The City of Palaces (17 page)

“Would you have had the Mexica prevail?” Sarmiento asked, genuinely curious.

“What's done is done,” Cáceres replied. “My concern is not with the Indians who were killed three hundred and eighty years ago, but with those who are dying today.”

B
ut you are a nonbeliever,” Cáceres sputtered when Sarmiento proposed that the priest marry Alicia and him.

“What does that matter? My wife believes.”

They had been walking through the neighborhood to a tenement where a child was ill with symptoms that sounded ominously to Sarmiento like typhus.

“You can't just mumble the words of the sacrament as if they were lines from a play, Miguel. That would be an affront to the Lord.”

“How could your God be affronted that I am doing something out of love for Alicia? God is love, isn't that what your Saint John says?”

“The devil quotes scripture,” the priest grumbled. They walked in silence for a moment. “I will do it, on one condition.”

“Name it.”

“You must establish a clinic at the church for my children. For one year after your wedding, you will come regularly and tend to their medical needs.”

“Agreed,” Sarmiento said. They had arrived at the tenement. “Now, let's hope I won't be treating them for typhus.”

F
rom the shaded corridor where she embroidered a tiny smock for Reina's baby, Alicia half listened to the murmured conversation between her husband and a man with a large goiter on his neck. Reina, sitting beside her, clumsily attempted to imitate Alicia's needlework. She pricked herself and cried out, “Fuck!” She quickly added, “Forgive me, Doña. My fingers are so clumsy, not quick like yours.”

Alicia took the cloth from the girl and examined it. “This is good work, Reina. When I first began to learn to chain stitch I stuck my fingers all the time. I can't tell you how much cloth I ruined by bleeding on it. It's simply a matter of practice and patience.”

She returned the cloth to the girl, who said, “Sometimes I have patience and sometimes I want to jump out of my skin.” She touched the little swell in her stomach. “Mamá says that's the baby.”

“I'm sure your mother is right.”

“You have no children, Doña?”

“No, my dear.”

“But you are so old,” the girl said. “I thought you would have many sons and daughters.”

Alicia smiled. In the months that she had been coming to San Francisco Tlalco she had learned it was a sign of acceptance when the people of the neighborhood dispensed with extraneous gentility and spoke their minds. And to the girl, who was no more than fifteen, she realized she must seem ancient.

“I have just married,” Alicia said. “My husband and I have not yet had time to have children.”

The girl took up her sewing and said, “The doctor is much nicer now that he is married to you.”

A
licia lifted her head from her own sewing and looked down the corridor into the room Miguel used as his clinic. His patient stood motionlessly as Miguel felt his neck. Palpitation, she thought, using the term he had taught her. “Diagnosis is an art, Alicia,” he had explained, “and the doctor has four tools: inspection, palpitation, percussion, and auscultation. That is, we look, feel, thump, and listen.” He had shaken his head in disbelief when she told him that her own childhood doctor, Don Ignacio, had never laid a finger on her except to briefly take her pulse.

“Then how did he diagnose and treat you?”

“My mother told him where my pain was and he gave her medicine for me. If I was truly ill, he bled me.”

He shook his head. “That's not medicine. It's witchcraft.”

He was distressed to discover that the inhabitants of San Francisco Tlalco shared Don Ignacio's ideas of professional propriety. He returned home from his first clinics with stories of the man who assaulted him when he thumped his chest to listen to his lungs, the woman who ran off at the sight of his stethoscope thinking it was made of snakes, and the little boy who clamped his teeth on the thermometer and ended up with a mouthful of mercury that nearly poisoned him. He complained that many of his patients spoke Nahuatl and that Padre Cáceres was too busy to translate for him. “Those people are impossible!” he concluded.

“Let me come with you,” she said. “I speak some Nahuatl and I know many of the people in the parish, and if you have your wife with you they may be less inclined to assault you.”

He resisted, but when he came home with a blackened eye given to him by the husband of a pregnant woman after he had touched her belly, he agreed.

“However,” he said, “I insist on teaching you some basic principles of anatomy and physiology so that you will understand what I am doing.” He smiled. “I need to knock Don Nacho out of your head.”

Her classroom was the room in their suite at the palace that he had converted into his office and laboratory, much to her mother's horror. Miguel had reluctantly acceded to La Niña's insistence that they live with her after their marriage. “I am an old woman,” she said. “You can't leave me to die alone in this big house.” But after he moved his medical equipment into their apartment, she complained, “This is a family residence, not a tradesman's place of business.” Only when he threatened to take Alicia and move did La Niña withdraw her objection.

For Alicia, however, the hours they spent in his office, where he instructed her in the body and its workings, were among the happiest of her marriage. He was a patient and kind teacher and she discovered in herself a thirst for knowledge. More than that, though, an intimacy arose between them that dispelled the awkwardness of having to play the roles of husband and wife and allowed them to resume their friendship, which had always been the strongest bond between them. Using his charts and models, he taught her the structure and parts of the body from skin to cells, explained the digestive and circulatory systems, and showed her a drop of his own blood beneath the microscope. He explained to her the causes and symptoms of various diseases and their treatments.

“Was this taught to you in the same way you teach me?” she asked.

“Ah, well, no,” he said. “I attended many hours of lectures, of course, but the deeper understanding of disease came from the clinicals where we learned to match symptoms to causes by observing sickness in our patients and then studying their bodies after they died.”

“You opened the bodies of the dead?” she asked, shocked.

He nodded. “We examined organs and tissues for disease. Only in that way could we confirm that our diagnoses were correct.” Her distress must have been evident because he added, “Alicia, this is how medicine must proceed for new knowledge to arise.”

She did not reply but thought that Miguel was virtually a different species than white-whiskered Don Ignacio.

One afternoon, as they examined a beautiful papier-mâché model of the brain, and he explained how its folds and convolutions contained the whole of human personality, she asked, “But in which part does the soul reside?”

“My dear,” he said. “You know my views on that subject. Does this study of the body in all of its gross materiality shake your faith at all?”

She shook her head. “Not at all, Miguel! The wonders of the body you have shown me only deepen my belief because who could have made these ingenious things but God?”

A
little boy of four or five in a calico shirt and droopy drawers ran up to Alicia and said, “
Feita
, the doctor wants you.”

“Luis!” Reina scolded. “You must call her Doña Alicia.”

“It's all right, Reina,” she said. “He only repeats in innocence what others say about me.”

“I have never called you
la fea
,” Reina said. “To me you are beautiful.”

Alicia smiled and patted the girl's head as she rose to go to her husband. She knew the people in the parish called her
la fea carinosa
—the kind but ugly woman—just as they called Miguel
el guapo doctor
—the handsome doctor. But while his nickname was simply descriptive, hers, she understood, was affectionate and, softened by the diminutive
feita
, intended as an endearment, and she held it as such.

M
iguel had carefully chosen the room he used as his clinic from all the other empty rooms that lined the garden and had been storerooms and priestly cells when the church was in its prime. This room, he explained to her, was sheltered from the wind and dust and had the largest window to let in the light. He had personally supervised its cleaning and even now the room smelled of carbolic acid, which, he had told Alicia, killed the tiny microbes that were invisible to the eye and the carriers of all disease. Try as she might, she could not help but picture these microbes as
diabolitos
—tiny demons—but she refrained from mentioning this to Miguel.

He was with a young girl—fifteen or sixteen, like Reina—who held in her arms a lace-wrapped bundle.

“Miguel, you wanted me?” she asked.

“The girl only speaks Nahuatl. Will you ask her about the baby?”

Alicia turned to the girl and asked, “What happened to your child, dear?” and then translated her answer. “She says her baby stopped crying two days ago. She doesn't know what's wrong. She begs for your help.”

“Let me see the child,” he said, and she translated his response.

She watched as the girl carefully unwrapped the lace coverings—which she realized were baptismal garments—to reveal the wizened, lifeless features of an infant. The girl fell to her knees and lifted the child above her head, presented Miguel with a tiny corpse—the skin of its fingers gray beneath delicate fingernails—and murmured, “Give my baby breath.”

Alicia caught her gasp before it could escape her lips and glanced at Miguel, whose face showed as much distress as he allowed himself with a patient.

“Please tell her to stand up,” he said.

Alicia addressed the girl gently and she rose from her knees. Miguel lowered his head and put his ear to the infant's face and then took its pulse.

“It's dead,” he replied. “Tell her to bury it.”

Alicia translated his response with soft words of sorrow and sympathy. Silently, the girl rewrapped the corpse in lace and slipped out of the room.

“I was harsh. I'm sorry,” he said when she had left.

“It was shocking.”

“Shock is a luxury of laymen,” he said. “Doctors are not permitted to be shocked, but it was because it was an infant and it called to mind …” He looked at her. “Well, you know what it called to my mind.”

“Yes,” she said. “I know. I will go into the church and pray for her and her baby. Won't you come and sit with me and rest?”

He shook his head. “I have to find Cáceres. There's been an outbreak of smallpox in La Bolsa, and we are going out to try to persuade the local people to be vaccinated against the disease. It hasn't been easy. Their witchdoctors have been telling them that I want to infect them with poison.”

She knew that what he called witchdoctors were the local
curan
deros
who doctored with herbs and magic and who resented his presence because he charged nothing for his services.

“I could come,” she said. “I could talk to the people.”

“No, the priest and I have our little show where I inject him with saline to show that no harm will come from the vaccine. Poor Cáceres is beginning to look like a pincushion.” He added abruptly, as if startled by the thought, “You could have been vaccinated. Why weren't you?”

“Oh, my parents would never have allowed Don Ignacio to take the liberty of injecting anything into my body,” she said. “It was not the custom.”

“Custom is the enemy of progress,” he said. “Especially in our poor benighted México. When you pray for that child, pray also for an end to the ignorance that keeps our people enslaved to custom.”

“Miguel, what was wrong with the man with the lump on his throat?”

“It's a problem with his thyroid,” he replied. “It's a butterfly-shaped organ at the base of your throat. It makes a secretion, a kind of fluid called a hormone that helps control the body's metabolism, the rate that we burn the calories we extract from our food, like coal for a furnace. Sometimes the thyroid becomes diseased and makes too much of the hormone or not enough and so there is too much heat or not enough. I do not know from which this man suffers, but the goiter is interfering with his sleep and breathing and ability to swallow. I will have to cut it out.”

“Is that dangerous?”

“No, I think I can perform the surgery here. But I may need your help.”

She paled at the thought of it. She had helped him when he had had to extract a rotten tooth even though the sight of blood made her dizzy and the patient's pain was hard to bear, but then she observed how much better the patient felt afterward. Cutting into the flesh was something different, though.