A Fiat Premier Padmini suits Dr. Ramasamy better than the stodgy Ambassador, or the cockroach-like Standard Herald. Those three rebranded foreign models are the only cars licensed to be built in socialist India; for any other car, one must be willing to pay a 150 percent import tax. Uma’s Fiat is custom-painted ebony black with a red top; it has an extra bank of headlights, tinted windows, and a throaty exhaust. And, unusually, she drives herself.
When Dr. Ramasamy first lectured to their class in the century-old Donovan Auditorium, even the murmuring backbenchers were silenced when the tall, confident woman in a short-sleeved lab coat floated in. She had launched right into inflammation, the body’s first response to any threat, the common denominator of all disease. In minutes she had drawn them into the thick of a battle: the invaders (typhoid bacteria) are spotted by the hilltop sentries (macrophages), who send signals back to the castle (the bone marrow and lymph nodes). The few aging veterans of previous battles with typhoid (memory T-lymphocytes) are roused from their beds, summoned to hastily teach untested conscripts the specific typhoid-grappling skills needed, and then to arm them with custom lances designed solely to latch onto and pierce the typhoid shield—in essence, the veterans clone their younger selves. The same veterans of prior typhoid campaigns also assemble a biological-warfare platoon (B lymphocytes) who hastily manufacture a one-of-a-kind boiling oil (antibodies) to pour over the castle wall; it will melt the typhoid intruders’ shields, while not harming others. Meanwhile, having heard the call to battle, the rogue mercenaries (neutrophils), armed to the teeth, stand ready. At the first scent of spilled blood—any blood, from friend or foe—these mercenaries will go on a killing frenzy . . . Dr. Ramasamy kicked out the fuchsia-and-gold border of her red sari as she paced before the board. Mariamma was reminded of the women conjured up in her mother’s sketches; the sinuous charcoal lines conveyed not just the drape of a sari but the form of the woman underneath.
A brass plaque outside her office simply reads HANSEN RESEARCH CENTER. Atypically, Dr. Ramasamy doesn’t seem to need to put her name on it. The air-conditioned chill within reminds Mariamma of the sari shops in the affluent suburb of T. Nagar, where the salesclerks seated on raised platforms recklessly pull one gorgeous sari after another from the stacks, unfurling and cascading them before the client. But here chrome refrigerators, water baths, incubators, sleek lab benches, and centrifuges take the place of palisades of silk and cotton. Mariamma’s eyes fall on the sleek binocular microscope. Her mouth waters. It even has a second binocular attachment on it—a teaching head—so student and teacher can study the same slide, illuminated from below with an electric bulb. Compared to this beauty, Mariamma’s one-eyed scope, which only works next to a bright window with much jiggling of its reflecting mirror, is a bullock cart.
“She’s a beauty, isn’t she?” Dr. Ramasamy is in an ocean-blue sari. She wears simple gold studs in her ears. She gestures to the high stools by the microscope. After preliminaries, she says, “So . . . I asked you over to see if you wanted to work on a project with me on the—”
“Yes-I’d-love-to, Madam!” she says, the words spilling over each other.
Dr. Ramasamy laughs. “Shouldn’t you find out what it is first? Or do you say yes to everything?”
“No-I-mean-yes, Madam.” Mariamma can’t keep her head movements straight. She must look like a very silly girl. She must speak more slowly, as Anita often reminds her.
“You’d be assisting my research on peripheral nerves. On Hansen’s disease.”
Why not just say leprosy? Mariamma wonders.
“The task is to carefully dissect the upper limbs we’ve preserved from patients with Hansen’s and expose the median and ulnar nerves and their branches fully. Then we photograph the gross specimens in place before we sacrifice the nerves and make multiple sections to examine microscopically. Some of those sections we will send for immunohistochemistry staining and study in Oslo.”
Mariamma pictures the lepers at the Maramon Convention, or the ones who shuffled up the path to Parambil, looking like aliens from another galaxy, and stopping at hailing distance to rattle their cups. She shudders inwardly at the thought of dissecting one of their limbs. Maybe “Hansen’s” is a better name after all.
“I’m honored to be asked,” she says.
Dr. Ramasamy cocks her head, her smile getting broader. “But . . . ?”
“No, nothing . . . Just wondering, Madam, why me?”
“Good question. Dr. Cowper recommended you. I saw your hand dissection from the prize exam. Amazing that you did that in two hours. That’s exactly what I need. But my specimens will be trickier.”
“Thank you, Madam. I’m happy that you didn’t pick me because of . . .”
“Because you crushed Brijee’s balls?” she says, her expression deadpan. Mariamma bursts out laughing, shocked.
“Ayo, Madam!”
“That was an added recommendation, to be honest. I was a student here not that long ago. We had our Brijees, though no one quite as poisonous. Sadly, some are still around.”
Mariamma begins the next day, retrieving a specimen from a formalin tank that seems to contain a pile of forearms with hands attached. She dissects by the window where the light is best. She has a magnifying glass on a stand if she needs it. She must find the trunks of the median and ulnar nerves in the forearm and dissect out their branches to the fingers, or rather to the stumps, since this specimen lacks fingers. The trouble is the skin is as thick as an elephant’s hide, more so than the usual formalin-preserved cadaver dissection. The fat and subcutaneous tissue feel rock-hard and glued to the skin; she must be so careful not to tear the nerve. She cannot use anything as sharp as a scalpel or scissor when she might be close to the nerve. So for hours she digs, pushes, and scrapes with gauze wrapped over her finger, or with the handle of the scalpel—“blunt dissection” they call this in surgery. She’s like a hunter looking for tracks. The signs are subtle, like the faint and darker ridge of earth raised by an earthworm. She sits bent over the specimen, just as when she did needlepoint as a child with Hannah. Are cloistered nuns allowed such hobbies?
It takes a week and aching wrists and a stiff neck to complete the first dissection.
“Wonderful!” Uma says when she comes to look. “I hired you because I can’t spare the time to do this. But I confess, I tried. I butchered it! What’s your secret?”
Mariamma hesitates. “It’s partly my eyesight. I learned needlepoint when I was very young. I found I could do very minute things that Hannah—the girl who taught me—couldn’t, though she had normal vision. In fact, I haven’t been using your magnifying glass because it makes me dizzy. Also, Madam—” She hesitates. When she tried to explain this to Anita, her roommate thought she was mad. “I don’t want to sound boastful . . . or mad. But during anatomy dissection I felt I was seeing differently. I mean, we could all be looking down at a flat, squashed mess of formalin tissue. But I could see it in three dimensions, I could rotate it in my head. It’s more than knowing what I was supposed to see—we had the dissection manual in front of us for that. I could see how the tissue below me differed from the figure. I could imagine it fully, almost see through it. After that, the challenge is to bring it out. For that I use every sense I have. I’m paying attention to the resistance of the tissue, to the feel, and even the vibration or friction as my instruments move on its surface.”