Chapter 36 Summary
Ghosh calls it heuristics, solving problems for which no formula exists. Life is full of signs; the key is learning how to read them. Marion’s heuristics are a mix of “reason, intuition, facial appearance, and scent”—and none of them are found in a book. But he does not trust his nose when he scents something different about Ghosh, the man who excelled at the “Three L’s: Loving, Learning, and Legacy.” Marion attributes Ghosh’s even more jovial self to his new position.
On the morning of Hema and Ghosh’s anniversary, Marion awakens at 4:00 a.m. to study. At six o’clock he leaves Ghosh’s old bungalow and goes to his boyhood home, where Shiva still lives. The door to the bathroom hallway is open and steam is coming from the room. Ghosh is wearing a towel around his waist and leaning heavily on the sink. It is early for him to be up, but Marion assumes Ghosh is using this bathroom so he will not wake Hema. Marion can hear the man’s labored breathing before he sees him; obviously the simple effort of bathing had winded him. In this unguarded moment, Marion sees the real Ghosh: a terribly fatigued man who is full of sadness and apprehension. Then Ghosh sees Marion, and by the time he turns around he has assumed his jovial persona.
Marion smells the familiar scent of death and asks what is wrong. Ghosh dismisses the question by saying how wonderful his life is and recounting his plans to go dancing with Hema that night and asking her to extend their marriage contract for another year. Hema appears and Ghosh dances her around the room while whistling, but his whistling is staccato because he does not have enough wind to do both activities.
Marion attends his early morning class but then follows his intuition—his nose—to find Ghosh in Casualty, where he sees Matron waiting for Ghosh. Adam enters with a bottle of blood and exits without it a moment later. Adam is startled at Marion’s presence and tries to close the door, but Marion has his foot firmly in the way. He walks in to see Ghosh lying in a lounge chair and Matron preparing to give him a blood transfusion. They are both stunned to see Marion. When the son tells the father not to bother to lie to him, Ghosh realizes the moment to tell him has arrived. Always the teacher, Ghosh is also now the patient, and he tells Marion to make a diagnosis.
Marion uses his own heuristics and realizes he had noticed Ghosh’s pallor but did not let it register. Then he remembers bruises on Ghosh’s arms and legs and a paper cut that would not quit bleeding. He remembers hours of exposure to radiation from Old Koot, the X-ray machine he used until Missing got a new machine. Marion speaks the dread word—leukemia—an ugly word that has come to life now that it has been spoken. Ghosh beams at Matron at his son’s acumen, but his next words are stripped of all pretense.
Ghosh has “myeloid metaplasia ,” an early stage of the coming leukemia. He has been in consultation with the best doctors, and he takes a blood transfusion to combat his only significant symptom, anemia. He tells Marion the best thing about his life is how normal it is, and when others eventually find out about his condition that will all change. He asks Marion for the gift of normalcy until things get more severe and he is forced to tell Hema. Ghosh asks Marion to keep...
(This entire section contains 1959 words.)
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the secret from both Hema and Shiva; he knows Marion understands his brother better than anyone does, despite their rift. Marion gives his word.
The next few months run together for Marion as Ghosh’s wisdom is revealed. Marion reads obsessively on the disease and realizes things do change when death is imminent. Ghosh’s condition grows worse, and Marion wants to learn everything Ghosh has to teach before his opportunity to garner his wisdom is gone. Marion takes everything in and wonders why it takes such a crisis before a son realizes the full worth of a father. Occasionally Ghosh winks at his son from across the room, and Marion knows Ghosh is teaching him how to die just as he taught him how to live.
Hema and Shiva do not notice Ghosh’s condition. Shiva has convinced his mother to begin treating women who have vesiculovaginal fistula (fistula, for short), which is a major commitment because it is a difficult condition to cure. It was the young girl with bowed head, dribbling urine, and horrible stench, walking up the hill with her father, who had this profound influence on the course of Shiva’s life. The boys had not known it, but Hema operated on the girl twice and it did not work. The third time she performed the operation, Hema assured her sons, the girl was fine, though emotionally scarred for life. The first successful operation on this condition was performed by Dr. Marion Sims, for whom Marion is named, in 1849. At dinner one night a month after Marion learned of Ghosh’s condition, Hema announces that she and Shiva have successfully treated fifteen consecutive fistula patients with no recurrences.
She credits Shiva with the success because it was his suggestion that they strengthen and heal the women before they attempt the surgery and then have them do postoperative physical therapy. Hema announces that Matron has found a donor who wants to support nothing but fistula surgeries, and Missing is now receiving a thousand dollars every month. Marion finds it hard to look at Shiva, let alone congratulate him.
Genet has failed several classes and is now behind Marion in medical school, but Marion is too busy worrying about Ghosh to fret over Genet. She has lost her desire, and it does not take long to get behind in the high-pressure world of first-year medical school. When he hears, halfway through his second year of school, that Genet has missed several anatomy lab sessions, he feels obligated to check on her. He finds her in her atypically messy room, talking with a well-known militant student who leaves angrily shortly after Marion arrives. Genet is clearly participating in radical political politics, particularly concerning the liberation of Eritrea, her father’s homeland. Genet is insulting to Marion, but he is not hurt by her manner as he once might have been. He wants to tell her about Ghosh and ask her to come spend time with his family, but he just tells her Ghosh would like to see her. Marion tells Genet he is worried about her schoolwork and encourages her to do better. She icily thanks him. He wonders at the spell she has woven that keeps him coming back to her and telling himself he still loves her though they are “so clearly drifting apart.”
During Marion’s final year of medical school, during his surgical rotation, Ghosh’s disease erupts. When he arrives home, Marion can see on Hema’s face that she knows. Instead of tears or a tirade, she simply hugs him. Almaz and Gebrew also know and have a hard time hiding their tears; they blame their own inattention to prayer for this calamity. Now Marion must find Shiva and tell him the news. He finds his brother in the tool shed, a place Marion has not been in for years. It is cluttered and Shiva is working on a contraption to improve fistula surgery. When he tells Shiva the news, Shiva says nothing and there is no visible response. Marion realizes he still needs his brother; he needs someone to share this burden with. But even this news is not able to break down the walls between them.
Marion is surprised to learn that Shiva slept on the floor outside Hema and Ghosh’s door for three nights after he learned about Ghosh as his way of expressing his love for his father. Something is broken in Marion when he hears this, and he moves back into the house and convinces Shiva to sleep in their bed instead of on the floor. Each of them begins the awkward night at the farthest corner of the mattress, but by morning their foreheads are touching.
Ghosh’s condition is getting seriously worse, and he now spends his time in his favorite armchair in the living room with his legs on a footstool. He begins systematically spending time with everyone he loves in preparation for his impending death. Ghosh is now on oxygen.
He finally summons Marion for their time together, which the son has been avoiding. Marion is surprised when Ghosh tells him he is not to feel responsible for the entire family. Hema and Shiva are strong, and Marion should not feel duty-bound to Matron or even Genet. He wants Marion to “take his medical career to great heights” and explains that America is a place where he can soar if he chooses to go there. His only regret is a small one, and it has to do with Marion’s father.
Marion quickly tells Ghosh that he is the only father he has ever known or wanted and wishes Thomas Stone had leukemia instead of him. Ghosh tells him how proud he is of Marion, but he wants his son to understand that he shared an intense love of medicine with Thomas Stone, which passion created a unique bond. Thomas Stone was a deeply wounded man who was afraid that if anyone got close to him someone would get hurt. Ghosh wants to let Thomas Stone know that he always considered him a friend, but he could never contact him because Hema made him promise never to do so. Hema has never forgiven Stone for leaving, even though she wanted the twins from the moment of their birth; after he left, she was always terrified he would come back and claim his sons. Ghosh believes Thomas Stone is ashamed and thinks Ghosh hates him, but he wants the man to know he still loves him and considers him a friend.
Shiva cannot do this for Ghosh; though he would certainly deliver the message, he would not know how to heal his father. Ghosh asks Marion to do this for him because he cannot do it himself—complete what is incomplete—without hurting Hema’s feelings. Then Ghosh unexpectedly asks Marion to forgive his brother for whatever he did. Marion is stunned, for he had no idea Ghosh understood the depth of his pain and bitterness. Marion promises to do his best with Thomas Stone but only because it is so important to Ghosh.
The end comes a week later. Ghosh dies in his chair with his boys holding one hand and Hema holding the other. Almaz is squatting behind his chair with a hand on his shoulder, but Genet is not present. His last sight is of his family gathered lovingly around him, and he passes from this life to the next with his “characteristic simplicity.” Marion had experienced loss before, but now he knows what real loss feels like. Immediately after Ghosh’s death, Marion feels the mantle of family responsibility fall directly on his shoulders and remembers that his father wanted him to wear that mantle lightly. He had transferred the “professional baton” to Marion, and he now promises to be the kind of doctor who would be even better than his mentor and pass that same knowledge to the generations that would follow, keeping the chain unbroken. Marion is no longer a son; he is a man.
