In Old Town, she sat having coffee in the Plaza de Santo Domingo trying to read the Quito newspaper. Bright-robed pedestrians, women in suits, and shoeshine boys holding footstools all listened to a band playing curbside while behind them a church bell rang. The paper listed movie times, and Gabrielle was wishing she had someone who would join her at the Cinema Esperan-zado when a white-haired woman carrying an enormous basket of long beans came close enough so that Gabrielle could smell the green shoots and heaped loose seeds.
“You want?” the woman asked. Gabrielle opened her mouth to speak but was suddenly very aware of her poorly accented Spanish so instead shook her head. In the windless dark, the old woman loomed large. Gabrielle wondered if she had children or grandchildren, if she’d hefted them to her two at a time and let them play with the folds of empty skin on her arms, if one had fallen asleep on her lap as the woman shucked the plump green beans of their pods. She thought about being held to the woman’s chest, and lying there hair-smoothed and quiet until she felt she’d found home.
“Hmm,” Andrea responds. Gabrielle can hear her lick her lips, imagines Andrea gnawing on dried lip skin. “And where are you now? Where am I calling?”
It’s a relief to speak English, and Gabrielle feels the words slide out fast, detailing her life from Quito to Manta, where she’d arrived four days later with time enough to bring her pack and carrying case to her new apartment and change into her scrubs before heading out to the sanded pavement and walking to the Centro Médico de Manta, the local hospital. The flight had been only forty-five minutes, and Gabrielle found that she enjoyed walking out to the small plane. On a postcard to Andrea, Gabrielle wrote that walking up the steep steps after being out on the windy runway made her feel like a president or a Beatle, and she’d waved even though no one was watching.
“Did you send it?” Andrea wants to know, then clarifies. “The postcard.”
Gabrielle shakes her head even though the gesture goes unseen by her friend. “No.” Then she sees herself in the mirror and watches her mouth move as she adds, “Not yet, I mean. Do you still want me to?”
“I guess so—even though, I don’t know, maybe you don’t have to? Since you told me what’s on it already.” Gabrielle remembers the corkboard in Andrea’s old bedroom, the postcards from over state lines, the Irish pen pal who wrote once and then stopped, Gabrielle’s school photo tacked to the corner under the yellow of a pushpin. “Send it anyway. So I can see the stamps. Is there a post office at the hospital?”
“No. Not even close.” Gabrielle goes on with her descriptions, tracing the past weeks in her mind as she speaks. Above the hospital’s front desk, the clock’s time was wrong. Gabrielle stood waiting for the clerk to bring her a name tag and read the letter Dr. Sandoval had left for her explaining the new initiatives—fewer cesareans, a bigger emphasis on family planning, a push for maternal prenatal vitamins. With the name tag pinned to her blue top, Gabrielle was given doctor status that denied her fourth-year medical school reality. A nurse took her arm and lead her toward the first curtained exam area; Gabrielle tried not to focus on the tiny white caps the nurses kept pinned to their bunned hair or the grainy kick of sand under her shoes.
Gabrielle takes a pause, waiting for Andrea to butt in, but she doesn’t. Andrea takes a sip of something—Gabrielle can hear her swallow—and says, “Then what?” like Gabrielle is reading a kid’s book with pictures, or sharing in grade school circle time.
Most of the hospital lights were dimmed or off for conservation, chips of paint flaked from the walls and lay in clusters on the linoleum floors. All the doctors and nurses wore white shirts and slim trousers that seemed even brighter against the walls and barely lit stockrooms. The supply rooms themselves were nearly empty of bulb syringes, suture kits, and Betadine swabs, and Gabrielle spent her second day hauling the stuff her medical school back in New York had donated to the hospital, which Gabrielle had shipped before her arrival.
Gabrielle tells Andrea about how she and her fellow fourth-years had raided the medical stock at Bronx Memorial first, before getting approval from the trustees and head of staff. Soft piles of gauze sponges, 3 cc syringes, needles, and sterile gloves all tucked in tight, an immigrant medical supply heading off to warmer climates.
“I’m going to miss Match Day,” Gabrielle says. Then, before she explains the match system to Andrea, she adds, “But there wasn’t another chance for me to do this.”
“How come?”
“It’s complicated,” Gabrielle says. She’d arranged the extended rotation in Ecuador knowing that she wouldn’t be there for the mid-March ceremony when all the fourth-years found out where they’d be going for their residencies. Gabrielle was fairly certain she’d get her first or second choice and stay on the East Coast, maybe at Hopkins, in Baltimore, where her father lived now with his new wife, Diane.
On Match Day, everyone gathered in the banquet hall near the president’s office and, at precisely the same time, opened white envelopes that revealed where they’d be for the next three, four, even seven years, depending on their specialty. Instead of this, the bagel breakfast, and the mad rush for the phones, Gabrielle would place a call back to New York the day after and have the secretary read her placement from a list. It seemed a bit anticlimactic, the lack of ceremony, but then, what was residency after all? Another four years of working sleepless nights, dreaming of cancerous ovaries and pregnant women with high blood pressure while pretending that she really lived in whatever city she was stationed.
Each segment of her life so far had been an extended visit in a particular state, so despite the name, Gabrielle felt residency would be another stop like that, a settling in to the point of familiarity and then going on to practice somewhere else.
Andrea listens while Gabrielle talks on and on into the phone.
“It’s so good to talk to you,” Gabrielle says. Andrea musters up a small hmm, as if she’s chewing on bread. Gabrielle wants to say she’s grateful for an English ear to hear her take on this country where she confused being a temporary resident, temporal residente with a temporal implantación in which the fertilized egg implants in the uterine lining. Gabrielle had thought about herself literally implanting somewhere, in something, but then realized she’d been incorrect. The doctors and nurses had laughed as she blushed behind her coffee-filled travel mug brought all the way from Manhattan. But all she says next to Andrea is how the smells are potent, how one reminds her of Andrea’s basement, some combination of alcohol and dankness the girls used to pinch their noses against.
In Manta, Wednesday nights had late vending hours. Unlike the weekend market, which smelled of fish parts and bags of roasted canahuate seeds, the extended hours in the cafés and open-air stalls meant smelling chicory coffee and mint liquor all the way up on her balcony. Gabrielle watched from above as the townspeople danced oceanside or sat eating bowls of soup while old men played guitar. The aluminum lights swung on wires connecting one shop to the next, splaying odd shadows onto the dancers, and when she’d ventured down, Gabrielle had leaned on the concrete wall that edged the beach, facing into the action as if it were a film reel until she’d been spotted by Gloria, one of the younger nurses at the hospital. Gloria was desperate for children and had told Gabrielle, in the first week, how many times they had tried to conceive, only to find she either couldn’t get pregnant or couldn’t hold the embryo once it implanted inside her.
In the stockroom, while Gabrielle had organized and stacked, Gloria had cried and pointed to her empty belly, wanting to know why. Gabrielle had tried to console her, giving a pat on her shoulders and telling her to try to relax, but it was her fifth day there, and the thought of attempting to translate Clomid or in vitro seemed impossible. Besides, there wasn’t much point in talking about drugs and procedures that weren’t possibilities in Manta, since they might make Gloria even sadder.
Gabrielle touched a pulpous bag of saline solution that lay like a beached jellyfish on a metal cart and wondere
d if she’d ever carry a child, not so much if she could conceive but if she could find the time amid all the training to meet, maybe marry, and produce. She tried to picture herself full-waisted with her bladder space infringed upon but couldn’t.
“Hold on,” Gabrielle says into the receiver. She pulls the phone back from her ear and wipes at the sweat that’s accumulated on the earpiece. As she had in New York, where a thirty-six-hour shift left her achy and nauseated, Gabrielle existed full-time in a nauseated but pleasant haze of fatigue. In Manta, she dreamed of needle sticks and preeclamptic women, the bloat of their bodies looming like clots. There was no one to talk to in English, and Gabrielle tried to force herself to think in Spanish, just so she’d sound more natural with the patients. Dr. Sandoval commended Gabrielle’s kindness, her ease with the worried women and speculum-invaded teenagers.
“I’ve had four babies named after me,” she says to Andrea.
“Oh, yeah?” Andrea says. “I could see that.”
“Two C-sectioned ones, a vaginal, one VBAC,” Gabrielle says.
“VBAC?” Andrea spells it out.
“Vaginal birth after cesarean. Sorry.” Gabrielle wonders what she is apologizing for and then covers up. “I’ve given out so many prescriptions for the morning-after pill I’ve lost count.”
“I took that once,” Andrea says. She is eating something, Gabrielle can tell from the crunching noises, the gulping.
“It can be a good thing,” Gabrielle says. Then she reconsiders her word choice. “A good option, I mean.”
Friday mornings Gabrielle assisted in the scheduled abortions. At the clínica terminación Dr. Sandoval had supervised a twenty-two-week abortion, first showing how to insert the prostaglandin rods, then, after the dilation, how to use the forceps. In a gloved hand, Dr. Sandoval had held a tiny gray organ and asked Gabrielle to identify it.
“A lung?” she’d said, looking closer.
“Pulmón? Are you sure? Right or left?”
“The right has three lobes and the left has two, so—I’m not sure, the right?” Gabrielle felt hot in her gown and mask. She meant heart, the chambers of the heart, and felt foolish for her mistake. From the tented rise of the patient’s stirruped feet, she could envision falling, knocking herself out on the hard floor.
“Realmente, this is the heart, el corazón, of a nearly twenty-three-week fetus,” Dr. Sandoval said and turned it gently with her finger to show Gabrielle how it pulsed.
Gabrielle nodded to show she understood and said, “Well, now I know for next time.”
Later, in the bare-walled recovery room, Gabrielle had put her hand on the woman’s shoulder and asked how she was feeling, if she had any questions. The woman shook her head and then asked how long the bleeding would last; the large obstetric pad was uncomfortable, held in place by disposable mesh underpants. Gabrielle assured her the flow would ease up in a few days and watched the woman as she covered her eyes either to rest or to cry, you could never be sure.
The white curtains billowed in the afternoon beach breeze, and it occurred to Gabrielle that, had she not known what the women were recovering from, the room could have been a spa, a post-herbal-wrap meeting place like some day spa somewhere on the Upper East Side. Gabrielle is proud of her detachment, her ability to comfort without being involved. She watched the conserjes, caretakers, the hospital employed just to tend to the emotional needs of the posttermination patients, and wondered at their grace, their casual kindness, felt she would benefit from more connectedness but she cannot think how to have it without changing her whole self.
Some of the patients had had elective procedures, others had been induced for stillborn deliveries at twenty-five weeks. The conserjes were the only hospital workers not outfitted in white. The murky blue of their drawstringed dresses made them appear fluid, gentle bodies of water seeping into the recovery rooms and over the emptied patients.
After the Friday outpatient clinics, Gabrielle went home to change before meeting Dr. Sandoval at her house on the western side of town, up where the mountains came into view behind the odd glow of dispersing light. The shuttle bus ended its route there, and sometimes, if she were the only passenger, the driver wouldn’t bother to poke a hole in her paper ticket and she’d save the thirty cents each ride cost. Once she’d started a letter to Andrea, imagining her paging through the skin-thin airmail sheets all the way back in Austin, but she’d gotten only as far as “Dear Andrea, I am on a bus,” before she’d been distracted by the purple margin of newly tarred roadway ahead.
Gabrielle liked to sit in the very front of the bus, facing forward as if she were a driver without a steering wheel. The front windshield was so large and flat, and the bus seats came up so close that you could see the sandy tarmac slipping underneath the rounded front, and if you looked too long, it seemed like you might go under there, too. Along the Río Tarquí beach, small, bright blue fishing boats bobbed unpeopled, various mesh traps and crates belted down with heavy cords.
When the fishermen returned from five days at sea with their catches onboard, hundreds of frigate birds wheeled overhead, waiting for a chance to swoop down and grab a meal left unguarded for even a few seconds. In the early mornings after her weekend shifts, Gabrielle brought hard cheese and a roll to the beach and watched the men unpack the boats, careful not to flaunt her snack as she had the first time, when the large birds dipped right to her, trying for a peck at her bread. Some of the birds were Tarquí residents, others flew in with the fishing boats and stayed until the sun slipped down and the sky went dark.
On the way to Dr. Sandoval’s house, the shuttle bus passed the ferry terminal where some of the Galápagos boats docked. Gabrielle tried to imagine her father and his wife on one of them as he’d described it to her: the diesel smell, the bottle-nosed dolphins cresting, the armies of marine iguanas that lined the shore as they’d disembarked, the continuous fuss his wife had made over her frizzing hair. Gabrielle hadn’t made the time to go out there, but, at Dr. Sandoval’s suggestion, she’d gone during her four-day vacation to the Parque Nacional Machalilla. A small group of locals had included her in a day hike, and then she’d joined a Spanish-language school for a program in the coastal province of Manabí, south of Manta.
Each morning Gabrielle sat in a hut roofed by tagua palm leaves and practiced her verbs, her accent, the idiomatic expressions that came only after living somewhere long enough. The hotel where she stayed was the Alándaluz, the “winged city of light,” which prided itself on being an ecologically minded place, self-sustaining with replenishable building materials and organic gardens. Gabrielle’s arch-shaped cabin was made from bamboo and located near the outdoor eating area.
She’d been taking Larium still, an antimalarial drug, and it gave her odd dreams in the national park. In one, she and Andrea had kissed, her friend’s tongue purple and long, darting. Sometimes people complained of nightmares from the medication, or depressive episodes, but Gabrielle enjoyed the bizarre flits and jolts of her sleep, especially in the jungle, where she fell asleep to the scent of babaco fruits cooking.
The fruits were served at breakfast. Heart-shaped and heavy, the five-sided babacos were about a foot long and yellow. Gabrielle thought they tasted some like a papaya and a bit like a strawberry, and like something else she couldn’t think of, and she loved how all of the fruit—the flesh, the juice, the thin outer skin—was edible.
Away from labor pains, the maternity rooms where the women clicked their tongues to the roofs of their mouths more often than moaned, separate from the white-gowned staff and dingy hospital walls, Gabrielle felt like a part of the jungle, some plant grown from a discarded fruit dropped by a tourist—a flower or tree that wouldn’t so much change the ecological system as blend into it. By boat, she’d gone from the hotel to the Isla de la Plata, the Silver Island, which contained some of the same bird and marine species found on the Galápagos. Blue-footed and red-footed boobies, masked boobies, and frigate birds all hunkered down in the headland
cliffs, then launched themselves airbound. From the sunny boat where Gabrielle ate her lunch, she thought about who she wished were with her and couldn’t say. With her medical school friends, the talk inevitably returned to studies or tales of the sad or dim-witted patients; with college friends, they past-delved and then came up with nothing. A childhood friend like Andrea was best, Gabrielle decided, since there was no middle to the relationship, no context—just Popsicles and flat chests and then suddenly adulthood.
When they’d met in Austin on Gabrielle’s way down to Ecuador, Andrea had talked about the job she had at Grant’s Books and Beans, the coffee place in town where used books nosed up to the mug racks. Andrea’s world seemed small and relaxing, and Gabrielle wondered what it would be like to move back to Texas—to move back to anywhere, really, since she preferred to move somewhere new. Andrea asked about medicine, about the procedures, wanting the details of Gabrielle’s everyday life, if she wanted to have her own practice, if she saw herself having kids of her own or just delivering them.
In Andrea’s red Ford Fairmont, they’d driven to the miniature golf place they’d gone to as kids. Putting into a windmill, a waterfall, a maze of hedges, and an enormous plastic hot dog, they hadn’t written on the scorecards.
“I can’t write with these things.” Andrea had laughed as she showed Gabrielle the abbreviated pencil that came with the clubs and balls. By the shaved ice stand inside the golf club return area, Andrea had tied some toddler’s shoelace. “That’s Ginger Lawson’s kid, do you remember her from fourth-grade social studies?”
Gabrielle shook her head. In the car on the way to the airport, she’d thought about how Andrea had patted the kid’s shoe when she’d finished tying it, quiet praise for standing still, the way Gabrielle did with her patients after an internal exam or when she’d given test results.
The Girls' Almanac Page 6
