Cutting for Stone

THE MILK COW WAS HEMA'S FOLLY, but once the first cream-rich mouthful slid down her throat there was no going back, even if Ghosh had taken away the reason for a cow.

“Are you joking, Hema? You can't give cow's milk to newborn babies!”

“Who says so?” she said, but without conviction.

“ I do,” he said. “Besides, they've been thriving on formula for weeks. They are staying on formula.”

After his sharp words at Sister's graveside, she'd felt a terrible premonition that he would leave Missing, but in the ensuing days he had proved true to her, returning to sleep on the sofa. The calm, methodical way he'd approached Shiva's problem was a side of him she hadn't appreciated. On the wall by the door he'd taped a paper that graphed the waning and disappearance of those terrifying episodes of apnea. Hema would never have had the confidence to say what he said one evening— that the night watch was over.

He'd been sleeping on the sofa since the day she summoned him, and now she didn't want him to leave—his snoring was a sound she'd come to depend on. But she couldn't resist arguing with him now and then; it was an old reflex. She thought of it as her way of being affectionate.

They didn't take the anklet off Shiva's foot, even though it was no longer needed. The sound had become part of Shiva, and to remove it felt akin to taking away his voice.

In the early morning a stone bell heralded the procession of cow, calf, and Asrat, the milkman, up the driveway. The cowbell was tonally related to the chime of Shiva's anklet. Asrat charged more for bringing the milk factory to the house, but by milking under Rosina's or Almaz's watchful eye, there was no question of the milk being watered down.

By the time Hema rose, the house was suffused with the scent of boiling milk. She took to adding more and more milk to her morning coffee. Soon when Hema heard the cowbell, her mouth watered, just as if she were one of Professor Pavlov's mutts. Her morning “coffee” grew to two tumblers, and she had another two glasses during the day, more milk than coffee, loving the way the buttery flavor lingered on her tongue. Unlike the buffalo milk of her childhood, this milk was made so very tasty by the highland grass on which the cow fed.

When Asrat, whose bovine equanimity Hema believed came from having his cows sleep inside his hut at night, said one morning, “If only madam would buy corn feed, the milk would be so thick a spoon would stand up in it,” she didn't hesitate. Soon a coolie arrived with ten sacks on a handcart stamped ROCKEFELLER FOUNDATION and NOT FOR RESALE. “The best investment I've ever made,” Hema said a few days later, smacking her lips like a schoolgirl. “Corn makes all the difference.”

“Hardly a controlled experiment, given the bias you introduced by paying for the corn,” Ghosh said.

Asrat tethered the animals behind the kitchen, the calf just out of reach of its mother's udders, while he delivered what milk remained to other homes. The cow and calf called to each other with such soothing and auspicious sounds. Hema remembered her mother saying, “A cow carries the universe in its body, Brahma in the horns, Agni in the brow, Indra in the head …”

The calf's call for its mother was nothing like the cry of her twins, but the emotion was identical. In her years as an obstetrician, Hema had never thought too much about a newborn's cry, never paused to consider the frequency that made a baby's tongue and lips quiver like a reed. It was such a helpless, urgent sound, but hitherto its importance lay in what it signaled: a successful labor, a live birth. Only when it was absent was it noteworthy. But now, when her newborns, her Shiva and Marion, cried, it was like no other earthly sound. It summoned her from sleep's catacombs and brought shushing noises to her throat as she rushed to the incubator. It was a personal call—her babies wanted her!

She remembered a phenomenon she'd experienced for years when she was about to fall asleep: a sense that someone was calling her name. Now she told herself it had been her unborn twins telling her they were coming.

There were other noises she became attuned to in her new-mother state. The thwack of wet cloth on the washing stone. The clothesline sagging with diapers (banners to fecundity) and raising a flapping alarm before a rain squall, sending Almaz and Rosina racing outside. The glass- harp notes of feeding bottles clinking together in the boiling water. Rosina's singing, her constant chatter. Almaz clanging pots and pans … these sounds were the chorale of Hema's contentment.

A Maharashtrian astrologer, on a tour of East Africa, came to the house over Ghosh's objections. Hema paid for him to read the children's fortunes. With his spectacles and fountain pens in his shirt pocket, he looked like a young railway clerk. After recording the exact time of the twins’ births, he wanted the parents’ birth dates. Hema gave hers and then volunteered Ghosh's, throwing Ghosh a warning look. The astrol oger consulted his tables and his calculations filled one side of a foolscap paper. At last he said, “Impossible.” He looked nervously at Hema, but avoided Ghosh's eyes. He capped his pen, put away his papers, and while an astonished Hema looked on, he made for the door. “Whatever is their destiny,” he said, “you can be sure it's linked to the father.”

Ghosh caught up with him at the gate. He declined Ghosh's offer of money. With a mournful expression he intoned, “Doctor saab, I'm afraid you cannot be the father.” Ghosh pretended to be deeply troubled by this news. Ghosh reported back to Hema, but she wasn't half as amused as he was. It left her fearful, as if the man had somehow predicted Thomas Stone's return.

The next day Ghosh found Hema squatting, cupping rice flour in her fist and drawing a rangoli—an elaborate decorative pattern—on the wooden floor just outside her bedroom, taking pains that the lines were uninterrupted, so the evil spirits could not pass. Above the door frame to the bedroom, Hema hung a mask of a bearded devil with bloodshot eyes, his tongue sticking out—a further deflection of the evil eye. It became part of her morning ritual along with the playing of “Suprabhatam” on the Grundig, a version sung by M. S. Subbulakshmi. The chant's hiccuping syncopation evoked for Ghosh the sound of women sweeping the front yard around the banyan tree in the early mornings in Madras and the dhobi ringing his bicycle bell. “Suprabhatam” was what radio stations used to begin their daily broadcast, and as a student, Ghosh had heard the words of “Suprabhatam” on the lips of dying patients. It amused him that he had to come to Ethiopia to learn exactly what it was: an invocation and a wake-up call for Lord Venkateswara.

Ghosh noticed that Hema's bedroom closet was now a shrine dominated by the symbol of Shiva: a tall lingam. In addition to the little brass statues of Ganesh, Lakshmi, and Muruga, now came a sinister-looking ebony carving of the indecipherable Lord Venkateswara, as well as a ceramic Immaculate Heart of the Virgin Mary and a ceramic crucified Christ, blood welling out of the nail holes. Ghosh held his tongue.

Without fanfare and quite unexpectedly, Ghosh had become Missing's surgeon. Though he was no Thomas Stone, he had now handled several acute abdomens (his stomach fluttering just like the first time) and dealt with stab wounds and major fractures and even put in a chest tube for trauma. A woman in the labor and delivery room had suddenly developed airway obstruction. Ghosh ran in and cut high in the neck, opening the cricothyroid membrane; the aspirate sound of air rushing in was its own reward, as was the sight of the patient's lips turning from deep blue to pink. Later that day, under better lighting in the operating theater, he did his first thyroidectomy Operating Theater 3 was now a familiar place, but still fraught with danger. Nothing was routine for him.

On the day the twins turned two months old, Ghosh was in mid-surgery when the probationer poked her head in to say that Hema urgently needed him. Ghosh was removing a foot so destroyed by chronic infection that it had become a weeping, oozing stump. The boy had traveled alone from his village near Axum, a voyage of several days, to beg Ghosh to cut off the offending part. “It has stuck to my body for three years,” he said, pointing to the foot that was four times the size of his other foot and shapeless, with toes barely visible.

Madura foot was found wherever people habitually walked barefoot, but the town of Madurai, not far from Madras, had the dubious honor of lending its name to this disease. No place ever came off well when a disease was named after it: Delhi belly, Baghdad blues, Turkey trots. Madura foot began when a field-worker stepped on a large thorn or nail. Their livelihood gave them no choice but to keep walking, and slowly a fungus overran the foot, invaded bone, tendon, and muscle. Nothing short of amputation would help.

Encouraged by the old surgical saw “Any idiot can amputate a leg,” Ghosh had decided to proceed. If he hesitated, it was because the rest of the saying went “but it takes a skilled surgeon to save one.” Still there was no saving this foot.

The boy was the first patient Ghosh had ever seen who sang and clapped his way into the theater, overjoyed at having surgery. Ghosh cut through skin above the ankle, leaving a flap at the back to cover the stump. He tied off the blood vessels and sawed through the bone and heard the thump of the foot landing in the bucket. It was at this