Bloodletting and Miraculous Cures (21 page)

It's stronger, squeezing at me. It has its own force, but stop! Stop! Why don't they turn down that monitor—that noise is like mourning.

60

50

NO VALUE

NO VALUE

50

60

My womb is choking my baby. Dr. Ming, why is she standing there?

“You don't need the anaesthetist,” said Janice.

She looks at me like I'm crazy, but like I've saved her.

“Do you?” she continued. “To cut me open?”

I'll pretend I'm not here. I'll just pretend that it's over already. That I only exist in the future.

“Get any of them,” said Dr. Ming. “Someone run and find an anaesthetist.”

“Just give me the laughing gas. There's no time, is there?” said Janice.

“You need more than that. There's no time for a spinal, we need them to knock you out.”

“The actual operation—you can do it even if I'm awake, right?”

Why do I feel calm, having said that? It's me asking, that's why. No—not asking, I've made my offer.

No one moved.

“They call it a Caesarean section,” said Dr. Ming, “because it comes from the time of the Caesars in Rome. They used to tie the woman down.”

 

So simple, that this doctor will cut me open and pull out my baby, who will cry. Then she will stitch me up again like a universe that has exploded from a dense star and then billions of years later condenses into a black hole.

“Get the nitrous,” said Dr. Ming. Her eyes did not meet Janice's. “And six of morphine. Give me a fifty-mil syringe of lidocaine.” She looked at Janice and said, “Breathe the gas deeply. I'll freeze the skin. We can't stop once we start.”

Who is that nodding? It's me.

Dr. Ming ran the long heavy needle under the skin at the incision line, made it swell with lidocaine like a sausage.

The laughing gas, which smells like clouds. A rush of warmth with the morphine injection. It's like a blanket through the intravenous. That jab in my skin—freezing. Why do they call it freezing when it burns, when it's hot like a brand on my stomach? Dr. Ming is picking up a knife. They call them scalpels, to make it official. I'm glad it's her. Why? Because she felt the cord—she knows it's there. She's cutting, I can see her stroking the blade into me.

It's true, the skin is frozen.

Oh.

It doesn't freeze deep, does it?

She's cutting muscle, the blade deep inside me now.

My mouth dry, throat too tight to yell.

Breathe the gas.

Where is the clock?

How long? I can't see the time.

The ring of operating lights is like suns, and moons, and stars, blinding me.

 

Dr. Ming operated quickly, methodically, as if she were alone in the room. A nurse assisted, pulled on spreaders, pushed on the belly as they slipped instruments through the layers of a woman. Dr. Ming directed the operation in short, tight phrases, and silence roared through the operating room. Her movements were fluid, and violent in the speed of cutting the uterus itself.

 

I need to let go, I may be close to evaporating, vanishing.

What is that noise?

Ripped open.

Myself screaming.

That's what it is—to hear my voice truly for the first time.

But, strangely, as if it's someone else.

The room black and swirling, where are the lights?

The strange beach.

The waves are going to crash over me, drown me. Why can't I move?

Foamed tops of breakers swirled high in front of Janice. The water rushed around her head, which lay heavy and aching on the wet beach. The sea pushed forward—hissing along the beach—and as the water fell back in a desperate clamber into the ocean, it dug a trench in the shape of her body around her, into the sand. Deeper, her shoulder blades seemed to settle like broken wings in the warm slurry. Her buttocks were heavy. Water ran around their edges to hollow out bowls for her flesh. She felt as if her balance had shifted, as if there were gravity lower within her that had been removed, lightened, now replaced by a searing torn-open pain. She tried to feel her belly, but found that she could not move her arms. Now the water fell over her, lifted her into a wave free and churning, and threw her tumbling into its froth of bubbles.

 

Janice saw hands flutter and whirl in the hard sun of operating lamps that shone on her belly. The soft, flat white of the gloves was streaked with red, and the fingers themselves beat like wings. One of the hands held a metal claw that descended into her belly with a needle, stung it, and then flew upward to pull the thread tight. The other hand flew around this thread to tie it, the fingers grasping and tying the thread like the movement of a bird's nest-building.

“I'm closing you,” said Dr. Ming.

Janice heard a sputtering, protesting cry. She turned, and glimpsed the exultant blood-smeared child between the green-mantled shoulders of those around the baby-warmer. As Dr. Ming began the last layer of closure, Janice no longer felt pain, because this outermost skin was frozen.

 

NIGHT FLIGHT

December 9, 17:45 EST—Toronto

My phone rings at home, waking me from sleep. It's dispatch in Calgary.

“Dr. Fitzgerald speaking.” I clear my throat.

“Dr. F? Be at the hangar at six-thirty. I'm faxing you the flight plan.”

As we talk, it spools out of my fax machine: 19:00—depart Toronto, 22:45—Tampa for fuel, 1:50—St. Therese, Guatemala. Local ambulance to the hospital, rapid assessment, grab the patient and
go. 3:20—takeoff from St. Therese. Tampa fuel stop, then the hop to Toronto.

“What's the rush? Ninety minutes ground time?”

“The St. Therese airport closes at 3:30 EST, 2:30 local.”

“Can't fly tomorrow, huh? I just got in from Thailand a few hours ago.” I had a little nip this morning to settle my nerves, then slept through the day. Now I am jittery and dazed, both from sleep disruption and from needing an eye-opener.

“Flight's booked, Dr. F.”

I have given up trying to understand the scheduling of flights. Sometimes we need to fly sooner than a competitor, sometimes it is a rush to get the plane back for another job, sometimes it is an insurance company's whim. I rummage for fresh underwear and socks and pull on my uniform, which is stale and crumpled over the chair where I left it this morning. In the blue flight suit is my passport, stethoscope, PDA, wallet, sunglasses, and my folded wad of emergency U.S. dollars, which I keep cellophane-wrapped in the inside zippered pocket. With a small funnel, I fill my hip flask with vodka. I pocket a fresh package of strong mint chewing gum. I close the vodka bottle.

I reopen the bottle, take a sip before putting it away, feel a bit better already. Just another little sip. Better not overdo it before driving, even if the flight doctor uniform carries some pull with the highway cops.

19:10 EST

I'm in the four-foot-wide back seat of the Lear 35. Our planes are kept in a side hangar attached to Pearson International, three highway exits west of the passenger terminals.

“We're supposed to be wheels-up at nineteen hundred,” says Niki, fidgeting. We often fly together, and I like Niki because she watches the details. “Already ten minutes behind schedule, Dr. Fitz,” she says. She's in the forward seat, next to the stretcher. Behind me, the cargo bay is tight with flight and medical bags. The plane jitters and bounces out of the hangar, ungainly as it turns onto the taxiway. I slip out the flask and take a real slug. It's a good warmth, and I'll be dry by the time we get to Guatemala. The other thing I like is that Niki's not one to say anything.

In front, the pilots activate switches and speak into their headset microphones. Their hands slip back and forth across the glowing instrument panels. The jets' vibration soothes and surrounds the plane, and frozen rain shatters the black of night. A storm's coming—this sleet that blows in from Lake Ontario. I stuff a pillow under the small of my back, a smooth miniature airplane pillow. I belt myself in snugly, the secure feeling of pulling the strap tight. I close my eyes as the plane comes to life at the end of the runway. I'm tired. I slept four hours after getting back from Chiang Mai this morning. Open my eyes again. Another little sip, I deserve it.

Marcus, the pilot, used to fly CF-18s but his wife got sick of living in Goose Bay. The co-pilot, Rafael, speaks Spanish, which is good for a Guatemala run. We taxi to our runway. The pilots have their posture of relaxed focus before takeoff.

Acceleration and disequilibrium come instantly in a drugged moment. The jets roar in thrust down the tarmac, jolt through tens of seconds, the nose lifts, back wheels drag for a moment, and then with a sudden calm we ascend the sky. I am sleepy. The earth shrinks and drops—a camera panning out. I used to watch the cities as we took off, tried to spot their monuments, trace their watercourses. Then I discovered this moment, the powerful sedative effect of hurtling down the runway followed by the sudden forceful calm of pushing up into sky. Takeoff has become one of my sleep drugs, especially in the Lear, where the back seat is a few feet from the fuel tornado urging us forward. I breathe slowly, fade away, and am out before we reach cruising altitude.

 

21:55 EST

A loss of altitude wakes me. How does my body know? We drop through cloud cover over Tampa. The land mass sparkles with electric light, and the water around coastal Florida is a dark, geographical shadow.

Night over Tampa, coming in for fuel. I like to be awake for landings. I don't expect disaster, but statistically it's upon landing that we're most likely to spin
into a ball of flame. I would like to experience that rare moment, to have the privilege of my last thought. A routine of acknowledging these small probabilities reassures me. Marcus is flying. He's slick—was trained to land on aircraft carriers—but I like to be awake.

“Dispatch says the patient had a stroke,” says Niki over the deep exhaling vibration of the wings. The flaps point down, poised to lose speed and altitude.

“Info is from the wife?” I ask.

“Here's what we have,” she says, and hands me the run sheet.

A handwritten note, rendered into brown pixels by a fax machine, reads:

 

Dear Sir/Madam,

Here is a summary of recent events concerning my husband, Franklin, which I hope is helpful. December 3: dizzy, bad headache, then got better. December 4: the hotel doctor came, and Franklin was feeling fine. December 5: so dizzy he couldn't walk, had a worse headache, doctor came, sent him to hospital. Diagnosed with stroke. Then got worse and very confused. December 7: he went to sleep, they said a coma, and a breathing tube was put in. Now they say he's stable but they can't help him.

I look forward to seeing you. Many thanks in advance for your help,

Mrs. Amiel

“This is all we have,” I say.

“And you've heard about the airport?” says Niki.

“Closes at 2:30 local. They won't wait for us, huh?”

“Adamant. They close, and we've got to be in the air or we're stuck.”

I read the fax again.

“Bet it's a bleed,” I say.

“Can't tell from that,” says Niki, putting up a palm in protest. “Don't be a jinx.”

I actually prefer flight evacuation's lack of information. It means that there are fewer options, and it's all about a simple goal: to collect the patient in Location A and deliver him, alive and hopefully not worse, to Location B. We don't claim to fix anyone, or to know more than we can. Not like at the hospital, where everyone must pretend to know more than everyone else, and no one can mind their own business.

“Doesn't matter, we're going to get him,” I say. We descend until we're alongside an elevated Florida over-pass. The night is an orange haze of city glow. For a moment, the plane skims through the air at the same height as a transport truck on the freeway, and then we drop to the ground.

Out of the plane. First, to the washroom to pee. We clear American customs as the fuel truck rolls up, warning light flashing. The airport caterer arrives on an electric golf cart with our dinner. Dispatch has ordered us the trays of big, hand-filling sandwiches, and pickles, and coleslaw, and white chocolates in the shape of
fighter planes all nestled in a bed of tough, bright green lettuce. Can't eat the stuff—it's like paper, simply live packaging to keep the sandwiches fresh. Our flight number is on the cellophane wrappers, and no one is hungry so we put the trays on the floor in the back.

I'm tempted by the flask. Sip just a little. Better watch it, we'll be there soon. The moment of takeoff puts me to sleep. It's something about being pushed back into the seat by the strong hand of exaggerated gravity.

 

1:55 EST

Descent into St. Therese, a mountain town. It's a steep landing, and Rafael says to hold on, he's flying by instrument. We bank, circle around to get the right approach, the yellow airstrip lights twinkling in the distance like stars turned upside down.

As we descend, I see a cloud of red light to the right of the plane. It is smoke in luminescent red globes, hot and bright from below. Like the earth cracking, opening, and venting anger.

“Fire,” I say to Niki.

“Seventy minutes on the ground,” she says, looking out the window. “It won't get to the strip.”

Neither of us knows a thing about judging distances from the air, about the influence of wind upon flame, or about forest fires in Guatemala. The glowing red clouds roll like fog over the ground. Our plane drops into a cleft in the earth, and the clouds disappear behind the opaque shoulder of a mountain ridge
that blocks the burning forest light as we fall toward the airstrip.

“We're down to seventy?” I ask.

Now the landing lights rush beneath us. There is the roar of slowing, the jolt of wheels on asphalt, and the scale of objects becomes human as if we just woke from a dream. At the end of the taxiway is a brilliant bank of floodlights. We swing around sharply toward it. The ambulance is parked just off from the hangar.

Niki says to Rafael, “Find out about the fire, but not until Dr. Fitzgerald and I are on our way to the hospital.”

“We will assess the situation,” says Rafael. “We will discuss it if it seems right.”

Marcus winks and says, “We're not going to get stuck here, so hurry back, boys and girls.”

“Radio if we need to get back fast,” I say.

Niki rotates the handle to release the doors, whose halves swing up and down like a jaw. A man in uniform stands next to a man in a cream-coloured shirt that is loose at the waist. The ambulance backs up toward the plane, beeping and flashing.

The man in the ironed cream shirt says, “Dr. Fitzgerald? I am Garcia.” Dispatch had given us his name. He is our facilitator. The air is damp with a fine, clear smell of wet leaves. Also, I think, a hint of burned cake. Birds wheel and dive over the plane. Excited, they circle and snap. “You must go quickly. The airport will close soon, and they will turn off the lights,” says Garcia, pointing to the orange globes along the airstrip.

“Are they always like this?” I ask as I haul out the heavy drug bag. He looks at me, and I realize the pointlessness of my question. I decide to gesture to the birds, “The birds, are they always like this?”

Garcia repeats my question in Spanish. He and the man in the uniform laugh.

“Amigo,” says the man in uniform, “they are bats.”

Garcia says, “The insects love airplanes. They swarm around when the jets land and the bats go crazy.”

The uniformed man takes our passports. He slips them into his shirt pocket, smiles, and flicks his wrist to wave us on. Instinctively, I fondle my emergency wad of American cash—my security blanket. From where we are on the ground, surrounded by the shadows of mountains, there is no fire. We load our stretcher into the ambulance, then the drug bag, portable monitor, hospital bag, airway bag, vent bag, field radio, Garcia, Niki, and myself. Garcia pulls shut the back door. We jolt as it clatters away, and no one has said a word about the flames.