Sex, Drugs, and Public Health

May 20, 2013


Filed under: Uncategorized — cbmosher @ 3:53 am

That deep into Louisiana, the air you breathe is liquid insects. The humid chittering slimes your skin. And after a while, you forget your vibrating eardrums, to relinquish yourself to the incessant vibrato that cocoons you everywhere.

You walk slowly across a lawn beneath the dripping oaks. The hanging moss whispers over your hair. Grass sprawls everywhere. You see only two man-made things: a rusting horse drawn harrow that’s been a lawn decoration for decades, and plantation-era whitewashed buildings to the left, the right, and straight ahead, all staring at each other with the blank look of sphinxes.

You came to see Ghosts, but they hide.

Across the road somewhere is a levee. Which is some kind of dike or water filled gully in reality, but in the languid music of the South, is a mythical icon. Maybe you’ll go see it some afternoon.

You stare at the whitewashed sphinxes: if the Ghosts won’t come out, you’re going in.

“Are you Dr. Mosher? They tol’ us you’d be comin’. Welcome to Carville. Ah’m going’ to ophthalmology clinic. Come along.”

And you follow her white coat as she leads you down corridors of squeaky wood past dozens of silent doors. You are girded, expecting to be startled by Apparitions around each corner. But each turn just reveals another silent corridor.

“Here we are,” she announces at just another door. She opens it. She in her long white coat and you in your sweat-impregnated shirt enter. The room is quiet and, like everything else, white. People in long white coats murmur greetings.

Finally. The Ghosts.

Three patients sit, awaiting exams, silent. You don’t want to stare, but can’t help it. Not as dramatic as you’d thought, their faces are pale. Their skin is lumpy, immobile and tight. Like masks. You realize how much we depend on that facial skin to show expression. Their lips are thin, stretched taut.

Lastly, you look at their noses. Noses are meant to cover the nares – the dark openings which, paradoxically, are necessary for life yet strike horror if visible. Only one of them has lost his nose architecture. The cartilage has collapsed and his nose caved into his face. His nares flare and contract with each breath. The pink inside of his nose pulses like a reptile’s throat.

“With this disease,” the woman in white begins, “the patients lose sensation. Even on their corneas. So if they get a speck of dust in their eye,” she pulls an ophthalmoscope from her pocket, “or even just an ingrown eyelash, it can scratch and ruin the cornea and there’s no pain to warn you.”

She smiles at a patient as if recognizing a friend, murmurs some comforting words, then begins the exploration of his eyes with her ‘scope.
You watch to see if she touches him – or if she skillfully avoids skin contact without being insulting. You see his hands politely cradled in his lap. Stubby, shortened fingers.

She examines all three, scribbles in their charts, explains a couple of things to you, but doesn’t offer to let you do an exam.

And she doesn’t touch.

They shuffle out of the clinic, into the silent corridors. You haven’t heard one word – one sound from them.

“Come with me to the lab,” she smiles. “We use armadillos.”

Occasional windows in the corridors reveal what you knew they would: deep emerald of grass, the swaying brown of Spanish moss, a pale blue Louisiana sky. If the windows were open, you know what you’d hear.

Then, one window is different. A half dozen people shuffle across the grass moving gradually in the same direction. Their clothes are pastel variants of colors which all feel white.

“It’s lunch time,” your guide explains.

You pass an open door.

“Oh!” your guide stops suddenly. “Let me show you this.”

Inside the room of the open door are many tables at waist height. Papers scattered over all of them. You see a printing press in the corner.

“This is where we write and print ‘The Star’,” she sweeps the room with her right arm. “It goes all over the world to tell people about the disease and our work here. The residents themselves produce it.”

Her face, all its muscles working in perfect harmony, beams.

She leaves the door open while we continue down the corridor.

Behind a door like any of the others, there is sound and movement. The lab has more activity than you’ve seen all morning.

“This bacteria grows at low temperatures,” she explains as you pass cages of armadillos. “It can’t survive at ninety-eight point six, unlike all other human pathogens. That’s why it never goes deep – just the skin. So to study it, we need a lab animal with cool soft tissue.”

She picks up an armadillo as someone would a pet rabbit. It curls into a bowling ball in her hand.

“His foot pad is exactly the right temperature. We grow our cultures of the Mycobacterium there. Now, we’ve got – for the first time in human history – an antibiotic that seems to work.”

She replaces the armadillo in its cage, and you observe: “Maybe someday Carville will be closed?”

She shakes her head slowly. Her moving hair actually makes noise.

“No. All the others may close, even Molokai, but the residents here, they don’t want to live outside. No one out there understands them. Even if they become non-contagious with the new antibiotics, they’ll always be treated as – well, outsiders,” she consciously avoids the obvious word. “They’ll die here,” her soft, pliable lips smile slightly. “This is their home,” her face muscles move to reveal her love for them. “But when they’re gone – when this generation dies off, that will be the end of Carville.”

You walk across the lawn again in the mid afternoon. The air buzzes and drips. You’re the only one visible on the century-old plantation. A car drifts slowly past on the road in the distance.

Maybe you’ll shuffle on over and find out what a levee is.

So you’ll have one thing, this afternoon, that you can understand.

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