Leon

I met Daniel Molino in 1987, in Miami. We were waiting for a plane. 

We were medical volunteers assigned to a hospital in Leon, up the coast from Managua. There was a war in Nicaragua then, forgotten now, largely ignored then. I'd signed up to go.

In black slacks and an embroidered guayabera, Molino was standing at the ticket counter of the Honduran airline, waiting for me. Movement people in New York had told me he was returning to Leon after a lecture tour. Molino was a Brooklynite, bluff and blocky, bull necked, big shouldered.  The eyes behind his steel-rimmed glasses opened my fears like a scalpel.

"So, Doc," he said after the introductions, "you ready?"

"I guess," I said, trying to hide behind my brightest Minnesota grin. 

"Christ," said Molino. "You guess." He rolled his eyes, shook his head, put a hand on my shoulder, and then stared into me. "Listen, Doc: you better be damn sure before you get on that plane. You ready?"

"I'm ready," I said, stiffening. Benjamin Linder was just a name to me, but I knew he'd been killed on an aid mission to Nicaragua. "I'm sure."

"All right. Glad to hear it. What's all this shit?" He waved at my luggage.

I told him. I was packed for safari, with two enormous suitcases, one full of clothes, shampoo and soap and toilet paper, film, stationery, a box of pens, needle and thread, and three of Conrad's novels. The other carried eleven cheap stethoscopes, thirty-four boxes of suture nearing their expiration dates, two cases of surgical gloves, Kodachrome teaching slides of female anatomy, textbooks in Spanish, and a Doppler stethoscope, all begged from sympathetic faculty at the medical school where I worked or bought with the proceeds of bake sales.

"Good," said Molino, who himself carried a portable echocardiograph, a case of surgical instruments, and more sterile gloves in a box wrapped up in packing tape. "Of course, compared to what Nicaragua hasn't got, this is nothing." He looked out through the big glass windows and we waited for the plane in silence.

In the air, the stewardess served us in Spanish. We flew past Cuba, stopped in Belize, changed planes in Tegucigalpa. It was the dry season, and everywhere the land looked burnt.

"Why're you doing this?" Molino asked. He glanced at me, then went back to studying the landscape out the scratched window.

I had asked myself that for months. After all, we were flying into a country at war. I knew many answers: because I wanted to ease Nicaraguan suffering and my guilt; because I despised bullies; because I'd grown exasperated with doctors who wore gold Rolexes, drove BMWs, studied the Gentlemen's Quarterly, and voted Republican; because I was sick of aerobicists, televangelists, yuppies, and arbitrageurs; because I needed something to believe in after my wife walked.

"Because I'm pissed," I told Molino.

Molino sat back against his headrest, pushed up his glasses, and rubbed fists into his eyes. "Yeah," he said. "Ain't that how it is."

We descended on Managua just after dusk. The lakes around the city were black pools ringed by a thousand points of light. In the east, mountains faded into night, while the western ocean was indigo darkness, streaked at its rim with the orange of an unseen sun.

We walked off the aircraft into another world, hot, dense, and charged with the roar of jet engines. Inside the terminal children in uniform seemed not soldiers, just boys at play. They lounged against walls in twos and threes, smoked, and stared at the foreigners, their only menace in the muzzles of their guns.

We had arrived four hours late. Our contacts were gone, all the telephones in the terminal out of order, so Molino went out to haggle with taxi drivers. I stood on the sidewalk under palm trees in a stillness broken by the shrieks of tropical birds, the barking of dogs, and truck traffic on the main road. Dirty children fluttered round me like pigeons, holding out their hands for chocolate, chewing gum, and change. One girl, smaller than the rest, hung back.

"What does she want?" I asked when Molino came back.

He went to the girl. Embarrassed, she put her hands over her face.  Molino knelt, touched her elbow, and whispered to her.

"She wants your pen," he called to me.

"My pen?"

He shrugged. "The Sandinistas made education universal," he said, "but they can't make pens by decree. No pen, no school."

I gave the girl the ballpoint in my breast pocket. She stared at it, too thrilled to thank me till Molino reminded her. After that, all the others wanted pens. We gave out what we had handy until Molino dragged me to the taxi.

A star fracture filled the windshield of the dusty Chevy. The side windows were broken out, which was good, since the tailpipe was holed.  Exhaust and engine noise filled the car. We sped up the carretera. Our one headlight played on the skeletons of derelict skyscrapers and on long grass where barrios had been before earthquake and revolution had erased them. 

I shrank into the ripped vinyl seat. "Where are we?" I asked Molino.

"Damned if I know," he said.

Our hotel was on an unmarked street. We humped our bags up to our room. I fell onto the narrow mattress beneath the open window in my clothes. Molino sat up, writing in a composition book by the lamp on the bedside table while innumerable insects screamed outside the screens. 

When I woke, Molino was gone. I showered and dressed and went outside. The air, cool with a breeze that rustled the palmettos, smelled of cooking fires and tropic flowers. Roosters crowed. Children shouted. 

In the hotel dining room, Molino sat with a lean brunette and a stack of papers. I joined them.

"Sleep well?" Molino asked.

"Like the dead," I said

"You are resurrected," the woman said in accented English, smiling.  Molino introduced us: Rachel, our liaison with the Health Ministry.

"Mucho gusto," she said, taking my hand. "How are you?"

"Nervous," I admitted.

"Don't be. Everyone in Leon is looking forward to your visit."

I nodded, bit my lip.

"You do not fear the war? The fighting these days is all up in the mountains. Where you are going is quite dull."

I looked at Molino. "Don't worry," he said. "She's half right: you'll be safe, but it's not dull." He put a hand on my arm, and I felt my throat relax. "Just focus on your work."

So we talked of postpartum infection rates and perinatal mortality, drug shortages and education while two young men in white shirts and navy pants brought coffee and fruit -- papayas, melon, bananas, pineapple with plates of white cheese and rice and red beans. An old woman swept stray leaves off the far side of the patio. A tethered parrot flapped rainbow wings. A girl came round with a pitcher of hot milk that we used to cut the coffee's darkness until it was gone and our plans were made. 

In the marketplace where the intercity cabs left for Leon, we stood for an hour in the sun. It grew hot. Molino bought a paper from a vendor.  Over his shoulder, I read news of the war: mobilizations, atrocities, casualties.  When we came to the front of the line, we pushed into a dented Ford with six other people. For three hours we rode along the two-lane road to Leon crushed close together, with our irreplaceable medical gear tied with scraps of twine under the open trunk lid. The driver flirted with the three young women in the front seat as we swerved among the potholes. 

We drove out of the city into tawny hills. Dust drifted over everything.  Humpbacked cattle and sunburnt herders on bony horses looked up as we passed. All along the road, people walked: men in broken shoes, women with loads on their heads, barefoot children. Clusters of low houses stood among leafless trees, surrounded by fences made of branches and scrap lumber. Ash blew from charred fields.

Traffic was heavy. Trucks rumbled along, some loaded with cartons under lashed tarps, others with young men standing and holding onto cattlebars.  We passed army trucks with their canvas tops down to let the wind cool the many soldiers they carried. One of our girls rolled down her window and shouted to them. The boys hooted and waved.

"The war," sighed Molino in answer to my question. "There isn't any war, only killing. The Contra come down out of Honduras, burn a co-op, shoot a teacher, mine a road. They hit clinics, health posts, medical auxiliaries.  The army goes on the chase. There's a firefight. The Contra fade back to Honduras. In a week or a day or a month, they start again."

In Leon, the heavy masonry of crowded houses shaded the narrow streets. Dropping passengers, our taxi wound all about, past the plaza, past the cathedral, down a long hill by the hospital. We went by an old man driving an oxcart down a rutted alley and a legless youth in an olive fatigue blouse struggling to get his wheelchair up a cobbled lane. We turned twice and then again and got out in front of a whitewashed bungalow. 

I stared at the pockmarks in the stucco. Molino took my arm and pulled me inside. "Ancient history," he said. I tried to act reassured. 

He showed me where I was to sleep, a whitewashed cell with walls bare but for a black cockroach squashed behind the door. The steel bed held a stained mattress. A bare bulb hung overhead, with crates against one wall as bookshelves. While I unpacked, Molino went into the kitchen to make coffee.

"I got sugar but no milk yet," he called. "I'll go to the market after we check in at the hospital."

I sipped his sweet and bitter brew on the patio in back of the house, where a masonry wall enclosed a couple of dry acacias, a few agave plants, brown bits of lawn. In one corner of the wall grew an enormous banyan tree, gnarled and contorted by the heat, whose thick leaves shaded all the open space. Beyond the walls, sparrows chirped. Otherwise, the city was quiet.

When my mug was empty, I washed my face and we went out, staying to the shaded side of the street. On the walls of the houses I read red and black graffiti: political slogans, anti-American slurs.

A crowd jammed the hospital lobby. Guards in plaid shirts and jeans with pistols in their belts stopped us at the door. They knew Molino, and he introduced me. They marched us down a long hall hung with black and red banners and heroic photographs of Sandino. We went into an office and sat on a bench, passing time in a desultory conversation I was too tired to take part in or understand. I shook many hands.

At last our contact came, a woman, a leader in the hospital union, dressed in white with black shoes. Behind the mascara, she was quite pretty. Her name was Marina.

"How do you say your name?" she asked. I told her. People in the room smiled to each other. She gave me a piece of paper.

"Write it down," she said. I did. She pronounced it slowly and very incorrectly. "What a name," she said with a smile.

"It's Greek," I told her.

"Ah," she said, "Greek. We don't see many Greeks here. Germans and Dutch and Swedish quite a few, but not many Greeks."

"It's not such a strange name," a stocky woman behind a desk said in Spanish. "You should try to speak a Russian name. Strange, like those people."

Many papers were filled out and stamped. I was given a pass and a meal ticket. Molino said something to Marina too fast for me to follow and then clapped my shoulder.

"All right, Doc. Don't worry. Work hard, and you'll be fine. I'll meet you at six."

"Good," I said.

"Right. Well, buena suerte."

"Thanks," I said.

Marina and I went up some stairs.

"Dr. Molino says you speak Spanish?"

"Enough, I believe," I said in Spanish.

"Good. We speak in Spanish, then. Where you will be working, few know English, except to read."

We turned into the office of the chief of gynecology and obstetrics, a mustached guy about my age. His window looked out on trees in a courtyard, where children in oversized pajamas played. From behind a desk covered with papers and used carbons, he stood to shake my hand. His name was Guzman. I gave him the things that I had brought. He thanked me effusively for the textbooks. He held the slides up to the window. 

"Beautiful," he said.

"Thank you."

He passed them to Marina and sighed. "But we have no bulb for our projector since 1983. Every year, we request, but . . ." He held up an empty hand.

I told him I was sorry. My ears burned. He asked me where I came from.

"Minneapolis," I told him.

"Minneapolis," he said. I could see that meant nothing to him. "In what state is that?"

"Minnesota," I said, but that was no help either.

"Oh, Minnesota," he said. "Good, very good." We sat through a long pause. "You have children?"

"No," I said.

"A wife?"

"No."

"And how long will you be staying in Leon?"

"Three months."

"Three months. Very good. We have many internacionalistas who come here, but not many stay so long. It is not always easy for them. This is your first time in Leon?"

"My first time in Nicaragua."

"Ah. You will see, it is not like -- how did you call it? Minnesota?"

"Yes. No, I have seen already that this is not Minnesota."

"And how did you come to decide to visit us here? Do you know people in Leon?"

"No. During my residency, I was a member of an international aid group in solidarity with the Nicaraguan people. When I finished, I was directed to Leon by our coordinators in New York."

Guzman glanced at Marina, his eyebrows lifted.

"You have finished residency? Few who come have done so much.  What do you do when you return to North America?"

"I will be a junior professor at a university in Chicago."

"Chicago? I know Chicago. I am honored to have a professor from Chicago to visit us in Leon. What class of work would it please you to do here?"

"I am at your service. I would like to work wherever there is need."

He shook his head for Marina.

"There is need everywhere," he sighed. Then he brightened. "But you will see. It is not so bad. We do what we can." He stood up and put out his hand. "It is not Minnesota, but it is not so bad."

Marina and I went out. In the halls and stairwells hung many posters.  "Do not throw garbage in our hospital," said one. "The duty of the revolutionary mother is to breastfeed," exhorted another. I saw black and red stencils of the flag of the Frente, on each a date and a name.

"What are these?" I asked Marina.

She did not break stride. "They are memorials to the martyrs of the revolution."

We passed scores of them, solitary ones taped up in lost corners, others stacked four high down long walls. Made of colored construction paper, some had already begun to fade, but many were as fresh as yesterday. 

Three women and a young man sat at desk on the labor ward. They all tried saying my name, shaking their heads and smiling apologetically.  Once more, I shook hands all around. Marina introduced me to a blond woman in a short white coat.

"This is Flor," said Marina. "She is a resident in the third year. She will show you how things are done here."

After a while, I figured out how Flor ran her ward. It had the familiar feel of any obstetric suite. Flor had two interns and three nurses. The patients, in torn gowns, labored on rows of narrow beds with rubber pads.  There were seven women. More came in every hour. There were no fetal monitors, no ultrasound machines, no trays for epidural anesthesia. There were no screens between the beds. Rubber gloves were kept in a steel jar, to throw into a basin when used, to be taken downstairs and re-sterilized. 

Birth is a mystery no doctor comprehends. In Nicaragua, it was not hidden under sterile drapes, since there were no drapes to spare. Instead, it was baptized with alcohol. The mothers lay back on a vinyl table pad and pushed their children into the doctors' hands.

Just before the baby's head burst out, the intern cut an episiotomy.  "That's a big wound," I said to Flor, who was watching her intern with me.

"We will close it," she said with a shrug. "If we did not cut like that, the flesh would tear, and she would never heal. These women, you know, are all campesinas. They don't eat well, and they don't heal well. Before the revolution, they had their babies at home. They had all sorts of complications: fistulas, hemorrhages, infections. Now we do what we can for them, and they do not die so often anymore."

The child was a boy. The nurse dried him and wrapped him in a heavy swaddling cloth. She put him on a shelf while she helped the intern to suture the wound. The baby looked about and smacked his lips while his mother, flat on her back with her legs in the air, told him how beautiful he was.

Flor took me on a tour of her floor. In a private room a woman lay very still under a clean sheet. Only her eyes moved when we came in. She had been admitted the day before, six weeks from term, in labor. With treatment, her contractions had weakened but had not stopped. 

"And what will happen if the baby is born now?" I asked.

"He will die," said Flor, speaking in English so the mother would not understand.

She sat on the side of the bed with her hand on the woman's abdomen.

"How goes it?" she asked, switching back to Spanish.

The woman shrugged.

"And the pains?"

"Less and less. What do you think?"

"I think that we will see. God willing, you will have a baby who will trouble you for many years to come."

We went out and sat again behind the desk.

"You have no respirators for premature babies?" I asked.

"We have two," said Flor. She made a face. "Both are broken, and there is no money for new parts. Even if there were money, we could not get parts because of your embargo. And if we could get parts, we have no engineer to repair the machines. We do what we can."

The residents all were members of the Frente, since without the revoution they would never have had a chance at medical school. They remembered the dictator and his overthrow. As teenagers, some had fought against the Guardia. Still, they wanted to learn about America. Most of them knew people who had gone there. Some had family in Miami sending dollars home. They asked about game shows and soap operas, the A's and the Braves, the lengths of skirts and the names of rock bands.  They were all very nice to me, except the pediatrics resident. When he came to carry a baby to the nursery, he heard that I was on the ward. He walked over to me and told me at length what he thought of my country. 

Flor interrupted him. The young man looked at his scuffed brown shoes. "He is a guest," she reminded him. He mumbled an apology and stalked away with the child in his arms.

"Pay him no attention," Marina said.

"No?"

She pursed her lips. "He forgets his manners. You must forgive him.  His brother was killed in the mountains last month. He is very bitter."

I wanted to run after him, to tell him I was sorry. But the hospital was a maze, and I was afraid.

One of the interns was helping a woman out of bed. She held her belly, her face twisted up in pain. She looked at me and staggered. 

"Ay!" she cried. "Ayúdame, Doctor. Help me."

I took her free arm, supporting her. "Where are we going?" I asked Flor.

"To the delivery room," she answered. "It is her time." She must have seen my eyebrows rise. "Well, but she cannot have the baby in the bed."

"Claro," I told her. "But where I come from, we have beds with wheels. The women need not walk with such pain."

"Beds with wheels," Flor repeated. "What a thing."

The woman pushed for two hours. Nothing.

"You have no vacuum extractor?" I asked Flor, though I knew. "No forceps?" She shook her head. "Your hands?"

She held them up. "Too small," she said.

I put on gloves. The child's head was jammed diagonally against the pelvic bones, but it turned against my palm.

"Push," I told the woman. She looked up to God, then lifted her head and bore down. The baby moved. I lifted my wrist. "Cut," I told the intern. He did. The infant fell into my hands.

"A girl," I said.

"Pobrecita," sighed the woman.

The baby hung in my hands, lifeless and blue, but when I tickled her feet she bawled. I passed her to the intern. I went to the sink. Where it had soaked through the cotton gown, I washed from my skin the blood of Nicaragua.

At six, Molino met me. "So," he said. "You do smile." He put an arm around my shoulder.

"Nicaragua is a strange country," I explained, waving at the women, the residents, and the delivery tables, "but here, on Labor and Delivery, is home."

At a little place up the street, five dollars worth of Nicaraguan cor - dobas bought beer and a big meal. The beer was yeasty, the flanked beef tough, and the fried snapper stared at us while we picked its bones, but it was a good end to the day. We sat together and watched the light fade out of the sky. Molino told me stories of the hopeful early days of the revolution, before the war had blighted everything.

I woke to the sound of gunshots, pops punctuated by automatic rifle bursts. They came from close by and went off into the distance and returned. I lay in bed, frozen, waiting for screams, explosions, breaking glass. The third time the gunfire came round, I got up.

Molino sat at the kitchen table, barefoot in scrub pants and a white teeshirt with the sleeves torn off, hunched over an atlas of trauma surgery and a mug of coffee.

"Want some?" he asked, pushing up his glasses to rub his eyes.

"Sure," I said. He poured me a cup.

"It's just the muchachos," he said. "Sometimes it's a provocation sets them off, or a saboteur. Sometimes it's nothing. Boys with guns. You'll get used to it."

"No way," I said.

But I did. One night, waiting for the spare oxygen bottle so we could start a cesarean section on a toxemic woman who'd been convulsing for a very long time, I lay on a mattress in the residents quarters and watched a red stream of tracer fire lick up into the hills. The fear had gone; I could only think how beautiful it was.

I got used to many things. To cold showers. To the nausea that came from taking antibiotics every day against turista and chloroquine every week against malaria. To the water shutting off on Tuesdays and the electricity going off at random. To the hospital ration that always left me pinched and hungry: rice and beans, plantains, reconstituted milk that tasted of chalk, one boiled egg twice a week.

I got used to walking each day through the plaza, where shuttered shops and the cathedral overlooked the square. There, in the cool of early morning, an old man swept paths under the dusty leaves of low trees with a broom made of twigs. He wore a white goatee and a straw cowboy hat with a rolled brim. We said good morning to each other every time we met; he was too old to address me in the new form as comrade, so we hailed each other as señor. I bought the party newspaper from an old woman who worked under the eaves of the cathedral and read it as I walked down the short hill to the hospital.

Some things I could not get used to.

A woman passed out in the emergency room one afternoon when all the regular faculty had left for the day. It took almost an hour to get her into surgery. She was young, with skin the rich color of wet earth and hair in an Indian braid like a skein of black silk. She was very beautiful, but by the time we found the ectopic pregnancy among all the clots in her abdomen, she was dead.

The residents had seen it coming. They filed out and went off to work on the living. I sat alone against the wall of the operating room with the naked, open corpse. After a long time, two young men came to take away the body while an old woman mopped blood off the floor. I wandered away.

Molino was working at a beer on the patio. I flopped down in the dirt beneath the banyan tree.

"Want a drink?" he asked.

"No," I said.

"Eat yet?"

"No."

"Want to talk about it?"

I told him. I felt entirely spent. "What a waste," I said. I was close to tears. Molino came over and knelt by me. He put his palm over my eyes.  The skin of his hand was cool and soft from many scrubbings, healer's hands. I felt all the anger and despair run out.

"It happens," he said softly. "It happens to everybody. It's hell, and it happens all the time in this damn country. Just remember why you came."

I got up and slumped into a chair. Molino brought me an icy beer and a plate of gallo pinto. In the morning we went back to work.

We bought our food in the public market, a warren of narrow stalls with corrugated steel ceilings. The place was full of smells: coffee, sugar, cheese, plantains, citrus, unrefrigerated meat, and the crowd. Old men sold sheets of lottery tickets. Kids hawked newspapers. Women sat behind iron carts that held skewered meat over charcoal fires. Drunks slept on curbstones.  Lank yellow dogs nosed about in piles of garbage. We met other Americans there and compared tales of the little victories of our days. 

One Friday night, the residents took me to a bar across town. Seven of us piled into a Fiat while two sat in the open windows. We wound our way over the cobbled streets, past huge open spaces littered with dry grass and rubble, neighborhoods that the dictator had bombed during the uprising, hundreds of ruined homes that had never been rebuilt. The bar was one dim room with an icebox and a grill, rank with the odors of grease and disinfectant. We went through to the back and sat under a pleasant arbor draped with Christmas lights and saints' figurines. A turkey cock strutted among the tables. We washed away the heat of the long week with white rum and Coke from tall glasses full of ice that the waiter had broken up with a pick. At first, the residents were quiet, but they mixed strong drinks, and by dusk they were singing. Marina stood up and recited lyrics by Darío, the national poet. I was too drunk by then to pick out the words, but these Nicaraguans' awe at the sad, gentle sound of her voice and the soft rhythms of the lines brought down on me a peacefulness I had not felt since leaving the prairies of Minnesota.

I was dead asleep and a little hung over when Molino burst into my room. I woke in a panic, then remembered where I was.

"What is it?"

"I need you to come to the hospital with me," he said.

"What, now?"

"Now."

"What time is it?"

"Doesn't matter. Get dressed."

We jogged to the hospital behind a kid in sandals, the local paging system when the phones were out. We ran through dark halls and up the stairs. There were people milling around outside the operating suite.  Molino had me change into scrubs, and we joined the crowd.

In the mountains, a truck carrying schoolchildren to a rally had hit a mine. It had taken half the night to get them to the hospital. Two kids were dead and several merely frightened and bruised, but many had been badly hurt. Surgical residents were working on them. Pretty children with round Indian eyes lay silent and dazed until someone touched their wounds and burns. Then they screamed, and their screams echoed all through the hospital.

"Ho!" Molino roared to me over the noise, waving at the chaos. "Your tax dollars at work!"

People shouted to be heard above the crying children, cursing the lack of bandages and suture. I stood against a wall. Molino spoke to an older man with a large mustache. Then he came over to me.

"We can only run two operating rooms at a time," he said. "Rivas will work one with a resident while you and I handle the other and the rest of the residents do what they can out here."

We scrubbed and put on masks and gloves and long green gowns. In the operating room, a girl lay asleep on the table with an anesthetic tube in her mouth. She looked about thirteen, her breasts just starting to bud. Her left leg was mangled below the knee, the foot attached only by a white strip of tendon. Her thigh was broken, with a deep wound where the bone had broken through. In her belly, a long gash oozed blood.

Molino slopped iodine over her, and then we draped her and went to work. He opened her belly from breastbone to mons and washed out blood and stool and bits of bowel. I retracted the edges of the incision while he worked, cut his sutures, and listened to him roaring out curses against our homeland.

Molino had marvellous hands. I have seen many surgeons work, but none like him. His hands moved too quickly for me to follow, clamping, cutting, stitching. He swore at me for my clumsiness. He took out the spleen and lacerated segments of intestine, sewed up two anastomoses, then left the resident to sew up the incision while he probed the wound in her leg and packed it with gauze. There was nothing to do about the foot. He cut it off with one snip of heavy scissors and pitched it into a basin. Then he made a clean amputation above and set the femur.

Between operations, slimy with sweat, I had only enough time to drink a glass of tepid water and piss into a broken toilet. The next case was a boy with a simple chest wound far from the heart. Molino resected a piece of lung. By the time he was finished, the daytime residents had come in.  In the end, we saved all the children but three.

Molino left. I sat with the obstetrics residents until I fell asleep in a rocking chair. When I woke, they sent me home.

Outside, the sun was blinding, the sky an incandescent blue. Molino got up when I came in, took a half empty liter bottle of dark Flor de Caña rum from the kitchen, and brought it out to me on the patio.

"You all right?" he asked.

I stared at the clay colored walls, dazzling in the light. My body felt pounded. I shrugged. Molino massaged my neck, then gave me the bottle.  "You need some sleep," he said. "Me, too. Besides, you'll like this."

The night's adrenaline dissolved in the heat and the first smooth, sweet taste of the liquor. After half an hour, the disgust and hatred I'd carried from the hospital receded. We sat without speaking and drank until the rum was gone. As I lay between the knees of the big banyan tree, the flies around my face buzzed me to sleep.

As my three months wound down, Molino took me in to surgery more and more. There was another hospital for military casualties, but we took in many of the civilian victims of the war. We tried to reassemble children from the campo who had come upon explosives in their play. When we crossed the hospital courtyard on our way out at quitting time, our little amputees used to come stumping up to us on their crutches, calling out Molino's name. He gave them sugar candy.

There were days when it seemed that my tour would never end, days when I couldn't understand what anyone said to me, days when laboring women bled and babies died despite the Yankee tricks I tried to teach, days when Molino worked through the night without me and I lay on my back all alone on the dry grass below the patio watching the stars whirl round my loneliness. But then suddenly, too soon, my time was up. In its little way, the pilot project Guzman and I had done to show the effectiveness of amoxicillin in preventing post-cesarean infections had changed the habits of the hospital. The residents threw a party. Marina gave me a kiss and a union button. Guzman gave a big speech about the importance to the women and infants of Nicaragua of international solidarity and the valued teaching of an esteemed colleague.

Molino found a Brit named Harris who was driving to Managua overnight on business. We three went together, the broken road unwinding faster and faster under the Land Rover. Harris left us at Rachel's office for my debriefing and evaluation. We picked up mail for me to drop in the States, bypassing the useless Nicaraguan postal system we knew and the FBI censors we suspected.

We met Harris again at a bar in the Hotel Intercontinental. We sat until midnight, eating steaks and drinking Dutch beer until all my cordobas were gone. We left a huge, worthless pile of the blue and red bills on the table by the pool and wandered around the devastated center of the city.  We went to several bars that Molino knew, shouting ‘vivas' for the revolution, the Frente, and ourselves. In the streets, bored sentries put aside their weapons to drink with us to the patria.

We put Harris to bed around four. Dawn found Molino and me sitting on the curb outside Sandino Airport. When the place opened, we got up and stood in a long line with refugees lugging trunks and boxes. 

"I'll be back," I promised when the airline people opened the doors to the departure gate.

Molino squinted past me to the robin's-egg rim of sky. "Won't be anything to come back to," he said. He shaded his eyes with his hand.  "The government can't pay for the war and the promises it's made. It'll break."

I didn't know how to answer his pessimism, so I hitched up my luggage strap and thanked him. He put his arms around me.

"De nada," he said. "Keep the faith."

I turned in the jet's entryway to wave good-bye, but Molino had already started back to Leon.

My diarrhea went away after the first week; my nightmares lasted longer. In Nicaragua, I had never belonged, but now I felt out of place at home, too. Chicago was big, busy, callous. New colleagues at the university complained to me about mortgages and taxes, disobedient kids, querulous wives, and obstacles along the tenure track: trivia I would not waste sympathy on. I worked with my patients, delivered their babies, did their operations, and tried to forget Molino and Leon. Still, when the evening television carried news from Nicaragua, I turned off the sound and stared at the harsh and beautiful country.

I rejoined my medical aid group. We held unnoticed demonstrations against the war, raised a little money for the Health Ministry, and sat around drinking and telling stories of our days in country. Through them, I arranged another sabbatical in Leon.

I had been gone for two years. There was no fear the second time as I dropped down over the lakes and into Managua on a connecting flight from Costa Rica. I had changed, and so had Nicaragua. The fighting had wound down. Talk of peace filled the newspapers. Peasants fleeing the Contra lived in hovels all over Managua. Malaria and malnutrition, tuberculosis and alcoholism were epidemic. In Masaya the same barrios that had begun the revolution rioted against the draft.

Molino had a pickup truck, and he met me at the airport. We drove to Leon in the dark. He was living with a woman who had come to pick coffee with a tourist brigade and returned soon after as a freelance journalist for the leftist press.

"Keeping busy?" I asked him.

He laughed. "I've been here since '81," he reminded me. "I've taught them everything I know. They don't need me anymore."

"You should be proud."

"Yeah," he said. "I should."

"So you'll go back home?"

"Where? Oh, sure. I been thinking about that. Making plans.

Making plans."

All the residents I had known were gone. Guzman had opened a private practice in Managua, and Marina had been promoted to the central offices of the health workers' union. The hospital was about the same -- the martyrs' memorials gone, the meal ration even smaller -- but I was useless there. I gave talks and was toured all about, but there was nothing for me to teach or to learn.

I'd brought a quart of MacAllan's. We sat up in the old kitchen. The freelancer sucked an unfiltered Camel and blew smoke rings at the dusty bulb.

"You remember how you said it would change?" I asked Molino.

He shrugged. "What would change?" she asked.

"I don't remember," he said.

"Everything," I told her. "The country, the revolution . . ."

"The revolution must be preserved," she quoted from some forgotten propaganda sheet, "by all means necessary."

"Oh, piss," said Molino.

"We are drunk," I observed.

"Astute, Doc," said Molino. "But then, you always were perceptive."

I was supposed to go back again, but the elections came and the government changed. My trip became pointless. Then, too, Molino was gone; I heard that he had met with an accident and finally flown home. At the time, the movement was absorbed by the crisis in Salvador, and no one could remember where he had moved. When I finally found out, I couldn't get away. I didn't see him until the fall.

He was back in Brooklyn. He lived on the fourth floor of an anonymous apartment building, far from the subway stops and any travelled avenue. My Haitian cab driver got lost looking for the place. Molino's sister let me in. He had a room to himself in the back.

"It happened to a hell of a lot of people," he said when he saw the shock in my face. "I should know."

I sat down hard in the chair by the window, suddenly and entirely deflated.

"But my God, man . . . " I started to say. He cut me off.

"No," he insisted. "It happened to thousands. Why should we be immune?"

He told me his story. He had left the demoralization in Leon to tour the boondocks with the journalist. She was searching out the last embers of the war; he was translating. One day they came on a hamlet in a ravine.  Smoke rose from the shells of houses. Dead cattle lay in the rutted road.  In the ruins, he found a woman's body. When he touched her to see if she were dead, the boobytrap beneath exploded.

The journalist drove him back to Leon. Nothing vital had been injured, but although they worked for many hours, Molino's old friends in surgery had been unable to save his right hand and eye.

I told him that his eyepatch was dashing. He joked that the mechanical claw would keep junkies and muggers at bay.

I stayed with him for three days. I took him all over the city -- into museums, nice restaurants, and crowded places. In the end, there was nothing I could do.

Stewart Massad, M.D.
Obstetrics & Gynecology
Third Place, Prose