Inside her office she’s startled by a very dark, barefoot man in khaki shorts and shirt, seated on the stool beside her desk and grinning at her. He has a faint Nepalese shade to his features despite his dark complexion, and a similar ageless quality to his face; only the gray eyebrows and his gray mop of hair suggest he’s well over sixty.
“Good morning, Doctor,” he says in English, springing to his feet. “Doctor ask Cromwell to give you!” She unfolds the paper while trying to untangle what she’s heard. “I am Cromwell,” he offers.
“What doctor?”
He points to a vehicle outside the front gate that’s a cross between jeep and truck. On its doors in faded lettering is SAINT BRIDGET’S LEPROSARIUM. A white man sits inside, waiting. She turns to the note.
Dear Mariamma: I’m a physician who knew your grandfather, Chandy. I seek your professional assistance for someone who is desperately ill. Someone you know. For your safety and mine, please allow me to explain further in the car. Till then, please speak to no one. May I also ask you to discreetly bring with you a trephine and such tools as you might need to open skull and dura?
Digby feels an indentation in the atmosphere before she comes into view. Her floating carriage is like that of a dancer, despite the heavy sanji she carries. She’s tall and beautiful, and her coral-blue sari complements her fair skin. The flaming pale streak at the center part of her hair gives her a maturity beyond her years. He flushes with shyness as she approaches.
She slides onto the seat beside him, shaking out her sari pleats so the fabric flows to the floor. He extends his hand; hers is warm and soft, while his must surely feel rough and stiff, unable to form a concavity to match hers.
“Digby Kilgour,” he stammers, and only reluctantly releases her hand. “I knew your grandfather Chandy well. And I met your mother when she was a girl—”
Mariamma takes him in, this man with blue eyes like sapphires that sparkle against his washed-out and weathered face. The back of his hands is a patchwork of rust-colored and albino-white skin. A loose cotton kurta exaggerates his gaunt neck. He’s in his late sixties or early seventies, lean and fit, but not as rugged as his dark-skinned driver.
“Boss, we go. Too much peoples,” Cromwell says, starting the engine.
“Yes,” Mariamma and Digby say in unison.
As soon as they’re out of sight of Triple Yem, she swivels to face him. “How is he?”
She doesn’t ask who, Digby notes. “Not well. Barely arousable but worsening by the hour.”
She ponders this. She slips her feet out of her sandals and brings her knees across the seat like a mermaid, tucking her bare feet under her.
“He showed up at Gwendolyn Gardens. That’s my former estate way north, near Trichur . . .” Digby struggles to keep his train of thought as those translucent eyes gaze at him. “Years ago, when Lenin’s mother was pregnant, she came to my estate with a stab wound and—” Mariamma nods impatiently. She knows that story. “Well, Lenin must have always known of Gwendolyn Gardens from his mother. And known of me. Part of his history. He showed up there last night, but you see I’ve not lived there for twenty-five years. I run a leprosarium here in Travancore. The estate is Cromwell’s. There’s a reward for Lenin’s capture, you know. To keep him at the estate would have been dangerous, too tempting for the laborers. So Cromwell drove all night to bring Lenin down to me.”
She looks nothing like a physician now; she’s a young woman confronted by a ghost from her past. “Dr. Kilgour, what are we to do?”
“Call me Digby, please. Yes, that’s the question. What to do? His presence puts us at risk. I didn’t know how to help him. I’m a leprosy doctor, a hand surgeon. He was stuporous by the time he arrived. I wouldn’t involve you. Mariamma, I’m here because he asked for you.”
She becomes very still. After a bit, she says softly, “Is he giving himself up?”
Digby shakes his head. “No. Listen, I have no sympathy for Naxalites. But the police are no better. You know they’d do nothing for him medically. They’d probably murder him on sight. He’s vomiting and complained of a terrible headache. He kept saying you would know what he has. I think I know too. I read about your family and the inherited disorder.”
She nods. “He almost certainly has acoustic neuromas, just like my father. On both sides. But that doesn’t mean I’m capable of curing him.”
Her hands are clasped together in her lap; she stares ahead, lost in thought. In profile, he thinks, her features—the eyes, the brow, the long, sharp nose—are just like those of Chandy’s daughter, Elsie.
“Listen, you don’t have to get involved, Mariamma. For all we know, it may be too late—” The look that comes over her face makes him realize he has misspoken. Cromwell glances back in the mirror at Digby as if to say, You made a mess of that. “I’m sorry! What a thing to say.”
Her voice is fragile, and she’s speaking more to herself than to them when she says, “So he shows up suddenly and asks for me? After all these years. What am I supposed . . . ?”
She doesn’t finish. Her eyes fill up. Digby roots for his handkerchief, thankful it’s clean. She presses it to her eyes. Then, to Digby’s surprise, she leans on him, rests her forehead on his shoulder. Digby’s hand goes around her and alights gently on her scapula, holding on with the greatest care so as not to add to her burden.
CHAPTER 76
Awakenings
1977, Saint Bridget’s
Digby watches Mariamma take in the grounds of Saint Bridget’s as they pull past the gates. What must she think of his home of a quarter century, this quiet oasis to itself, whose high walls don’t even let sounds from the outside world reach their ears? Suja, one of Digby’s “nurses,” brings her left palm to the stump of her right hand. Mariamma responds automatically, barely registering that Suja’s “namaste” must be imagined to be complete.
The room in which they have Lenin is private and secluded from the rest of the leprosarium. Mariamma hesitates at the threshold, then follows Digby, moving like a sleepwalker. Thank goodness he’s still breathing, Digby thinks. He watches her fingers tremble as they rise to touch Lenin’s cheek. The unconscious figure on the bed has dark stubble on his face and scalp, like a devotee returning from a pilgrimage to Tirupati or Rameswaram. The sinuous veins on his thin arms stand out because of the complete absence of subcutaneous fat. His scalloped belly and the prominence of his rib cage make him look like a man on the brink of starvation, not a guerilla fighter.
Digby quietly straps the blood pressure cuff on Lenin’s floppy arm. His action brings Mariamma out of her trance. Her fingers seek Lenin’s pulse. “A hundred and seventy over seventy,” Digby says eventually, removing the cuff. “About what it was before.”
“Pulse is forty-six,” she says. “The Cushing response.”
When was the last time Digby heard that phrase? A half century ago in a Glasgow operating theater? He’s had few occasions to remember the pioneering neurosurgeon’s triad. Cushing observed that if a bleed or a tumor raised the pressure within the rigid confines of the skull, it caused the systolic blood pressure to rise, the pulse to slow, and the breathing to become irregular.
“We should sit him up,” Mariamma says. “It helps lower intracranial pressure.” It isn’t an admonishment, but Digby knows he should have thought of it. With Cromwell’s help and using a folded mattress from the other empty bed in the room, they prop Lenin up, his head lolling forward like a rag doll’s.
“May I examine?” she asks.
“He’s all yours!”