Cutting for Stone
An old man's palsy overtook his hands as they reached for her face. He kissed her forehead. In that extraordinary and unstoppable act he realized, not without a twinge of pride, that he loved her, and that he, Thomas Stone, was not only capable of love, but that he had loved her for seven years. If he'd been blind to his love, perhaps it was because it had happened as soon as he met her on those slippery stairs, it had happened when she had nursed him, bathed him, tried to revive him on the Calangute. It had happened when she'd held him in her arms and wrestled and dragged his dead weight to a hammock and then spoon-fed life back into him. It had happened as they crouched over Sister Anjali's body. But love reached its apogee when Sister Mary Joseph Praise came to work alongside him in Ethiopia, and then it had never wavered. Love so strong, without ebb and flow or crests and troughs, indeed lacking any sort of motion so that it had become invisible to him these seven years, part of the order of things outside his head which he had taken for granted.
Did Mary love him? Yes. Of this he felt certain. She had loved him, but following his cue—always following his cue—she'd said nothing. And what had he done all these years? Only taken her for granted. Mary, Mary, Mary. Even the sound of her name was a revelation to him since he'd never called her anything but Sister. He was sobbing, terrified of losing her, but that, too, he saw was his selfishness, his need for her manifesting itself again. Would he have the chance to make amends? How stupid could a man be?
Sister Mary Joseph Praise barely registered his touch. Her cheek was hot against his. He lifted the sheet. A generous swelling of her belly met his eyes.
It was an axiom of his that any swelling in a woman's abdomen was a pregnancy until proven otherwise. But his mind overrode that thought, refusing to consider it—this was a nun, after all. Instead he came to a snap diagnosis of bowel obstruction … or free fluid in the peritoneal cavity … or hemorrhagic pancreatitis … some sort of abdominal catastrophe …
Maneuvering through the door frame, then trying not to bump her feet on the banister, his sobs changing to grunts of effort, he carried her out from her quarters, and then down the path to the operating theater. She felt heavier to Stone than she had a right to be.
There was a question the chief examiner had posed to him when he appeared for the Royal College of Surgeons viva voce after passing his written examinations in Edinburgh: “What first-aid treatment in shock is administered by ear?” His answer “Words of comfort!” had won the day. But now, in place of reassuring and soothing words that would have been humane and therapeutic, Stone yelled for help at the top of his voice.
His shouts, taken up by the keeper of the virgins, brought everyone including Gebrew the watchman, who came running from the front gate, along with Koochooloo and two other unnamed dogs at her heels.
The sight of the blubbering, helpless Stone shocked Matron just as much as the sight of Sister Mary Joseph Praise's terrible state.
Lord, he's done it again, was Matron's first thought.
It was a well-kept secret that Stone had on three or four occasions since his arrival at Missing gone on a drunken binge. For a man who rarely drank, who loved his work, who found sleep a distraction, who had to be reminded to go to bed, these episodes were mystifying. They came with the suddenness of influenza and the terror of possession. The first patient on the morning list would be on the table, ready to be put under, but there'd be no sign of Stone. When they went looking for him the first time they found a babbling, disheveled white man, pacing in his quarters. During these episodes he did not sleep or eat, slipping out in the dead of night to replenish his supplies of rum. On the last occasion this creature had climbed the tree outside its window and perched there for hours, muttering like a cross hen. A fall from that height would have cracked its skull. Matron, when she had seen those bloodshot, mongoose eyes staring down at her, fled, leaving Sister Mary Joseph Praise and Ghosh to keep vigil and to try to talk him down, get him to eat, to stop drinking.
As abruptly as it started, in two days, no more than three, the spell would be over, and after a very long sleep Stone would be back at work as if nothing had happened, never making any reference to how he'd inconvenienced the hospital, the memory of it erased. No one ever brought it up to him because the other Stone, the one who rarely drank, would have been hurt and insulted by such inquiry or accusation. The other Stone was as productive as three full-time surgeons, and so these episodes were a small price to pay
Matron came closer. Stone's eyes were not bloodshot and he didn't reek of spirits. No, he was unhinged by Sister Mary Joseph Praise's condition, and rightly so. As Matron turned her attention from Stone to Sister Mary Joseph Praise, she nevertheless felt a ghost of satisfaction: at last the man had bared his soul, displayed his feelings for his assistant.
Matron ignored Stone's ramblings about volvulus or ileus or pancreatitis or tuberculous peritonitis. “Let's go to the theater,” she said, and when they were there, she said, “Lay her on the operating table.”
He set her down and Matron saw a sight she had seen seven years before: blood soaked Sister Mary Joseph Praise's dress in the region of her pubis. Matron's mind raced back to Sister Mary Joseph Praise's first arrival from Aden, and how blood on her habit then had caused similar concern. Matron had never asked the nineteen-year-old, point-blank, what caused the bleeding. The irregularity of the stain on that occasion had invited the observer to read meaning in its shape. Matron's imagination had constructed so many scenarios to explain that mystery. In the ensuing years, memory had changed the event from mysterious to mystical.
Which was why Matron now glanced at Sister Mary Joseph Praise's palms and breast as Stone laid her down, as if she half expected to see bleeding stigmata, as if that first mystery had grown into this second mystery. But no, the only blood was at the vulva. Lots of blood. With dark clots. And bright red rivulets that ran down the thighs. Matron had no doubt, as blood dripped to the floor: this time it was secular bleeding.
Matron seated herself between Sister Mary Joseph Praise's legs, willfully ignoring the stomach swelling that loomed in front of her. The labia were engorged and blue, and when Matron slid her gloved finger in, she found the cervix fully dilated.
Of blood there was much too much. She swabbed and dabbed and pulled down on the posterior vaginal wall for a better view. When a piteous sigh emerged from her patient's lungs, Matron almost dropped the speculum. Matron's chest was pounding, her hands shaking. She leaned forward, tilted her head again to peer in. There, like a rock at the bottom of a mud pit, a stone of the heart, was a baby's head.
“Lord, she's,” Matron said, when she could finally speak, gasping at the sacrilegious word that threatened to choke her and which her mouth could no longer contain, “pregnant.”
Every observer I later talked to remembers this moment in Theater 3, when the air stood still, when the loud clock across from the table froze and a long, silent pause followed.
“Impossible!” said Stone, for the second time that day, and even though it was incorrect and hardly the thing to say, it allowed them all to breathe again.
But Matron knew she was right.
She would have to deliver this baby. Dr. K. Hemlatha—Hema to all of them—was out of station.
Matron had delivered hundreds of babies. She reminded herself of this now to try and keep herself from panic.
But how was she to push away not just her qualms but her confusion? One of her own, a bride of Christ—pregnant! It was unthinkable. Her mind refused to digest this. And yet the evidence—an infant's skull— was there, right before her eyes.
The same thought distracted the scrub nurse, the barefoot orderly, and Sister Asqual, who was the nurse anesthetist. It caused them to trip over one another and knock down an intravenous drip as they scurried around the table, readying the patient. Only the probationer, who was mortified that she had failed that morning to recognize this crisis when she visited Sister Mary Joseph Praise, didn't stop to wonder how Sister Mary Joseph Praise go
t pregnant.
Matron's heart felt as if it might gallop right out of her chest. “Lord, what worse circumstance can you construct for a delivery? A pregnancy that's a mortal sin. A mother-to-be who is like my own daughter. Massive bleeding, ghostly pallor …” And all this when Hema, Missing's only gynecologist, not only the best in the country, but the best Matron had ever seen, was away.
Bachelli up in the Piazza was marginally competent in obstetrics but unreliable after two in the afternoon, and his Eritrean mistress was deeply suspicious of him leaving on “house calls.” Jean Tran, the half-French, half-Vietnamese fellow in Casa Popolare, did a bit of everything and smiled a lot. But assuming they could be reached, it would still be a while before either man would come.
No, Matron had to do this herself. She had to forget the implications of the pregnancy. She had to breathe, concentrate. She had to conduct a normal delivery.
But that afternoon and evening, normal would elude them.
STONE STOOD BY, his mouth open, looking to Matron for direction, while Matron sat facing the vulva, waiting for the baby to descend. Stone alternately crossed his hands in front of him and then dropped them by his sides. He could see Sister Mary Joseph Praise's pallor increasing. And when Nurse Asqual in a panicked voice called out the blood pressure— “systolic of eighty palpable”—Stone wobbled as if he might faint.
Despite uterine contractions which Matron could feel through the belly and see in Sister Mary Joseph Praise's contorted face, and despite the fact that the cervix was wide open, nothing happened. A baby's head high up in the birth canal with the cervix flattened like a gasket around it always reminded Matron of the shaved scalp of a bishop. But this bishop was staying put. And meanwhile, such bleeding! A dark and messy pool had formed on the table and tidal eddies of blood came out of the vagina. Blood was to delivery rooms and operating theaters what feces were to tripe factories, but even so it seemed to Matron that this was a lot of blood coming out.
“Dr. Stone,” Matron said, her lips quivering. A bewildered Stone wondered why she was calling on him.
“Dr. Stone,” she said again. For Matron, Sound Nursing Sense meant a nurse knowing her limits. For God's sake, she needs a Cesarean section. But she didn't say those words because with Stone it could have the opposite effect. Instead, her voice low, her head drooping, Matron pushed down on her thighs to bring herself to her feet and to vacate her spot between Sister Mary Joseph Praise's legs.
“Dr. Stone. Your patient,” she said to the man who everyone believed to be my father, putting in his hands not only the life of a woman that he chose to love, but our two lives—mine and my brother's—which he chose to hate.
CHAPTER 3
The Gate of Tears
WHEN SISTER MARY JOSEPH PRAISE felt the herald cramps of labor, Dr. Kalpana Hemlatha, the woman I would come to call my mother, was five hundred miles away and ten thousand feet in the air. Off the starboard wing of the plane Hema had a beautiful view of Bab al-Mandab—the Gate of Tears—so named because of the innumerable ships that had wrecked in that narrow strait that separated Yemen and the rest of Arabia from Africa. At this latitude, Africa was just the Horn: Ethiopia, Djibouti, and Somalia. Hema traced the Gate of Tears as it widened from a hairline crack to become the Red Sea, spooling north to the horizon.
As a schoolgirl studying geography in Madras, India, Hema had to mark where coal and wool were produced on a map of the British Isles. Africa figured in the curriculum as a playground for Portugal, Britain, and France, and a place for Livingstone to find the spectacular falls he named after Queen Victoria, and for Stanley to find Livingstone. In future years, as my brother, Shiva, and I made the journey with Hema, she would teach us the practical geography she had taught herself. She'd point down to the Red Sea and say, “Imagine that ribbon of water running up like a slit in a skirt, separating Saudi Arabia from Sudan, then farther up keeping Jordan away from Egypt. I think God meant to snap the Arabian Peninsula free of Africa. And why not? What do the people on this side have in common with the people on the other side?”
At the very top of the slit a narrow isthmus, the Sinai, thwarted God's intention and kept Egypt and Israel connected. The man-made Suez Canal finished the cut and allowed the Red Sea to connect with the Mediterranean, saving ships the long journey around the Cape. Hema would always tell us that it was over the Gate of Tears that she had the awakening that would change her life. “I heard a call when I was in that plane. When I think back, I know it was you.” That rattling, airborne tin can always seemed an improbable place for her epiphany.
HEMA SAT ON THE WOODEN BENCH SEATS that ran lengthwise on both sides of the ribbed fuselage of the DC-3. She was unaware of how badly her services were needed just then at Missing, the hospital where she had worked for the last eight years. The drone of the twin engines was so loud and unrelenting that half an hour into the flight she felt as if the sound inhabited her body. The hard bench and choppy ride were raising blisters on her behind. Whenever she closed her eyes, she felt as if she were being hauled across a rutted landscape in the back of a bullock cart.
Her fellow travelers on this flight from Aden to Addis Ababa were Gujaratis, Malayalis, French, Armenians, Greeks, Yemenis, and a few others whose dress and speech did not as clearly reveal their origins. As for her, she wore a white cotton sari, a sleeveless off-white blouse, and a diamond in her left nostril. Her hair was parted in the middle and gathered with a clip at the back, and loosely braided below.
She sat sideways looking out. She saw a gray dart below—the shadow cast by the plane on the ocean. A giant fish she imagined was swimming just below the surface of the sea, keeping pace with her. The water looked cool and inviting, unlike the interior of the DC-3, which had grown less steamy but was still thick with the mingled scents of the human freight. The Arabs had the dry, musty smell of a grain cellar; the Asians contributed the ginger and garlic; and from the whites came the odor of a milk-soaked bib.
Through the half-open curtain to the cockpit she could see the pilot's profile. Whenever he turned to glance at his cargo, his bottle-green sunglasses seemed to swallow his face, only his nose poking through. The glasses had been perched up on his forehead when she boarded, and Hema had noted then that his eyes were red like a rodent's. The odor of juniper berry on his breath advertised his fondness for gin. She'd developed an aversion to him even before he opened his mouth to herd his passengers onto the plane, snapping at them—“Allez!”—as if they were subhuman. She bit her tongue then, because this was the man about to take them aloft.
His face and jug ears resembled a figure a child might draw with crayon on butcher paper. But the details were beyond a child: the fine arbor of blood vessels on his cheeks; muttonchop sideburns dyed bootpolish black; the white ring of arcus senilis around his pupils; gray eyebrows that betrayed his pretense at youthfulness. She wondered how a man could look in the mirror and not see the absurdity of his own appearance.
She studied her own reflection in the porthole. Hers was a round face, too, the eyes widely spaced with a doll's pert nose. The red pottu in the center of her forehead stood out. Her cheeks had a Martian tint cast on them by the cobalt-blue water below, and the hint of green in her eyes—unusual for an Indian—was accentuated. “Your gaze encompasses all men, makes your most ordinary glance seem intimate, carnal,” Dr. Ghosh had told her, “as though you are ravishing me with your eyes!” Ghosh was a tease and forgot what he said as soon as the words rolled off his tongue. But this statement of his lingered with her. She thought of Ghosh's fur-covered limbs and shuddered. Body hair was one of her pet dislikes, or so she'd believed. She knew it was a fatal prejudice for an Indian woman. His was like a gorilla coat, the chest tendrils poking out through his vest and peeking up above his shirt collar. “Ravishing? You wish, you lecher,” she said now, smiling as if Ghosh were sitting across from her.
She had to give him this much: if she stared fractionally too long at a man, she attracted more attention than she intended. I
t was partly why she used spectacles with large wire frames, because she thought they made her eyes seem closer together. She liked the exaggerated Cupid's bow of her upper lip, but not her cheeks, which she felt were too chubby. What to do? She was a big woman. Not fat, but big … Well, maybe a bit fat, and she'd certainly put on a kilo or two or three in India, but how could she help that in the face of a mother's astonishing cooking? Because of my height, I get away with it, she told herself. Wearing a sari helps, of course.
She grunted, remembering how Dr. Ghosh had invented a special term for her: magnified. Years later, when Hindi movies with their song and dance became all the rage in Africa, the ward boys in Addis Ababa would call her Mother India, not in mockery, but in reverence for the tearjerker of the same name starring Nargis. Mother India had run for three straight months at the Empire Theater and then moved to the Cinema Adowa; that, too, without the benefit of subtitles. The ward boys could be heard singing “Duniya Mein Hum Aaye Hain”—”We've Arrived in This World”—though they didn't understand a word of Hindustani.
“And if I'm magnified, what term shall we apply to you?” she said, carrying on the imaginary conversation, surveying her old friend from head to foot. He was not a conventionally good-looking man. “How about ‘alien’? I mean it as a compliment. I say ‘alien,’ Ghosh, because you are so unaware of yourself, of your looks. There's a seduction in that for others. Alien becomes beauty. I'm saying this to you because you're not here. To be around someone whose self-confidence is more than what our first glance led us to expect is seductive.”
Mysteriously, during her holidays, Ghosh's name kept popping up in her conversations with her mother. Despite Hema's lack of interest in marriage, her mother was terrified that her daughter would end up with a non-Brahmin, someone like Ghosh. And yet as Hema neared thirty her mother had begun to feel that any husband was better than no husband at all.