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Authors: Anthony Flacco

Tags: #BIOGRAPHY & AUTOBIOGRAPHY/Medical

Tiny Dancer (14 page)

BOOK: Tiny Dancer
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At that point neither Peter nor Rebecca could stay out of the picture any longer. They invited the host family to bring Zubaida over for another weekend stay, to try to see for themselves what the situation really was with her.

Their offer was met with receptive ears. Zubaida was there the next weekend. The moment she and her host mother arrived, it was clear to Rebecca that the tensions were high between the pair; the air between them felt brittle. The woman made no effort to conceal her relief to have a couple of days off. Zubaida appeared so glum and closed down in the host mother’s presence that Rebecca felt a sudden rush of concern over what she was getting herself into.

It was a great relief for her to see how much Zubaida relaxed once again after the host mother was finally gone. The change was almost immediate. By the time Peter got home from the hospital, the two were getting along well. Zubaida had learned a very few words of English, but not enough to be useful in conversation. Without an interpreter, they made a game out of communicating with the same sorts of gestures and non-verbal sounds that everybody uses when they don’t share a language but need to make themselves understood. The process allowed Zubaida as much self-expression as she wanted to use. That seemed to suit her well. The extra energy involved in the most basic acts of communication helped to focus the flighty energies of a girl who was alternately timid and defiant.

For their first outing together, they took her bowling, since the simple sport doesn’t require much conversation. Zubaida was only mildly interested in the challenge of rolling the ball down the wooden lane, but seemed very impressed by the echoing sounds of multiple bowlers rolling out their games and by the mechanical pin changers working like robots. It was her first opportunity to interact with an American pastime in a uniquely Western setting, but the lesson for the couple was that hands-on experience was good for her. In an environment of people who sounded to her like they had motors in their mouths, chugging out whole clouds of nonsense syllables, she began to take real pleasure in just grabbing a big, heavy ball in her hands and rolling it down a long, flat lane to try to knock over some wooden pins.

Zubaida knew for certain that the Taliban would hate to see her out in public playing this big, silly game—plus, she had already turned ten years of age and so was expected to spend most of her life hiding indoors from now on, and this knowledge gave any noisy public sport a lot of extra appeal to her.

The next day, Peter and Rebecca drove her out to a small public beach set inside of a Malibu cove, to play in the waves that break on the curved spit of sand which forms the horseshoe-shaped beach. Zubaida seemed to open up and drink in the environment. She splashed in the surf and ran around in the sand with them, while Peter and Rebecca delighted in seeing her come to life and jump around like any other kid. It was clear the sheer physicality of the activity was good for her after the long convalescence. They felt like they were watching an entire section of her healing process taking place in a single afternoon, as if some strong force that had been invisibly accumulating inside of her and only needed some invisible element contained in the waves or perhaps the seashore air in order for it all to be released. Watching her run and twist and leap on the sand, it was easy to forget for a second or two that the little girl they were playing with was unlike any other.

By the end of that day, though, Rebecca was already beginning to pick up a number of disturbing signs—little things—clues to what might have been going on at the host family’s house. The more comfortable that Zubaida became in their presence, the more that the pleasant artifice of manners tended to occasionally slip for a moment or two. A simple point of conflict such as, “Can we walk in this direction?” “No, we need to go the other way,” could be greeted with the same sort of petulant face and slump in body language that could be typical of many girls her age, but it was hard not to notice that for some time following any point of minor conflict, Zubaida seemed to be struck by a whole series of little inspirations about how to best provoke annoyance in anyone who happened to be around. Little bits of mischief began to stream out of her, and they were frequently pushed a few notches too far.

There was nothing endearing about it. Passive hostility became the main presence in the room. It wasn’t enough to lessen Rebecca’s desire to spend more time with Zubaida, but it was easy to imagine how destructive such generally defiant behavior could be—especially if it got ramped up a few more levels, the way the hosts had described it.

That didn’t change the fact that after Zubaida went back to her host family, Peter and Rebecca both talked of how satisfying they found the brief experience as surrogate parents. They were trying to have a child of their own, and their frustration up to that point only served to sharpen their appreciation for having a child around. Both realized that Zubaida’s visits had likely been just as good for them as for her.

All of that made it a much more daunting prospect to have to sit by and idly pray that things didn’t blow up over at the host family’s house. They had seen her capacity for asserting her will by provoking annoyed reactions, but they were unaware of anything that appeared to be genuinely dangerous to her or anyone else.

They wondered, could the hosts be exaggerating? And if they were telling the truth, could it be that they had somehow provoked these responses from Zubaida themselves, perhaps without even realizing it?

As usual when so many different points of view are involved, it was vitally important to determine the truth and nearly impossible to find it.

Chapter Six

Zubaida’s first surgery for
the month of October was on Monday the 7th. At the same time that she was going under general anesthesia, the Associated Press released a text copy of the speech that President George W. Bush would be making later that day at the Cincinnati Museum Center in Cincinnati, Ohio. The speech contained every one of the justifications for a massive pre-emptive strike inside of Iraq which would later become the familiar hot buttons of national and international punditry. The repercussions of the speech would remain long after the date itself was forgotten.

Off into the distant future, worldwide debate continued to flare over how to best use military force in coping with the human condition.

* * *

Peter Grossman began the surgical session of October 7th with a series of multiple steroid injections throughout Zubaida’s face, neck, and both sides of her body, to help break down existing scar tissue and prevent it from thickening the way it had done in those first months after her burn.

There was a sizable, tight scar remaining under one side of Zubaida’s jaw that was still preventing full movement. When he cut the binding scar tissue away from her neck, the open wound that remained required sixty square centimeters of skin to seal it. The area would be temporarily covered with that special type of split-thickness graft called a homograft, made from processed cadaver skin. The Grossman’s clinic routinely carries quantities sufficient to completely graft a large male adult. But since these grafts can’t take life in the patient’s body, they are only good as temporary measures to allow the patient to recover some strength before enduring the process of donating their own skin. The same sixty square centimeters of homograft that the skin bank could easily supply from its stock would soon have to be replaced with an identically sized piece of living tissue from one of the few unscarred areas still left on her body.

The subtlety of the day’s work culminated in the work to her chin, underneath the vermilion border of the lip on both the left and right sides. He carefully traced the outlines of each lip, cutting away any binding scarification, then reconstructed the tissue using a “Z-plasty,” one of the powerfully effective tools of reconstructive surgery.

Since any cut leaves a straight scar whose stiffness will resist stretching from both sides, a Z-plasty allows that principal to cancel itself out by re-cutting the line of a scar into a relaxed “Z” shape. In this way the natural pull from the skin will be distributed all along the “Z,” allowing much more natural movement of the surrounding flesh. The depth, the angle and the size of the “Z” have everything to do with what that living surface will look like in six months, in a year, in ten years. Errors in such choices would be measured in millimeters.

This is the part of medicine that challenges Peter Grossman the most, the one that raises his pulse the highest. Whether he was working on the little girl whose life he had brought so far into his own, or on some total stranger who has just been pulled from the back of an ambulance, the surgeon leaves the body’s moment to moment, three-dimensional well being to his attendant colleagues while he occupies the fourth dimension of time in order to visualize every cut for its long term effect.

Everything went as hoped and expected that day, so Zubaida stayed at the hospital; she was scheduled to be back for the second round of this set of procedures in three days. It was much easier to assure that he dressings were maintained in a sealed and clean condition under constant care. Dr. Peter had noticed that since Zubaida’s last procedures, nearly two weeks before, she seemed to be filled with a nearly compulsive need to hum or sometimes sing out loud and even dance her body around despite her limited range of movement, so he made it a point to wrap her with extra thick gauze and asked the nurses to do whatever they could to keep her still so that the grafts stayed clean.

That afternoon, after Zubaida was awake enough for a conversation in the recovery room, he gave her the same caution about not wiggling around to music and stretching her new skin grafts, using simple words and gestures to make his point. Her gaze detached from his and fixed on some point far away while she murmured a generic “okay” that could have meant anything.

* * *

On October 10, 2002: Senator Bob Graham of Florida made a floor statement on the pending resolution to use massive military force against Iraq. He quoted Winston Churchill for his response to the Iraqi Resolution: “I close with the words spoken in one of the darkest periods of history of the Western World, in 1941, by Winston Churchill: ‘Never, never, never believe [that] any war will be smooth and easy, or that anyone who embarks on the strange voyage can measure the tides and hurricanes he will encounter. The statesman who yields to war fever must realize that once the signal is given, he is no longer the master of policy but the slave of unforeseeable and uncontrollable events.’” Senator Graham vehemently protested the Iraqi Resolution as not being a strong enough use of military force to gain control of the human condition.

* * *

On that same day, Zubaida went back under general anesthesia so that Peter Grossman and his team could replace the cadaver skin temporary grafts with an equal amount of full-thickness grafts from the inside of her thigh. There was enough unscarred skin there to get the needed sixty square centimeters of donor skin, but since the donor site’s skin would also have to be replaced, the surgical wound would be covered by a split-thickness graft from her own body, so that it could incorporate into her skin even though it would never stretch like the surrounding tissue. He swabbed the finalized surgical wounds with a mesh dressing impregnated with a solution called “Scarlet Red.”

Scarlet Red is a user-friendly name for a synthesized organic dye that Dr. Peter would be applying liberally on Zubaida’s donor graft sites. Scarlet Red has been in widespread use for over fifty years by the mainstream medical community as a topical antiseptic and for its known power to speed healing for many types of burns, even though no one is sure exactly how—or even why—the bright red organic dye works the way that it does.

Experiments on the thin red liquid have shown it to have the power to stimulate the proliferation of new cells in an injured area, and it has also been used to enhance the speed of wound healing. Since Scarlet Red shares most of its chemical makeup with more than half of the world’s commercial dyes, the understanding of why it should work when other colors don’t is a dissertation topic looking for a doctoral student.

Scarlet Red is also picky about where it spreads its power—a different kind of organic dye will have the same antiseptic and healing effect on a slightly different type of wound. Medical dictionaries can list the various shades of organic dye one after another, noting the particular types of injuries for which each one is prescribed, with no specific explanation as to how Scarlet Red or any of the other dyes work.

The concept of using of an organic dye as a wound-healing substance may go back much, much farther than the fifty years it has been recognized in mainstream medicine. And so it was in that bright red topical elixir that
modern Western medical touched fingertips for a moment with the impoverished clinics of an ancient nomad culture—who also rub their patients’ wounds with ointments whose power they can’t explain.

* * *

The cultural laws mixed into Zubaida’s blood and impressed onto her view of the world were clear in telling her that adults around her represented the Law. Of course, that wasn’t supposed to hold true with the Others, but she was alone among them now and they seemed to be in charge of every aspect of her existence, so whether it was right or wrong, the adults around her also represented some sort of law. It was law because they had authority and she did not.

They explained things to her, so many things, over and over again, as if the words of their own laws had any meaning to her other than as the pronouncements that the adults made about what was to happen to her next. Her hosts could communicate with her in a language that she could now understand fairly well, but which still sounded foreign to her ears. In the hospital or at her hosts’ home, most of what was said to her didn’t seem to mean anything much, whether it was perfectly translated or not. All the adults around her, all of the cold and impersonal adults around her, tried so hard to be friendly and only succeeded in looking like strangers trying hard to appear friendly. It was consoling sometimes, but other times sent a cold shiver of warning up her back.

BOOK: Tiny Dancer
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