Cutting for Stone - Abraham Verghese [229]
ONE EVENING as they lay next to each other, their beds pulled together, and as he read to her from the daily worship book, she exclaimed in surprise. He looked back at the sentence to see if he had missed a word. He looked up to see blood staining her white nightgown and spreading out as if she had been shot.
As long as he lived he would remember that in the awful moment when she realized she was dying, and when her eyes sought his, her first thought, her only thought, was about abandoning her son.
For a second Thomas was paralyzed. Then he jumped up and pulled aside the soggy blouse. A red geyser shot up from her chest and arced to the ceiling, then fell to earth. In the next instant it did it again. And again. A pulsing obscene blood fountain, timed to every beat of her heart, kept striking the ceiling, showering him, the bed, and her face with blood, soaking the pages of the open book.
He recoiled from the monstrous sight, this eruption from his mother's chest which painted everything around it red. When it occurred to him to try to staunch it with the bedsheet, the jet was already dropping in height, as if the tank were empty. Hilda lay soaked in her blood, her face white as porcelain and flecked with scarlet. She was gone.
Thomas cradled her soggy head, his tears falling on her face. When Dr. Ross arrived, a white coat thrown over his pajamas, he said to Thomas, “It was inevitable. That aneurysm has been ticking in her chest for over a year. It was just a matter of time.” He reassured Thomas that the blood was not infective—the thought had not crossed the boy's mind.
ALONE, TRULY ALONE, Thomas developed fever, and a cough. He refused to be moved from the cottage to the infirmary; the cottage was the last thing on earth to connect him to his mother. He let them take him for an X-ray. Later he watched Muthukrishnan, the compounder, arrive with a pushcart carrying the bulky pneumothorax apparatus in its polished wooden case. Muthu squatted on the balcony and, after wiping his face with a towel, he opened the wings of the fancy box and began unpacking the large bottles, manometers, and tubing. Dr. Ross, himself once a consumptive, soon cycled up. “The X-ray was no good, lad. No good at all,” Ross said.
It is just a matter of time, Thomas thought. He looked forward to joining his mother.
He didn't flinch as the needle went between his ribs posteriorly and into the pleural space that lined the lung, a space that was normally a vacuum, Ross explained. “Now we measure pressures.” He maneuvered the needle while Muthu fiddled with the two bottles, raising and lowering them on Ross's command. “This is ‘artificial pneumothorax.’ Fancy way of saying we put air in that vacuum that lines your chest to collapse the infected part of the lung, lad. Those Koch bacteria need their oxygen to thrive, and we won't give it to them, will we?”
Facedown, from the depths of his illness, Thomas thought this reasoning was illogical: What about my oxygen, Dr. Ross? But he said nothing.
For twenty-four hours Thomas had to lie prone, propped in position by sandbags. Muthu came by many times a day to check on him. Muthu noted the sudden fever and the chills. The artificial pneumothorax had introduced other bacteria into the pleural space around the lung. He heard Ross's voice from afar. “Empyema, my boy. That's what we call pus collecting around the lung. Doesn't happen that often