4 - Alpha Omega Alpha

HIV- positive, like everyone, paralyzed from the waist
down from a tuberculosis infection in his spine. By the time
Philipo came to us he had already spent months immobilized
in bed, and the sore across his lower back was as large as a
compact disc, and exposed the lower rungs of his spinal column
and his pelvic bones. Every day I clean the dead tissue
away. I almost fainted the first time I did it. I felt the temperature
rise in the room. A bead of sweat gathered on my
forehead and I watched it run down over my eye and gather
again at the end of my nose. I leaned forward, and when that
didn’t feel right I leaned backwards, collapsing onto the bed
behind me where I was able to grab my breath and regain my
composure. Since then I have been able to work quickly and
confidently in tending his wounds—more sores on each hip
also expose the heads and insertion of his femurs.
In the last week, Philipo has begun to regain feeling in his
back. I hoped he would die before it fully returned. His wife
stopped visiting him, his children never came. He looks at
pictures in my National Geographic while I work on him and
he points at things he’s never seen before, places he would
like to go. I like Philipo and I care about him, but we are unable
to speak to each other. Even with his little English, and
my little Nyanja, we are never really connecting with each
other. Even with perfect communication I think I would not
know what to say.
Rearranging bodies in the morgue
I am already dressed so it is easy to slip out of bed and
away from Sarah to head back to the clinic. Philipo doesn’t
weigh anything but he is tall, and even with both of us it is a
little difficult. The nurse helps me move him out of his bed,
across the dirt courtyard, and onto the floor of the morgue.
The women there wail even louder as we walk by with Philipo
wrapped in his own bed sheet. The nurse leaves me and
heads back to the clinic, closing the door behind her, muting
the shrill shrieking from outside and leaving me instead with
the deafening silence of the cooler and its inhabitants.
When I open the bottom drawer I am not surprised to see
the top of a dark head facing me out of the void. The second
drawer is also taken. The third drawer is full. I hate when this
happens. Now I have to reach in and rearrange the bodies.
I have to push one of the bodies up against the side of the
drawer and then I will have to shove in Philipo, a little bit at
a time.
His legs dangle and drag on the floor. Alone with me in the
dim light he feels heavier than he did crossing those hundred
feet. The body already on the drawer rocks over when I am
halfway done and bottlenecks any progress. I practically have
to climb over Philipo to push the other body away, and then
it is a continuous balance to keep the one from overturning
the other. Philipo feels soft, and even a little warm. He smells,
By and about Gabriel Cade
I was raised on a small goat farm in
the mountains of North Carolina where
my father was a family physician and
my mother an ICU nurse. To avoid a
hereditary career in medicine, I dropped out of college
and wandered, walking 2200 miles along the
Appalachian Trail, waiting tables and writing for a
newspaper in Hollywood, climbing rocks and rafting
in New Zealand, and fighting sand fleas and strangers
on “Survivor: Marquesas.” A disjointed collection
of skills and experiences ultimately led to Zambia,
where I worked with my twin sister in a small AIDS
hospice and orphanage. The experiences in Zambia
and other parts of Africa convinced me to return
to finish my undergraduate education and pursue a
medical degree at the University of North Carolina at
Chapel Hill School of Medicine.
well, like Africa, like dirt and work and sunshine and dry
grass and death. He makes the body next to his seem even
more repulsive than usual. It is cold and clammy and stiff, and
smells only like death.
In this moment, I realize that the capacity of the morgue
to comfortably house death has been tied to the capacity of
my own heart to do the same. I realize I am so sick of death.
I am so sick of it. I even try to throw it up, to purge myself of
the aching in the pit of my stomach. I even try to scream. I try
my own wailing to trounce the sorrow and pain around me.
Nothing comes. There’s nothing there. I already feel so emptied
by this work, by this never-ending work. I don’t want to
see any more death. I don’t want to wait for any more patients
to die. I don’t want to be there to help move the body.
Philipo’s legs still stick out of the cooler. It looks grotesque.
I yell at the four bodies. I won’t give them tears, just anger. I
am so angry at them all for dying and leaving me to deal with
their death. I’m angry that when I do sleep I dream of bodies
piled on bodies, and that when I look at patients still alive in
the clinic I can close my eyes and see them dead. I hate that
the dead cling to the inside of my eyelids. I’m so angry that I
can’t do anything to stop it and that, no matter how angry I
get, I will just have to do this again tomorrow night.
When I am home, someday, back in my home in America,
am I going to wake up expecting that rap on my window?
Am I going to sleep again and dream again?
The author’s address is:
118 Milton Avenue
Chapel Hill, North Carolina 27514
E-mail: gcade@med.unc.edu
The Pharos/Spring 2009 15