by Rosa Jordan
“There will be an internal exam first and a blood test. Uncomfortable but not painful. Then they will X-ray your knee and that shoulder.”
Celia knew she was dealing with a mixture of embarrassment, repressed anger, and physical pain. The bruises were every colour from black and blue to grey and yellow. The swollen knee was causing a pronounced limp and both eyes were swollen to slits.
“What about my face?” Liliana whimpered.
“The doctor may think the cut over your eye needs stitches.” Experience had taught Celia that it was not only adults who needed some sense of control over their own bodies. Children were equally resistant to being “done to” without having any say in the matter, so she added, “But it’s up to you. You can decide whether it gets stitches or not.”
Knowing that Liliana would be most nervous about the internal exam, Celia had scheduled it first and requested that it be performed immediately upon their arrival with a particular nurse in attendance. The nurse, a wiry black woman called Orquídea, came striding into the examining room, clipboard in hand. “Ah ha! So you’re that niece Dr. Cantú is always going on about. Girl, aren’t you a mess this morning! Well, let’s get this show on the road. Get yourself naked, child, and up on that table. I’ll be right back.”
Celia helped her undress and waited in the room until she heard Orquídea coming back down the hall, singing a pop tune in a voice good enough to have given her a chance at a musical career had she chosen to pursue it.
“Doc’s on his way,” Orquídea announced cheerfully. And to Celia, “El Jefe wants you upstairs, Dr. Cantú, and, sorry to say, we got no use for you around here.”
Although Celia and Orquídea had entirely different “bedside manners,” their respect was strong and mutual. Orquídea often tried to get Celia involved with very young girls who had developed health problems due to high-risk sexual activity because she felt Celia was more sensitive than some of the hospital’s male doctors. And Celia called on Orquídea whenever possible to deal with difficult teens. Orquídea’s breezy irreverence never failed to captivate adolescents, just as it now held Liliana’s attention, distracting her from the dreaded internal exam.
Orquídea glanced over her shoulder. “You still here, Doc? The boss is gonna chew your—oops, sorry. Forgot we had a minor in earshot.”
Liliana laughed. Celia waved. “I’m going. I’m gone. See you later, mi corazón.”
The door to Dr. Leyva’s office was open. The secretary nodded Celia in. He was on the telephone. His hunched posture gave her a view of the top of his head. Celia was again surprised at how white his hair had become, considering that he was not yet fifty. He glanced up and motioned her to a chair. Dropping the receiver back into the cradle, he said cheerfully, “So you found your niece and you’re back. As of today, or tomorrow?”
“Actually, there are complications. You see, she was injured.”
“Oh?” He fastened his grey eyes on her in the way she remembered from their previous interview, which said he wanted the whole story, quickly, and it would have to be good to convince him to give her more time off. “I understood that she was coming in for some fairly routine tests.”
“It’s not the visible damage. It’s . . . she was abducted, you see. Held prisoner. Then the man tried to kill her by throwing her out of a speeding car.”
Leyva’s gaze remained level, but his eyes conveyed the same skepticism initially conveyed by Luis, Quevedo, and Muñoz. “I presume you contacted the authorities?”
“MININT is looking into it. Because the man was a foreigner. They interviewed Liliana yesterday. Today they will be talking to witnesses.”
“There were witnesses?”
“To the vehicle incident, yes.”
There was a silence during which Leyva processed this information. Celia supposed that he was trying to decide whether, in the absence of a serious injury, Celia’s staying home was really necessary. She had to give him a convincing reason.
“Besides the physical injuries, she has been traumatized. She cannot return to school immediately and I cannot leave her alone in the apartment. There are only the two of us. My parents, her parents, the grandparents, are dead. Most of my friends are at work and hers of course are in school. There is no one I could ask to stay with her.”
Of course there were neighbours, dozens of them, whom she might have asked to look in on Liliana. Leyva would know that and would guess that this was not her real reason—or at best, was only part of it. He was silent. Celia used the technique often enough herself. If you don’t get the whole story, keep quiet until the other person spills it out. The director was waiting, not with the greatest patience, for the real reason. She sighed, bowed her head, and told him.
“Something went wrong, Dr. Leyva. She seemed so happy, many friends, good grades, no health problems. But she took a wrong turn. I do not know exactly when, or why. It was months ago. She started skipping school, hanging out at resorts. Her focus shifted to clothes, cosmetics, jewellery—all the superficial, appearance-related things they sell in dollar stores. I never noticed. That was the problem. I never noticed.”
Celia looked up, her eyes anguished. “I missed it because I was working too much. If I go back to full time, I will go on missing . . . whatever it is I need to understand. I must not make the same mistake again.”
Leyva’s changeable grey eyes changed yet again, to an expression she could not read. He was no longer looking at her, but at the picture of his two daughters. Celia sensed a connection but had no idea what it might be.
“Your daughters,” she ventured. “They must be grown now.”
Leyva turned the picture around so she could see it: two girls close to the same age, dark curls and sparkling brown eyes, waving to whoever was taking the picture.
“The one on the left is twenty-two now. She is an intern at Children’s Hospital in Manzanillo. She’ll soon be a doc like her papá.” There was a very long silence, in which Celia felt he was deciding whether to say more. At last he said, “The one on the left, the younger one, is dead.”
Celia was stunned. Hospital gossip being what it was, she could not believe she had never heard of the director having lost a daughter. His wife, yes, everyone knew she died of colon cancer two years ago. And it was common knowledge that he had a daughter who was following his footsteps into medicine. If anyone on the hospital staff had known there was younger daughter, they would have assumed she was still in school.
“She was a good student,” Leyva said. “Probably the brightest person in our family. And full of self-confidence. But restless. Easily bored. During her last year of pre-university she became involved with a boy. He seemed fairly ordinary. But he got it into his head to build a raft to go to Florida and convinced her to go with him.”
He paused and shook his head. “Or maybe that was not what happened. Some of their friends say that she was the one who pushed the idea and the boy only carried it out to prove that his daring matched hers. We will never know. The raft was found, with their things. But the bodies were not recovered.”
Leyva lifted the picture to study the girl’s face. “Who would have guessed that she would become a balsera? Why did she make that choice? Where did we go wrong?”
In the outer office, Celia could hear the secretary telling someone that the director was busy, and in the hallway, the usual sounds of a busy hospital. She could even hear traffic noises from the street below; the bicycle bus pulling in to pick up cyclists to carry them through the tunnel and into Centro Habana. But in Leyva’s office silence lay as heavy as sand. Celia stared at him, beyond him, and back into her own mind. Those were the very questions she had asked ever since Luis raided Liliana’s room and dumped that armful of awful dollar-bought trash under her nose. The answer, which had eluded her from one end of Cuba to another, was now forming in her mind.
“Have you ever considered . . . ?” she began tentatively.
Leyva gave her a weary look that said, My dear, there is nothi
ng I haven’t considered. But with the trained courtesy of a good doctor, he waited for whatever she was about to say.
“We do everything we can to ensure our children’s physical health. Proper rest, good diet, enough exercise. We take that approach because it is impossible to prevent them from being exposed to pathogens. The best defence is a strong immune system. We know that. At the same time, we know that no matter how healthy they are, some pathogens can breach the immune system. HIV, for example. Hepatitis. Swine flu. Besides the really nasty viruses, we know that some pathogens are deadly because there has been no previous exposure, no opportunity to build up defences.”
Leyva was watching her with a small frown. He was not making the connection, which to Celia suddenly seemed crystal clear—not merely obvious but undeniable. She leaned toward him. “I think there is a social parallel. We have raised our children in an environment rich in healthy values like service, social justice, and sharing. But when new elements are introduced—for example, the hedonism of recreational tourism with all that false freedom and illusion of endless pleasure—I think our children may be as susceptible to that as Cuba’s indigenous population was to small pox.”
It was a long time before Leyva responded, but Celia did not need his assurance that she was right. She knew this was what had happened to Liliana and possibly to Dr. Leyva’s daughter and to countless other young Cubans. They were of a vulnerable age. The pathogen was there. They had no immunity.
He did not respond at once, but when he did she knew he had grasped her point. “It’s not just tourism,” he said sadly. “It’s what’s over there.” He waved his hand toward the window from which could be seen, a kilometre away, the Strait of Florida. “They can imagine the wealth of America from here, but not its violence and inequality.”
Celia nodded. “All that glittering materialism. Descriptions from relatives who have emigrated, plus what they see on television. But tourism is what brings the reality of materialism here, to Cuba.”
“The government never wanted recreational tourism,” Leyva mused. “Everyone was aware of how it warped the fabric of Cuban society back in the ’40s and ’50s. In the ’60s, when I was a boy, tourism meant trips around the countryside to show off the successes of the Revolution. And in the ’70s, there was medical tourism. Which to this day remains the best showcase for our health professionals, pharmaceutical advances, and the humanitarian values of our Revolution.”
Celia nodded as she picked up and pursued her analogy. “Good medicine, yes, but it was not strong enough to save us when we lost Soviet support. The government was forced to encourage recreational tourism. Strong medicine for an economy that was close to death. And it worked. It saved our economy and our way of life.”
Leyva nodded. “That it did. And still is doing.”
Celia continued. “But the stronger the medicine the worse the side effects. Like chemotherapy—look at the damage it does in the process of affecting a cure!”
Celia suddenly stopped speaking. She had no more to say. She, like Leyva, was hearing her words for the first time. She needed time alone, quiet time, to consider their ramifications and test them for veracity against her own experiences.
The secretary, who unbeknownst to Celia had been hovering in the doorway behind her, took their mutual silence as an intermission in which to interject, “Dr. Leyva, your eleven-thirty appointment—did you wish to cancel?”
He rose immediately. “No, no. Show him in.” To Celia he said, “I have long been aware of your skill as a pediatrician. And as an administrator, since you became jefa de la sala.” He smiled. “But only now am I discovering what an analytical mind you have.”
“Gracias.” Celia moved slowly toward the door, hoping he had not forgotten her original question. Apparently he had, so she asked, “About time off . . . ?”
Leyva looked at is watch. “Let’s discuss that over lunch. Meet you in the cafeteria at twelve. You and your niece.”
FIFTY-SIX
CELIA found Orquídea where she had left her, but Liliana was not there. “She’s in radiology,” the nurse informed her. “But hold on. The doc who did the internal wants a word with you.”
The gynecologist entered the room and began scrubbing for his next exam. It struck Celia as a little unprofessional that he had turned his back to her. Perhaps he was still young enough that it embarrassed him to speak with someone of the opposite sex about sexual matters? Or was it what he had to tell her that caused him to turn away? She drew a breath and prepared for the worst.
He must have heard the intake of breath because he turned from the sink to look at her, eyes saying that he did indeed find it difficult. “The violation was primarily anal. Quite rough. Your instructions were to not ask questions, so I didn’t. But I did say to her, when I saw the anal lacerations, ‘This must have been a painful experience.’”
“How did she respond?”
“She said, ‘That’s all he wanted. To hurt me.’”
Celia flinched. She did not need to be told that while the rapist’s focus on anal penetration reduced the chance of pregnancy, it heightened the risk of HIV and hepatitis.
The young doctor must have seen the blood drain from her face, but he didn’t spare her. “The lesions are severe. We drew blood for serological testing so we’ll have a baseline in case anything nasty develops. And swabbed the area.”
Clean hands in the air, he looked at Orquídea. She opened the door to the exam room for him and answered Celia’s unasked question. “Already sent to the lab, along with the pregnancy test. I told them to expedite and to call you directly, Dr. Cantú.”
“Thanks,” Celia mumbled, too shaken by the graphic information to say more.
“Oh, by the way, there’s that knee too,” the doctor said as he started out. “They’ll be able to tell you more about it in radiology.”
• • •
Liliana sat in a plastic chair, head leaned back against the wall, eyes closed. At a light table, the radiologist was studying an X-ray. “Want to see your bones?” he was asking Liliana as Celia stepped into the room.
“No.”
“I do,” Celia said.
“It’s the collar bone.” He put his finger on a faint line across the collar bone. “Hairline fracture.” He winked at Celia. “She’ll look cute in a neck-to-waist cast.”
Liliana looked away and said nothing.
“What about the knee?” Celia asked.
He laid another X-ray on the light screen. “No broken bones. Soft tissue damage. But that wouldn’t show up here.”
“We will keep it elevated and ice-packed awhile and see how it goes,” Celia decided. “Thanks for the quick feedback.”
“Can we go home now?” Liliana whined. “I’m hungry.”
“We’ll have lunch here, in the cafeteria. I haven’t been shopping in almost two weeks and there’s not a scrap of food in the apartment.”
Grocery shopping would take well over an hour and require her to leave Liliana alone, whereas lunch here would be immediate and take no more than thirty minutes. Also, Celia wanted Dr. Leyva to see Liliana and judge her condition for himself.
Liliana put her hands over her face. “I can’t go in there. Everybody will stare at me. They’ll throw up!”
“Liliana, we will be in the staff dining room. Everyone in there will have seen patients who look just as bad as you, and some a whole lot worse.”
“For sure.” The radiologist spoke over his shoulder. “There was a bicycle accident victim in here less than an hour ago. Somebody opened a car door in front of his bike. The boy went sailing right over top and I don’t know how far along the pavement on his face. One cheek was sanded right down to the bone.”
Liliana shuddered. “Let’s get out of this place. Please?”
“We are having lunch in this place,” Celia informed her. “Dr. Leyva is my boss and it was not an invitation. It was an order.”
• • •
Dr. Leyva was waiting when the
y entered the dining hall. He waved for them to join him in the cafeteria line.
“This is my niece, Liliana,” Celia said, falling in behind him.
“Encantado,” he said with barely a glance in her direction as they picked up lookalike plates of pork-flavoured congrí and grated cabbage salad.
As they were placing their plates on the table Leyva had selected, he leaned forward and peered at the cut over Liliana’s eye. “That’s a nasty one. No stitches?”
“I decided not,” Liliana informed him.
“No? Why?”
“My mother was a soldier. She had a scar like that over her eye.”
“I see.”
Dr. Leyva tucked into his meal and said nothing more. Celia did likewise, and Liliana, after pushing the food around on her plate for a few minutes, began to eat. Not until they had cleaned their plates, and Dr. Leyva had gone and come back with demitasses of hot sweet coffee, did he address Liliana again.
“Are you aware that your radical aunt has got this hospital into hot water?”
Liliana turned to stare at her aunt. “Tía Celia? A radical?”
“Who, me?” Celia laughed, wondering what the joke was. Then, with a sinking feeling in her stomach, she remembered. It was no joke.
“She presented a paper in Santiago wherein she blamed the government for the high incidence of asthma in Cuban children.”
“Oh that.” Liliana was clearly disappointed. “She’s always on about smoking.”
“It’s one thing to be ‘on’ to family and friends. It is quite another to stand up in public and accuse a government that considers itself to have one of the best health systems in the world of being negligent in the area of a preventable illness like asthma.”
“Is it preventable?” Liliana looked from one to another. “I thought it was like, you know, just something some kids had.”
“Not according to Dr. Cantú.”
