learning-'
His tongue sat inert in his dry throat.
' – and it just sort of kicked up when I fired it. It went way high into the trees. I'm so sorry.'
'It's an outrage,' he managed to say, weakly. 'I could have died. Apology. I demand apology. Your name.'
'Look, I've already apologised several times. I'll apologise again: I'm sorry. No-one was hurt. It was an accident.'
'What is your name?' It came out almost as a shriek.
She looked at him.
She sighed. 'My name has nothing to do with this, or with you,' she said, her tone changing, becoming angrier, no-nonsense. 'Whoever you are, you silly little self-important man. Your behaviour is most unreasonable, not to say offensive. Would you now please be on your way as you are interrupting our lesson.'
BAD BLOOD
The Chinese boy had died in the night, suddenly, but not unexpectedly. Ever since his operation it had been obvious he was ailing: he was feverish, he had absolute constipation, his tongue – which had been healing admirably – began to ooze pus and blacken around the sutures. Listerism and asepsis had achieved marvels. Even here in Manila, in San Jeronimo, the recovery rate in his wards was five times better than in Cruz's, but when he saw these signs he knew his ability to intervene was over. It was rare to find peritonitis associated with erysipelas of the throat, but he had encountered it two or three times before. He assumed the streptococcus reached the serous membrane through the blood somehow. Anyway, he had dosed the boy with opiates, tried to make him comfortable and stood uselessly by as he had died. He knew the worst when he had come into the ward and seen the boy lying on his back, his knees drawn up, his fluttering hands held above his head to increase the capacity of the thorax. His face was already gaunt, his eyes restless, his hands cold and damp. He began to vomit regularly and his abdominal wall grew rigid, board-like. Meteorism became present, the abdomen tense and tympanitic on percussion. He complained not only of a burning pain in his gut but of a tormenting thirst. He was given a rectal injection of cold water. He drank a little iced milk and soda water, the tongue was painted with a solution of glycerine in an attempt to keep it moist. To no lasting avail. The boy's pulse grew rapid, hard and wiry. He began to hiccough violently, a most disturbing symptom that Carriscant knew marked a serious failure in prognosis. He developed the classic face grippee, pinched and sunken, the naso-labial crease very deep. His tongue became coated and f6ul and the vomited matter was highly offensive. Sordes were present on the teeth and lips. Carriscant watched the boy's piteous restlessness -there was no blessed coma in cases of peritonitis to ease the suffering – and watched as his limbs became cold and blue. In the act of dying there was a great gush of foul and brownish fluid from the mouth and rectum. Moments like these tormented Carriscant with a vision of the huge void of his ignorance and helplessness. His instruments were sterile, his operating theatre clean and disinfected, his hands were scrubbed pink, he wore freshly laundered white gowns and yet somehow, from somewhere, the dreaded streptococcus infected the boy's blood, corrupting it. From 'somewhere'… that vague supposition alone was bad enough. An incision in the tongue had produced an infection of the serous membrane in the abdomen. He knew the intestines would be covered in an exudation of pus and fluid, a thick layer of lymph along the lines of contact between the various coils of the bowel. Once infected, the patient's body succumbed inevitably to the toxin of bad blood and a new impotency took over as you watched and waited for death. Bad blood… At times like these he understood his benighted precursors' vain obsession with leeches and bleeding.
He looked at the boy's naked body as it lay before him on the dissecting table in the mortuary as he prepared to examine its morbid anatomy. Slightly plump with almost girlish breasts and a small scribble of pubic hair above the clenched genitals. He touched the cool, yielding flesh, pressed down on the rib cage, allowed his hands to shape the contours of the youth's belly. He knew every component of that individual body, everything hidden behind that pliant but tough integument of skin. The inside of a man or woman was as familiar to him as the face of a friend or the layout of his sitting room, but it was a familiarity afforded only after death. The head, the chest, the spine, the heart… He did not dare advance across that threshold while the body lived. Here he was, a highly trained surgeon, the equal, he liked to think, of any in the entire civilised world and yet to all intents and purposes he was trapped, pinioned by fear and the pathetic limits of his knowledge. He was like a man of vast wealth who has purchased a palace of immense and unparalleled splendour. He can wander in the grounds, circle the exterior, peer through the windows, admire the gilded furniture and the lavish textiles, the fabulous works of art and glittering chandeliers. It is all mine, he could think, and yet he was for ever denied entry, on pain of death. On pain of death.
He turned the boy over. Of course, he thought scornfully, one is always allowed access to the bladder or rectum, and those other portals the body provided itself, where catheters and probes, pincers and scalpels, could reach. How many times had he patiently ground down a suffering man's bladderstones, his thin instruments deep inside the bladder, sawing and grinding. He was renowned for the delicacy of his manipulation: of the dozens of operations he had performed in the bladder only three had subsequently died of peritonitis. He knew at once when his touch had let him down. As the lithotrite was withdrawn or the catheter extracted from the penis, there was that small fatal signature of blood. Then the silent prayer: oh Lord, let it only be a scratch on the bladder wall. Even the tiniest of punctures seemed to bring down the heaviest of sentences…
He rolled the boy over again, and reached for his scalpel, about to pull back once more the curtains on the body's baffling fragile treasures. He had read recently of certain American doctors who were recommending the use of rubber gloves during operations – he could practically hear Cruz's incredulous scoffing. Even he, Salvador Carriscant, proud herald of all that was new in medicine, had some doubts about that course of action – what would happen to your 'touch', the magic of the surgeon's gift? That unique combination, as he had heard it expressed, of a lacemaker's fingers and a seaman's grip? What was the point of honing a skill if you then wilfully smothered it in rubber? It was like those Arab princesses hidden behind black veils. Why should a beautiful woman not bestow…
And he thought of the American woman again, of course. Hardly an hour seemed to go by these days without her coming, unbidden, to mind. Something about the quality of her gaze, the geometry of her face, her odd colouring, had acted upon him with fiercesome, uncompromising effectiveness. Never before, never before… Like an inert liquid galvanised into crazy effervescence by a strange catalyst. And here she was, in his city… This was what unmanned him: he felt that curious weakness come upon him again, flowing out from some new gland in the base of his spine and spreading through his body like a tree.
He set down his scalpel with a rattle, and bracing his arms, hung his head over the boy's pale ruined corpse. Jesus Christ, he said in unfamiliar prayer, heaven help me.
' Salvador, what's wrong?' Pantaleon stepped into the room, anxious, concerned to find him this way.
'I'm fine, fine,' he said straightening. 'Just a little tired, I think.' He put the scalpel down. 'This can wait.'
He turned. Pantaleon thrust his hands deep into his pockets.
'What is it?' Carriscant said. 'Can I have a discreet word?'
Carriscant had one of the hospital porters drive him down to the docks where the quays on both banks of the Pasig were as clotted as ever with shipping – steamships, square- and lateen-rigged schooners, junks and ferry boats, fat shallow-draught paddle steamers that could negotiate the silty reaches of the river upstream and the great wallowing cascos, barges cum houseboats, homes for the river's transient population, moored four or five deep along the wharves. He was happy to be out of the hospital, quite content to do this favour for Pantaleon, as it gave him an opportunity both to compose himself and also scrutinise every European and American he saw in the passing carriages in the fervid hope of glimpsing that pale freckled face again and feeling the cool gaze of those candid brown eyes…
The carriage pulled up at the foot of a narrow lane, Calle Crespo in Quiapo, where it seemed every second shop was a tinsmith's and the air vibrated dully with the sound of hammers on galvanised iron. As he descended Carriscant saw a new illuminated advertisement across the junction: coney island shooting gallery – clearly the Americans were here to stay. At number 89, Crespo, he found the sign he was looking for: between 'Sam. M. Goodforth, marine surveyor' and 'Pablo Eulegio, hat cleaner' was his destination – 'Udo Leys, tobacco merchant'.
