Cutting for Stone by Abraham Verghese
His foot lay twisted under him in a fashion that made me want to throw up. He moaned, clutching at his upper belly. His face was a bloody mess. It was a grotesque sight.
Neither his face nor his foot seemed to concern him as much as his belly. “Please,” he said. His breath was short and he clawed at his belt.
His eyes found me.
“Please. Get it out.”
For a moment Id forgotten what he had done to Zemui or Rosina and Genet, or what he'd done to Ghosh. All I could see was his suffering, and I felt pity.
I looked up to see Rosina, her lip swollen and split, a front tooth missing.
“Please …,” he said again, clutching at his chest. “Get this out. For the love of St. Gabriel, get this out.”
“I'm sorry,” I said.
He kept rooting ineffectively, desperately, at his belly, and now I could see why. The pistol butt was digging into him—it had just about disappeared under his ribs on the left side.
“Watch out!” Rosina yelled. “He's trying to get his gun.”
“No,” I tried to say, “the gun handle has smashed in his lower ribs.” I did hear myself say to him, “Hold on. I'll get it out!” I wrapped my hands around the handle of that gun and pulled with all my strength. He screamed. It would not budge. I changed my grip.
I felt a mule kick in my hand before I heard the shot.
Then the gun came sliding free in my hand, as if it had never been wedged there but had simply been sitting on his belly button.
I smelled burned clothing and cordite. I saw a red pit in his belly. I saw life slip out of his eyes as easily as a dew drop rolls off a rose petal.
I felt his pulse. It was a variety Ghosh had never shown me: the absent pulse.
ROSINA SENT GENET to fetch Gebrew.
He came running. He hadn't heard the shot. The bungalow was far enough removed and the gun so muffled by the man's belly that the sound had not carried.
“Hurry. Someone might come for him,” Rosina said. “But first we must move the motorcycle.” With all five of us heaving, we righted the BMW and managed to get it to the toolshed, just past the curve at the bottom of our driveway. Other than a ding on the tank, the bike looked no worse for wear. In the toolshed we rearranged the cords of firewood, the stacks of Bibles, the sawhorse, incubator, and other junk kept there, so that the bike was hidden from sight.
Returning to the body, we had little to say to one another. Gebrew and Shiva fetched the wheelbarrow, and with Rosina and Genet's help, they fed the body into its rusty cavity. I leaned against a tree, looking on. He lay in the wheelbarrow in the kind of unnatural posture only the dead achieve. Now with Rosina leading us, we pushed him through the trees on the perimeter trail, just inside of Missing's wall, until we reached the Drowning Soil. The hospital's old septic tank was located here, deep underground, and for years it had overflowed before it was taken out of use. USAID concrete, Rockefeller funds, and a Greek contractor named Achilles had built a new one. But the old tank's effluent had digested the land. A downy growth of moss served to deceive the eye; anything heavier than a pebble would sink. The odor, present at all times, kept trespassers away. Matron had barbed wire strung around it, and the sign in Amharic said DROWNING SOIL, which was the closest translation for “quicksand.”
The smell was powerful. Pushing down the fence post so that the barbed wire was flat on the ground, Rosina and Gebrew got the wheelbarrow as far forward as they dared. I glared at Shiva. He was impasive, looking on. He could have been watching shoeshine boys at work—it was the opposite of what I felt. They were about to pitch the body forward when I said, “No!” I grabbed Rosina's hand, forcing her to set the wheelbarrow down. I was shaking, crying. “We can't do this. It is wrong. Rosina … Oh my God, what have I done—”
Rosina slapped me hard. Shiva put his hand on my shoulder, more to restrain me perhaps than to offer support. Rosina and Gebrew took the handles again, and they tipped the dead man out.
The mossy ground sagged like a mattress. The face on that body no longer belonged to the man who had terrorized us; it was a pathetic face, a human face, not that of a monster.
When the body finally disappeared, Rosina spat in its direction. She turned to me, the anger and bloodlust contorting her face. “What's wrong with you? Don't you know he would have killed us all for the fun of it? The only reason he didn't is he was even hungrier to steal Zemui's motorcycle. Don't feel anything but pride for what you did.”
WE WALKED BACK in silence. When we were home, inside the kitchen, Rosina turned to us, her hands on her hips. “No one but us knows what happened,” she said. “No one can know. Not Hema. Not Ghosh. Not Matron. No one at all. Shiva, you understand? Genet? Gebrew?”
She turned to me. “And you? Marion?”
I looked at my nanny, her face bloodied and the missing tooth making her look like a stranger. I steeled myself for more harsh words from her. Instead, she came over and held me in her arms. It was the hug a woman gives either her son or her hero. I held her tight. Her breath was hot in my ear as she said, “You are so brave.” This was my consolation: all was well between me and Rosina. Genet came over and put her arms around me.
If this was what brave felt like—numb, dumb, with eyes that could see no farther than my bloody fingers, and a heart that raced and pined for the girl who hugged me—then I suppose I was brave.
CHAPTER 27
Answering Medicine
HANGING SEEMED TO BE THE FATE of anyone who'd been close to General Mebratu. What spared Ghosh thus far was that he was a citizen of India. That and the prayers of his family and his legions of friends. His imprisonment did more than suspend everything in my world; it took away any meaning life once had for me.
It was then, as we despaired, that I thought of Thomas Stone. Before the coup, Id go for months without thinking of him. Having no picture of him, and no knowledge that he had authored a famous textbook (Hema, I learned later, had given away or removed every extant copy of A Short Practice at Missing), Thomas Stone seemed unreal to me, a ghost, an idea. It didn't seem possible that I might have been fathered by someone as white-skinned as Matron. An Indian mother was easier to imagine.
But now, as time stood still, this man whose face I couldn't picture was on my mind. I was his son. This was my moment of greatest need. When the army man came to steal the motorcycle and could have killed us, where was Stone? When I murdered the intruder—that was still how I saw it—where was Stone? When that death mask loomed in front of my eyelids at night, or when cold hands clutched at me from the shadows, where was Stone? Above all, when I needed to free the only father I ever had, where was Stone?
In those awful days which soon stretched out to two weeks, as we went back and forth from house to jail, to Indian Embassy, to Foreign Ministry, I was convinced that had I been a better son to Ghosh, if I'd been worthy of him, I might have spared him his present torture.
Perhaps it wasn't too late.
I could change. But what form should this change take?
I waited for a sign.
It came on a blustery morning when word of fresh hangings in the Merkato reached us. I set out hurriedly for the gate for no particular reason: wherever I was, I was ready to be somewhere else. On my way there, a mysterious sweet, fruity odor reached my nostrils. Simultaneously, a green Citroën, floating on its shocks, its back tires hidden by skirtlike fenders, wheezed into the portico of Casualty. A portly man slumped in the backseat was carried out by two younger men, and at once the scent got stronger. He had the café-au-lait skin and jowly features of the royal family, as if hed been raised on clotted cream and scones in place of injera and wot. To me he looked asleep. His breathing was deep, loud, and sighing, like an overworked locomotive. With every exhalation he gave off that sweet emanation—it even had a color: red.
I knew I'd encountered this odor before. Where? How? I stood thinking outside Casualty as they carried him in, trying to solve this puzzle. I realized I was engaged in the kind of
Later Dr. Bachelli told me the man had diabetic coma—the fruity odor was characteristic. I went to Ghosh's office—his old bungalow— and read from his textbooks about the ketones that built up in the blood and caused that scent. Which led me to read about insulin. Then about the pancreas, diabetes … One thing led to another. It was perhaps the only time in the two weeks since Ghosh had gone to prison that I'd been able to think of anything else. I expected Ghosh's big books to be unreadable. But I found that the bricks and mortar of medicine (unlike, say, engineering) were words. You needed only words strung together to describe a structure, to explain how it worked, and to explain what went wrong. The words were unfamiliar, but I could look them up in the medi cal dictionary, write them down for future use.
Hardly two days later, I encountered the scent again at Missing's gate. This time an old woman stretched out on the bench of a gharry, propped there by her relatives, was the source. She had the same sighing, breathing, and not even the horse's strong scent could conceal the fruity odor. “Diabetic acidosis,” I said to Adam, and he said it was possible. The blood and urine tests confirmed that I was right.
Somehow, life went on at Missing. Whether we had one doctor or four, the patients kept coming. The simple things—treating dehydration in infants, treating fevers, conducting normal deliveries—were routinely managed. But anything surgical had to be turned away I hung around Casualty with Adam, or else I hid in Ghosh's old bungalow browsing through his textbooks. Time didn't speed up, nor did my fear for Ghosh diminish one bit, but at last I felt I had found something that was the equivalent of Shiva's drawing or his dancing, a passion that would keep disturbing thoughts at bay. What I was doing felt more serious than Shiva's pursuits; mine felt like an ancient alchemy that could cause the prison gates in Kerchele to spring open.
During that awful period with Ghosh in jail, Almaz holding vigil outside prison, and the Emperor so distrustful of everyone that Lulu had to sniff every morsel of His Majesty's food, my olfactory brain, the feral intelligence, came awake. It had always known odors, the variety of them, but now it was finding labels for the things it registered. The musty ammoniacal reek of liver failure came with yellow eyes and in the rainy season; the freshly baked bread scent of typhoid fever was year-round and then the eyes were anxious, porcelain white. The sewer breath of lung abscess, the grapelike odor of a Pseudomonas-infected burn, the stale urine scent of kidney failure, the old beer smell of scrofula—the list was huge.
One night after supper, Matron dozed on the sofa while Shiva drew intently at the dining table. Hema, who was pacing the room, stopped by my armchair. This was Ghosh's spot. I had my feet up and books piled next to me. I think she understood that I was preserving his space. Over my shoulder she saw the thick gynecology textbook of hers that I'd opened, purely by chance, to a picture of a woman's vulva distorted by a giant Bartholin's cyst. I made no attempt to hide what I was doing. I sensed Hema struggle to find an appropriate response. She put her hand on my hair and then the hand slipped down to my ear, and I thought she was going to twist my pinna (that's what I learned the fleshy part of the ear was called). I felt her indecision. She caressed my pinna and stroked my shoulder.
When she walked away I felt the weight of what she left unsaid. I wanted to call after her, Ma! You have it all wrong. But just as she kept her thoughts to herself, I was learning to do the same. This was what growing up was about: hide the corpse, don't bare your heart, do make assumptions about the motives of others. They're certainly doing all these things to you.
I'm sure Hema believed that a prurient interest in a woman's anatomy took me to that page in the textbook. And perhaps it did, but that wasn't all there was to it. Would she believe me if I said that those musty old books with their pen-and-ink drawings, their grainy photographs of people parts contorted and rendered grotesque by disease, held out a special promise? Kelly's Obstetrics and Jeffcoate's Gynecology, and French's Index of Differential Diagnosis (at least in my childish way of thinking), were maps of Missing, guides to the territory into which we were born. Where but in such books, where but in medicine, might our conjoined, matricidal, patrifugal, twisted fate be explained? Where else could I understand the urge in me (was it homicidal? Id lie awake at night wondering) that did away with the army man, and then the simultaneous urge to keep it concealed and to confess? Maybe there were answers in great literature. But I discovered in Ghosh's absence, in the depths of my sorrow, that the answer, allanswers, the explanation for good and evil, lay in medicine. I believed that. I was sure that only if I believed would Ghosh be freed.
ON THE THIRD WEEK of Ghosh's abduction, I walked to the front gate in the morning, just as St. Gabriel's sounded the hour, which was Gebrew's command to allow entrance. The narrow pedestrian opening permitted just one person at a time to come through. What prevented chaos and a stampede was the sight of Gebrew in his priest's garb.
Two men jostled each other, high stepping over the frame of the gate like hurdlers. “Behave yourselves, for God's sake,” Gebrew admonished. Next came a woman who stepped over gingerly, as if getting out of a boat and onto the dock. As the patients took turns to peck like hens around the four points of Gebrew's handheld cross—once for the crucified Christ, then for Mary, then once for all the archangels and the saints, and then for the four living creatures of the Book of Revelation—and waited for Gebrew to touch it to their forehead, order was imposed. These visitors to Missing feared illness and death, but their fear of damnation was greater.
I studied the faces, each one an enigma, no two alike. I hoped that the next face would be Ghosh's.
I imagined the day my “real” father—Thomas Stone—would step through the gate. I imagined myself standing here. I'd be a doctor by then, and I might be in my green scrubs, taking a break between surgeries, or in my white coat with a shirt and tie beneath. Even though I had no photograph or memory of Stone to go by, Id know it was him right away
I knew what I'd say to him: You're much too late. We went ahead with our lives without you.
CHAPTER 28
The Good Doctor
IAWOKE WHILE IT WAS NOT YET DAYBREAK. I ran as fast as I could in the dark to the autoclave room. This was the thought that woke me up: What if Sister Mary Joseph Praise could intercede and free Ghosh? My “father” would never come, but what if my birth mother was just waiting to be asked? I hoped she wouldn't hold my long absence from her desk chair against me.
Seated, staring up at that print of the Ecstasy of St. Teresa, seeing only faint outlines as I hadn't put on the light, I felt as if I were in a confessional, but with no desire to confess. I was silent for ten minutes or so.
“You know for the longest time I assumed that all babies came in twos,” I said. I was making conversation. I didn't want to get to Ghosh or the favor I sought right away. “Koochooloo's pups came in fours and sixes. At Mulu Farm we saw a sow with twice that number.
“We are identical twins, but the truth is we aren't exactly identical. No, not the way a one-birr note is identical with another birr note in all but the serial number. Shiva is actually my mirror image.
“I'm right-handed, and Shiva's left-handed. The swirl on the back of my head is on my left. Shiva's is on the right.”
My hand went to my nose, again something I wasn't telling her. A month before the coup, I had a confrontation with Walid, who'd been teasing me over my name (such an easy target). I found myself flattened by a head butt—a testa—and the fight went out of me. Testa—Italian for “head”—some claim is an ancient Ethiopian martial art, but if so, there are no dojos, no belts, just lots of broken noses. The only defense against the “big knuckle” is to lower your head. Walid used his testa when I wasn't expecting it.
To my surprise, Shiva helped me up. Shiva was so tu
That night Shiva allowed me to explore his head. Unlike me, he had a gentle peak at the vertex, and his frontal bones were very thick and as hard as steel. My topography was different. I had asked Ghosh why this might be, and he postulated that the instruments used on Shiva at birth might have caused the bones of his head to heal in this “exuberant” manner. Or else it might have had to do with the fact that we were conjoined. I was too proud to ask what exactly that meant.
A folio-size book in the British Council Library had pictures of Chang and Eng of Siam, the most famous Siamese twins. A few pages later was a portrait of the Indian Laloo, who toured the world as a circus freak. Laloo had a “parasitic twin emerging from his chest.” Laloo stood in a loincloth, and from his bare chest sprouted two buttocks and a pair of legs. To me it looked as if the parasitic twin wasn't “emerging” from Laloo, but climbing back into him.
When I could unglue my eyes from the pictures, every word in that text was a revelation to me. I learned that when two embryos just happened to grow in the mother at the same time, the result was fraternal twins—they didn't look alike and they could be boy and girl. But if a single embryo in a mother happened to split very early on in its growth into two separate halves, the result was identical twins like me and Shiva. Conjoined twins, then, were identical twins where the early split of the fertilized egg into two halves was incomplete, so the two halves remained stuck to each other. The result could be like Chang and Eng, two individuals connected at the belly or some other spot. It could also result in unequal parts, like Laloo and his parasitic twin.