Salomon Halevi ships Rune his stored surgical instruments, and now he has a clinic and a rudimentary theater. He can do more than dress wounds and drain abscesses. He operates selectively on hands, trying to preserve function or to restore it by releasing contractures. To raise money, Rune writes many letters. The Paradesi Jews fund the brick kiln, while a Lutheran mission in Malm? pays for the sawmill and a small carpentry workshop. At Christmas, the same Lutheran mission commits to an annuity for the leprosarium; Rune’s chatty letters in Swedish are printed in their newsletter. Mr. Shaw, whose wife Eleanor was Rune’s patient, arranges the gift of two dairy cows and a stack of lumber.
Fifty years after Armauer Hansen discovered, under the microscope, the rodlike bacilli in the tissue of lepers—mycobacterium leprae—there is still no medicine to cure leprosy. Rune provides a home and meaningful work, but he’s frustrated that he can do little to prevent the progressive damage to the hands and feet. The day after they open the sawmill, he discovers a severed finger in the shavings. The owner, still working, doesn’t notice the missing digit until Rune points out the bleeding stump. That leads Rune to hold a weekly catechism on preventing injuries. He pairs the residents off for daily inspections of their partners’ hands and feet; he dresses fresh injuries. He is quick to put a finger or a foot into a cast to prevent further damage and to allow the wound to heal. Every tool at Saint Bridget’s carries a padded strap, to make up for fingers that can’t grip, and to protect the skin. Buckets and wheelbarrows have harnesses that go around the neck.
In the lazaretto’s first year, a grinning newcomer walks in, blissfully unaware that his ankle is grotesquely dislocated, with bone sticking through skin. Anyone but a leper would be shrieking in pain, while this garrulous fellow is proud to have walked all day to the new lazaretto. Rune has noted in his residents this same perverse pride: their “advantage” over those who rejected them is that they can walk forever; and they can also stand like statues for hours, having no need to shift weight from one foot to the other because they have no discomfort. The cumulative trauma of walking on injured feet, and of prolonged standing, inflames, stretches, and ultimately ruptures the ligaments that hold the bones of the foot together. When the talus—the saddle-shaped bone under the tibia that transfers body weight to the heel—finally collapses, the arch of the foot becomes as flat as an appam, then convex, like the bottom of a rocking chair. The body weight is no longer spread over the entire foot but concentrated on one spot, and a pressure-ulcer results. If neglected, the ulcer grows and turns gangrenous, forcing Rune to amputate. But it never hurts.
CHAPTER 25
A Stranger in the House
1923, Parambil
When she is thirty-five, in the year of our Lord 1923, she’s pregnant again. It feels like a miracle. Her first clue is a metallic taste in her mouth, followed by her appetite walking away. When she tells her husband, he seems startled. She’s tempted to say, Don’t tell me you have no idea how it happened! But his worried expression stops her; there’ve been three miscarriages in the long years since Baby Mol was born, each bringing crushing sadness, a sense that she’s being punished for JoJo. Her husband’s fears are never spoken, but she knows how badly he wants a son to whom he can pass on the Parambil he created; a son who will care for his parents in their old age. If he is anxious, she’s at peace, confident this pregnancy will come to term. Her certainty must come from God. Has it really been fifteen years since she brought a child into the world? Her only sadness is that her mother isn’t with her. The cancer took her within two months of their visit to the doctor in Cochin.
When she’s in her seventh month, her center of gravity lowered, her feet spreading out as she walks, she finds her husband seated on the verandah after dinner, staring at the moonlit yard. His expression is dreamy, a rare sight. In profile he’s ageless, though his hair is receding and mostly gray and he hears poorly. At sixty-three, he still pitches in to repair a bund, or dig an irrigation channel. He makes room for her, smiling. Of late, he’s often troubled by headache, though he never complains; she knows only from the set of his jaw, his furrowed brow, and because he’ll quietly take to bed with a wet cloth over his eyes.
She eases down beside him, her back aching, the baby pressing down on her. She remarks on her swollen feet, and that she can’t imagine how Odat Kochamma had ten children . . . She has hungrily watched Shamuel and his wife Sara in their unguarded moments, seen their back-and-forth, their talking over each other—even their arguing feels intimate. But she must carry speech for both herself and her husband.
He watches her lips so as not to miss a word. His feet swing almost imperceptibly in time with his heartbeat. “Why do you speak so little, my husband?” she says after a while. He answers wordlessly by lifting and slowly lowering both his eyebrows and shoulders. Who knows? She shakes him in annoyance. It’s like trying to shake the trunk of a banyan tree.
He says, “Since you fill the spaces where I might drop in some words . . . I keep quiet.”
She makes to rise, offended, but laughing silently, he pulls her into him. His laughter, silent or otherwise, is even rarer than his speech, and she especially loves it when it leaves his body, unguarded and booming. His arms encircle her. She laughs with him. Why should she be self-conscious about anyone seeing them embrace? His nephews—the twins—walk together holding hands (even if their spouses are at each other’s throats); heading to church, she sees women hold hands. But married couples stay conspicuously apart, as if to deny that in the dark they touch and more.
He releases her, but his shoulder still presses against hers. She waits. It’s too easy to snuff out what he might say by speaking first. “I never learned to read,” he says at last. “But I learned that ignorance is never revealed if one holds one’s tongue. To speak is what removes all doubts.” You aren’t ignorant! You’re wise, my husband. His confession sits between them in the friendly twilight. She puts her arms around him as if to enfold him, but she can no more do this than wrap her arms around Damodaran.
In the throes of labor, she screams her resentment that men should be spared what they brought about, just as she resents this thankless infant she’s grown within her who now wants to split her in two. But then, when that minuscule mouth latches onto her nipple, she feels a rush of both colostrum and forgiveness, the latter bringing a kind of amnesia. Why else consent to sleep once more with the man who caused such pain?