WITH HIERONYMOUS BOSCH IN INDIA

by Irving Kenneth Zola

 

I had expected many unusual things when I first visited India in 1969, but the welcoming questions which greeted me were not among them. As I walked from my plane, a government official, a Sikh, resplendent in his turban, rushed forward through the crowd to greet me. After we introduced ourselves and shook hands, he asked in quick succession, "Where in the States are you from? From where was your undergraduate degree? Your graduate degree? And what happened to your leg?"

The latter, as any American would know, was hardly a typical opening between strangers. I answered in turn, "Boston, Harvard B.A., Harvard Ph.D." and then, somewhat hesitatingly, "Polio complicated by an auto accident." The question bothered me, and I began to wonder about Sikhs.

When we reached our car, I was introduced to our colleague, a Tamil, who asked about my home, my schooling and what happened to my leg. The next several hours produced more of the same. Whether it was heads of bureaus or government ministers, the introductory questions varied little. My responses, on the other hand, seemed to be taken as merely pertinent bits of information to be received and stored. I was curious, even a little put out at this intrusion into what Americans regard as so private a matter. It had been many years since others made me directly aware that I wore a back support and a long leg brace, used a cane, and walked with a limp. But I decided to ignore it and turn my attention to the business at hand. This was, however, an omen of things to come, of an event a week hence which would make me acutely conscious of "what happened to my leg."

On Friday afternoon at about 2:00 p.m., I was outside the posh Oberoi Hotel in New Delhi. It was hot and dry, nearly 100 degrees in the shade, but my excitement overcame my usual dislike of heat. A week of conferences had been interesting but today was to be my first "adventure." After touring several impressive medical facilities, I was anxious to see something more local, and, I thought secretly, more real. In response to my request, colleagues had arranged a visit with an Ayurvedic healer, a local folk physician. And so I waited and wondered about the questions I would ask.

A horn sounded and the bus pulled up, marked with the familiar World Health Organization symbol. In the rear seats I could see my guides for the day, Doctors T. and M. They waved and I saluted back. Paying more attention to Dr. M., who looked exquisite again in a sari, I pushed myself to a standing position. As I did, I heard a crack. It sounded as if it came from within me, but I felt all together. As I stepped toward the bus, there was an unpleasant squeaking and clicking sound. I climbed in and when I sat, my trouble became obvious. Something was trying to poke its way through the knee of my trousers. The brace, one I had for 15 years, had snapped somewhere just below the knee.

Here I was, thousands of mi-les from home, in a strange land, without friends and, needless to say, without a spare brace, on my way to see an Ayurvedic healer. I had certain confidence in his ability to deal with a myriad of problems, but a welder he was not!

I turned, hesitatingly, to my hosts. "Uh," I stammered eloquently, "I seem to have a problem," and pointed to my leg. Unfortunately, as an explanation, this did not suffice, so with great embarrassment, I rolled up my trousers to show the dangling part.

"No problem," they said and gave the driver new directions.

By this time I was soaking in sweat - partly through anxiety, and partly because this enclosed bus felt like an oven.

Within a few minutes we arrived at a series of low-lying buildings, paint peeling and baked a dull orange by the sun. With an air of confidence that I lacked, Dr. T identified it as the Nehru Rehabilitation Center. As I limped toward the door a hundred yards away, the 'clickety-clack' of my brace seemed to announce my coming. Neither the appearance of the building nor my first glimpse of its occupants reassured me.

I was confronted by what I can only describe as an Hieronymous Bosch painting in all too living color. While my Indian colleagues explained my trouble to those in charge, I was trying to absorb - or rather deny - the scene before my eyes. Within uncomfortable touching distance was a panoramic history of physical disability. An old man in a turban, toothless, blind in one eye, with his right foot missing below the ankle, stood quite straight, leaning on a makeshift crutch; a twentyish young man wandered around, speaking to many but with no one returning the attention; countless children limped to and fro; still younger ones, some with shrivelled limbs, some crying, some just staring, were held and occasionally rocked by their mothers. So many people had missing extremities that I flashed to scenes of wartime surgeries, where, one after another, limbs are amputated, cast aside, and stacked in piles. Hardest to take were those who moved about in what felt to me like grotesque ways. Kneeling on a cart, a man in his mid-twenties pushed himself forward with his hands - a Porgy, but without his grandeur. Another with no legs used his hands to hop from place to place with a slowness that was painful to watch.

But this was no whining mass as in the Bosch pictures. If anything, there was an air of resignation. And I seemed to be the only one showing signs of physical discomfort. As my stomach did flip-flops, I wondered what the hell was I doing here. Why did I leave safe Geneva for this? After days of hearing of the problems in the delivery of local medical services, was I about to experience it firsthand? This was far beyond the limits of my intended participant-observation of Indian health care.

The appearance of an eight year old boy helped curb my anxiety. He was wearing a long leg brace just like mine. I wanted to shout for joy. It meant they could really help me. Guiltily I realized it also meant at least some of the younger generation were receiving up-to-date rehabilitative care.

I heard Dr. M. call me and then saw Dr. T approaching. "Everything will be taken care of and we will pick you up in about two hours. All right?"

I nodded my head in agreement, not really meaning it. Were they really going to leave me here? Alone? I was bothered by my own thoughts. What was it I feared? And so, acting braver than I felt, I shrugged my shoulders. Directed to a bench, I limped over and sat down. From this less vertical position I felt even more overwhelmed, almost suffocated, but I didn't know why. After all the time I'd spent in hospitals, I was surprised at my own reaction. But just as suddenly I understood. My hospital time was spent amongst people who were getting better or were struggling to. The troubles here were chronic and the patients were not likely to improve.

Maybe my thoughts showed, for soon people began to introduce themselves and explain the surroundings. They were trying to be helpful and friendly but I could not understand a word. So I only smiled in return. Then, as if he had hit on the source of my discomfort, a young man said something to the man beside him. When his bearded seatmate nodded approval, the young man excitedly jumped up, and dragging his left foot, rushed off through the crowd. In a few minutes he returned. In his outstretched hand was an opened bottle of Coke.

My stomach sank and I hesitated. I remembered that just two days earlier my WHO colleagues and I had been wedded to our toilets because of dysentery contracted from the drinking water. Was I going to go through all this again?

Noting my reluctance, he smiled knowingly and took the first drink himself. Turning to the crowd who had gathered around us, he nodded his head and handed me the bottle. Embarrassed, and I guess grateful for this kindness, I couldn't resist. I drank and then passed the bottle. Everyone seemed pleased, including me.

There was little time to relish my bravery, for a clerk in a long white coat appeared. "Dr. Zola, please come with me, and we will take care of you." Out of the corner of my eye I noticed someone carrying a young boy out of a cubicle. It was to that place that I was directed.

"You'll be more comfortable here. So please take off your brace."

He left and I looked around. He had closed the tattered curtain, which provided, at best, a psychological sense of privacy. The table on which I was supposed to sit held a pool of urine - perhaps left by the young child made anxious when he was carried out so quickly to make room for me. I was upset, but it made little sense to insist that he be brought back to his puddle. So I sat on the rickety chair, took off my trousers, removed my brace, dressed again and then limped out, now moving more slowly and unsteadily, brace in hand, its right side cracked and dangling. I handed it this time to a young woman in white.

Calmer now, I returned to my bench. All I could do was watch the hubbub. People were going back and forth, but because of their often lurching movements it all appeared like a movie in slow motion.

A wheelchair came bounding through the door, and a young teen-age boy with dark curly hair, muscular above the waist, thinner below, gave a piece of paper to the clerk. Then I noticed that many of them had pieces of paper in their hands. But I had nothing. Nothing to do. Nothing to read. No one to talk to. More confused than scared, I smiled at the children, and they smiled back. Amidst the rags and disfigurements, one thing began to stand out - all the medical staff in their stiff, white gleaming coats. All these men and women looked so young, so beautiful, so handsome. Was it just that they were healthy and we were not? Or were they chosen, maybe motivated to work in such a place because of their appearance? I kept thinking of all the times I have sat at the mercy of a dentist, while his dental hygienist with sparkling, cavity-free teeth, proceeded to pick at my gums and instruct me about the perils of failing to brush properly.

My reverie was eventually interrupted. "Dr. Zola, it's ready." I rose and there was my brace - repaired and straight. Once again directed to the cubicle, I began to dress.

A head poked in. "I wonder if you would mind coming out or just standing there with your brace." For a moment I did not grasp the man's meaning. He continued, "It would be nice for them. So that they could see their work."

More out of gratitude than understanding, I rose and walked forward through the entrance. My trousers were draped over my arm and there I stood - above the waist a jacket, shirt, tie, and below, undershorts with my brace and me more exposed than usual. With barely a glance the attendant announced my presence and called for the staff to appear.

Still another shock awaited me. There were five men: one missing an arm and a leg, one on crutches, one with a withered arm, and off to the side a husky man, who carried in his arms a co-worker. Part of the hubbub was now clear to me, the people with pieces of paper going back and forth had been carrying messages and order forms. For the past several hours I had been not only at a rehabilitation center, but at a sheltered workshop.

I thanked everyone, proudly pointed to my brace and even shook my leg as if to indicate its regained strength. They smiled, giggled and left. I finished dressing and looked around. And there to one side were my WHO colleagues. I was glad to see them and glad to leave. I was sure that I was fleeing something, but I didn't know what. Perhaps I felt guilty that I could leave and that, in a sense, these people could not? Guilty even that I felt quite restored to normal society, even whole again. Without knowing my thoughts, my companions reaffirmed this with an Americanism, "You look as good as new." I was uncomfortably elated with his cliche. As we walked to the car, they asked, almost perfunctorily, about the care I received. When I said "Fine," they asked no more and went on to talk about the next stop on our itinerary.

Like the opening words of greeting a week ago, my three hour experience was to them just another piece of information, just another incident in their busy day, recorded and quickly forgotten. But not for me, not for me.

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