In the small ward a young woman sits upright in bed. A dressing tray is at the ready. Digby puts a hand on the patient’s shoulder.
“This is Karuppamma. She’s in her fifties. Looks like she’s twenty, doesn’t she? That’s lepromatous leprosy for you. It pushes out the wrinkles. Not like the tuberculoid form.”
Karuppamma is shy. Her free claw of a hand goes up to cover her mouth.
“A week ago I did the same procedure on Karuppamma that you just saw. I cut the flexor digitorum superficialis tendon going to her ring finger. I can do that because she has the profundus as backup. I affixed the tendon here,” he says, pointing to the root of his thumb. “She should now be able to make opposing movements. Get back the grasp function she lost. The thing is, though, to get her thumb to move, she must imagine she’s moving her ring finger. The brain thinks it’s impossible. It has to be convinced that things aren’t what they seem.”
Are you talking about me? Mariamma is calmer outwardly than when she first arrived, lulled into that state by waiting and by watching him at work. But her insides roil with anger, resentment, and confusion. She needs the truth. I didn’t come for surgical knowledge. Still, she won’t be rude in front of a patient.
Digby says in Malayalam, “Touch your thumb to your little finger.” He butchers the language, lacking the swallowed “errah.” Karuppamma understands. She grimaces with effort. Nothing happens.
“Stop. Now . . . move your ring finger.”
Her thumb moves instead. There’s a pause, and then Karuppamma bursts out laughing. Digby shares her happiness, grinning. A small crowd has gathered, sharing Karuppamma’s triumph. Despite herself, Mariamma is moved. But when Digby turns to Mariamma, his expression is profoundly sad.
“This disease only takes away. Year after year, you lose something. Not from active leprosy, but from the nerve damage it caused. This is one of those rare moments when we give something back.”
He tells Karuppamma that she’ll get to move it more each day, till it is at full strength, but for today she mustn’t overdo it. He directs Suja to immobilize the hand and wrist with a posterior slab of plaster.
Digby says, “Soon she’ll move the thumb without thinking. It’s astonishing. As Valery says, ‘At the end of the mind, the body. But at the end of the body, the mind.’ ”
Mariamma follows him out. He says, “Paul Brand in Vellore and Rune here were the first to really understand that these fingers get damaged from repeated trauma. Not from leprosy chewing them away, but because they lack pain sensation . . .”
Her mind wanders. She’s thinking of the schoolboy Philipose taking that reckless boat ride here and serving as Digby’s hands, because Digby was still recovering from surgery.
“. . . Paul Brand saw a patient cooking over an open fire, struggling to flip a chapati with tongs. She got frustrated and just reached in with her bare hand and turned it over. You and I would scream in pain if we tried that, but she felt nothing. That’s when Brand understood. Without the ‘gift of pain,’ as he says, we have no protection.” Digby is talking to himself. “Amazing to me how few understand this. That’s the nature of clinical leprosy. Not many physicians want to study it. Fewer surgeons wish to treat it.” Digby gazes directly at her.
It rattles Mariamma to look at his face, seamed by age, mottled by burn scars, because it calls out to the face she sees when she looks in her mirror. Doesn’t Digby see the likeness?
They enter his study, where, in what feels like a previous life, she took a nap. It’s a glorious morning. She’s drawn to the French windows, to see once more the jewel of a garden outside. Yellow, red, and violet roses rim the lawn, different colors than she recalls from her last visit. The gate at the far end of the picket fence is ajar. On the lawn a patient in a white sari sits in the sun and sorts roasted millet in her palms, then clumsily shovels the little pearls into her mouth. Her hands are like trees with their branches lopped off, leaving nubs. The rudiment of a thumb is what she uses for sorting. Her head is covered with the pallu of her sari. Mariamma sees her flattened profile, the nose leveled as if someone standing behind her is pulling on her ears. It takes a particular kind of courage to make leprosy one’s calling. She must grant Digby that.
“When their facial nerves are affected, it robs them of natural expressions,” Digby says, standing behind her at the window. “You think they’re baring their teeth in anger when they might be laughing. It adds to the isolation of leprosy.” He’s still instructing. She wishes he would shut up. “I’ve learned to listen more than look,” he says.
She hears the sadness in his voice. It would be so much easier to be angry with him if he were a boozy planter who’d gone to seed instead of this man who’s given his life to those whose affliction has turned them into pariahs.
Doesn’t Digby understand why she’s here? He must at least know that he could be her father, even if he never saw Elsie again, and never knew he had a child. And if he does know, then he’s part of the deception that hid the truth from her.
She’s about to turn to him and speak when he whispers, “Notice how many times she blinks.” The woman is unaware that she’s being watched. “Count how many times you blink for every one of hers.”
She tries not to blink. Her eyes itch, then burn. She gives in to the urge. The patient has yet to blink. The woman cocks her head toward a dog barking, the way the blind seek to localize sound. One eye is sunken, milky white, unseeing. The cornea of the other eye is cloudy.
“They fail to blink, the cornea desiccates, and blindness follows. Most of the residents didn’t come here blind. When it happens, it’s a sad moment.”
The tea arrives. Mariamma sits down in the same chair where she had once napped. Without thinking, she removes the shawl draped over the back and places it on her lap. Digby pours.
On the bookcase she sees the silver-framed photograph of Digby as a little boy with his mother. Your gorgeous, stunning mother, Digby. With the movie star looks. With the piebald streak in her hair. My grandmother. When Mariamma had first glanced at the faded black-and-white photograph on her last visit, she’d thought that Digby’s mother was starting to turn gray. But the woman was young. The clue had been right there, before her eyes . . . but it didn’t register. And never would have if she hadn’t read her father’s journals.
Digby sits across from her, leaning over his cup to sip. It’s clearly too hot because he sets it down, the saucer knocking against the pipe stand and making a sound like a gong.
She steels herself. “Dr. Kilgour—”
“Digby, please.”
Digby, then. What I won’t call you is “father.” I had a father who loved me more than life.
“Digby . . .” she says, but the name doesn’t sit well with her anymore. It feels like a jagged tooth scraping her tongue. “Don’t you want to know why I came here today?”
He sits back in the chair and is quiet for a long time. “For years I’ve wondered if you would come, Mariamma. And if you would ask me what you propose to ask me.” Their eyes are locked on each other. “You’re the spitting image of your mother,” he adds.
She takes a deep breath. Where does she begin? “D—” She can’t say his name. She starts again. “How did you know my mother?”
Digby Kilgour sighs and stands. For a moment she has the absurd notion that he’s about to open the door and walk out on her for asking the question he knew was coming. But no, he stands there. The eyes that meet hers are solemn, contrite, and full of compassion. “I knew one day you’d come looking for her.”
She doesn’t understand what he’s saying. He goes to the French windows and stands there like a man about to face the firing squad, his nose almost touching the glass. She rises, teacup still in hand, to join him.