By Allyson Armistead
The translator’s two days late, if he’s still coming to Macha, and 5,000 CCs of quinine are floating useless in their glass vials. I can’t speak this language, even the basics, and so much depends on yes and no and can you please just trust me.
Zehra’s my only patient today, the last patient I’ve had in almost seventy-two hours. She sits tall and rigid on my examination table, her black eyes gauging my syringe. Her husband stands silently beside us, his eyes dark and tired, and I wonder if Paul would look the same in this situation, if he were this husband in this little village, his wife staring blue and vacant and somewhere far away.
“This,” I say, and hold up the syringe of quinine, “will save you,” and point to Zehra to help her understand. “And save your baby,” I say, and place my palm against her crimson burlap dress that’s pulled taut against her round, firm belly.
“Ndwifye bwino,” she says—what I can only imagine means no, go away—and shoos my needle away like all the other women have before her. But I can’t go away because it’s only a matter of time before the malaria finds its way to her uterine lining, the parasite pushing her child cold and still into the African light. There’s a cramp in my side just watching her, and I’ve never subscribed to empathy if that’s what it is, and yet it’s here, pinching my lower abdomen.
“You don’t understand,” I say, but somehow, I need her to. It’s an invisible disease, this one: a light-winged predator you never feel on your skin, its proboscis pushing illness, yellow and billowing, into your bloodstream. It’s fatal if left untreated, and a thousand people are already buried across the plains and under the muombo trees, fanning green under this Zambian sun.
“Please,” I say, but her husband holds out a pink and tender palm, helping Zehra and her round midsection find the floor. I watch them leave my tent, thinking how I must seem in this place, an alien wielding needles in the name of healing.
“You’ll have a hell of a time without translation for the first few days,” Carl had explained when he phoned me in Baltimore about a month ago, telling me about Macha and the 15 million dollar USAID grant we’d won for the construction of a research center. We’d written the proposal six months ago, Carl spinning a vision of malaria treatment and mosquito observation, a hub of outbreak prevention in the wetlands of rural Africa, a pebble rippling an ocean.
“Am I medical lead?” I’d asked, because this had been our plan.
“You bet your ass you are.” I smiled at Carl’s insertion of euphemisms in the right place, the rattle in his larynx, all thirty years of Marlboro poisoning. His was a kind of rugged charm that kept me going somehow.
I’d have a week head start on the treatment before we’d commission the construction crew, and Carl explained, as I already knew, that the pregnant women of the village were at the top of our triage list: their immune systems most susceptible, their unborn children among the highest fatalities. Everything had already been arranged, including transport to Macha and a translator who’d meet me on the Wednesday after my arrival. I’d have field supplies and medicine: insecticide-treated nets, medical kits, gallons of distilled water, and 5,000 CCs of quinine for initial treatment. Carl’s team would join me a week later, but there seemed so much to work out, so many details to coordinate, and I was nervous about venturing to Africa alone.
“These folks have no medical context, so do what you can until the translator gets there. You’ll be fine.” Something in his reassurance was feigned, stretched, like covering a dead body with a sheet and saying everything’s okay, just don’t look over there. “If you need us, use the short wave. The connection only goes as far as Lasaca. Bruce is your contact. You know radio language?”
“You’re in for a treat then.” Forty-eight hours later, I was on a flight to Lasaca, assured by Carl that our mission would come together.
“Where’s the translator? Over,” I short wave over the field phone before the rain begins, when there are no more patients to see. Funny, patients would imply plural, more than one, and that’s not accurate since there’s been only Zehra today, and she’s gone to spread rumors like wildfire among the community: white lady has nothing, nothing, just a long needle, and we’re all going to die here. Tomorrow, I’m convinced, I’ll have no patients.
Static crackles on the other end of the line, a high-pitched squeal, a red hum of an invisible violin. How long does it take for my voice to cross a river, to reach Lasaca? There are no telephone lines here in Macha, no towers for relaying cell-phone calls, and there is no Internet. The capitol is only six hours away and as modern as Baltimore, but here there are only plains and people, 4,000 sick and dying—no freshwater, no buildings, no connection. Grades of civilization should not be so black and white, I think, stripes of alternating development seven hundred miles apart: disease and health, disease and health. Here, only disease.
The static has shifted to an echo, and it’s occurred to me that the humidity might be fizzling out the transmission between our invisible connection, the condensation weighing down the words between us. It’s always, it seems, a matter of words.
There’s so much rain here in April, the people holding their breath and taking shelter under the muombo trees, waiting to surface in the sun. It’s the rainy season, the wetlands, and the clouds darken at the same time every day. It’s comforting in a way, this routine.
Static, still static, and I’m uncertain if I even know how to use this thing properly since I’ve only secured a connection two times—once to report arrival, once to confirm set-up of the medical station—and how strange it’s only been five days this small blip in my life.
“Six months,” Carl had told me, when I asked how long he needed me in Zambia, what I should tell Paul about my leaving.
Paul and I had never been apart for more than a few weeks at a time when I went to China or Bermuda on research trips, and when he traveled abroad for his company. The 6th of April had been circled red on our refrigerator calendar for weeks, square and in the middle, the date we’d celebrate our anniversary, but when Carl explained the timeline, I erased it and drew a long blue arrow through the month of April and past August and well into October: Charlotte in Macha.
“What about Paul?” I asked.
“What about him?”
“How can I reach him?”
“Shortwave Bruce and he’ll take care of it,” Carl said, and that seemed reasonable enough, and there were always letters, but my handwriting was like blips on a heart monitor screen, spiked and illegible. It was strange, really, how Paul and I seemed to operate on an inverse equation in space and time: he was flying east while I was flying west, and our lovemaking, though warm and close and quick in its passion, was timed carefully so we’d meet in the middle, in the center of flights and deadlines and trips away. We were two people passing one another on parallel winding staircases, fused together like DNA helixes, within reach but a rung away somehow, a bar too close, too far: always a matter of time.
“Cheryl likes when I write her,” Carl said, and I thought of Carl’s wife at home with Betsy, Charlie, and Maggie, washing little faces and dressing small bodies and reading Carl’s letters in a moment of quiet, the only time she had to herself since leaving her research position at Hopkins. “Letters are more personal. Keeps you in the loop, helps time fly.”
And it would fly, it always flies, and I was afraid of it flying. Two years of med school, four years interning and a residency, one year at Hopkins, and now six months in Zambia: my twenties gone, my thirties here, the door of my career just opening. And Paul and I had talked about children.
“Letters are a good idea,” I said to Carl, and wondered if writing your life on paper would slow it all down somehow, if the ambidextrous could write two lives simultaneously.
How lucky for them, I thought.
Static is still on the radio, and I’m wondering if a handwritten letter would reach Lasaca faster than the time it takes to make a connection this way, over the wire. I hold the white phone out to the side, up to the ceiling, thinking this will help somehow, but the static grows more erratic.
I fold my arms and hold the phone by the cord because all I can do is wait. I fill the time, counting the seams of my white tent: five for the panels, five for the ceiling, one to hold them all together.
In between the fourth and fifth, there’s something red: a flap curved and resting like some exquisite creature on my examination table. I wonder how it got here, if it carries disease. I’m irrational again.
I leave the static running on the phone unit and walk across the tent. It’s Zehra’s head cover, and she’s left it behind. She’ll need it in this rain, I think, and decide to leave it fast asleep on its side.
“I said do you copy? Over,” again into the phone unit. It’s strange speaking in this radio language, waiting for a sound to emerge from the tinny crackle, for any signal across the Zambezi River that’s grown wider in the last ten days from all this rain, this flooding. I can’t describe the color really. I’ve never seen water soiled with lead the poisoned run-off from the pollution in Kabwe. It’s blue probably, the water—dark blue—but in the sunlight you can see the lead compounds mixing with oxygen and it’s almost indigo then, darker than the positive sign of a pregnancy test.
“Stay away from the rivers down there.” Carl had phoned the evening of my flight to Lasaca, and I said I already knew that, but appreciated his concern. It wouldn’t be an issue, I told him, as long as the supplies were waiting. Macha was landlocked after all, the nearest river a few kilometers south.
“I see you’ve done your research.”
“That’s why you’re my lead,” he said, and while I had waited years to hear those words, they felt distant, like someone saying you’ve won the lottery when you’d already won it years ago. All the hours studying mosquito anatomy, the money spent in tuition, the years Paul had been so patient, waiting until the time was right for me, for my career, to have children. And now that Zambia was here, I wondered if I’d really won anything, if somewhere along the way I’d given away another prize in exchange for the winnings.
“Is Africa what you want to do with your life?” Paul asked me the evening we drove to Dulles Airport. I knew where this question would go, deep into the pink and blue recesses of what it is and means to start a family.
We had discussed children before, and we’d even named them: Pele, Pedor, and Pepi. We did this jokingly of course, on a lazy Sunday afternoon, him squeezing my knee while my mosquito anatomy book lay open and splayed across my abdomen. We’d need to have them soon. My fertility peak was already beginning its steady decline at thirty-one, down by 5 percent and continuing to drop in the next five years as my career was just beginning, another inverse equation.
“I don’t know,” I said. “It’s all getting complicated, isn’t it?” I had watched it get that way for Cheryl in the last several years with Betsy and then Charlie, running the lab at Hopkins four days a week, grocery shopping, dinner, bedtime stories. It became too much somehow, and she seemed to age, her olive skin pigmented with a faint yellow and pallid undercurrent, her eyes weighing down, the tender bags billowing. It was on a Tuesday that she handed her work over to a pretty young woman with horn-rimmed glasses—four years’ worth of work she’d never finish, saved and e-mailed in a PDF attachment.
I wondered how many letters Carl wrote her when he was away, if reading about his research abroad was painful to her alone in her house with her Ph.D. and public health degrees, settling along with the wood floors while her children slept. Did she miss it, her lab and studies and mosquito traps, testing new hypotheses on the transmission of the disease, the crossbreeding of the predator we were all fighting to remedy in Africa?
They never tell you that about the scientific field: how it won’t wait for reproduction, how women like Cheryl find themselves pregnant and out of the loop, their degrees and training out of date, expiring and useless. It’s a field that moves continuously like whitewater rapids, always moving, moving, moving, and I was moving, had been moving right along with it, and to jump off now would be like hurling myself to the rocks, abandoned and all wet and without the same bravery to throw myself back in again. I wish I could stop and start time again without the world growing—only my womb, a child within it, the three Ps when I’d granted them permission—and return when I was ready, to rejoin all the scientific happenings, exactly as I had left them.
“Here we are,” Paul said, and we sat idling in the airport departure lane.
“Here we are.” I was not sure what else to say, and I stared at the console of our little gray Honda. “I’ll write,” I said some moments later, and my own voice surprised me, but I really would write, and I hoped saying so would make Paul understand or say okay or do something to ease the silence between us.
Instead, he nodded and smiled as he looked straight ahead, and I was unsure if he had dismissed my offer or if he really had heard me, pocketing it away for the time being.
“Kick some mosquito ass, all right?” He mimicked Carl in his best Marlboro voice, and I found it hard to laugh. Maybe it was how hard he was trying, maybe it was how kind he was being, but the laughter, even feigned, wouldn’t come.
“I will.” I smiled, and stared at his face a moment longer, his long aquiline nose, his green eyes, memorizing the dips, the planes He’d been so patient. Maybe in another life, I thought to myself, when I’m a florist or a homemaker, when there’s no need to wish for a stop-and-go watch, for a quantum translation of time into manageable, coexisting units.
“I love you,” I said, and opened the door of our little car and walked into the airport.
Paul said nothing.
“We copy translator,” Bruce says on the other end of the line, and finally we have contact through the static. He’s the only English-speaking voice I’ve heard in days and I’m glad he’s there to hear me. “There’s a mix-up about the translator in Lasaca. It’s a no-go. Carl’s tracking another one. Over.”
“Copy that. Not what I had bargained for, but whatever. Over.”
“Copy, Charlotte. Hang in there. We’re doing the best we can. Out,” he says, and it’s fitting his name is Bruce, his voice bellowing and baritone and warm like cigar smoke I want him to stay with me, here for a little while, but the connection is lost in the static.
I shake my head, remembering Carl’s feigned reassurance about the translator, my resourcefulness in the absence of one, almost as though Carl never had a translator to begin with. But I’m sure he did: he must have.
I cradle the white plastic phone back into the field unit and wrap myself in one of the navy wool blankets from a medical kit. I lean against the wall of my tent, watching the rain run down the plastic door and fork into miniature rivers.
My abdomen is cramping again, pinching somewhere under my rib cage and through my pelvic bone, and I wonder if it’s my period, the hot stabs along my uterus somehow familiar, but thicker, insulated.
Abdominal cramping, fatigue, thickness, delayed menstruation: the diagnoses are endless. Side effects of the immunization? Vertigo? Dehydration. Stress.
It’s simply a matter of mathematics, really, and I count forward from February 27th in segments of seven. I hold out my hands and fold my fingers to mark off a day, a week. Twenty-seventh, March fifth, twelfth, nineteenth, sixteenth.
Last spring I had stopped birth control and Paul had agreed. It was a rational decision to switch to latex: the latest research in Medical Digest, Scientific American, and a number of OB/GYN periodicals cited a strong correlation between prolonged birth control usage and cervical cancer. Stopping had been a preventive measure.
It was a shift at first, but we were adamant that risking pregnancy was a disaster with the start of my career ahead of me. And Paul, though he wanted children, wanted us.
“You’re not angry?” I asked him sometime in March, after we had made love, in a day layover at home: he from Anchorage, me from Nassau.
“I knew this when I got involved,” he said, saying I took it all so seriously, this life. “We’ll have them when we’re ready, and hopefully that’s closer to now than not now, but we’ll have them when we’re ready.”
“I just wish I could start and stop time,” I said, my dark hair fanned across his chest. “Just stop time, be a mother, and start it again.”
“You could always catch up, if you wanted both,” he offered. “These things can work, you know. They have to.”
It was a logical solution but not feasible, when gene silencing mosquito DNA was in the works over the next five years, when a new drug called artemisin was found to cure malaria in a single-dose among mice populations, when it would take three years for the construction of the research center in Macha, and another seven, Carl predicted, to eradicate malaria across the rural regions of Zambia. It was like nailing down four corners of a tent at one time, with a single hammer and only two arms, and maybe the aide of toes, if I stretched far enough.
“How far does it all go, Charlotte?” Paul said then. “I mean, how is all this supposed to work?
“I don’t know,” I said, but thought it would be so much easier if humans were like seahorses: males birthing the young, females exploring for sustenance along the surface of coral and seaweed.
“Even as a seahorse you’d find a way to complicate yourself, Charlotte,” Paul said, and there was some truth to that, I knew.
There are two hundred home pregnancy tests in the medical field kit. I pick one at random, remove its plastic wrapper, and pop off the blue indicator tip. I open a gallon of distilled water and cleanse the litmus stick, swing it back and forth to dry in the air, and walk over to the empty biohazard bucket I’ve been using as a makeshift toilet when it’s too wet to go outside behind the muombo trees.
I’d always imagined that we would take the test together, Paul and I, when we were ready for a baby: he would wait outside the upstairs bathroom door, sitting on the steps, and I would try my best to aim for the small white stick between my legs, hovering above the toilet water.
“Are we pregnant yet?” I can hear him say, while I’d balance the stick on the back of the toilet seat so the indicator could tell us the news, undisturbed by human vibration.
But this is not how it’s happening.
I put the lid back on the litmus stick, the smell of my urine sharp and acidic, and balance the white, rectangular test on the examination table. I stand back. I wait. It’s like Schrödinger’s cat, this moment, the theory physicists and metaphysics talk about and debate: the moment when two possibilities exist at once, on one plane, in one time. In these few seconds I am both mother and scientist.
I calculate a minute, and walk closer to the examination table. The plastic indicator waits for me.
I take a deep breath. I linger for a moment, hovering across two possibilities. I close my eyes and lean over the indicator. I keep them shut, squeezed.
I open them.
The storm is heavier now and the water rivets on the plastic door are wider, blurring together. No more rivers, just an estuary, swirling and chaotic. The rain is thick here, , and the lead poisoning is in these drops, the way all water in this place is polluted and dying. If I collected it in a glass and drank it, would it abort the fetus? It would be easier: a flush, a vanishing. Disappearance. The timing is wrong for all this. There’s no comfort in a hardwood floor settling, there never will be, no amount of cracks and pops while my child sleeps, not while the world runs like a machine without me.
I run my hand along my abdomen for swelling but calculate I’m only five weeks along and wouldn’t be showing. Morning sickness should start soon. Paul will want me to leave this post, I think, when I tell him. I should leave now, pregnant in a malaria zone, but I’m immunized and tell myself that should be enough. It’s out of my hands.
I’m standing here with a blanket over my shoulders and the only explanation I can find is the two point five percent probability of a defective condom, a hole the size of a pinprick and invisible. Funny how I can’t remember it even when I think back to it: the shriveled, damp plastic that had once been inside of me, thrusting. I can’t remember.
I’ve narrowed it to two moments of conception: one after a glass of Pinot Grigio, the other the night I wished I was a seahorse, for the reversal of reproduction. It’s the latter, I’ve decided.
The rain has slowed to a patter, and I don’t know how long I’ve been standing here, my hand on my abdomen. I think of the birdlike creatures we’ve buried stillborn in the soil, the red mounds of dirt twelve inches in diameter. How strange I know the size of an aborted child.
It’s then that I hear it: a light flapping on the plastic of my tent. At first I think it’s the rain, that it’s hail, but there is no hail on the wetlands and this much about Macha I know.
The tapping is louder now, but I know it’s not the rain because I see her hand against the plastic, the same dark, insistent hand that shooed me away earlier this morning.
It’s Zehra. She looks so different in the rain. Her faint eyebrows have collected beads of water, and she looks almost fairy-like with her crystalline adornments.
“Eya mukwai?” she says, a question I think, and I hold the plastic flap back to let her in from the rain.
Her eyes are so white in this darkened light, wide and curious, and they drop to the ground for a moment, down to where my hand’s still resting on my abdomen. I had forgotten that it was there and move it away, pulling the blanket from my shoulders.
She moves across the room holding her round belly, her crimson burlap wet and slapping against the canvas floor, her bare feet leaving footprints. Her hand is steady on her pregnant stomach, and I wish I could save her child, such a good mother. I find I can’t look at her for long, the hypocrisy of it all: wishing for her, wishing against my own, the one growing without my permission.
She stops at the examination table and reaches for the crimson fabric she’s left behind. Her head covering. I hoped for a moment she’d reconsidered the quinine. Too soon, I thought. The translator will explain everything, when he or she or whomever gets here, the way they promised me.
She raises the piece of red for me to see.
“Yes, it’s fine. Take it,” I say. I nod my head. “It’s fine,” I say again, and watch her secure the fabric under her arm for safekeeping. She’s so calm now, I think, without a needle in her face.
She moves towards me and I stand aside to let her pass through the door, but she stops then, as though she forgot something else, trying to recall it. She looks at me and points to my abdomen.
She pats her stomach and points to mine, and I can’t make out what she’s doing, this charade in Bemba. She reaches out a dark palm to my stomach, and I flinch then, why is she touching me? But she is so calm at my jolting, her palm still hovering above my skin, waiting for permission. She wants to touch my stomach. When I am still, I watch her palm move towards my abdomen. We are moving in slow motion. Her hand presses warm into my t-shirt, a small heating pad over my belly button.
“Eya mukwai?” she asks.
“Am I pregnant? Is this what you’re asking?” and my words fall on non-English ears. How do you know? And then I remember my hand on my abdomen. Her perception amazes me, and I think for a moment how delicate it all is, pregnancy in this place.
“Eya mukwai,” I nod. “Pregnant,” I say, and I can’t look at her, only at the smooth brown tops of her feet, the illness coursing even there, through the veins and up her ankles. Stillbirth is only a matter of time; eight months is so unstable with what little immunization Zehra has left, and I wish our wombs could trade places, but I’m ashamed at how morbid I am, here, in this suffering.
Zehra smiles, and her teeth are beautiful and white in the darkness. She pats my stomach again, and we have a new understanding somehow. What it is, I don’t know.
It’s then that she holds out her long dark arm to me, how easy she extends it now, the light brown of her underside exposed to the ceiling of my tent, a vein ready. Is she asking for the quinine? I motion for her to follow me towards the examination table and remove a syringe from the stainless steel tray.
“This?” I ask her, and hold up the needle for her to see.
She nods again, and reaches over to touch my child, then extends her arm again. I hold her arm and find the vein, brown and strong and already raised to the surface of her skin.
The needle slides in easily.
“It’s okay,” I say, relieved in this moment. She smiles at me, never flinching, steady, and I replace the needle with a white square of gauze and press it into the crux of her elbow.
“You’re safe.” I picture the quinine coursing through her, her own child folded and asleep in a pocket of blue.
Rumor, I think, spreads like wildfire.
“Do you copy? Over,” I radio the next morning.
“I copy, Charlotte. Over,” and I’m surprised at the speed, how quickly Bruce is here with me through the static.
“I need you to relay a message to my husband. I need you to tell him I’m pregnant.” And how strange this is, announcing Paul’s a father thousands of miles from home in this broken radio language. “Tell him I’m immunized, that my work is here, that I love him. Tell him I’m a seahorse. He’ll know what I mean. Over,” I say, and I can only hope Paul will understand I’ve found a way, in this place.
“Copy pregnant, seahorse, not coming home. This is a first for me. You? Over.”
“Copy that. First for me, too. Over,” and with that I cradle the phone and look out among the few women Zehra’s brought to me today, their brightened faces cued in the African sunlight, ready for answers.
Allyson Armistead is a graduate of the MFA program at George Mason University. She has been nominated for 2012 Best American Short Stories, Best New American Voices, two Pushcart Prizes, a PEN/O. Henry Prize, and the 2012 Tobias Wolff Annual Fiction Prize. Her short has appeared in Coal City Review, Narrative Magazine, Bellingham Review, Ruminate, Redux, Buried Letter Press, Citron Review, A River and Sound Review, among others, and is forthcoming in a special edition of the U.K.-based journal Strutco. She resides in the Washington, DC metro area with her husband Chris and daughter Evie. Find out more at http://allysonarmistead.com/