Abraham Verghese - Cutting for Stone

In the male ward, which was long and narrow and held forty people, she kept up her recitation. The patients who could tried to sit up to greet them. One man was comatose, his mouth open, his eyes unseeing. Another sat leaning forward on a special pillow, struggling mightily to breathe. Two men, side by side, had bellies swollen to the size of ripe pregnancy.

“Rheumatic heart valve damage, nothing we can do … and these two fellows have cirrhosis,” Matron explained.

Harris was struck by how little it took to nurture and sustain life. A huge chunk of bread in a chipped basin and a giant battered tin cup of sweetened tea—that was breakfast and lunch. Very often, as he could see, this feast was being shared with the family members squatting by the bed.

When they emerged from the ward, Matron stopped to catch her breath. “Do you know that at this moment we have funds for three days, that's all? Some nights I go to sleep with no idea of how we can open in the morning.”

“What will you do?” Harris asked, but then he realized he knew the answer.

Matron smiled, her eyes almost disappearing as her cheeks pushed up, giving her a childlike quality. “That's right, Mr. Harris. I pray. Then I take it out of the building fund or whatever fund has money. The Lord knows my predicament, or so I tell myself. He must approve the transfer. What we are fighting isn't godlessness—this is the most godly country on earth. We aren't even fighting disease. It's poverty. Money for food, medicines … that helps. When we cannot cure or save a life, our patients can at least feel cared for. It should be a basic human right.”

Harris's anxiety about the steering committee had all but gone.

“I'll confess, Mr. Harris, that as I get older, my prayers aren't about forgiveness. My prayers are for money to do His work.” She reached out for his hand and held it in both of hers, patting it. “Do you know, dear man, that in my darkest moments, you have so often been the answer to my prayers?”

Matron felt she had said enough. It was a gamble. She had nothing to put on the table but the truth.

THE NEWBORNS SEEMED UNREAL to Ghosh, all noses and wrinkles, as if they'd been planted in Hema's house, a lab experiment gone awry. Ghosh tried to make appropriate noises and act interested, but he found himself resenting the attention they were getting.

It was five days since Sister Mary Joseph Praise's death. He had stopped by Hema's house in the early evening before setting out to look for Stone. He'd found his Almaz there, very much at home, immersed in the task of caring for the babies, barely registering his presence. The last few days, he had been forced to make his own coffee and heat his own bathwater. Matron, Sister Asqual, Rosina, and several nursing students were there, too, fussing over the newborns. Rosina, with nothing to occupy her now that Thomas Stone was gone, had also moved over to Hema's. No one noticed when he left Hema's bungalow.

He drove first to the Ghion and the Ras hotels, then to the police headquarters where he sought out a sergeant he knew. The man had no news for him. He drove through the Piazza from one end to the other, and then, after a beer at St. George's, decided it was time to go home. His plans to leave had solidified. He had an airline ticket to Rome, then on to Chicago, leaving in four weeks. By that time, perhaps things at Missing would have settled. He couldn't see himself staying on, not now, not with Stone gone and Sister dead. But he had yet to find the courage to tell Matron or Almaz—or Hema.

It was dark when he pulled into his carport. He saw Almaz squatting by the back wall, wrapped against the cold so only her eyes showed. She was waiting for him just as she had the night Sister Mary Joseph Praise had died.

“Oh God. What now?”

She came to the passenger door, yanked it open, and climbed in. “Is it Stone?” he said. “What happened?”

“Where have you been? No, it's not Stone. One of the babies stopped breathing. Let's go to Dr. Hema's bungalow.”

THE BLUE NIGHT-LIGHT made Hema's bedroom seem surreal, like a set for a movie. Hema was in a nightdress, her hair loose and flowing over her shoulders. He found it difficult to look away.

The two newborns were on the bed, their chests rising and falling evenly, eyes closed, and their faces peaceful.

Turning back to Hema, he saw she was trembling, her lips quivering. He put his hands out, palms up, asking what had happened. By way of an answer, she flew into his arms.

He held her.

In the years he had known her, he'd seen her happy, angry, sad, and even depressed but, underneath, always feisty. He had never seen her fearful; it was as if she'd become some other person.

He tried to lead her outside of the room, his arm still around her shoulder, but she resisted. “No,” she whispered. “We can't leave.”

“What's going on?”

“I happened to be looking at them just after I put them to bed. I saw Marion breathing evenly. But Shiva …” She sobbed now, as she pointed to the child with the dressing on his scalp. “I saw his stomach rise, then it went down as he exhaled … and then nothing. I watched as long as I could. ‘Hema, you are imagining things,’ I said. But I could see him turning blue, even in this light, especially when I compared his color with Marion's. I touched him, and his arms shot out as if he was falling, and he took a deep breath. His fingers curled around my finger. He was saying, Don't leave me. He was breathing again. Oh, my Shiva. If I hadn't been standing there … he'd be gone by now.”

She sobbed into her hands, which rested on his chest. Ghosh held her, her tears making his shirt damp. He didn't know what to say. He hoped she didn't smell beer. In a moment, she pulled away, and they stood arm in arm, Almaz just behind them, gazing at Shiva.

Why had Hema taken on the naming of the babies? It felt premature. He couldn't get his lips around the names. Were the names negotiable? What if Thomas Stone showed up? And why name the child of a nun and an Englishman after a Hindu god? And for the other twin, also a boy, why Marion? Surely it was temporary, until Stone came to his senses, or the British Embassy or someone made arrangements. Hema was acting as if the kids were hers.

“Did it happen more than once?” he asked.

“Yes! Once more. About thirty minutes later. Just when I was about to turn away. He exhaled … and stopped. I made myself wait. Surely he has to breathe. I held back until I couldn't stand it any longer. When I touched him he started breathing as if hed been waiting for that little push, as if he forgot. I've been here for the last three hours, too scared to even go to the loo. I didn't trust anyone else to watch, and besides I could not quite explain it to them … Thank God Almaz decided to stay to help me with the night feeds. I sent her to get you,” Hema said.

“Go ahead,” he said. “I'll watch them.”

She was back in no time. “What do you think?” she said, leaning against his arm as she dabbed her eyes with a hankie. “Shouldn't you listen to his lungs? He wasn't coughing or struggling.”

Ghosh, finger to chin, his eyes narrowing, studied the child quietly. After a long while he said, “I'll examine him thoroughly when he is awake. But I think I know what it is.”

The way she looked at him made his heart swell. This wasn't the Hema who reacted to everything he said with skepticism. “In fact, I'm sure. Apnea of the premature. It's well described. You see, his brain is still immature, and the respiratory center, which triggers each breath, isn't fully developed. He ‘forgets’ to breathe every now and then.”

“Are you sure it isn't something else?” She wasn't challenging him; like any mother, she wanted certainty from the doctor.