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The Strength of Bone

Autor Lucie Wilk
en Limba Engleză Paperback – 14 oct 2013
An Amazon.ca Best Book of 2013: Top 100/Editors' Pick

“A gorgeous debut.”—JOSEPH BOYDEN, author of Through Black Spruce and The Orenda

At the hospital in Blantyre, Malawi, Bryce is learning to predict the worst. Racing heart: infection, probably malaria. He’ll send Iris for saline. Shortness of breath? TB. Another patient rolled to the ward. And the round swellings, the rashes with dimpled centres, the small rough patches on a boy’s foot? HIV. Iris will make him comfortable. They’ll move on.

Then there will be sleeplessness, rationed energy, a censuring of hope: the doctor’s disease. Iris sees that one all the time.

Henry Bryce has come to Blantyre to work off the grief he feels for his old life, but he can’t adjust to the hopelessness that surrounds him. He relies increasingly upon Sister Iris’s steady presence. Yet it’s not until an accident brings them both to a village outpost that Bryce realizes the personal sacrifices Iris has made for her medical training, or that Iris in turn comes to fathom the depth of Henry’s loss.

The Strength of Bone is the story of a Western doctor, a Malawian nurse, and the crises that push both of them to the brink of collapse. With biting emotion and a pathological eye for detail, novelist and medical doctor Lucie Wilk demonstrates how, in a place where knowledge can frustrate as often as it heals, true strength requires the flexibility to let go.

Advance Praise for The Strength of Bone

“In supple, beautiful prose, Lucie Wilk recounts a doctor’s struggle with technology and faith, and with the mysteries of death and love … The Strength of Bone is an extraordinary look at the clash of worlds.”—ANNABEL LYON, author of The Golden Mean and The Sweet Girl

Lucie Wilk grew up in Toronto and completed her medical training in Vancouver. Her short fiction has been nominated for the McClelland & Stewart Journey Prize Anthology, longlisted for a CBC Canada Writes literary prize, and has appeared in Descant, Prairie Fire and Shortfire Press. She is working toward an MFA in Creative Writing at the University of British Columbia. She practices medicine and lives with her husband and two children in London, UK.
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Specificații

ISBN-13: 9781927428399
ISBN-10: 1927428394
Pagini: 309
Dimensiuni: 140 x 216 x 18 mm
Greutate: 0.45 kg
Editura: BIBLIOASIS
Locul publicării:Canada

Recenzii

"Wilk aptly captures the bleakness of medical crises in Africa … [her] prose never entirely relinquishes its rational edge, and so many of the tensions which move the story remain necessarily unresolved. This is a book honest in its brutality, though brightened by hopeful sparks.”—ForeWord

“Absorbing and finely crafted … Wilk enthralls the reader in smooth and unsparing prose as her starry-eyed protagonist learns the hard way that sometimes acceptance is the only way forward.”—Minneapolis Star Tribune

"Masterfully literary."—The National Post

“If you suppose [The Strength of Bone] is a love story across racial and political lines, you’re underestimating the inventiveness and grace of Lucie Wilk’s meditative debut. Wilk instead works with what is unspoken, hinted at, and left to the imagination … anything but typical.”—Kamal Al-Solaylee, Quill & Quire

"Wilk illuminates the differences between Malawian culture and that of the West while capturing both the fever-dream beauty and desperation of the country … Readers who enjoyed Abraham Verghese’s Cutting for Stone may want to give this book a try."—Library Journal

"Deeply felt but never sentimental, thoughtful but not preachy, Lucie Wilk's first novel, The Strength of Bone, delivers strong characters involved in a page-turning plot. Imagery drawn from African and Canadian settings, and also from the world of medicine, enriches the novel throughout. A memorable story."—Cynthia Flood, 49th Shelf

"A lyrical debut novel."—CultMontreal

"Detailed, unique and undeniably human."—The Gauntlet

Notă biografică

Lucie Wilk grew up in Toronto, completed her medical training in Vancouver, and now makes London, England her home. Her short fiction has been nominated for the McClelland & Stewart Journey Prize Anthology, long-listed for a CBC Canada Writes literary prize, and appeared in Descant, Prairie Fire and Shortfire Press. She is working towards an MFA in Creative Writing at the University of British Columbia. She practices medicine and lives with her husband and two children in London, UK.

Extras

From Part 1, Chapter 2

Jakob rises from where he had been sitting, helping to shell peas in a group of his aunties. It is women’s work, but he enjoys it. He likes listening to the women talk and sing. He easily moves from groups of men to women, boys to girls, children to adults. His foot buys him entry. If he is honest with himself, he will admit to exaggerating the limp as he approaches a group of girls, he will bask in their sympathetic sounds. With the boys, he hides the limp, walks as smoothly and normally as possible with a foot that is like a clenched fist, on a leg that is too short. He has a foot like a horse, he has been told. But he keeps up, or nearly does. He runs on it, even kicks a football around with it. And the boys respond in as supportive a way as they can muster: they allow him to stay.

He walks over from the group of aunties to where his mother sits, looking drawn and tired, massaging her lower leg with her thumb. She has positioned herself near the well, and Jakob knows this means she wants him to fetch some water. He nods at the people he passes along the way and receives broad smiles in return.

Jakob’s foot may be like a horse but his face resembles something less earth-bound. His aunties used to hold him by the chin, turn his face this way and that, try to isolate the angelic ingredient. “It’s not that he’s handsome, exactly,” they would say to each other, “but there’s something honest about it. Open and honest. Clear like a lake.” And then they would let him go, watch him wend his way through the community, nearly an orphan (his mother was his last living close relative, and God knew she was on her way to join Him soon) yet such a part of everyone, and everyone wanting a part of him, somehow.

His mother calls him aliyense for this; everyone. He is everyone to her: son, brother, daughter, sister. He has to be, for he, like no one else he knows, has no siblings and no father. His mother lost her womb after delivering him. She delivered him and then a river of blood that wouldn’t stop flowing. Eventually, she had to be taken to the hospital on the hill where they cut the bleeding womb out of her. They stitched her up and sent her home with her newborn, her only child with his strange and twisted foot. Soon after this Jakob’s father died from an illness of the blood, although the sing’anga had another opinion. And since then Jakob has tried to fill those roles, as many roles as stars in the sky, it sometimes seems.

Now he crouches down over his mother’s foot and unwraps the bandage around it. The odour of the wound grows as he uncovers the flesh, the bandage soaked with mangy fluid from the wound and coloured milky yellow, brown, and green in parts. The wounded area has been expanding and the flesh itself is looking more chewed up each time he uncovers it to cleanse it. It looks like a beast has been gnawing on it. And the smell is getting worse. He dabs at it with a wet cloth, wipes off the thick substance collected within it. Underneath there is a clean, pure white spot. He tries not to look at that spot; seeing the skeleton of a person still alive seems a bad omen. He takes a clean cloth and wraps it up again.

Earlier today Jakob saw a man at the market. He was walking along the other side of the road from where Jakob sat with his cousins, selling their carvings. Jakob was kneeling beside some Chief’s Chairs, rich mahogany slabs of carved wood that fit together to make a low and impractical seat that tourists love. The crowd shifted between them and for a moment he lost sight of the man across the road. His cousin beside him said: “He’s not a tourist. He’s one of the new doctors at the hospital.” Jakob watched the man as he dodged the crowd, his head tucked down, his neck flushed and damp, his mouth wide and flat.

“Look at his hair,” he said.

“Like a tomato.”

“Brighter than that. Like some kind of metal. Or fire.” How could you describe that hair? Brassy and loud as the marching band he’d seen once celebrating some other people’s victory.

“Maybe he has feathers on his head,” his cousin laughed and resumed his carving, chipping away chunks of wood with delicate taps on the chisel. “Anyway, there’s no point bothering with him. These doctors only buy when they’re about to leave.”
Jakob watched the doctor make his way down the lane and eventually he and his red hair disappeared from view.

Now, looking at his mother’s leg, Jakob thinks of this doctor. This is the type of man who should be looking after his mother. This is the type of man - he is sure of it - who could save her. A man like that.
“We should go to the hospital,” he says.

He has said it before and each time she always shook her head and replied: “They will take it. They will take off my foot like they took out my womb.” Then she would go to where her money was stored, pull out a few kwatcha, and instruct him to go to their local sing’anga, a secretive and strange man who lives alone and prefers to keep himself and his home in shadows. Also, he has a reputation for being dishonest. Jakob hated handing the money over to him which he took quickly and with dirty fingers, throwing back at Jakob a bundle of herbs. “Boil them in water. Put them on the foot.” Then he’d turn away, light up a cigarette, tuck Jakob’s mother’s money into a pocket of his silty grey trousers.

And now, when his mother does not reply, he says it again. He thinks of the doctor in the market and says it again. If necessary, he will remind her that their savings, gathered kwatcha by kwatcha from years of his father’s work in the tea fields, are gone. Into the pockets of the sing’anga. They have nothing left to spend. But he does not have to remind her because this time his mother nods.


Jakob has seen the hospital from the outside, but has never ventured inside. Except, of course, when he was carried in and out as a newborn. Even the doors are huge, much bigger than they need to be. They force him to stagger to pull them open. Perhaps this is the test: if you haven’t enough strength to move the doors, then you shouldn’t bother coming in at all. But Jakob manages to get one of them open and holds it open for his mother whose grip on him is weakening. Together, they struggle into the dim entranceway.

A man at a kiosk in the foyer glances up at them and then gestures wordlessly, points to somewhere further into the building. They make their way down the corridor. Having now entered this place, Jakob understands why his mother did not want to come back here. The size of the entrance is bigger than the church, bigger than the entire marketplace near their home. And then there are the people in purposeful-looking uniforms who bustle past them. And the endless branching corridors and gaping rooms they pass filled with beds. Filled with bodies. Everything here seems important. This place feels bigger, more powerful, and capable of more miracles than the Church of St. Michael and All Angels which they attend every Sunday.

The long journey to get here - almost a full day’s walk from the outskirts of town - has taken its toll. His mother struggles to walk now, and leans heavily against him, eyes closed. Her cheekbones seem to have grown sharper just over the day. She breaths rapidly through her mouth.

They are waved on to three different kiosks at the ends of three different hallways before a nurse, after looking at them unhappily from the other side of her desk, finally rises from her chair, comes round to where they stand and fastens a plastic band on his mother’s thin wrist with something scribbled on it in pen. His mother’s name. Jakob recognises some of the letters, symbols he had learned once, years ago, before he stopped attending school. The nurse is wrapping something around the upper part of his mother’s arm. It puffs up and then wheezes out air. She scribbles something on a piece of paper. She tells Jakob to take his mother to the end of the hallway, where there should be a place to sit on the floor. Jakob rouses his mother and they make their way down the corridor, choose the next empty space, sit down and wait.

***

There have been no miracles in the time they’ve been here at the hospital. Not for Jakob’s mother, nor for any of the other men, women and children who line its halls, fill its beds and floors. Jakob had not expected anything; he does not know what it is to have an expectation, to feel that something good must happen. But he does know hope, and he’d hung a lot of it over the doorway of this place, even before his mother became ill. Maybe because he knew the hospital had saved his mother when he was a baby, thus rescuing him from the responsibility of her death so soon after she gave him life. Maybe it was the influence of the strong and powerful who created this place, who named it after their queen. Perhaps it was the name itself: The Queen Elizabeth Hospital, like it were guarded by royalty. Over the years as he grew up, every time he passed the building, or glimpsed it through the trees up on the hill, he had felt a stirring of hope, like it safeguarded the chance of a better future behind its walls.

But since arriving here, the future has taken on the long, narrow and dark dimensions of the corridors in this place. The doctor - Kumwembe is his name - knelt down and grimly studied his mother’s foot the first day. He tsked as he held the heel and ignored her wincing as he turned and lifted it so he could see the wound in the waning light that came through the window above them. A nurse had then come to tunnel a tube beneath the skin of his mother’s arm, and a bag of clear, clean liquid now hangs above them, slowly emptying into her. When she has to go to the toilet, Jakob takes care to move the pole alongside her and he guards the lengths of tubing to not disturb the flow of the precious liquid. But each time the doctor checked her foot he tsked again, shook his head, muttered under his breath that it was not responding, not responding. It was then that they met Dr. Ellison.

The big, white doctor filled the hallway. He bent his head slightly and Jakob could see where the thin yellow hairs sprouted from his shiny red scalp. This was a surgeon. A man who used knives to cure and Jakob couldn’t help feel his mother’s fear of his knife, where it might land. After looking at Jakob’s mother’s foot from his great height, he squatted down and pointed his red, thick finger at her lower leg, above the wound. He traced a line across the leg with his finger. His nail left a white line in her scaly skin.

“Right here,” he said as he traced. “OK?”

Jakob watched his mother when the doctor touched her leg, but her eyes were closed. He wondered if she’d understood. When he told her in Chichewa that she would, indeed, lose her foot, she just nodded, eyes still closed. He’d looked up at Dr. Ellison and nodded. “Yes, OK,” he heard himself say.
He hoped his mother hadn’t heard him give permission.

It wasn’t very long after he said those words - yes, OK - that they came to take his mother away. They brought a gurney for her. He helped her up onto it from where she had spent so many days slumped against the wall in the hallway; they had never made it into a ward. But now she would earn a place on a bed and the price of admission was her foot. She lay on the gurney and opened her eyes once to look up at the ceiling before closing them again. His mother had spent most of her hours in the hospital - awake or asleep - with her eyes closed. Jakob squeezed her hand once and whispered, “God willing, you will be safe, Mama,” before they wheeled her away.

When Jakob’s mother is returned from the surgical suites, he follows her squeaking gurney down the hall to a new room - one of the expansive rooms that she will occupy with a sea of others who have shared a taste of the surgeon’s knife. She is groggy. A thin sheet is draped over her and Jakob can see where her right leg ends too soon, lacking the tented rise of a foot beyond it. It looks just like he had feared it would.

His mother finds his face with eyes that are cloudy and confused. “My foot.” She says to him.

“Yes, Mama.”

“Is it safe?”

He hesitates only briefly. “Yes, Mama.”

He wonders if she had asked this of the doctors when she lost her womb. A womb is easier to lie about, hidden as it is inside the body. He squeezes her hand and watches her drift off again.

***

Jakob’s mother has teebee. It is in the lungs. This was the reason for the cough she’d had for as long as he could remember. It had been living in her foot, too. He is going to be checked for it and they will both need treatment. They will both need to stay here for a long time.

Dr. Kumwembe explains this to them in Chichewa so his mother can understand, too. The only English word he uses is teebee. He lifts his arm and points down the long hallway.

“The teebee ward is that way,” he says. “Down the main hall, left at the junction, at the end of that hall. You’ll see the sign.” He assumes that Jakob can read. This flatters Jakob and he wishes he could show the doctor that his assumption is right. He is determined not to get lost on the way to the teebee ward.

As he leads his mother down the hallway to the ward, pushing her in the wheelchair a nurse found for them, Jakob thinks of his aunties and cousins and friends back home. The two of them have been in the hospital for many days, and now they will be here much longer. The treatment requires taking medicine every day for many months. He pushes his mother easily up the slope of the hallway. She is very light and pushing her takes no effort at all. She has lost a lot of weight since arriving here.

He nods to a group of orderlies who loiter at one end of the hall. They wave back. There are familiar faces as he moves down the hallway, now. There are smiles, nods, knowing looks. He is not sure if this lightness has always been here, or whether the cloud had only recently lifted. But gradually he is starting to recognise within the wards and halls what he’d felt when he viewed the hospital from the outside: that feeling of something better.

He sees the letters on the sign and knows them right away: TB. So this will be their new home. He pushes his mother’s chair into the ward.

Descriere

Culture-shocked Western doctors, nurses alienated from their villages, undersupplied hospitals, a 10% AIDS rate: how does African medical practice endure?