The Cole Trilogy: The Physician, Shaman, and Matters of Choice (115 page)

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.

19

A CHANGE

Two weeks after ridding her of the large stone, Rob J. was ready to remove the smaller calculus from Sarah’s bladder, but she had become reluctant. The first few days after the removal of the stone, she had passed more small crystals with her urine, sometimes accompanied by pain. Ever since the last bits of crushed stone had left her bladder, she had been symptom-free. For the first time since the onset of her illness she didn’t have crippling pain, and the absence of the spasms had allowed her to regain control of her body.

“You still have a stone in your bladder,” he reminded her.

“I don’t want it removed. It doesn’t hurt.” She looked at him defiantly but then dropped her eyes. “I’m more afraid now than I was the first time.”

He noted that already she was looking better. Her face was still drawn with the suffering of a long affliction, but she had gained enough weight to
make inroads against the gauntness. “That big stone we removed was once a little stone. They grow, Sarah,” he said gently.

So she agreed. Again Makwa-ikwa sat with her while he removed the small calculus—about one-fourth the size of the other stone—from her bladder. There was a minimum of discomfort, and when he was through, a sense of triumph.

But this time when the postoperative fever arrived, her body became fiery. He recognized impending disaster early and cursed himself for having given her the wrong advice. Before nightfall her foreboding had been justified; perversely, the easier procedure to remove the smaller stone had resulted in a massive infection. Makwa-ikwa and he took turns sitting next to her bed for four nights and five days, while inside her body a battle raged. Holding her hands in his, Rob could feel the waning of her vitality. Now and again Makwa-ikwa seemed to stare at something that wasn’t there and chanted quietly in her own language. She told Rob she was asking Panguk, the death god, to pass this woman by. There was little else they could do for Sarah except to bathe her with wet cloths, support her while they held cups of liquid to her mouth and urged her to drink, and dress her cracked lips with grease. For a time she continued to fail, but on the fifth morning—was it Panguk, or her own spirit, or perhaps all the willow tea?—she began to sweat. Her nightshirts became sodden almost as quickly as they could be changed. By midmorning she had fallen into a deep and relieved sleep, and that afternoon when he touched her forehead it felt almost cool, a temperature that nearly matched his own.

Makwa-ikwa’s expression didn’t change much, but Rob J. was beginning to know her, and he believed she was pleased by his suggestion, even if at first she didn’t take it seriously.

“Work with you. All the time?”

He nodded. It made sense. He’d seen that she knew how to look after a patient and didn’t hesitate to do as he asked. He told her it could be a good arrangement for each of them. “You can learn some of my kind of medicine. And you have so many things to teach me about the plants and herbs. What they cure. How to use them.”

They discussed it first in the buckboard after bringing Sarah home. He didn’t press the idea on her. He just kept quiet and allowed her to think about it.

A few days later he stopped by the Sauk camp and they talked again over a bowl of rabbit stew. The thing she liked least about the offer was his insistence that she had to live close by his cabin, so he could fetch her quickly in times of emergency.

“I have to be with my people.”

He had pondered about the Sauk band. “Sooner or later some white man will file with the government for every piece of land you folks might want to use for a village or a winter camp. There’s going to be no place for you to go except back to that reservation you ran away from.” What they must do, he said, was learn to live in the world as it had become. “I need help on my farm, Alden Kimball can’t do it all. I could use a couple like Moon and Comes Singing. You could build cabins on my land. I’d pay the three of you in United States money, as well as found from the farm. If it works out, maybe other farms would have jobs for Sauks. And if you earned money and saved, sooner or later you’d have enough to buy your own land according to white man’s custom and law, and nobody could ever order you from it.”

She looked at him.

“I know it offends you to have to buy back your own land. White men have lied to you, cheated you. And killed a whole lot of you. But red men have lied to one another. Stolen from one another. And the different bands have always killed one another, you’ve told me that. Color of skin doesn’t matter, all kinds of people are sonsabitches. But not everybody in the world is a sonofabitch.”

Two days later she and Moon and Comes Singing, along with Moon’s two children, rode onto his land. They built a
hedonoso-te
with two smoke holes, a single longhouse that the shaman would share with the Sauk family, large enough to accommodate the third child who already swelled Moon’s belly. They raised the lodge on the riverbank a quarter of a mile downstream from Rob J.’s cabin. Nearby they built a sweat lodge and a women’s lodge to be used during menstruation.

Alden Kimball walked around with wounded eyes. “There’s white men out there looking for work,” he told Rob J. stonily.
“White men
. Never occurred to you I might not want to work with damn Indians?”

“No,” Rob said, “it never did. Seems to me if you’d come across a good white worker, you’d have told me to hire him long since. I’ve gotten to know these people. They’re really good people. Now, I know you can quit on me,
Alden, because any body’d be a fool not to grab you if you were available. I’d hate to have that happen, because you’re the best man I’m ever going to find to run this farm. So I hope you’ll stay.”