From Kunming, family flew to Canton (Guangzhou) to pick up an exit visa for patient at the U.S. consulate. On the flight to Los Angeles, patient turned blue and stopped breathing. An EMT on board performed CPR and monitored her progress until landing. Baby was first seen at Centinela Hospital Medical Center near the airport. Patient’s parents had her transferred to Huntington Hospital near their home and your office in Pasadena. Patient was diagnosed with antibiotic-resistant Clostridium difficile and nearly died a second time. You referred her to me. I admitted her to our pediatric intensive care unit.
Clearly, patient had been in the presence of infected fecal matter, unclean water, and unsanitary food supply. Diagnoses of Ascaris lumbricoides, Entamoeba histolytica, Giardia intestinalis, Helicobacter pylori, Sarcoptes scabiei followed. I’m treating the roundworms with mebendazole. The other intestinal parasites have been harder to address given the limitations caused by the ongoing protocol for her C. diff. Although she has been moved down to specialized care, morbidity rates are high for each condition, especially in a patient so young and immunocompromised. While I explained to parents that I cannot be confident of recovery, I hope you will more fully prepare them for the worst.
I will keep you posted as to patient’s progress.
Sincerely,
Roger Siegel
P.S. Would you and Millie like to drive out our way one evening for dinner? It’s been ages.
PEACE, QUIET, AND SANCTUARY
This morning, as every morning, I meet neighbor women, and together—safe in a group—we forage for wild yams, mushrooms, and birds’ eggs in the mountains. I like Wife-of-Ah-joe, Wife-of-Shaw-kah, and Wife-of-Za-po. They’ve held me when I cry from homesickness and for the sorrow of my life, which has not turned out as I imagined. Recently, however, Wife-of-Ah-joe, the strongest and eldest of us, has become impatient with me. “Wife-of-San-pa, do you think your story is worse than mine? Have you suffered more than any other woman in this buffalo sputum village?” She is right, of course.
San-pa and I have been here three months. When he came to get me, he told A-ba that he’d gone away to earn money, not that he’d made much money. Only when we arrived in Thailand did he confess that he’d counted on my taking the gaokao for our future. “Now your wedding cash will have to do,” he said. I gave it and the money I earned from Mr. Huang to San-pa. He used it to rent a plot for us to build a small bamboo and thatch house barely larger than a newlywed hut, without even space beneath our floor to protect chickens and pigs, if we had them. But he hunted, keeping us well fed, and he promised to look for a job soon. He continued to lament the loss of our daughter, but we sought the remedy for that sadness by doing the intercourse almost nightly, fully naked, staring into each other’s eyes, trying to make another baby. But by the end of one Akha cycle—twelve days—I understood exactly where San-pa had brought me.
The Akha who live in Thailand have strayed so far outside our culture and so against nature that we’re under constant threat. Here, we are the poorest of the hill tribes. We aren’t allowed Thai citizenship. We can’t own property. We’re at the mercy of developers who can confiscate land we’ve slashed, burned, and planted. We can also be displaced by soldiers, businessmen, and drug runners on a whim. The first time I heard the words Golden Triangle, I understood the darkness of this place. I remembered when San-pa and I saw the men with their machine guns and mysterious baskets the day before we arrived here. He knew who those men were and what they were carrying. He tried to protect me, but I wish he had warned me of the world we were entering before we left Nannuo Mountain. How could he have ever thought this was a place to bring me or our daughter? When I asked him this question, he answered, “We had to conceal your disgrace, and I knew I could get work here.” When I asked why he didn’t have a job, he looked at the ground and turned away from me.
Over the next few weeks, San-pa stopped hunting and chopping firewood. I reminded him of old sayings: If you work hard, you will eat easy. If you work easy, you will eat hard. He responded with the words from a love song that dates back to the time of our great-grandparents: True lovers will love each other unto death. Even if both are buried alive, they will not be afraid. This did not give me confidence. Without money or food, we were, I realized, poorer than my family was when I was a little girl. Hunger, familiar as an old friend, began to gnaw at my insides. I’ve lost weight, but I’m still not as thin as my husband. “Does your stomach speak to you too?” I asked him one night as we lay together on our sleeping mat. When he didn’t answer, I believed he was in his dreams. By dawn, I thought better of asking such a question again.
No wife wants to poke at her husband’s manliness with a sharp snout, but I couldn’t help myself. Every time I ask him to pick up his crossbow, he comes back at me with inquiries weighted by two different thoughts spread apart: “Why didn’t you perform the rite?” or “Why did you abandon our baby?” With either question, he had the answer: “You cursed and ruined us.” This was his grief speaking, and I caused it. When he began to steal away into the jungle and not return for a day or two, I blamed myself for that too. Such sadness I have brought to my husband.
This morning, I asked why he’d married me. He answered, “You were supposed to change my fortune. You were supposed to grow from the number one girl to the number one woman. The first from Nannuo Mountain to go to university. The first to be a leader of women. With me standing proudly at your side.” With a chill, I remembered San-pa’s moment of hesitation when he heard that I hadn’t taken the test. As if reading my thoughts, he added, “I was trying to be honorable. I was to marry the number one girl, but I ended up the number one fool. Now all we can do is hide from your mistakes.” My mouth could not form a response. The worst part? Everything he said was true.
Now, as I dig up a mountain tuber with the tip of my knife, I try to think of ways to bring him back to the person he was. Have a son. Have a son. Have a son. Make your husband happy. He will love you again.
After our hunt for food, my friends and I return to the village, change into our wedding attire with our glorious headdresses, and meet at the spirit gate, where we join other women similarly outfitted. We’re supposed to be watching the mountain path for the arrival of our daily visitors, but we’re also casting wary looks at the skinny men who lounge before their huts. They need to disappear before our guests get here.