18

STONES

Rob J. tried to explain to Makwa-ikwa what a bladder calculus was, but he couldn’t tell if she believed that Sarah Bledsoe’s illness really was caused by stones in her bladder. Makwa-ikwa asked him if he would suck out the stones, and as they talked it became apparent that she expected to witness a sleight-of-hand humbug, a kind of juggling trick to make his patient believe he had removed the source of her trouble. He explained several times that the stones were real, that they existed painfully in the woman’s bladder, and that he would go inside Sarah’s body with an instrument and remove them.

Her puzzlement continued when they got to his cabin and he used strong brown soap and water to wash down the table Alden had made for him, on which he would operate. They called for Sarah Bledsoe together, in the buck-board. The little boy, Alex, had been left with Alma Schroeder, and his mother was waiting for the doctor, her eyes large in her pinched white face. On the return trip Makwa-ikwa was silent and Sarah Bledsoe nearly dumb with terror. He tried to ease the situation with small talk but had little success.

When they reached his cabin, Makwa-ikwa leapt lightly from the buck-board. She helped the white girl down from the high seat with a gentleness that surprised him, and she spoke for the first time. “Once I was called Sarah Two,” she told Sarah Bledsoe, only Rob J. thought she said “Sarah too.”

Sarah wasn’t an accomplished drinker. She coughed when she tried to swallow the three fingers of sourmash whiskey he gave her, and she gagged on the additional inch or so he added to her mug for good measure. He wanted her subdued and dulled to pain but able to cooperate. While they waited for the whiskey to work, he set up candles around the table and lighted them despite the heat of the summer, for the daylight in the cabin was dim. When they undressed Sarah, he saw that her body was red from scrubbing. Her wasted buttocks were small as a child’s, and her blue-skinned thighs looked almost concave in their thinness. She grimaced as he inserted a catheter and filled her bladder with water. He showed Makwa-ikwa how he wanted her knees held, then he greased the lithotrite with clean lard, taking care not to get any on the little jaws that would have to grasp the stones. The woman gasped as he slid the instrument into her urethra.

“I know it hurts, Sarah. It’s painful as it goes in, but … There. Now it will be better.”

She was accustomed to far worse pain, and the groaning dwindled, but he was apprehensive. It had been several years since he had probed for stones, and then under the careful eyes of a man who undoubtedly was one of the best surgeons in the world. The day before, he had spent hours practicing with the lithotrite, picking up raisins and pebbles, picking up nuts and cracking their shells, practicing with the objects in a small tub of water, with his eyes closed. But it was quite another thing to poke around within the fragile bladder of a living being, aware that to thrust carelessly or to close the jaws on a wrinkle of tissue rather than on a stone might result in a tear that would bring terrible infection and painful death.

Since his eyes could do him no good, he closed them now, and moved the lithotrite slowly and delicately, his whole being fused into one nerve that functioned at the end of the instrument. It touched something. He opened his eyes and studied the woman’s groin and lower abdomen, wishing he could see through flesh.

Makwa-ikwa was watching his hands, studying his face, missing nothing. He brushed at a buzzing fly and then ignored everything but the patient and the task and the lithotrite in his hand. The stone … Lord, he could tell at once that it was large! Perhaps the size of his thumb, he estimated as he maneuvered and manipulated the lithotrite ever so slowly and carefully.

To determine if the stone would move, he tightened the jaws of the lithotrite onto it, but when he put the slightest backward pressure on the instrument the woman on the table opened her mouth and screamed.

“I have the biggest stone, Sarah,” he said calmly. “It’s too large to come out in one piece, so I’ll try to break it.” Even as he spoke, his fingers were moving to the handle of the screw at the end of the lithotrite. It was as though each turn of the screw tightened the tension within him as well, because if the stone wouldn’t break, the woman’s prospects were dismal. But blessedly as he continued to turn the handle there was a dull crunching, the sound of someone grinding a shard of pottery beneath his heel.

He broke it into three segments. Although he worked with great care, when he removed the first piece he hurt her. Makwa-ikwa wet a cloth and wiped Sarah’s sweaty face. Rob reached down and unclenched her left hand, peeling the fingers back like petals, and dropped the piece of the stone into her white palm. It was an ugly calculus, brown and black. The middle piece was smooth and egg-shaped, but the other two were irregular, with little needle points and sharp edges. When she held all three in her hand, he inserted a catheter and rinsed the bladder, and she voided a lot of the crystals that had broken from the stone when he had crushed it.

She was exhausted. “That’s enough,” he decided. “There’s another stone in your bladder, but it’s small and should be easy to remove. We’ll take it from you another day.”

In less than an hour she had begun to glow with the fever that followed quickly after almost every surgery. They force-fed her liquids, including Makwa-ikwa’s efficient willow-bark tea. Next morning she was still slightly febrile but they were able to take her back to her own cabin. He knew she was sore and torn up but she made the jolting trip without complaint. The fever wasn’t gone from her eyes but there was another light there, and he was able to recognize it as hope.

A few days later, when Nick Holden invited him to go off on another doe hunt, Rob J. agreed warily. This time they caught a boat upstream to the town of Dexter, where the two LaSalle sisters were waiting at the tavern. Although Nick had described them with roguish masculine hyperbole, Rob J. recognized at once that they were tired whores. Nick chose the younger, more attractive Polly, leaving for Rob an aging woman with bitter eyes and an upper lip on which caked rice powder couldn’t hide the dark mustache—Lydia. Lydia was openly resentful of Rob J.’s emphasis on soap and water and his use of Old Horny, but she carried out her part of the transaction with professional dispatch. That night he lay next to her in the room that contained the faint olfactory ghosts of past paid passions and wondered what he was doing there. From the next room there were angry voices, a slap, a woman’s hoarse shouting, ugly but unmistakable thuds.

“Jesus.” Rob J. knocked his fist against the thin wall. “Nick. Everything all right in there?”

“Dandy. Dammit, Cole. You just get yourself some sleep now. Or whatever. You hear?” Holden called back, his voice thick with whiskey and annoyance.

Next morning at breakfast Polly had a red swelling on the left side of her face. Nick must have paid her very well for her beating, because her voice was pleasant enough when they said good-bye.

On the boat going home, the incident couldn’t be evaded. Nick placed his hand on Rob’s arm. “Sometimes a woman likes a bit of the rough stuff, don’t you know it, ol’ buck? Practically begs for it, to get her juices flowing.”

Rob regarded him silently, aware that this was his last doe hunt. In a moment Nick took his hand from Rob’s arm and began telling him about the upcoming election. He had decided to run for state office, to stand for the legislature from their district. He knew it would be helpful, he explained earnestly, if Doc Cole would urge folks to vote for his good friend whenever he made a house call.