Abraham Verghese - Cutting for Stone

“Hema, Hema, what have you done,” he muttered to himself, convinced that the worst had happened and Hema had returned married. Why else would Almaz stay so late except to tell him this? She and the whole world knew how he felt about Hema. The only person who didn't know was Hema.

The ghostly figure ran over to the passenger side, opened the door, and climbed in. Bowing her head and in the most formal tone and without meeting his eyes, she said, “I am sorry to bring you bad news.”

“It's Hema, isn't it?”

“Hema? No. It is Sister Mary Joseph Praise.”

“Sister? What happened to Sister?”

“She is with the Lord, may He bless her soul.”

“What?”

“Lord help us all, but she is dead.” Almaz was sobbing now. “She died giving birth to twins. Dr. Hema arrived but could not save her. Dr. Hema saved the twins.”

Ghosh stopped hearing after her first mention of Sister and death. He had to have her repeat what she said, and then repeat again everything that she knew, but each time it came down to Sister being dead. And something about twins.

“And now we can't find Dr. Stone,” she said at last. “He is gone. We must find him. Matron says we must.”

“Why?” Ghosh managed to ask when he found his tongue, but even as he said that he knew why. He shared with Stone the bond of being the only male physicians at Missing. Ghosh knew Stone as well as anyone could know Stone, except, perhaps, Sister Mary Joseph Praise.

“Why? Because he is suffering the most,” Almaz said. “That is what Matron says. We must find him before he does something stupid.”

It's a bit too late for that, Ghosh thought.

THE MORNING AFTER the births and the death, Matron Hirst came to her office very early as if it were any other day Shed slept but a few hours. She and Ghosh had driven around, hunting for Thomas Stone late into the night. Stone's maid, Rosina, had kept a vigil in his quarters, but there had been no sign of him.

Matron pushed away the papers stacked on her desk. Through her window she could see patients lined up in the outpatient department, or rather she could see their colorful umbrellas. People believed the sun exacerbated all illnesses, so there were as many umbrellas as there were patients. She picked up the phone. “Adam?” she said, when the compounder came on the line. “Please send word to Gebrew to close the gate. Send patients to the Russian hospital.” Her Amharic, though accented, was exceedingly good. “And Adam, please deal with the patients who are already in the outpatient department as best you can. I'll be asking the nurses to make rounds on their wards and to manage. Let the probationers know that all nursing classes are canceled.”

Thank God for Adam, Matron thought. His education had stopped at the third grade, which was a shame, because Adam could have easily been a doctor. Not only was he adept at preparing the fifteen stock mixtures, ointments, and compounds which Missing provided to outpatients, he also had uncanny clinical sense. With his one good eye (the other milky white from a childhood infection) he could spot the seriously ill among the many who came clutching the teal-blue graduated Missing medicine bottles, ready to have them refilled. It was a sad fact that the commonest complaint in the outpatient department was “Rasehn … libehn … hodehn,” literally, “My head … my heart … and my stomach,” with the patient's hand touching each part as she pronounced the words. Ghosh called it the RLH syndrome. The RLH sufferers were often young women or the elderly. If pressed to be more specific, the patients might offer that their heads were spinning (jasehn yazoregnal) or burning (yakatelegnal), or their hearts were tired (lib dekam), or they had abdominal discomfort or cramps (hod kurteth), but these symptoms were reported as an aside and grudgingly, because rasehn-libehn-hodehn should have been enough for any doctor worth his salt. It had taken Matron her first year in Addis to understand that this was how stress, anxiety, marital strife, and depression were expressed in Ethiopia— somatization was what Ghosh said the experts called this phenomenon. Psychic distress was projected onto a body part, because culturally it was the way to express that kind of suffering. Patients might see no connection between the abusive husband, or meddlesome mother-in-law, or the recent death of their infant, and their dizziness or palpitations. And they all knew just the cure for what ailed them: an injection. They might settle for mistura carminativa or else a magnesium trisilicate and bella donna mixture, or some other mixture that came to the doctor's mind, but nothing cured like the marfey —the needle. Ghosh was dead against injections of vitamin B for the RLH syndrome, but Matron had convinced him it was better for Missing to do it than have the dissatisfied patient get an unsterilized hypodermic from a quack in the Merkato. The orange B-complex injection was cheap, and its effect was instantaneous, with patients grinning and skipping down the hill.

THE PHONE RANG, and for once Matron was grateful. Normally she hated the sound because it always felt like a rude interruption. The small Missing switchboard was still a novelty. Matron had declined an extension in her quarters, but she thought it was important to have phones in the doctor's quarters and the casualty room. Even this phone in her office she considered a luxury, but now she grabbed the receiver, hoping for good news, news about Stone.

“Please hold for His Excellency, the Minister of the Pen,” a female voice said. Matron heard faint clicks, and imagined a little dog walking on the wooden floors of the palace. She stared at the stacks of Bibles against the far wall. There were so many they looked like a barricade of shiny, cobbled rexine.

The minister came on, asked about Matron's health, and then said, “His Majesty is saddened by your loss. Please, accept his deepest condolences.” Matron pictured the minister standing, bowing as he spoke into the phone. “His Majesty personally asked me to call.”

“It is most kind, most kind, of His Majesty to think of us … at this time,” Matron said. It was part of the Emperor's mystique and a key to his power that he knew everything that went on in his empire. She wondered how word had reached the palace so soon. Dr. Thomas Stone with Sister Mary Joseph Praise assisting had removed a pair of royal appendices, and Hema had performed an emergency Cesarean section on a granddaughter who didn't make it to Switzerland. Since then a few others in the royal family came to Hema for their confinement.

Matron only had to ask, the minister said, if there was something the palace could do. The minister didn't touch on the manner of Sister's death, or the fate of the two babies.

“By the way, Matron …,” he said, and she was alert because she sensed this was the real reason for the call. “If by any chance a military … a senior officer comes to Missing for treatment, for surgery in the next day or so, the Emperor would like to be informed. You can call me personally.” He gave her a number.

“What sort of officer?”

She took the silence to mean the minister was giving thought to his answer.

“An Imperial Bodyguard officer. An officer who has—shall we say— no need to be at Missing.”

“Surgery, you say? Oh, no. We've closed the hospital. We have no surgeon, Minister. You see Dr. Thomas Stone … is indisposed. They were a team, you see …”

“Thank you, Matron. Please let us know.”

She mulled over the call after she hung up. Emperor Haile Selassie had built up a strong, modern military, consisting of army, navy, air force, and the Imperial Bodyguard. The Bodyguard was a force as large as the others, the equivalent of the Queen's Guard in England who stood outside Buckingham Palace. But just like the Queen's Guard, the Imperial Bodyguard wasn't merely a ceremonial unit; its professional soldiers and its units were no different than the rest of the armed forces, and trained for battle. Up-and-coming cadets from all the services went to Sandhurst or West Point or Poona. But those sojourns had a way of expanding one's social conscience. The Emperor feared a coup by these young officers. Having the second-or third-largest standing armed force on the continent was a matter of pride, but it was also potentially dangerous to his reign. The Emperor deliberately kept the four services in competition with one another, kept their headquarters far apart, and he transferred generals who were getting too powerful. Matron sensed some such intrigue—why else would the Minister of the Pen call personally?