Cutting for Stone

nurse because this was the first time she had encountered a physician like him. She bit her tongue because she wanted so much to say all this and more to him.

“Coma vigil,” he said, and Sister Mary Joseph Praise assumed he was instructing her. “See how her eyes keep roving as if she's waiting for something? A grave sign. And look at the way she picks at the bedclothes—that's called carphology and those little muscle twitches are subsultus tendinum. This is the ‘typhoid state.’ You'll see it in the late stages of many kinds of blood poisoning, not just typhoid … But mind you”—and he looked up at her with a little smile that belied what he said next—”I am a surgeon, not a medical man. What do I know of medical matters? Except to know that this is not a surgical illness.”

His presence had done more than reassure Sister Mary Joseph Praise; it calmed the seas. The sun, which had been hiding, was suddenly at their back. The crew's drunken celebration indicated how grave the situation had been just hours before.

But though Sister Mary Joseph Praise did not want to believe this, there was little Stone could do for Sister Anjali, and in any case, nothing to do it with. The first-aid box in the galley held a desiccated cockroach— its contents had been pawned by one of the crew at the last port. The medicine chest which the captain used as a seat in his cabin seemed to have been left over from the Dark Ages. A pair of scissors, a bone knife, and crude forceps were the only things of use within that ornate box. What was a surgeon like Stone to do with poultices, or tiny containers of wormwood, thyme, and sage? Stone laughed at the label of something called oleum philosophorum (and this was the first time Sister Mary Joseph Praise heard that happy sound even if in its dying echo there was something hard-edged). “Listen to this,” he said, reading: “ ‘containing old tilestones and brickebats for chronic costiveness’!” That done, he heaved the box overboard. He'd removed only the dull instruments and an amber bottle of laudanum opiatum paracelsi. A spoonful of that ancient remedy seemed to ease Sister Anjali's terrible air hunger, to “disconnect her lungs from her brain,” as Thomas Stone explained to Sister Mary Joseph Praise.

The captain came by, sleepless, apoplectic, spraying saliva and brandy as he spoke: “How dare you dispose of shipboard property?”

Stone leaped to his feet, and at that moment he reminded Sister Mary Joseph Praise of a schoolboy spoiling for a fight. Stone fixed the captain with a glare that made the man swallow and take a step back. “Tossing that box was better for mankind and worse for the fish. One more word out of you and I'll report you for taking on passengers without any medical supplies.”

“You got a bargain.”

“And you will make a killing,” Stone said, pointing to Anjali.

The captain's face lost its armature, the eyebrows, eyelids, nose, and lips all running together like a waterfall.

Thomas Stone took charge now, setting up camp at Anjali's bedside, but venturing out to examine every person on board, whether they consented to such probing or not. He segregated those with fever from those without. He took copious notes; he drew a map of the Calangutes quarters, putting an X where every fever case had occurred. He insisted on smoke fumigation of all the cabins. The way he ordered the healthy crew and passengers around infuriated the sulking captain, but if Thomas Stone was aware of this he paid no attention. For the next twenty-four hours he didn't sleep, reexamining Sister Anjali at intervals, checking on the others: keeping vigil. An older couple was also quite ill. Sister Mary Joseph Praise never left his side.

Two weeks after they left Cochin, the Calangute limped into the port of Aden. The Greek captain had the Madagascar seaman hoist the Portuguese flag under which the ship was registered, but because of the shipboard fever the Calangute was promptly quarantined, Portuguese flag or no Portuguese flag. She was anchored at a distance, where, like a banished leper, she could only gaze at the city. Stone bullied the Scottish harbormaster who had pulled up alongside, telling him that if he didn't bring a doctor's kit, bottles of lactated Ringer's solution for intravenous administration, as well as sulfa, then he, Thomas Stone, would hold him responsible for the death of all Commonwealth citizens on board. Sister Mary Joseph Praise marveled at his outspokenness, and yet he was speaking for her. It was as if Stone had replaced Anjali as her only ally and friend on this ill-fated voyage.

When the supplies came, Stone went first to Sister Anjali. Making do with the crudest of antisepsis, with one scalpel stroke he exposed the greater saphenous vein where it ran just inside Sister Anjali's ankle. He threaded a needle into the collapsed vessel that should have been the width of a pencil. He secured the needle in place with ligatures, his hands a blur as he pushed one knot down over another. Despite the intravenous drip of Ringer's lactate and the sulfa, Anjali didn't make a drop of urine or show any signs of reviving. Later that evening, she died in a final dreadful paroxysm, as did two others, an old man and old woman, all within a few hours of one another. For Sister Mary Joseph Praise the deaths were stunning, and unforeseen. The euphoria she felt when Thomas Stone had risen and come to see Anjali had blinded her. She shivered uncontrollably.

At twilight, Sister Mary Joseph Praise and Thomas Stone slipped the shrouded bodies over the rail, with no help from the superstitious crew who wouldn't even look their way.

Sister Mary Joseph Praise was inconsolable, the brave front she'd put up shattering as her friend's body splashed into the water. Stone stood beside her, unsure of himself. His face was dark with anger and shame because he had not been able to save Sister Anjali.

“How I envy her,” Sister Mary Joseph Praise said at last through tears, her fatigue and sleeplessness combining to release custody of her tongue. “She's with our Lord. Surely that is a better place than this.”

Stone bit off a laugh. To him such a sentiment was a symptom of impending delirium. He took her by the arm and led her back to his room, lay her down on his bunk, and told her she was to rest, doctor's orders. He sat on the hammock and watched as life's only sure blessing—sleep—came to her, and then he hurried off to reexamine the crew and all passengers. Dr. Thomas Stone, surgeon, did not need sleep.

TWO DAYS LATER, with no more new cases of fever, they were finally allowed off the Calangute. Thomas Stone sought out Sister Mary Joseph Praise before disembarking. He found her red-eyed in the cabin she'd shared with Sister Anjali. Her face and the rosary she clutched were wet. With a start he registered what he had failed to before: that she was extraordinarily beautiful, her eyes big and soulful and more expressive than eyes had a right to be. His face grew warm and his tongue wouldn't unstick itself from the floor of his mouth. He shifted his gaze to the floor, to her travel bag. When he finally spoke it was to say, “Typhus.” He'd looked in his books and given the matter a great deal of thought. Seeing her puzzlement, he said, “Indubitably typhus.” He had expected the word, the diagnosis, would make her feel better, but instead it seemed to fill her eyes with fresh tears. “Most likely typhus—of course a serum test could have confirmed it,” he stammered.

He shuffled his feet, crossed and uncrossed his hands. “I don't know where you're going, Sister, but I'm heading to Addis Ababa … it's in Ethiopia,” he said, mumbling into his chin. “To a hospital … that would value your services if you were to come.” He looked at her and blushed again, because the fact was he knew nothing about the hospital he was going to or whether it could use her services, and because he felt those moist dark eyes could read his every thought.

But it was her own thoughts that kept Sister Mary Joseph Praise silent. She remembered how shed prayed for him and for Anjali, and how God had answered just one of her prayers. Stone, risen like Lazarus, then brought his entire being into understanding the fever. Hed barged into the crew's quarters, run roughshod over the captain, and bullied and threatened. Doing the wrong thing, as Sister Mary Joseph Praise saw it, but in pursuit of the right thing. His fierce passion had been a revelation to her. At the medical college hospital in Madras where she trained as a nurse, the civil surgeons (who at the time were mostly Englishmen) had floated around serene and removed from the patients, with the assistant civil surgeons and junior and senior house surgeons (who were all Indian) trailing behind like ducklings. At times it seemed to her they were so focused on disease that patients and suffering were incidental to their work. Thomas Stone was different.

She felt his invitation to join him in Ethiopia hadn't been rehearsed. The words had slipped out before he'd been able to stop them. What was she to do? Saintly Amma had identified a Belgian nun who had broken away from her order, and who had made a most tenuous foothold in Yemen, in Aden, a foothold that was in jeopardy because of the nun's ill health. Saintly Amma's plan was for Sister Anjali and Sister Mary Joseph Praise to start there,