Islands: A Novel Part 6

"It's not close to anywhere," he said. "It's a terribly poor and backward region, and for years the only health care has been a bankrupt government clinic in a town fifty miles away, with only a burro path connecting the two, and that covered by rock slides and cave-ins half the year. But there's a new road now, just opened, and it puts the village within range of a bigger national highway that leads to several larger towns. A Dr. Mendoza has established a little hospital there, or hopes to, and found a couple of nurses and some funding for equipment. He got in touch with our folks in Was.h.i.+ngton, and asked for help from whoever could come. I was up, so said I'd be there. Now that there's some access to other, more populated areas, a setup on the order of Outreach-not nearly so sophisticated, of course, but a start-would be salvation for the village. Anny, please come. I can't pay you, but I can guarantee you a clean bed and three squares a day, and all the backup I can give you. There'll be some other docs there; I don't know who, or what their specialties are. But we'll have company, and you might enjoy the native people. I always have. There's an interpreter along, too. How about it? You like burritos?"

I thought of my last board meeting, which had been consumed entirely by a discussion of our PR effort to acquire gifts and services. I had nearly drifted into sleep during the excruciating minutiae of our current fund-raising confection, a dinner dance at the Kiawah Island home of a board member who had just redecorated and built a large pavilion out over the dunes, facing the sea. The gala's working t.i.tle was the "Outreach Beach Ball."

"I have some vacation time coming," I said to Henry. "I think I'll go. I'm being Kiawahed to death right now."

Only then did I look at Lewis, questioningly.

"I love burritos," he said. "You got s.p.a.ce for an old bone man?"

Henry laughed and hugged me and pounded Lewis on the bicep.

"Did you know that the mountains of Mexico have more poisonous scorpions than any other region in the world?" Fairlie said, swirling wine around in her gla.s.s. She was smiling, though. Through some alchemy, she and I had become friends, to the point where we could tease each other without wondering if there was a barb embedded.

"No wonder they need doctors," I said. "Why don't you come, Fairlie? I could use somebody to go to the ladies' room with."

"They got no ladies' rooms," Fairlie said, grinning. "Besides, what would I do? Teach them to dance?"

We all laughed, and Camilla smiled at me.

"Good for you, Anny," she said. "I've always worried about Henry on these little sorties. I keep thinking he might run off with a fiery senorita or something, and we'll never see him again. You can keep watch."

"He's already got a fiery senorita," Fairlie said, baring her teeth ferociously at Camilla, who laughed outright.

"So he does," she said.

That evening, just after sunset, I walked down the beach with only Gladys for company. The day had been blisteringly hot, but there was fog coming in over the dunes from the waterway, which meant, I knew, a change of weather. All of a sudden the empty beach and the warm water swirling around my ankles felt poignant, elegiac. This summer was ending. It made me sad.

I turned to go back. The fog had reached the top dune line and blurred the beach house. Its lit windows burned cheerful holes in the mist. All at once I could not wait to get off the empty beach and into the house. I started across to the steps to the wooden walkway, whistling to Gladys. She came larruping happily behind me. Both our feet slipped in the dry, s.h.i.+fting sand.

I looked up to see Camilla on the top of the dune line, a little way from the house. She wore her old raincoat, and it blew about her. I wondered what she was doing out in the fog. She always said that it made her bones hurt.

"Hey!" I called. "What are you doing up there?"

She did not answer, and I cupped my hands to throw my voice farther.

"Camilla?"

Again, there was no answer. I turned to make sure Gladys was with me, and when I turned back, Camilla had gone inside. Gladys and I bounded up the steps and into the house as if pursued.

They were all sitting around the unnecessary but beautiful fire, drinking wine. I loved them suddenly. Loved them all with a weight that hurt my heart.

"You've got wet hair," Lewis said.

"There's a big fog bank out there, in case you haven't noticed," I said. "Camilla, what were you doing out there on the dunes? I yelled, but I guess you didn't hear me."

She looked at me.

"I haven't been outside," she said. "Not this whole afternoon."

"I was sure it was you. It looked like that old raincoat of yours, the one with the hood."

"I gave that to the Salvation Army last spring," she said.

There was a silence.

"You saw the Gray Man," Simms said, leering. "Gonna be a storm sure as gun's iron."

"Oh, I did not," I said peevishly. "It was probably somebody up there looking for a dog or something."

"Nope. The Gray Man," Charlie jumped in. "Come all the way down from Pawley's just to see you. We better batten down."

On the way home, the fog thick and white by now, I said to Lewis, "I did see somebody on the dunes. Somebody real. Why does everybody have to carry on about the d.a.m.ned Gray Man?"

"Teasing you," he said briefly. He did not say any more.

"Lewis, you can't possibly think..."

"I guess not," he said.

We did not speak again until we got home.

"Want cocoa?" he said.

"I think I'd just like to go to bed. I've got to get up early if I'm going to arrange to take two weeks off."

"Well, I think I'll read awhile," he said, and kissed me on the forehead. "Be up later."

I lay awake for a long time, even after he came up, even after I heard his breathing deepen into sleep. I had wanted amused denial, fond ridicule, and, I realized, rea.s.surance. Their absence felt like hunger.

Ciudad Real means "royal city," and it is difficult to imagine that any one of its 355 inhabitants gives much thought to the irony of that. It lies in the north-central state of Chihuahua, huddled in a gap in the Sierra Madre Occidental range, approximately halfway between the small city of Madera and the sea. Until very recently, it was connected by road only to the slightly larger village of Oteros, whose own road led to the spectacular Barranco del Cobre, or Copper Canyon, and stopped. There were footpaths over the mountain to small towns on the Sonoran coast, but it was not possible to get goods and crops for trading and selling over them, and the great Copper Canyon Railway that connects the arid mountainous interior of northern Mexico to the Pacific was beyond the means of most of the villagers. Few of them harvested crops or fabricated goods anyway. It was a desperately poor little hamlet set among stunted oaks and stubby cacti. A cloud of dust hung over it perpetually. There was a small, crumbling adobe church, a cantina with rooms above it for the thin teenage prost.i.tutes and their guests, a sort of store/gas station affair that sold fly-specked canned goods and American snacks and sodas and the occasional gallon of elderly gas. There was a telephone in the cantina and store, but none of the horrendously dirty and dilapidated houses seemed to have one, and the only TV aerial I saw was on the roof of the cantina. In its sun-smitten little central square, the fountain was dry and the market stalls all but empty. A few merchants sold thin, dispirited chickens and a skinny, cold-eyed goat or two, and bits of lumpish pottery, and baskets of wilting vegetables and fruit that grew in the gardens behind the homes. English, we found, was spoken only by the unkempt priest, the doctor who had summoned us, and the bar mistress of the cantina, who was also its madam. To get there from Charleston, you flew to Atlanta and from there to Mexico City and from there to Chihuahua, took a battered bus from Chihuahua to Madera, and depended for the remainder of the journey to Ciudad Real on the kindness of strangers.

We came into Madera at three in the afternoon on September the eighth, dirtier and more tired than I, at least, had ever been in my life, and were met by the aforementioned Dr. Lorenzo Mendoza, in a Land Rover that made Lewis's Range Rover look like a Rolls-Royce limousine. He was a short, stocky, swarthy man with the darting energy of a Tasmanian devil and a gold-starred smile as wide as his entire face.

"My Americans are here!" he shouted, and hugged us all in turn. He hesitated when he came to me, said, "You are a nurse, perhaps? Wonderful!" and continued his hugging without listening for an answer. He smelled powerfully of stale sweat, but so did we. I so badly wanted a bath and a nap that I would have gotten into the Land Rover with the world's gamiest Sasquatch. Wedged in between Henry and a gastroenterologist from Houston, I found myself trembling with insane, suppressed laughter. I felt Henry's shoulder shaking and knew he was desperately trying to contain laughter, too. I did not look at him; that would have been death for both of us. In the seat ahead of me, Lewis slept. He could sleep anywhere. I hated him momentarily. The gastroenterologist stared straight ahead. Two general surgeons from Fort Worth cowered in the front seat with Dr. Mendoza, being bombarded with shotgunned information.

The new road, the good doctor said, connected Ciudad Real to Madera, from there to Chihuahua, and then on to Highway 40, which wound its way across the waistline of the country and entered Texas at McAllen.

"Now we are in reach of many health care facilities, and we can receive supplies," he cried gaily. "I put up my little hospital and some temporary housing for the staff even before the bulldozers rolled out. It is small, but it will grow, and it is not uncomfortable, I don't think. With my new friends to teach new techniques to me and one or two new a.s.sociates coming in, and even a nurse to instruct my nursing staff, we will soon be a distinguished regional facility."

And he laughed, a trifle hysterically. The two surgeons grinned desperately. Lewis snored. Henry snorted.

"Don't you dare," I hissed furiously at him. The gastroenterologist did not move his eyes from the road ahead.

We caromed through deserted little Ciudad Real, scattering dust and chickens and a few skinny black dogs. A fat woman with impossibly lush, lacquered black hair waved from a window over the cantina-the madam, I learned later, Senora Diaz. In the entire two weeks we were there, I never saw hair nor hide of Senor Diaz. He was very much alive, Dr. Mendoza a.s.sured us, though he was seldom seen.

"It is just that he is shy," he said.

We careened around a curve overhung by a huge boulder, and there was the hospital of Dr. Mendoza. The distinguished regional medical facility. It consisted of three brand-new double-wide trailers placed side by side in a meager grove of scrub oaks and connected by a wooden walkway. A low wooden barracks affair sat a little behind the trailers, with a few folding plastic chairs set about it in the dirt and an outside shower affixed to one end. I wondered, crazily, how he had gotten the trailers and the material for the barracks over the new road.

In front of me, Lewis woke up.

"Holy s.h.i.+t," he said.

"Yes!" Dr. Mendoza shouted in ecstatic agreement. "It is truly holy s.h.i.+t, is it not?"

It was a sh.e.l.l-shocked and surreal sort of evening. The American doctors would be housed in the barracks-"brand new, still smelling of sweet new wood!"-but no one had told him I would be coming. The nurses had lodging with a couple of villagers, but he did not think there was any more available. We would go and have our dinner at the cantina, and give thought to the matter of where I was to sleep.

"A clean bed and three squares, huh?" I glared at Henry. "Maybe there's a goat shed around somewhere I could share."

"I'm sorry, Anny," he mumbled. "I've never been on one of these things that didn't have some kind of hotel or motel or something."

"You d.a.m.ned well ought to be sorry, Henry, my man," Lewis said ominously. But I could see his lips twitching. It was clear to all three of us, even before the arrangements were made, that I would be sleeping upstairs over the cantina with the three adolescent prost.i.tutes.

"But by far the best room," Dr. Mendoza a.s.sured me earnestly. "It is for the ones who stay three or four hours. There is a television set and flowered sheets."

"You could come out of this a wealthy woman," Lewis said. And we all burst into laughter. It was clear that the surgeons and the gastroenterologist did not get the joke.

Looking back, I can picture those two weeks in Ciudad Real as if I were watching them on a screen. They have the surreal vividness of a fever dream: details stand out as if limned in light. I can remember the sights, sounds, smells, tastes so clearly that I become lost in them. Almost anything can call them back: the bra.s.sy wail of cantina music, the taste of dust, the smell of new wood in the barracks and old sweat and perfume in my seraglio bedroom, the taste of warm beef and tacos. I do not wish to summon that time; in many ways it was ghastly in the extreme, and pales utterly beside some of the beautiful places Lewis took me in the years after that. Nevertheless, there it is, lodged in my subconscious like a bone in a dog's throat. I think it's because those weeks were so absolutely self-contained, so totally without context. Nothing-not time, not the world-seemed to intrude upon them. That hyperreality is still a source of both pleasure and pain to me.

Nothing, absolutely nothing, went as we had supposed it would. The first morning we went into the hospital's minimal little waiting room and found it boiling with the miserable humanity of Ciudad Real. Patient old men and women; wailing children; vastly pregnant women; stoic, sullen men with racking coughs or b.l.o.o.d.y rags wrapped around an arm or a leg; even a black dog, tail thumping under the receptionist's desk. If there had been a receptionist. The two promised doctors did not appear.

"I have had word that they have been detained in Guatemala," Dr. Mendoza said. "Some foolishness at the border, no doubt."

"Those docs can kiss their a.s.ses good-bye," Lewis muttered to Henry.

The three nurses, rubbing sleep from their eyes, were short and squat, with Indio blood apparent in their opaque black eyes and slightly flattened noses. They wore proper nurses' uniforms, none too clean, and did not speak a syllable of English. The interpreter had missed his plane to Chihuahua and was considering renting a car.

"We can kiss his a.s.s good-bye, too," Henry growled.

"I didn't realize there would be a clinic," Lewis said as amiably as I have ever heard him. It was an ominous sound. "It's going to be hard to share techniques and suggestions if we're busy all day treating walk-in patients. I was prepared to show you some new orthopedic surgery, and I know that Dr. McKenzie has some new wrinkles in cardiology. Most of these folks look like a nurse or a family physician could handle them."

"Oh, but you will treat and I will watch, and then I will show the two doctors when they come," Dr. Mendoza said happily. "And as you see, we have nurses." He gestured at the three young women. They gazed back with blank, obsidian stares.

"But they have no English," one of the general surgeons said, in a tight, constipated voice. "And unless I'm mistaken, none of us has adequate Spanish. Who is going to interpret?"

Dr. Mendoza looked hopefully at me.

"No, I'm sorry," I said. "I'm not good at all with Spanish. I'm really here to help you set up a program of resources available to your patients."

Dr. Mendoza puzzled for a moment, and then spat out something in rapid-fire Spanish to a young girl who looked relatively mobile. She left the trailer and trudged back toward the town.

"I have just the answer," the doctor said. "Mrs. Diaz speaks wonderful English. She will help us out."

And so it was that the first day in the hospital of Dr. Mendoza, the madam of the local house of joy served as interpreter and sometime disciplinarian, and did it very well indeed.

"What will happen when you have to go back to your daytime work?" I said to her as we sat, wiping sweat from our faces, in the folding plastic chairs outside the barracks. I had been drafted to serve as receptionist and appointments secretary, and that is what I did until the day we left. Almost immediately I liked this big, vital woman with luxuriant dyed hair and enough lipstick to frost a cake. She was intelligent, industrious, matter-of-fact, and virtually unflappable. I thought she was sorely wasted as a small-town madam, though I did not say it.

Carmella Diaz grinned. She had a fine gold tooth.

"My no-account esposo can get his sorry a.s.s out of bed and keep the cantina," she said tranquilly. "Work really doesn't start until nighttime, and it don't take much to keep those hyenas in line. By the time they want one of my girls, they're too drunk to cause trouble, anyway."

I felt my cheeks burn, and then laughed. Why not? It was the way of things in Ciudad Real.

We triaged and treated as best we could until past eight that evening. Fevers, diarrhea, broken bones, cuts from G.o.d knows what, endless coughs and colds, one or two real medical problems that, without facilities and a.s.sured nursing care, the doctors could not handle.

"You need to evaluate every case and get the ones in real trouble over to the nearest big town," Lewis said at the end of that interminable day. "I can't operate here without surgical nurses and equipment and no antibiotic except penicillin. There are many good new ones; I'll make you a list. And anesthetics, too. You can't use the same one for everybody. You'll need an internal medicine man immediately; he can tell you what supplies you're apt to need. And you'll need a highly trained head nurse. Nursing care is going to make the difference out here."

"But here they are," Dr. Mendoza said, indicating the three young women, who had not moved.

"But who's going to train them?" one of the general surgeons asked.

"You doctors?" Dr. Mendoza said hopefully.

"No. Out of the question," Henry said. "I wish you'd been more specific about your problems when you got in touch with our people in America. You don't need new techniques. You need trained clinicians."

"And here you are," the doctor said, beaming.

The next morning the silent gastroenterologist said curtly, "Boil the G.o.dd.a.m.n water," and hired the husband of Senora Diaz to drive him to Madera. The two surgeons lasted until Wednesday. At this rate, I thought, Mr. Diaz is going to be a rich man.

Somehow it did not occur to the three of us to leave. There was a staggering load of illness to handle, and we did our best, day after day. Henry and Lewis swabbed throats, lanced boils, listened to chests, sewed up lacerations, thumped pregnant stomachs, handed out aspirin and vitamins and what little penicillin they had left. I held babies for shots and wrote down appointments, and learned to give injections. The three nurses watched it all impa.s.sively.

In the evenings, so tired that it was hardly possible to stumble up the hill, we retired to the cantina. It was a rough, smoky place, with a kind of savagery not far under the surface, but the patrons soon became used to us, or too drunk to bristle like roosters at the usurping gringos, and the food was not bad. If it ran heavily to chicken and what I thought might be goat, but did not ask, it soon ceased to matter. After the first four or five offers for my services, Carmella Diaz's blistering tongue got the message across that I was not for sale. I don't know what the patrons thought when I kissed Lewis and Henry on the cheek and went up to bed at the ridiculous hour of nine o'clock, even before the putas came to work.

"The word is out that you're some kind of fertility G.o.ddess," Lewis smirked.

"G.o.d forbid," I said.

I seldom found it difficult to fall asleep, lying coc.o.o.ned in my floral sheets. I had long since given up on the television. There was only one fizzing channel, and it was in Spanish. It seemed to be football. No English newspapers or magazines made their way into Ciudad Real.

"You can send them all your old office magazines," I said, and they laughed. We laughed a great deal in those two weeks, Lewis and Henry and I. Our time there had a kind of comrades-in-arms feeling to it, as I imagined must have been engendered during the blitz of London. I felt skin close to both of them, as if we were a single unit.

I was sitting with Carmella in the plastic chairs, toward the end of our stay, thinking that I would miss her very much. She asked me why I had come to Ciudad Real and I told her about Outreach, and what it did.

"But I don't think you're far enough along for anything like that," I said. "Maybe when the hospital is fully staffed..."

"So you need someone to find out what people need and then get it for free," she said, going straight to the heart of the matter.

"That's it exactly," I said.

"I can do that," she said dismissively. "Many wealthy men will be coming to our village now that the new road is open. People have heard of my girls. I will remind them that our people need many things they could supply, far more than their wives need to know about their evenings here."

It was a measure of my a.s.similation that I said, "Perfect. I couldn't have done better myself."

On our last night in the village, Lewis gave Carmella fifty American dollars and followed me up the stairs to my room.

"They'll be talking about it for years," he said. "Wondering what kind of woman you are to cost a man fifty dollars a night."

We lay in bed, my cheek against his heart, listening to the music drifting up from the cantina, and the thin howls of ersatz l.u.s.t the three young women employed. They were invariably the same: a piercing "Aye, mi Dios!" followed by a series of yips, as from a small dog.