So now they’re giving me medicine and the gout is getting better but hasn’t gone away. Sometimes my ankles and knees hurt so bad I can hardly walk. No more sailing for papa—I’m living in the Seamens Home and I work a little at the docks when my arms and legs don’t hurt. When the medicine works better maybe I can get back to Kalaupapa. Meantime write soon, O.K.? I love you little girl,
Papa
P
apa was not alone in his medical problems. Emily’s health worsened throughout most of 1911, and as her face became more deformed her boyfriend grew disgusted, leaving her for a prettier girl in an earlier stage of the ma'i pk. Rachel had never thought much of the boyfriend but was sad to have her opinion so vividly confirmed. Emily stubbornly refused to check herself into the infirmary. “Dying stinks enough without doing it in a strange bed.” But since she was hardly able to take care of herself, Rachel temporarily moved in with her. She cooked for her, dressed her sores, took her out to sit in the sun or to the movies that now played regularly at the settlement. Emily was never too sick not to laugh at comedies like Happy Jack, or to shudder at Edison’s horrific Frankenstein. She particularly liked the films featuring the lovely “Biograph Girl” and the dimpled “Girl With the Golden Hair,” beautiful young women with faces but no names, who lived lives filled with glamour and adventure. She spoke often of the Bishop girls’ daring journey topside. “Remember when I slipped and almost went splat?” She grasped Rachel’s hand, her weak grip turning firm: “You saved me, Rachel. You been the best friend I’ve ever had.” A few weeks later she contracted what the doctors here called “swollen-head fever,” an adenitis of the lymph nodes, and died soon after. She was laid to rest in the Catholic cemetery with Father Maxime officiating and Sister Catherine attending alongside Rachel, Leilani, and Francine. Emily had lived seventeen years in the settlement—a relatively long life by Kalaupapa standards, but Rachel still wept for the years she might have had.
When, after six weeks, Rachel returned to the cottage she shared with Leilani, her housemate seemed a bit jittery to have her back. For half a day Lani fluttered nervously around the house, prattling on at great length about nothing in particular. And though they’d seen each other often enough while Rachel had cared for Emily, only now, at close and sustained proximity, did Rachel notice that Lani seemed somehow . . . different. She’d gained weight, that much Rachel could tell, but . . . had her voice always been that high-pitched? Something was different, and Rachel’s suspicions were confirmed at dinner when Leilani put down her fork, leaned forward and announced breathlessly, “Rachel, I have something to show you. Something wonderful!”
She stood, grinning as she contemplated whatever delicious secret she was bursting to reveal. “Wait here,” she instructed, “until I tell you to come in.” She hurried into her bedroom, shut the door. Rachel heard the faint strike of a match as a kerosene lamp was lit; then after a minute, Leilani’s muffled voice: “You can come in now!”
Rachel went to the door and opened it.
Leilani stood by her bed, her body bronzed by the lamplight. On first glance the only thing Rachel noticed was her state of complete undress, but there was nothing unusual in that; Lani could be quite casual about nudity.
But on second glance Rachel could hardly believe what she was seeing. Leilani’s body bore the familiar marks of her disease, her skin mottled with sores—but it had changed dramatically in other ways as well.
Leilani had breasts.
Not male pectorals. Not the muscled contours of a man’s chest. Breasts! Tapered and firm, each the size and shape of a large papaya, hanging ripely from her chest. Rachel was dumbfounded. The more she stared the more Leilani laughed, the odd protuberances jiggling as she did.
“Aren’t they wonderful?” Leilani giggled.
Rachel said, “Where in hell did you get them?”
“And look!” Lani hurried over, and reflexively Rachel recoiled a bit, as though caught in the headlights of an oncoming train. Lani cupped a hand beneath her left breast, holding it out for Rachel to inspect. “Areolae!” she said in a tone of hushed wonder. It was true: each nipple was ringed by a pink halo of flesh, distinctly female flesh.
“I know it sounds incredible,” Lani said, “but a few weeks ago I noticed that my chest seemed a little swollen. I thought, well, it’s the disease, that’s what leprosy does, isn’t it? But the swelling kept getting bigger and bigger, rounder and rounder, until—” She thrust her chest forward and raised her hands, as if to say, Ta-da!
“Your voice is different, too,” Rachel said, trying to make some sense of all this.
“Yes, I’ve gone from a tenor to a soprano! But oh, Rachel, that’s not all! As my breasts got larger, these”—Leilani pointed south—“got smaller.” Rachel looked down and saw that her friend still had an ule, but her testicles had shrunk to the size of marbles.
“Now, I’d be worried about that,” Rachel said.
“Why? Good riddance!”
“But can you still get a—uh—”
Leilani glanced down at her flaccid ule and admitted she could not. “I don’t care! I’m more than happy to trade it for the feel of a bouncing bosom.” She admired her new curves in the dressing mirror, but Rachel viewed them with a bit more concern:
“Did you . . . see Dr. Goodhue about this?”
“No. Why should I?”
Rachel said, exasperated, “Because you up and sprouted a pair of titties! If I suddenly grew an ule you can bet I’d be down at the infirmary before I had time to pee!”
But Leilani just laughed, happily taking Rachel’s hands in hers. “Rachel, don’t you understand what’s happened? Don’t you see? God finally answered my prayers! He’s made me a woman!” She laughed again, a joyous laugh. “I go to church now every Sunday and I thank God for His gift and His goodness, and I beg His forgiveness for ever doubting Him!”
Rachel harbored enough doubts for both of them. “Lani—what if it’s not God, but like you said, the disease? What if they aren’t breasts but—tumors?” Leilani pursed her lips in a sulk. “It can’t hurt to let Dr. Goodhue take a look.”
“No! He’ll try to cure me!”
Rachel sighed. “Lani . . . when have haole doctors ever been able to cure anybody of anything?”
Try as she might Leilani couldn’t rebut that, so she reluctantly accompanied Rachel to the new infirmary with its green gabled roof and wide verandah. Dr. Goodhue was in surgery and Rachel and Lani had to wait to see him; as they did a young Japanese man entered pressing a cold compress against his mouth, and took a seat across from them. At least Rachel thought he was Japanese; it was hard to tell. A gash on his forehead trickled blood into his swollen right eye, his cheeks looked as if they’d been sandpapered, and his lip had been split open like an overripe guava.
When he noticed her staring at him, Rachel quickly asked, “Are you all right?”
“Relatively,” the man said in perfect, unaccented English: probably a Nisei, a second-generation Japanese.
“What on earth happened to you?” Lani asked.
The man shrugged lightly. “Got into a scrape.”
“Looks more like the scrape got into you,” Rachel said. He smiled, but his split lip seemed to protest the movement; wincing, he pressed the ice pack harder against his mouth. “I hope you won, at least,” she added.
He sighed. “Only in the most figurative sense.”
“Can I ask you a question?” Lani said. Even before the young man could answer: “Do I look healthy to you?”
Rachel rolled her eyes. Puzzled, the Nisei looked her over. “As healthy as any of us in this place,” he allowed.
Leilani turned to Rachel and said, “See? See?” She turned back to the young man, proudly puffed up her chest and blurted out, “Do you like my breasts?”
His cheeks reddening, the Nisei seemed too flustered to vocalize an answer. Luckily a nurse entered just then to escort him to an exam room; he smiled nervously at Leilani, nodded to Rachel, then
fled.
“I hope you’re satisfied,” Rachel said. “You scared that poor man half to death.”
When Dr. Goodhue came to examine Leilani he was, to say the least, bemused. “Well,” he said as she slipped out of her dress, “what have we here, hm?” He proceeded to study the recent additions to Lani’s chassis, clinically hefting one breast and then the other in his hand; palpating the tissues of the breasts; peering over his glasses as he examined the areolae. He looked down her throat, palpated the larynx, had her sing the musical scale: “Do, re, me, fa, sol, la, ti, do.” He told her she had a lovely voice, then moved his attentions lower, frowning as he examined her shriveled testicles. When he was finished, he took a step back as if contemplating the entirety of the problem and nodded soberly.
“Well,” he said finally, “this is quite remarkable. I’ve read about such things in the case literature, but never seen one myself, till now.”
“Are they tumors, Doctor?” Rachel asked, fearful.
“Oh, no,” Goodhue said cheerfully. “They’re breasts.”
Leilani glared triumphantly at Rachel.
Rachel said, “But how is that possible?”
“Ah, that’s what’s so remarkable. Leprosy bacilli, you see, have a preference for cooler parts of the body. The larynx, for instance, is a cooler organ, relative to others, and when an aggressive colony of M. Leprae invade it, it can cause the sort of change in vocal quality you’ve noticed in your friend.
“The testicles are cooler as well, and in this case they’ve been pretty well infiltrated and, I’m sorry to say, destroyed.” To Leilani he explained, “Your body is in the throes of a hormonal imbalance; it’s producing more estrogen than testosterone. The result is gynocomastia—enlargement of the breasts—and gynocotilia, development of female nipples. You understand?”
“Yes.” Leilani was beaming. “I’m a woman.”
“Well,” Goodhue said lightly, “let’s just say you’re more of a woman than I am. Now, I’m afraid we can’t reverse the damage to your testicles; you won’t ever, I regret to say, be able to . . . function as a man again. But I might be able to surgically remove your breasts.”
Leilani stared daggers at him. “Don’t you dare!”
Unsurprised, Goodhue nodded. “They are,” he admitted, “rather well-formed.”
Tears were welling again in Leilani’s eyes. “I was right,” she said softly. “God answered my prayers.”
“Lani,” Rachel said, “it’s the leprosy that did this.”
“I know that.” Lani was unfazed. Her eyes shone, her smile was almost beatific. “It all makes sense now. I prayed to God to make me a woman and He gave me leprosy—so it could make a woman of me! Don’t they say He works in mysterious ways?” She closed her eyes and recited, “Be thankful unto Him, and bless His name. For the Lord is good; his mercy is everlasting; and his truth endureth to all generations.”
It was hard to contest her logic, and really, what was the point? Dr. Goodhue assured them this posed no threat to Leilani’s health, so Rachel saw no reason to dampen her friend’s newfound piety. She even agreed to accompany her to services that Sunday—at the Church of Latter Day Saints, chosen primarily because of their enthusiasm for dancing—and Rachel had to admit she had never seen Lani quite so happy. In all the rest of her days at Kalaupapa Lani would never miss a service, always singing loudly and joyfully along with the choir. And when one Sunday the pastor told the congregation, “Miracles are all around us, we have but to look,” Leilani smiled to herself, knowing even more surely than he that this was so.
N
ot long afterward, Rachel was returning from a day of surfing at Papaloa when, nearing the baseball diamond, she heard the sounds of a game in progress. Not a serious match-up hosting a large crowd, but a friendly practice game between two of the town’s rival teams. The grandstand was empty and Rachel, having nothing better to do, took a seat in the front row. She was relieved to see that Jake Puehu was not among the players, but at least one of them was familiar to her: the young Nisei from the infirmary sat in the dugout, awaiting his turn at bat. His injuries had healed nicely and Rachel idly noted that with his swellings gone he was rather handsome. Yet for someone engaged in what was supposed to be a relaxing activity he seemed extraordinarily serious: unsmiling, eyes downcast, almost brooding.
When it was his turn at bat he swung and missed the first pitch but connected solidly with the second. As the ball arced over left field, he ran and took first base. The next batter bunted and was tagged out on his way to first, but the Nisei made it safely to second. Then a big stocky Hawaiian hit a line drive and all bets were off. He lumbered to first, the Nisei made it to third—and unwisely decided to steal home. The ball was quickly thrown from an infielder to the catcher, who stepped onto home plate at pretty much the same moment the Nisei slid into it.
There followed a spirited disagreement over whether he was safe or out. The umpire called him out; the Nisei disagreed. Refusing to leave the field, he yelled an obscenity at the umpire, then gave him a rude shove. The imposing-looking catcher shoved the Nisei.
This, Rachel decided, would have been a good time for him to storm off the field in a huff. Instead he dove at the catcher, knocking him to the ground; the umpire lunged at the Nisei; and something of a free-for-all erupted. Rachel was startled by this violent outburst from such an otherwise unassuming fellow; but then she reminded herself what had brought him to the infirmary in the first place.
Calmer heads converged on home plate and pulled the combatants apart. The umpire was bleeding from the head and the catcher, with a nasty cut on his leg, was helped to the bench. The game was called off and the players dispersed. Rachel watched the Nisei, sporting fresh bruises, as he limped off the field alone. She considered going down to see if he was all right, but she held back; it had been his belligerence, after all, that had started the whole donnybrook, and there was something in the way he kept himself apart from his fellows that suggested he wasn’t interested in anyone’s sympathy. She left, but found herself thinking about him despite herself.
A few weeks later, straddling her surfboard off Papaloa Beach as she waited for the next set of waves to roll in, she noticed a swimmer heading in her general direction. It was the Nisei again. He was a good swimmer, capable of powerful strokes, and he was experienced enough in the ocean to know to dive into the base of the larger waves as they approached. Rachel thought at first he was swimming out to meet the incoming waves for body-surfing . . . but then he passed her and kept right on going.
Rachel was curious enough to forego the next ride and let the wave pass under her. Bobbing on the swell she watched the young man swim well past the wavebreak . . . and a distressing thought occurred to her.
She bellied onto her board and paddled after him.
He was only a short distance ahead; it wouldn’t take her long to overtake him. She hoped he’d be turning around any moment now, but he kept on swimming. Rachel paddled like mad to close the gap between them.
“Hey,” she called, now only a few feet behind him. “You gotta watch yourself, there’s a bad undertow out here.”
Over his shoulder the Nisei called, “Thanks,” but didn’t pause in his stroke.
Rachel paddled up alongside him now; it took some effort to keep pace. “No, really, it’s dangerous. You get tired, get a cramp, doesn’t take a lot to suck you under.”
He didn’t reply at all this time, just continued swimming. But although his stroke was still strong, his breathing was becoming a bit more labored. She glanced behind them and saw the white, red, and green buildings of Kalaupapa growing ever more distant.
“Hey,” she called again. “C’mon. I know what you’re thinking, but it’s crazy.”
He didn’t answer. Rachel said, “O'ahu is twenty-two miles away! That’s a lot farther than it looks.”
For the first time the Nisei stopped swimming—turning round in the water to face her.
“Go away!” he told h
er, the exertion beginning to show in his face. “For your own sake!”
He turned and started swimming again.
Rachel continued to paddle.
He swam north/northwest for another ten minutes, the pali shrinking to the size of a sandbar, the surf growing heavier in stiff winds. Rachel stubbornly followed.
“Remember what the boat trip here was like?” she said, hoping to taunt him into turning back. “That nice smooth ride—how many times did you throw up? You think you’re gonna swim the Kaiwi Channel like it’s some-body’s bathtub?”
“I’m going to try!” he snapped back, but Rachel could hear the mounting exhaustion in his voice.
“And if you don’t drown, some hungry shark’s gonna bite off your leg—right there, right under the knee!”
“Let him! What the hell difference does it make!”
He was slowing, and now by paddling furiously Rachel was able to overtake him—she guided her board directly in front of him, forcing him to a stop. She sat up, straddling the board with her feet in the water, and shouted, “Hey! You’re a leper! Get used to it!”
Her words struck him like the slap of a wave. He floated there, momentarily at a loss, as Rachel’s tone softened. “You can swim to China,” she said sadly, “and it’s not going to change anything.”
Was that resignation in his eyes or just fatigue? He treaded water for long moments, looking away from Rachel and across the whitecapped waters to the distant shores of O'ahu on the horizon. When he looked back Rachel was startled to see tears welling in the corners of his eyes.
“All right,” he said, his voice thick with emotion. “All right.”
He turned and started swimming back toward Moloka'i.