Exiles (5 page)

“When they’re engorged, they just want to get back into the pond,” Mina said. “So we bring the pond to them.” She set the glass on the counter. The leech sunk to the bottom, wiggling.

The girl’s nose started bleeding profusely. Peter grabbed some gauze and put pressure on it.

“It’ll stop in a little while,” Mina said. “Where did you go to medical school, for heaven’s sake?”

“I’m a cardiologist, not an ENT.”

“Then presumably you’ve heard of heparin.”

“What about it?”

“Leeches invented it; that’s why she’s bleeding. When you can’t get any heparin and you have a patient with thrombosis, remember this and maybe he won’t lose his leg.”

Peter huffed. “Great,” he said. “Let’s also get some maggots for debriding wounds.”

“I’ve tried them, and they work pretty well. But that’s not the sort of thing they teach you at Stanford.”

“How did you know I went to Stanford?”

“There’s this thing called the Internet, Doctor. Check it out sometime.”

“But if you knew, why did you ask?”

“It was a rhetorical question,” she said. “Perhaps you’ve heard of those too.” She picked up the glass with the leech and left.

The girl in the chair stared at him, wide-eyed. He took a couple of breaths to calm himself down and spoke gently to her. “It’s okay,” he said, figuring she’d get the tone even if she didn’t understand the words. “You’ll be out of here in a bit.”

He wished he spoke Nepali so he could find out how she’d gotten a leech up her nose in the first place, but Mina had disappeared and there was no one to translate. He showed the girl how to apply the pressure, left her holding the gauze, and walked down to Franz’s office.

“Any chance I could work with someone else?” he asked.

“Someone other than Mina?” said Franz, smiling. “Oh, no. She’s a necessary terror. Remember the Belgian?”

“What about him?”

“She threw a book of practice guidelines at his head. A
thick
book. Said if he wouldn’t read it, perhaps it could make an impression some other way.”

“And how long after that did you fire him?”

“Within the week, as I recall.” Franz was practically humming with pleasure at the memory of it.

“So it was him or her, and that was your choice.”

“Oh, absolutely,” said Franz. “Best to keep it in mind.”

|   |   |

Peter had fled one cage, seeking freedom, and now to his chagrin he found himself in a different one in another part of the world, and a dirtier cage at that. How had everything gotten screwed up so quickly? He had come here to deliver his daughter from a nasty situation, and now she was indignant and he was lost in a maze of frustration and bafflement. She didn’t appreciate anything he tried to do for her, but then everything he attempted seemed to fall apart before his eyes. He had patients to attend to here in the clinic, but
mainly he felt like bolting for the door, disappearing down some street until he was as ragged as a beggar. His skin raised up in prickly welts under his shirt, as if something had infested him and begun to bite.

“Ankhaa,”
said the boy, pointing. He was not crying at the moment, but he had tear tracks, outlined with dust, on his cheeks.

“Your eyes.”

“Ankhaa.”

“Okay, let’s have a look.”

Peter forced himself to focus. The boy was about fourteen, shirtless and bony. His mother, also thin, rested a hand on his arm. She looked fifty, so Peter figured, based on what was now four days of experience, that she was in her late thirties. She wore a clean but threadbare sari, and like her son she was shoeless, with thick calluses on the bottoms of her feet. They’d walked to the clinic from one of the sprawling refugee camps that surrounded the city, shantytowns filled with villagers driven from the mountains by fighting between the RNA and the communist rebels.

Mina leaned calmly against the counter, legs crossed at the ankles, arms folded over her chest, watching and translating as needed. Her eyes retained their cool, unnerving gaze. Peter felt those eyes on him, persistent and relentlessly acute. Already he couldn’t stand to be in the same room with her, for reasons far more complex and troubling than simple loathing (though loathing was certainly part of the mix). She seemed equally ill at ease.

He shone a light into the boy’s eye and pulled down the lid while the boy looked up, to the left, down, to the right. The pupil dilated normally and there was no obvious inflammation, but his cornea didn’t look right. Peter peeled back the upper lid, then checked the other eye. He’d read about this in med school but had never seen a case. He looked at Mina.

“Much trachoma in the camps?” he asked.

“There you go, Doctor.”

The infection had scarred the undersides of the boy’s eyelids. The scar tissue, in turn, pulled the lashes under so that they raked the cornea every time he blinked. The boy must have felt like he had sandpaper glued under his lids.

“Ask her how long he’s been like this.”

Mina spoke to the mother and then translated. “Off and on for two or three years.”

“Years?”

“That’s how things are here, I’m afraid.”

“What’s your luck with antibiotics?”

“They’re better for a while, then they usually get it again,” Mina said. “The flies spread it. How well the cornea heals depends on how strong the child is, how much he gets to eat, all the usual things. If he wants to keep his eyesight, he probably ought to have the surgery.”

“Can they do it at the teaching hospital, or at Kanti?”

Mina’s lips pulled into a thin smile. “This woman has no money for a hospital, Doctor.”

“It’s not something I’m trained to do,” he said impatiently, as if she ought to know this.

“I think if you watch me two or three times, you’ll have it.”

Peter looked at her. The smile remained on her lips, though it had compressed just slightly in the middle and begun to look smug. “You can do it?” he asked.

“Of course.”

Of course
, he thought. He almost wanted her to fail, then felt ashamed for having the thought. They took the boy to the room with the tilt chair and brought in a seat for his mother. Mina and Peter scrubbed up and put on gloves, then she talked soothingly to the boy as they rolled in the stools, one on each side. Peter was surprised, again, by her sudden gentleness, but this time he deliberately avoided her eyes.

“Numb him up, will you?” she said.

“Outer lid?”

She nodded. But when the boy looked over and saw the needle
headed toward his eye, the eyeball rolled up and he passed out cold. The mother came to her feet, apparently fearing the worst, but Mina reassured her.

“Well, go ahead and do it now, while he’s out,” she said to Peter.

Peter gave him a small injection in each lid, then Mina broke an ammonia capsule under his nose and he came to.

“Aama,”
he said. His mother spoke to him, and he settled down.

“Next time we see one of these, which should be in a few days, come over the top and pull the lid up so the child doesn’t see the needle,” Mina said, a little more patiently. “It requires a certain amount of stealth.”

She pulled the right lid up, reached in with the scalpel, and made an incision the length of the lid’s underside. She lifted the side with the lashes outward so it would be placed correctly, then removed the scar tissue with a few more strokes.

“Hold this with a clamp,” she said.

Peter reached in and did as she asked. She wielded the scalpel with calm, steady hands. She stitched the lid closed so the lashes stayed where they should, then moved to the next eye. In all, it took less than half an hour.

Peter was impressed enough that he felt a little conciliatory in spite of himself. “You learned that at UCSF?” he asked.

“You’ve discovered the Internet.”

“No, I just went into Franz’s office and read your file.”

She nearly smiled, but not quite. “At UCSF they never would have handed a scalpel to a lowly nurse,” she said. “I learned it here, courtesy of a visitor from the Carter Center. A few earnest souls make the rounds doing cleft palates and eyelids, things like that. They like to refer to it as the Journey of Conscience, but I just call it the Guilt Trip.”

Now Peter had to stifle a smile. “What do you send the kids home with?” he asked.

“A course of Zithromax is the best way to go, but we won’t have any for another few weeks. So it’s drops.”

She spoke forcefully to the boy’s mother, pointing to a calendar and apparently insisting that they return the following week. The woman made all manner of assenting bows and namastes, and Mina showed them to the door and waved goodbye. After she closed the door, she turned and said, “They won’t be back until he’s got it again.”

Peter lay on their couch as Alex fanned him with a handful of parakeet feathers she’d collected from the backyard. The fanning was intended ironically, of course, but he didn’t care. His back ached and his feet hurt, and the air felt good.

He was thinking about how he might have to suck it up, admit that he’d been stupid and rash, and take her home. The prospect was humiliating; what sort of example was he setting, for Christ’s sake? But what if things only got worse?

“You all caught up with your homeschooling?” he asked.

“I’m a week ahead already,” she said. “You owe me a calculus test.”

“Now I have a headache along with everything else.”

“In fact, I’ve been so good I believe I’m due a reward.”

“You do, do you?”

“Think of it, Dad,” she said. “We could be in Rockridge tonight, for pizza at Rustica. Or we could be in Kathmandu eating
dal-bhat
again.”

“Who are you torturing, me or yourself?”

She spoke to him the way a mother might soothe a distraught child. “Guess what I heard about today?”

Resistance would be futile, and he didn’t really want to resist anyway, so he prepared to be assimilated. They caught one of the quiet electric
tempos
downtown, then walked over toward Thamel, the district where Western tourists hung out. The evening was warm and inviting, the streets busy. What was most striking about the Nepalis, Peter realized, was not their physical grace or their bright saris and
dauras
but their demeanor. Nobody was angry, nobody was rushed; everyone was just going about their lives and seemed reasonably considerate of one another. Malefemale couples didn’t often touch each other in public—a cultural thing, apparently—but women strolled comfortably arm in arm, as did some men. It was like San Francisco’s Castro district, except on lithium, and with cows.

They passed a street demonstration, a few dozen people carrying signs and chanting. Soldiers in riot gear lined the street, but they stayed back and things seemed relatively calm.

“Communists?” Peter asked.

Alex squinted, trying to decipher the signs. “I think so, but there are like fifty political parties, so it’s hard to tell. You used to be a commie in college, right, Dad?”

He vaguely remembered something about this, about idealism and dreams of an equitable world. The young man who’d believed those things seemed like some other person now, viewed through a fog of time. “Pampered college commies are a dime a dozen,” he said. “In the real world the problem is income disparity, not ideology.”

She staggered, and even her staggering was ironic. “I feel a lecture coming on,” she said. “Let me just sit down and put my head between my knees.”

Which made him a little indignant. “Look at this place,” he said. “Everybody gets around on bikes and oxcarts while the army officers drive Mercedes and the royal family has Bentleys. You want a revolution, that’s how to get one. The rest is rhetoric.”

She patted his shoulder affectionately.
“Paternas pompous insufferabilis,”
she said. “You’d better get that blood sugar back up before you hurt yourself with some sort of Great Leap Forward.”

Soon they saw more Americans and Europeans, heard English and French and German spoken, passed scruffy trekkers with duct-taped backpacks and trashed boots. There were also fresh tourists in lethal cologne and immaculate white safari clothing who seemed to lack only a mahogany walking stick and a pith helmet. Peter and Alex looked at each other.