- This Is How It Always Is
“No X-ray,” K answered cheerfully. After two weeks of working together, K had grown amused by all Rosie requested as if she were asking if the clinic stocked mind readers.
Rosie eased the patient from wheelbarrow to bed. She remembered the night she’d accidentally X-rayed Poppy—well, Claude, almost-Claude, Claude-in-utero—all those years ago in the ER in Wisconsin. Here, she often found that absent being able to see entirely, insides included, it was better to see not at all. Until Thailand, closing her eyes was not a diagnostic technique she’d reverted to much, but it beat going to the grocery store. Especially since there was no grocery store. She held her hand above the patient’s leg to feel how hot it was. She pressed gently with her fingers, feeling for the break, feeling where it was twisted and misaligned. She pictured the X-ray sketched for her by her gently tracing fingers, the ghostly bones reaching for one another as if through time. It was remarkable, really, how well she could see without seeing. Later, she would detect fractures with the far more advanced technologies of a tuning fork and a stethoscope, but she was a couple weeks away from that trick yet. This first one, fortunately and unfortunately, was broken enough she could feel it easily, displaced enough, maybe from the wheelbarrow ride into the clinic rather than the break itself, that the patient was going to need something more than just a cast.
The art of bone setting is not a modern one. Rosie knew this. She knew that once upon a time, broken bones were treated by barbers and blacksmiths, that physicians felt fractures were beneath them. But she also knew why. You sought a blacksmith because you needed someone strong to realign the bone, to overcome the complete freakout the muscles around it were going to have when you started pulling. You sought a barber because you lived in the Middle Ages and were totally screwed.
K was tending to a patient who’d been carried in on a ladder, so Rosie was on her own. Her patient’s husband spoke no English at all. Rosie steered him by the shoulders and positioned him behind his wife’s head, his arms looped around her shoulders up to his own. Rosie went back to the other end of the wooden pallet and took the woman’s ankle gently into both hands. The patient gasped. This boded ill. She made the patient take five deep, slow breaths. She made the husband take five deep, slow breaths. She took five deep, slow breaths. Then she pulled like hell. The patient screamed. The husband screamed. But the bone realigned. And the baby stayed put. Lacking an intramedullary nail—she knew enough not to even ask for that one, not that she could have placed it without an X-ray anyway—she stabilized the leg with fabric wrap, a section of branch, and plates made of coconut shells. As long as the remedy required was something that grew on a palm tree, you were all set.
The patients in Thailand also knew what to do without what they never knew they were doing without. Absent antibiotic ointment, honey would stop a burn from getting infected. Dried papaya seeds crushed into powder would get rid of intestinal worms. Tea made from corn silk would reduce swelling. It was the way here. It was the only way. So it was this skill Rosie started employing, a few weeks into Thailand, a few weeks into Claude 2.0, not so much looking for remedies on palm trees as looking for them where she hadn’t been looking before.
She wasn’t so na?ve as to imagine there was something she could crush up or stir in or scavenge from a plant to help her child live in the world. But if she could doctor without drugs, medical equipment, or sterilized bedding, surely there was another option besides the ones she and Penn had been considering so far. Surgeries, side effects, appropriated choices, and life interrupted on the one hand versus misery, failure to fit, and life disallowed on the other was not a choice any more than dying from dehydration or dying from an enema used to treat dehydration. The trick was neither to make peace with medical intervention nor to eschew it altogether. The trick was to doctor a palm frond to help Poppy and Claude find their way in the world. Rosie didn’t know what that trick was yet, but she was getting a crash course in looking for it.
After three weeks at the school, Claude’s hair was two and a half centimeters of pathetic brown fuzz, and his class had grown from three to seven to ten to twenty-five children. The woman in charge with the painted cheeks (principal? teacher? secretary? mayor?) who’d assured him on the first day, “You fine,” had evidently not believed it herself. It became gradually clear to Claude that Mya, Dao, and Zeya were sent over first because they were the easy ones. They were well behaved, and their English was strong, and they weren’t really in need of the dubious skills of a ten-year-old American tagalong. This meant they were the ones Claude most wanted to spend time teaching. It also meant, Naw Ga, the principal/teacher/secretary/mayor explained, they were the ones who needed it least. She’d sent them over in the first place so as not to overly traumatize the new teacher—who in addition to being not even a teenager yet had no training whatsoever—but she got over that quickly.
“I don’t know how to teach English.” Claude was mildly panicked as his class doubled in size then doubled again and again.
“You speak.” Naw Ga gave him international so-what’s-the-problem eyes.
“I speak it, yeah, but I don’t know how to, you know, teach it to someone else.”
“No one know.” Naw Ga waved her hand, already turning off toward other students, other lessons. “How you learn?”