'What's wrong with him?'
'Very, very sick.' Berry, berry sick. 'Maybe dying now. This way, sir.' He was
pointing away from camp, but at this hour there was nothing that way except night
and more night. Still Nima was not the sort to cry wolf.
'Yes, okay.' Abe heaved himself to sitting. There was never a dignified way to rise
from sleeping on the ground, and he felt doubly awkward under the beam of Nima's
light. He dressed quickly, then thought to check the time. It was three-thirty.
Abe rooted through the open boxes lining his tent wall and located some of the
basics. He stuffed a stethoscope, a BP cuff, and a penlight into his parka pocket, then
laid out some medicines on the sleeping bag. A bottle of injectible lidocaine and a 3-cc
syringe for local anesthesia, plus a few packs of silk and needles. A number 15 scalpel.
Scissors. A Betadine scrub brush. Gloves. Bandages. Cipro for general infection,
though that was expensive and not so plentiful. Percodan for pain. Benadryl for
inflammation. He glanced through the mechanisms and chemicals and, satisfied,
tossed it all into his little day-pack. He trailed Nima out into the cold blackness.
Abe splashed white light through the silent camp, then swung it outward in Nima's
direction. There was only darkness. Almost until they reached Mallory's Tomb, Abe
could not figure out where he was being led.
Now he saw that someone – the Sherpas or the herders – had lashed old tent fabric
on top of the listing walls for a roof. Yesterday the hut had been an empty shell. The
raggedy improvement actually made the building appear less habitable and more
inconspicuous. By the light of Abe's headlamp, the hut had achieved a look of eerie
corruption befitting its nickname.
At the hut door, Abe paused and silently wished for a mug of hot tea and hoped this
was blood or bones, not some disease. He was good with trauma. With trauma, the
problem was often obvious, and better yet, it usually responded to touch. It healed
and you could see it heal. But with disease, the body hid its problems. It impeached
whatever you thought you knew and made you suffer for the suffering.
Abe took a deep breath and slipped through the ripped tentage posing as a front
door. He was unprepared for the primitive scene. The hut was lit with two headlamps
hung from pegs in the wall. Thick incense choked the air and it was impossible to see
how many people were crowded inside. Their eyes glowed white in the gloom.
The patient was lying in an expedition sleeping bag on top of three or four
brand-new air pads, a luxury even Jorgens would not have allowed himself. The
Sherpas had obviously donated their own gear to this man's comfort, which was
extraordinary because Abe had seen no love lost between the Sherpas and the
yakkies. Nima roughly ordered the herders to make room, and they scuttled
backward.
The patient was a young man, probably still in his teens, and his hair was cropped
close. Underneath a layer of grime and blue wood smoke, the boy's face was
handsome, more round than long, and yet slighter than most of the Tibetan faces Abe
had seen. Under his dark sepia pigmentation, the boy's big Mongolian cheeks were
flushed and rosy. He was unconscious and his respiration was labored, yet he looked
healthy enough, even robust. Abe hadn't noticed the boy among the yakkies and
concluded he'd arrived in the night, maybe herding strays.
'Hold my light,' Abe told Nima.
He knelt in the cold dirt. Overhead, the nylon ceiling rustled in the wind. The
incense drifted like fog, gray and aquatic. Everything in the room had an aspect of
slippery illusion. Abe peeled back the edge of the sleeping bag.
Then Nima moved the light or the fog shifted and suddenly the left side of the man's
face leapt into view. It was completely different from the healthy face of a moment
before. From his lips to left ear, the jaw was contused, purplish and swollen, a fighter's
mask. Very obviously the boy had been beaten. Abe had heard how violent these
Tibetans got when they drank, but if this was the result of a brawl, then it was an old
one. The bruises were too mature, days old, maybe older.
Abe made a mental note to check for facial fractures and loose teeth, then moved on.
Vitals first, he told himself. Then head to toe. Keep in order.
The boy's throat was hot under Abe's fingertips, the pulse fast and thready. His
blood pressure was high, but then everyone was running high BPs because of the
altitude. Abe pressed back the eyelids. The pupils looked unequal, one blown, one
pinpoint. That could mean an epidural hematoma: arterial bleeding within the
cranium. This far from a hospital that would spell certain death. Abe leaned in closer
to the boy, determined to prove himself wrong.
He ran his fingers around the back of the boy's skull, searching for lumps or blood.
The boy's hair was stubbly in Abe's palms. He handled the skull carefully, almost
sacramentally. No matter how many times he held a victim's head, it never ceased to
astonish him that a lifetime of memories and thoughts could weigh so little, and yet at
the same time that a mere two handfuls of bone and water could weigh so much.
With an epidural hematoma, most patients died within eight hours. And yet the
discoloration on this man's jaw – which might coincide with any possible skull fracture
– looked a week or more old. There were no goose eggs. No blood or fluid in his ears.
What then, Abe silently demanded. Head injury or not? And then Nima moved the
light again and suddenly the pupils evened out. Now they looked equal in size. Abe
was baffled but relieved. He moved south from the troublesome head.
'Let's see what else,' he said to Nima. Together they unzipped the sleeping bag and
exposed the boy to view. He was dressed in yak skins and a pair of quilted pants. Abe
smelled old vomit and there were bloodstains on his shirt. Whoever had laid him here
hadn't gotten around to removing the Chinese sneakers from his wide feet. Abe
opened the hide jacket and lifted up the bloody shirt. And halted.
In the first instance Abe thought it was measles. A dozen or more circular wounds
splashed across the boy's barrel chest, each the size of a pencil eraser. But they were
grouped – oddly – around his nipples. Abe revised his guess. The pustules might be
the infected bites of some large parasite. Then he reverted to disease theory and
conjectured it might be some sort of Asian plague. That could explain the fever and
coma. But it might not.
Mystified, Abe looked up at Nima. 'What happened to this boy?' he asked.
Nima shrugged helplessly.
'He was beaten,' Abe said, and clenched his fist for illustration.
'Yes sir.'
'Who did this?' Abe asked. Then he amended his question. 'When?'
'This man, very good man,' the Sherpa said.
All right, Abe thought. Let's talk about the man. 'Who is he? Where's he come from?'
Nima shook his open palm in the air to show uncertainty. 'I don't know, sir. Some
guy.'
'Is he a yakherder?' Abe tried.
'Yes.' Nima's eyes shifted away. 'Yok hoda.' Nima knew more than he was saying.
Abe didn't know why, nor did he ask. That was a different pursuit.
'Did this happen on the trail?'
'Yes.'
