She hears a report on the radio about people who are setting up a strange society, the National Patients’ Union. They want to form a kind of trade union where people can defend themselves against doctors, protect themselves from medicine. It immediately occurs to Karina that Ernesto Durán is likely to be involved, that he’s probably one of the leaders of this infant organization. She tries to listen as closely as possible to the item. That same night, on television, she sees an interview with some of the people behind the movement. The first to speak is a lady who describes how she was bitten on the arm by some strange creature, which she assumed was an insect, although she didn’t know which kind. It wasn’t any common-or-garden variety, not a mosquito or a gnat or a midge. It was something else, she says. Anyway, her arm started to swell up and turn purple and she had no option but to go to the emergency room. She was seen by the doctor on duty, who—according to her—merely poked around in her inflamed arm with a syringe. He didn’t ask her anything, or say anything, or give any explanations. Karina guesses that the woman is telling the truth because, even now, when she recalls the moment, she grows angry and finds it hard to get the words out, she seems about to weep with rage. When the doctor finally grew tired of scraping around beneath her skin, he said that he’d found nothing, left her under observation for two hours and then gave her an antibiotic, explaining that the antibiotic wasn’t for the bite, but for what he’d been doing with that wretched syringe. “Don’t worry about the bite,” the doctor said. “It’s nothing. It’ll clear up in time.” She paid a small fortune and went home with an idea jumping about inside her head: a National Patients’ Union.
Then several other people speak. A boy whose little sister died from a lack of oxygen in a hospital in the west of the city. A man with only one leg, who accuses an anesthesiologist of negligence. A nurse who claims to know the world of doctors from the inside and who says that, as well as being a nurse, she, too, is in need of nursing. There’s no sign of Ernesto Durán. Karina even tries to get in touch with the organization, and manages to speak to one of the people interviewed, but to no avail. No one knows him, no one knows anything about Durán.
“You’re not well. This obsession of yours isn’t normal.”
Adelaida thinks someone has put the evil eye on Karina, that someone—who knows, perhaps Ernesto Durán himself—has paid for some kind of spell to be put on her and send her mad. She also believes that Karina should fight back with the same medicine. Through herbs, a medium, voodoo, or a soothsayer, some power that doesn’t belong to the known world, that calls for more faith than science. Karina has given her a vague, truncated version of what’s happening to her. She hasn’t again experienced quite what she did in the video store, although there have been a couple of similar incidents, the worst of which happened only two days ago, on the subway. It was, of course, the rush hour. Karina was standing, crammed up against the other passengers. It took only two seconds for her to realize she was about to have an attack. She was gasping for air, her heart was pounding, she broke out in a cold, sticky sweat, her tongue swelled up so much she felt as if she had a huge toad in her mouth, a rough-skinned creature scraping against the roof of her mouth and preventing her from breathing, suffocating her. She jumped out at the next station, swearing that she would never again travel on the subway.
Adelaida insists that it isn’t something physical or biological. No syringe can protect you against the evil eye. No antibiotics can do battle with a curse. Faced by such a situation, science crumbles, it’s a war that has to be waged by different means, with different weapons. Karina prefers to think that it’s just a phase, part of the temporary anxiety she’s feeling, that it won’t last, that she’ll wake up one morning and it will be gone, that somewhere a pleasant, calm Thursday awaits her, with no fear, no feelings of asphyxia, no dizziness, a Thursday when Ernesto Durán will not even be a memory.
He spent the morning in the operating room. Although he chose to work in general medicine because he’d never felt at ease with surgical practice, Andrés does sometimes help out at the occasional operation. Usually, this is at the request of a friend. Miguel often asks him. Today it was Maricruz Fernández. They had opened up a patient with two tumors on her liver. Maricruz wanted Andrés to have a look at them, to get his opinion. The second tumor, in particular, was causing confusion. Half of it was soft and the other half hard, and only one side of it was cerebroid in appearance. This time, Andrés felt dizzy, something that had never happened to him before. As he bent over the woman’s body, he suddenly felt as if the ground had slid from under him, as if he might drown in those intestines, plunge in and be lost forever inside that dark, slimy liver.
He made an excuse and left as quickly as he could. He went to the cafeteria and drank a glass of orange juice. Now he’s sitting outside the door of the chemotherapy room, staring into space, thinking. In the last week, his father has deteriorated terribly fast. The voracity of certain diseases is truly repugnant. Andrés finds his tolerance for such things is decreasing as his own suffering increases. He even finds the clinical terms unbearable:neoplasm exeresis staphylococcal empyema pleural empyema anastomosis iliocolostomy biopsy hemostasis prosthesis laparotomy ischemia lithiasis
These are words that travel up and down hospital corridors all the time. He closes his eyes and he can hear them. They glitter and gleam in the middle of any conversation, they stand out among the other simple words, the words that serve only to live, but not to confront death. It seems to Andrés now that they form part of a pretentious, useless dictionary. This morning, when he went to fetch his father, he found him sitting on the bed, naked. He looked unconscious, although his eyes were open. Andrés hesitated for a few seconds, thinking that his father might feel embarrassed. Such unexpected intimacy was very cruel. He decided to go over and sit down beside him. His father didn’t move. From closer to, Andrés could see how fragile he was. His spindly legs. His limp penis, like a finger fallen asleep in the wrong place, as if it had never been a penis. His bones were more prominent. They now provided the dominant framework of his body. The expression on his face was one of deep disillusion.
“How are you?” Andrés put his arm around his father’s shoulder, taking care to feign a quite incomprehensible optimism.
“Terrible.” His father still didn’t look at him. “I’ve had enough, Andrés. I don’t want to go on. I don’t want any more treatment.”
“You’ve just woken up feeling a bit low, that’s all,” Andrés insisted, although the words felt rough on his tongue. It seemed to him it was his duty, his role, to say something of the sort.
“I woke up today feeling exactly as I did yesterday. And the day before yesterday. And the day before that.”
“Come on, I’ll help you get dressed.”
“No, I mean it. I don’t want to go.”
“You have to.” Andrés crouched down in front of him. They looked hard into each other’s eyes.
“It hurts,” his father said after a pause, almost in a whisper. Almost like an exhalation. “Everything hurts. It hurts like hell.”
Now, sitting in the corridor, he can no longer hear the clinical words, no more neoplasm ischemia pleural empyema. It hurts like hell. That’s all he can hear.
Julio Ramón Ribeyro wrote in his diary: “Physical pain is the great regulator of our passions and ambitions. Its presence immediately neutralizes all other desires apart from the desire for the pain to go away. This life that we reject because it seems to us boring, unfair, mediocre, or absurd suddenly seems priceless: we accept it as it is, with all its defects, as long as it doesn’t present itself to us in its vilest form—pain.”
Andrés decides to spend the rest of the day with his father. He invites him to have lunch in his favorite restaurant, a discreet place whose food has been much praised, assuring him that they make real homemade fare. His father doesn’t seem very keen. Andrés insists. So much so that, in the end, it’s as if his father were making a real sacrifice in accepting
. They don’t enjoy the food. His father is feeling horribly nauseous. He has such chronic acid reflux that he can’t eat anything. They go home in silence. His father undresses and gets into bed. Andrés sits down beside him again. What can he do? What does his father expect of him? Is there anything he can do, is there any way of helping him? His father lies down on his back, staring vacantly up at the ceiling. Andrés opens the drawer of the bedside table.
“I was looking for your pills the other day and I came across this,” he says, and shows him the book.
His father doesn’t seem particularly interested, and so Andrés holds the book in front of his eyes. His father eventually manages to whisper:
“A nurse at the hospital recommended it to me.”
“Dying with Dignity,” Andrés reads. “Not exactly optimistic.”
“Life isn’t optimistic.”
Andrés sighs, leans closer and affectionately strokes his father’s bald head.
“You’re not thinking of doing anything foolish, are you, Dad?”
“The only foolish thing I can do is to die, and I’m doing that right now.”
Andrés doesn’t know what else to say. He drops the book onto the bed and continues stroking his father’s head. They both stay like that for a few moments, until Andrés decides to take a risk.
“Why did you never tell me?”
“About what?”
“About Inés Pacheco.”
His father sits up and looks at him. He seems more disappointed, even angry, than surprised. Despite his weak state, he maintains a haughty, almost severe mien.
“I met her. I went to see her,” says Andrés.
And then the old man slowly deflates, as if that sudden burst of spirit had simply emptied out through some secret hole. He gives a snort and slumps back onto the bed. Then he closes his eyes, as if he didn’t want to hear any more.
“Didn’t she tell you? Didn’t she mention it?”
His father remains sunk in his own thoughts.
“Does she know what’s happening to you, that you’re ill?” Andrés continues asking questions even though his father refuses to answer.
After a few moments of silence, Andrés also lets himself slide very slowly onto the bed, so that he’s lying beside his father. Then he, too, lies staring up at the ceiling. They probably both just wish it would end, that it was over. Death is preferable to pain. Illness is a very bitter toll to pay, a tax so capricious that it can make death the object of all our final desires.
“I smell bad,” his father says suddenly, still with his eyes closed.
He’s right, but Andrés doesn’t respond. Every illness produces inside the body its own particular distinguishing marks.
“It’s as if I’d already started to rot.”
Andrés doesn’t look at him either. He doesn’t dare.
“It’s just that you’re very depressed, Dad,” he whispers, a lump in his throat.
“Can’t you smell it? I smell strange, of ammonia and things. Even when I’ve showered, I still smell.”
Andrés gently reaches out and takes his father’s hand in his. He closes his eyes, as if he wanted to close his memory too, as if he didn’t want it to hold on to that image.
“I’m desperate,” he confesses. “There’s nothing I can do. I don’t know what to do.”
The silence is a knife plunging into the skin of the afternoon. Neither of them dares now to open his eyes.
“What can a man do when, suddenly, one morning, he’s told that he has only three or four weeks left to live?”
This is how the second workshop session begins. Two new participants have joined them: a very fat woman who has difficulty breathing, and a young man of about thirty, who looks healthy enough, but is clearly feeling uneasy and nervous. Roger, the same smiling facilitator from the first session, quickly gets the group involved.
“Think about yourselves for a moment. There may be people among us today who are in a similar situation. It wouldn’t be the first time, I can assure you. I’ve led a lot of these workshops and there’s often someone who has had just such an experience. But, if not, it doesn’t matter. Just take a moment to do this mental exercise. Imagine that, at this very moment, a celebrated doctor, a notable specialist comes to you and says: sir, madam, miss, young man, I regret to inform you that you have only one month to live. What would you do?”
Merny thinks of Javier Miranda. She thinks of his age, of the pain he’s in, of his terrible pallor. He seems to grow daily more absent. What has he done with these final days of his existence? Has he used them well or has he wasted them? Who can say? Who can judge?
“Obviously, it’s not easy.” Roger again walks round the circle. “We don’t always react the way we think or believe we’ll react. Perhaps, after receiving a piece of news like that, we might waste a whole week simply digesting, believing and accepting it. The big difference between human beings and other animals is that we’re the only ones who know we’re going to die. A dog doesn’t know. A cat has no idea, cannot even imagine such a thing. On the other hand, we can. And we spend our lives thinking about it. Suffering and enduring that knowledge. More than that, there are people who spend their whole lives trying to avoid what they know, trying not to think about it. There are people who can only live when they forget they’re going to die. That’s why I’m asking everyone to do this exercise. Right, you’ve got four weeks left to live. What do you want to do with that time?”
When Javier Miranda found out the truth, he spent quite a long while trying to grapple with that question. He thought about his son, he thought about Mariana and his grandchildren, he thought about a long-dreamed-of trip to the Amazon, he thought, too, about Inés Pacheco. But he and Inés had long ago made a pact. Moreover, the idea of setting up a series of goals before he died became mixed up with the clear sense that, gradually and unstoppably, his death would become something ever more public. That is another of the consequences of being ill: the private agony becomes a collective ceremony. The result of this was that Javier Miranda began, instead, to want to withdraw, to hide away, to become more distant, more absent. As the days passed and the tests and treatments and doses of medicine increased, so any pleasure or delight he might feel diminished. This wasn’t a selective deterioration. At that point, everything was lost. There are no half measures when one says goodbye.
“What about taking a trip somewhere. That’s a possibility. That’s a great idea.” Roger moves from one to another of the participants, searching out and sharing answers. “So where would you like to go?”
“New York,” murmurs an old lady.
“New York, very good.” He moves on, and finds himself in front of the very thin, very pale young man. “And what about you, Rodolfo, what would you do?”
“If I was told I only had four weeks left to live, I’d do everything I could to find a cure, to live longer.”
“What for example?”
“I’d go and see one of those doctors who cure by laying their hands on you, I’d try natural medicine, I’d pray to María Lionza, I’d eat roots, I’d do whatever they told me to.”
“Very good. Thank you, Rodolfo,” he says, as he moves on, keeping a close watch on each member of the group. “Who else would like to say something?” He stops next to a man in his sixties, with a bandage over his eyes. “Ah, Don Esteban. What about you? What would you do?”
“I’d do it with a Chinese woman,” he says and roars with laughter.
Some of the other members of the group laugh too, others keep silent and exchange glances that presage future days of tittle-tattle.
“Well, I’ve never been with a Chinese woman. I mean it.”
“I don’t doubt it, Don Esteban. We believe you. That’s perfectly fine.” He stops suddenly in front of Merny. He bends toward her, resting his hands on his knees. His tone is warmer. “And what does Merny have to say? What would you do?”
Merny feels awkward. The whole group is looking at her and that frightens her
. She feels as if she had done something wrong, or is about to. She’s embarrassed. She feels that what she has to say is wrong, stupid, irrelevant.
“So, Merny, you have four weeks left to live. What are you going to do with that time?”
“Take my son to Mérida,” she blurts out nervously, not even daring to look up.
“Dr. Miranda!”
Karina is the first to hear him. Or so, at least, she thinks. Dr. Miranda, who is walking by her side, appears not to react, but walks on as if he’d heard nothing, absorbed in his own thoughts. So much so that even Karina wonders if she really did hear it or perhaps imagined it. Then she thinks that’s impossible, you don’t imagine noises.
“Dr. Miranda!”
She hears it a second time and feels the same shiver run through her. The voice comes from behind, from behind and from the left, from above too. Behind, above, and to the left. Karina feels those two words crowd into her head. She had gone with Dr. Miranda to help him carry some samples and, there they are, walking back to the office, strolling serenely down the corridor, when that voice appears, a voice that is like a bolt of lightning to Karina, but to which Dr. Miranda appears oblivious.
“I think someone’s calling you,” Karina says at last, placing one hand on Dr. Miranda’s arm.
And then they both turn round. They do so quite naturally and slowly, although Karina experiences this quite differently, more quickly and more tensely. She’s quite right: Ernesto is coming toward them. He looks so unchanged, so normal, that, for a second, Karina feels slightly disappointed. He doesn’t even look thinner or paler, there’s nothing to show that he has just been through a health crisis or a time of terrible suffering. Not that he’s exactly in festive mood either, he approaches wearing a tentative smile and looking quite calm, timid but quite calm.
The Sickness Page 13
