The Covenant of Water
: Part 4 – Chapter 34

1936, Saint Bridget’s

Philipose, baby in his arms, drenched through and through, stands staring at the sign, wondering if in fact he really has drowned. Did the river swallow them after all? The sign reads:

In his mind that translates to Saint Bridget’s Treatment Center / Asylum for Those Suffering from Leprosy, even though the English words below are more concise: SAINT BRIDGET’S LEPROSARIUM. Is this really the gate to a leprosarium or the gate to hell? Are the two different?

His lungs are burning, but at least it is air, not river water, he is sucking in. The baby is as heavy as a burden stone, its purple face just as still. Won’t a leprosarium have a doctor or nurse? It’ll have lepers, that he knows. To step inside feels as reckless as pushing the dugout into the river. How would he explain to Big Ammachi why he risked his life for the boatman’s baby? Ammachi, I felt the baby was me. I felt I was drowning, fighting for air, trying to surface, struggling to survive. I had no choice!

He still has no choice. He pushes through the gate and runs with his burden. The boatman has no idea where they are. The sky is dark, but here and there light burns through rents in the celestial fabric. Up ahead is a tile-roofed central building, with smaller ones all around it, like offshoots, all whitewashed, though stained a muddy red where they meet the earth. If this is hell, then hell is neat and orderly. He heads to the main structure.

“What’s going on? No children here! Why have you come?” A thin man in a blue shirt and mundu bars their way. To Philipose he looks like an egg with his smooth and expressionless face, lacking eyebrows and hair. One eye is white, and the nose flattened. The boatman recoils.

“This child is dying,” Philipose says. “Summon your doctor.”

“Ayo! Our doctor died!” the man shouts. “Didn’t you know? He can’t help you.”

A white man enters from the room beyond, hearing the commotion. He’s perhaps thirty, tall, a handsome man. But the scarred hands that fumble with his buttons seem to belong to an old man; his eyes sit in dark hollows.

The boatman shouts, “If he died, then who’s this white man? Tell him to help us, for the love of God!”

“I’m not talking about this doctor. The other one, the big doctor. Now get out! No children, I told you.”

The white man winces at the raised voices. He takes in the bedraggled and winded strangers: one dark, short, shirtless, and thin; the other a boy in a soaked school uniform, his hair streaked down over his forehead. The boy holds a moribund baby with the glassy eyes of a mackerel on a fish stall.

“Gowon, give us peace!” the white man says sternly in English to the shouting men, as he beckons Philipose to the light. His meaning is clear in any language. “What in the world have we got here?” the doctor says to himself, bending over the baby.

“The baby ceased its breathing,” Philipose says. He colors as the doctor looks up, surprised. Philipose has never been this close to a white person, never conversed in English with a native speaker. He’s even harbored doubts that there really is a world where people speak the language of Moby-Dick. “Baby having much white . . . barnacles in his mouth and throat. Like whale blubber. But tough . . . like leather. I harpooned some and he breathed a little. Then presently it ceased again, sir.”

The doctor stares at the boy, baffled by the strange diction. Harpooned? He pries open the baby’s mouth with clumsy hands and stiff, awkward movements, driven by the elbow more than by the wrist. He gestures for Philipose to put the baby on the table, while he turns an instrument tray upside down with a great clatter, scrabbling for something.

“Rune, really, no tracheal tubes?” the white man mutters. The doctor’s strangeness fits this place, as if he, like the white buildings with their mud-red skirts, pushed himself up from the earth, his hands not yet fully formed, the soil still clinging to them.

“You! My harpooner! I’ll need your help,” the doctor says. He swipes the baby’s neck with a dab of pungent liquid. “Are you and he kin, then?” he asks, nodding in the direction of the boatman.

“Not kin, sir. I was pacing straightly for the school, and seemingly bounded for that destination.” He cannot help this voice of recitation, even if it’s not truly his, but Ishmael’s. Melville is musical, Dickens less so, and Philipose’s English leans heavily on great swaths of their prose committed to memory. “The needle of the compass allowed me to hark the cry and I saw his child. This father he feared the river . . . but I, it swayed me to purpose, and hither thither we boatingly floated.”

“Why here?”

The boy looks flummoxed. “God’s grace?”

The doctor grimaces. He pulls a lamp down close to the baby’s neck. He tries to pick up an instrument but cannot. He points and Philipose picks up and hands over the scalpel.

“What’s your name?”

“Call me Philipose.”

The doctor’s lips move, as though practicing the sound. “Listen, you’re going to be the one to do this,” he says, thrusting the knife back at him, handle first.

“No!” It comes out louder than he intended.

“The baby’s as good as dead,” the doctor hisses. “Do you understand? You have nothing to lose. Even now, its brain is beginning to die. Come on. You saved its life once already.”

“But I’m a schoolboy, not a—”

“Look, I can’t do it with my hands. I had surgery. I am still recovering their use. And no, I don’t have leprosy. I will tell you exactly what to do.”

The blue eyes give him no choice. With a finger seized up in a stiff curve, the doctor traces the vertical path where Philipose should cut, at the lowest part of the neck just where it meets the breastbone. “The windpipe. That’s where we’re headed. Quick! Cut!”

He’s seen Shamuel cut a chicken’s neck, but never to save the chicken. He drags the scalpel down the imaginary line and steps back, terrified, expecting a blood spurt, expecting the baby to flap its arms and take off around the room. It doesn’t flinch.

“Too shallow. Hold it like a pencil. Push harder. Until you see the skin part. Go on!”

He does, and now a pale line appears where the knife ran, and dark blood blossoms in its wake, pushing out like a river overflowing its banks. He feels the room spin and his stomach turn. The doctor ignores the blood and with gauze on his fingertip pushes the skin away on either side of the cut, revealing a cobweb of pale tissue.

He hands Philipose a blunt-tipped instrument like scissors, but without cutting edges. “Stick this under there and spread,” he says, miming the movement with two fingers. Philipose slides the closed instrument under the wound edge, then opens it. He’s too tentative because the doctor’s stiff claw clamps over his, guiding him to the right plane. “Spread. All the way.” He feels tissue rip. More blood wells up, dark and menacing.

“What about the bleeding?”

“Means he’s still alive, lad,” he says, pawing with the gauze like an anteater, until he reveals a pale, corrugated cylinder no bigger than a drinking straw.

“That’s the trachea. Now we make a small vertical cut into its front wall with just the scalpel tip.” Seeing Philipose balk, he says, “There’s only air in the windpipe, not blood. But don’t cut deep. We just want to make a small opening.” When Philipose hesitates, the paw closes over his thin hand, steadying it. Together, they access some grace as they press the scalpel tip into the trachea, where it lodges like an axe in a tree. The boatman creeps up to peer in horror at the wound in his son’s neck.

“Stop. No deeper,” the doctor says. “Now we saw very gently down.”

The blade tip slices as if through balsa wood. The bile rises in Philipose’s throat. He looks up to ask, Now what?

Just then there’s a wet, sucking sound whose origins are not in the mouth, nor in the nose, but in the bloody neck, a bubbly intake of air around the knife tip. The toddler’s chest balloons out. As it exhales, a fine spray shoots out of the wound, and before Philipose can move, it lands on his cheeks.

The doctor removes the scalpel, inverts it, then slips the blunt end into the slit they made, turning it ninety degrees to splay open the slit. Inside the hollow windpipe, jockeying for space with the bubbling air, is a thick curd. The doctor pulls out a long, rubbery piece, like a strip of linen. At once breath rasps in and out of the small opening, a coarse, ravenous sound.

“That’s the membrane of diphtheria. Greek for ‘leather.’ You used that word, didn’t you? ‘Leather’? You made the diagnosis when you said that. It’s the dead lining of the throat that sloughs off, all tangled with pus cells. You’ve heard of diphtheria? Well, it’s common. There’s a vaccine now. It’s the young’uns who die of it.”

He sees flecks of blood on the doctor’s face, just as there must be on his.

“Can we get it?”

“We probably had it as children, whether we knew it or not, so we are immune. This baby is malnourished, couldn’t fight it well. As adults if we get it, because of our bigger airways, it’s not this severe.”

The doctor picks up a metal straw and eases it into the slit of the windpipe in the direction of the feet. Breath flutes through the tube, harsh aspirations. Color washes into the baby’s face. Then it moves its limbs.

Philipose is stunned to witness this resurrection. His hands are badged with the blood of a stranger, and the sight brings another wave of nausea. The moment is both transcendent and revolting; he feels lifted above this room with its pungent antiseptic smell, looking down at the child, the father, the doctor, and his hands. Metal, blood, water, soil, flesh, sinew, white and brown skin are all one. He feels no triumph, just a desire to run away. But the doctor hands him pliers with a curved needle and a thread affixed to it, and the white paw clamps over his fingers. The movements don’t originate with Philipose, but he executes them all the same, as they stitch the tube to the skin and close the wound. “You’re my amanuensis,” the doctor says to his assistant, who has no idea what he means.

The baby’s eyes focus on them, alert and looking ready to speak. Then, as it spots its father’s face, its hands reach up and the corners of its mouth turn down. It takes a lungful of air and its face contorts for a mighty wail . . . but no sound emerges, just air through the tube. The baby is surprised.

“Your vocal cords were bypassed, little one,” the doctor says. “Welcome back to the bloody world. Maybe you can do something to change it.”