CHAPTER XXVII


 

TZAAB-KAAN

When the young doctor was going back to Jacinto's house, his temporary home while he fought the epidemic, he was thinking of his father who, at the beginning of the 30's, had been a teacher, in this tiny village, here where his father had met his mother. He imagined the simple, peaceful passing of his days during all that time, also the anguish of the isolation, and helplessness at the death of his mother, as Jacinto had told him everything. His father had never come back after taking him to Zaci, and he had never again worked as a teacher.

He remembered his childhood on the hacienda that his father inherited from the old colonel, his grandfather. Raised by his father's mother during his first years, it wasn't until he was old enough to go to school that he went to live in Valladolid in the old colonial mansion that had belonged to his father's family for generations. His father married again, and with his new family, he dedicated more time to the hacienda and returned it into its former splendor.

All of his vacations when he studied in Valladolid and later when he studied in the austere boarding school in Merida, he enjoyed them with his grandmother in the country among the cattle and great cornfields and in the orchard, sometimes picking fruit or hunting birds.

Alhambra BeachFront  Hotel Playa del Carmen Q. Roo,  México

 

His stepmother belonged to one of the families of the "center" of Valladolid whose prejudice against the Indians dated back to the first years of the colonization, and renewed by the hate of the Caste wars. She accepted him and his grandmother but she did not forgive their humble roots.

His stepbrothers and sisters, almost ten years younger than he, didn't like him. So his father sent him to a boarding school in Merida. His admiration for his father cooled off with the passing of the years; but when he was studying medicine he came to understand what his mother had meant to his father. When alone together, he talked about her and of their short time together, and let him know the significance of his life. Now the memories of his uncle seemed to be witnesses of that time.

"What happened Marcelo?" Jacinto stopped his thoughts at the threshold of the house"

How are your patients? It looks like the disease is dying out now, there are not as many patients as you had before. Everybody talks about your dedication. Some ask about your father, you still haven't told me how he is doing, I would like to hear about it. Tell me how is your grandfather's hacienda is -It must be very prosperous now."

"My father lives there most of the time, only on weekends, or family feasts or the Candelaria fiesta does he go to Valladolid. My stepmother hardly ever goes to the hacienda, I think she hates the country, and I don't think my brothers and sisters like it much either. One of them is also named after my father and my grandfather whose name was Manuel. They say we look a lot alike, but his eyes are clear color like my father’s"

"You aren't married yet I suppose" In the little time we've had to talk you haven't said anything about a wife"

The young doctor smiled "Uncle, soon I will marry my girl friend who is a tsuul. I am only waiting to establish myself to have an office, and possibly study a specialty. I want obstetrics, that is childbirth, maybe because of what happened to my mother, I don't know, but I think that is what I'll do. Beside, it is not so easy, because my girl friend's family is, as they say now, a little bit racist and I have a Maya last name, like my father. But that doesn't matter to her. We are in love and we are going to get married. Don't doubt it. It is what we want"

Jacinto smiled. The expression and the gestures of his nephew made him remember the tenacity of his old friend when he followed Jacinto and Jose Chuc on his first trip to the village. It was a nice memory.

The dialogue was interrupted by an indian man who came to them, visibly upset.

"Don Jacinto, a ‘tzaab kaan’ has just bitten my wife as she was gathering fire wood. My family went for the medicine man. But I want your nephew the doctor to take care of her. They don't want to, but I have told them that I want the doctor"

The máasewa'al looked at the young Marcelo inquisitively.

"Let's go right away. Wait just a minute, I will get the injections and the serum. Uncle, have water boiled to sterilize the instruments I'll need to open the wound. -"Where was she bitten?"

"On the hand."

When they arrived at the maasewa'al's house, the family members and the neighbors, who had already heard about it, were inside the house around the patient who was lying in a hammock holding her right hand straight up with her left hand. Two line of blood flowed from her right arm. The bite marks showed the size of the snake. There was at least an inch between the two holes. Above the elbow a red ribbon like a band blocked the circulation to the rest of the arm. The young doctor went to her accompanied by Jacinto.

"Did they kill the snake? I want to know what kind of snake it was.

"Yes", said Jacinto who had already asked.

"Tsaab -kaan" said the husband.

"A rattle snake, then, I'm surprised.Bites from the "four nose" are more frequent," said the doctor.

"It is not so unusual"-said Jacinto. "There is a lot of rattlers around here. This was a big one. They tell me it had fourteen bones."

While he was talking the doctor opened his bag to take out the injections and the sterilized syringes.

"Uncle"-he said- "tell the boys to bring the box of serum that we have in the house. We have to administer the medicine through and intravenous solution"

A máasewa'al with unfriendly look interrupted them.

"Don't bring anything, the shaman will take care of my daughter. He has always treated the snakebites.

"Julian" - interrupted Jacinto. "What you say is true, but it also true that he has not saved everybody. Do you remember Pedro's son and Maruch, don't you remember that he couldn't save them?

"When they went for the doctor, we discussed the matter. The shaman will treat my daughter; it has always been that way. If he can't save her, it won't be his fault, you know that, Jacinto."

"Don't you realize that things aren't the same any more?

"Don't you know how many people have been saved by the medicine my nephew brought with him for the epidemic that was attacking us?"

Julian listened passively to Jacinto's reasons. He didn't answer. He looked away; he lowered his eyes, avoiding looking at the doctor.

"Let me save her, in the hospital I have seen many cases like this and even worse, because they come two or three days after the bite. I'm sure I'll be able to cure her if you let me and I must begin right away, because seconds count. The poison is running into the blood, and it will get more difficult to save her."

Julian said his last word -"The medicine man will treat her" The doctor tried to answer, but Jacinto took his arm and said in Spanish.

"Let's go nephew, it is useless, I know what I'm saying" He turned to the woman's husband and he said. "If you want the doctor later, come see me."

Two days later, Marcelo was still thinking about the case and worrying about the woman. He tried to be informed about the patient through Jacinto without results because the family refused to talk about it.

Jacinto came into a house where Marcelo was treating one of the last victims of the epidemic.

"Let's go, Marcelo."- Juanita’s husband asked me to get you, She is the woman who was bitten by the snake. He said his wife is dying. If you want, you can refuse, you saw how the family didn't want you to treat her. If she dies they will blame you. Don't doubt it"

" I understand, Uncle, but it is my duty. I will try even if later they blame me and try to kick me out of town. It wouldn't be the first time it has happened."

"Let's go then, nephew" he turned to go as he saw his nephew pick up his bag, and they went to the hut that was about 10 mecates south of the square.

After checking his bag and picking up a bottle of serum from the box of one of his assistants, Marcelo followed him,

The young doctor entered the house carrying a bottle of glucose solution, the I.V. equipment and box of injections of 10 ml of thiosulfate of sodium, also soap, antiseptic solution, a cotton bandage and other medicines.

Many hours had passed since the snakebite. The red band that stopped the circulation had done its part, the whole hand, the forearm and almost all the arm was grotesquely swollen by the edema. It had dark purple color, with many blisters that oozed among the residue of the herb plasters that had been applied to it. She was breathing hard, Her paleness, and scarce sweating revealed clearly the effects of the snake poison and the gangrene toxins from the tissues in process of the decomposition.

"How long has it been since she last urinated," "Have you given her water." The absolute silence of the family that stood around the patient was the answer.

"No doctor," said the husband, the only one who wanted the doctor, "the Shaman told us that she couldn't drink anything, otherwise the poison would run. At first she only drank the water where we had boiled the antidote herbs but she vomited almost all of it. They said it would be better if she didn't drink anything."

Marcelo didn't comment. He had gotten the necessary information. He knew from experience that they would not say anything else. From that moment on, they would watch him carefully, and if she died, they would blame him. He didn't ask anymore questions. He began his preparations. The antivenin wouldn't have any effect now, the poison would have attacked the vital organs, the sores that she had were probably caused by bleeding on the gums, nose, and urine, he knew all of the variables. He had seen many of these cases in the hospital. Grave cases that arrived late after being manipulated by "healers", "medicine men, and even by "mediums."

The important thing to do now was to administer the glucose solution to reestablish diuresis and re-hydrate the patient; clean and scrape the necrotic tissues; so he began his task. Installing the I.V. was a problem, and after several attempts he was able to put the needle in the vein of her left foot. He hung the solution on a rope that went from beam to beam.

Immediately, he cleaned one by one the blisters with boiled water and soap. He asked for more water to be boiled for later. He applied oxygenated water and antiseptic solution to the scraped areas and covered them with sterile gauze. A light bandage covered the first treatment. The rapid, weak pulse made him fear the worst, although he hoped that the youth of the patient would pull her through. He disconnected the I.V. tube and injected an ampoule of antivenin and reconnected it. He put the rest of the antivenin into the I.V. solution so that slowly, in three of four hours, it would run out.

"We'll have to give her other bottles in the next 24 or 48 hours, depending on how she responds. For now, we can't do anything else. I will come back in three or four hours to examine her. Prepare a bucket of boiled water, I will have to change the bandage and the gauze at least twice a day, and lastly I want you to know that she has to take fluids, orange leaf tea with sugar or honey, orange juice, water, or whatever but you have to give it to her. Offer her it every time you see that her mouth is dry. Don't wait for her to ask. She doesn't know what is happening or even what she is saying when she talks, she is delirious, or as you say, her brain has been affected.

After saying that he put his things into his doctor’s bag and said to his Uncle...

"Let’s go, let God do his work. He looked at the husband, and he said, "Do you see these drops? – he pointed to the drops that fell slowly from the I.V. equipment. They should keep falling; if they stop, send for me at any time, don’t forget... your wife’s life depends a lot on that"

When they arrived at Jacinto´s house, he asked...

"Will she make it?"

"I hope to God. She is very sick. They let so much time to pass. If only I could have treated her from the beginning"

From that moment on, Marcelo went to see Juanita between patient and patient. That same night, he changed the I.V. solution, washed the arm affected by the edema and necrosis; applied antiseptic and administered antibiotics. The profound state of edema didn't recede, but he felt that the stability of the pulse, at least, revealed that she wasn't getting worse. The patient talked in her unconsciousness, and the incoherence was at longer intervals. He recommended that someone always watched the drops of the I.V. solution and went home to rest. His uncle was waiting for him, even though it was very late. His watch said it was almost mid night.

"Are you still up Uncle," he asked as he entered the yard, the tenuous light of the vigil candle showed the figure of the máasewáal in the door.

"I was waiting for you, I have coffee on the fire. Would you like some? There are also crackers. Should I call your aunt to serve you?"

"No, uncle. Please, don't bother her they have enough to do with my assistants and me. A little coffee will be enough then I am going to lie down. They might call me later for Juanita. I don't think there is any other serious case. The other patients are coming out of the crisis.

"Drink your coffee and go to rest," said Jacinto, sternly, "otherwise, we'll have to treat you, you are paler than most of your patients.

"Ok uncle, let's drink our coffee and get some sleep."

Few minutes later, fully dressed Marcelo was sound asleep, exhausted by a hard-days work.

" It must be six o'clock in the morning" - Marcelo looked at his watch.

"Aunt, why didn't you call me, It's very late"

Carmen didn't answer, approaching the hammock with a basin of warm water, she said: "Wash your face and come to have breakfast. I have prepared your a broth that will make you feel better. There are eggs. How would you like them? And beans and atole with condensed milk, one of your assistants gave it to me, they already ate.

Marcelo washed his face with the warm water and dried himself with a cotton cloth, and enjoyed it while he listened to his aunt.

"Let's eat. Where's my uncle?"

"He'll be with us in a few minutes. He ate at dawn, he told me not to wake you up, until you woke up by yourself."

After a splendid breakfast which he consumed quickly. He took his bag, which he replenished with medicine and with another bottle of I.V. solution in hand he went to Juanita's house. When he arrived, her family opened the rustic door. He nodded a greeting, and opened the door for more light. He inspected the I.V. It had almost run out, the look on the face of the young woman was calm. Her regular respiration gave him hope. He took her pulse, tense, rhythmic, he counted the beats: 82,83,84,85, it didn't get to 90 before the minute passed.

Turning to the family he asked. "Has she urinated?" The answer made him smile broadly. The family god the message.

Marcelo changed the I.V. and put up another bottle with antibiotics. The patient woke up and moaned a little and went back to sleep. Her normal reaction was another positive sign.

"When she wakes up, give her diluted atole, if she wants to eat, give her crackers. We have some at my uncles house. Give her chicken and broth, a lot of broth and don't forget, corn water, "chaya leaves tea" lemonade, orange juice, she needs a lot of liquid."

He got up and said to the husband to cheer him up. "I'll come back in the afternoon. Prepare a chicken to eat tomorrow"

The young máasewáal with a happy expression answered.

"Whatever you want Doctor; today or tomorrow whenever you want.

Marcelo smiled, took his bag and left to visit his other patients.

The sun shone over the trees. The neighbors greeted him as he passed, wishing him respectfully a good day. They already knew about the rattlesnake, and that Juanita would get well.

"Tell me uncle, you must know well. My father has told me many times the things he lived here in the village but sometimes, I think his memories are so painful, that I prefer not to ask. What was my mother like? I don't have any idea. There isn't any picture of her."

"We didn't know about photographs then, even though we had heard something about them. We lived in a world apart, much more than you can imagine. Your father was the first ‘tsuul’ to step in our town and to live among us. All of the older people remember him well. He was very brave and determined. He was a noble and righteous man. I believe he still is, because that kind of character doesn't change. We esteemed him very much, and even those who rejected him in the beginning, later learned to respect him, if not love him. For us he was part of the family. For me, he was a brother. I still think of him as my brother even though I haven't seen him in years. You remind me of him a lot. See what fate is. Your presence has brought back many things to us. That's why the people respect you and appreciate you, you remind them of him. Those who knew him and those who heard about him.

"And what about my mother?"

"She died very young. You would say she was still a child, but one thing I can tell you, the year she lived with your father was worth more than all the years she had lived. She was very happy with him and you gave to her, the happiest moment in her life, even though she only saw you for a few minutes."

Jacinto was silent, He was looking into the horizon. He felt that he was living his story again in that moment. Marcelo couldn't speak a knot closed his throat and his eyes shone intensely with tears.

The two kept silent, each one lost in their own thoughts.

"Well, uncle Jacinto, thanks for everything. Now I think I know her better."

"Your cousin look a lot like her especially when she was younger, before she got married."

" Which one of them."

"The oldest, Carmen"

Marcelo remembered the face of his cousin Carmen, trying to imagine in it the face of his mother.



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