Chandu unfolded it and glanced across the page. “From Papa,” he said, showing it to Kiran. “You sure it’s not for you, Anil?”
Anil nodded, explaining what he’d realized upon his third reading of his father’s letter. It was addressed not to him, but simply to the next family arbiter.
33
PARKVIEW HOSPITAL WAS REASSURING IN ITS PREDICTABILITY: everything sparkling clean, white, and sterile. There were no odors, nothing in the air but the scent of brisk efficiency and lingering antiseptic. It was an environment that made Anil feel at home, one he could slip right back into, yet it also made him acutely aware of everything he’d left behind, the lushness of India that had penetrated his being once again.
“Patel! Welcome back.” Trey grabbed one of his shoulders. “Two weeks and counting ’til applications are due. You ready?” He leaned in closer and lowered his voice. “Hey, the research project’s going well. I got the preliminary results back, and I think we’ll get a strong brief out of it by the end of the year. It’s going to look good for the fellowship.” He smiled his million-dollar smile, and Anil caught the faint scent of mint chewing gum.
“Yeah,” Anil said. “I need to talk to you about that, Trey.”
Trey glanced at his watch. “I’ve got thirty minutes now, want to go outside?”
They sat on the low perimeter wall of the courtyard, which had been landscaped to resemble a peaceful Japanese garden. “Listen, Trey,” Anil said. “I don’t want you to include my name on your research project. It’s your work, not mine.”
Trey squinted. “What are you getting at, Patel?” The corner of his mouth curled up. “You’re not reneging on our deal, are you?”
Anil shook his head. “We didn’t have a deal. Listen—” He took a slip of paper out of his shirt pocket.
“You’re breaking your word? Are you an Indian giver, Patel?” Trey snorted with laughter, evidently at some joke Anil didn’t get. “You think you’re going to push me out of the way to make a spot for yourself? Good luck with that shitty little MRSA project and your chances at a cardio fellowship without my help.”
Anil should have been prepared for Trey’s threats, though they were unnecessary. He’d already determined it would be futile to report Trey’s behavior. While Anil had been away in India, Parkview’s new Heart and Stroke Center had been named for the senior Dr. Crandall, in honor of his sizable donation. Between the prominence of his father and the support of the Cardiology head, Trey was untouchable. No one would believe Anil, particularly so long after events had transpired—or worse, he would appear to be a rival with an ax to grind.
“Trey, listen. I’m not going to report you,” Anil said. “But I do think you should seek help. There’s a confidential program in Richardson, designed for health professionals. Completely private; one-on-one counseling.” He handed the slip of paper to Trey and saw the muscles in Trey’s jaw pulse visibly as he chewed harder on his gum.
“You don’t want it to become a problem, Trey. You’re too good a doctor for that.” After everything, Anil knew at his core this was inarguably true. Even the technically correct action, in this case, would not result in the greater good.
Trey stood up and walked back toward the hospital, spitting his gum into the slip of paper and tossing it into the trash before he passed through the sliding doors.
Anil watched him go, then removed his specs and rubbed at his eyes. America, despite its billing as the ultimate meritocracy, was just like everywhere else. Trey would always come out on top because of his confidence, his connections, his charm. Others would continue to be fooled by him as Anil had been. Anil would not be able to solve every problem that came before him, just as he would not be able to save every patient. His new life in the modern world would still retain many of the problems from the past.
THE DECISION arrived in a thin envelope a few months later. Anil took the mail back to the apartment before opening it, but he had a sense even as he turned the key in the lock. He scanned down the page until he reached the word regret.
We regret to inform you we are not able to offer you a fellowship in the Department of Cardiology at Parkview Hospital. . .
At the bottom of the letter was a handwritten note from Dr. Tanaka explaining that it was a particularly competitive year, and encouraging Anil to apply again.
News of the fellowship decisions had spread by the time Anil arrived at the hospital the following day. Charlie offered to take him out for a drink at the Horseshoe after work. They sat with their beer glasses in front of them, trying to hear each other above the din of other residents quickly on their way to inebriated celebration. “I heard Trey and Lisbeth were the only two who matched at Parkview for Cardiology,” Charlie reported. “Everyone else came from other programs. Competition was tough this year.” He made a halfway attempt to smile. “I know it’s not much consolation. Sorry, mate.”
Anil tried not to think, as he had since receiving the news, of the near-holy quiet of the catheterization lab, the precision with which Tanaka had operated, the images on the monitor delivering the promise of a whole new interior world, all now out of his reach. He cleared his throat. “When do you leave for Sydney?”
“First of July, just in time to catch a bit of ski season before the job begins.” Charlie held his glass up. “Couldn’t have done it without you, mate. The hospital loved our MRSA study. It totally sold them on hiring me, even though I told them you were the brains of the operation. You sure you don’t want to come make your home at Infectious Disease at Sydney General?”
Anil raised his glass and clinked it against Charlie’s. “I’ll miss you, mate.”
IN THE break room on Ward 4, Sonia listened while Anil lamented the outcome of the fellowship decisions. “I should have taken your advice and applied to more programs,” Anil said. “Now it’s too late for cardiology or any other specialty.”
“Haven’t I taught you anything, Patel?” Sonia shook her head. “You don’t need a specialty. You’re already a doctor, and a damn good one—maybe even exceptional, one day. You’re supposed to learn the basics of clinical medicine in your residency, which you’ve done. But you’ve also learned to trust your eyes and your hands, how to use technology when you need it, how to relate to patients. Those are all important skills. Not all residents figure it out while they’re here—or ever, frankly. Not everyone can do what you did in your village in India, despite what O’Brien says at orientation.” She pointed her finger at him. “And don’t let that go to your head.”
“Don’t worry.” Anil smiled. When he’d told his Oncology team about the impromptu medical clinic he’d set up at the Big House last summer, Sonia was the only one who understood how treating lacerations and minor infections all day could be interesting.
“You know, Patel, we could use a few more doctors with your skills in Internal Medicine—someone to help me keep all those fresh-faced interns in line.” Sonia smiled. “You remember what that’s like, don’t you? Give us a year and see how it goes. You can always apply to Cardiology again next year, if you still want to.”
“Thanks, Sonia.” Anil smiled. “I appreciate the offer.”
“Always happy to help, Patel.”
“Actually, I could use your advice on something.” Anil reached into his backpack, pulled out a small glass jar filled with thick green paste, and slid it across the table.
“You made me pesto?” Sonia grinned as she unscrewed the lid and peered inside, then pulled back at the strong odor.
“It’s a paste made from the leaves of the neem tree, also known as Indian lilac,” Anil said. “They’re plentiful on my family’s land. It’s a natural and highly effective topical antibiotic. Reduces the size of an abscess by half in the first day. No need to see a doctor to lance or drain.” Anil pointed to the bottle. “That’s easily a million-dollar-a-year over-the-counter product. Safe, effective, no regulation, and I’ve got a reliable supply.”
“Hmm.” Sonia dabbed her finger into the open
jar and rubbed the paste between her fingers. “My little sister, Geeta, just moved to town to start her internship at Baylor. One of the senior docs she works with is into this kind of stuff.” Sonia scribbled something on a slip of paper and handed it to him. “Geeta doesn’t have much free time as an intern, but you should give her a call.”
THE FARMER’S SONS
ANIL HAD PRACTICED THE NATIONAL ANTHEM FOR MONTHS—IN the shower, in the car on the way to the hospital, any time he was alone. Geeta teased him about this, but he was determined to sing each and every word at the citizenship ceremony. After eight years in America, at the age of thirty-one, he would pledge himself to his adopted country.
On the day of the ceremony, in an auditorium with thirteen hundred people and with his wife’s family in the gallery, Anil watched the film of Ellis Island with tears in his eyes, then stood up when the country of India was announced and took his oath. When it came time for the anthem, he could only manage to get out the first couple of lines before the swell of emotion choked off his voice.
He was living in two worlds comfortably, or at least as comfortably as he could. There were times he still felt like a foreigner in America, like when he got up in the middle of the night to watch live cricket games on television. And there were times he felt like an outsider in India. The moments he felt most at home were those he spent practicing medicine, whether he was treating patients at Parkview Hospital or at the simple clinic in Panchanagar. What brought him a sense of home was what he carried within: his knowledge and experience, his compassion for his patients—all of which helped him make the right judgments most of the time. Mistakes and failures still happened, and when they did, he ensured his residents understood their value.
“ONE MONTH sabbatical, Dr. P?” a junior resident asked at the send-off party. “That’s pretty sweet. I didn’t think you could get that kind of time off as an attending.”
“Yes, well, I know the department head pretty well.” Anil chuckled. “Dr. Mehta seems to think I’m very dispensable around here.”
“Not true, not true,” Sonia interjected, pointing a finger at him in playful accusation. “But I might change my opinion if you don’t take good care of my sister over there. You’ve got the IV bags and antimalarials?”
“Yes, yes,” Geeta said as she joined them. “Don’t worry, we have an entire suitcase full of medical supplies. Two suitcases, in fact.”
“Good,” Sonia said. “Bottled water only, no street food. Don’t take any risks with my future niece.” She patted her sister’s belly, which was beginning to show a slight rise under her white coat.
Anil smiled as he watched their interplay. Geeta had some things in common with her older sister: besides being doctors, they shared a killer competitive spirit for board games and a taste for very spicy food. But Geeta didn’t have the same ambitions as Sonia: she’d chosen to specialize in dermatology so she wouldn’t be subject to the vagaries of call schedules. She freely admitted that Sonia was the better student and had a more natural aptitude for medicine. Geeta enjoyed her work but had other interests: she was a voracious reader and maintained a large vegetable garden in the backyard of their Lakewood house. She wanted to start having children soon after they got married, so they could have three or four if they wanted.
Their daughter was now due in four months. Anil had already painted the nursery a pale shade of butter yellow and assembled a crib with the aid of Mahesh, who had built one last year for his son, and Baldev, who was now back in Dallas.
It hadn’t been easy to get Ma to come around to Geeta. She resented the idea that Anil had found a woman himself, without the involvement of his elders or the village pandit. That Geeta was an American, born and raised in the West, who spoke only a few words of Gujarati and had little knowledge of cooking, made things more difficult still. Anil was up-front about the fact they had met and dated before choosing to live together. Before Geeta moved in, he went to his mother and told her in calm, unequivocal terms that he had met the woman he planned to marry; he hoped for her blessing but didn’t need it to carry on with his life. Ma found it easier to object to Geeta in the abstract, grumbling to Anil’s siblings in his absence about the corruptions of the West and women who tried to be no different from men. Once she met Geeta, though—the first time Geeta had traveled to Panchanagar with Anil—Ma had fallen under the same mesmerizing spell he had.
Geeta had held his mother’s hand loosely in hers as they sat on the couch together, leaning forward as Ma told stories of farming adventures, and raising five children, and her late husband. Geeta asked questions and listened intently to Ma’s answers, nodding while she mentally filed away every detail to retell the stories later to their friends in America. “Can you believe she once nursed three children at the same time? Two of her own and a niece, after her sister died. And she never stopped cooking meals for all of them. Such an amazing woman!” She told the stories with a sense of pride and enthusiasm that reflected how she saw the world, as if wondrous things were around every corner, and she was fortunate to witness them. Each time she did, Anil felt a swell of love for her, and his own eyes opened to the wonder of the world they occupied together.
Some of the stories Anil overheard Ma telling Geeta were new to him, such as the first time his mother had made tea for Papa’s parents after Anil had been born. They’d insisted she stay off her feet and look after her new baby, but she was eager to impress them and went into the kitchen early one morning after she’d been awoken by Anil—“Only in the night and the morning was he hungry, wouldn’t you know? He slept all day long.” Ma shook her head at him with a pursed-lip smile. She’d been so sleep deprived that she’d mistaken the salt for sugar. She was so appalled when she’d tasted the tea later, after it had already been served, that she hid away in her bedroom for the rest of the day.
As Geeta sat in the gathering room listening to Ma, her tea grew cold. Ma dispatched the servant back to the kitchen repeatedly to reheat the tea, then implored him to bring some snacks for the poor girl, who barely ate anything. Before long, Ma was fussing over Geeta’s too-thin figure and making sweets laden with ghee to fatten her up. “Golden son has been replaced by soon-to-be golden daughter-in-law,” Piya had teased Anil in a whisper.
That was Geeta’s first visit to India, over three years ago, and they had returned every year since. This trip would be their last before the baby’s arrival, and he expected his mother would be in full doting mode.
MORE THAN a dozen people were lined up outside, awaiting their turn to enter the small cottage. There was not much to look at inside, only two beds and a few chairs. A counter along one wall held a number of imperfect ceramic bowls filled with antiseptic, gauze, bandages, syringes, and pills of varied shapes and colors. In addition, there were cloves, ground turmeric, ointments, and tinctures not found on any pharmacy shelf—a mixture of coconut oil and aloe used to heal burns, the extract of a particular plant leaf that alleviated swelling and bruising. And there was the Neem product line, now bottled and sold in America, which generated enough profit to fund the clinic on an ongoing basis.
Despite its modest furnishings, the clinic was well equipped, with a portable ultrasound, electrocardiograph, and ventilator. They were older models, shipped over from Parkview after the hospital had upgraded to the latest technology, but they were more than adequate for the clinic. When Anil was here, he and Piya could see fifty patients in a day, but today they were preparing to close up early. Their last patient was a woman Anil suspected of having early symptoms of hepatitis C. He gave her some medicine and instructed her to return the following week when his friend, an infectious disease specialist from Australia, would be visiting.
A REPORTER from the town paper had arrived in Panchanagar to do a story on the medical clinic. The spindly man with thick black spectacles was particularly interested in interviewing Nirmala and Leena, as the widow and daughter of the late farmer for whom the clinic had been named.
“People come from al
l around to receive treatment at this clinic bearing your husband’s name. Your family name has become synonymous with good medical care for everyone, regardless of caste, religion, or gender. You must be very proud.”
“Yes,” Nirmala said, leaning forward to speak into the reporter’s recording device. “My husband was a good man. He devoted himself to his family, and he loved this community. We were very proud when this clinic was established in his memory.” Nirmala smiled at Anil, standing at the edge of the small crowd.
“The clinic operates on the land your father once farmed? And you still live there?” The reporter pointed his recorder toward Leena.
Leena smiled and tucked a lock of hair behind her ear. “Actually, the clinic—where we are standing right now—the land and cottage were donated by Mina Patel, and we are very grateful. Our home is over there.” She pointed beyond the gully.
“And the doctor is tireless.” Leena smiled over at Piya. “She is training my sixteen-year-old niece, Ritu, to assist in the clinic after school. I wish I could spend more time here, but my pottery business keeps me busy.”
ANIL AND Piya watched the reporter follow Leena to her house to get some photographs of her pottery. “How is she doing?” Anil nodded toward Ritu, standing at the outskirts of the assembled crowd.
Piya moved her head in a noncommittal gesture, not quite a nod or a shake. “She’s a little hard to reach. Stays very close to Leena. And she loves Kiran. He’s like a true older brother to her. Not the kind who tortures you with early-morning math lessons.” She elbowed Anil. “But she picks things up quickly. She’s quiet, but I can see she’s taking it all in. Last week we were so busy, she did her first sutures. Can you believe it?”