Back in the rancho, a shell of a student doctor saw the remaining patients. I was distracted, stressed, and all things in between; it was not my finest work. My mind kept drifting to the girl, and I felt the weight of my decision. I doubted myself at every turn. It’s almost laughable that I had to try and act normal after everything that had just happened. The first patient I saw was a lady in her forties.
‘My back hurts’ she said.
Of course your f*cking back hurts, I thought to myself.
She turned out to have a sore back and newly discovered hypertension, with a systolic blood pressure in the 180s. She was prescribed a 5mg tablet of amlodipine and given some paracetamol for her pain. I wondered if my pressure readings might show something similar. The next lady I saw brought me a little girl, a chichi aged one year and nine months. She was very cute and curious, playing with a bottle of vitamins and oogling around with baby eyes, soaking up her surroundings. Mom told me that she was completely well, but couldn’t walk. The baby was just a bit older than eighteen months, when babies should be walking, and I could tell she was totally fine. I sat there and listened to all the details of how her daughter was completely fine in every way, could crawl around just fine and stand up straight while holding onto something. She was the youngest of a lot of children, and often-times there is not much incentive in learning to walk as a result, this was common enough and most people who thought about it long enough could figure it out. I felt like rolling my eyes, but my head nodded with concern, trying its best take her complaint seriously. She was rambling.
‘She cant feel anything in her legs.’ she told me, holding up one of her feet. I thought about how I might prove to her that there was no cause for concern. I took the big toe of her right foot, and I pressed my pen cap into it. I started gently, adding more and more pressure until her face reacted. I had gone too far, and she immediately burst into tears. I probably could have had some more tact, at least explaining what I was about to do. Like I said, not my finest work.
‘Oh no you poor thing’ I said trying to win her back, but to this twenty month old I was already evil incarnate forever. Then I turned to mom. ‘Sorry about that.’ I said ‘Why did you tell me she couldn’t feel anything? I look like such a jerk now!’ I joked. ‘This has me less worried though, as you can see she can feel just fine’.
I tested all her other domains, fine touch, social, verbal, and gross motor as best I could. I told her to give it another three months and we would see her again. I saw one more patient after her that I can’t even remember.
The rain still hadn’t come back, but the sky looked uglier than ever. The wind rattled the walls of the schoolhouse as anxious hands put the last of my things into my bag. I had been so distracted by everything, I hadn’t realised there was a few loose ends still left to tie up, and I caught Jack as he darted across the doorway.
‘What happened to other women?’ I said ‘The ones that told us yesterday they’d be coming back with us. Two of them I think are not urgent, but the other… I think she might have an infected fetus. Is she not here? They said yesterday they would come with us.’
‘I know’ Jack replied. ‘I went to find them while you were seeing the last patients. They don’t want to come. Any of them. Not even the one that we tried to send yesterday’
Fair enough, I thought. Their choice. I had other things to deal with. My mind was moving at such a frantic pace as I packed up all our stuff that I hoped I wasn’t forgetting anything but knew I probably was. Marlon had gone out in the boat with a group of locals to check the status of the canal before giving a final word. It was a tremendous piece of thinking, and it also meant that I had a spare moment to eat, and shaky legs walked me to the kitchen house. The two ladies that cooked for us were waiting for me. I sat down with them and put an end to a bowl full of rice, black beans, and chicken. They asked me if I was married. ‘Not even close’ I said. If I had been, maybe I would thought more carefully about what I was about to embark on.
Once I got down to the dock, the locals were waiting there to see us off. Their faces were oddly somber. One was a young lad, wearing a hat with bright colours. I joked to him about how much I liked it; his face remained stone cold. A few days later Jack would tell me about a conversation he had with one of the village leaders on the shore while we were about to set out. It went something like this:
‘We are going to set out now’ he said to her ‘Thank you for everything’.
‘You shouldn’t’ she answered.
‘What do you mean?’ Jack replied. I imagine his hand flailing to his chest as he said this.
‘I have this feeling… Right here.’ She said as she pointed to her heart ‘This is not good. It is a bad sign. It is the same feeling I had one year ago. My best friend, on a day like this. He sailed out into the sea and died. You should not go.’
Poor Jack. Imagine being him. I am glad he kept that to himself. Of course she was right. What we didn’t know was that the Panamanian coast guard had suspended all maritime operations on the coast that day, the storm ahead was biblical. We had no way to get the message.
We sailed across the back part of the bay to collect the girl for transport to hospital. We pulled into a little dock that lead up into a house on wooden posts, with a straw roof. At first I thought we had the wrong one, but as soon as we touched wood, one by one the natives walked out from behind the house. There was dozens. They walked in complete silence, as if they all thought and moved as one. Nobody said a word. A shifting in their numbers brought out our patient, still hunched over in pain clutching her grandmother. Grandma helped her into the boat, before the mother herself took her place at the edge of the dock. Noiseless arms helped them both into the boat. Mom was a big woman, with a squint in one eye. She was worried sick about her daughter. At the time I didn’t appreciate how worried she was, that knowing what she knew she still climbed into that boat. As we put the propeller in reverse someone broke the silence. They shouted to Marlon.
‘Capitan, como esta el agua? How is the water?’
‘El agua?’ Marlon said. ’We’re gonna try’.
In the back of the bay things started calm. Everyone was still as the propeller pushed us forward, out farther and farther into the broadening stretch of water. The wind blasted across the bow, and the sky in the distance was pure greys, extending in every direction. The waves began to rise. I could see maybe two kilometres in the distance the two ends of the bay, before it opened into the canal de Tigre. The waves grew higher slowly, first once or twice a minute. Marlon angled our bow to hit them perpendicular, as if to cut through. With every contact throwing water up the side of the hull, the wind obliterated it to mist, peppering my face. As we moved forward slowly, every subsequent wave brought us higher, and dropped us farther. The drops were now become sharp, thudding us down into the trough. The trauma of it rattled my jaw. I worried about the girl behind me, and a quick look over my shoulder showed intense pain written or her face. Then the waves started coming faster.
The swells were high and the waves short. Before I even had the chance to realise it we were hitting one after the other, maybe five or six times a minute. The boat rose up and fell back down, sometimes dropping its nose as it did, breaking the riptides of the subsequent wave and splashing water everywhere, into my eyes and in my mouth. I was just waiting for us to go nose first into a wave coming ahead, and be rattled off our axis. I looked at the gear in front of me for anything cup shaped, to bail the water out if it happened. I couldn’t see anything. All I saw was a cooler for our food. Knowing my phone was in my pocket and destined for death, it opened it with one hand quickly and dropped it in. My right hand remained fixed onto the side, and I tried to use my left to wipe the salt out of my eyes, but soon as I covered them we dropped again, and I buckled. I didn’t make that mistake twice. I was getting soaked, and the salt stung terribly, but I kept my eyes open. With my one free hand I put on sunglasses to keep the water out of my eyes. They made no difference.
All of a sudden we were square in the middle of bay, with the coast 700 metres either side of us. The waves were everywhere, like swirling sharks, swelling and breaking in every direction. Point breaks from the two ends of the bay converged with reef breaks below us, and the strength of ocean bolstered by storm made them like aquatic moguls, with our twenty foot boat floating atop them like a piece of paper in the wind. We were absolutely nothing against the power of the water. More water splashed up, water everywhere, with wave after wave battering our sides every ten seconds. The thundering sound of sprays and wind had us deaf. White knuckles gripped the edge of the boat and I felt a profound, nearly cosmic sense of duty. I was jacked up. More water in my face. I could barely see. The waves kept getting rougher, getting bigger, and coming faster. I began to feel that gnawing, crippling voice inside my head, that seed of doubt equal parts uncertainty and panic: Did we made the wrong decision?
I have an acute abdomen behind me, in a twenty foot boat, crossing the most perilous canal on this coast in the middle of a storm. What have I done to her? The sheer trauma jarred us up and down like ragdolls. She has a previous pelvic surgery, and all that scar tissue breaking down in the context of her infection—what if she launches a clot right now? Will she bleed out right here in this boat and die by our hands? Would it have been a better decision to listen to the locals, to wait until tomorrow? I thought about our crew. Jack, Iraida, Marlon, and me, we were all in our twenties. I asked myself if someone older, wiser and more seasoned would have made a different choice. Have I just put all our lives at risk? I felt a lump form in my throat. I kept telling myself I didn’t make the call alone, ‘we made the choice as a team’ I kept saying internally. I had to believe that some part of had been thinking, doing the cost benefit analysis and made the right appraisal. This girl was really sick, she needed a hospital. The reality in front of me was dark however: if this boat tips over, both her and her mother are dead. Plain and simple. Maybe not not just them either.
My grip tightened further and my jaw clenched down. Somewhere deep I felt fragments of thought circulating. If they die, what happens to me? Am I insured for this? Do the Ngäbe sue? These notions were present, I know I had them, but they felt far away, like something stood between us. More water came up into my face, and despite my best attempts, I swallowed and I choked. Each wave brought us up sharply, three or four metres and dropped us like a stone. We were at their mercy. In front me Jack didn’t move, next to me Iraida was made of stone, and behind me the girl and her mother were looking straight down, as if in prayer. One person I didn’t look at was the captain. I didn’t want him to think that I had any shred of doubt.
After half an hour of clawing against the current we were reaching the mouth of the bay. I kept my gaze forward. The waves waging war around us seemed to make less noise. We reached a periodic lull, likely a drop off, and for ten seconds I felt like we were in the clear. Okay, I thought, Jesus Christ. That’s when the huge rollers began.
The point breaks of the bay no longer sheltered us by squashing the Ocean swells. The short, high amplitude waves changed into long, sweeping chasms. They rolled in the distance to my right, one after another like an army in single file, against the mist of floating foam and vaporised salt. They were fucking massive. I felt no evil, only power, raw and unstoppable. Every single one rose like a deity, with a surface pull that brought us forward like a slingshot. I felt Marlon thrust on the propeller, racing to reach the peak before they broke at the top, trying to beat the curl that would knock us over surely. I felt him angle the boat with every adjustment, sometimes surfing the waves and sometimes climbing straight up into them. I looked at the girl behind me and she was now laying flat on the bottom, a better spot for her, although she was getting bathed in water.
I was terrified.
It’s a difficult thing to articulate, what it’s like to feel genuine fear. I know we’ve all been scared, whether it is public speaking, a big test, maybe the odd barfight or contact sport, but I had never felt true fear as an adult. It’s something that I never truly understood as an emotion until now, several days after what I lived on that boat crossing that channel. It amazes me that I am capable of feeling such intense emotions, in every cell of my body, and at the time not understand what it is. I imagine that the Ocean has a brand of fear that is unique to itself, tied intrinsically to what it is to feel meaningless against the void of blue. For a man like me who holds himself to high regard, who believes he forges his own destiny and blazes his own trail, the powerlessness that you feel against the Ocean shakes you to your core. I was grinding my teeth, my forearms were nearly in spasm, and my eyes were bloodshot open. I didn’t want to close them, I wanted to see what I was facing, and even though it burned like hell it didn’t matter. I choked on it, the water and my fear, and although I didn’t cry, I welled up. I told myself I was in control, and maybe I was, but something from inside me was exploding in all directions, emanating from my fingertips. In that moment I had no awareness, I was so sucked in that it’s only with retrospect that I understand what I felt. It was fear, the most primal, raw, rendition of it that must exist in man. Anyone who has felt fear like that has my respect.
An hour of that intensity feels like an eternity, and once we finally passed the canal, the skies dropped their load on us. By the grace of someone up above, it only started once the ocean settled. If that rain would have hit us just thirty minutes earlier in the canal, we were dead men sailing, I can almost guarantee it. Visibility came down to maybe 200 metres either direction. The rain was sharp, and cold as ice. It hurt my face, and I picked my hat up off the ground behind me and passed to our patient’s mom to hold over her face. We stayed close enough to shore that we could see it and rumbled forward.
Cold snaps came and went as the microclimates formed by the islands shocked us and we swerved in and out of bays on the way home. We finally reached a point after nearly two hours of sailing, that I felt comfortable to speak. I turned to Iraida and said something about the cold. She nodded and gave me a smile. I felt reassured. The girl behind me was still crippled in pain, but she was at least sitting up now. Finally, the sailboat in front of base came into view. We docked without a word, and I got up immediately, our job only half done. My phone was floating in water inside the cooler when I opened it. I turned to the girl and her mother, asked how they were doing. Mom looked at me with a cheeky grin.
‘You should have told me and I would have brought a tarp to keep us dry’
