leprosy infection can damage the trigeminal nerve which supplies the cornea. This leads to exposure keratitis and ultimately blindness. Careful patents wear patches and dark sunglasses to protect their eyes. Post-cataract surgery patients also wear sunglasses to protect their eyes.
The boys play this ball game that involves pegging a foam ball at each other and trying not to be “It”. I was amazed by how unphased each boy was by his deformity. Catching and throwing with one hand is not a problem for these boys. They play expertly.
Liju, the male nurse found me eating tomatoes outside of the mess. “He’s back!” Liju exclaimed. “Im sorry?” i said.
“Your little friend, he’s back.”
My heart leapt and so did I: up from the ground, depositing my plate of unfinished tomatoes in the sink I bolted to the wards. Sumit is back. My little pemphigus prince! But why has he returned so early, is there something wrong? Then I saw him, sitting on the floor of the medical ward, his ghost costume sheet draped over his head, his body still naked and riddled with sores. When he saw me he smiled. Now it is a nice toothy smile, unrestricted by the tight skin that used to pull his mouth down. But his face was so round and puffy. He looked so different. And on his arms were new blisters, indicating active pemphigus breakout. Oh god.
He smiled though. He is in good hands here. The doctors and nurses know how to manage his disease. He will be OK. it’s just difficult to witness relapse. I took him to the piano and played for him while he sat on one of the pews. I looked up after a long time and he had fallen asleep on the pew, his eyelids fluttering in some dream.
“I heard a rumor that you’re getting fat”, Liju, the male nurse said, beaming.
“Why don’t you just look at me and decide for yourself– I see you and everybody else here everyday”, I said, laughing by the ridiculousness of this. How can this possibly be a rumor? Doesn’t rumor imply some degree of secrecy? It is no secret that my cheeks are getting chubby and my once-potato sack Indian attire now actually fits me. “No”, Liju explained, “all the nurses are talking about it. They think you look so good.”
“Yeah” Thapa, the physiotherapist chimed in: ‘”you were skinny (he said this word distastefully) when you got here, but now you are nice and healthy”. I have noticed more attention from bachelor doctors and therapists since I started getting “healthy”. In India health and beauty are much bigger than their American counterparts.
Well maybe they like it, maybe the nurses are chatting excitedly about the additional 5 kg, but I don’t like it. I long for open space where I can run, bicycle, hike, walk, swim— move my body like I am accustomed to doing everyday in America. I really miss moving through space carried by my own strength. Running is not only a way for me to release abundant physical energy, it is also a mental hygiene practice. At the end of the day, when reading, or sitting at the computer, or piano my legs are twitching, itching to move long distances and my brain feels trapped. So the “getting healthy” rumor, as funny as it is, is actually just pointing out my unfulfilled need to move. The long stretches of jog-able coast in Madagascar are calling to me.
They sat on the edge of his bed, staring up at him in awe and reverence as they listened to his stories from prison. Samil, having waited three weeks in a cast for his surgery to set has come back to the hospital from prison for physiotherapy. He is a young man who had been unfairly tried as an adult in a murder case and was sentenced to life in prison. In his shadow at all times are two guards armed with long pointy guns. He wears thick metal handcuffs with ropes dangling off of them. He also carries the attention of every boy in the surgical ward. They worship the ground he walks on. I sat down on his bed with the other boys and listened to his stories one evening. He told us that he had to kill a boy when he was 15. This boy was the son of the man who murdered his father; he was also 15. Samil isn’t a typical murderer and I hesitate to consider him a murderer at all. He is a boy who committed a horrific act out of love for the father he lost. This was a misguided, albeit terrible action carried out by a naive youngster. It is tragic.
Looking at his face you would never believe he actually killed somebody and that he has been living in a prison for 12 years. His smile is quick and radiant. He stops to say hello to all the patients, even the old deaf babas who shout things forever when you start talking to them. Samil spent his time in prison learning how to read and write. He has transcribed numerous books into lined notebooks so that he can refer to his own copies. He is learning English. He wants so badly to be a normal student, go to school, get a job, have a normal life, but he can’t. Trailing behind him are the armed reminders that his life isn’t free. This doesn’t seem to phase him in the surgical ward though. Late at night you can see him encircled by a crowd of little boys telling bedtime stories. In the daytime he is in the physiotherapy department like every other physio patient, moving the operated fingers, massaging oil into his palms, having each finger wrapped in plaster to straighten it. I sometimes see him walking loops around the campus. In his wake the omnipresent guards and a gang of giggling kids at his heels.
None of the patients view him as a bad person. It is as if the handcuffs and guards and knowledge of his past are invisible, overwhelmed by the light of his character. My piano boys sometimes even ditch lessons in order to hear one more story from him or walk around the campus by his side.
As I waved goodbye to the guards at the gate I felt the fullness of freedom. The driver was bringing me to the train station where, if I wanted, I go take a train anywhere in the entire country. I was excited to go to New Delhi because this is an ancient city full of history and beautiful architecture. I got to tag along with the ISDA/Oberlin group on their guided tour of the city. It was fascinating. We went to Humayun’s Tomb, a precursor to the Taj Mahal and a prominent architectural marvel from Moghal dynasty in the 1500s. We visited the Bahai Lotus Temple, a marble flower unfolding pointy petals above pools of water. This was a place of worship and when you go inside you have to be silent. I really enjoyed this.
I went with the tour group to the Lodi Gardens for a beautiful lunch and some fascinating conversations with the travelers. These are people who had gone to Oberlin for college, have carried out various careers, and now are in the next phase of their lives. This is the phase when you get to explore topics to which you have always been drawn but have not until retirement had the opportunity to explore. It felt good to speak English and to be understood from the perspective of my own culture. Sometimes the most difficult part about traveling is trying to navigate cultural differences. Although I appreciate this aspect of the year and am learning a great deal because of it, it was nice to take a break in New Delhi. I only spent one night in Delhi before i felt the pull of the hospital and wanted to come back. This place feels like home now. I need to get out once and a while for brief periods, but I always want to come back.
When it becomes infected, bone feels soft and sinewy. Necrotic bone is grey/ black. I learned how to “nibble” through necrotic cancellous bone up to the healthy bone. “Nibble” is a euphemism. It is more like crunch, scrape, chisel, crack, gnaw. Cutting though bone with the nibbler requires strength and I’m afraid my 10 push-ups each morning on the roof won’t cut it. I better start lifting weights. Surgery can demand surprising strength and endurance. Septic surgery reminds me of wood-working. We actually use a malate and chisel to cut (hack) through the tibia. We use a scraper for hypergranulated tissue, and of course there are saws and rasps and clamps and the operating table is like a bench press.
Today after observing hours of reconstructive surgeries, I operated on an abscess. Dr. Das said: “make a superficial incision in the abscess along the length of the arm. Don’t go too deep because there are major vessels there- the brachial artery, radial and ulnar arteries, cephalic vein and if you cut them longitudinally, the patient will bleed out and die”. OK, I thought, taking the scalpel firmly in my hand. I made a very superficial incision and pus started coming out of the abscess. “Go a little deeper”. I retraced my incision this time about 1mm deeper. And then: Squirt! A jet stream of thick green pus ejected from the abscess at high pressure, landing on Dr. Das’s scrubs. I could hear the surgical team laughing but i was focused on the patient’s abscess which was now bleeding significantly not because I had punctured any major vessels, but because it was a large one with lots of fluid and anastomosis.
I apologized about the pus and Dr. Das said jokingly, “next time we do a hydrocoelectomy I will make sure that YOU are in the projectile line.”
I’ll make sure to wear a shield to the OT next time…