by Ann Patchett
“You make no end of suppositions, Dr. Singh. Is that a habit of yours? I have to say that was one thing I admired about Dr. Eckman: no preconceived conclusions whatsoever. A truly open mind is a scientist’s greatest asset. He must have been very thoughtful in his research. Had the circumstances been different I could have imagined asking him to stay on.”
Marina was not in the least bit unsettled by the praise for Anders. She knew the role of compliments in Dr. Swenson’s pedagogy: they were used not to raise one person up but to tap another down into place. She was only sorry that she didn’t have Anders to repeat it to, no doubt he would be shocked to hear such kindness after his death.
“You, however, suppose that Easter is Lakashi. He is not. I of course cannot be certain where he came from as he simply appeared in camp one morning and could neither hear nor speak. Were I to follow your example, I would suppose that he was Hummocca based on the shape of his head and the arrangement of his sinuses. The Hummocca have sinus cavities that are less pronounced than the Lakashi. Their faces are more curved, not quite so flat, but the difference is subtle. The Hummocca are somewhat smaller as well, and this goes to your original question about his age. I say all of this based on a single brief and unpleasant encounter with the tribe many years ago. Still, I find that fear can sometimes heighten our powers of observation to a point of great clarity. I remember the heads of the Hummocca so vividly it was almost as if I had dissected one.”
A double-decker tourist boat glided by without slowing and for a moment they were caught in its churning wake. As they pitched forward and back, rolling like a barrel in the little waves, Marina grabbed on to a pole and Easter raised his fist at the bigger boat. A tourist on the upper level pointed a camera in their direction. Dr. Swenson dropped her head for a moment, as if willing the other boat to sink through powers of concentration.
After the worst of the rolling had abated, Dr. Swenson lifted her head, her blue eyes bright and ringed in sweat. “Always buy a pontoon,” she said, panting lightly as if making an effort not to vomit. “You cannot imagine how hard that wake would have hit us had we not been in a pontoon. But I was making a point: Easter is a very small child, I would go so far as to say he is stunted. This could have been caused by a consistent lack of nutrition. It seems quite possible that no one was willing to give much of the tribe’s resources to a deaf child, or it could be that whatever illness rendered him deaf also rendered him small but now I am straying into what can only be called guessing, which is never helpful. Given his skills, his ability to learn, I would think him to be a twelve-year-old of normal, perhaps above-normal, intelligence. I’ll have a more precise judgment when he reaches puberty. The onset of puberty in the Lakashi male falls consistently between thirteen-point-two and thirteen-point-eight, a much narrower window than you find in American males. Whether or not this holds true of the Hummocca I am afraid I will never know. Do you have children, Dr. Singh?”
Marina was at least three questions behind. She wanted very much to know about the unpleasant encounter but, feeling she had been called on to give the easiest answer, merely shook her head. “None.”
“That’s good. Dr. Eckman had no business coming down here leaving three children behind. Are you married?”
“I am not.”
“Good again.” Dr. Swenson nodded her approval before turning her face towards the breeze. The sky spooled blue above the river in both endless directions. “This is a business for old maids, and I don’t say that derogatorily, being one myself. I feel better about you being on the boat knowing your circumstances.”
Speaking of suppositions, how much light could being unmarried and childless shed on her circumstances? Did it mean that no one would miss her terribly if she were to die, that there wouldn’t be the same set of complications brought about by Dr. Eckman’s death? Marina said nothing but sat down on the deck near Dr. Swenson’s feet. The sun edged beneath the boat’s awning and she wanted more of the shade.
Dr. Swenson leaned to the side and patted her case of canned hash with an open hand. “I prefer to sit on a box. A box doesn’t protect one from the roaches but I like to think it sends a message: We are on another level. There is a case of grapefruit juice there. I would recommend that.”
Obediently, Marina got up and pushed the box of juice forward, sat. They passed a handful of open houses built onto stilts. Several children, all of them too young to be standing alone in the water, were standing waist deep in the river, waving.
“As for Easter’s parents—” Dr. Swenson stopped then and looked at the captain’s small back. She tilted her head. “Parents seems a very sentimental word to use in his case. The man who inseminated the woman, the woman who pushed the child out of her body, other members of the tribe who may or may not have tried to raise that child when the original duo failed in their responsibilities: his parents have not been in evidence. The Hummocca left it up to the Lakashi, which, considering the nature of the tribe, strikes me as a startling act of humanity. I would have thought them more inclined to abandon a child in the jungle to starve to death or be eaten. All of which is to say he has been with me some eight years now, eight this past Easter. I suppose I am his parents.”
“It sounds as if the Hummocca may have left Easter for you then and not the Lakashi, assuming they knew you were here.” Marina realized she had made another assumption as soon as it was out of her mouth but this one Dr. Swenson let pass.
“Oh, they knew I was here,” she said, nodding her head. “Everyone knows everything eventually. Upon first consideration a person believes herself to be very isolated in the jungle but it isn’t the case. Word travels between the tribes, although I’ve never figured out how it happens as many of them refuse to communicate with one another. It would make a brilliant dissertation topic if you ever become interested in furthering your education.” (Marina would have mentioned her Ph.D. as well as her M.D. but there was not a glimmer of a break.) “I say it’s the monkeys,” Dr. Swenson said. “But then I tend to blame the monkeys for everything. ‘A white woman is living with the Lakashi.’ News like that goes up and down the river in a matter of hours. Then one afternoon a boy is cutting at a tree with a machete and when his arm goes back he sinks the blade into his sister’s head. Amazing that this sort of thing doesn’t happen every fifteen minutes out here. So I found a needle and some gut in my bag and I sewed the girl up. It was mostly blood, she was a very dramatic bleeder, but one hardly has to go to medical school to sew up a head. It didn’t take many events like this, a snake bite, a breech birth, and suddenly the whole of Brazil knows there is a doctor available off the Negro. Now, you must understand this, Dr. Singh, so few people do: I am not Médecins Sans Frontières. I have not come to the Amazon to be a family practioner. I am simply a person who made certain mistakes at the onset. They didn’t know me as a doctor when I arrived. The Lakashi knew me as a member of Dr. Rapp’s party. They thought I was like Dr. Rapp, that I was there for the flora and not for them. For the first few years I came alone they were forever bringing me mushrooms and various fungi to look at. They lugged so many fallen trunks of enormous, rotted trees back to camp it would have sent any mycological society into a frenzy. The fact that I took their temperature and drew blood samples and measured their children was completely lost on them, they continued to see me as the person they first met—as an extension of Dr. Rapp. And it had been my intention to be like him, to float on their misguided perceptions, but then I sewed up that girl’s head. It was my fatal mistake. The next thing I knew sick people were being paddled up the river to receive my care, and a deaf child had been left off for me to deal with.”
The deaf child had gotten her to town. He had ferried her guest to the restaurant after the opera and loaded the boxes on the boat and steered the boat through the river. The deaf child was not without his uses. “What would the alternative have been?” Marina asked. “Going back to that first girl.”
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��The bleeder. The question is whether or not you choose to disturb the world around you, or if you choose to let it go on as if you had never arrived. That is how one respects indigenous people. If you pay any attention at all you’ll realize that you could never convert them to your way of life anyway. They are an intractable race. Any progress you advance to them will be undone before your back is turned. You might as well come down here to unbend the river. The point, then, is to observe the life they themselves have put in place and learn from it.”
Marina felt remarkably unmoved by this. “So go back in time, do it again: there is a child standing in front of you with a machete in her head. What do you do?” The farther they went down the river, the fewer boats they saw. From time to time there was still a group of people, mostly very small children, in clusters on the shore but they were thinning out. It felt good to ask a question twice. It was something she could never have managed in the past.
“That’s a dramatic flourish, Dr. Singh. Did I tell you the child had a machete in her head? I said she was cut. There was no doubt that she had a skull fracture. I picked out bone fragments with my tweezers but there was nothing else to be done about that. If she was draining cerebral spinal fluid she didn’t do it in front of me. I sewed her up, I gave her some antibiotic ointment, hooray for me, now I can meet your expectations of decency, unless of course your expectations include my taking her back to Manaus for an X-ray. But the actions you admire are not thoughtful, they were automatic, the actions I had brought with me from my Western medical background. The question you should be asking is what would have happened to the girl if I hadn’t been there? There was someone in the tribe who had managed these situations before me and I suppose that he, in this case it was a he, would have used the available means to help her. Would it have been a sterile needle? I think not. Would she have died? Very doubtful. And while you are moralizing, ask yourself this question as well: What happens to the girl whose brother cuts her after I’ve gone? Does the tribe still have faith in the man who sewed up heads before me? Has he kept up with his own skills or was he too busy watching mine? I don’t intend to be here forever.”
“The man who puts the girl’s scalp back together, the one you are respecting, do you think his methods are as successful as yours?”
“Now you are being purposefully ridiculous. I have very little respect for what passes as science around here. There’s nothing a Westerner loves more than the idea of being cured by tinctures made of boiled roots. They think this place is some sort of magical medicine chest, but for the most part the treatments here consist of poorly recorded gossip handed down throughout the ages from people who knew very little to people who know even less. There is much to be taken from the jungle, obviously—I am here to develop a drug—but in most cases the plants are as useless as the potted begonia that grows on your kitchen windowsill. The ones that do have potential can only be medicinal when they are properly employed. For these people there is no concept of a dosage, no set length for treatments. When something works it seems to me to be nothing short of a miracle.”
Marina remembered that cup of sludge Barbara Bovender had brought her from the shaman’s stand and wondered if she was no more than a Westerner given to the charms of boiled tinctures. It was a cure she would never admit to now.
Dr. Swenson brightened for a moment. “I’ll tell you what the locals do have a real genius for, and that’s poison. There are so many plants and insects and various reptiles capable of killing a person out here that it seems any idiot could scrape together a compound that would drop an elephant. As for the rest of it, people survive regardless of the care they get. The human animal is too resilient for it to be otherwise. It is not for me to meddle.”
“I appreciate your point. It’s only that I believe in the moment—the child, the blood—it would be hard not to act.”
“Then perhaps it will actually open up some of my time to have you here. I’ll send the daily medical emergencies to you.”
Marina laughed at this. “Then I know they’d be better off with the local medical care. I haven’t threaded a needle in nearly fifteen years.” Suddenly Marina realized she couldn’t remember sewing up that last woman she’d operated on. She remembered lifting out the infant, and at that instant realizing what she had done. She remembered one of the nurses taking him away, but what came after that? Where was the needle? She didn’t leave the patient there, uterus and abdomen open to the world, but she could not find a picture in her memory of closing.
“It comes right back,” Dr. Swenson said. “You were my student. Believe me, I pounded it all in there.”
Marina was still looking for the conclusion to the surgery in her mind when she had another thought. “What about Dr. Rapp?”
“What about him?”
“Wouldn’t he have sewn up the girl’s head?”
Dr. Swenson snorted. “He most certainly would not have, and not because he wasn’t a medical doctor. He had a perfect understanding of human physiology and the steadiest hands I have ever seen in my life. He could have grafted a vein by a campfire had he thought it was necessary. But Dr. Rapp had no self-aggrandizing notions about his role in the tribe. He never set himself out to be the great white hero. He never took a single specimen more than what was absolutely needed. He disrupted nothing.”
“So he would have let her bleed to death.”
“He would have respected the order that was in place.”
Marina nodded, thinking perhaps she was luckier than she realized to have found herself with an expedition still capable of making errors of compassion. “Is Dr. Rapp still alive?”
She might as well have asked if President Kennedy had survived his assassination attempt. “Do you read, Dr. Singh? Do you live in this world?”
It was a beautiful question to be asked by a woman on a boat who was taking her down a river into the beating heart of nowhere. “I do,” Marina said.
She sighed and shook her head. “Dr. Rapp died nine years ago. It will be ten years this August.”
And Marina, sensing that sympathy was in order, said that she was sorry to hear it, and Dr. Swenson thanked her.
“Were you studying mycology at the time? Is that how you came to work with Dr. Rapp?” It seemed possible, after all; anything was possible. She may have been coming down here as an operative for the CIA.
“I was a student of Dr. Rapp’s, and the location of his classroom was unpredictable. I followed him through Africa and Indonesia, but the Amazon was the source of his most important work. He studied botany, and I was free to study the workings of a true scientific mind. As an undergraduate at Radcliffe I wasn’t allowed to take his class at Harvard, Harvard couldn’t have stood for anything as radical as that, but Dr. Rapp let me travel on the expeditions. He was the first teacher I encountered who saw no limitations for women. As it turned out he was the only one.”
They were quiet for a long time after that, both staring off at different aspects of the jungle as it rolled past them, the same bit of scenery recycled indefinitely. Two hours later, Easter left the protection of the right-hand bank and crossed the width of the Negro to the left. There he turned up a tributary that was in every way similar to the countless other tributaries they had passed, and while it was unmarked, it was the exit ramp from the interstate, the one that would eventually take them to the street where Dr. Swenson lived. No other boats followed them though the entrance was wide at the mouth. In a matter of minutes the nameless river narrowed and the green dropped behind them like a curtain and the Negro was lost. Marina had thought that the important line that was crossed was between the dock and the boat, the land and the water. She had thought the water was the line where civilization fell away. But as they glided between two thick walls of breathing vegetation she realized she was in another world entirely, and that she would see civilization drop away again and again before they reached their final destination. All Marin
a could see was green. The sky, the water, the bark of the trees: everything that wasn’t green became green. All in green my love went riding.
Dr. Swenson announced that lunch was now in order. “The boy deserves a break. He stands up there so rigid that I think he would shatter if a nut hit him just right. There is no way of communicating that one should relax, do you realize that? You can shake out your arms and swivel your neck and it all looks like nonsense.” Dr. Swenson put her hands on her thighs and pushed up but she did not stand. She was thicker around the middle than she had been in Baltimore and the weight and the long time sitting seemed to keep her tied to her case of hash. Dr. Swenson, so far as Marina could calculate, would be in the neighborhood of seventy. It was possible at this point that even Dr. Swenson was tired. Marina stood up and extended her hand. Dr. Swenson rubbed her knees for a minute, looking pointedly away, then she took the hand. “Thank you for the assistance,” she said. She stood up and then let Marina go. “These are different days. For all I know about the body this is still not what I expected.” She went over and tapped Easter on the shoulder, then made a turning motion with her wrist and pointed to the shore. He nodded, keeping his eyes ahead. “He won’t go in right away,” Dr. Swenson said, coming back to where Marina was standing. “There’s a spot he likes where he can tie up to a tree. The anchor makes him nervous. It’s not reliable. Once he dropped it off and we had a devil of a time getting it back in the boat. There’s a lot for an anchor to get caught on in this river.”
Marina looked over the side of the boat. She couldn’t even imagine it. “How long have you been coming out here?”
“Dr. Rapp first found the Lakashi”—Dr. Swenson craned back her head, looked towards the tops of the trees—“it was fifty years ago, I suppose. I was on that trip, standing right on the stage of history. I remember coming down this very river for the first time. It was a glorious day. I had no idea that I would be coming back for the rest of my life.”
