The Covenant of Water

Three generations of us are here in the Brain Room, Mariamma thinks. When Big Ammachi lit the seven-tiered lamp the night her namesake was born, she’d said to the kaniyan, “There’ll never be another like my Mariamma, and you can’t begin to imagine what she’s going to do.” As a child, whenever her grandmother recounted that tale, she’d always say they lit the lamp so it might show Mariamma the way for whatever she might choose to do in life. “What will I do, Big Ammachi?” Mariamma asks aloud now, just as she did so long ago, her voice echoing in the Brain Room. She hears her grandmother’s reply: “Whatever you imagine.”

Ammachi, I imagine taking on this enemy that drowned my father, drowned him when a train wreck couldn’t kill him. I imagine conquering this cramped territory at the base of the brain, making it my battlefield, and giving myself to better understanding these tumors. It will take years of training, but this is what I imagine, Ammachi, and I’ve never been more certain—I’ll be a scientist and a neurosurgeon.

Mariamma spends two more years in Madras after graduation, the first of which is her required internship, rotating through all the specialties. For her second year, she’s a “senior house surgeon”—a glorified intern—but on the general surgery service alone. Only when she completes the two years is she qualified to apply for a training spot in neurosurgery.

Deciding to be a neurosurgeon is far easier than getting a spot in one of the few neurosurgical training programs in the country. She has excellent grades, a prize medal in anatomy, strong letters of recommendation, and by this time she has two published papers with Uma (one on leprosy, and the other a case report on her father’s acoustic neuroma and its presentation in one family over generations). But, even if no one says this outright, many centers don’t think women should be in neurosurgery.

At the eleventh hour, she’s accepted to the oldest and best-known neurosurgery program in the country: the Christian Medical College in Vellore, just two and a half hours west of Madras by train. Founded by Ida Scudder, an American missionary physician, it was first a women’s clinic and then a women’s medical school before becoming coeducational. It has become an outstanding referral center, staffed by dedicated physicians. Church missions of every denomination support the medical school by sponsoring students.

Mariamma’s admission has a caveat. Since she applied for a “sponsored” training slot supported by her diocese in Kerala, she must fulfill a two-year service obligation at a mission hospital before she begins her training. Then, after becoming a fully-fledged neurosurgeon, she must serve for two more years in a mission hospital to complete her bond.

Seven years after she first stepped into the Red Fort, she leaves Madras, with tearful goodbyes to Anita, Chinnah, Uma, and so many others. She will begin her two-year bond in a brand-new, but unfurnished, four-story mission hospital that is to have the absolute best equipment. She’ll be its first, and for now its only, physician.

The location of this mission hospital is a stone’s throw from where her grandmother lit the lamp on the occasion of her birth: the district village of Parambil.





Part Nine





CHAPTER 73


Three Rules for a Prospective Bride

1976, Parambil

Under Joppan’s watch, Parambil is becoming a lush Eden, a model farm, the plantain and mango trees sagging with fruit, and young palms sporting thick yellow necklaces of coconuts. Their thriving dairy sells milk to a cold-storage business, providing an additional source of revenue. Joppan’s two young cousins serve as his permanent assistants. For the past two years, while Mariamma was in Madras, Joppan at first wrote her monthly letters, listing expenditures and income. But in just six months, at his urging, they hired a part-time bookkeeper. Parambil is doing well.

The house, however, shows its age in the spider’s web of cracks on the red oxide floors; the dull teak walls cry out for a varnish. Mariamma takes Anna Chedethi to Kottayam to pick out a new paint scheme for the entire house, and to select ceiling fans, new sinks and fixtures, a two-burner gas range, and a backup generator. The grin on Anna Chedethi’s face only falters when a refrigerator is delivered. “Ayo, molay! What do I do with this? How will it listen to me? Does it know Malayalam?” The first time Mariamma brings her a glass of sweet lime juice, frosted on the outside and with ice cubes clinking on the top, Anna Chedethi becomes a believer. Now meat, fish, vegetables, and milk will keep for days.

The Mar Thoma Medical Mission Hospital is the tallest structure around for miles. The sprawling grounds around the hospital are enclosed by a whitewashed boundary wall; the NO POSTING warnings stenciled on the wall are covered by Congress and Communist Party posters. Across from the main gate is a bus stop and Cherian’s tea shop. Further down the road, a new long, rectangular building holds Kunjumon’s Cold Storage, London Tailors, and Brilliant Tutorials. Mariamma struggles to recall the time when all this was uncleared land with trees that she and Podi climbed.

Raghavan, the poor watchman, is hoarse from explaining to clamoring patients that yes, the hospital looks finished, but no, it’s not ready for business. If they call him a liar, he shows them the unfurnished interior, the crates of equipment stacked everywhere, some donated by foreign missions. One night, Raghavan rouses Mariamma at home at two in the morning because of a child with severe asthma who he thinks is in mortal danger. He is right. Without the adrenaline in Mariamma’s medical bag, the child would not have survived.

Mariamma mentions this at the weekly board meeting; the bishop who is chair of the board has ensured this one room is lavishly furnished. The members listen politely as she tries to convey the urgency of opening a casualty room with basic supplies, then without comment they move to the more urgent task of deciding the size of the inaugural plaque in the lobby and whose names should or should not be on it.

She leaves the meeting, seething, and is surprised to find Joppan outside, puffing on a beedi. He walks back with her in the dark as she voices her frustration. “It’s comical! At this rate, the hospital might never open.” They cross the gated private pedestrian bridge arching over the canal and into Parambil. When they reach the house, he says, “Molay, nothing is happening because Uplift Master’s not there. He’ll know how to deal with them. I’ll send word.” Only after he leaves does Anna Chedethi tell her that the reason Joppan had been at the hospital was to escort her home because it was dark. It’s just what her father might have done.

The rumor that Master only ventures out at the witching hour and prefers the company of ghosts to that of humans must be true, because Anna Chedethi is already asleep when Master comes. Mariamma shares her frustrations about the hospital. She gets the sense Master is pleased to hear about the hospital’s administrative dysfunction. She begs him to talk to the board.

“Never! They must ask me themselves. They still blame me for that woman who tried to embezzle the Hospital Fund.” Mariamma assures him that no one faults him. “Aah, people say that. But if I drop by for tea, they count the grains of paddy in their ara when I leave. That’s how our people are.”

She pleads, invoking the names of her grandmother and her father, but he holds firm.

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