Cutting for Stone - Abraham Verghese [118]
Day after day a white-robed mass flowed up our hill, gravity the current against which they swam. Those whose breath ran short as well as the crippled and the lame stopped at the halfway point to look up, to gaze past the tops of the flanking eucalyptus to where the African hawks soared against the blue sky.
Once they crested the hill, patients went to the registration desk to get their card. From there it was on to Adam, the man whom Ghosh called the World's Greatest One-Eyed Clinician. “Short of breath, are you?” Adam might say to a patient. “But still you managed to run up the hill and get the fourth card of the day?” In Adam's book, a number under ten on the outpatient card identified a hypochondriac more accurately than any test Ghosh might do.
From my spot observing the daily influx, I once saw a proud Eritrean woman carrying a heavy basket; inside was something large, sprouting, with a surface that was red, raw, and weeping. It was her breast. It had become so huge from cancer that this was the only way for her and her breast to come to Missing.
I drew such sights in my notebook. My sketches were nothing like Shiva's, but they served me well. A glance at them allowed me to recall the memory, even if it was not Shiva's photographic kind.
On page thirty-four I drew a child in profile, chubby-cheeked, healthy. But from the other side, his profile showed a chunk of his cheek, one nostril, and the eye missing, so that his glistening teeth and pink gum and the recess of the orbit were visible. I learned from Ghosh to call this ghastly sight cancrum oris. It came about from a trivial gum or tooth infection which spread because of malnutrition and neglect, often during an episode of measles or chicken pox. Once ignited, it progressed rapidly, usually causing death before the child could be brought to Missing. Sometimes, the disease simply ran out of steam, or the body's defenses were finally able to contain the march, but at the expense of half the face. Death was perhaps a better fate than to live with the disfigurement. I watched Ghosh operate on this child. It was terrifying, and then I was in awe at what this man who sat down to dinner with us each night was capable of doing: rotate a flap of skin to cover the cheek, and another the hole in the nose. Further flaps and reconstruction he planned for a later surgery. Even so there was no restoring to normal the face, much less the soul, of a child so scarred. After the surgery, what Ghosh said to me was, “Don't be too impressed. I'm an accidental surgeon, son. I do all I can do. But your father … what he could have done to that face would have been as good as the best plastic surgeon alive. You see, your father was a real surgeon. I don't think I've seen anyone better.” What made someone a real surgeon, I asked. Ghosh didn't hesitate: “Passion for his craft … and skill, dexterity. His hands were always ‘quiet.’ I mean he had no wasted movements, no dramatic gestures. It looked slow, routine, but when you looked at the clock you realized how fast it must have been. But even more important is the confidence once you make the first cut, the belief in yourself, which allows you to do more and get better results. I'm thankful I can do the simple things, the bread-and-butter operations. But I'm scared to death half the time.”
He was being modest. But it was true that Ghosh was a different being in the outpatient department where he saw “consultations”—the patients Bachelli and Adam kept for him to render an opinion. Ghosh's real skill emerged with those who looked “normal” to my gaze. Hidden from us unschooled observers, a disease had left its traces. A woman who wove baskets said, “On St. Stefano's Day I passed urine on a barbed-wire fence …” Or this from a sad, distraught coolie: “The morning after the Wednesday