Opposing Forces Transcript
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I was about to graduate from dental school when I told my mother that I had been assigned to do my residency at a hospital in a small town in Colombia, called Neva. My mother was really upset. It was 1992, I was 21 years old, and we lived in Bogota, Colombia. This was the Colombia of Pablo Escobar, of government corruption and assassinations, of daily kidnappings and bombings, of paramilitary groups in massacres. It was also the Colombia of the FARC, the oldest guerrilla movement in modern history. It was also Columbia, where these wars between opposing forces became normal to us. You hear a loud noise like when a car backfires and you went down to the ground, you waited, you got up, you dusted off, and you moved on.
My mother called my father, who at the time lived in Granada, another very violent town in Colombia. My father came to the phone and asked me if I was scared, and I said, “Yes.” He said, “You know, mija, you know how I live here in Granada, you know how dangerous it is? You know how violent it is? And you know why I stay? Because if the good people don't stay and serve, then the bad people take over. So, you go where you're being called to serve, and you help those who need you the most. Just be smart, be careful, and call your mother.”
And with that, I went to Neva, and I arrived one April afternoon at this hospital and my first impression was that it was overcrowded and underfunded. But also, that there were plenty of people helping it stay afloat. My daily work at the hospital began at 7:00 AM. I did the round with the resident physicians, and then I went and took care of my outpatients until 5:00 PM. My focus is strictly in general dentistry, taking one patient every 15 minutes and two short breaks during the day. At night and on the weekends, I would be on call at the emergency room for any emergencies that dealt with superficial injuries above the neck. That's how I learned how to put noses, eyelids, and ears back on people.
The room where I lived at the hospital during the residency faced this roof terrace, that I quickly came to find out was inhabited by hundreds of bats. At night, I had to sleep with the window open because temperatures rose up to 105 degrees and there was no AC at the hospital. So, I figured that by wrapping myself in a soaking wet beach towel, I could combat the heat and avoid the bats. This, I figured, after I woke up one hot night to the horror of a baby bat sleeping comfortably next to me on my pillow and another one bathing in the glass of water that I had left on top of my night table.
Another one of these hot nights, I went to sleep and the next thing I remember is standing in the room next to a man holding a rifle. I didn't know what time it was. I think it was dark outside, I guess the early hours of the morning. In the dark, I could see another armed person guarding my bedroom door. The man held me by my arm and ordered for me to get dressed and that's when I realized has been pulled out of my beach towel and I was standing in my underwear in front of them. I rushed to look for my uniform in the dark, and while I got dressed, I began to think of my parents and of the stories I had heard of doctors and nurses being kidnapped and taken away. Once dressed I turned to the man, I asked him if I could leave a note for my parents, and he said “no.” He grabbed me by the arm and I was rushed out of the room. We went down this emergency stairwell that was lined with men that were dressed like these two men with these rags wrapping their heads and letting their eyes only visible. I did not look at any of them in the eye. I didn't want them to think that I could remember them, all of them address the man holding me as Commander.
Once we got to the first floor, I realized the rebels had seized the hospital. I was ordered not to speak and go straight to my office. So, I did. We went down this long corridor that led to my office. And the farther away I got, the more hopeless I felt. Once we got to the office, I realized the doorknob had been broken, and inside in the dark, two men awaited. The man holding me said that I had three hours to help him or I will have to come with him. I was terrified. I didn't know what else to ask. So, I ask “who is the patient?” From within the shadows, one of the men turned on a flashlight and revealed a child about 15-years-old, wearing this dirty t-shirt, and broken pants, and soiled boots, and his face completely deformed by an exacerbated abscess, that made the left side of his face look like a water balloon about to burst. The man holding me let me go, but when I approached and tried to touch the child, I felt the pressure of the rifle on my back. And he said, “Can you help us or not?” I said, “Yes, I can.”
We went in, and I told him to sit the child on the chair, but I also told him that I needed to turn on all the instruments and lights, and he agreed, but he told me to warn him about every move that I would make, and I agreed to that. Once inside, I also realized that I was going to need assistance, I needed someone to hold that kid down. I couldn't make him drowsy because I knew they were on foot and they had to leave the hospital on foot. I couldn't give him anesthesia because given the degree of the infection, no anesthesia would catch. So, I was going to have to do this procedure without numbing him and it was going to hurt a lot. I explained this to the Commander, and he signaled to one of his men, who immediately put the rifle on the floor, jumped on top of the kid, straddled him at his thighs, grabbed his arms and held him by the side of his body. So, I had my assistant ready.
I was shaking. I had an idea of what I had to do. I had seen it in books and in numerous live presentations in my oral pathology classes, but I had never done this. This was the first time that I will do this by myself. What I did know though was that I made a mistake in my incision, and I touched the nerve that runs by that area of the face, I could cause paralysis of half of this kid's face for life. I also knew that if this infection progressed, this kid could go into sepsis and die. In the back of my head, I also knew that if the army had been notified that the guerrillas were in the hospital, they could burst in at any moment, and there would be a crossfire, and I would become collateral damage by the end of the morning.
I grabbed the towel and I wet it in cold water, and I rubbed the kid’s forehead with it. He was burning in fever. I didn't want to ask his name. And so, I call him “pilau,” which means kid in the area of Colombia where I come from. I explained to him what I was going to do, and I told him that it was going to hurt a lot, that he could cry and scream, but not bite. That if he wanted me to stop, I would stop and let him rest. He looked up at me, and his little eyes filled with tears and he nodded, and my heart shrunk. This kid was in so much pain, and he was terrified. But so was I. I had a weapon in my back.
I put my protective gear on and wrapped my hand around the child's face to prevent him from hitting me. I prepared the scalpel and a handful of gauze. I took a deep breath. I calculated the position of that nerve inside that bloated balloon of skin, and I made my first incision, slow and careful, and I began to drain. The kid was screaming and twitching in that chair. The greenish-yellow pus came bursting out of his cheek. The man holding him closed his eyes and turned away. The smell was nauseating. The kid’s tears began to roll and I kept draining, but suddenly the kid began to cry uncontrollably, so I had to stop. I reached down for his hand and I held it. It was this small, cold, rough hand and I grabbed it and I told him that he was a brave kid. And he closed his eyes and nodded.
We were both sweating profusely. I went back to draining, and I felt the rifle in my back. Once the inflammation gave in enough, I managed to look into the mouth and I found the culprit. It was a rotten molar. And I had to pull it, it was part of the procedure. I explained this to the Commander, and they agreed. With every piece of tooth that I pull, the screams came along, and with every scream, the barrel of that rifle shook on my back. When the kid couldn't take it anymore, he yelled out, "Ay papa, no mas!" It was then that I felt that pressure strongest than my back. The Commander who had been pointing at me broke his silence and he said, “Almost there, mijo.” I realized whose kid I was cradling in my arms. This was the Commander's son. I couldn't screw this up. I had to do this right.
I went back to draining and squeezing as fast as I could. As I worked, I saw how the relief came on the kid’s face. It was getting late, it was close to dawn, and I had to finish up. So, I finished preparing the wound, and I got up and grabbed some free samples of antibiotics and some medical supplies. I handed them to the Commander and I explained to him how to clean the wound. And I said he should be fine in two weeks. And that's when he said, “I hope so, doctora, because I don't want to come back and you don't want to come where we're going.”
I was terrified. He ordered the kid off the chair and he got up immediately. They circled around me and began to walk away behind me to the door. I felt the pressure of the rifle off my back, and I closed my eyes and I prayed to God that he wouldn't shoot me right there. Then I heard him from the door when he said that if I didn't move or speak for at least a half an hour, I would be okay. I nodded. Then, I heard the door close. When I opened my eyes, I looked at my hands and the kid’s blood was drying on my latex gloves and inside, my hands were drenched with sweat.
For the following two weeks, I was cold. I didn't want to eat. Everything made me nauseous. I didn't want to answer any questions about the incident. I didn't even tell my parents. I continue to take care of my out-patients, but every time one walked in, I would fear it would be the kid. And then one day, I was at my office and the phone rang, it was from the front desk. They said I had a package. I was so scared but I went. When I got to the front desk, the girl said, “A man stopped and left you this note and that. And so I inched toward the desk to look and I found a sack of oranges with a live chicken tied to it.
I opened the envelope and pulled out the note, and in almost illegible writing, it said, “The pilau is okay, doctora. No need to come back. Gracias.” I felt some kind of awkward relief, but I put the note back, and I put it back in my uniform and I went back to work. Later that night, I went to my room and I climbed out of the window onto the roof terrace. I could hear the bats flapping their wings in the air. I didn't care. I brought the note and matches with me, and I pulled it out and I burned it. I burnt it because it reminded me of how scared I had been that night, of how frightened I had been for the last two weeks. But I also burnt it because I felt that it connected me to the bad guys. And then I thought, “Well, what bad guys? This was a sick child.” And the bad guys in Colombia, in the 90s, who knew who the bad guys and the good guys were? Nobody knew. We were all just people caught in this war, these battle of warlords that nobody knew how to stop. That to this day, as you know we're trying to stop. These people that had come to me in search of help, they were just people with mothers and fathers and toothaches, capable of hating and loving and gratitude amidst all this violence, capable too of killing and hurting and kidnapping. And yet, this father had risked his life that day for his son, like my own father would, and he had respected my life.
I thought about my father's words about serving the people. So, I've come to think that in times of war, it's very hard to tell who the good people and the bad people are. And if you're gifted with the opportunity of helping another human being, especially in times of war, you do it, because that's who you serve, not a faction, not a party, not a cause, but the people. So, the next night I volunteered at the ER, and I went down again to help the people of Neva. Thank you.