“Yes, of course,” he said.
The compassion in his voice told me he had known my kind of pain. There are legions of us.
AS FAR AS THE EVENTS of the next few weeks, I recall one night waking to the shrill ring of the telephone. Receiver in hand, I was lost, uncertain whether I was at Our Lady or back at Missing. I was the backup trauma consultant. But I couldn't decipher what the resident at the other end wanted. This isn't uncommon for the first ten seconds of a middle-of-the-night conversation. The caller understands. But, as we kept talking, the fog in my brain refused to lift. I hung up. I pulled the phone from its moorings. The next morning, my mind felt clear, but my body wouldn't rise off the bed. I was weak. The thought of food turned my stomach. I rolled over and went back to sleep.
Perhaps that same day, perhaps a few days later, a man was on the edge of my bed. He took my pulse, called my name. It was my former Chief Resident and now my colleague at Our Lady, Deepak Jesudass. I desperately held his hand and asked him not to leave—I must have recognized the danger of my situation.
“I'm not leaving,” he said. “Just pulling back the curtain.” My memory is that I told him everything that had transpired. He examined me as I spoke. He pulled down my eyelids, interrupting me only to ask that I look down at my feet, or say “Ah!” At one point he inquired if I had a stethoscope in the house. I said, “Are you kidding? I'm a surgeon,” and we laughed together, a strange sound that had been missing from my home. I said “Ouch” when he probed just under my ribs on the right. I found this funny. I heard him murmuring on the telephone. All the while, I did not let go of his hand.
Three men whose faces I knew arrived with a stretcher. They wrapped me in a flannel cocoon, carried me out to the curb, and lifted me up into their ambulance. I remember wanting to say something about the beauty of their motion, the inherent grace, and how incredible it was, this baby-kangaroo-in-pouch feeling. I apologized for not having appreciated their skill all these years.
Deepak rode with me. At Our Lady, he walked alongside my gurney past the shocked faces of the staff we encountered in the halls and elevator. He wheeled me into the Intensive Care Unit of Our Lady of Perpetual Succour. My eyes glowed yellow under the harsh fluorescent lights, but I didn't know it. My skin, too. I bled wildly from every needle stick. Too late, the nurses tried to hide the ominous tea-colored urine in my catheter bag from me, but I saw. For the first time, I was very, very scared.
The increasing swelling in my brain made me desperately sleepy. I held on to consciousness long enough to ask Deepak to come near. “Whatever happens,” I whispered, “don't take me from Our Lady. If I must die and can't die at Missing, I want to die here.”
At some point I was aware that Thomas Stone came to my bedside and was studying me, but not with the concern of a clinician. It was the petrified look I knew so well, the look of a parent whose child had suffered some misfortune. It was at about this time that I lost consciousness.
AS I LEARNED LATER, the cable to Hema read: COME AT ONCE STOP MARION CRITICALLY ILL STOP THOMAS STONE STOP P.S. DO NOT DELAY STOP—and she did not. Hema called in her favor with the Comrade President-for-Life's wife, who understood all too well Hema's need to be at her son's sickbed. The American Embassy readily provided visas, and by day's end, Hema and Shiva were on their way to Frankfurt via Cairo. Then, still on Lufthansa, they crossed the Atlantic. Hema pulled out the telegram more than once, studying the letters, looking for a hopeful anagram. Over Greenland, she said to Shiva, “Perhaps this means Thomas Stone is near death, not Marion.”
Shiva said with absolute certainty, “No, Ma. It's Marion. I can feel it.”
At ten in the night New York time, they floated into the Intensive Care Unit, a graying woman in a maroon sari, the face striking despite the raccoon rings around her eyes. With her was a tall youthful man who was so obviously her son and my identical twin.
They slowed outside my glass cubicle, weary Old World travelers peering into the glow of a New World hospital room. There I was, the son who went to the States for higher studies, who became a practitioner of the artful, lavish, disposable-everything, lucrative, and incredibly effective American brand of medicine, with no prices on the menu, so different in style and substance from what they did at Missing; only now it must have appeared to them as if the American medicine had turned on me, like the tiger turning on its trainer, so that I lay moored to a blue-gray ventilator, chained to moni tors on the consoles behind my bed, comatose and invaded by plastic tubing, by catheters and wires. There was even a stiff wire like a nail poking up from my skull.
They saw Thomas Stone seated on the side of my room closest to the window, his head resting awkwardly against the bed's safety rail, his eyes closed as if in sleep. In the seventy-two hours since he sent the telegram, my condition had worsened. Thomas Stone opened his eyes, suddenly aware of them. He stood up, bedraggled, stiff, and somewhat shrunken in his borrowed scrubs, relieved but apprehensive. Worry lines ran into his eyes, and his face was drawn and pale under his shock of white hair.
The two old colleagues and combatants had last seen each other in a delivery room, moments after my birth and our mother's death. That was also when Stone had last seen Shiva: in Operating Theater 3, held tight in Hema's arms.
The bedside table and the ventilator blocked Hema's approach to the near side of the bed. She circled to where Stone stood, her eyes on me.
“He is ‘critically ill’ from what, Thomas?” Hema said, referring to the two words in the telegram that had most frustrated her. Her tone was professional, as if she were asking a colleague about a patient; it allowed her the pretense of being calm when inside she was quaking.
“It's hepatic coma,” Thomas said, responding in the same manner, grateful that she'd elected to converse in the language of disease, a fallback which allowed even their son to be reduced to a diagnosis. “He has a fulminant hepatitis. The ammonia level is very high and the liver hardly functioning.”
“What from?”
“Viral hepatitis. Hepatitis B.”
Stone let down the bed rail and the two of them stood over me. Hema's hand reached behind her for the tail end of her sari, the part that went over her shoulder. She brought it to her mouth.
“He looks anemic, not just icteric,” she managed to say at last, clinging to the idiom of medicine to describe my pallor and jaundice. “What's his hemoglobin?”
“Nine, after four units of blood. He's bleeding from his gut. His platelets are down and he isn't making clotting factors. The biliru-bin is twelve, and his creatinine just today is four, rising from three yesterday …”
“What's this, please?” Shiva said, pointing at my skull. He stood across from Thomas Stone, the bed between them.
“An intracranial pressure monitor. Goes into the ventricle. He has cerebral edema. They're giving him mannitol and adjusting the ventilator settings to keep the pressure down.”
Shiva looked skeptical. “It goes through his skull, through brain into the ventricle just to measure? It does not treat?”
Thomas Stone nodded.
“How did this begin?” Hema asked.
As Thomas Stone recounted the sequence of events, Shiva freed the bedside table and found slack between the bed and ventilator. He let down the bed rail on his side. Moving with the slow efficiency of a contortionist, he slid under the tubes and wires. Deepak entered in time to see Shiva lying on his side next to me, his head touching mine. His being there looked both precarious and entirely natural. All Deepak could do was stare, noting, however, that my intracranial pressure tracing, which had done nothing but go up for three days, went down.