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Authors: Diane Ackerman

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BOOK: A Natural History of Love
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As the morning gives way to the afternoon and early evening, Spanish, French, Portuguese, and English mix in the operating rooms, where a procession of children arrives from their villages, appear suddenly on the tables, have their faces and lives rearranged while they are unconscious, and disappear into the recovery room and then into the pediatrics ward. Not only the children dwell in this shudder out of time. All of us are temporarily yanked out of the normal course of our lives. There is a war-zone feel to the day. In their normal practices, cosmetic surgeons can afford to do subtle, elective surgeries, touch-ups, and all the niceties. Interplast teams burst into a town like a squad of commandos, to operate on gross deformities. Teams are thrown together in emotionally charged circumstances, and, as a result, people often form intense friendships and interdependencies. Then the red alert of the trip ends suddenly, like a small death, and, returning home, team members often sink into parabolas of depression.

“It’s strange not knowing the before and after,” Dave Thomas says, as he operates on a boy with one upper arm that is so constricted it looks like an animal someone has twisted out of balloons. Opening the constriction, he does a “Z-plasty,” a favorite type of operation for lengthening, in which two pennants of skin are cut loose and rotated from the horizontal to the vertical plane. Lifting up a sail-shaped wedge of upper-arm skin, he folds it in one direction, then takes a second flap and folds it in the opposite direction. A small geyser of blood hits his smock and mask. “Bleeder,” he says matter-of-factly. He clamps it, cauterizes it, and goes on to put in two stitches, which he draws together to make a harlequin pattern of the skin. A Z becomes an N. “Suddenly these children appear with their predicamerits,” he continues. “Then they vanish. You only see them at that one moment in time. In that moment, you may be changing the whole course of their lives. But you never see them again. The good part is that plastic surgery is unique in that, with many surgeries—a hernia, for example—you can’t see the result right away. But I can see right away what I’ve done to reconstruct an arm or, especially, a face.”

By midweek, there are signs of our presence on all the children: colored deputy sheriff badges, colored barettes and earrings, toy trucks and tops and puzzles, new dresses and T-shirts. In the children’s ward, rows of full beds and cribs line the room. There is a sweet, mousey smell of pus, urine, and illness. On one wall, a framed, yellowing picture of a Gerber baby’s smiling and perfect face is the center of a large, open, dewy red rose. A hand-drawn rabbit with a merry smile and long lashes watches from the wall, near Raggedy Ann and Andy clothes hooks. Although the hospital is old and worn, it is very clean, and it is staffed by a caravan of devoted nurses. They get paid little—indeed, sometimes don’t get paid for weeks—yet they keep coming to work. In the same blue dress she wore to the clinic, Isabel’s mother feeds her daughter with an eyedropper. Shaped normally now, her mouth wears a design of fine stitches. Cardboard splints on her arms will keep her from pestering the stitches until they dissolve. Whenever possible, the doctors use dissolvable stitches because they can’t rely on the compliance of the patients, who might not have enough money to make a return trip. Mother bundles Isabel up in her arms, hugs her close. Smiling, relieved, she says good-bye and thanks everyone, emotionally, then turns around and thanks them all over again. The moment she leaves the room, nurses clean the crib and change its linens. Soon another young mother arrives with her baby, which is installed in the crib. Below the girl’s frizzy, golden topknot of hair, an unsightly cyst bulges; tomorrow, the doctors will remove it.

After the last operation of the day, the team gathers in the break room to change back into street clothes and try to find places to rest on the benches and school desk-chairs. Some sit on a table, or lean against a wall. We have finished earlier than expected—it is only 6:30. Lightning flashes from the black batteries of the sky, and the rain falls thick as rubber. The rain is so dense we joke about needing a machete instead of an umbrella, and no one wants to run through the down pour to the parking lot to see if the driver is waiting with the blue van. Grabbing our rucksacks and satchels filled with scrub clothes, medicine, and personal items, we finally sprint to the van and arrive drenched, laughing. All fourteen of us pile on board. After dinner at a restaurant downtown, we head for a glitter-ball-hung discotheque full of colored lights, loud music, local beer, and never-ending songs. Today there were twelve hours of operations, and we are shot through with every caliber of exhaustion. Tomorrow there will be twelve hours more. Strobes splatter the dancers with light, cutting them into fast, dizzying snapshots. Overwrought from the day, and filled with too many warring emotions to name, people dance out their pent-up furies. Midnight arrives like an express train, and we leave. Tomorrow there will be another sea of faces to heal; over a hundred will be operated on by the week’s end. Swamped by fatigue, we pile into the van. If possible, the starless night has grown even hotter. The rain has stopped, but lights continue to sizzle overhead. As part of a fiesta to celebrate a local political candidate, fireworks fill the sky like small perfect cauteries.

FOR THE LOVE OF STRANGERS: LIFE AND DEATH IN THE SOUTH SEAS

In the South Seas, the morning sun scalds the water, the air feels close and damp, and a single hot breath pours around the islands. One could die in the suffocating stammer of the winds that blow for days on end without ever cooling or refreshing. One could live in the relentless searchlight of the sun that will find you wherever you hide and hold you in its glare, the sun that also sneaks like a bright rodent into the smallest and grimmest holes, and at some point fills every shadowy corner with a moment of illumination. The sun that brands one’s retinas with yellow sparks, and hurls comets of blinding glitter onto the waves. Beneath such a sun one lives in the penitentiary of one’s own body. Beneath such a sun one wears an ocean of sweat wherever one wanders. But, at twilight, the heat lathers out of the sky behind a heap of red plumes, the moon rises with its seas stark and clear, and night lays a cold compress on the brow of the Pacific.

It was April, and we had set sail from Tahiti, once an almost mythic place, now tawdry and cheap in the way that tourist lay-bys come to be. We arrived at Makatéa Island, in the Tuamoto Archipelago, and dropped anchor near the port of Temao, where the rusty derricks of an abandoned phosphate mine stood offshore like a species of giant seabird. For sixty years, the thriving mine filled the pockets and bellies of the 1,200 islanders, and then at last the phosphate ran out, and the locals fled to Tahiti and other spots. What is it about such ports of call that people always find irresistible? You would think that degradation had its own small magnetisms of decay, a force strong enough to draw decent and simple people over ornery seas and impassable lands to become part of a neon swill. Anyone who has watched the carcass of an animal for any length of time, seen the insect armies arrive and begin boiling in the flesh, knows that it is the habit of the fly to leave the sound parts of an animal and rush to the festering wounds. I do not know why. When the phosphate ran out, the people of Makatéa fled to Tahiti, and took jobs in its factories, hotels, restaurants, and sin parlors. They left behind a small green gazebo of an island.

The loading platform collapsed long ago, ravaged by the salty talons of tropic storms, and undone by time, that great mindless rearranger of places and people. Occasionally, the local authorities tried to blow up the rusting structures for fear someone might get injured on them, but such efforts always failed, leaving the jagged cranes shuffled around a little, but still above water. One could see where the main conveyor belt had been, and the loading chutes, in the tangle of metal now green with algae and pitted by salt. Beyond the shore, a thick expanse of vine-clad trees led up a winding hill, where fairy terns fluttered like small, white, perfect angels; hibiscus and chenille plants spilled their intense red; and a small village lay nestled with cast-off machinery among the dense undergrowth. All this was visible in the distance, through binoculars, and the passengers clustered at the cruise ship’s rails for their first glimpse of an island remote in time, distance, and culture.

Then a six-note bell sounded—what the crew call the “ding dong”—landing instructions followed, and, as usual, everyone headed for the boat deck, where they lined up in a narrow corridor, took blue horse-collar-shaped life vests from hooks, slipped them over their heads, and secured the waist straps. Filing out to the waiting Zodiacs, they passed a large wooden board holding numbered tags on metal hooks. Next to the board, a manifest listed each passenger’s name and its corresponding tag number. Whenever someone left the ship, they turned their number to the red side; returning, they turned the tag back to black. In that way, the staff knew who was on shipboard and whether or not someone was late on shore.

Though it was only 8:30
A.M
., the same ferocious sun had begun to climb the sky by the time the Zodiacs set off down the main channel through the coral reef to a small protected cove. A dump truck waited at the base of the hill to take nonhikers to the village and then farther inland to a freshwater cave for a noon swim. Fifty-five people were already ashore, climbing into the truck, and walking along the trail. I had just started up the trail myself, when something made me turn to look back at the shore. There was no sound or alarm or anything out of the ordinary, just an invisible tugging at my mental sleeve. I saw a full Zodiac heading through the channel, its driver a length of orange standing at the rear beside the motor. Suddenly and inexplicably the Zodiac turned broadside to the beach, ran parallel for a few moments, then caught a wave underneath, skidded up in slow motion, and tumbled over in the surf, spilling the driver and twelve passengers into the violent water just outside the reef. My arm rose as if suddenly weightless, as if I could reach across space and grab them. Peter, one of the crew members, saw the same thing in that instant and we began running toward the water, where half a dozen men were already lunging out into a strong, heaving surf. A rescue Zodiac cut fast through the water and picked up most of the people—including two little girls and a woman in her late seventies who was badly cut around the head and neck. Meanwhile, Steve and Mike, two more crew members, hauled her husband out of the surf. He was naked from the waist down—the force of the water had sucked his clothes off—but he still wore his shirt and his blue life vest, from the straps of which hung a length of Zodiac rope. Perhaps he had tried in vain to hold on to the rope as the raft flipped over. Staggering in our arms, he was a man in his eighties, slightly potbellied with reddish hair plastered to his arms and legs; his skin was deathly white and covered with freckles. Blood trickled from a gash on his forehead. One eye was badly bruised and swelling. There was something appallingly human about his nakedness.

“I was in an amphibious unit during the war,” he said in a sort of walking faint, as we held him up and guided him toward the waiting arms of others near shore. “I remembered to hold my breath and swim for the surface … I knew what to do.”

“That’s right, that’s right, you did the right thing,” I said, trying quickly to assess his injuries, and hoping he wouldn’t ask about his wife, whom I had seen pulled, badly hurt, into the rescue Zodiac. It was good that his mind had snagged on this small precision. Fresh hands came to guide him, and we ran back toward the surf out of which Anna, the ship’s photographer, was walking all by herself with a zombielike stare. It was then, already minutes after the accident, that we saw an orange shape tumbling in the surf, and we ran to it, Peter, Steve, and I. The men pulled the figure out, lifted him by the arms and legs, and I stooped, trying to give him mouth-to-mouth resuscitation as we hurried toward shore. Holding his nose closed with one hand, and his jaw down with the other, I forced my mouth onto his and blew hard into his chest, regularly, heavily, as best I could while he swung between the two men and the surf broke over us. At last we reached the overturned Zodiac in the shallows, and hoisted him on top of it. Peter straddled his waist and began CPR, and I kept forcing breath into him. It felt like screaming into a cave that had no echo. His sharp teeth sliced open my gums, and all the fluids in his stomach poured out through his mouth and nose. I washed them away quickly with the salt water, and kept breathing into him. I think it was then that Peter recognized the man as Tavita, a Philippine Zodiac driver he had worked with for years, and cried out his name with a combination of recognition and anguish. A white foam, a kind of lather, welled up from inside Tavita. Pulling back his eyelids, I saw large open pupils. There was no pulse. But I kept breathing hard into him. Peter was screaming at him not to go, calling him by name—”Tavita, my friend! Come back! come back!” Steve leapt on top of the raft to spell Peter, then me. The doctor, trembling and shaken as the rest of us, kept checking Tavita’s pulse, directing our movements. What a confused, strange horror it is to kiss a man with a fully open mouth as one would a lover, hold him in your arms, assume some of the gestures of passion, even exchange fluids with him—but all in the arena of death. As his jaws grew stiffer, his teeth felt sharper, and they lacerated the insides of my lips as I tried to force air deeper and deeper into him. In the end, an hour later, when at last we gave up, and he lay dead among us, my mouth was full of blood.

BOOK: A Natural History of Love
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