Ars Medica (Spring, 2013)
The small examination room collapses around us in a shattering roar, so suddenly that the patient’s last words are forced from her mouth in a constricting scream. “Mon Dieu! Mon Dieu!” Her cries to God changed to a few moans, then complete silence after shifting support beams and falling plaster encloses us more tightly, as a predator closing its jaws. I lie entombed in darkness near my translator and Madame Laguerre, the patient I had been examining moments ago. Dirt scuffs my throat with each gasping breath. My right arm is pinned at my side, both legs trapped under massive weights. Surges of pain prevent me from trying to move anything except my left arm which, curiously, is unaffected, its hand searching in darkness as if separate from the rest of my body. It feels softness beneath me. A body. A rope. My head rests on the abdomen of Madame Laguerre, still encircled with the crude belt I remembered seeing when I first met her.
She has nothing, I had thought then. Even making her belt out of hemp and tying it in a knot to keep her faded dress in place. “Where does she come from?” I had asked Odette, my translator who sat beside me in her own roughly sewn dress, quite comfortable without shoes.
“From the far away mountains near the Dominican Republic,” she said. “Madame comes because she has lost weight and feels weak. Painful sores on her skin and in her mouth are infected, and fever comes each afternoon. Her husband has become a stick man and is dying. She thinks she also might have the AIDS.”
My hand reaches the patient’s wet, airless face. Her eyes are closed. I am confused and terrified; there is no light but the hand tells me that my head and left arm are protruding from rubble into a small space and that somehow I’m lying on top of Madame Laguerre.
I call out: “Odette! Odette!”
“I am here, doctor!” Her voice rises somehow unaffected from the ruins of the Hôpital de l’Université d’Etat in Port-au-Prince where we had worked together for several weeks before the shaking started. Then Odette, wide-eyed with carefully barretted black hair and simple dress, looked cool and professional as she carefully told me about patients’ symptoms while I, in crumpled shorts and sweat-soaked shirt, mopped perspiration from my face as I examined patients.
My eyes burn. I rub them but still cannot focus in the absolute blackness. She can be only a few feet away in the ruins of the small room.
“Where are you?”
Odette answers. “I do not know; there is only darkness. I have no pain,” she gasps, “I am a prisoner. There are moans nearby but I can not go to them—only a small space near your voice. We have each other. We can help each other.”
“Come closer if you can,” I shout. “Help, I cannot move!”
She crawls closer. “Doctor, we are the same now, trapped here together. The voodoo gods must be angry with what we have done to this country.” How can she believe a god could do this, I wondered. How could she believe in an angry god who punished believers? I certainly didn’t.
“An earthquake just happens. The gods have nothing to do with it, Odette.” Still, I had been impressed with how happily the Haitians lived with their religion. Witchcraft to ease the pains of poverty and illness, I had thought.
Odette has somehow crawled through a narrow opening in the rubble and pulled me away from the confining wreckage. I scream as crushed leg bones suddenly rasp together. We are confined by fallen beams, broken plaster, and the body of Madame Laguerre. Our bodies touch, an embrace of necessity. “My god, Odette. What will happen to us?” My arm sweeps away crumbled debris between us. She unbuttons my shirt and pulls it back on inside out. “The devil will not smell you now,” she says.
Whatever, I think, feeling the buttons against my skin. How can it hurt?
Her head resting against mine, she coughs violently and continues. “We can only wait and pray that He will send someone to find us.”
“God would be fine but a rescue team would be better,” I say. Her finger crosses my lips for quiet.
“We must not forget Madame Laguerre,” Odette says. “She needs to return to her family to begin her next life. Her soul will be confused without their help.”
I ignore her talk of next lives and confused souls. “Tell me about your family,” I ask, trying to change the subject and take my mind away from searing leg muscle spasms. Odette’s unsteady hand touches my face. She shivers, her voice now short and raspy. “I was raised by my mother in a worn-out town south of St. Marc. Father had died from an ear infection. The devil took my brother and my older sister.” The force of her cough shakes my body. She grips me more tightly. “We lived near the dusty main street, and I helped Mother sell water to people traveling along the road. Some spoke English. I learned their language and came to Port-au-Prince looking for a better life. My mother still lives in that old town, selling water.”
There is another heavy shaking, more collapsing, more dust. We cling to each other, gasping for air. I had seen fatal suffocation in the Army—the astonished expressions, the blueness of trapped blood, the broken facial blood vessels caused by forceful attempts to breathe. Looking at their faces then, I had thought that the victims had seen their death approaching as their breathing was progressively constricted. Terrified, I take a deep breath.
I think about how I finally quit that surgical practice. My phone had rung again. I pulled it out of my pocket, glancing at the page showing next week’s full schedule. My life was constricted and confined, out of control. Try to save the lives you see and touch. There was little time to ponder rebirth and certainly no mysticism about the next life. On impulse, I cast the tight schedule aside and returned to Haiti where I had briefly worked during medical training. Haiti, where time seemed endless, where people repeated old stories, sang memorized hymns, and shared what little they had with each other. The voodoo candles, the frenzied dances with animal sacrifices, the Boku hexes. I would see it again.
How much time has passed? My cracked tongue can no longer moisten my lips. The thought of water overpowers even constant aching of both legs or fear of suffocation.
I’m having chills. Is infection starting? Nothingness, black time. I feel something in my pocket when I rest on my side: that small flashlight used for physical examinations I had forgotten. I pull it out carefully and push the switch. My hand is gray. Odette is gray. She brushes off a feathered amulet around her neck. A layer of dirt covers everything.
“Talk to me, Odette. Say anything. I’m losing my mind.” Eyes closed, her mouth moves hesitantly, her hands grasping the charm and its leather cord. “We have hopes and fears, the same,” she mumbles. She continues more softly than before. “Yes, Father, I’m coming with my friend Elna. We gathered some dry sticks for tonight’s cooking. We are so hungry and thirsty, Father. Can you give us water?” Her voice drifts away as we press together for warmth. “The Boku doctors say to shut up your house at night. Close the doors and shutter the windows to protect from evil spirits that fly at night.” She is then silent until I hear her whispering: “He makes us safe. We will trust Him and not be afraid of the night. He watches over us. Are we safe now, Father?”
“Please take my hand,” she says. “The next life, Doctor, there will be no pain or thirst. Think of the next life.”
“Do you really think He can make us safe? That He cares?”
I shine the light on Odette more closely. She clings to her faith, her whispered strength somehow lifts us both. How can I be certain there isn’t another life? Maybe she is right. I grasp Odette’s right hand. There is a red streak down her blouse, the blood forming a small pool beneath her. The ruins shake again. Another cloud of dust. How long has it been? The calendar of my watch shows two days have passed. Is it night or day? I force my mind to think outside the crushed building. There is more shifting of the ruins, noises of heavy machinery smashing into the fallen beams.
Suddenly a shout: “Gen ou Vivian, Gen ou Vivian? Gen lavi anba-a?” (Are you alive? Is anyone down there?)
“Wi! Wi!,” Odette murmurs. “Nou gen isit.” (We are here) “Eske ou ka ede nou, souple? Souple.” (Can you help us, please?)
I shout, “Help! For god’s sake, get us out!” Light appears above us. Someone shoves a water bottle to us and says: “We heard your prayers.”
Odette whispers: “Take Madame Laguerre first, then we will come.”
The Artibonite River flows smoothly through the valley, where slender plantings of rice and corn crowd the narrow trail near my window. Fever has blurred my vision. Long experience with patients tells me my legs are seriously infected and that I might lose them. I focus outside and try to stay calm. The hot sun has softened, illuminating straight-backed women striding home from market, heavy packs piled high on their heads. They talk rapidly. They laugh. An old woman carrying a bundle on her shoulder silently follows them and turns onto the trail leading to the hospital. A soothing breeze brings singing of hymns from nearby country churches and lifts away hot odors. I lift my head from the bed to see other earthquake victims crowding the beds and floors. Many have lost arms and legs. It is Sunday afternoon. Women and children are dressed brightly; the men have clean clothing. Families crowd the surgical ward. They hold hands with each other, with all the patients. They sing hymns, the injured singing when tears permit. A prayer book is placed under unconscious patients’ pillows, a Bible at their feet. Stories are told. Back and forth it goes in Creole. There is a joke that starts with a patient wildly swinging his arms, imitating an unsteady walk during the earthquake—says he was walking down a street in Port-au-Prince when the devil bit off his foot. Another patient adds to it. “Too bad the devil didn’t get your arms.” Laughter. More patients and visitors add to the story. “Too bad he missed your head!” Louder laughter. Now tears of pain mixed with tears of laughing. I’m not going anywhere, just thinking, straightening thoughts.
The old woman enters the room and drops her heavy load near the doorway. She removes the faded red cover from a plastic water bag and shuffles up to my bed. Her wrinkled face is unchanged as she places her hand on my head and makes me drink. She blows on my face and fans my body after lighting a small candle. A Creole Bible is placed at my feet. My eyes close. She scuffs away and returns with Doctor Exe who unwraps my sweat-soaked bandages. I see the infection. It hurts. He looks worried. Soon I am wheeled away; the walls seem to turn but do not fall or close over me. I am in a shiny room. The ceiling light blinds me. I hear metallic ringing as surgical instruments are sorted. Hushed Creole voices. A door swings open. Two silent masked people enter; their wet arms held high. Desperate for help, I whisper: “He leads me beside still waters. I fear no evil, for You are with me. No evil shall befall thee.”
She wears a blue hat and a wrinkled paper dress. I don’t know her. The mask covers her face but not her large brown eyes. They smile. Softly humming a beautiful song, she turns me on my side.
A needle stick in my back. I think Odette is with me. I reach up and take her hand. She tells a story about magical evil birds sent by Bokus. She soothes me, rubbing my hair, caressing my face. “The birds cannot harm you,” she says. Placing her lips against my face, she whispers, “We are still together.” She removes my clothing and places feathers around my neck. White liquid enters my arm through plastic tubing. I am no longer there.