State of Wonder - Ann Patchett [83]
“Dr. Eckman wrote everything out for him, a sort of study chart. Easter practices constantly. I let him keep Dr. Eckman’s pens when he died. For a while he was making letters all over his arms and legs but I put a stop to that. I don’t know how much of the ink is absorbed through the skin but it can’t be good for a child. It’s a bad habit when there’s plenty of perfectly usable paper. I don’t know what he thinks the letters are exactly, but he remembers them, most of them. He gets them in the right order.”
“Maybe he thinks of them as something that belonged to Anders.”
Dr. Swenson nodded. She watched the boy watch the river. “Easter cries out in his sleep. It’s the only time I’ve heard his voice, but he has one. Months go by and I don’t hear him, but since Dr. Eckman died he’s had nightmares every night. It’s a terrible sound he makes.” Dr. Swenson turned then and let her eyes stay on Marina’s. “It’s a shame you can’t talk to him about it. It’s something that the two of you have in common. I will assume that the issue for you is mefloquine and that Mr. Fox did not send me a doctor with a debilitating mental illness.”
“I’m taking Lariam.” She wished she could bring back the box of grapefruit juice for Karen. It was, all things considered, a remarkable achievement.
“I’ve seen my share of screamers down here but when it happens I never think of Lariam. In the moment I always think it’s a snake.”
“Better to be safe.”
Dr. Swenson nodded. “Lariam is for tourists, Dr. Singh. I sincerely hope you are a tourist, out of here in the next canoe. But short of that I suggest you throw those pills in the river. Do you think I take Lariam? A person can’t live here having screaming nightmares and paranoia and suicidal fantasies. The jungle is hard enough without that.”
“I haven’t been suicidal.”
“Well, good for you. It can still come. I knew a young man who walked into the river one night and didn’t walk out. The natives saw him, thought he was going for a swim.”
“I don’t take it because I enjoy it, believe me.”
“Ever more the reason not to take it. It affects certain people quite seriously. I would say given this display that you’re one of them.”
Marina drew a slow breath in, held it, let it out. She could feel herself coming back even as the fire was raised in her arm. “All the same though, I’d rather not get malaria.”
“Well, I wouldn’t say it’s rampant. I haven’t gotten it, or I got it once but it wasn’t here. And there is after all a cure.”
“Was Anders taking Lariam?”
Dr. Swenson put her hands in her hair and gave her scalp an aggressive scratch. “He didn’t scream in his sleep so we never had the opportunity to discuss it. Are you asking me if Dr. Eckman died of malaria?”
It hadn’t been what she was asking, though it was a perfectly reasonable question. “It seems possible.”
“Malaria is something of a specialty of mine,” Dr. Swenson said. “So I can tell you no. Not unless it was P. falciparum that turned cerebral. That would be a true rarity, of course, there isn’t a great deal of P. falciparum in these parts.”
P. falciparum, P. vivax, P. malariae, and there was one more. When was the last time Marina needed to know the strains of malaria?
“P. ovale,” Dr. Swenson said.
“You think he might have had P. ovale?”
“No, that’s the one you can’t remember. Mention a strain of malaria to any doctor and they try to remember the other three, but no one remembers P. ovale. You see very little of it outside West Africa. Do you have the same dream every time?”
Marina had been too recently asleep to understand everything, too recently on this boat, too recently discussing snakes, too recently in Calcutta, too recently with Anders. P. ovale? “More or less.”
“I find mefloquine interesting in that way, how it taps into a single pocket of the subconscious. You could just as easily use it as a treatment