Brother''s Keeper

  Burkett seems to have touched on a sensitive topic. He decides not to pursue it further, but later that evening, after dinner, Nick stops him outside the bathroom.

  ‘Hassad and Abu are followers of Christ, but that doesn’t mean they don’t still live in a strict Muslim culture.’

  ‘Sure,’ Burkett says. At the moment he is more interested in urinating and taking a Xanax than in hearing a lecture from Nick on the cultural practices of Christian converts.

  ‘All I’m saying is that you’re right to question it,’ Nick says.

  ‘It’s really not a big deal.’

  ‘I don’t want you to think I can’t see where Owen was coming from. In order to follow Christ you have to give up everything. Jesus said, “If anyone comes to me who does not hate his own family, then he cannot be my disciple.” That’s all well and good but my opinion is that the separ­ation has to come more gradually.’

  Hate. The word follows him into the bathroom. He locks the door and places his shaving kit on the counter and takes out the vial of Xanax – which is nearing its end faster than he might have hoped. He swallows a pill and stares at himself in the mirror. Was he hated by his brother? Was it hatred that drove Owen so far from home? He wonders if he’ll ever under­stand what his brother actually believed.

  The sign over the herbalist’s store features a snake coiled around the stem of a goblet. On the shelves are mason jars full of herbs, spices, or animal specimens. Snakes and lizards float in murky fluid.

  The herbalist, who wears a light blue lab coat, speaks no English but understands the terms ‘Xanax’ and ‘Valium’. From behind the counter he peels open a Tupperware box to reveal four red and white packages of generic alprazolam. The expiration dates are long past, which Burkett expected.

  ‘What about Valium?’

  The herbalist shakes his head without apology.

  ‘I’ll take them all,’ he says. Thirty in each package, one hundred and twenty pills. He unfolds a stack of banknotes and the apothecary takes his share, the equivalent of twenty dollars.

  He pauses on his way out. ‘What about siddique?’ he asks.

  The man motions for him to wait, and disappears into a smoke-filled room. Through the open door Burkett notes a pair of middle-aged men hunched over a hookah. The TV shows an empty bedroom through a gap in a shuttered window – probably bootleg footage from a surveillance drone. A woman passes into view, but only for a moment.

  The herbalist returns with a plastic bottle, approximately twenty ounces. Burkett eyes the fulvous liquid and unscrews the cap, the smell alone probably strong enough to inebriate a child.

  ‘Do you have any more?’

  The herbalist says something in Arabic.

  ‘Any more?’ Burkett asks again. He holds up five fingers. ‘How about five – five bottles?’

  He waits while the herbalist retrieves two additional bottles. Perhaps supplies are low. He decides it isn’t worth the trouble to complain.

  ‘How much?’

  The herbalist opens his palms in a manner of helplessness, perhaps apologizing for the high cost. Burkett lays a couple of five-hundred­khandar banknotes on the counter, totaling around fifty dollars. The man crumples one of the notes into his pocket and slides the other back across the counter. To Burkett it seems like a discount after what he paid at the hotel in the capital. That concierge either ripped him off or sold him a product of much higher quality. He wonders if he’ll go blind drinking from this cheaper batch.

  He thinks he knows a shorter way back to the clinic. The streets in the village are quiet. He passes the site of last week’s suicide bomb, but all that remains is a black tattoo where the explosion scorched the pavement.

  It starts to rain, but his face and bare arms feel numb to it, as if he were covered by an invisible membrane. He’s struck by the notion that he could take a blade to his own skin and hardly feel it. A kind of intrinsic anesthe­sia, as if his consciousness, his soul, had somehow become detached from his nervous system.

  Eyes bore into him: two young men on a weed-infested tennis court. They stride toward him. Nimbly one of them hops over the sagging net. From their jeans and tee shirts, their cleanly shaven faces, he knows they aren’t Islamic militants, but there are plenty of others who would harm an American. In the capital he heard warnings about foreigners beaten and robbed. After what happened to his brother, he is perhaps a fool to have left the compound by himself, even if Nick does it on a daily basis. Nick might insist that divine forces render bodyguards unnecessary, but he also has the advantage of being a former Navy Seal.

  Burkett imagines lying in the gutter in the rain while hands search his pockets and satchel. No doubt they’d make off with the siddique and the expired Xanax – his wallet as well.

  The young men are jogging now. They will overtake him in a matter of seconds. He considers running, the smartest option, but something keeps him from doing so. His heart races, but more from anger than fear. His muscles flex as if to fill a surrounding void.

  As far as he can tell, they are unarmed. He imagines fighting, two against one. He is stronger than either of them, perhaps stronger than both of them combined. An old saying comes to him: Once a wrestler, always a wrestler.

  He stops and turns. He grips the strap of his satchel, thinking he’ll use it as a weapon. The combined weight of two books and sixty ounces of sid could do real damage to a man’s face.

  They are close now – not men but boys. Teenagers just past puberty, not even old enough to shave. The desire to fight leaves him as fast as it came, and to his relief they run past him to take shelter from the rain under the awning of an empty café. One of them meets Burkett’s gaze and offers a polite nod, making him feel foolish for having ever seen them as a threat.

  Back in his module he opens the packages and lays out the foil-lined cards. The pills sit in their little domes, prisons from which they await release, but these have waited too long: the most recent expiration date is two years past, the oldest nearly three.

  He puts the cards in his shoulder satchel and jogs through the rain to triage. In the top drawer of the desk he finds the key to unlock the safe. The exchange is easy: the expired tablets for those in the safe. He hopes no one will find it strange that all four boxes of Xanax have been opened or notice that the tablets have changed color. These are risks he’ll have to take.

  8

  Burkett has been at the clinic almost three weeks when news arrives of Abu’s murder, his body found hanging from a tree just outside town. In a handwritten note, the Heroes of Jihad accused Abu not only of convert­ing to Christianity, but also of collaborating to sterilize Muslims at the medical clinic.

  It is past noon when Nick returns from the police station. He embraces his wife but hardly speaks. Burkett and Hassad stand in the courtyard hoping for more information, but Nick turns from them and slouches alone behind the modules. They can see him sitting in the shade at a picnic table he built himself and recently painted bright red. Nearly half an hour passes before Burkett, against Beth’s wishes, goes back and sits across from him.

  ‘Tell me what happened,’ Burkett says.

  ‘He was killed,’ Nick says, his face blank.

  ‘I heard they found him hanging from a tree.’

  Nick looks away. Even if he’d prefer not to discuss it, Burkett has no choice but to ply him for details: the murder feels too close to Owen’s.

  ‘A man in the image of God,’ Nick says.

  Burkett waits and asks, ‘What did they do to him?’

  ‘Gouged out his eyes, castrated him.’

  ‘Was he still alive?’

  ‘I don’t know,’ Nick says. ‘They killed him by cutting his throat.’

  Burkett feels a horror verging on nausea, but he tells himself he needs to know everything Nick does.

  ‘What else did they do to him?’

&n
bsp; ‘His genitals were discovered in his mouth.’

  Maybe he shouldn’t be surprised by the spectacular cruelty of it – he could find similar atrocities in stories of religious conflict the world over – but still it shakes him to the core. Such evil, pure and absolute.

  Through his mind drift images of blood and skin, the resistance of flesh against a blade. The surgical terms seem outrageously inappropriate: enucleation, orchiectomy. But what is torture if not a ghastly caricature of surgery? The torturer if not the demonic inverse of a physician? The priv­ileged access to the body, the concern with pain: it’s an analogy he can’t bear to make, the very idea an affront to his profession and all he stands for, but he has no control over the movement of his thoughts. Do no harm means nothing unless one is also capable of doing harm.

  How does a man become a torturer? What happens in his mind? Is it the result of some monstrous event in childhood – some kind of abuse? Burkett wants to write it off to a kind of insanity, but if he were to find Owen’s killer, when would doing harm become torture? Is it only a matter of degree? He would have no qualms about harming that man, causing prolonged pain, but how far would he be prepared to go?

  Compared with Abu, Owen hardly suffered. Burkett is struck by the inconsistency. Did Abu’s murderer just happen to be more of a sadist? Or do these different methods of execution reflect some difference in their crimes? Perhaps the Heroes have a system of justice that demands spe­cific penalties for different Christian activities. While evangelism calls for death by gunshot, apostasy warrants mutilation.

  In the late afternoon Hassad unlocks the gates for a black Mercedes to drive in. Through the window Burkett watches Nick and Beth shake hands with three men in business suits, two of whom carry automatic weapons. The shortest and oldest of the three must be Walari, their puta­tive protector, here to discuss his recent failure in the case of Abu.

  Burkett is annoyed not to have been summoned for the meeting. He crosses the courtyard while the driver, barely visible through the tinted glass, turns the Mercedes so that it faces the open gate. Burkett expects some kind of challenge from the henchmen guarding the door of the clinic, but without a word they step aside to let him pass. One of them even nods in greeting. Perhaps they were expecting him. Or perhaps it’s simply inconceivable that a threat to their boss could have white skin and western clothing.

  Nick and Beth sit with Walari at a folding table normally used for triage. Nick rises and introduces Burkett. Walari shakes hands with a limpness typical of Khandarians, but still unexpected in a warlord, and the clam­miness of it gives Burkett a momentary urge to wash his hands. There is nothing in the man’s appearance to support the rumors of brutality. He supposedly built his fortune during the interregnum, the chaotic decade before the Behemoth took control.

  ‘Mr Walari personally knew our friend Abu,’ Nick says. ‘He’s here to express his condolences.’

  ‘Will there be increased security after what happened?’ Burkett asks. ‘Tell him we need somebody standing by, a twenty-four-hour guard.’

  ‘That’s what we’ve been discussing,’ Beth says, ‘but apparently it’s going to cost us. For this upgrade we have to get approval from IMO.’

  After an exchange in Arabic Nick says: ‘He questions what Abu might have confessed – under pressure. If, say, we had Bibles here, the Heroes of Jihad would have reason to raid the clinic.’

  ‘All the more reason to have round-the-clock guards,’ Beth says, looking at her husband.

  ‘I worry that the presence of armed guards would undermine our ministry,’ Nick says. ‘Shouldn’t we look to God for protection?’

  ‘We have,’ Beth says, ‘and he’s delivering armed guards.’

  Husband and wife lock eyes and in a moment of silence, as Burkett imag­ines it, replay a years-old dispute before Nick concedes by looking away.

  ‘What if this is a scam?’ Burkett asks. He glances at Walari, just to make sure he understands no English. ‘How do we know it wasn’t his people who killed Abu?’

  ‘No way,’ Nick says.

  ‘Ryan has a point,’ Beth says. ‘Do you remember that road construc­tion project? Supposedly he was behind the very attacks that made it necessary to hire him in the first place.’

  Nick shakes his head. ‘That was hearsay, and this is small beans by comparison. The torture – and mutilation.’ He shakes his head in sadness. ‘It’s just not his style.’

  Walari speaks gently, looking at Beth, and Nick interprets: ‘Until the issue of payment is resolved, Mr Walari will have someone drive by the clinic every hour.’

  ‘That’s very kind of him,’ Beth says.

  Burkett wonders if sarcasm sounds the same in both languages, but Walari seems sincere as he bows and places his hand to his chest.

  They file into the parking area and say their farewells. The portable operating unit sits dormant just outside the gates. It is too large to fit inside. What, if anything, keeps the fanatics from blowing it up? Or the clinic itself for that matter? The wall and gate would tear like tissue with a large enough car bomb.

  Burkett watches Nick shake hands with Walari. First Owen, now Abu – and still Nick would question the need for armed guards. At what point will he acknowledge the risk? When the bomber shouts Allahu Akbar ? Maybe Nick is suffering from some kind of delusion. Beth at least can offer an element of pragmatism – pragmatism being a relative term and perhaps unsuited to circumstances as decidedly unpragmatic as a Chris­tian mission in the Muslim world.

  ‘I want out,’ he says as Hassad closes the gate behind the Mercedes.

  ‘Why don’t you give it a week,’ Nick says, ‘to let the dust settle?’

  An image comes to mind: that swollen, infested foot. He would have operated this morning if Nick hadn’t closed the clinic to all but emergencies.

  ‘Call the patient with Madura foot,’ he says. ‘I want to do the amputa­tion this afternoon.’

  ‘It’s too dangerous,’ Beth says, nodding toward the portable unit outside the gate.

  ‘I’ll do it in one of the examining rooms.’

  ‘The patient has to be nil by mouth for eight hours,’ she says.

  ‘Then we’ll do it first thing in the morning.’

  ‘What about a two-stage operation?’ she asks. ‘Owen had talked about doing a guillotine first and letting the wound drain for twenty-four hours.’

  ‘It’s not unreasonable,’ he says, irritated not so much by Beth as by his brother – his brother still second-guessing him even from beyond the grave. ‘But this is an indolent infection. I’d only start with a guillotine if he were septic.’

  It occurs to him that his professional value is greatest where he’s most likely to be killed. Perhaps he’ll join Doctors Without Borders and work somewhere in Africa, as far as possible from lunatic jihadists. Would they take a surgeon with a suspended license? No doubt something could be arranged.

  ‘When is the next car to the capital?’ he asks.

  ‘Pierre from IMO is visiting next week,’ Nick says. ‘You can ride back with him.’

  Burkett goes to his room and swallows a pill with a shot of siddique. He recalls a moment last month in Atlanta, maybe a week before he left, but he hasn’t thought of it again till now. Some time in the night he woke on the couch of his apartment. The lights were on so he could see himself clearly reflected in the plate glass of the sliding doors. What woke him? Some presentiment he couldn’t explain at the time, a feeling hardly miti­gated by any pill. Only now does he realize it could have been the exact moment of Owen’s death.

  The next morning, the patient, whose name is Sabib, sits on the padded table in a gown that snaps in back. His diseased foot looks like a lump of clay stuck to the end of his leg. Beth gives him a pair of red tablets, which he swallows with a thimbleful of water.

  ‘What are those?’ Burkett asks.

 
‘Xanax,’ she says.

  The long expired tablets are unlikely to have any effect. He considers telling her, but it would require some kind of explanation, no doubt leading to lies upon lies. The open packages might already have started her on the path of suspicion. Then again, how much does the patient actually need Xanax? Without it, he might have trouble sleeping through the operation, but there shouldn’t be any difference in the pain he experiences.

  ‘How about giving him Versed IV as well?’ Burkett suggests.

  ‘We don’t have it,’ Nick says, having just returned from the portable unit with another bag of supplies.

  Beth pulls open the man’s gown, exposing his bare back, and runs her fingers down the bumps of his spine. Since an amputation requires only regional anesthesia, Burkett doesn’t need the mechanical ventilator in the portable operating room. An orthopedist would use a peripheral nerve block, but Beth, who has extensive experience in obstetrics, is something of an expert in epidural anesthesia.

  Burkett watches while she sponges betadine onto the patient’s lower back and numbs the skin with lidocaine. She inserts a needle and attaches an air-filled syringe and taps the plunger while driving the needle into the epidural space. Burkett is impressed: it takes skill to distinguish muscle from fat by resistance in a needle. She threads a tiny catheter through the bore and after removing the needle she tapes the catheter to the skin.

  Last night, after they scrubbed the examining room, Burkett for a third time watched the surgical video his brother had left in Sabib’s file: a DVD of a below-the-knee amputation. Afterward he couldn’t help but replay the operation in his mind from start to finish. He had to take an extra dose of Xanax to keep himself from going through it yet again. This was always one of his problems in medical school and residency: the endless mental repetitions that would distract him from daily tasks and rob him of sleep.

  ‘Do you feel that?’ he asks as he pokes Sabib’s skin with a scalpel. A simple question of pain – Nick doesn’t need to interpret. Sabib smiles at Burkett, as if to assert himself against the useless Xanax, but just as quickly, thanks no doubt to the Fentanyl, he falls asleep.