7

The following day Jace awoke at six a.m., a clear sign he was making progress on resetting his clock to African time. He brewed strong coffee and wondered if adjusting his Western mind-set to the pace of Kenya would be as easy. That’s a joke. I’m not sure I could ever be patient enough not to resent the pace of change here.

At ten, Jace knocked on the office door of Kijabe Hospital’s medical director. Blake Anderson, MD, was a wiry blond Aussie with sideburns that sloped down his ruddy cheeks and met the corners of a mustache so long that Jace couldn’t tell if he had an upper lip at all. He spoke a Kiswahili greeting with a strong down-under accent. “Karibu, mate!”

Jace held out his hand. “Jace Rawlings.”

“Good day to ya. How’s the head?” he asked with a chuckle. “I’m always in a cloud the first week back from home furlough.”

“I’m adjusting.” Jace shrugged. “I’m anxious to see the place.”

The medical director pointed to a stack of papers. “Here’s your orientation packet. Our formulary is limited, but better than the government’s district hospitals. Here’s your pager,” he said, handing him the device.

“Wow. I was hoping I’d seen the last of this in America.”

“Yeah, well, we’d all rather do without the night business, wouldn’t we, mate?” He handed Jace a sheet of paper. “This,” he said, “is the call schedule. I left you off this first week so you could get your feet on the ground. Your first call is Monday night.”

“Call?” Jace looked at the paper. “I didn’t anticipate much call until the heart program was up and running.”

Blake raised his bushy eyebrows and stared at Jace. “Good joke. I like a bloke with a sense of humor.” He paused before proceeding without a smile. “Everyone here does his or her share of call. Since you were a board-certified general surgeon before you did heart surgery, you’ll be on the call schedule for general surgery. Perhaps later if the heart program gets off the ground and is busy enough to justify taking you off the general surgery call, we’ll let you take cardiothoracic call only.” He chuckled to himself as if to say, We’ll see if that ever happens.

Jace felt a stab of anxiety. General surgery? How long has it been since I even saw an appendix?

“Dr. Rawlings?”

Jace looked up, suddenly aware that he’d been staring blindly at the call sheet. “Look, Blake, I thought we had an agreement about setting up this program. You talked to the minister of health. You even talked to the airline about my extra supplies. I thought everyone was on the same page about the heart program.”

Blake smiled. “Of course. But things move slowly here. I can’t afford to house a capable surgeon for months while the wheels start to turn.”

Jace forced himself to return a weak smile.

“Shall we take a tour?”

Jace followed quietly as Blake entered the long main hospital corridor and wove through a sea of patients. They seemed to be everywhere. Standing, sitting on wooden benches lining the halls, sitting on the floor, leaning in through the windows, and crowding the doorframes. There were Kikuyu mamas carrying babies on their backs in cloth slings called kangas. Somali women with head coverings peered out through slits revealing only glimpses of dark eyes.

Blake edged past a series of stretchers lining a hallway leading to the X-ray department. Two men with bloody faces and twisted limbs looked back at Jace and muttered something in Kiswahili.

“Sorry about the crowding. Seems we’ve just had a bit of a road traffic accident.”

Jace nodded and plodded along behind him. The smell was a mix of human sweat, urine, and iodine. Funny. The smell is exactly the same as I remembered it. “I used to come down here and watch my father operate. It’s like nothing has changed.”

Blake chuckled and kept moving. “Here’s the lab. We can do basic chemistries, blood counts, urine analysis, malaria smears, amylase, liver functions, bacterial cultures, and HIV testing. The crew is quite good at identifying TB.”

“May I see the blood bank?”

“This is it,” he said, pointing to a single refrigerator. “There is no separate room for the blood bank.”

The blood bank is a refrigerator. Jace scratched his head.

“Let me show you our new HDU, the high dependency unit. Not quite an ICU, but getting there. It’s just up the ramp here.”

They walked up the long sloping hallway. Because there were no elevators, the hallways were long and graded so you could push a stretcher up a series of two long hallways to go from first to second floor.

Could I really do open-heart surgery in a place so primitive it doesn’t have an elevator?

Blake showed Jace around the HDU, introducing him to the nurses and pointing out supplies. The monitors above the beds looked modern but were already a few generations behind the ones he’d used in Virginia. Jace squinted down the row of patients.

The medical director smiled. “Bed one is a head-injury patient from a road traffic accident. Bed two has cerebral malaria. Bed three is an HIV patient who presented with a perforation of the bowel from typhoid fever. Bed four is a chest injury from a hippo. Bed five is a patient who had esophageal cancer and a resection.” He paused. “Welcome to Africa.”

Jace took a deep breath. It was clear that, as a general surgeon, he’d be expected to pull his weight. And he knew that if he didn’t, he wouldn’t likely swing the staff in favor of letting him do open hearts. He offered a weak smile in response, aware that he felt nothing positive. What did he feel?

Scared. Alone.

He was in the deep end of the pool and had forgotten how to swim.

 

That afternoon, Jace sat at his computer, happy to have gotten his Internet connection. He needed to send some emails back home. His first message was to Heather.

Heather, arrived safely, but my equipment is hung up in customs. I could have predicted this. I didn’t want to bribe the official, so here I am in Kenya without my bypass pump.

I did meet with the Kenyan minister of health. Hopefully, he will grease the wheels and I’ll get my stuff. I also met with the Kijabe Hospital administrator. They want me to do general surgery until things can be sorted out with the heart program. I’m not sure I remember anything about general surgery. I’d better learn fast. I picked up a book at the library to help.

I’ve been thinking a lot about us. I’ve never been one to analyze feelings and relationships, but perhaps this space will help me figure things out. I miss you. Strange, this place feels like home.

Jace

Jace clicked Send, then sighed and reflexively traced a small scar on his scalp. The bony indentation for a burr hole was filling in and soon would be hard to find. Two months, Jace thought. Enough time to recover from drainage of a subdural hematoma.

Two months. A whirlwind of change, recovery, physical therapy, seeking approval to start a heart program, and securing donated equipment—details that fell magically into place like dominos tumbling down a line. The speed of the change amazed him, and he’d entertained thoughts that someone very powerful was pulling strings on his behalf. But in the end, he shoved those thoughts aside and wished his memory would return. But because those memories eluded him, Jace hid from the media and wondered if his own questions would ever be answered.

In two short months, bone had reached out to bone to link and repair the small defect in his skull. But will my marriage ever heal?

Will I ever remember?