ALSO BY ABRAHAM VERGHESE

The Tennis Partner

My Own Country

For George and Mariam Verghese

    Scribere jussit amor

And because I love this life

    I know I shall love death as well. The child cries out when

    From the right breast the mother Takes it away, in the very next moment To find in the left oneIts consolation.

    Gitanjali—Rabindranath Tagore, from

    PROLOGUEThe Coming

    AFTER EIGHT MONTHS spent in the obscurity of our mother's womb, my brother, Shiva, and I cameinto the world in the late afternoon of the twentieth of September in the year of grace 1954.We took our first breaths at an elevation of eight thousand feet in the thin air of AddisAbaba, capital city of Ethiopia.

    The miracle of our birth took place in Missing Hospital's Operating Theater 3, the very roomwhere our mother, Sister Mary Joseph Praise, spent most of her working hours, and in which shehad been most fulfilled.

    When our mother, a nun of the Diocesan Carmelite Order of Madras, unexpectedly went into laborthat September morning, the big rain in Ethiopia had ended, its rattle on the corrugated tinroofs of Missing ceasing abruptly like a chatterbox cut off in midsentence. Over night, in thathushed silence, the meskel flowers bloomed, turning the hillsides of Addis Ababa into gold. Inthe meadows around Missing the sedge won its battle over mud, and a brilliant carpet now sweptright up to the paved threshold of the hospital, holding forth the promise of something moresubstantial than cricket, croquet, or shuttlecock.

    Missing sat on a verdant rise, the irregular cluster of whitewashed one- and two-storybuildings looking as if they were pushed up from the ground in the same geologic rumble thatcreated the Entoto Mountains. Troughlike flower beds, fed by the runoff from the roof gutters,surrounded the squat buildings like a moat. Matron Hirst's roses overtook the walls, thecrimson blooms framing every window and reaching to the roof. So fertile was that loamy soilthat Matron—Missing Hospital's wise and sensible leader—cautioned us against stepping into itbarefoot lest we sprout new toes.

    Five trails flanked by shoulder-high bushes ran away from the main hospital buildings likespokes of a wheel, leading to five thatched-roof bungalows that were all but hidden by copse,by hedgerows, by wild eucalyptus and pine. It was Matron's intent that Missing resemble anarboretum, or a corner of Kensington Gardens (where, before she came to Africa, she used towalk as a young nun), or Eden before the Fall.

    Missing was really Mission Hospital, a word that on the Ethiopian tongue came out with a hissso it sounded like “Missing.“ A clerk in the Ministry of Health who was a fresh high-schoolgraduate had typed out THE MISSING HOSPITAL on the license, a phonetically correct spelling asfar as he was concerned. A reporter for the Ethiopian Herald perpetuated this misspelling. When

    Matron Hirst had approached the clerk in the ministry to correct this, he pulled out hisoriginal typescript. “See for yourself, madam. Quod erat demonstrandum it is Missing,” he

    said, as if hed proved Pythagoras s theorem, the sun's central position in the solar system,the roundness of the earth, and Missing's precise location at its imagined corner. And soMissing it was.

    NOT A CRY or a groan escaped from Sister Mary Joseph Praise while in the throes of hercataclysmic labor. But just beyond the swinging door in the room adjoining Operating Theater 3, the oversize autoclave (donated by the Lutheran church in Zurich) bellowed and wept for mymother while its scalding steam sterilized the surgical instruments and towels that would beused on her. After all, it was in the corner of the autoclave room, right next to thatstainless-steel behemoth, that my mother kept a sanctuary for herself during the seven yearsshe spent at Missing before our rude arrival. Her one-piece desk-and-chair, rescued from adefunct mission school, and bearing the gouged frustration of many a pupil, faced the wall. Herwhite cardigan, which I am told she often slipped over her shoulders when she was betweenoperations, lay over the back of the chair.

    On the plaster above the desk my mother had tacked up a calendar print of Bernini's famoussculpture of St. Teresa of Avila. The figure of St. Teresa lies limp, as if in a faint, her

    lips parted in ecstasy, her eyes unfocused, lids half closed. On either side of her, avoyeuristic chorus peers down from the prie-dieux. With a faint smile and a body more muscularthan befits his youthful face, a boy angel stands over the saintly, voluptuous sister. Thefingertips of his left hand lift the edge of the cloth covering her bosom. In his right hand heholds an arrow as delicately as a violinist holds a bow.

    Why this picture? Why St. Teresa, Mother?

    As a little boy of four, I took myself away to this windowless room to study the image. Couragealone could not get me past that heavy door, but my sense that she was there, my obsession toknow the nun who was my mother, gave me strength. I sat next to the autoclave which rumbled andhissed like a waking dragon, as if the hammering of my heart had roused the beast. Gradually,as I sat at my mother's desk, a peace would come over me, a sense of communion with her.

    I learned later that no one had dared remove her cardigan from where it sat draped on thechair. It was a sacred object. But for a four-year-old, everything is sacred and ordinary. Ipulled that Cuticura-scented garment around my shoulders. I rimmed the dried-out inkpot with mynail, tracing a path her fingers had taken. Gazing up at the calendar print just as she musthave while sitting there in that windowless room, I was transfixed by that image. Years later,I learned that St. Teresa's recurrent vision of the angel was called the transverberation,which the dictionary said was the soul “inflamed” by the love of God, and the heart“pierced” by divine love; the metaphors of her faith were also the metaphors of medicine. Atfour years of age, I didn't need words like “transverberation” to feel reverence for thatimage. Without photographs of her to go by, I couldn't help but imagine that the woman in thepicture was my mother, threatened and about to be ravished by the spear-wielding boy-angel.“When are you coming, Mama?” I would ask, my small voice echoing off the cold tile. When are

    you coming?

    I would whisper my answer: “By God!” That was all I had to go by: Dr. Ghosh's declaration thetime I'd first wandered in there and he'd come looking for me and had stared at the picture ofSt. Teresa over my shoulders; he lifted me in his strong arms and said in that voice of histhat was every bit a match for the autoclave: “She is CUM-MING, by God!”

    FORTY-SIX AND FOUR YEARS have passed since my birth, and miraculously I have the opportunity toreturn to that room. I find I am too large for that chair now, and the cardigan sits atop myshoulders like the lace amice of a priest. But chair, cardigan, and calendar print oftransverberation are still there. I, Marion Stone, have changed, but little else has. Being inthat unaltered room propels a thumbing back through time and memory. The unfading print ofBernini's statue of St. Teresa (now framed and under glass to preserve what my mother tackedup) seems to demand this. I am forced to render some order to the events of my life, to say itbegan here, and then because of this, that happened, and this is how the end connects to thebeginning, and so here I am.

    WE COME UNBIDDEN into this life, and if we are lucky we find a purpose beyond starvation,misery, and early death which, lest we forget, is the common lot. I grew up and I found mypurpose and it was to become a physician. My intent wasn't to save the world as much as to healmyself. Few doctors will admit this, certainly not young ones, but subconsciously, in enteringthe profession, we must believe that ministering to others will heal our woundedness. And itcan. But it can also deepen the wound.

    I chose the specialty of surgery because of Matron, that steady presence during my boyhood andadolescence. “What is the hardest thing you can possibly do?” she said when I went to her foradvice on the darkest day of the first half of my life.

    I squirmed. How easily Matron probed the gap between ambition and expediency. “Why must I dowhat is hardest?”

    “Because, Marion, you are an instrument of God. Don't leave the instrument sitting in itscase, my son. Play! Leave no part of your instrument unexplored. Why settle for ‘Three BlindMice’ when you can play the ‘Gloria’?”

    How unfair of Matron to evoke that soaring chorale which always made me feel that I stood withevery mortal creature looking up to the heavens in dumb wonder. She understood my unformedcharacter.

    “But, Matron, I can't dream of playing Bach, the ‘Gloria’ …,” I said under my breath. I'dnever played a string or wind instrument. I couldn't read music.

    “No, Marion,” she said, her gaze soft, reaching for me, her gnarled hands rough on my cheeks.“No, not Bach's ‘Gloria.’ Yours! Your ‘Gloria’ lives within you. The greatest sin is notfinding it, ignoring what God made possible in you.”

    I was temperamentally better suited to a cognitive discipline, to an introspectivefield—internal medicine, or perhaps psychiatry. The sight of the operating theater made mesweat. The idea of holding a scalpel caused coils to form in my belly. (It still does.) Surgerywas the most difficult thing I could imagine.

    And so I became a surgeon.

    Thirty years later, I am not known for speed, or daring, or technical genius. Call me steady,call me plodding; say I adopt the style and technique that suits the patient and the particularsituation and I'll consider that high praise. I take heart from my fellow physicians who cometo me when they themselves must suffer the knife. They know that Marion Stone will be asinvolved after the surgery as before and during. They know I have no use for surgical aphorismssuch as “When in doubt, cut it out” or “Why wait when you can operate” other than for howreliably they reveal the shallowest intellects in our field. My father, for whose skills as asurgeon I have the deepest respect, says, “The operation with the best outcome is the one youdecide not to do.” Knowing when not to operate, knowing when I am in over my head, knowingwhen to call for the assistance of a surgeon of my father's caliber—that kind of talent, thatkind of “brilliance,” goes unheralded.

    On one occasion with a patient in grave peril, I begged my father to operate. He stood silentat the bedside, his fingers lingering on the patient's pulse long after he had registered theheart rate, as if he needed the touch of skin, the thready signal in the radial artery tocatalyze his decision. In his taut expression I saw complete concentration. I imagined I couldsee the cogs turning in his head; I imagined I saw the shimmer of tears in his eyes. Withutmost care he weighed one option against another. At last, he shook his head, and turned away.

    I followed. “Dr. Stone,” I said, using his title though I longed to cry out, Father! “An

    operation is his only chance,” I said. In my heart I knew the chance was infinitesimallysmall, and the first whiff of anesthesia might end it all. My father put his hand on myshoulder. He spoke to me gently, as if to a junior colleague rather than his son. “Marion,remember the Eleventh Commandment,” he said. “Thou shall not operate on the day of apatient's death.”

    I remember his words on full-moon nights in Addis Ababa when knives are flashing and rocks andbullets are flying, and when I feel as if I am standing in an abattoir and not in OperatingTheater 3, my skin flecked with the grist and blood of strangers. I remember. But you don'talways know the answers before you operate. One operates in the now. Later, theretrospectoscope, that handy tool of the wags and pundits, the conveners of the farce we callM&M—morbidity and mortality conference—will pronounce your decision right or wrong. Life,too, is like that. You live it forward, but understand it backward. It is only when you stopand look to the rear that you see the corpse caught under your wheel.

    Now, in my fiftieth year, I venerate the sight of the abdomen or chest laid open. I'm ashamedof our human capacity to hurt and maim one another, to desecrate the body. Yet it allows me tosee the cabalistic harmony of heart peeking out behind lung, of liver and spleen consultingeach other under the dome of the diaphragm—these things leave me speechless. My fingers “runthe bowel” looking for holes that a blade or bullet might have created, coil after glisteningcoil, twenty-three feet of it compacted into such a small space. The gut that has slitheredpast my fingers like this in the African night would by now reach the Cape of Good Hope, and Ihave yet to see the serpent's head. But I do see the ordinary miracles under skin and rib and

muscle, visions concealed from their owner. Is there a greater privilege on earth?

    At such moments I remember to thank my twin brother, Shiva— Dr. Shiva Praise Stone—to seekhim out, to find his reflection in the glass panel that separates the two operating theaters,and to nod my thanks because he allows me to be what I am today. A surgeon.

    According to Shiva, life is in the end about fixing holes. Shiva didn't speak in metaphors.Fixing holes is precisely what he did. Still, it's an apt metaphor for our profession. Butthere's another kind of hole, and that is the wound that divides family. Sometimes this woundoccurs at the moment of birth, sometimes it happens later. We are all fixing what is broken. Itis the task of a lifetime. We'll leave much unfinished for the next generation.

    Born in Africa, living in exile in America, then returning at last to Africa, I am proof thatgeography is destiny. Destiny has brought me back to the precise coordinates of my birth, tothe very same operating theater where I was born. My gloved hands share the space above thetable in Operating Theater 3 that my mother and father's hands once occupied.

    zaa-zee, zaa-zee, thousands of them drowning out the coughs andSome nights the crickets cry

    grunts of the hyenas in the hillsides. Suddenly, nature turns quiet. It is as if roll call isover and it is time now in the darkness to find your mate and retreat. In the ensuing vacuum ofsilence, I hear the high-pitched humming of the stars and I feel exultant, thankful for myinsignificant place in the galaxy. It is at such times that I feel my indebtedness to Shiva.

    Twin brothers, we slept in the same bed till our teens, our heads touching, our legs and torsosangled away. We outgrew that intimacy, but I still long for it, for the proximity of his skull.When I wake to the gift of yet another sunrise, my first thought is to rouse him and say, I owe

    you the sight of morning.

    What I owe Shiva most is this: to tell the story. It is one my mother, Sister Mary JosephPraise, did not reveal and my fearless father, Thomas Stone, ran from, and which I had to piecetogether. Only the telling can heal the rift that separates my brother and me. Yes, I haveinfinite faith in the craft of surgery, but no surgeon can heal the kind of wound that dividestwo brothers. Where silk and steel fail, story must succeed. To begin at the beginning …

    PART ONE

    … for the secret of the care of the patient

    is in caring for the patient.

    Francis W. Peabody, October 21, 1925

    CHAPTER 1

    The Typhoid State Revisited

    SISTER MARY JOSEPH PRAISE had come to Missing Hospital from India, seven years before ourbirth. She and Sister Anjali were the first novitiates of the Carmelite Order of Madras to alsogo through the arduous nursing diploma course at the Government General Hospital, Madras. Ongraduation day my mother and Anjali received their nursing pins and that evening took their

    final vows of poverty celibacy, and obedience. Instead of answering to “Probationer” (in thehospital) and “Novitiate” (in the convent), they could now be addressed in both places as“Sister.” Their aged and saintly abbess, Shessy Geevarughese, affectionately called SaintlyAmma, had wasted no time in giving the two young nurse-nuns her blessing, and her surprisingassignment: Africa.

    On the day they were to sail, all the novitiates rode from the convent in a caravan of cycle-rickshaws to the harbor to send off their two sisters. In my mind's eye I can see thenovitiates lining the quay, chattering and trembling with excitement and emotion, their whitehabits flapping in the breeze, the seagulls hopping around their sandaled feet.

    I have so often wondered what went through my mother's mind as she and Sister Anjali, both just

    Calangute. She wouldnineteen years old, took their last steps on Indian soil and boarded the

    have heard stifled sobs and “God be with you” follow her up the gangway. Was she fearful? Didshe have second thoughts? Once before, when she entered the convent, she'd torn herself awayfrom her biological family in Cochin forever and moved to Madras, which was a day and a night'strain ride from her home. As far as her parents were concerned, it might just as well have beenhalfway across the world, for they would never see her again. And now, after three years inMadras, she was tearing herself away from the family of her faith, this time to cross an ocean.Once again, there was no going back.

    A few years before sitting down to write this, I traveled to Madras in search of my mother'sstory. In the archived papers of the Carmelites, I found nothing of hers, but I did findSaintly Amma's diaries in which the abbess recorded the passing days. When the Calangute

    slipped its mooring, Saintly Amma raised her hand like a traffic policeman and, “using mysermon voice which I am told belies my age,” intoned the words, “Leave your land for mysake,” because Genesis was her favorite book. Saintly Amma had given this mission greatthought: True, India had unfathomable needs. But that would never change and was no excuse; thetwo young nuns—her brightest and fairest—were to be the torch-bearers: Indians carryingChrist's love to darkest Africa—that was her grand ambition. In her papers, she reveals herthinking: Just as the English missionaries discovered when they came to India, there was nobetter way to carry Christ's love than through stupes and poultices, liniments and dressings,cleansing and comfort. What better ministry than the ministry of healing? Her two young nunswould cross the ocean, and then the Madras Discalced Carmelite Mission to Africa would begin.

    As the good abbess watched the two waving figures on the ship's rail recede to white dots, shefelt a twinge of apprehension. What if by their blind obedience to her grand scheme they werebeing condemned to a horrible fate? “The English missionaries have the almighty Empire behindthem … but what of my girls?” She wrote that the seagulls’ shrill quarreling and thesplatter of bird excreta had marred the grand send-off she had envisioned. She was distractedby the overpowering scent of rotten fish, and rotted wood, and by the bare-chested stevedoreswhose betel-nut-stained mouths drooled bloody lechery at the sight of her brood of virgins.

    “Father, we consign our sisters to You for safekeeping,” Saintly Amma said, putting it on Hisshoulders. She stopped waving, and her hands found shelter in her sleeves. “We beseech You formercy and for Your protection in this outreach of the Discalced Carmelites …”

    It was 1947, and the British were finally leaving India; the Quit India Movement had made theimpossible come about. Saintly Amma slowly let the air out of her lungs. It was a new world,and bold action was called for, or so she believed.

    THE BLACK-AND-RED FLOATING PACKET of misery that called itself a ship steamed across the IndianOcean toward its destination, Aden. In its hold the Calangute carried crate upon crate of spun

    cotton, rice, silk, Godrej lockers, Tata filing cabinets, as well as thirty-one Royal EnfieldBullet motorcycles, the engines wrapped in oilcloth. The ship wasn't meant to carry passengers,but the Greek captain did just that by housing “paying guests.” There were many who wouldtravel on a cargo ship to save on passage, and he was there to oblige by skimping on crew. Soon this trip he carried two Madras nuns, three Cochin Jews, a Gujarati family, threesuspicious-looking Malays, and a few Europeans, including two French sailors rejoining theirship in Aden.

    The Calangute had a vast expanse of deck—more land than one ever expected at sea. At one end,like a gnat on an elephant's backside, sat the three-story superstructure which housed the crewand passengers, the top floor of which was the bridge.

    My mother, Sister Mary Joseph Praise, was a Malayali from Cochin, in the state of Kerala.Malayali Christians traced their faith back to St. Thomas's arrival in India from Damascus inA.D. 52. “Doubting” Thomas built his first churches in Kerala well before St. Peter got toRome. My mother was God-fearing and churchgoing; in high school she came under the influence of

    a charismatic Carmelite nun who worked with the poor. My mother's hometown is a city of fiveislands set like jewels on a ring, facing the Arabian Sea. Spice traders have sailed to Cochinfor centuries for cardamom and cloves, including a certain Vasco de Gama in 1498. ThePortuguese clawed out a colonial seat in Goa, torturing the Hindu population into Catholicconverts. Catholic priests and nuns eventually reached Kerala, as if they didn't know that St.Thomas had brought Christ's uncorrupted vision to Kerala a thousand years before them. To herparents’ chagrin, my mother became a Carmelite nun, abandoning the ancient Syrian Christiantradition of St. Thomas to embrace (in her parents’ view) this Johnny-come-lately pope-worshipping sect. They couldn't have been more disappointed had she become a Muslim or a Hindu.It was a good thing her parents didn't know that she was also a nurse, which to them would meanthat she soiled her hands like an untouchable.

    My mother grew up at the ocean's edge, in sight of the ancient Chinese fishing netscantilevered from long bamboo poles and dangling over the water like giant cobwebs. The sea wasthe proverbial “breadbasket” of her people, provider of prawns and fish. But now on the deck

     without the Cochin shore to frame her view, she did not recognize theCalangute,of the

    breadbasket. She wondered if at its center the ocean had always been this way: smoking,malevolent, and restless. It tormented the making it pitch and yaw and creak,Calangute,

    wanting nothing more than to swallow it whole.

    She and Sister Anjali secluded themselves in their cabin, bolting the door against men and sea.Anjali's ejaculatory prayers startled my mother. The ritualized reading of the Gospel of Lukewas Sister Anjali's idea; she said it would give wings to the soul and discipline to the body.The two nuns subjected each letter, each word, line, and phrase to dilata-tio, elevatio, and

    excessus—contemplation, elevation, and ecstasy. Richard of St. Victor's ancient monasticpractice proved useful for an interminable ocean crossing. By the second night, after ten hoursof such close and meditative reading, Sister Mary Joseph Praise suddenly felt print and pagedissolve; the boundaries between God and self disintegrated. Reading had brought this: a joyoussurrender of her body to the sacred, the eternal, and the infinite.

    At vespers on the sixth night (for they were determined to carry the routine of the conventwith them no matter what) they finished a hymn, two psalms, and their antiphons, then thedoxology, and were singing the Magnificat when a piercing, splintering sound brought them toearth. They grabbed life jackets and rushed out. They were met by the sight of a segment of thedeck that had buckled and pushed up into a pyramid, almost, it seemed to Sister Mary JosephPraise, as if the Calangute were made of corrugated cardboard. The captain kept his pipe lit

    and his smirk suggested his passengers had overreacted.

    On the ninth night, four of the sixteen passengers and one of the crew came down with a feverwhose flesh signs were rose spots that appeared on the second febrile day and that arrangedthemselves like a Chinese puzzle on the chest and abdomen. Sister Anjali suffered grievously,her skin burning to the touch. By the second day of illness she was raging in feverishdelirium.

    Among the Calangutes passengers was a young surgeon—a hawk -eyed Englishman who was leavingthe Indian Medical Service for better pastures. He was tall and strong, and his rugged featuresmade him look hungry, yet he avoided the dining room. Sister Mary Joseph Praise had run intohim, literally, on the second day of the voyage when she lost her footing on the wet metalstairs leading up from their quarters to the common room. The Englishman coming up behind herseized her where he could, in the region of her coccyx and her left rib cage. He righted her asif she were a little child. When she stuttered her thanks, he turned beet red; he was moreflustered than she by this unexpected intimacy. She felt a bruising coming on where his handshad clutched her, but there was a quality to this discomfort that she did not mind. For daysthereafter, she didn't see the Englishman.

    Now, seeking medical help, Sister Mary Joseph Praise gathered her courage to knock on hiscabin. A faint voice bid her to enter. A bilious, acetone odor greeted her. “It is me,” shecalled out. “It is Sister Mary Joseph Praise.” The doctor lay on his side in his bunk, hisskin the same shade as his khaki shorts, his eyes screwed shut. “Doctor,” she said,

hesitating, “are you also with fever?”

    When he tried to look at her, his eyeballs rolled like marbles on a tilting plate. He turnedand retched over a fire-bucket, missed it, which didn't matter, as the bucket was full to thebrim. Sister Mary Joseph Praise rushed forward and felt his brow. It was cold and clammy, notat all feverish. His cheeks were hollowed, and his body looked as if it had shrunk to fit thetiny cabin. None of the passengers had been spared seasickness, but the Englishman's afflictionwas severe.

    “Doctor, I am wanting to report a fever that has affected five patients. It comes with rash,chills, and sweats, a slow pulse and loss of appetite. All are stable except for Sister Anjali.Doctor, I am most worried about Anjali …”

    She felt better once it was off her chest, even though other than letting out a moan theEnglishman made no response. Her eyes fell on a catgut ligature that was looped around a bedrail near his hands and that displayed knot thrown on top of knot, ten-score of them. The knotswere so plentiful that the thread stood up like a gnarled flagpole. This was how he had loggedthe hours, or kept track of his bouts of emesis.

    She rinsed out the bucket and put it back within his reach. She mopped the mess on the floorwith a towel, then she rinsed the towel out and hung it up to dry. She brought water to hisside. She withdrew, wondering how many days it had been since he'd eaten anything.

    By evening he was worse. Sister Mary Joseph Praise brought sheets, towels, and broth. Kneeling,she tried to feed him, but the smell of food triggered dry heaves. His eyeballs had sunk intotheir orbits. His shriveled tongue looked like that of a parrot. She recognized the room'sfruity odor as the scent of starvation. When she pinched up a skin fold at the back of his armand let go, it stayed up like a tent, like the buckled deck. The bucket was half full of clearfluid. He babbled about green fields and was unaware of her presence. Could seasickness be

    forme fruste of the fever that afflicted Sister Anjali?fatal, she wondered. Or could he have a

    There was so much she did not know about medicine. In the middle of that ocean surrounded bythe sick, she felt the weight of her ignorance.

    But she knew how to nurse. And she knew how to pray. So, praying, she eased off his shirt whichwas stiff with bile and spit, and she slid down his shorts. As she gave him a bed bath, she wasself-conscious, for shed never ministered to a white man, or to a doctor for that matter. Hisskin displayed a wave of goose bumps at the touch of her cloth. But the skin was free of therash shed seen on the four passengers and the one cabin boy who had come down with fever. Thesinewy muscles of his arms bunched together fiercely at his shoulder. Only now did she noticethat his left chest was smaller than his right; the hollow above his collarbone on the leftcould have held a half cup of water, while that on the right only a teaspoon. And just beyondand below his left nipple, extending into the armpit, she saw a deep depression. The skin overthis crater was shiny and puckered. She touched there and gasped as her fingers fell in, notmeeting bony resistance. Indeed, it appeared as if two or perhaps three adjacent ribs weremissing. Within that depression his heart tapped firmly against her fingers with only a thinlayer of hide intervening. When she pulled her fingers away, she could see the thrust of hisventricle against his skin.

    The fine, translucent coat of hair on his chest and abdomen looked as if it had drifted up fromthe mother lode of hair at his pubis. She dispassionately cleaned his uncircumcised member,then flopped it to one side and attended to the wrinkled and helpless-looking sac beneath. Shewashed his feet and cried while she did, thinking inevitably of her Sweet Lord and His lastearthly night with His disciples.

    In his steamer trunks she found books dealing with surgery. He had penned names and dates inthe margins, and only later did it occur to her that these were patients’ names, both Indianand British, mementos to a disease hed first seen in a Peabody, or a Krishnan. A cross next tothe name she took as a sign the patient had succumbed. She found eleven notebooks filled withan economical handwriting with slashing down-strokes, the text dancing just above the lines andobeying no margin save for the edge of the page. For an outwardly silent man, his writing

reflected an unexpected volubility.

    Eventually she found a clean undershirt and shorts. What did it say when a man had fewerclothes than books? Turning him first this way and then that, she changed the sheets beneathhim and then dressed him.

    She knew his name was Thomas Stone because it was inscribed inside the surgical textbook hedplaced at his bedside. In the book she found little about fever with rash, and nothing aboutseasickness.

    That night Sister Mary Joseph Praise negotiated the heaving passageways, hurrying from onesickbed to the next. The mound where the deck had buckled resembled a shrouded figure and sheaverted her eyes. Once she saw a black mountain of a wave, several stories high, and theCalangute looked poised to fall into a hole. Sheets of water smashed over the bow, the noisemore terrifying than the sight.

    In the middle of the tempestuous ocean, groggy from lack of sleep, facing a terrible medicalcrisis, her world had become simplified. It was divided into those with fever, those withseasickness, and those without. And it was possible that none of these distinctions mattered,for very soon they might all drown.

    She awoke from where she must have drifted off next to Anjali. In what seemed like the nextinstant she awoke again, but this time in the Englishman's cabin where she'd fallen asleepkneeling by his bed, her head lolling on his chest, his arm resting on her shoulder. In thetime it took her to recognize this, she was asleep again, waking at daybreak finding herself onthe bunk, but on its very edge, pressed against Thomas Stone. She hurried back to Anjali tofind her worse, her respirations now sighing and rapid. There were large confluent purplepatches showing on Anjali's skin.

    The anxious faces of the sleepless crew and the fact that one fellow had knelt before her andsaid “Sister, forgive my sins!” told her that the ship was still in danger. The crew ignoredher pleas for help.

    Frantic and frustrated, Sister Mary Joseph Praise retrieved a hammock from the common roombecause of a vision she had in that fugue state between wakefulness and sleep. She strung it inhis cabin between porthole and bedpost.

    Dr. Stone was a dead weight and only the intercession of St. Catherine allowed her to drag himfrom bunk to floor, then feed him, one body part at a time, onto the hammock. Answering more togravity than to the roll of the ship, the hammock found the true horizontal. She knelt besidehim and prayed, pouring her heart out to Jesus, completing the Magnificat which had beeninterrupted the night the deck had buckled.

    Color returned first to Stone's neck, then his cheeks. She fed him teaspoons of water. In anhour he held down broth. His eyes were open now, the light coming back into them, and theeyeballs tracking her every movement. Then, when she brought the spoon up, sturdy fingersencircled her wrist to guide the food to his mouth. She remembered the line shed sung momentsbefore: “He hath filled the hungry with good things, and the rich He hath sent empty away.”

    God had heard her prayers.

    A pale and unsteady Thomas Stone came with Sister Mary Joseph Praise to where Sister Anjalilay. He gasped at the sight of the wide-eyed and delirious nun, her face pinched and anxious,her nose sharp as a pen, the nostrils flaring with each breath, seemingly awake and yetcompletely oblivious to her visitors.

    He knelt over her, but Anjali's glassy gaze passed right through him. Sister Mary Joseph Praisewatched the practiced way he pulled down Anjali's lids to examine her conjunctivae, and the wayhe swung the flashlight in front of her pupils. His movements were smooth and flowing as hebent Anjali's head toward her chest to check for neck stiffness, as he felt for lymph nodes,moved her limbs, and as he tapped her patel-lar tendon using his cocked finger in lieu of areflex hammer. The awkwardness Sister Mary Joseph Praise had sensed in him when she had seenhim as a passenger and then as a patient was gone.