MAYA HOPE, a medical thriller - The Dr. Nicklaus Hart series 1

by Timothy Browne, MD

  Charles got the feeling that this was a required part of their visit when the sullen man behind the girl deepened his glare. Charles was tired. He was not interested in gigantic statues of dead guys. Not only was he jet-lagged, he was extremely hung over from the party on the plane.

  Man, what I would do for a score of snort.

  He had cut a line in Beijing before they left for North Korea, but had been warned countless times about misbehaving in North Korea and ending up in one of the rumored gulag camps and tortured. The State Department guy was dead serious. Charles had left the remainder of the coke behind.

  Man, what a headache.

  But he needed this trip. He was a quarter million dollars behind on his taxes, with no relief in sight. Oakland told the press the players and staff were doing this for goodwill, but no one in this group did anything for free. It was how they rolled. The 50,000 dollars he was promised was not much, but better than a kick in the shorts. It was the 100,000-dollar bonus that had gotten his attention.

  Charles patted the front pocket of his suit to make sure the envelope and small metal box were there. He thought back to how he got to this place.

  * * *

  It had started when he was at the gym getting into reasonable shape for these games and a man approached him. Dressed in a casual jogging suit, the small, oriental man confronted him as he sat alone at the bench press.

  “Charles Hall?”

  “Yeah, what about it?”

  This man did not look like a cop.

  “I have a business proposal for you that I think you will like.”

  “Oh really? You a fag or something?”

  The man was neither intimidated nor deterred. “Mr. Hall, let me be brief. I know of your many problems.” He paused to let Charles catch up. “I have a very simple request that could put a dent in your debt.”

  He paused again to let the big man comprehend. “Something so simple, even you, Mr. Hall, could do.” He glared into Charles’s eyes to let him know who was in control.

  Charles nodded.

  “In the next few days, before you go to North Korea, I will give you an envelope and a small package that—”

  “Hey, dude, how do you know I’m going to North Korea? I haven’t even decided for sure myself.”

  “I think once you hear my offer, you will not have a difficult time with your decision.”

  * * *

  Charles returned to the present when the woman guide ordered the men in the bus to stand and prepare to unload.

  Man, oh man! She’ll make someone a good wife someday. Nasty little Nazi woman!

  He stood with the rest of the rag-tag team. He knew he was on his way to becoming a has-been, and the parties and coke didn’t help. At least the organizers told them the games would be a joke, and they were expected, no, required to lose. The whole saving-face thing.

  But for him, relief was in sight. He patted the package in his pocket.

  CHAPTER 16

  * * *

  Day One

  Nick was already sweating, and it was only his first hour in the Guatemalan clinic. He hadn’t thought much beyond seeing Maggie on this visit, but this was the furthest thing from his mind. He couldn’t resist Maggie’s plea to see a few patients.

  We have different ideas of a few. He sweated even more thinking of the long line of people waiting to see him.

  A wrinkled old woman sitting across from him beamed a toothless grin. She alternated between clapping her hands and holding Nick’s arm, all the while chattering in Spanish.

  “Dios te bendiga, Dios te bendiga.”

  Nick looked at Anna from Alabama—his new shadow and translator sitting next to him. She had been in Guatemala for five weeks with a group of young adults from a church in northern California.

  “She is saying, ‘God bless you.’ ” Anna smiled at him as the woman continued to jabber.

  “She wants me to tell you that you are a good man, and God will richly bless you and your family.”

  Anna leaned closer to the woman, trying to catch all her words. The woman kept raising one hand to the heavens and patting Nick’s arm with the other.

  “She wants to know where your wife is and how many children you have and she says ‘God bless you. Thank you for coming to Guatemala.’ ”

  Using the universal sign language, Anna finally told the woman to slow down, but she continued to chatter in Spanish, then leaned over and kissed Nick’s hands over and over again.

  “Thank you, thank you,” Nick said reassuringly, trying to squelch her enthusiasm by gently pulling his hands away.

  “Ask her how I can help her,” he pleaded with Anna. This was awkward; Nick had never worked through a translator.

  “Abuelita, Abuelita,” Anna said, still trying to slow the little grandmother. She leaned toward her and patted her arm affectionately to get her to focus.

  The woman began a highly animated story, talking with her hands as much as with her mouth. The story went on and on. Nick was getting anxious; he looked through the doorway of the small clinic room. He could see the long line of patients snaking through the courtyard and out the gate.

  Yikes, this might be a long day.

  Nick watched Anna talk with the woman. She caught his glance and smiled at him. He liked her already. She had bright blue, clear eyes and golden blond hair. Her royal blue scrubs complemented her eyes and fit snuggly around her shapely body. Judging from her translations, he thought she spoke incredibly good Spanish.

  He and Anna sat in old plastic deck chairs that were already uncomfortable. The woman continued her story. She clasped her shoulder and tried lifting her arm above her head, but could only raise it to shoulder level.

  Nick understood a few words here and there that were similar in English, and he nodded.

  “How long has her shoulder bothered her?” he asked Anna.

  Anna was surprised at his question, knowing he didn’t speak Spanish.

  “I’ve been doing this a few years,” he said.

  She smiled at him.

  “Ask her how she hurt her shoulder.”

  Anna asked, prompting a brand new, dramatic story from the woman—a very long story.

  Anna related the tale about a bus and the market and going to get fruit for her grandchildren. She had seven children and twenty-two grandchildren and eight great-grandchildren.

  Nick sighed, ran his fingers through his hair, and pushed it back.

  Anna saw Nick’s impatience and mouthed sorry to him.

  “It’s okay, let’s try another way. Ask her what she can’t do and what she would like to do.”

  Anna looked him in the eyes. “I tell you what, Dr. Hart. Let’s do this.” She hesitated, hoping not to step out of bounds because she realized they were in for a long day. “Just think of me as the Google translator on your phone. Talk to the patient like you normally would, and I’ll automatically translate for you.”

  He smiled at Anna, leaned toward the grandmother, and spoke directly to her. “What can you not do because of your shoulder?”

  Anna translated almost simultaneously.

  The woman responded with a calm, measured explanation.

  “Smart girl,” Nick whispered to Anna.

  She put up her hand to silence Nick and leaned closer to the woman to catch all her words, smiling gently.

  Love the spunk. And nice to look at, he thought, admiring how Anna’s form filled out her scrubs.

  “I have a hard time with firewood,” Anna translated. The woman’s demeanor changed rapidly as she held her shoulder and looked pained and discouraged.

  Nick leaned back in his chair to consider the problem. The grandmother was dressed in a clean, respectable, church-going dress and a colorful apron with large pockets. She smelled strongly of smoke.

  “They cook with wood,” Anna said, as she studied him, seeming to read his mind.

  Nick smiled at Anna again. “You ever watch ‘MASH’?”

  “You mean the old TV show?
No, but my papa did all the time. Why?”

  “I’m going to call you Radar.” He suddenly realized that he could be her father’s age. That sobered him up and turned his mind on task.

  Anna raised her eyebrows in question.

  “I’ll explain later,” he said turning back to the old woman.

  “You can’t carry the wood here in front of you?” Nick asked holding both arms in front of him like he was carrying a small bundle of wood. He couldn’t imagine why this eighty-seven-year-old would carry any wood with all those children and grandchildren to help.

  Anna continued to translate: “I can’t gather the wood any more and it is my job.”

  “I guess I don’t understand. She obviously has a rotator cuff tear, but people can usually carry things in front of them.” He held out his arms again.

  Anna continued to question. A large tear ran down the woman’s face.

  It was Anna’s turn to sit back in her chair. “She can no longer gather firewood because she cannot climb the trees to gather it.” She turned to Nick. “You see, Dr. Hart, the country is so deforested that if you live close to the city, you are forced to climb tall trees to cut branches.” She shook her head. “These are very poor people.”

  Nick saw Anna’s compassion. He nodded. The old woman looked inquisitively at Nick, pleading for an answer.

  “You have a tear of one of the main tendons in your shoulder,” he told her and patted her hand.

  “She is asking what you can do for her?”

  He suddenly realized that everything was happening so fast, he hadn’t asked Maggie what to do if he wanted to operate on someone or even if he could.

  Geez, what about x-rays?

  “I suppose you didn’t bring an MRI scanner from Alabama, did you?” Nick quipped. That was the first thing he would do back home to evaluate the size of the rotator cuff tear. He couldn’t believe he actually missed the MED.

  Anna frowned.

  “Well, tell her that I am going to talk with the Director of the Hope Center and see what we can do.”

  When Anna told her, it was as if the old woman had won the lottery. She began praising God and kissing Nick’s hands.

  “Okay, okay,” Nick stood up and held out his hands to help the woman up. “Tell her there are no guarantees. I still have to look into it.”

  As he walked her to the door, he noticed how short she was, how old age had reduced her height well below five feet. She tenderly patted Nick, reaching out to him with her good arm.

  “Dios te bendiga. Dios te bendiga,” she said and left the clinic room.

  * * *

  After seeing a number of people with low back pain, an old machete wound to the forearm, and a woman with bad rheumatoid arthritis, Nick and Anna settled into a comfortable flow. There was not much he was able to do for many of the patients, except to suggest a few exercises and to provide some reassurance.

  He looked up and smiled as Maggie walked through the door. Behind her was a young woman in a colorful embroidered skirt and top.

  “El Doctor. How’s it going?” Maggie smiled at Nick. “You tired yet?”

  “Just another day at the ol’ office.” He rolled his eyes around the sparsely appointed room.

  “You get paid in any chickens yet?” she teased.

  “Hey, I need to ask you about what to do about any surgical cases.”

  “Aha! I wondered when you’d ask. I can’t wait to show you John’s operating room. I know you probably feel like you have fallen off the edge of the world, but I think you will be pleasantly surprised at our abilities. You know John,” she smiled.

  Nick nodded at the girl standing silently behind Maggie. She carried a small bundle of what appeared to be blankets, and kept her gaze locked on the floor.

  “Who’s your friend?” Nick asked.

  Maggie turned and put her arm around the girl, encouraging her to move closer to Nick and Anna. She gently swept the girl’s black hair out of her face and whispered to her. The girl shook her head and tightened her grip on the bundle.

  “This is precious Elena, and she has something she wants to show you.”

  Maggie kept her arm around Elena’s waist to keep her from bolting. She talked with the girl and tugged at the bundle.

  Anna went to the girl and put a hand on her shoulder. She spoke to her in Spanish; she said something about Nick. Elena looked at Anna and then shyly at Nick. With a sigh of resignation, she unwrapped her bundle. One blanket, then two, then a third, until a tiny little face appeared and whimpered.

  Elena stared at the newborn.

  “One of the ladies from the local Catholic church found them on the side of the road last night,” Maggie explained. “She had recently given birth and was lying in the ditch. The baby was found naked a few steps away. Thank God that it was not very cold last night. Elena will not tell us what happened to her. I can only imagine. It has taken us most of the morning to get her name and convince her to let us clean them up and feed the baby.”

  Anna spoke with Elena who responded to her, perhaps because Anna was only a few years older. Anna asked if she could touch the baby, and the girl held the baby toward her.

  Anna gently touched the baby’s cheek, ran her finger over its eyebrows, and felt its fine black hair. “She’s beautiful. ¡Qué milagro que es!,” she told Elena and translated for Nick: “What a miracle she is.”

  Anna stroked Elena’s hair, and the small Guatemalan girl wept. Maggie still had her arm around Elena and gently kissed her forehead. By now, all three women were crying. Nick swallowed hard. He almost said something and then held his tongue.

  Maggie finally looked at Nick. “We’ll probably get the full story over time. Obviously, an unexpected pregnancy; probably rape or incest or some terrible injustice is what we usually find in these cases,” She knew the girl spoke no English.

  “You mean there are others?”

  Maggie sighed. “Welcome to the jungle, Dr. Hart.”

  Nick shook his head, but wondered why they were showing him this heartache.

  “Can you look at the baby’s hands?” Maggie asked, moving the blankets enough to show the tiny arms and hands.

  Nick looked at the young mother and held out his hands toward the baby as if to say, Is it all right if I touch your baby?

  Elena understood and held the baby toward Nick. The baby really was beautiful. Thick, jet-black hair, and tiny features. She still had white vernix at the corners of her nose and in the folds of her ears. They missed cleaning a bit of the waxy material that covers most babies when they are born. This one looked remarkably healthy for being born prematurely and found naked in a ditch.

  Then the baby started to fuss at being uncovered and handled.

  Nick held one tiny hand and then the other. They were doll hands, dwarfed in his. Nick counted four fingers and a thumb on each hand.

  Beautiful.

  But as he tried to separate the fingers, he saw the problem. Syndactyly. Each finger was joined to the next by thin sheets of skin.

  “Hmmm,” he said and looked at the mother’s face. A large tear rolled down her cheek.

  Nick studied the baby’s fingers. There were many different types of syndactyly, some with webbing between the fingers and others much more complicated that involved the bones. He was glad to see that the baby had the simplest form.

  “Well, the good news is,” Nick started, “the syndactyly is fairly simple, and I think we could separate the fingers relatively easily, in a month or so. We need to put a little weight on this nipper before we give her an anesthetic.” He smiled at Elena.

  Maggie translated Nick’s words for Elena. “You have a beautiful baby, and you are a beautiful girl. The doctor will fix your baby’s hands, and they will be a good as new. You will stay here at the Hope Center with us.”

  Nick could tell that Maggie was embellishing his words to encourage Elena.

  Maggie stroked the girl’s hair like a loving mother. “Oh my dear, I am so sorry this happ
ened to you, but God has given you a great gift.”

  The girl wept and spoke for the first time. “But God is mad at me for having this baby. See? Look at her fingers.”

  Anna continued to translate the conversation for Nick.

  “Oh, Elena, God is not like that. He loves you and brought you here to us,” Maggie assured her.

  Anna added, “You will see. You will know that God loves you. We love you already, and we hardly know you. God knows every hair on your precious head. He loves every part of you, and He loves your baby.”

  Maggie held Elena’s cheeks. “Oh my dear child. I am so glad you are here!” She wrapped her arms around both mother and child as the girl sobbed.

  Nick watched them all wipe tears from their eyes and, growing uncomfortable, he pushed on his sternum.

  CHAPTER 17

  * * *

  School Begins

  Nick couldn’t explain the feeling except that it felt like freedom. Something similar to what he remembered at the start of college spring break. Maybe it was the young men tossing the football in front of him or the group of young men and women sitting around him that filled the atmosphere with chatter and laughter, creating an almost festive atmosphere.

  Nick and Anna sat on a picnic table outside the clinic in an area of randomly grouped picnic tables shaded by palm and banana trees. The day was warm with a fair amount of humidity, stirred by tropical breezes. Birds with a multitude of shapes, sizes and colors darted in and out of the trees, serenading their lunch break.

  He should feel anxious about the significant amount of trauma and heartache he had already seen in one short morning. It was an overwhelming amount of orthopedic pathology. Untreated broken arms and legs had left patients with deformed and disabling injuries. Maybe they brought all the really hard cases first?

  In spite of the difficult procedures, he felt a curious peace deep inside.

  Nick was accustomed to witnessing acute trauma, but what he’d already seen was altogether different. Back at the MED, he patched people up and sent them on their way. Once their fractures and wounds healed, he rarely saw them again. Here, he’d been dropped into a reality where suffering people could not afford to pay for treatment, and in some cases, treatment was not available. These were terrible odds; nevertheless, Nick connected to the simple and joyous rhythm of life.