will make it drinkable.”
Chapter 31
The work was exhausting. After he had worked through the line of patients in the waiting room he might be called to ride out to one of the outlying towns for some patient too unwell to make the long journey to the clinic. He never refused, and tried to keep as busy as he could. When he was with his patients he didn’t have to think about anything else, and he especially didn’t have to think about Elena.
He worked on his schoolboy Spanish; ‘cough medicine’ was tos, ‘stomach-ache’ was dolor del estómago, ‘antibiotics’ was antibióticos.
Every morning he woke to the sound of a cockerel right under his window. He would jerk awake, not remembering where he was, then he would hear the chickens and pigs fussing outside and he remembered he was in Mexico. His first thoughts were always about Elena.
What was she doing right now? Had she changed her mind?
He still could not break the morbid habits of Boston, no matter how he tried. At least here she was in a different city, in a different country, there was no temptation to try to email her or text her. It was like being in rehab, but with snakes.
* * *
Luis and Rosa had a decrepit outdoor shower with its own colony of frogs, but he preferred to go down to the creek with Bernard in the afternoons to bathe. As a river there wasn’t much to it, some turgid water and a few rocks, but it was a welcome diversion from the dust and heat of the pueblo, and Bernard was an interesting and erudite companion. He seemed to know as much about history and medicine as he did about religion.
They rarely agreed on anything but Bernard never tried to preach to him, and never seemed perturbed by Adam’s contrary beliefs.
“You say your father was a good Protestant?” he asked him one day.
“He would have said he was.”
“But you? You’re not a man of faith, are you?”
“Agnostic, I’m afraid.”
“Agnostic. Now what is that, exactly? Does that mean you don’t believe in God, or you don’t want to irritate God by saying aloud that you’re an atheist?”
“I only believe in those things we can see.”
“You can’t see bacteria but you believe in those well enough.”
“I also see children die, Bernard, every day, and it makes me think if there is a God, he’s sleeping on the job.”
“You think you could do better?”
“I’m damned sure I could.”
“So you believe in God, but you don’t like Him. What’s the name for that? An antaganostic perhaps?”
Adam smiled in spite of himself. “If someone prayed to me for their child’s life, I’m damned sure I wouldn’t ignore them.”
“You think that’s what God does?”
“If there were such a being.”
He smiled and shook his head. “Well there’s no mystery in life to you, then. You know what it’s all about.”
“Just tell me then, explain to me why God lets little kids drown in a bathtub or why He allows them to catch typhoid and die?”
“I don’t have the answers for you, Adam. My job is to remind people that there’s more than just this little Earth and that all life is a mystery. I ask them to try to look for the good in themselves and others even through the worst of times. It’s not for me to know everything. That I leave to smart Boston doctors.”
They took off their sandals and t-shirts and went and sat down in the river in their shorts. It was shallow, clear and cold.
<
br /> “Jamie told me about you and her mother,” Adam said. “It’s quite a story.”
“All love stories are special, Adam.”
“Not all of them. Others are bitter and sad. But then I guess you only know how much you love someone when you have to fight for them.”
“There was a fellow called Pedro Calderon de la Barca. Have you heard of him? He was one of Spain’s foremost dramatists from the seventeenth century. He said: ‘if love is not madness, it is not love.” I agree with him. It was madness for Inez to marry me, a poor Baptist güera and her a proud, rich Mexican catholic. Her parents never spoke to her again…did Jamie tell you that? They disinherited her and shamed her and yet she married me anyway. I’ll never understand why she did it, but I’ll thank God for it till the day I die.”
“It couldn’t have been easy for you either.”
“My parents had already given up on me. My father wanted me to be a lawyer, not a preacher.”
“Do you ever hear from them?”
“They’ve passed now, God bless them. They left me a bit of money and I spent it all on that hospital up there.”
“So they didn’t stand in your way?”
“I tried to stand in my own way. I told Inez not to do it, I begged her to go back to her family and forget about me, I even asked the administrators of the church to send me back to the United States.”
“Why?”
“Because I loved her so much. I wanted what was best for her and I didn’t think that was me. Yet I couldn’t stop thinking about her, night or day.”
“And you were happy?”
“I had found the best woman in the world. Why wouldn’t I be?”
“I’ve always thought that love couldn’t last.”
“Is that what you thought?”
“Your wife...”
“Inez.”
“Inez. She was the love of your life, right?”
“Some people call it that.”
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