Here is a truth: I can’t feel. I’m not allowed to feel; to feel risks the possibility of falling and I can’t fall when we are surviving. I have to conserve energy. Hold on for the girls, for Mike. Hold on for sanity’s sake. I need sanity in order to survive. Feeling? Ha! What a concept!

    – Mission journal entry, October 1994, Barrio El Trompillo, Venezuela

The story begins when I have returned, returned to the States. Each time I look in the mirror I see an old woman, gray haired, stooped, small, in a faded housedress from the fifties with flabby arms, sunbaked. This is me, an old tired woman with two children, aged five and one. That is the odd part. The children are there and I know I must raise them but I am old and I also know that I am ready to die, willing to die if it is my time. That is how long I have been living, an eternity. The mirror reflects this, only the mirror. Everyone else sees a thirty-six-year-old woman. But I do not see her. I lost her a long time ago.

Dengue; Venezuela 1995

The silvered roach darts out from between the gray mosquito netting and beelines its way toward Mary’s plump arm lying motionless against the sweat-stained sheet.

I stretch to flick it away but cannot manage the distance. I lie sideways, flattened to the sheet, Mary upon my nipple, her weak lips sucking intermittently. She is flushed, hot, feverish—we sweat as one. The heat pouring down from the sun-scorched, corrugated metal roof bakes us together.

The roach scatters up on her forearm. I lurch, repelled by its brashness, and Mary whines. It runs faster than I can smack it and darts back down into the crevices of the netting.

Mary’s fever rages 102, 103, 104 degrees. I cannot keep her cool. The fan motions hot dusted air upon us. The wet rag feels heated, dry.

I call to Emma. She takes the rag, dips it into the pan of lukewarm water, squeezes with her tiny five-year-old muscles and hands it, dripping, back to me. We wait for Mary to sleep.

Pulling my nipple out, I slip myself away from her. Tiny droplets of sweat lie across her pursed lip.

She has dengue.

Each day we awake, dress, climb into the gray dust-covered jeep and make our way through the barrio, out into the main thoroughfare and into town twenty miles, to the clinic. We wait in line one, two, three hours until it is our turn for Mary to have her blood drawn. She screams in weak, muffled sobs, her eyes suddenly wide, then drooping, her fever sapping any strength she may have. They tell us yesterday's readings: her platelets are stabilizing. We remain on the outpatient list. She is on the mend. She is only weak.

For ten days we follow the same routine. We arrive home. She suckles, sweats, suckles, and sleeps. There is no urine output. I am engorged. Still they say she is on the mend.

On the tenth day they give her a clean bill of health. We have “beat the dengue,” they say. Mary is still weak.

We are given metoclopramide to combat nausea and vomiting. “Dale tres gotas cada cuatro horas hasta que deje de vomitar.” Give her three drops every four hours until she stops vomiting.

I administer the tres gotas and lay next to Mary as she sleeps. She does not awaken through the night. A first. I sense she is on the mend.

I arise early. Mike will watch the girls. It is my turn to climb the hill to meet with the catechists. It is Saturday and classes are at nine. The children will be coming. I focus on the task ahead. Children ask about Mary. Word has spread.

We are like the plague, ourselves and one other family with a four-year-old. Dengue has reached our homes and everyone is glad they live up the hill and not near us. Dengue kills. Already, this year, five babies under the age of one have died in our state of Lara, Venezuela. Mary is ten months old. It is mid-January.

In a trance I finish my work, descend the dust-caked hill. The sun beats down, relentless. When I arrive home Mike is holding Mary. She is listless, her head arched back. He says she has not wakened today: “She can’t wake up.”

I grab her and we rush her next door. Maria, the neighborhood healer, the one who administers shots and diagnoses fevers, chills, and colds, who prescribes herbs and aspirins, looks at her. She needs a doctor she says. She needs a doctor now.

Maria offers her phone, one of five phones in the barrio. She places a call to the hospital. She talks to someone and explains the circumstances. Get her in right now. Come quickly, they say.

I hold Mary. Emma sits in back. Mike winds his way through the barrio, onto the thoroughfare, into town. We park and carry our little Mary in.

A nurse takes her from me and puts her on a gurney. For the first time I realize that Mary’s back, too, is arched, like rigor mortis. Her head lunged backward, the whites of her eyes visible, her pupils drawn toward the back of her head. They look into her eyes. I find a way to hold on, to hold my baby while they work around her. She is stiff and does not move. She does not cry.

A doctor appears.

He asks, “What does she have?’

“Dengue.”

“What have you given her?”

Tres gotas de metoclopramide.”

“How did you administer it?”

“In her mouth.”

“Direct in her mouth?” he asks.

“Yes direct.”

“Why?” he snaps. “It is to be placed in her milk. Did they not tell you it is to be placed in her milk?”

“No,” I say, “I did not know.”

“She is having a reaction to the medication,” he says.

I think, All night she has been like this?

“We do not have the antidote here,” he says. “I will call other clinics. You will have to find it. We do not have it here.”

He leaves. I hold on to my stiff little baby. She lies alone upon the gurney and I want to climb up and cuddle her. I want her to awaken and to nurse. She lies motionless. Head lurched back.

The doctor returns with a slip of paper, an address upon it. He turns to Mike. “You must go to get this antidote. We do not have it and your baby needs it.”

Mike searches for directions. He looks into my eyes and holds my hand. He hugs Emma. He kisses Mary’s head. He leaves. We wait.

Within two hours he returns. Mary is still stiff. The vial he carries looks empty. There is a drop of clear liquid at the bottom; a drop. “It is not enough,” he says. “I don’t think it is enough.”

The doctor returns. “Ah good—” he says, and looks. “Yes this is enough, we are lucky, there is enough.”

He draws a needle syringe out. He administers the antidote. I cuddle Mary, lying half upon the gurney. Emma draws near. We are being transferred upstairs.

Lisa, a veteran missioner, arrives. She has lived here eight years. Her children come along and Maya goes into the corner to play with Emma. We relate the occurrences. She immediately asks, “Did they draw her blood?” No, we say. “Then how do they know this reaction is from the medicine and not from the dengue?” We do not know.

She calls for a nurse. Lisa is in control, her Spanish rapid-fire and precise. “This baby needs her blood drawn—she has had dengue—call the doctor,” she demands. The nurse leaves and returns. “Yes we will draw her blood—the doctor says it is okay.” Lisa goes on, “Yes the blood must be drawn. She has dengue.”

It is late. What is it, two, three, four a.m.? Mary sleeps in a bed with rails drawn up. I have been left to care for her. I am her nurse. I pump my breasts into the sink to relieve the pressure. I cannot relieve the pressure. They are burning red and hot. My head burns and pounds. I lie beside my baby. She does not nurse. In here at least we are air-conditioned and the heat is not as intense, I think. At least here we can burn in coolness.

The doctor arrives.

I get up.

“The platelets are 47,000,” he says. I hear 470,000.

“Oh good,” I say. “She is better—it is not the dengue.”

“No,” he says, “it is not good. It is worse, peor. She has hemorrhagic dengue. The worst stage.”

Hemorrágico?” I ask.

Sí—peor. We must move you to isolation,” he says. “El hemorrágico es el más peligroso.”  Hemorrhagic dengue is more dangerous.

“We must hook her up for a transfusion. If we do not she may begin to hemorrhage inside. Her organs may begin to hemorrhage and we cannot save her.” He must repeat this two, three, four times. I do not understand all the words. Lisa has gone home. Mike has gone home. He draws me a picture.

He is a specialist—un especialista. “I know the path of dengue,” he says. “Your doctor—he did not know the path. It is a tricky path. Not many know the path of the worst stage—el hemorrágico.” With pen in hand he draws the path: first platelets fall then rise then fall again. “Three times they fall and rise. This is dengue. The last rise is the critical one—from there they either rise or fall. Your baby’s fell. They fell drastically. Now it is hemorrágico. We must do a transfusion now,” he says. “You get some rest, we will be back.”

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