by Damon Galgut
‘Laurence,’ I said. ‘Understand one thing. This isn’t a real hospital. It’s a joke. When you were driving here, do you remember the last town you passed, an hour back? That’s where the real hospital is. That’s where people go when they’re sick. They don’t come here. There’s nothing here. You’re in the wrong place.’
‘I don’t believe that.’
‘You’d better believe it.’
The red coal hung still for a moment, then rose and fell, rose and fell. ‘But people get injured, people get sick. Don’t they need help?’
‘What do you think this place means to them? It’s where the army came from. It’s where their puppet dictator lived. They hate this place.’
‘You mean politics,’ he said. ‘But that’s all past now. It doesn’t matter any more.’
‘The past has only just happened. It’s not past yet.’
‘I don’t care about that. I’m a doctor.’
I lay and watched him for a while. After a few minutes he stubbed out the cigarette on the windowsill and threw the butt out of the window. Then he said one or two words I couldn’t hear, made a gesture with his hands and sighed and went to sleep. It was almost instantaneous. He went limp and I could hear the regular sound of his breathing.
But I couldn’t sleep. It had been years and years since I’d had to spend a night in the same room with anybody else. And I remembered then – almost incongruously, because he was nothing to me – how there had been a time, long before, when the idea of having somebody sleeping close to me in the dark was a consolation and comfort. I couldn’t think of anything better. And now this other breathing body made me tense and watchful and somehow angry, so that it took hours before I was tired enough to close my eyes.
2
For a long time now there had only been the seven of us: Tehogo and the kitchen staff, Dr Ngema, the Santanders and me. Once upon a time it was different. There had been an Indian woman doctor when I first arrived, but she was long gone, and a white man from Cape Town who’d got married later and emigrated. There had been four or five nurses too, but they’d been retrenched or transferred, all except Tehogo. There were too many of us to deal with the tiny trickle of human need. So when somebody went away they were never replaced, the empty space they left behind immediately sandbagged and fortified as a bastion against final collapse.
So Laurence’s arrival was a mysterious event. It made no sense. When Dr Ngema told me there was a young doctor coming to do a year of community service, I thought at first that she was making a joke. I had heard about the community service – it was a new government scheme, aimed at staffing and servicing all the hospitals in the country. But we seemed too obscure to qualify.
‘Why?’ I said. ‘We don’t need anybody else.’
‘I know,’ she said. ‘I didn’t request anybody. He asked to come here.’
‘He asked? But why?’
‘I don’t know.’ She was looking in perplexity at a letter that had been faxed to her. ‘We don’t have a choice, Frank. We have to find a place for him.’
‘Well, all right,’ I said, shrugging. ‘It doesn’t affect me.’
Dr Ngema looked up and sighed. ‘It does affect you, I’m afraid,’ she said. ‘I have to put him into the room with you.’
‘What?’
Nothing like this had ever happened before. She saw the dismay in my face.
‘It won’t be for long, Frank. When the Santanders go I’ll put him in there.’
‘But... we have a whole passage full of empty rooms. Why can’t he go into one of those?’
‘Because there’s no furniture in those rooms. The only thing I can provide is a bed. But what about tables, chairs . . .? He’s got to sit somewhere. Please, Frank. I know it’s hard. But somebody has to compromise.’
‘But why me?’
‘Who else, Frank?’
This wasn’t a simple question. But there was one other room, down at the end of the passage, that was under dispute.
‘Tehogo,’ I said.
‘Frank. You know that’s not possible.’
‘Why not?’
She shifted uncomfortably in her chair and her voice rose a note or two in protest. ‘Frank. Frank. What can I do? Please. I will sort something out, I promise you. But I can’t just evict him.’
‘You don’t have to evict him. Why can’t they share?’
‘Because... Tehogo isn’t a doctor, you are. It makes sense for two doctors to share.’
Behind the words were other words, not spoken. It wasn’t just that Laurence Waters and I were doctors; it was that we were two white men, and we belonged in a room together.
When the alarm woke me in the morning he was already up and dressed, sitting on the edge of his bed, smoking a cigarette.
‘I want to meet Dr Ngema,’ he said immediately.
‘You can. But you’ll have to wait a bit.’
‘I could go over to her office. You don’t have to take me. I could go on my own.’
‘It’s six in the morning, she isn’t there yet. Relax, goddamn it, calm down. Have a shower or something.’
‘I’ve already had one.’
When I went into the bathroom, the floor was swimming with water and he’d slung his damp towel over the door. There were bristles and shaving foam in the basin. My mood dropped as I cleaned up behind him, and it dropped even more when I came out again into the blue haze of his cigarette smoke. He was walking around aimlessly, puffing and thinking. When I coughed he stubbed the cigarette out on the windowsill, just as he’d done last night, and threw it away.
‘You can’t keep doing that. You’re making burn marks everywhere.’
‘There isn’t an ashtray. I looked.’
‘I don’t smoke. You’ll have to buy one.’
‘It’s a dirty habit, I know, I must give up.’ He cast around him in a feverish way, then subsided on to the bed. ‘Are you ready to go?’
‘I have to get dressed, Laurence. Why are you in such a hurry? There’s nothing to rush for.’
‘Really?’
I dressed slowly, watching him. His attention settled on me only every few seconds, then flitted off to some arbitrary detail, sometimes outside the window. He seemed pent-up and distracted for no reason that I could see. It was a quality I would come to know well in him, but on that first day it was peculiar and disturbing.
Finally I was ready. ‘All right,’ I said. ‘We can go. But, Laurence... your white coat. We don’t really wear them here.’
He hesitated for a second, but he didn’t take it off. I locked up and we went along the footpath under the heavy leaves, the light getting stronger all around. I could feel him edging towards the main block, to the office and officialdom, but I took him on a side path, to where we had breakfast. The dining room was in a third building of the hospital, along with the kitchen and the quarters for the cooking and cleaning staff, which were almost deserted by now. It was a long hall, half of which was used as a recreation room, the other half taken up by a big rectangular table, covered with a dirty cloth.
I introduced Laurence to the Santanders, Jorge and Claudia; they looked at him in startled surprise.
‘You are... new?’ Jorge said.
‘Yes, community service. One year.’
‘Excuse,’ Claudia said, ‘what service you say?’
‘It’s a government plan,’ I said. ‘All new doctors have to do it. After they’ve qualified.’
‘Ah. Ah.’ But they looked at him in bemusement. They had seen a few people leave this place, but he was the first one to arrive.
A silence fell. There was always an awkwardness around me and the Santanders, but it was deepened today by Laurence, who fidgeted his way through breakfast, pushing his toast around the plate, not really eating. He made a few desultory attempts at conversation and then none of us talked any more; there was only the scraping of metal spoons on plates and laughter from the kitchen next door, before they excused themselves and left.
&n
bsp; Then it was just him and me, staring at the other half of the long room, with its clutter of ping-pong table and black-and-white television and old magazines and boxes of games.
I think it had started to dawn on him what sort of a place this was. There was no trace left of the manic urgency from the bedroom. When he’d finished eating he lit another cigarette, but he hardly puffed at it, just sat gazing into the distance while the smoke unravelled from his fingers.
Later we went over to the main building together. There was nobody in the office, although Claudia Santander was still officially on duty and Tehogo was supposed to be around. While we waited for Dr Ngema to appear, we sat and drank coffee in silence. Years of my life, sour with caffeine, had been sipped away in this room. A clock on the wall stood silent and broken, the hands fixed for ever at ten to three. The only thing that had changed here since I arrived was the dartboard on the back of the door. I had brought it up from the recreation room one Sunday, hoping to while away some hours. But there are only so many times that you can throw a dart into a board before the idea of an aim and a target begins to lose its point.
Dr Ngema arrived punctually at nine. She was here for ward rounds. This was a daily routine, even on those days – which is to say most of the time – when there were no patients in the hospital. There was always something to discuss, however inconsequential or arbitrary, some point of protocol or procedure. But today, as it happened, there were two patients to attend to.
She stopped in the doorway and her eyes went sideways to the anomalous brightness of Laurence’s white coat. He had stood up and was smiling, holding out his hand.
‘I’m Laurence Waters,’ he said.
She shook his hand in confusion. ‘Oh, yes,’ she said, ‘yes. When did you arrive?’
‘Yesterday. Last night. I wanted to come and see you then, but Frank said...’
‘I thought it would be too late,’ I said. ‘I told him to wait till today.’
‘Yes,’ Dr Ngema said. ‘Yes.’ She nodded vigorously.
A silence fell. Laurence was standing there with a broad and expectant smile, eyes shining, and it was obvious that he thought something would finally happen. All the rest – his arrival, waiting, talking to me – was just preparation. He had met the boss now, and a life of duty and meaning would be given to him.
But Dr Ngema was looking around, frowning. ‘Where is Tehogo?’ she said.
‘I don’t know. He hasn’t arrived yet.’
‘Oh. Well. Yes... Shall we go?’
I walked next to her, while Laurence followed behind. Our footsteps echoed importantly in all the emptiness. Both the patients were in the first ward, the only one that was really functioning. This was two doors up the passage from the office. The first room you passed, on the left, was the surgery, where examinations and any kind of operating were done. That door was closed. The next one you came to, on the right, was the ward. It looked like a normal room in a normal hospital. Two rows of beds, curtains, a dim fluorescent glow.
We all congregated around the bed of the first patient, a young man in his early twenties who had come into the country illegally on foot. Because we were close to the border we got a lot of these cases: people who had walked great distances without money or food. The border crossing was dangerous. This young man had made it through, but he was badly sunburned and dehydrated and his feet were raw. He was being intravenously rehydrated, and seemed to be making good progress. He didn’t communicate with us, except by frightened glarings of his eyes.
‘His blood pressure is 130 over 80. When did Tehogo do this chart?’
‘I have no idea.’
‘He must write in the time. He must do it clearly. Will you tell him? Frank, his temperature’s a bit high. But he’s passing urine again. What do you think?’
‘Try him again with solid foods in the morning.’
‘I agree. Will you pass that on to Tehogo as well?’
‘Okay.’
‘When do you think he can be discharged?’
‘He’s making good progress,’ I said. ‘Day after tomorrow.’
Dr Ngema nodded. We weren’t friends; she didn’t have any friends, but she always made a public point of asking my opinion. We had what is known as ‘a good working relationship’.
We crossed over now to the other patient, a woman who’d been brought in by her husband a couple of days before in a lot of pain. It was her appendix, about to burst, and Dr Ngema had operated immediately. Appendicitis was the sort of emergency we liked: recognizable and treatable, within the scope of our resources.
Most surgery in the hospital was carried out by Dr Ngema, though her hand was far from steady, and in my opinion she had an unreliable eye. For personal reasons I was keen to build up some kind of record with surgery, but I was only allowed to do occasional minor procedures. It rankled with me, but I couldn’t afford to let any resentment show. I had swallowed a lot of frustration over the years.
This morning, for example. I could see very quickly that all wasn’t well with this patient – she was weak, and a brief examination showed some distension of her abdomen – but this wasn’t the time or place to be too direct. Dr Ngema was sensitive to criticism, but there was more to it than that. If anything was wrong we would have to send the patient to that big hospital in the nearest town, an hour away, where there were more sophisticated supplies and staff. In extreme cases, where we could do nothing more, we were obliged to pass the patients on, but this was always a last resort, because every failure on our part made it harder to justify the thin funding we still had.
‘Why don’t we keep an eye on her?’ I said. ‘We can monitor it.’
Dr Ngema nodded slowly. ‘All right.’
‘It’s leaking,’ Laurence said.
We both looked at him.
‘The stump is leaking,’ he said. ‘Look. Distended abdomen. Painful to pressure. You can’t leave it too long.’
The silence that followed was filled with the hoarse breathing of the woman in the bed.
‘Laurence,’ I said.
I had spoken sharply, to put him in his place, but there was nothing to follow on his name. He was right: we both knew it, and the simple fact of his statement was obvious enough to shame us.
‘Yes,’ Dr Ngema said. ‘Yes. We can all see that, I think.’
‘What would you like me to do?’ I asked quickly.
‘Take her this morning. I’ll stand by for you, Frank, while you’re gone. It’s better that we... yes. Yes. Let’s do it.’
She was talking calmly and carefully, but it wasn’t a happy moment. When she turned abruptly and walked back to the office I didn’t take up my usual place next to her, but lagged behind, a pace out of step. Laurence jumped in next to her.
‘Dr Ngema,’ he said. ‘Could I talk to you for a moment? I want to know what’s expected of me.’
‘What do you mean?’
‘What are my duties?’ he said cheerfully. ‘I’m keen to get started, you see.’
She didn’t answer immediately, but at the office door she turned to him. ‘You ride along with Frank,’ she said. ‘You might learn something.’
‘Okay.’
‘Yes,’ she said. ‘Frank is a very experienced doctor. You can learn a lot... from experienced people.’
It was the sharpest I’d ever seen her, but he seemed oblivious. He followed me like a puppy into the office, where Tehogo was sitting at the desk, staring darkly at the grain in the wood.
‘I’m taking that appendix patient to the other hospital,’ I said. ‘And Tehogo, you must write in the time on the chart. The other patient, the young man, can have solid food from tomorrow.’
‘Yes,’ Tehogo said, not looking up. He managed to make it sound as though he was granting permission. Nothing punctured his dour composure, not even surprise, but he did look startled for a moment when my new room-mate sprang at him, hand extended.
‘Hello,’ he said. ‘Pleased to meet you. My name’s Laurence Waters.’<
br />
I busied myself with routine and it was late morning already when we set out. The hospital owned one antiquated ambulance, though the official driver had long ago departed; whenever the ambulance was sent out, one of the doctors had to drive it. We put the woman into the back on a stretcher and I got into the driver’s seat. I expected Laurence to sit up in the front with me, but he got into the back with the patient and crouched over her with intense attention, like an owl over its prey.
‘Give her space to breathe,’ I said. ‘You’ll make her feel claustrophobic’
‘Sorry. Sorry.’ He pulled back, looking abashed, and I studied his broad face in the mirror. He seemed to wear a perpetual frown, as if one eternal question continually niggled at him.
I didn’t speak to him while I warmed the engine and then pulled out into the street. The town, with all its vacant, impressive space, passed slowly by. Then we were on the tributary road that led to the main road, and the bush pressed in on either side. Heat made the leaves blurred, like a solid wall you couldn’t penetrate. The road wandered between ridges and low hills. It was a hot, dense country, growing between extremes of brown grass and the brilliant green of riverine bush.
When I first got here I loved the landscape, the fertility and fecundity of it, the life it gave off. There were no bare places. Everything was shrouded in shoots and thorns and leaves; there were little paths running everywhere, made by animals or insects. The smells and colours were powerful. I used all my free time, hours and hours of it, to go off walking into the bush. I wanted to move closer to the lush heart of things. But over time what had compelled me most deeply began to show a different, hidden side. The vitality and heat became oppressive and somehow threatening. Nothing could be maintained here, nothing stayed the same. Metal started to corrode and rust, fabrics rotted, bright paint faded away. You could not clear a place in the forest and expect to find it again two weeks later.
When we got to the main road, the countryside changed around us: the bush was thinner here, there were more human settlements. Villages appeared on either side – congregations of huts, roofed conically in thatch and painted with bright designs. The ground was tramped hard and flat with use. The eyes of children or toiling men or idle old people watched us pass. Women stood up from scrappy fields of vegetables, hoe in hand.
