Cutting for Stone (58 page)

“And the second was your book, with that bookmark inside. I didn't know how he got it, or how long he had it. I didn't even know you had written a book. The book was hardly opened. I don't think Shiva ever read it, certainly not like he devoured his
Gray's.
He probably saw and read the bookmark. But you have to know Shiva. He wouldn't be curious about the bookmark or the letter she referred to. Shiva lives in the now. I don't know just how he got the book or why he wanted to give it to me.”

Stone remained silent, his gaze on the empty basket between us, as if it stood in for all that was unknown about his past, our past. His look of pain was so intense, it pierced me. “I can ask him,” I offered. I wanted to know just as much as Thomas Stone did. “I will ask him,” I said.

Thomas Stone was a world away. When he lifted his gaze, I understood the depths of his sorrow; I saw it in a darkening of his iris, even though that delicate structure should not change color. I could see that the almost mystical aura of this legendary surgeon—the single-mindedness, the dedication, the skill—was mere surface. The surgical persona was something he had crafted to protect himself. But what he had created was a prison. Anytime he strayed from the professional to the personal, he knew what to expect: pain.

When he spoke, his voice sounded tired, old. “And here I thought you had it, and you thought I …”

“What do you think is in the letter?”

“How I wish I knew,” he said abruptly. “I'd give my right arm …”

It had been a few months since I met Thomas Stone. The anger I felt obliged to have had subsided. The story he told me of his childhood, his mother's death—it should have been enough to forgive him, but I didn't think I was ready for that. I hadn't forgiven Shiva, so why forgive Thomas Stone? Even if I
had
forgiven him, a perverse streak in me refused to let him know that. But I had unfinished business with him.

“There's something I have to tell you,” I said. I never thought I would be ashamed in front of this man. “Something I was charged to tell you by Ghosh.” Ghosh's wish had seemed irrational to me at the time. But now, looking into that hard, craggy face, I understood why Ghosh had wanted me to reach out to Stone. Ghosh knew Thomas, but Ghosh had overestimated my maturity.

“Ghosh had a dying wish which I promised to fulfill. But I didn't. I ignored it. I hope you—and he—will forgive me. Ghosh told me that he felt his life would be incomplete without my doing this … His wish was for me to come and find you. To let you know that he considered you a brother.”

This was hard, both because I could recall Ghosh's labored breathing, could recall Ghosh's every word, and because I was now seeing the effect these words had on Thomas Stone. Other than his mother, and Dr. Ross in the sanatorium, who had ever expressed love for him? Sister Mary Joseph Praise perhaps, but did she ever get to tell him, and if she did, did he hear?

“Ghosh was disappointed that you never contacted him. But he wanted you to know that whatever your reason was for being silent all those years, it was all right with him.” Ghosh had felt it was shame that kept Thomas from looking back. He was right, because it was shame that colored his face now.

“I'm so sorry,” Stone said. I don't know whether he was speaking to me, or Ghosh, or the universe. It wasn't enough, but it was about time.

If there were other people in the restaurant, I was no longer aware of them. If there was music playing, I couldn't hear it.

I studied my father as I might study some specimen set before me: I saw the smile that struggled for purchase on his face and failed, and then I saw the haunted and hunted look that came in its wake. God help us if such a man had tried to raise us, if he had taken us away from Ethiopia. With all the sorrow and loss I'd experienced, I'd never have traded my past at Missing for a life in Boston with him. I should have thanked Thomas Stone for leaving Ethiopia. The love he felt for Sister Mary Joseph Praise had come too late. She was the mystery, the great regret that he would take to his grave—and he would regret nothing more than not knowing what she said in that letter.

“I'll write to Shiva,” I said. “I'll ask about the letter.” I suppose I understood Thomas Stone's shutting people out. After Genet's betrayal, I never wanted to have such strong feelings for a woman again. Not unless I had a written guarantee. I'd encountered a medical student from Mecca, a saint compared with my first love; she was kind, generous, beautiful, and seemed to transcend herself, as if her existence was secondary to her interest in the world and the things in it, including me. My belated and muted response must have pushed her away, lost me any chance of a future with her. Did I feel sad? Yes. And stupid? Yes, but I also felt relieved. By losing her, I was protected from her and she from me. I had that in common with this man sitting before me. I thought of a watch that had stopped ticking, and how it showed the correct time twice a day. He paid. I rose with him. At the door of the restaurant, our hands in our pockets, I waited.

“ ‘Call no man happy until he dies,’ “ he said. Before I could tell if that was a smile or an expression of sadness on his face, he nodded and walked away.

CHAPTER 48
Five Fingers

J
UST AFTER MIDNIGHT
on the first Sunday of every month, I would ring Hema at her bungalow. It was seven o'clock, Monday morning, Addis time. The rates were best at this hour, but since Almaz, Gebrew, and sometimes Matron came on before Hema, it could still be a long and expensive call. Ever since Hema delivered Mengistu's—sorry,
Comrade
Mengistu's—child, we no longer worried about the secret police eavesdropping on us; besides, they were preoccupied with real enemies. Mengistu Haile Mariam, Strength of Mary, Secretary General of the Council of Peasants and Workers, Chairman of the Military Council of Socialist Ethiopia, President-for-Life of the Armed Forces of the Democratic Peoples of Ethiopia, General in Command of the Bureau for Armed Struggle Against Imperial Aggression in Tigre and Eritrea, had adopted an Albanian style of Marxism. The upper and middle classes and even the working poor had their houses confiscated and land taken away. But favors to Mengistu and particularly favors to his wife weren't forgotten; Missing's medicines and supplies were not held up in the Customs godown, and there were no palms to grease.

As I dialed Hema's number that Sunday, I pictured my Missing family watching the clock, coffee cups in their hands, waiting for the phone to ring from a continent none of them had seen. Almaz picked up the receiver, with Gebrew leaning in, both of them suddenly shy and self-conscious. Their side of the conversation consisted of repeated
Ende-menneh? Dehna-ne-woy?
—How-are-you? Are-you-well, then?—until these godparents of mine were satisfied that their
lij,
their child, was all right. They told me they kept me in their prayers, fasted for me. “Pray that I'll see you soon and may God take care of you and your health,” I said. Matron was just the opposite, chatty and spontaneous, as if we had run into each other in the corridor outside her office.

I had reported to Hema my first sighting of Thomas Stone. Shed listened without comment, and she must have smiled when she heard of her son breaking and entering Thomas Stone's apartment. I didn't censor information for her benefit; surely, Thomas Stone was no longer the threat he'd once been to her when we were minors. When I had told her about placing the bookmark on Stone's desk as my calling card, I had read from Hema's silence that she'd known nothing about Shiva's having
The Expedient Operator: A Short Practice of Tropical Surgery.
I surmised from that and later confirmed from Matron that Hema had made every attempt to banish the book from Missing; she'd never wanted me or Shiva to see his work, much less a picture of him.

“I had dinner with Thomas Stone, Ma,” I said when she came on the line. “I ate
injera
for the first time in well over a year.” She was miffed to learn that Ghosh had a message for Stone—I read that in the fact that she said nothing. When I told her just what Ghosh had wanted me to say to Stone, I heard a vigorous honk on her kerchief. The message said more about Ghosh and his selflessness than it did about Thomas Stone. I asked if she knew about the bookmark or a letter that accompanied it. She didn't.

“Maybe Shiva knows,” I said. “Can I speak to him?”

She called out his name, a summons I had heard so many times since I was a child. I heard Shiva's reply, and could judge from its echo that it had come from our childhood room. While I waited, I heard Hema asking Matron about the bookmark; her “No!” told me it was news to her.

THE TELEPHONE WAS NEVER
a comfortable instrument in Shiva's hands. He was fine, the fistula work was going very well, and no, he knew nothing about any missing letter.

“Do you remember the bookmark, Shiva, and the reference to a letter?” I asked.

“Yes.”

“But you're saying there was no letter in the book?”

“No letter.”

“How did you get the book, Shiva?”

“Ghosh gave it to me.”

“When?”

“When he was dying. He wanted to talk with me about many things. This was one. He said he'd taken the book from Thomas Stone's quarters on the day we were born. He had kept it. He wanted me to have it.”

“Was that the first time you'd seen the textbook or seen a picture of Thomas Stone?”

“Yes.”

“Did Ghosh mention a letter from Sister Mary—our mother—to Stone?”

“No, he didn't.”

“Did he say why he wanted you to have the book?”

“No.”

“When you saw the bookmark and the reference to the letter, did you go back and ask him?”

“No.”

I sighed. I could have stopped there, but I had come this far. “Why not?” I asked.

“If he wanted me to have the letter, he would have given it to me.”

“Why did you give me the book, Shiva?”

“I wanted you to have it.”

There was no annoyance in Shiva's voice; his tone was no different than when we began—I wondered if he'd picked up the irritation in mine. Shiva was right: there either was no letter, or Ghosh had the letter and had his reasons for destroying it.

I was about to say good-bye. I knew better than to expect my brother to ask about my health or my welfare. But he took me aback by saying, “How are your operating theaters?” He wanted to know about the layout, how far away the autoclave and the locker rooms were, and was there a sink outside each room, or one common scrubbing area. I gave him a detailed picture. When I was done, I waited. Once again, he surprised me: “When are you coming home, Marion?”

“Well, Shiva … I have four more years of residency.”

Was this his way of saying he was sorry for everything that had happened? That he missed me? Did I want that from him? I wasn't sure, so all I added was, “I don't know if it is safe for me to come, but if it is, I'd love to come a year or so from now … Why don't you come visit here?”

“Will I be able to see your operating theaters?”

“Sure. We call them operating rooms here, not theaters. But I can arrange for you to see them.”

“Okay. I'll be there.”

Hema came back on the line. She was in a chatty mood, reluctant to let me go. Listening to her lilting voice, I was transported back to Missing Mean Time, as if I were sitting by the phone under Nehru's photograph and looking across the room at the portrait of Ghosh which consecrated the spot where he spent so many hours listening to the Grundig.

When I hung up I felt despair: I was back in the Bronx, my walls bare but for the framed
Ecstasy of St. Teresa.
My beeper, silent till then, went off. In answering its summons, I slipped the yoke back around my neck; indeed, I welcomed my slavish existence as a surgical resident, the never-ending work, the crises that kept me in the present, the immersion in blood, pus, and tears—the fluids in which one dissolved all traces of self In working myself ragged, I felt integrated, I felt
American,
and I rarely had time to think of home. Then in four weeks, it was time to dial Missing again. Were these phone calls just as difficult for Hema? I wondered.

In a letter after our call, Hema said that shed checked with Bachelli, Almaz, and even W. W. Gonad to see if they had heard of Ghosh or Sister leaving a letter behind, but no one had. She told me that Shiva's application for an exit visa to come visit me was held up by the government; he was asked to provide affidavits to show he had no debts in Ethiopia, and moreover that
I
had no debts for which he might be responsible. She said she would remind Shiva to work on the visa. Reading between the lines, I knew and she knew that Shiva had lost interest.

I wrote to Thomas Stone to let him know that the whereabouts of Sister Mary Joseph Praise's letter remained a mystery. He never wrote back to me thanking me for my troubles.

OVER THE NEXT FOUR YEARS,
I saw Thomas Stone now and then when he came to conduct conferences or bedside teaching rounds; he was impressive, as I knew he would be, masterful, serious, and in command of his subject. He had the kind of perspective that could only come from careful study of the literature of surgery and from living it for many years. I much preferred being around him in that fashion than having a dinner with him. Perhaps he felt the same way, because he didn't call or visit again.

I went up to Boston for three separate, month-long rotations: plastic surgery, urology, and transplant, and the work was engrossing, challenging, so that each time my anxieties about being there and near him were forgotten. I worked with him in that last rotation, which was busier than I'd ever imagined. He suggested once during that time that we have a meal, but I begged off because my work in the transplant intensive care unit simply did not allow me to get away before nine in the evening, even on my nights off. I think he was relieved.

By
1986
I had finished my year as Chief Resident, which was also my fifth year of training, and I stayed on as an assistant to Deepak as I prepared to take my board exam. Grudgingly, Id come to admire the long, arduous American system of surgical training; it was easier to admire when you were about done with it. I felt technically competent to do all the major operations of general surgery, and I knew my limits. There wasn't much I hadn't seen at Our Lady. More important, I was confident about caring for patients before and after surgery, and in the intensive care settings.

ALSO IN 1986,
my brother became famous; it was Deepak who showed me the feature article in the
New York Times.
What a shock it was to see Shiva's picture, to see in it my reflection, but with shorter hair, almost a crew cut, and without the gray that had completely taken over my sideburns and temples. The image brought immediate bitterness, the recollection of the pain of betrayal. And yes, envy. Shiva had taken the first and only girl I loved and spoiled her for me. Now, he was making headlines in my backyard, in my newspaper. I'd followed all the rules, and tried to do the right thing while he ignored all the rules, and here we were. Could an equitable God have allowed such a thing? I confess, it was a while before I could read the article.

According to the
Times,
Shiva was the world's expert and the leading advocate for women with vaginal fistula. He was the genius behind a WHO fistula-prevention campaign that was a “far cry from the usual Western approach to these issues.” The
Times
reproduced the colorful “Five Failings That Lead to Fistula” poster: it showed a hand, the fingers splayed out. Peering at the photograph, I could see that it was Shiva's hand. In the palm was a seated woman in a posture of dejection—was the model the Staff Probationer?

The poster was distributed all over Africa and Asia and printed in forty languages. Village midwives were taught to count off on one hand the Five Failings. The first was being married off too young, child brides; the second was nonexistent prenatal care; the third was waiting too long to admit that labor had stalled (by which time the baby's head was jammed halfway down the birth passage and doing its damage) and a Cesarean section was needed; the fourth failing was too few and too distant health centers where a C-section could be done. Presuming the mother lived (the baby never did), the final failing was that of the husband and in-laws who cast out the woman because of the dribbling, odiferous fistula from bladder to vagina, or from rectum to vagina, or both. Suicide was a common ending to such a story.

“Somehow women with fistula find their way to Shiva Praise Stone,” the article said. “They come by bus, as far as they can before the other passengers kick them off. They come on foot, or by donkey. They come often with a piece of paper in their hand that simply says in Amharic, ‘MISSING’ or ‘FISTULA HOSPITAL’ or ‘CUTTING FOR STONE.’”

Shiva Stone was not a physician, “but a skilled layperson, initiated into this field by his gynecologist mother.”

When I next spoke to Hema, I asked her to congratulate Shiva for me. “Ma,” I said, “you should have gotten more recognition in that story. Without you, Shiva couldn't be doing what he does.”

“No, Marion. This is really all his doing. Fistula surgery wasn't something I relished. It suits someone as single-minded as Shiva. It needs constant attention, before, during, and after surgery. You should see the hours he spends thinking over each case, anticipating every problem. He can see the fistula in three dimensions.” Shiva had fashioned new instruments in his workshop and invented new techniques. The article had mentioned Matron's fund-raising efforts and the desperate needs, and the article brought donations pouring in. Matron had in mind a new Missing building devoted to women with fistula. “Shiva has had the plans drawn out for years. It will be in the shape of a V with the wings converging on Operating Theater
3
.” Theater
3
was to be overhauled and remodeled, making two operating rooms with a shared scrub area in the middle.

I reread the
Times
article late that night. I felt a hollow sensation in my belly this time as I went through it again. The writer's unabashed admiration for Shiva came through, and one sensed she had abandoned her reserve, her usual dispassionate tone, because the man more than the subject so moved her. She ended with a quote from my brother: “What I do is simple. I repair holes,” said Shiva Praise Stone.

Yes, but you make them, too, Shiva.

I HAD MY OWN SUCCESS,
albeit a quieter one: I passed the written exam of the American Board of Surgery. A few months after that, I was assigned to take my oral exams in Boston at the Copley Plaza Hotel. After a grueling hour and a half in front of two examiners, I was done. I knew I did well.

Outside, the day was glorious. The monolith of gray stone that was the Church of Christian Scientists stood serene at the end of a long reflecting pool and framed against a blue sky. For five years I had spent my nights and days in the hospital, not seeing the sky, not feeling the sun on my face. I felt the urge to wade through the water fully clothed, or to let out a victory whoop. I contented myself instead with an ice-cream cone, which I enjoyed while sitting by the reflecting pool.