I didn’t have much time to dwell on the journey. I got out of the boat, found the other Doctor Nicole, and quickly presented her case. She told me right away that this girl had to go to hospital. Just hearing that reassured me greatly. It calmed a lot of the existential angst that I had garnered on the boat about our due diligence in a time of crisis. I chucked my phone into a bowl of rice, now dead to the world, and took the company iPhone before I hopped back in the boat with Jack. We were heading straight for Bocas in the pouring rain, to deliver our patient to hospital.

After arriving, we docked, all got into a taxi together, and were presenting at the emergency room within fifteen minutes. I did all the talking, and told them who I was. When the triage nurse heard I was with Floating Doctors, her demeanor changed. I had their respect already. Nobody even asked me for ID. I told them our patient had a four day history of vaginal discharge and bleeding, a fever and extreme pain on palpation of the abdomen; a fairly alarming presentation, especially in the way I phrased it. We were told to wait until the ED doctor was ready. Our patient took a seat and did what teenagers do: pulled out her phone. She looked like she was doing okay. In the spare minute I called the boss.

I explained to him her case, the exam findings, and our journey through the canal. ‘I might almost say that I was scared. I’ve never felt that as an adult before.’ I said \making light of it, as is my usual coping mechanism when I experience grief. Dr LaBrot understood right away what I had lived through like no other. His own story and experiences had given him an understanding of what it was like to be in my position. He had probably suffered the same emotions more times than one.

                ‘This type of medicine is crazy.’ He said.  ‘There are no words to explain it. We could sit down for hours, and unless you’ve lived it for yourself, there’s just no way that you can understand.’

He was right, and probably didn’t realise that he was debriefing me from the most intense experience of my life. I felt it then already, like I was a different man. I understood that some things would never be the same for me. I had learned something about myself and about this trade. Crazy is a good word, I might prefer bat-shit insane. His words took a lot of weight off of my shoulders. He put things into perspective. We talked about it for a moment, and I almost let emotion get the best of me through the phone. I told him that I really wasn’t sure if I had made the right decision. He told me not to dwell. Whatever happens next doesn’t matter; based on the information that I had, it was the right decision. I gave myself a little credit when considering how many other physicians had been in my position.

                ‘How many Profs at The College of Surgeons do you think have sailed through open water with an acute abdomen in the back?’ I said to him. We both laughed.

Our chat was cut short, as the ED doc had come out to collect our patient. I followed them both inside, to nobody’s disagreement. The ED doc brought her into the first room on the left, just inside the door, and asked me what was going on. I presented the case and fumbled my words. I repeated myself, crossed from presentation to medical history to exam and back again. It was a bonafide mess, the type that would probably get me torn to pieces on my final med exams. He treated me with respect despite my incompetency. He then turned to the girl, and asked how she was doing. She didn’t answer. He pressed her again. Again she didn’t answer.

                ‘I can’t help you unless you talk’ he said, seeming annoyed. She still wasn’t answering, maybe shy, maybe due to fear, I can’t say. It wasn’t uncommon to get those kinds of empty eyes in clinic from the Ngäbe. Sometimes it’s almost like they’re ignoring you. You need to give them time to speak. I do it because I know I have to, and because I don’t want to be rude, but if it was my own kid who looked at me like a mime without an answer after I asked a simple question I’d probably get frustrated too. This doc didn’t seem bountiful with patience. He got her up on the bed, and then Mom came in with some documents from her previous stay in hospital, with the c-section and neonatal death. The papers were soaking wet, and he commented on that as well. He then asked her about sexual contact, something she denied.

                ‘Come on’ he said. ‘You were pregnant once right? How did you get pregnant?’ He turned to the mom ‘Really?’ he said. Then he felt her abdomen. She wasn’t wincing, I saw none of the clawing and moaning that I had gotten just three hours earlier. I didn’t really know what to make of that, my mind resembling wet cardboard in functionality. Maybe this guy was onto to something, this was all an exaggeration, and I had just been duped. ‘I have to call the gynecologist now.’ He said. ‘We’re going to have to do a speculum. We’re going to have to get an ultrasound…’

When he asked her to get down from the bed she moved slowly ‘Yes you’re in pain, we know we know’ he said. He was really sassing up a storm. He put her in a wheelchair and turned to wheel her up the hospital, but first stopped and turned to me. ‘Okay. She’ll get seen. We’ll take things on. You can go about your ways now. Thanks for bringing her’.

Just like that the door closed in front of me. The whole exchanged happened so fast, I barely registered what had happened. I went back outside and talked to Jack. ‘That’s it’ I said to him. I didn’t know what else to say. We were free to go. I didn’t know what to think or feel about the doctor, about the girl and her seeming recovery before my eyes. I was still in a funk, and figured I would leave all the contemplation for tomorrow.

A quick word with mom and we grabbed a cab to the boat taxi outpost, stopping for fried chicken on the way. The boat taxis, charged us double ‘The water is too rough’ they said. He was right. I had crossed that bay dozens of times now, and never once did it jar the boat with so much fervor as it did crossing that night. In complete darkness no less.

When the dock came into sight, we saw a flashlight, combing the water, signalling us in. It was Anselmo, the keeper of our lighthouse. He took a good look at me when I stepped onto the dock, and didn’t speak until spoken to. Nothing had to be said; Anselmo knew these waters and knew this job.

                ‘How we doing?’ I said.

                ‘I am well Juan… And you?’ he answered.

                ‘Boy…’ I said ‘Let me tell you something Anselmo. If I didn’t believe in God, I think I do now’

                ‘Of course’ he said with a chuckle. I knew we’d talk more about this later.

I didn’t want to call my parents that night, though I usually would have. I was afraid that I might choke up when speaking, and I didn’t want to worry them. I sent them a message that everything was okay and I was tired. We would talk tomorrow. Tomorrow would be a better.

I slept alright.