Cutting for Stone (10 page)

What he saw made him turn pale: the cervix was past grapefruit, on its way to melon. And there, as if at the bottom of a bloody well, was a baby's head, the tissues around it flattened. The fine wet black hair on the skull reflected the theater lights.

At that moment it was as if someone who'd lain dormant within Stone took over.

If there was a connection between him and the poor infant within, it was something that Stone didn't see. Instead, the sight of that skull agitated him. Fear was driven out by anger, and anger had its own perverted reasoning: What cheek this invader had to put Mary's life in jeopardy! It was as if he'd spotted the corpse of a burrowing mole that had attacked Mary's body, and the only way he could bring her relief was to extract it. The sight of that bright scalp wrought no tenderness from Thomas Stone, only revulsion. And it gave him an idea.

“Find the enemy and win the firefight” was a saying of his.

He had found the enemy.

“
F
latus,
F
luid,
F
eces,
F
oreign Body, and
F
etus feel better out than in,” he said aloud, as if he'd just invented the phrase. In his book he had called it the Five-F rule. He drove himself to his terrible decision. Far better, he decided, to drill a hole in the skull of the mole—he'd already stopped thinking of it as a baby—than to experiment on Sister Mary Joseph Praise by doing a Cesarean, an operation that was both unfamiliar and one that he feared would kill her in her fragile state. The enemy was more a foreign body, a cancer, than it was a fetus. No doubt the creature was dead. Yes, he would tap that skull, empty its contents, crush it just as if he were crushing a bladder stone, and then he'd pull out the deflated head which was the part that was hung up in the pelvis. If need be, he'd use scissors on its collarbones, scalpel on ribs; he would grab, slash, slit, and smash whatever fetal part obstructed delivery, because only by getting
it
out could Mary be out of her misery and the bleeding cease. Yes, yes—better out than in.

Within the boundaries of his irrational logic, this was a rational decision.
Doing the wrong thing to do the right thing,
as Sister Mary Joseph Praise might have said.

To a shocked and horrified Matron, the man who sat between Sister Mary Joseph Praise's legs didn't resemble
their
fierce, shy, and exceedingly competent Thomas Stone. This man had nothing in common with Thomas Stone, FRCS, author of
The Expedient Operator.
His place had been taken by this desperate, agitated fellow who did not look like a Fellow of the Royal College of Surgeons, but rather someone for whom the letters FRCS could mean (as Dr. Ghosh often claimed they did) “Farting Round the Country-Side.”

Stone, animated now, consumed by a sense of mission, propped
Munro Kerr's Operative Obstetrics
open, cookery-book fashion, on the down slope of Sister Mary Joseph Praise's protuberant belly. “Damn it, Hemlatha, you picked a hell of a time to be away,” he said aloud, feeling his courage return.

Two
blasphemies, Matron noted. “Custody of the tongue,” she murmured under her breath. She took her own pulse because despite her faith in the Lord she was anxious about the heart flutter that had turned up in the last year like a surprise guest. Her heart was skipping beats now and she felt faint.

The strange instruments that Stone had requested and that Matron dug up from an old supply closet refused to be tamed by his hands. “Where the devil is Ghosh?” he shouted, because Ghosh often pitched in to help Hema with abortions and tubal ligations, and, as a jack-of-all-trades, he had more experience with a women's reproductive anatomy than Stone. Matron once again sent a runner over to Ghosh's bungalow, more to placate Stone than with any faith that Ghosh was back. Perhaps she would have done better to send the maid to inquire at the Blue Nile Bar or its vicinity for the
banya
doctor. But even an inebriated Ghosh could counsel Stone that what he was about to do was not the act of an expedient surgeon but an idiotic one, and that his decision was wrong, his logic illogical. Matron felt this pregnancy, this birth, was somehow her fault—some inattention on her part had resulted in this. Still, she also assumed in the face of torrential bleeding that the child was long dead. Had she believed for a moment that the child was alive (she knew nothing about twins), she would have intervened.

Stone cocked his head from side to side, trying to match
Munro Kerr's
illustrations of instruments—Smellie scissors, Braun's cranioclast, Jar-dine's cephalotribe—with the objects he juggled in his hand. His tools were distant cousins of the ones depicted in the book, but clearly designed for the same sinister purpose.

With two Jacobs clamps, he grabbed the oval of my brother's scalp. “I see you in the depths, burrowing creature! Damn you for torturing Mary,” he muttered. Then, using scissors, he cut the skin between the two clamps and gave the intruder its first introduction to pain.

His next move was to try to put the cephalotribe—the skull crusher— on the head. This awkward medieval instrument had three separate pieces. The middle was a spear meant to go deep into the brain, cutting a big opening in the skull as it did so. Flanking it were two forcepslike structures to clamp to the outside of the skull. Once all three pieces were in place, their stems interlocked to form a single handle with convenient finger indentations. Stone would be able to crush
and
grip the skull so it wouldn't slide away. Out would come the intruder.

It was cool in the operating theater, but sweat from his brow trickled into his eyes and wet his mask.

He tried to drive the spear in.

(The child, my brother, Shiva, sheltered for eight months and already hurting from the cut of scissors on his scalp, cried out in the womb. I pulled him to safety as the spear slid over the skull.)

Stone decided it would be easier if he first applied the outer two blades of the cephalotribe,
then
dragged the head within reach, and
then
inserted the spear. His hands were clumsy in this awkward space. Matron shuddered at the damage he might be doing to Sister Mary Joseph Praise's tissues and to the baby as he jammed each piece past an ear until, finally, he had the skull in his grasp, or thought he did.

Matron was close to dropping. “It is the duty of the nurse to assist and anticipate the doctor's every need.” Wasn't this what she herself preached to her probationers? But it was all wrong, all wrong, and she didn't know how to begin to turn it around. She was sorry she ever dug out the instruments. A humane obstetrician invented these instruments for mothers with the most desperate needs, not for desperate physicians. A fool with a tool is still a fool. In Stone's hands the instruments had taken over, and they were doing the thinking for him. Matron knew that nothing good could ever come out of that.

CHAPTER 5
Last Moments

A
T THE VERY LAST SECOND,
just as she braced for the plane to smash into the water, Dr. Hemlatha saw the ocean give way to dry scrubland.

And before she could digest this, the plane flared to a touchdown over shimmering asphalt, squealing its tires, wiggling its tail, and, when it bled off its speed, scampering down the runway like a dog unleashed.

The passengers’ relief turned to bewilderment and embarrassment, for the most godless among them had prayed for divine intervention.

The plane stopped, but the pilot continued arguing with the tower while dragging on a cigarette, even though he had made a big point of turning on the
NO SMOKING
light after they landed.

The little boy whimpered, and Hema rocked him with an adeptness she didn't know she possessed. “I'm going to put a
tiny, tiny
bandage on your leg, okay? Then the hurt will be all gone.” The young Armenian somehow found a cane, and the two of them fashioned a splint.

When the throb of the engine ceased, Hema felt the silence within the cabin press on her eardrums. The pilot looked around, a smirk on his face, as if he were curious to see how his passengers had held up. Almost as an afterthought, he said, “We are stopping to pick up some bagg-aje and some Very Important People. This is Djibouti!” He smiled and showed his bad teeth. “They did not give me permission to land unless it is emergency. So I make an engine failure.” He shrugged as if modesty prevented him from accepting their accolades.

Hemlatha was startled to hear her own voice shatter the silence.

“Baggage? You bloody mercenary. What do you think we are? Goats? You just shut down an engine and drop out of the sky like that and stop in Djibouti? No warning? Nothing?”

Perhaps she should have been grateful to him, happy to be alive, but in the hierarchy of her emotions, anger was always trumps.

“Bloody?”
the pilot said, turning red. “Bloody?” he said, clambering out of the cockpit, white knees knocking under his safari shorts, as he struggled free.

He stood before her, huffing from the effort. He seemed to take far more exception to “bloody” than “mercenary.” His contempt for this Indian woman was greater than his anger. But he had raised his hand. “I will offload you here, insolent woman, if you don't like it.” Later he would claim that he had raised his hand merely as a gesture, with no intent to strike her—God forbid that he, a gentleman, a Frenchman, would strike a woman.

But it was too late, because Hemlatha felt her limbs move as if by their own volition, fueled by anger and indignation. She felt as if she were observing the actions of a stranger, of a Hemlatha who had not previously existed. The new Hemlatha, whose license on life had just been renewed and its purpose defined, came to her feet. She was as tall as the pilot. She could see the tiny feeder vessel in the starburst on his left cheek. She pushed her glasses up on her forehead and met him eyeball to eyeball.

The man squirmed. He saw she was beautiful. He fancied himself a lady's man, and he wondered if he'd blown the opportunity to have drinks with her at the Ghion Hotel that evening. Only now did he notice the people huddled over the whimpering boy. Only now did he notice the father's rage, and the clenched fists of some of the other passengers who had lined up behind her.

What a specimen, Hema thought as she studied him. Spider angiomas all over his exposed skin. Eyes tinged with jaundice. No doubt his breasts are enlarged, his armpits hairless, and his testes shriveled to the size of walnuts—all because his liver no longer detoxifies the estrogen a male normally produces. And the stale juniper-berry breath. Ah yes, she thought, coming to a diagnosis beyond cirrhosis: a gin-soaked colonial resisting the reality of postcolonial Africa. If in India they still are cowed by all of you, it is from long habit. But there are no such rules on an Ethiopian plane.

She felt her rage boil over, and it was directed not just at him but at
all
men, every man who in the Government General Hospital in India had pushed her around, taken her for granted, punished her for being a woman, played with her hours and her schedule, transferred her here and there without so much as a please or by-your-leave.

Her proximity to him, her encroachment of sacred
bawana
space, rattled him, distracted him. But his hand was still up there. And now, as if he just noticed it, he moved the hand, not to strike her, he would claim, but as if to determine whether it really was his hand and to see if it still answered to his commands.

The upraised hand was insult enough, but when Hema saw it start to move, she reacted in a manner that made her blush when she recalled it later.

Hemlatha's fingers shot up the pilot's shorts and locked around his testicles, only his underwear intervening. There was an ease to her movements which surprised her, and an ease to the way the gap between her thumbs and index fingers allowed passage for the spermatic cords that connected balls to body. Years later she would think that what she did was conditioned by her surroundings, by the propensity in East Africa for
shiftas
and other criminals to lop off their victims’ testicles.
When in Rome…

Her eyes burned like a martyr's. Sweat changed
the pottu
on her forehead from a dot to an exclamation mark. She had worn a cotton sari for the heat, and earlier, when she had been seated, she had hiked it to her knees—modesty be damned—and now that she was standing it stayed that way, outlining her thighs. Sweat glistened on her upper lip as she squeezed to extract the same measure of distress and fear the Frenchman had caused her.

“Listen, sweetie,” she said (deciding that there was indeed testicular atrophy and also trying to recall
tunica albugineae,
and
tunica
something else, and vas deferens, of course, and that craggy thingy at the back, whatsitcalled … epididymis!). She saw his shoulders sag and the color drain out of his face as if she'd opened the spigot below. Dampness quite different from sweat appeared on his forehead. “At least your syphilis isn't far advanced because you can feel testicular pain, huh?” His upraised hand came floating down and then hesitantly, almost lovingly rested on her forearm, pleading with her not to increase the pressure. A cathedral of silence descended on the plane.

“Are you listening now?” she said (thinking that she didn't really want to know a man's anatomy this way). “Are we talking as equals? … My life in your hands and now your family jewels in mine? You think you can terrify people like that? That little boy broke his leg because of your stunt.”

She turned her head toward the other passengers but, keeping her eye on Frenchie's face, said, “Anybody have a sharp knife? Or a Gillette?”

The rustle she heard might just have been the cremaster muscles of all the males on board involuntarily reeling their dangling sperm factories back up to shelter.

“We were unauthorized … I had to …,” the pilot wheezed.

“Take your wallet out right now and pay for this child,” Hema said, because she didn't believe in IOUs.

When he fumbled with the notes, the young Armenian grabbed the wallet and handed it to the boy's father.

One of the Yemenis, finding his voice, let out a stream of profanities, wagging his finger in the pilot's face.

Hema said, “Now, you refund the plane tickets for the boy and his parents. And you get us back in the air very soon, … otherwise, you will not only be a eunuch, but I will personally petition the Emperor to make sure that even a job as a camel driver, let alone flying khat, will be much too good for you.”

They heard the cargo door open and sharp exclamations from the coolies milling around outside.

The Frenchman, his eyeballs sinking in their sockets, nodded mutely. France had colonized Djibouti and parts of Somalia, and they had even jockeyed with the English in India before settling for a foothold in Pon di cherry But on this steamy afternoon, one brown soul who would never be the same again, and who had Malayalis, Armenians, Greeks, and Yemenis backing her, showed she was free.

“Well, how can one be sane in hot weather?” Hemlatha said to no one in particular, letting go and making for the outside to wash her hands, stifling her laughter.