The Covenant of Water

1977, Saint Bridget’s

The shrunken, ancient driver of Mariamma’s tourist taxi is dwarfed by the Ambassador’s large steering wheel, yet he expertly coaxes the column-mounted shifter through its changes with deft thrusts of his palm. Like many in his trade, he sits sideways, pressed against the driver’s door, accustomed to having at least three family members squeezed onto the bench seat with him, in addition to the women, children, and infants in the back, transporting them to weddings or funerals.

From the rear seat, Mariamma looks out at the world with new eyes. Parambil is the home she’s always claimed, but like so much she’s believed about herself up to this point, that is a lie. “The only thing you can be sure of in this world is the woman who gave birth to you,” Broker Aniyan said. Mariamma never knew her mother, and now it turns out that she never knew her father either.

The last time she came this way in Digby’s car, racing to see Lenin, she wasn’t thinking of the Thetanatt house. Her driver has been everywhere, and like a marriage broker, he knows just where the Thetanatt house was, before Elsie’s late brother sold it. On that land now sit six “Gulf mansions”—built by Malayalis who returned from Dubai, Oman, or other outposts to construct their dream homes. The only thing Mariamma can see of her mother’s past is the stately river at the edge of their former land. They press on.

“Here, Madam?” her driver says hesitantly, well before the open gate to Saint Bridget’s leprosarium. In all his travels, she doubts that he has brought a fare here. Perhaps he’s hoping that she’ll hop out and stroll in.

“Drive to that building behind the lotus pond. I’ll have them bring you tea.”

“Ayo, thank you, Madam, not necessary!” he says, panicked. She hands him ten rupees and asks him to come back after lunch. It might be her imagination, but she thinks he receives the note gingerly.

She asks for Digby. Suja, the woman in nurse’s garb whom she’d seen last time, leads the way. Suja’s bandaged right foot, and her sandals, fashioned from old tires, give her a stiff, lopsided gait. They pass through the shady cloister, then the corridor leading to the theater, the disinfectant soapy odors giving way to the steamy hothouse scent of the autoclave.

Digby Kilgour is operating, but Suja encourages her to go in. Mariamma grabs a mask and cap, slips on shoe covers, and enters. Digby’s assistant is short a few digits, the fingerless stalls of her glove taped out of the way. Digby looks up. He smiles above the mask. “Mariamma!” he exclaims happily.

Seeing her expression, he pauses. “Lenin . . . ?”

“He’s fine.”

The pale eyes study her, trying to read what he can in hers. He nods slowly. “I’m about to start. You’re welcome to scrub in . . . ?” She shakes her head. “Shouldn’t be much longer.” The act of surgery supersedes everything. She remembers her surgical professor in Madras, a twice-divorced man, saying that in the theater the messy parts of his life—the disappointments, the debts—vanished. For a time.

Her thoughts no longer feel like her own. She struggles to stay focused. Digby makes three separate incisions on the patient’s hand framed under the green surgical towels. She’s tempted to rap his knuckles. Are you a carpenter using a hammer? Hold that scalpel like a violin bow, between thumb and middle finger. Index finger on top!

The pale lines unfolding in the wake of his blade, then the delayed blossom of blood, are just as she’s used to seeing them. His movements are slow, deliberate.

“I’m not a pretty surgeon to watch,” he says. He fusses over bleeding that she might ignore. After gaining his exposure, he severs a tendon from its insertion and tunnels it to a new location. “I’ve learned the hard way,” he says, “that free grafts of an excised segment of tendon . . . don’t work.”

She bites her tongue. Surgeons like to think aloud. Assistants need quiet hands and quieter vocal cords. Observers, too.

“Rune was a pioneer in free tendon grafts. But I’ve come to believe a tendon needs to remain attached to its parent muscle, for blood supply and for function. The real enemy is scar tissue. I use the smallest incisions and I keep it bloodless.”

She’s grudgingly impressed at what he accomplishes with his stiff fingers—his left hand does most of the work. If she worked at this pace, Staff Akila would say, “Doctor, your wound is healing at the edges already.”

Digby says, “You need the patience of an earthworm nosing between rocks . . . detouring around roots to get to where it must. Even the most rigid structures in the wrist have an almost invisible layer of slippery tissue, or so I believe. It’s not in any textbook. It needs faith. You must believe without proof. I try not to disrupt that layer. Must sound like witchcraft.”

She doesn’t trust her voice. Every surgeon has beliefs, but also a bit of Doubting Thomas in them too. They need proof. Proof is why she is here. Reach hither thy finger, and behold my hands; and reach hither thy hand, and thrust it into my side: and be not faithless, but believing.

Digby sutures the tendon to its new insertion at the base of a finger. He fusses over it. “These wee fraying fibers at the cut end of a tendon are like vines, but tough as steel cables. One loose tendril can grab onto something it shouldn’t and ruin your result.”

He’s finished. By habit she looks at the theater clock. It hasn’t been as long as it has felt.

“Tourniquet off?” That came out of Mariamma’s mouth, also from habit.

“Don’t believe in them. The best tourniquet is one you can see hanging on the wall.” He dresses the wound and immobilizes the hand in a cast. He strips off his gloves and gown.

He asks his assistant to arrange for tea to be brought to his study. “Do you mind if we pop in on one patient on our way? It’s her big day and she’s waited all morning.”

I mind very much! I’ve only waited all my life.

She follows him.

In the small ward a young woman sits upright in bed. A dressing tray is at the ready. Digby puts a hand on the patient’s shoulder.

“This is Karuppamma. She’s in her fifties. Looks like she’s twenty, doesn’t she? That’s lepromatous leprosy for you. It pushes out the wrinkles. Not like the tuberculoid form.”

Karuppamma is shy. Her free claw of a hand goes up to cover her mouth.

“A week ago I did the same procedure on Karuppamma that you just saw. I cut the flexor digitorum superficialis tendon going to her ring finger. I can do that because she has the profundus as backup. I affixed the tendon here,” he says, pointing to the root of his thumb. “She should now be able to make opposing movements. Get back the grasp function she lost. The thing is, though, to get her thumb to move, she must imagine she’s moving her ring finger. The brain thinks it’s impossible. It has to be convinced that things aren’t what they seem.”

Are you talking about me? Mariamma is calmer outwardly than when she first arrived, lulled into that state by waiting and by watching him at work. But her insides roil with anger, resentment, and confusion. She needs the truth. I didn’t come for surgical knowledge. Still, she won’t be rude in front of a patient.

Digby says in Malayalam, “Touch your thumb to your little finger.” He butchers the language, lacking the swallowed “errah.” Karuppamma understands. She grimaces with effort. Nothing happens.

“Stop. Now . . . move your ring finger.”

Her thumb moves instead. There’s a pause, and then Karuppamma bursts out laughing. Digby shares her happiness, grinning. A small crowd has gathered, sharing Karuppamma’s triumph. Despite herself, Mariamma is moved. But when Digby turns to Mariamma, his expression is profoundly sad.

“This disease only takes away. Year after year, you lose something. Not from active leprosy, but from the nerve damage it caused. This is one of those rare moments when we give something back.”

He tells Karuppamma that she’ll get to move it more each day, till it is at full strength, but for today she mustn’t overdo it. He directs Suja to immobilize the hand and wrist with a posterior slab of plaster.

Digby says, “Soon she’ll move the thumb without thinking. It’s astonishing. As Valery says, ‘At the end of the mind, the body. But at the end of the body, the mind.’ ”

Mariamma follows him out. He says, “Paul Brand in Vellore and Rune here were the first to really understand that these fingers get damaged from repeated trauma. Not from leprosy chewing them away, but because they lack pain sensation . . .”

Her mind wanders. She’s thinking of the schoolboy Philipose taking that reckless boat ride here and serving as Digby’s hands, because Digby was still recovering from surgery.

“. . . Paul Brand saw a patient cooking over an open fire, struggling to flip a chapati with tongs. She got frustrated and just reached in with her bare hand and turned it over. You and I would scream in pain if we tried that, but she felt nothing. That’s when Brand understood. Without the ‘gift of pain,’ as he says, we have no protection.” Digby is talking to himself. “Amazing to me how few understand this. That’s the nature of clinical leprosy. Not many physicians want to study it. Fewer surgeons wish to treat it.” Digby gazes directly at her.

It rattles Mariamma to look at his face, seamed by age, mottled by burn scars, because it calls out to the face she sees when she looks in her mirror. Doesn’t Digby see the likeness?

They enter his study, where, in what feels like a previous life, she took a nap. It’s a glorious morning. She’s drawn to the French windows, to see once more the jewel of a garden outside. Yellow, red, and violet roses rim the lawn, different colors than she recalls from her last visit. The gate at the far end of the picket fence is ajar. On the lawn a patient in a white sari sits in the sun and sorts roasted millet in her palms, then clumsily shovels the little pearls into her mouth. Her hands are like trees with their branches lopped off, leaving nubs. The rudiment of a thumb is what she uses for sorting. Her head is covered with the pallu of her sari. Mariamma sees her flattened profile, the nose leveled as if someone standing behind her is pulling on her ears. It takes a particular kind of courage to make leprosy one’s calling. She must grant Digby that.

“When their facial nerves are affected, it robs them of natural expressions,” Digby says, standing behind her at the window. “You think they’re baring their teeth in anger when they might be laughing. It adds to the isolation of leprosy.” He’s still instructing. She wishes he would shut up. “I’ve learned to listen more than look,” he says.

She hears the sadness in his voice. It would be so much easier to be angry with him if he were a boozy planter who’d gone to seed instead of this man who’s given his life to those whose affliction has turned them into pariahs.

Doesn’t Digby understand why she’s here? He must at least know that he could be her father, even if he never saw Elsie again, and never knew he had a child. And if he does know, then he’s part of the deception that hid the truth from her.

She’s about to turn to him and speak when he whispers, “Notice how many times she blinks.” The woman is unaware that she’s being watched. “Count how many times you blink for every one of hers.”

She tries not to blink. Her eyes itch, then burn. She gives in to the urge. The patient has yet to blink. The woman cocks her head toward a dog barking, the way the blind seek to localize sound. One eye is sunken, milky white, unseeing. The cornea of the other eye is cloudy.

“They fail to blink, the cornea desiccates, and blindness follows. Most of the residents didn’t come here blind. When it happens, it’s a sad moment.”

The tea arrives. Mariamma sits down in the same chair where she had once napped. Without thinking, she removes the shawl draped over the back and places it on her lap. Digby pours.

On the bookcase she sees the silver-framed photograph of Digby as a little boy with his mother. Your gorgeous, stunning mother, Digby. With the movie star looks. With the piebald streak in her hair. My grandmother. When Mariamma had first glanced at the faded black-and-white photograph on her last visit, she’d thought that Digby’s mother was starting to turn gray. But the woman was young. The clue had been right there, before her eyes . . . but it didn’t register. And never would have if she hadn’t read her father’s journals.

Digby sits across from her, leaning over his cup to sip. It’s clearly too hot because he sets it down, the saucer knocking against the pipe stand and making a sound like a gong.

She steels herself. “Dr. Kilgour—”

“Digby, please.”

Digby, then. What I won’t call you is “father.” I had a father who loved me more than life.

“Digby . . .” she says, but the name doesn’t sit well with her anymore. It feels like a jagged tooth scraping her tongue. “Don’t you want to know why I came here today?”

He sits back in the chair and is quiet for a long time. “For years I’ve wondered if you would come, Mariamma. And if you would ask me what you propose to ask me.” Their eyes are locked on each other. “You’re the spitting image of your mother,” he adds.

She takes a deep breath. Where does she begin? “D—” She can’t say his name. She starts again. “How did you know my mother?”

Digby Kilgour sighs and stands. For a moment she has the absurd notion that he’s about to open the door and walk out on her for asking the question he knew was coming. But no, he stands there. The eyes that meet hers are solemn, contrite, and full of compassion. “I knew one day you’d come looking for her.”

She doesn’t understand what he’s saying. He goes to the French windows and stands there like a man about to face the firing squad, his nose almost touching the glass. She rises, teacup still in hand, to join him.

The view hasn’t changed. The lawn outside is brilliant, like spilled green paint. In its center, clad in pure white, the unblinking woman still sits, sorting the millet.

“Mariamma, the woman there in the sun . . . She’s probably the greatest Indian artist alive. She’s the love of my life, the reason I’ve spent twenty-five years at Saint Bridget’s. Mariamma, that is Elsie. Your mother.”