up a head. It didn’t take many events like this, a snake bite, a breech birth, and suddenly the whole of Brazil knows there is a doctor available off the Negro. Now, you must understand this, Dr. Singh, so few people do: I am not Medecins Sans Frontieres. I have not come to the Amazon to be a family practioner. I am simply a person who made certain mistakes at the onset. They didn’t know me as a doctor when I arrived. The Lakashi knew me as a member of Dr. Rapp’s party. They thought I was like Dr. Rapp, that I was there for the flora and not for them. For the first few years I came alone they were forever bringing me mushrooms and various fungi to look at. They lugged so many fallen trunks of enormous, rotted trees back to camp it would have sent any mycological society into a frenzy. The fact that I took their temperature and drew blood samples and measured their children was completely lost on them, they continued to see me as the person they first met — as an extension of Dr. Rapp. And it had been my intention to be like him, to float on their misguided perceptions, but then I sewed up that girl’s head. It was my fatal mistake. The next thing I knew sick people were being paddled up the river to receive my care, and a deaf child had been left off for me to deal with.”
The deaf child had gotten her to town. He had ferried her guest to the restaurant after the opera and loaded the boxes on the boat and steered the boat through the river. The deaf child was not without his uses. “What would the alternative have been?” Marina asked. “Going back to that first girl.”
“The bleeder. The question is whether or not you choose to disturb the world around you, or if you choose to let it go on as if you had never arrived. That is how one respects indigenous people. If you pay any attention at all you’ll realize that you could never convert them to your way of life anyway. They are an intractable race. Any progress you advance to them will be undone before your back is turned. You might as well come down here to unbend the river. The point, then, is to observe the life they themselves have put in place and learn from it.”
Marina felt remarkably unmoved by this. “So go back in time, do it again: there is a child standing in front of you with a machete in her head. What do you do?” The farther they went down the river, the fewer boats they saw. From time to time there was still a group of people, mostly very small children, in clusters on the shore but they were thinning out. It felt good to ask a question twice. It was something she could never have managed in the past.
“That’s a dramatic flourish, Dr. Singh. Did I tell you the child had a machete in her head? I said she was cut. There was no doubt that she had a skull fracture. I picked out bone fragments with my tweezers but there was nothing else to be done about that. If she was draining cerebral spinal fluid she didn’t do it in front of me. I sewed her up, I gave her some antibiotic ointment, hooray for me, now I can meet your expectations of decency, unless of course your expectations include my taking her back to Manaus for an X-ray. But the actions you admire are not thoughtful, they were automatic, the actions I had brought with me from my Western medical background. The question you should be asking is what would have happened to the girl if I hadn’t been there? There was someone in the tribe who had managed these situations before me and I suppose that he, in this case it was a he, would have used the available means to help her. Would it have been a sterile needle? I think not. Would she have died? Very doubtful. And while you are moralizing, ask yourself this question as well: What happens to the girl whose brother cuts her after I’ve gone? Does the tribe still have faith in the man who sewed up heads before me? Has he kept up with his own skills or was he too busy watching mine? I don’t intend to be here forever.”
“The man who puts the girl’s scalp back together, the one you are respecting, do you think his methods are as successful as yours?”
“Now you are being purposefully ridiculous. I have very little respect for what passes as science around here. There’s nothing a Westerner loves more than the idea of being cured by tinctures made of boiled roots. They think this place is some sort of magical medicine chest, but for the most part the treatments here consist of poorly recorded gossip handed down throughout the ages from people who knew very little to people who know even less. There is much to be taken from the jungle, obviously — I am here to develop a drug — but in most cases the plants are as useless as the potted begonia that grows on your kitchen windowsill. The ones that do have potential can only be medicinal when they are properly employed. For these people there is no concept of a dosage, no set length for treatments. When something works it seems to me to be nothing short of a miracle.”
Marina remembered that cup of sludge Barbara Bovender had brought her from the shaman’s stand and wondered if she was no more than a Westerner given to the charms of boiled tinctures. It was a cure she would never admit to now.
Dr. Swenson brightened for a moment. “I’ll tell you what the locals do have a real genius for, and that’s poison. There are so many plants and insects and various reptiles capable of killing a person out here that it seems any idiot could scrape together a compound that would drop an elephant. As for the rest of it, people survive regardless of the care they get. The human animal is too resilient for it to be otherwise. It is not for me to meddle.”
“I appreciate your point. It’s only that I believe in the moment — the child, the blood — it would be hard not to act.”
“Then perhaps it will actually open up some of my time to have you here. I’ll send the daily medical emergencies to you.”
Marina laughed at this. “Then I know they’d be better off with the local medical care. I haven’t threaded a needle in nearly fifteen years.” Suddenly Marina realized she couldn’t remember sewing up that last woman she’d operated on. She remembered lifting out the infant, and at that instant realizing what she had done. She remembered one of the nurses taking him away, but what came after that? Where was the needle? She didn’t leave the patient there, uterus and abdomen open to the world, but she could not find a picture in her memory of closing.
“It comes right back,” Dr. Swenson said. “You were my student. Believe me, I pounded it all in there.”
Marina was still looking for the conclusion to the surgery in her mind when she had another thought. “What about Dr. Rapp?”
“What about him?”
“Wouldn’t he have sewn up the girl’s head?”
Dr. Swenson snorted. “He most certainly would not have, and not because he wasn’t a medical doctor. He had a perfect understanding of human physiology and the steadiest hands I have ever seen in my life. He could have grafted a vein by a campfire had he thought it was necessary. But Dr. Rapp had no self-aggrandizing notions about his role in the tribe. He never set himself out to be the great white hero. He never took a single specimen more than what was absolutely needed. He disrupted nothing.”
“So he would have let her bleed to death.”
“He would have respected the order that was in place.”
Marina nodded, thinking perhaps she was luckier than she realized to have found herself with an expedition still capable of making errors of compassion. “Is Dr. Rapp still alive?”
She might as well have asked if President Kennedy had survived his assassination attempt. “Do you read, Dr. Singh? Do you live in this world?”
It was a beautiful question to be asked by a woman on a boat who was taking her down a river into the beating heart of nowhere. “I do,” Marina said.
She sighed and shook her head. “Dr. Rapp died nine years ago. It will be ten years this August.”
And Marina, sensing that sympathy was in order, said that she was sorry to hear it, and Dr. Swenson thanked her.
“Were you studying mycology at the time? Is that how you came to work with Dr. Rapp?” It seemed possible, after all; anything was possible. She may have been coming down here as an operative for the CIA.
“I was a student of Dr. Rapp’s, and the location of his classroom was unpredictable. I followed him through Africa and Indonesia, but the Amazon was the source of his most important work. He studied botany, and I was free to study the workings of a true scientific mind. As an undergraduate at Radcliffe I wasn’t allowed to take his class at Harvard, Harvard couldn’t have stood for anything as radical as that, but Dr. Rapp let me travel on the expeditions. He was the first teacher I encountered who saw no limitations for women. As it turned out he was the only one.”
They were quiet for a long time after that, both staring off at different aspects of the jungle as it rolled past them, the same bit of scenery recycled indefinitely. Two hours later, Easter left the protection of the right-hand bank and crossed the width of the Negro to the left. There he turned up a tributary that was in every way similar to the countless other tributaries they had passed, and while it was unmarked, it was the exit ramp from the interstate, the one that would eventually take them to the street where Dr. Swenson lived. No other boats followed
