The Covenant of Water

1974, Madras

Near the end of Mariamma’s internal medicine rotation, a khaki-clad peon summons her to see Dr. Uma Ramasamy, in the Department of Pathology. Mariamma’s first reaction is to worry that she’s done something wrong. But her pathology course is long over. Her next reaction is excitement. Uma Ramasamy is a divorcée just over thirty, a sensational teacher. Mariamma’s male classmates have a crush on the professor. Chinnah says, “She’s got subject,” a phrase that in med school jargon signals mastery of a field. “Chinnah, are you sure it’s ‘subject’ and not something else that attracts you?” “What, ma? You mean Madam’s Premier Padmini?” he says innocently. “Chaa! Not at all!”

A Fiat Premier Padmini suits Dr. Ramasamy better than the stodgy Ambassador, or the cockroach-like Standard Herald. Those three rebranded foreign models are the only cars licensed to be built in socialist India; for any other car, one must be willing to pay a 150 percent import tax. Uma’s Fiat is custom-painted ebony black with a red top; it has an extra bank of headlights, tinted windows, and a throaty exhaust. And, unusually, she drives herself.

When Dr. Ramasamy first lectured to their class in the century-old Donovan Auditorium, even the murmuring backbenchers were silenced when the tall, confident woman in a short-sleeved lab coat floated in. She had launched right into inflammation, the body’s first response to any threat, the common denominator of all disease. In minutes she had drawn them into the thick of a battle: the invaders (typhoid bacteria) are spotted by the hilltop sentries (macrophages), who send signals back to the castle (the bone marrow and lymph nodes). The few aging veterans of previous battles with typhoid (memory T-lymphocytes) are roused from their beds, summoned to hastily teach untested conscripts the specific typhoid-grappling skills needed, and then to arm them with custom lances designed solely to latch onto and pierce the typhoid shield—in essence, the veterans clone their younger selves. The same veterans of prior typhoid campaigns also assemble a biological-warfare platoon (B lymphocytes) who hastily manufacture a one-of-a-kind boiling oil (antibodies) to pour over the castle wall; it will melt the typhoid intruders’ shields, while not harming others. Meanwhile, having heard the call to battle, the rogue mercenaries (neutrophils), armed to the teeth, stand ready. At the first scent of spilled blood—any blood, from friend or foe—these mercenaries will go on a killing frenzy . . . Dr. Ramasamy kicked out the fuchsia-and-gold border of her red sari as she paced before the board. Mariamma was reminded of the women conjured up in her mother’s sketches; the sinuous charcoal lines conveyed not just the drape of a sari but the form of the woman underneath.

A brass plaque outside her office simply reads HANSEN RESEARCH CENTER. Atypically, Dr. Ramasamy doesn’t seem to need to put her name on it. The air-conditioned chill within reminds Mariamma of the sari shops in the affluent suburb of T. Nagar, where the salesclerks seated on raised platforms recklessly pull one gorgeous sari after another from the stacks, unfurling and cascading them before the client. But here chrome refrigerators, water baths, incubators, sleek lab benches, and centrifuges take the place of palisades of silk and cotton. Mariamma’s eyes fall on the sleek binocular microscope. Her mouth waters. It even has a second binocular attachment on it—a teaching head—so student and teacher can study the same slide, illuminated from below with an electric bulb. Compared to this beauty, Mariamma’s one-eyed scope, which only works next to a bright window with much jiggling of its reflecting mirror, is a bullock cart.

“She’s a beauty, isn’t she?” Dr. Ramasamy is in an ocean-blue sari. She wears simple gold studs in her ears. She gestures to the high stools by the microscope. After preliminaries, she says, “So . . . I asked you over to see if you wanted to work on a project with me on the—”

“Yes-I’d-love-to, Madam!” she says, the words spilling over each other.

Dr. Ramasamy laughs. “Shouldn’t you find out what it is first? Or do you say yes to everything?”

“No-I-mean-yes, Madam.” Mariamma can’t keep her head movements straight. She must look like a very silly girl. She must speak more slowly, as Anita often reminds her.

“You’d be assisting my research on peripheral nerves. On Hansen’s disease.”

Why not just say leprosy? Mariamma wonders.

“The task is to carefully dissect the upper limbs we’ve preserved from patients with Hansen’s and expose the median and ulnar nerves and their branches fully. Then we photograph the gross specimens in place before we sacrifice the nerves and make multiple sections to examine microscopically. Some of those sections we will send for immunohistochemistry staining and study in Oslo.”

Mariamma pictures the lepers at the Maramon Convention, or the ones who shuffled up the path to Parambil, looking like aliens from another galaxy, and stopping at hailing distance to rattle their cups. She shudders inwardly at the thought of dissecting one of their limbs. Maybe “Hansen’s” is a better name after all.

“I’m honored to be asked,” she says.

Dr. Ramasamy cocks her head, her smile getting broader. “But . . . ?”

“No, nothing . . . Just wondering, Madam, why me?”

“Good question. Dr. Cowper recommended you. I saw your hand dissection from the prize exam. Amazing that you did that in two hours. That’s exactly what I need. But my specimens will be trickier.”

“Thank you, Madam. I’m happy that you didn’t pick me because of . . .”

“Because you crushed Brijee’s balls?” she says, her expression deadpan. Mariamma bursts out laughing, shocked.

“Ayo, Madam!”

“That was an added recommendation, to be honest. I was a student here not that long ago. We had our Brijees, though no one quite as poisonous. Sadly, some are still around.”

Mariamma begins the next day, retrieving a specimen from a formalin tank that seems to contain a pile of forearms with hands attached. She dissects by the window where the light is best. She has a magnifying glass on a stand if she needs it. She must find the trunks of the median and ulnar nerves in the forearm and dissect out their branches to the fingers, or rather to the stumps, since this specimen lacks fingers. The trouble is the skin is as thick as an elephant’s hide, more so than the usual formalin-preserved cadaver dissection. The fat and subcutaneous tissue feel rock-hard and glued to the skin; she must be so careful not to tear the nerve. She cannot use anything as sharp as a scalpel or scissor when she might be close to the nerve. So for hours she digs, pushes, and scrapes with gauze wrapped over her finger, or with the handle of the scalpel—“blunt dissection” they call this in surgery. She’s like a hunter looking for tracks. The signs are subtle, like the faint and darker ridge of earth raised by an earthworm. She sits bent over the specimen, just as when she did needlepoint as a child with Hannah. Are cloistered nuns allowed such hobbies?

It takes a week and aching wrists and a stiff neck to complete the first dissection.

“Wonderful!” Uma says when she comes to look. “I hired you because I can’t spare the time to do this. But I confess, I tried. I butchered it! What’s your secret?”

Mariamma hesitates. “It’s partly my eyesight. I learned needlepoint when I was very young. I found I could do very minute things that Hannah—the girl who taught me—couldn’t, though she had normal vision. In fact, I haven’t been using your magnifying glass because it makes me dizzy. Also, Madam—” She hesitates. When she tried to explain this to Anita, her roommate thought she was mad. “I don’t want to sound boastful . . . or mad. But during anatomy dissection I felt I was seeing differently. I mean, we could all be looking down at a flat, squashed mess of formalin tissue. But I could see it in three dimensions, I could rotate it in my head. It’s more than knowing what I was supposed to see—we had the dissection manual in front of us for that. I could see how the tissue below me differed from the figure. I could imagine it fully, almost see through it. After that, the challenge is to bring it out. For that I use every sense I have. I’m paying attention to the resistance of the tissue, to the feel, and even the vibration or friction as my instruments move on its surface.”

Uma ponders this. “Don’t worry—I don’t think you’re mad. You have a gift, Mariamma. There’s no other way to dissect like this. Our brains have extraordinary capabilities. In our simplistic understanding, we put each function in its box—Broca’s area for speech, and Wernicke’s area for interpreting what we hear. But the boxes are artificial. Simplistic. The senses intertwine and spill over from one area to another. Think of the phantom limb. The leg is amputated, but the brain feels pain in what isn’t there. So I can see how your brain might take the visual signal and do something different with it.”

Mariamma thinks about the Condition. Already, with the knowledge of anatomy and physiology that she has, she thinks the Condition must involve parts of the brain associated with hearing and balance. Perhaps for those affected by the Condition, immersion in water causes the signals to spill over to parts of the brain that should be off limits—the opposite of a gift. She must ask Uma, but before she can, Uma speaks.

“I’ve seen some of your sketches. You draw well.”

“Not really. I wish I had my mother’s artistic gifts.”

“What sort of art does she do?”

“Well, she doesn’t. But she did once . . . I never knew my mother. She drowned soon after I was born.”

“Oh, Mariamma!”

The sadness in Uma’s voice makes Mariamma feel a rush of grief. It’s not grief for her mother, exactly. How could she grieve for someone she didn’t know? And she’ll never get over her grief for Big Ammachi, who was mother, grandmother, and namesake all rolled into one. But being around Uma Ramasamy, given her age, and her dynamic, vibrant nature, affords Mariamma a sense of what it might have been like to converse with her mother. If she hadn’t drowned.

Uma rises, squeezes Mariamma’s shoulder, and goes back to her office.

Her classes, clinics, dissections, and books keep her mind occupied. Now and then she has the absurd urge to write to Lenin, who is of course unreachable. The only letters she gets now are from her father, full of the news from home. Joppan has agreed to be the manager of Parambil, and from his first day it feels as if he’s been doing it forever. Her father says he can breathe for the first time. And there’s drama around Uplift Master and the Hospital Fund, he reports. Podi used to work for Uplift Master, helping him with accounts. After she left, Master hired a new girl, who has apparently embezzled. The mess is being sorted out, but meanwhile poor Uplift Master is suspended, even though he’s quite innocent. It hasn’t affected the construction:

The outside walls are almost complete. I look at it and think I am dreaming to see such a beautiful modern building in our Parambil. I wish Big Ammachi could see this. It’s her vision. Perhaps she does see it. She certainly knew we were on our way. Anna Chedethi sends love. We are so proud of you.

Your loving Appa

On a Saturday, when Mariamma catches up on her dissections, Uma drops by and they look at some of the first nerve sections together under the two-headed microscope. Uma says, “I often think about Armauer Hansen. So many scientists looked under the microscope at leprous tissue before him, but they didn’t see the leprosy bacillus. It’s not that hard to see! It’s because they’d decided no such thing could be there. Sometimes we must imagine what is there to find it. That, by the way, I learned from you!”

It’s flattering and inspires Mariamma to work harder. She’s drawn to Uma. When she was a child, she would daydream of her mother coming home, bejeweled, always in a chariot, and with her hair flowing free, released at last from a magician’s spell that kept her asleep for years. Such fantasies came to her usually when she was with the Stone Woman, or in the nest, because her mother was alive in those creations, alive in her incomplete sketches and ­paintings—an artist interrupted who would be back any moment. But as the years passed, the sleeping beauty never did return, the paintings remained incomplete. Uma, her living, breathing, vibrant mentor, the sort of woman who, she discovers, competes in rallies and is rebuilding an engine with her own hands, is more real than any drawing, more real than a faceless stone relic in Parambil.

She books a ticket to go home for a week during the short holidays. Two days before she’s to leave, she toils in the lab, readying her dissection to be photographed.

She senses a presence behind her. She turns. Uma stands half in and half out of her office, the oddest expression on her face, her eyes wet. Mariamma’s first thought is that Uma’s been fishing in the formalin tank and the fumes got to her.

Uma floats toward her in slow motion like a sleepwalker and gently clasps her shoulders.

“Mariamma,” she says, “there’s been an accident.”