Authors: John Twelve Hawks
“Edward?”
“Yes, sir.”
“Display the Marian Community Hospital emergency room report.”
“I’ve found it, sir. It’s on the computer screen.”
CHIEF COMPLAINT: Motor vehicle accident with severe head trauma.
HISTORY OF PRESENT ILLNESS: This is a 31-year-old Caucasian male who was brought by ambulance to the emergency department. The patient had been riding a motorcycle at high speed when he hit a stalled truck on Route 30. Ambulance was called and arrived at the accident scene approximately 20 minutes later. The EMTs (M. Spencer/J. Watts) checked patient vital signs. They placed him on a backboard, started an IV, and applied oxygen. Patient was unresponsive. During the trip to the hospital, the cardiac monitor indicated that the patient had flatlined. An EMT immediately started CPR and a thready pulse was apparent when the patient arrived at the emergency room.
Only two nurses and one doctor work in the Marian Hospital emergency room during an eight-hour shift. Dr. V. Rahman, the first physician who encountered me, was born in Bangladesh and went to a third-tier medical school. According to the report, Rahman called upstairs and a cardiologist named Mitchell ran down to help.
PAST MEDICAL HISTORY: Medical staff inspected contents of patient’s wallet. No medical insurance card. Driver’s license indicated that that patient was not an organ donor.
PAST SURGICAL HISTORY: Information not available.
MEDICATIONS: Information not available.
PHYSICAL EXAMINATION: This is a Caucasian male, age 31, who has experienced traumatic head injury due to a motorcycle accident. The patient is comatose. A rising blood pressure and slowing pulse indicate that the patient’s brain is swelling. The pupil size was checked and did react to light.
VITAL SIGNS: Temperature 97.1 degrees. Pulse 32. Blood pressure: 74/40. Respiratory rate 8. Pulse oximetry level 83% on oxygen.
HEENT: Laceration of the scalp with bleeding. Fractured nose and mandible.
NECK: Supple. Minor laceration.
HEART: Slow. Irregular rate and rhythm.
LUNGS: Clear to auscultation bilaterally.
ABDOMEN: Soft. Nondistended.
EXTREMITIES: Left tibia fractured.
PERIPHERAL VASCULAR: Capillary refill is more than 2 seconds in all extremities.
NEUROLOGIC: Patient unconscious. Eye movement fixed.
MUSCULOSKELETAL: Patient has fractured left tibia. Fractured skull with severe head trauma.
SKIN: Cold. Cyanotic. Multiple lacerations and abrasions.
DIAGNOSTIC STUDIES: After patient was stabilized, he was given a CT scan and X-ray. X-ray indicated fractured skull, fractured left tibia, and fractured ulna. CT scan indicated profound brain damage of the left frontal lobe.
EMERGENCY DEPARTMENT: Immobilized left lower extremity. Immobilized left upper extremity. Removed all clothes and prepped for emergency surgery.
ASSESSMENT AND PLAN: Patient given oxygen. Lacerations were cleaned and sutured. Cardidor and Vican were administered via IV. Patient was sent to surgery via gurney.
The report of the surgical procedure sounded like a document created to defend the hospital against a medical malpractice suit. When my body was placed on the operating table, my rebellious heart decided to stop beating. Dr. Mitchell made an incision in my chest, spread my ribs with a piece of equipment called a self-retaining retractor, and then held my heart in his hand and squeezed it rhythmically.
His efforts were useless. I had died on the road and in the ambulance, and I died one final time in the operating room.
So how was it possible that I was lying on my back in the first-class cabin of a passenger plane as it traveled east toward a darkening sky?
When the plane reached New Delhi, I retrieved my suitcase, passed through customs, and saw an Indian driver holding a sign with my name. Miss Holquist had told me that my travel expenses would be paid by Transmotion Ltd., a corporation registered in the Republic of Mauritius. I had no desire to travel to an island in the southwest Indian Ocean to see if this company actually existed. Transmotion Ltd. could open a bank account and obtain credit cards. It could sue people and sponsor political ads in the United States, but I doubted that this legal entity had any products or employees. Like many international corporations, Transmotion Ltd. was both real and completely imaginary.
My driver led me to a car he called an Ambassador: a large, old-fashioned gray sedan with a rounded back. We passed through a control gate and then we were absorbed by India. The thruway into the city was still under construction and the car followed a two-lane road that snaked its way around detour signs and packs of scrawny men shoveling sand into cement mixers. A mud-splattered bus rolled past us packed with passengers, and I saw a family of four riding on a motorcycle: the baby on the fuel tank, the man clutching the handlebars, and a little girl wedged between her mother’s breasts and her father’s back.
Back in America, I could limit the power of the world by reducing everything to a series of flat images. But that wasn’t possible in
this country. Waves of energy flowed toward me; it felt as if I was going to be knocked off my feet and pulled out to sea.
We passed a one-room hut near the edge of the road with a dirt yard and a tethered cow and four-foot-high cones of dried cow dung used for fuel. We passed a line of eucalyptus trees, each with a number painted on its trunk, and a water tank that looked like an orange animal with four legs and a flexible snout. Gradually, the buildings began to grow larger and there were wedding palaces and nightclubs surrounded by concrete walls topped with shards of broken glass.
A construction zone. The road disappeared and rocks clattered up in the car’s wheel wells. The Ambassador moved slower and slower until a man in rags stepped in front of us with a scrap of red cloth tied to a stick. This road flag was not just his job, but proof of his existence. Stop. He waved the flag again. Stop.
Tap, tap.
I looked left and saw the faces of three small children staring at me. Faces that looked as fragile as chips of dry clay. Stick arms and legs. Glistening eyes. One little girl was wearing nothing but a man’s T-shirt with a strip of fabric for a belt. She squeezed her fingers into a single point and rapped again on the passenger window.
Tap, tap.
“Beggars,” said the driver and shook his head. But I had no intention of rolling down the window and getting closer to them. Children bothered me. I had no idea where to place them in my system.
But children weren’t dogs or animals or the Dead. And they weren’t like the women with baskets of gravel on their head who trudged past the Ambassador. Small children radiated so much energy that it was difficult to predict their movements. It made me nervous to be around them.
The ragged man lowered his flag and our car lurched forward. Now tall buildings and crowds appeared and the car was surrounded by auto rickshaws—three-wheeled vehicles with passenger cages welded onto the back. Peering through the glass, I saw an elderly woman with a parasol, a pack of children sorting through trash, a Sikh with a handlebar moustache, and two white cows eating a mound of banana peels.
“Haan … Haan …”
the driver chanted, and then the traffic stopped for no apparent reason. More beggars tapped on the window as a bicycle rickshaw man squeezed past us. He was pumping hard, standing on his pedals, while sharp shoulder blades jabbed inside his skin.
Finally, we passed through golden gates and followed a circular driveway to the Taj Mahal Hotel. Men wearing Nehru jackets and little white caps hurried out to take my suitcases. At the front desk, the hotel manager handed me a sealed manila envelope and told me that my room had already been paid for by Transmotion Ltd.
“Welcome to Delhi, sir. Please let us know if there is anything we can do for you.”
“I want to lie down.”
Two bellboys escorted me to a ninth-floor suite. They switched on the air conditioner and showed me that the bathroom faucets really did work. When I was finally alone, I opened the check-in suitcase that was filled with a travel supply of ComPlete. I drank a bottle, took off my shoes, and lay down in the middle of the kingsize bed. The hum of the air conditioner, the white plaster walls, the faint smell of the lavender laundry soap coming from the sheets and pillows were comforting. Whenever I read about hotels and restaurants in an in-flight magazine, the writers are always talking about places that are picturesque or romantic or historical. I desire none of those qualities. Bland is the truest expression of an advanced
civilization. It took a great deal of money to create this pocket of cool, calm bland among the rickshaw men and the beggar children tapping on the car windows.
The envelope contained a plane ticket to a city called Ahmedabad in West India. An information sheet explained that the hotel would provide a car to take me to the airport and that another car would be waiting at my next destination.
Following Dr. Noland’s Rule #2, I took a shower and then slept until dawn. When I left the hotel at five in the morning, Delhi was a different city. The streets were quiet and empty, and now I could see the dogs that were hidden by the traffic in the daytime. In this country, the dogs knew they were dogs. They didn’t look friendly and eager for attention, but they were always aware of their surroundings. At this early hour, all the dogs were out, sitting separately, royally, as they surveyed their Dog Kingdom.
The plane to Ahmedabad was much smaller than the airliner that took me to Delhi, and most of the other passengers carried computers and attaché cases. I found my driver at the airport and we stepped out of the air-conditioned terminal into a wave of hot air that felt like a weight was pushing down on my Shell. Ahmedabad was surrounded by a ring of steel mills and textile factories and the sky looked like a blue bowl smeared with yellow chalk dust.
As we approached the central city, the streets became narrow and dirty and filled with carts and motor rickshaws. Each two- or three-story building had a shop on the ground level that sold one kind of product—millstones or dog leashes or motorcycle helmets. I had to assume that an occasional customer bought these objects, but most of the shopkeepers sat on the sidewalks, drinking tea and gossiping with their friends. They lived in the Kingdom of Sitting Around.
My driver dropped me off at a sprawling three-story mansion that had been converted into a luxury hotel. I had to sit in front of an air conditioner in my room for a half hour until I felt like opening
a second manila envelope. Transmotion Ltd. told me to leave the hotel at 3 p.m., find an auto rickshaw, and ask the driver to take me to the Adalaj Stepwell north of the city. An enclosed brochure said that the well was a historical ruin, a multilevel sanctuary built for pilgrims in 1500.
The heat made my Shell feel like it was melting away. After changing money at the hotel, I found an auto rickshaw and sat behind the driver as he steered through the crowded city. The smells were very strong in India and I saw these as different shades of red and orange in my mind. Nobody was wearing G-MID eyeglasses and I didn’t see any surveillance cameras. A young mother in a faded sari dragged a small boy down the sidewalk. Two soldiers wearing green camouflage uniforms chatted with friends as a mechanic repaired a motorcycle. The rickshaw motor made a grinding sound like a broken lawn mower and everyone riding or driving any kind of vehicle was constantly beeping their horn.