G
amini felt happiest when he stepped from disorganized youth into the exhilaration of work. On his first medical appointment, travelling to the hospitals in the northeast, it seemed he was finally part of a nineteenth-century journey. He remembered the memoir he had read by old Dr. Peterson, who wrote of such travels, it must have been, sixty years before. His book included etchings—a hackery travelling along canopied roads, bulbuls drinking at a tank—and Gamini recalled one sentence.
I travelled by train to Matara and the rest of the way on horse and cart, with a bugler going ahead all the way, blowing his bugle to keep the wild animals off the road.
Now, in the middle of civil war, he rode the slow, wheezing bus at almost the same pace, into almost the same landscape. In a small romantic section of his heart he wished for a bugler.
There were just five doctors working in the northeast. Lakdasa was in charge, responsible for assigning them out to the peripherals and the small villages. Skanda was main surgeon, head of triage operations when there was an emergency. There was the Cuban, with them for just one year. C——, the eye doctor, who had joined three months earlier. ‘She’s got an unreliable diploma,’ Lakdasa said to the others after a week, ‘but she works hard, and I’m not letting her go.’ And the young graduate Gamini in his first posting.
From the base hospital at Polonnaruwa they would travel to peripheral hospitals, where some of them were to live. An anaesthetist turned up one day a week, which was the day surgery was performed. If there were emergency operations on other days, they improvised with chloroform or whatever pills they could find to knock the patient out. And from the base hospital they drove to places Gamini had never heard of and couldn’t even locate on a map—Araganwila, Welikande, Palatiyawa, visiting clinics in half-built schoolrooms, met by mothers and infants, malaria and cholera patients.
The doctors who survived that time in the northeast remembered they never worked harder, were never more useful than to those strangers who were healed and who slipped through their hands like grain. Not one of them returned later into the economically sensible careers of private practice. They would learn everything of value here. It was not an abstract or moral quality but a physical skill that empowered them. There were no newspapers or varnished tables or good fans. Now and then a book, now and then the radio with cricket commentary alternating between Sinhala and English. They allowed a transistor radio into the operating room on special occasions or for a crucial few hours in a test match. When the commentator switched to English there had to be an instant translation into Sinhala by Rohan, the anaesthetist. He was the most bilingual of the staff, having had to read the small-type texts that came with tanks of oxygen. (Rohan was a reader, in any case, often travelling down to Colombo by bus to hear a local or visiting South Asian writer read from a new book at the Kelaniya campus.) Patients in the surgical ward often drifted back into consciousness and found themselves within the drama of a cricket match.
. . .
They shaved at night beside a candle and slept clean-shaven as princes. Then they woke at five a.m., in the dark. They would lie there for a moment locating themselves, trying to remember the shape of the room. Was there a mosquito net above them or a fan, or just a Lion brand mosquito coil? Were they in Polonnaruwa? They travelled so much, they slept in so many places. There was the stirring outside of koha birds. A
bajaj.
Predawn loudspeakers being turned on so there was just their hum and crackle. The doctors opened their eyes when someone touched them on the shoulder, in silence, as if in enemy territory. And there was the darkness, and the minimal clues as to where they were. Ampara? Manampitiya?
Or they would wake too soon and it was still only three hours past midnight, and they feared they would not go back to sleep again but did so within the sweep of a minute. Not one of them had sleeplessness in those days. They slept like pillars of stone, remaining in the same position they had lowered themselves into in the bed or cot or on the rattan mat, on their backs or facedown, usually on their backs because it allowed them the pleasure for a few seconds of resting, with all their senses alive, certain of coming sleep.
Within minutes of waking they got dressed in the dark and gathered in the corridors, where there was hot tea. Soon they would be driving the forty miles to clinics, the vehicle chiselling with two weak headlamps through the darkness, jungle and an unseen view alongside them, now and then a villager’s fire beside the road. They would stop at a food stall. A ten-minute breakfast of fish cutlets in the lesser dark. The noise of utensils being passed. Lakdasa coughing. Still no conversation. Just the intimacy of walking across a road with a cup of tea for someone. These always felt like significant expeditions. They were kings and queens.
Gamini worked in the northeast for more than three years. Lakdasa would remain there, setting up clinics. And the eye doctor with the dubious diploma would also never leave the peripheral hospitals. During the worst crises Gamini had seen her passing out swabs and lotions to trainees even as she operated on an emergency case. What the others envied most about her, apart from her presence as an attractive woman, was the physical evidence of her work. Gamini loved the sight of her ward as everyone in the fifteen-bed room turned towards the door when he walked in, all with the same white patch taped over their dark faces, the same badge of belonging to her.
Somebody once brought a book about Jung into their midst. In the book one of them had found a sentence and underlined it. (There was a habit among them of critical marginalia. An exclamation point beside something not psychologically or clinically valid. If there was any instance in a novel of outrageous or unlikely physical prowess or sexual achievement, Skanda, the surgeon, would write in the margin beside the scene:
This happened to me once . . .
and add with even more irony,
Dambulla, August 1978.
A scene where a man was met in a hotel room by a woman in a negligée and handed a martini received similar comments. When Skanda left to work in the cancer wards in Karapitiya, near Galle, the others knew he would be defacing books there as well, medical texts as well as novels; he was the worst of the marginalia criminals among them.) In any case, it was the anaesthetist who probably brought in the book about Jung. Pictures, essays, commentaries and biography. And someone had underlined
Jung was absolutely right about one thing. We are occupied by gods. The mistake is to identify with the god occupying you.
Whatever this meant, it seemed a thoughtful warning, and they let the remark seep into them. They all knew it was about the sense of self-worth that, during those days, in that place, had overcome them. They were not working for any cause or political agenda. They had found a place a long way from governments and media and financial ambition. They had originally come to the northeast for a three-month shift and in spite of the lack of equipment, the lack of water, not one luxury except now and then a tin of condensed milk sucked in a car while being surrounded by jungle, they had stayed for two years or three, in some cases longer. It was the best place to be. Once, after performing surgery for almost five hours straight, Skanda said, ‘The important thing is to be able to live in a place or a situation where you must use your sixth sense all the time.’
The quotation about Jung and Skanda’s remark were what Gamini carried with him. And the sentence about the sixth sense was the gift he gave to Anil a few years later.
Between Heartbeats
I
t was in the Arizona labs that Anil met and worked with a woman named Leaf. A few years older, Leaf became Anil’s closest friend and constant companion. They worked side by side and they talked continually on the phone to each other when one was on assignment elsewhere. Leaf Niedecker—what kind of name is
that,
Anil had demanded to know—introduced Anil to the finer arts of ten-pin bowling, raucous hooting in bars, and high-speed driving in the desert, swerving back and forth in the night.
‘Tenga cuidado con los armadillos, señorita.’
Leaf loved movies and remained in depression about the disappearance of drive-ins and their al fresco quality. ‘All our shoes off, all our shirts off, rolling against Chevy leather—there has been nothing like it since.’ So two or three times a week Anil would buy a barbequed chicken and arrive at Leaf’s rented house. The television had already been carried into the yard and sat baldly beside a yucca tree. They’d rent
The Searchers
or any other John Ford or Fred Zinnemann movie. They watched
The Nun’s Story, From Here to Eternity, Five Days One Summer,
sitting in Leaf’s lawn chairs, or curled up beside each other in the double hammock, watching the calm, carefully sexual black-and-white walk of Montgomery Clift.
Nights in Leaf’s backyard, once upon a time in the West. The heat still in the air at midnight. They would pause the movie, take a break and cool off under the garden hose. In three months they managed to see the complete oeuvres of Angie Dickinson and Warren Oates. ‘I’m asthmatic,’ Leaf said. ‘I need to become a cowboy.’
They shared a joint and disappeared into the intricacies of
Red River,
theorizing on the strangely casual shooting of John Ireland before the final fight between Montgomery Clift and John Wayne. They rewound the video and watched it once more. Wayne swirling around gracefully, hardly interrupting his walk, to shoot a neutral friend who was trying to stop a fight. On their knees in the parched grass by the television screen they looked at the scene frame by frame for any sign of outrage at this unfairness on the victim’s face. There seemed to be none. It was a minor act directed towards a minor character that may or may not have ended the man’s life, and no one said anything about it during the remaining five minutes of the film. One of those Jacobean happy endings.
‘I don’t think the bullet killed him.’
‘Well, we can’t tell where it hit him, Hawks goes off too quickly. The guy just puts his hand up to his stomach and then drops.’
‘If he got hit in the liver he’s had it. Don’t forget, this is Missouri in eighteen-fuck-knows-when.’
‘Yeah. What’s his name?’
‘Who?’
‘The guy shot.’
‘Valance. Cherry Valance.’
‘Cherry? You mean like Jerry, or Cherry, like apple.’
‘Cherry Valance, not Apple Valance.’
‘And he’s Montgomery’s friend.’
‘Yeah, Montgomery’s friend Cherry.’
‘Hmm.’
‘I don’t think it hit him in the liver. Look at the angle of the shot. The trajectory seems to be going up. Popped a rib, I suspect, or glanced off it.’
‘. . . Maybe glanced off and killed some woman on the sidewalk?’
‘Or Walter Brennan . . .’
‘No, some dame on the sidewalk that Howard Hawks was fucking.’
‘Women remember. Don’t they know that? Those saloon girls are gonna remember Cherry. . . .’
‘You know, Leaf, we should do a book.
A Forensic Doctor Looks at the Movies.
’
‘The film noir ones are tough. Their clothes are baggy, it’s too dark.’
‘I’m doing
Spartacus.
’
In Sri Lankan movie theatres, Anil told Leaf, if there was a great scene—usually a musical number or an extravagant fight—the crowd would yell out ‘Replay! Replay!’ or ‘Rewind! Rewind!’ till the theatre manager and projectionist were forced to comply. Now, on a smaller scale, the films staggered backwards and forwards, in Leaf’s yard, until the actions became clear to them.
The film they worried over most was
Point Blank.
At the start of the movie, Lee Marvin (who once played Liberty Valance, no relation) is shot by a double-crossing friend in the abandoned Alcatraz prison. The friend leaves him for dead and steals his girl and his share of the money. Vengeance results. Anil and Leaf composed a letter to the director of the film, asking if he remembered, all these years later, where on the torso he imagined Lee Marvin was shot so that he could get to his feet, stagger through the prison while the opening credits came up and swim the treacherous waters between the island and San Francisco.
They told the director that it was one of their
favourite
films, they were simply inquiring as forensic specialists. When they looked at the scene closely they saw Lee Marvin’s hand leap up to his chest. ‘See, he has difficulty on his right side. When he swims later in the bay he uses his left arm.’ ‘God, it’s a great movie. Very little music. Lots of silence.’
G
amini worked in the base hospital at Polonnaruwa during his last year in the northeast. This was where the serious casualties from all over the Eastern Province, Trincomalee to Ampara, were brought. Family murders, outbreaks of typhoid, grenade injuries, attempted assassinations by one side or another. The wards were always in turmoil—outpatients in General Surgery, floor patients in the corridors, technicians arriving from a radio store to fix the electrocardiogram unit.
The only cool place was the blood bank, where the plasma was refrigerated. The only silent place was Rheumatology, where a man slowly and quietly turned a giant wheel to exercise his shoulders and arms, which had been broken in an accident a few months earlier, and where a solitary woman sat with her arthritic hand in a basin of warm wax. But in the corridors, the walls mildewed with dampness, men would be rolling giant cylinders of oxygen noisily off the carts. Oxygen was the essential river, hissed into neonatal wards where incubators sheltered babies. Outside this room of infants, and beyond the shell of the hospital building, was a garrisoned country. The rebel guerrillas controlled all roads after dark, so even the army didn’t move at night. In the children’s ward Janaka and Suriya circled their patients—one had a heart murmur, another suffered from fits—but if there was bombing or a village attack they too became part of the hospital ‘Flying Squad,’ and even those in the neonatal ward worked the triage and operating room. They left an intern behind.
The specialists who came north seldom worked only in their specific area of knowledge. They were in Pediatrics one day, but might spend the rest of the week helping to contain an outbreak of cholera in the village settlements. If cholera drugs were not available, they did what doctors in another era had done—dissolved a teaspoon of potassium permanganate in a pint of water and poured it into every well or standing pool. The past was always useful. At one time Gamini tried to keep an infant alive for four days. The girl could hold nothing down, not her mother’s milk, not even water, and she was dehydrating. He remembered something and got hold of a pomegranate and fed the child the juice. It stayed down. Something he’d heard about pomegranates in a song his
ayah
had sung . . . It was legendary that every Tamil home on Jaffna peninsula had three trees in the garden. A mango, a murunga, and the pomegranate. Murunga leaves were cooked in crab curries to neutralize poisons, pomegranate leaves were soaked in water for the care of eyes and the fruit eaten to aid digestion. The mango was for pleasure.
Gamini was working with Janaka Fonseka in children’s surgery when they began hearing news in the corridors that a village had been attacked. In front of him on the operating table was a small boy, naked except for white shorts, a huge mask over his tiny face. The two doctors had been preparing for the operation all week; neither of them had attempted it before, they had been reading the text of the procedure in Kirklan’s
Cardiac Surgery
over and over. They had to cool the boy’s body down to twenty-five degrees Celsius by running cold blood into him, reducing his temperature until the heart stopped. Then they would operate. As they began cutting, the wounded started coming into the halls and they were aware of the Flying Squad in action around them.
He and Fonseka stayed with the boy, keeping just one nurse. A heart the size of a guava. They opened the right atrium. This was as close to magic as the two of them got in their days there. They talked frantically back and forth to be certain of what they were doing. They could hear the carts carrying equipment or bodies, they couldn’t tell which, racing down the halls. There’d been a massacre, they now heard, a village thirty miles away had been pretty well wiped out. Somebody had to be sent there to see if any were still alive. The child in front of them had a congenital abnormality, a beautiful kid, Gamini kept wanting to take the mask off and see his face again. Wanted to look at the boy’s dark black eyes, which had been full of trust, which had looked up at him as he gave the needle that had put him into uncontrolled sleep.
Fallot’s tetralogy.
Four things wrong with the heart, so he would live perhaps only into his early teens if they didn’t operate now. A beautiful boy. Gamini was not going to leave him alone, betray him in his sleep. He kept Fonseka with him, not letting him go to the others as Fonseka thought he should. ‘I have to leave, they keep calling out my name.’ ‘I know. This is just one boy.’ ‘Fuck, that’s not what I mean.’ ‘You have to stay.’
The operation took six hours and all that time Gamini stayed with the boy. He let Fonseka go after three hours. The nurse would have to help him reverse the bypass. He knew her as a starting intern, the Tamil wife of one of the staff. She and her husband had come to the peripheral hospital in the last month. Gamini stood by the boy and explained what they had to do. The boy would have to be rewarmed with blood at a higher temperature, and at the key moment the bypass had to be removed.
Fallot’s tetralogy.
No one had ever performed the procedure in this country.
So in the fifth hour Gamini and the nurse reversed the process that he and Fonseka had set up. The young nurse watching him for any sign that what she was doing might be wrong. But she was faultless, faultless, calmer, it seemed, than he was. ‘This one?’ ‘Yes. I need you to cut a shallow three-inch line there. No, to the left.’ She cut into the boy’s body. ‘Don’t remain a nurse. You’ll be a good doctor.’ She was smiling under the mask.
As soon as the boy was in Recovery, Gamini left him with her. There was no one else he could trust. He got two beepers and told her to contact him if something seemed wrong. He washed up and then went into the chaos of the triage. There was blood on everyone except him.
It took a few more hours to deal with the crisis. In surgery they wore white rubber boots and all the doors had to be closed. Sometimes if a doctor had heat exhaustion he slipped into the refrigerated blood bank for a few minutes among the plasma and pack cells. Gamini took over in surgery. There was a small Buddha lit with a low-watt bulb in nearly every ward, and there was one in surgery as well.
All the survivors had been brought in by now. The killings had happened at two in the morning in a small village beside the main road to Batticaloa. They had brought him nine-month-old twins, each shot in the palms and one bullet each in their right legs—so it was no accident, a close-range job and intentional, left to die; the mother had been killed. In a couple of weeks those two children were peaceful things, full of light. You thought, What did they do to deserve this, and then, What did they do to survive this? Their wounds, in reality quite minor, stayed with him. It was the formal evil of the act perhaps, he didn’t know. Thirty people had been massacred that morning.
Lakdasa drove to the village and did the postmortems, otherwise relatives would not receive compensation. For everyone in the region was poor as grass. In those villages the father of a family of seven earned one hundred rupees a day working in a wood shop. That meant each of them could have a five-rupee meal a day. For that you could buy a toffee. When political entourages came up to the provinces and received tea and lunch, the visit cost forty thousand rupees.
The doctors were coping with injuries from all political sides and there was just one operating table. When a patient was lifted off, blood was soaked up with newspaper, the surface swabbed with Dettol, and the next patient laid down. The real problem was water, and in the larger hospitals, because of frequent power failures, vaccines and other drugs were being thrown away constantly. Doctors needed to scavenge the countryside for equipment—buckets, Rinso soap powder, a washing machine. ‘Surgical clamps for us were like gold for a woman.’
Their hospital existed like a medieval village. A chalkboard in the kitchen listed the numbers of loaves of bread and the bushels of rice needed to feed five hundred patients a day. This was before massacre victims were brought in. The doctors pooled money and hired two market scribes as registrars who moved alongside them in the wards listing and recording the patients’ names and their ailments. The most frequently seen problems were snakebite, rabies caused by fox or mongoose, kidney failure, encephalitis, diabetes, tuberculosis, and the war.
Night had its own activity. He woke and was attached instantly to the sounds of the world. A dogfight, a man running to fetch something, the pouring of water into a vessel. When Gamini was a boy, nights were terrifying to him, his eyes wide open till he fell asleep, certain that he and his bed had lost their moorings in the darkness. He needed loud clocks beside him. Ideally he would have a dog in the room, or someone—an aunt or an
ayah
who snored. Now, working or sleeping during the night shifts, he was secure with all of the human and animal activity beyond the ward’s light. Only bird life, so vocal and territorial during the day, was shut down, though there was one Polonnaruwa rooster that cried out false dawns from three in the morning on. Interns had been trying to kill it.