The Good Doctor (3 page)

Later we went over to the main building together. There was nobody in the office, although Claudia Santander was still officially on duty and Tehogo was supposed to be around. While we waited
for Dr Ngema to appear, we sat and drank coffee in silence. Years of my life, sour with caffeine, had been sipped away in this room. A clock on the wall stood silent and broken, the hands fixed for
ever at ten to three. The only thing that had changed here since I arrived was the dartboard on the back of the door. I had brought it up from the recreation room one Sunday, hoping to while away
some hours. But there are only so many times that you can throw a dart into a board before the idea of an aim and a target begins to lose its point.

Dr Ngema arrived punctually at nine. She was here for ward rounds. This was a daily routine, even on those days – which is to say most of the time – when there were no patients
in the hospital. There was always something to discuss, however inconsequential or arbitrary, some point of protocol or procedure. But today, as it happened, there were two patients to attend
to.

She stopped in the doorway and her eyes went sideways to the anomalous brightness of Laurence’s white coat. He had stood up and was smiling, holding out his hand.

‘I’m Laurence Waters,’ he said.

She shook his hand in confusion. ‘Oh, yes,’ she said, ‘yes. When did you arrive?’

‘Yesterday. Last night. I wanted to come and see you then, but Frank said...’

‘I thought it would be too late,’ I said. ‘I told him to wait till today.’

‘Yes,’ Dr Ngema said. ‘Yes.’ She nodded vigorously.

A silence fell. Laurence was standing there with a broad and expectant smile, eyes shining, and it was obvious that he thought something would finally happen. All the rest – his arrival,
waiting, talking to me – was just preparation. He had met the boss now, and a life of duty and meaning would be given to him.

But Dr Ngema was looking around, frowning. ‘Where is Tehogo?’ she said.

‘I don’t know. He hasn’t arrived yet.’

‘Oh. Well. Yes... Shall we go?’

I walked next to her, while Laurence followed behind. Our footsteps echoed importantly in all the emptiness. Both the patients were in the first ward, the only one that was really functioning.
This was two doors up the passage from the office. The first room you passed, on the left, was the surgery, where examinations and any kind of operating were done. That door was closed. The next
one you came to, on the right, was the ward. It looked like a normal room in a normal hospital. Two rows of beds, curtains, a dim fluorescent glow.

We all congregated around the bed of the first patient, a young man in his early twenties who had come into the country illegally on foot. Because we were close to the border we got a lot of
these cases: people who had walked great distances without money or food. The border crossing was dangerous. This young man had made it through, but he was badly sunburned and dehydrated and his
feet were raw. He was being intravenously rehydrated, and seemed to be making good progress. He didn’t communicate with us, except by frightened glarings of his eyes.

‘His blood pressure is 130 over 80. When did Tehogo do this chart?’

‘I have no idea.’

‘He must write in the time. He must do it clearly. Will you tell him? Frank, his temperature’s a bit high. But he’s passing urine again. What do you think?’

‘Try him again with solid foods in the morning.’

‘I agree. Will you pass that on to Tehogo as well?’

‘Okay.’

‘When do you think he can be discharged?’

‘He’s making good progress,’ I said. ‘Day after tomorrow.’

Dr Ngema nodded. We weren’t friends; she didn’t have any friends, but she always made a public point of asking my opinion. We had what is known as ‘a good working relationship’.

We crossed over now to the other patient, a woman who’d been brought in by her husband a couple of days before in a lot of pain. It was her appendix, about to burst, and Dr Ngema had operated
immediately. Appendicitis was the sort of emergency we liked: recognizable and treatable, within the scope of our resources.

Most surgery in the hospital was carried out by Dr Ngema, though her hand was far from steady, and in my opinion she had an unreliable eye. For personal reasons I was keen to build up some kind
of record with surgery, but I was only allowed to do occasional minor procedures. It rankled with me, but I couldn’t afford to let any resentment show. I had swallowed a lot of frustration over the
years.

This morning, for example. I could see very quickly that all wasn’t well with this patient – she was weak, and a brief examination showed some distension of her abdomen – but this wasn’t the
time or place to be too direct. Dr Ngema was sensitive to criticism, but there was more to it than that. If anything was wrong we would have to send the patient to that big hospital in the nearest
town, an hour away, where there were more sophisticated supplies and staff. In extreme cases, where we could do nothing more, we were obliged to pass the patients on, but this was always a last
resort, because every failure on our part made it harder to justify the thin funding we still had.

‘Why don’t we keep an eye on her?’ I said. ‘We can monitor it.’

Dr Ngema nodded slowly. ‘All right.’

‘It’s leaking,’ Laurence said.

We both looked at him.

‘The stump is leaking,’ he said. ‘Look. Distended abdomen. Painful to pressure. You can’t leave it too long.’

The silence that followed was filled with the hoarse breathing of the woman in the bed.

‘Laurence,’ I said.

I had spoken sharply, to put him in his place, but there was nothing to follow on his name. He was right: we both knew it, and the simple fact of his statement was obvious enough to shame
us.

‘Yes,’ Dr Ngema said. ‘Yes. We can all see that, I think.’

‘What would you like me to do?’ I asked quickly.

‘Take her this morning. I’ll stand by for you, Frank, while you’re gone. It’s better that we... yes. Yes. Let’s do it.’

She was talking calmly and carefully, but it wasn’t a happy moment. When she turned abruptly and walked back to the office I didn’t take up my usual place next to her, but lagged behind, a pace
out of step. Laurence jumped in next to her.

‘Dr Ngema,’ he said. ‘Could I talk to you for a moment? I want to know what’s expected of me.’

‘What do you mean?’

‘What are my duties?’ he said cheerfully. ‘I’m keen to get started, you see.’

She didn’t answer immediately, but at the office door she turned to him. ‘You ride along with Frank,’ she said. ‘You might learn something.’

‘Okay.’

‘Yes,’ she said. ‘Frank is a very experienced doctor. You can learn a lot... from experienced people.’

It was the sharpest I’d ever seen her, but he seemed oblivious. He followed me like a puppy into the office, where Tehogo was sitting at the desk, staring darkly at the grain in the wood.

‘I’m taking that appendix patient to the other hospital,’ I said. ‘And Tehogo, you must write in the time on the chart. The other patient, the young man, can have solid food from tomorrow.’

‘Yes,’ Tehogo said, not looking up. He managed to make it sound as though he was granting permission. Nothing punctured his dour composure, not even surprise, but he did look startled for a
moment when my new room-mate sprang at him, hand extended.

‘Hello,’ he said. ‘Pleased to meet you. My name’s Laurence Waters.’

I busied myself with routine and it was late morning already when we set out. The hospital owned one antiquated ambulance, though the official driver had long ago departed;
whenever the ambulance was sent out, one of the doctors had to drive it. We put the woman into the back on a stretcher and I got into the driver’s seat. I expected Laurence to sit up in the front
with me, but he got into the back with the patient and crouched over her with intense attention, like an owl over its prey.

‘Give her space to breathe,’ I said. ‘You’ll make her feel claustrophobic’

‘Sorry. Sorry.’ He pulled back, looking abashed, and I studied his broad face in the mirror. He seemed to wear a perpetual frown, as if one eternal question continually niggled at him.

I didn’t speak to him while I warmed the engine and then pulled out into the street. The town, with all its vacant, impressive space, passed slowly by. Then we were on the tributary road that
led to the main road, and the bush pressed in on either side. Heat made the leaves blurred, like a solid wall you couldn’t penetrate. The road wandered between ridges and low hills. It was a hot,
dense country, growing between extremes of brown grass and the brilliant green of riverine bush.

When I first got here I loved the landscape, the fertility and fecundity of it, the life it gave off. There were no bare places. Everything was shrouded in shoots and thorns and leaves; there
were little paths running everywhere, made by animals or insects. The smells and colours were powerful. I used all my free time, hours and hours of it, to go off walking into the bush. I wanted to
move closer to the lush heart of things. But over time what had compelled me most deeply began to show a different, hidden side. The vitality and heat became oppressive and somehow threatening.
Nothing could be maintained here, nothing stayed the same. Metal started to corrode and rust, fabrics rotted, bright paint faded away. You could not clear a place in the forest and expect to find
it again two weeks later.

When we got to the main road, the countryside changed around us: the bush was thinner here, there were more human settlements. Villages appeared on either side – congregations of huts, roofed
conically in thatch and painted with bright designs. The ground was tramped hard and flat with use. The eyes of children or toiling men or idle old people watched us pass. Women stood up from
scrappy fields of vegetables, hoe in hand.

After half an hour we reached the escarpment, where the road lifted and climbed. This marked the edge of what had used to be the homeland, and the beginning of viable industry: the land was dark
with pine trees, planted in rows. From the top there was a brief view of the plain we’d left behind, an undulating sheet of mildewed bronze, before the grasslands started.

The town that we were going to, with its busy hospital, wasn’t far on the other side of the escarpment: a turn-off, a short side road, and we were there. Even in the midday heat, when the
surrounding streets were torpid and sun-struck, there was a quiet commotion of activity around the hospital entrance – cars and people coming and going. Although the patient wasn’t quite an
emergency case I delivered her to the emergency section. There was a doctor I’d often dealt with, a cocky young man not much older than Laurence, called du Toit. He was working today; I’d spoken to
him earlier on the phone. He’d got all the forms ready to be signed and came to meet me with an insolent grin.

‘Another one for us to take over,’ he said. ‘What’s the matter, haven’t you managed to kill her properly yet?’

‘I thought I’d leave it to you.’

‘Any time you want a real job, you know where to come. How long are you going to keep yourself buried in the backwoods down there?’

‘As long as it takes,’ I said, signing my name for the hundredth time on the same official form, watching the woman being wheeled away. Every time I came to make a delivery there was a variation
on this dark exchange of banter between du Toit and me.

He was looking at Laurence with interest. ‘You’re new,’ he said. ‘I thought they were getting rid of people, not taking them on.’

‘I’m here for community service,’ Laurence said. ‘One year.’

Du Toit snorted. ‘Bad luck. You drew the short straw, hey?’

‘No, no. I wanted to come.’

‘Sure. Sure. Don’t worry, it’ll be over soon.’ He slapped Laurence on the shoulder and said to me, ‘Want some lunch?’

‘Got to go back, thanks. I’m on duty. Next time.’

When we were outside again Laurence said, ‘I don’t like him.’

‘He’s all right.’

‘He’s spoilt. He’s full of himself. He’s not a real doctor, you can see that.’

Near the top of the escarpment I pulled over at a roadside restaurant I knew.

‘What now?’ Laurence said.

‘I’m stopping for some lunch. Aren’t you hungry?’

‘I thought we were on duty. You see,’ he said knowingly, ‘you didn’t want to have lunch with that guy. You don’t like him much either.’

We sat at a table and had our lunch while we watched the other customers come and go. Most of the traffic on this road consisted of trucks on their way to and from the border, and the drivers
often stopped here to eat and drink. I liked the look of these men. They had none of the harried introspection that doctors carried around with them. Their lives unravelled in the long lines of the
road.

‘So that’s it,’ Laurence said suddenly. ‘The other hospital. The one where everybody goes.’

I nodded heavily. ‘That’s it.’

‘That’s where all the funding’s going, the equipment, the staff, all that?’

‘That’s it.’

‘But why?’

‘Why? An accident of history. A few years ago there was a line on a map, somewhere around where we’re sitting now. On one side was the homeland where everything was a token imitation. On the
other side was the white dream, where all the money —’

‘Yes, yes, I understand that,’ he said impatiently. ‘But the line on the map’s gone now. So why aren’t we the same as them?’

I shrugged. ‘I don’t know, Laurence. There isn’t enough money to go round. They have to prioritize.’

‘They’re high priority, we’re nothing.’

‘That’s about it. They’d like to close us down.’

‘But. But.’ The frown on his forehead was deep and vexed. ‘That’s all politics again, isn’t it.’

‘Everything is politics, Laurence. The moment you put two people in a room together, politics enters in. That’s how it is.’

This thought seemed to quieten him; he didn’t talk again until we were leaving. Then he suddenly announced that he wanted to drive.

‘What?’

‘I feel like it. Come on, Frank, let me have a turn. I want to see how it feels.’