He smiles. “By now you must surely know.”
A few stray dogs run around the streets of the small provincial town that is Vellore. Dawn is still hours away as they pass through the gates of the Christian Medical College Hospital. They’re expected, and as interns and nurses swarm over Lenin, the neurosurgical registrar comes by, talks to Mariamma at length. He orders a loading dose of anticonvulsant and forbids Lenin from taking anything by mouth. When day breaks, Lenin is whisked away for tests.
She finds Cromwell, who’d slept in the car. She encourages him to head back—it’s pointless for him to stay. He leaves reluctantly. She calls Digby. He is relieved they arrived safely. “Listen,” he says, “I think it might be a good thing for you to call the editor of the Manorama. Tell him what’s going on. If they connect Lenin to your family, your father, the Condition, it might serve notice to the police not to harm him. By the way, at Vellore they know who he is. I told them. They’ll have to let the Madras state police know. They will eventually inform their Kerala counterparts.” After she hangs up with Digby, she makes the call to the Manorama.
Lenin returns after his tests, his head fully shaved. He falls asleep. She does too, in the chair by his bed. At noon, the entire neurosurgical team returns, this time with the chief, a compact, quiet man with kind, intelligent eyes behind rimless glasses. He’s still in surgical scrubs. He nods politely to Mariamma as the senior registrar presents Lenin’s case in a low voice, and shares the test results. Mariamma is tongue-tied before her future boss. The chief examines Lenin quickly, but thoroughly.
“You came just in time,” he says to both of them. “We discussed your case with our neurologists as well. We had to postpone a major surgical case. So we’ll operate right away, no point waiting. Let’s pray for a good outcome.”
The orderlies arrive to take Lenin away. It’s happening faster than Mariamma dreamed possible. All she gets to do is kiss him on his cheek. Lenin says, “It’ll be all right, Mariamma, don’t worry.”
There’s nothing emptier than a hospital bed to which a loved one might not return. She’s overcome, slumped on the chair, her face buried in her hands. The woman caring for her son in the next bed comes over to comfort her. To Mariamma’s surprise, a nurse comes and sits beside her and prays aloud. Faith at this institution is concrete, not abstract. After her father’s death she’d turned her back on religion, having lost faith. But she closes her eyes while the nurse prays . . . Lenin needs all the help he can get.
Now she must wait. Three hours, then four. The wait is agonizing. All she can do is helplessly stare at her watch and look up whenever anyone enters the ward. Then, an orderly comes for her—the chief wants to see her, that’s all he knows.
They walk through corridors, up stairs . . . her thoughts are a blur. She is led into a large hall outside the surgical suites where the chief waits calmly, seated on a bench. His mask dangles from one ear. He pats the bench beside him.
“He’s doing well. We managed to remove most of it. I had to leave some capsule behind because it was dangerously adherent. His facial nerve may or may not recover, but I’m hopeful.” His smile reassures her even more than his words.
Relief floods her being and tears spill out. He waits patiently. “Thank you! I’m sorry,” she manages to say at last, dabbing at her eyes. “I’m just overwhelmed. I can’t help thinking of my father. And of my father’s father. And so many of my relatives who never understood what they had. This is the first time anyone in my family who suffered this disease has had it treated.”
He listens, nodding, waiting. When he’s sure she is done he says quietly, “I read the papers you sent us with your application. It made me wonder if some of our patients with acoustic neuromas over the years might not have been from families like yours. We’re paying closer attention to the family histories now. Good work.”
“Thank you. I’m honored to be coming here,” she says. “What you did . . . removing such a tumor in that tiny space seems . . . impossible. A miracle.”
He smiles. “Well, we don’t believe we do anything alone.” He nods toward a large mural on the opposite wall. It depicts gowned, masked surgeons bent over a patient, under the halo of a theater lamp. In the shadows, figures observe the surgery. One of them is Jesus, his hand resting on the surgeon’s shoulder. Mariamma stares at it. She’s envious of the chief’s kind of faith.
“We pride ourselves here that we can do just about anything that the top centers in the world can do, but at a fraction of the cost. But the surgery we just performed, taking a rectangle of skull out just above his hairline, pushing aside the cerebellum . . . well, quite honestly, it’s crude compared to another operation for acoustic neuroma that right now only two or three centers in the world are doing. It was invented by an ENT surgeon, William House, who was a dentist before he became a surgeon. He began using a dental drill to get at the inner ear, the bony labyrinth, and realized that he could, by deepening that tunnel, approach an acoustic neuroma. It’s a brilliant innovation, yet incredibly difficult if you don’t know what you are doing.”
Mariamma has read about this surgery, but she doesn’t interrupt the chief lest she come across as a know-it-all.
“That’s what we need to offer here. It requires an operating microscope, the dental drill, and irrigation and other tools he adapted. But more than anything, it requires special training, many hours of dissecting the temporal bone on cadavers till one learns to do it. Right now only House and a few surgeons he trained perform the surgery. In time I’d like to send someone to train with him.” He smiles, rising. “Who knows, maybe that’s God’s plan for you, Mariamma. Let’s see. Let’s pray about it.”
Big Ammachi would have loved this man, relished his words. God had answered her grandmother’s prayer: heal the Condition or send someone who can.
The chief says, “By the way, DSP Rajan of our local police talked to me. I’ve given him my assurance that Lenin won’t be going anywhere. I know you’ll help me keep my word.”
CHAPTER 78
Watch This
1977, Vellore
In the recovery room, Lenin’s face is puffy and swollen. His eyelids flutter, and he retches from the anesthetic. He’s restless. She dabs Vaseline onto his parched lips, and wonders: Did time expand for him again, as it did after his seizure? Did the four hours of surgery feel like four years? Without this tumor that defined his whole life, will he be the old familiar Lenin or somebody new? She spoons ice chips past his lips, murmuring soothing words. He comes awake, his eyes unfocused at first. “Mariamma!” It is barely audible. She feels a fist unclench in her chest—it’s been there ever since Digby showed up at Triple Yem, a lifetime ago.
The next day, Lenin is on the regular ward. He’s weak but all his limbs are working, his speech and memory are intact—no damage to anything but the tumor, as far as they can tell. Mariamma feeds him, holds his urine bottle for him, cleans him, doing her best to spare the busy nurses. By watching the probationers, she’s learned how to change soiled sheets under a bedridden patient, how to turn him, and give him a proper bed bath. It’s humbling. Shouldn’t every physician learn this? Isn’t this what medicine is really about?