by Laurel Dezieck, School of Medicine, Class of 2015
First Prize Winner 2014 Gerald F. Berlin Creative Writing Award
L’Hôpital-Central is a public hospital, but even so there is a crowd of people locked outside the front gate, languishing in the subsaharan heat. The smell of sweat and spoiled meat, combined with the stench of poultices from healers or scam artists, and the smoke of coconut frond fires lingers with the masses. The colors of cheap patterned cotton, with dark skin and dusty legs from the scooter-taxis blend together into a desperate kaleidoscope, sectioned off by the pattern of the chicken-wire fence.
The girl from Boston, a volunteer, who often feels like a tourist or a gawker depending on the day, has watched people bleed out at those gates. She has seen women weep and pray to their God and any others that might listen, and families grieve at their collective silence. Today, she rushes past the chicken wire to the main hospital building. It isn’t fast enough to escape notice. Behind her, she hears the shouts- La Blanche, La Blanche! S-il vous plaît. She doesn’t turn around, in part because she’s afraid that if she does, she’ll lose her nerve completely, and in part because she knows she can’t give any of them what they beg her for. The first day she came, the desperation and poverty nearly overwhelmed her. She handed out her spare change feverishly and wept every night behind her mosquito net for the rest of the week. Now the impact of the scene has dulled with repetition, but still the volunteer aches as her naiveté is slowly stripped away each morning like Prometheus’s liver, only to be slowly regrown each day by the unwavering optimism of a young woman with an able body and an expensive education.
The ward is little more than a line of rickety beds, a few with stained curtains separating them. Fine red dust covers everything, from sheets, to wrinkled IV bags, to people of all ages, in various states of misery. The physicians are already harried; the patients are crying out for water, medicine, mercy. Someone is begging for help. La Blanche searches for the source, desperate to be asked for something she can provide. She kneels next to an old man that is clutching his chest, his eyes closed as he mutters nonsensically, and the girl whispers meaningless words of comfort in broken french as they fall on deaf ears.
A young boy, no more than four or five, coughs in the corner and the girl knows that something is seriously wrong, not from any of her fledgling medical training, though she sees his cracked lips and sucked in ribs, but rather a human instinct that senses impending calamity. She turns from her charge, who remains oblivious to her presence, and calls for help. There are two Cameroonian physicians on the ward but one is busy pushing what seems like the entire lower portion of a young man’s small bowel back into his abdominal cavity and the other is whispering urgently to an increasingly hysterical young woman in the corner. There is a Swedish physician, an ex-pat or a missionary. He is a grey-haired, fair skinned man in his fifties who stands across the room from the child as he argues with his mother about antibiotics. She has tuberculosis, but stopped taking the pills weeks ago when she felt better. The rest she saved and gave to her son when he started coughing. Now she is sick again, and her son is bent over double, sweating and grunting at her feet. The woman argues that if she takes all the pills, even when she‘s not sick, she won‘t have any to give to her son. Besides, she doesn‘t really think that they will work anyway. In fact, she knows that a vindictive neighbor cast a spell on her last week. Her son shivers at her feet. She touches his shoulder, and the Swedish man wrings his hands and bites his tongue.
The Cameroonian physician gives up on the small bowel, which is stinking and gray, and turns to the child, who is now a similar color; La Blanche is pulled away from her fruitless ministrations to help. Once she sees that her son is being tended to, the child‘s mother departs for work. She knows she needs to make enough money that day to keep the doctor’s hands on her child, or at least to pay the bills she’s already incurred, so that the hospital will release his body to her if he dies.
He dies an hour later, quietly, without much ceremony. The girl remains crouched next to him and holds his hand. It’s cold, and limp but she clutches it anyway, unwilling to acknowledge that he was gone, another person she couldn’t help.
The Swedish doctor noticed first, that the child’s lips had turned blue, the muscles in his chest and abdomen that had struggled to keep him alive now are finally still. Someone carries the boy from the room quickly to make space for the next patient in his corner of the floor, next to the kneeling girl. She stares at the cracks in the wood of the floor, a handprint smudged in the dust, and decides not to move for the moment. For some reason she worries that if she gets up and leaves, the boy will be completely forgotten and will cease to have existed as soon as that handprint is wiped away.
The child’s mother returns late that evening, and still La Blanche hasn’t moved from her solitary post. No one has to tell her, and no one does. She covers her mouth with one hand and quietly sinks to her knees, clutching a dirty curtain to her body as though to shield herself from the grief that hurdles towards her. The girl rouses herself from her vigil in the dead child’s corner and sits down next to the young mother, now satisfied that someone else will remember that the boy was there. The woman holds the curtain to her mouth and coughs, staining it with flecks of red that smudge pink when they mix with tears and dust.
La Blanche looks at the young mother and suddenly sees not a stricken fruit vendor from West Africa, but the heroine of a nineteenth century novel. She sees Helen, Marguerite, or Fantine, instead. They sit, wasting behind the dilapidated curtain, the martyrs of the TB that until now resided in romanticist novels, back in a well-lit classroom in Boston. She remembers the beauty of the romantic consumptive and wonders if the loveliness of Hugo and Dumas’s crafted deaths was a coping mechanism. She supposes that the novelists spun tales of the ethereal madonna to combat the helplessness and frustration of inevitable death, in filthy poverty as she did now. Old books coming alive in the worst possible sense, winding their way onto the dusty ward. She realizes the absurdity of this comparison, but it’s her only frame of reference; the only way that she’s even known this disease, because in her life before this one, comprised of suburbs and lofty goals, Tuberculosis was flowery prose and doomed red-cheeked girls.
The girl puts her hand on the young mother’s shoulder, and the woman turns to her, eyes automatically shuttering her internal anguish. She notes the color of the girl’s skin and lowers her eyes. La Blanche decides against speaking, but leaves her hand on the woman’s shoulder and the young mother doesn’t shrug it off, out of a desire for comfort or for the sake of politeness.
La Blanche closes her eyes to the chaos of the room, and for the first time hates Hugo and Dumas, and Mann and even Murger and maybe Bronte for making their consumptives tragic and lovely. The TB of the novel was so twisted by the horrifying blue child on a dusty floor. She feels betrayed and angered that they had set up a false expectation for her, pained that the reality was so horrifying, and devastated that this reality existed at all. It was distasteful to her that death from tuberculosis was so esoteric in one part of the world that it had become nothing more than a symbol in the western literary canon of pretty tragedy. The whole time, the disease thrived, unchecked and ugly if one knew where to look for it.
The young mother eventually wanders off to find her son’s body, and the girl from Boston stirs and leaves the ward slowly, glancing back at the spot where the boy had died, outside of the pages of any book she knew. The handprint in the dust was gone. She trudges out, past the chicken wire fence, deaf to the calls- La Blanche, La Blanche!
Two months later, the volunteer flies back to Boston. She immediately has two tuberculin skin tests and they both come back negative, but she feels as though she’s contracted something nonetheless.