The Whole World Slid

Dr. Kala would take his first flight with no aircraft and no visible means of power one month after the Indonesian tsunami made landfall. But he knew nothing about that when he joined the relief effort, half-hoping to be assigned to India, his grandparents’ birthplace, but routed to Sri Lanka instead. It didn’t matter, really; he wanted only to help.

At the airport in Jaffna, he and seven other American doctors and nurses were scooped up by a van that would take them to the small coastal town of Mullaitivu. On the way, they drove by collapsed buildings, bright tent encampments, and people searching through the rubble for their dead. They passed a wrecked train, and the strange angle of the train cars reminded Dr. Kala of a broken leg he had once set.

The day after Christmas, an earthquake far out at sea had churned up long waves — barely noticeable humps if you saw them from a boat. Radars dutifully recorded the changes, but the radars weren’t set up to warn people about tsunamis. So, although the waves took hours to travel across the ocean, to smash against the seabeds in shallow waters, and then grow to monstrous heights, almost no one knew ahead of time about the storm headed toward them.

Now, water sat in sulky pools next to a carpet of mud marking how far the waves had rushed inland, and the cries outside in the street and the stench of mud and disease were overwhelming. Dr. Kala started to retch, and he wondered if he’d be able to help at all. The thought filled him with disgust, and he stared out the window again, despairing at the detritus littered across the landscape, at the air trembling with heat.

Then, a shift in the haze on the horizon.

Suddenly, he felt he was surveying the damage from far above. He could see people wandering in the streets below, and what looked like bodies in a crinkled heap at the corner of a field. He could see a group of fishermen working together to drag a stranded boat back into the water, and a line of relief trucks snaking toward the coast. And from this safe distance, the landscape looked almost peaceful, as if the countless misfortunes and calamities were puzzle pieces in some giant pastoral scene.

Then the bus jolted, and they were there, at the hospital.

The medical director met them at the entrance, and Dr. Kala thought she seemed like a small, calm ship guiding them through a sea of catastrophes. The hallways were lined with rows of people sitting or lying on the floor, some groaning, some sobbing quietly. More cots were being set up, and the Red Cross had erected tents for the local hospital staff and patients who were still arriving. Dr. Kala noted the bare rooms and wondered how sanitary they were, and what sorts of surgical tools he would have to work with.

After the tour, they were taken to a slightly scruffy motel where they would be staying, and where a staff of volunteer cooks and waiters would serve meals in the tiny courtyard. Dr. Kala’s group sat there now, eating bowls of rice curry as the director continued with her briefing. When their eyes had begun to glaze over with weariness, she divided them into two teams, and Dr. Kala was relieved to learn his team would start immediately.

During that first hallucinatory shift, time itself altered, rushing by in a torrent as the medical team treated dozens of patients, or slowing to a trickle in which Dr. Kala observed the pause between someone’s lips moving and the voice reaching his ears. He felt as if it were not he but someone else calling out for an IV or scalpel or fluids, or scanning body after body to assess injuries amid the chaos and moans and shrieks. A local nurse gave him a notebook and pen. He wrote down notes and instructions — all in English, because who knew what nationality the next doctor or nurse might be? — and she taped them to the foot of the bed. When he asked for anything, she pointed it out to him, or shook her head. A sink? On the wall to the right. Soap? In the cabinet underneath. Better lights? She shook her head. The other nurses moved almost wordlessly with him among the patients, as they determined whom to operate on, and who could wait and what they could reasonably do for any one patient, given the numbers still pouring in and the short supplies, and Dr. Kala thanked God that there was plenty of morphine as they set broken bones, treated and sewed up wounds, amputated in a few cases, and — for those who were already too close to death — administered the morphine to ease their pain.

Somewhere in the midst of it all, someone tapped his shoulder to say his shift was over, and he couldn’t believe it, but then the fatigue hit him, almost knocked him over, and, still in a daze, he removed his rubber gloves, took the van to his motel room — which was like a very clean, dimly lit closet — showered, and collapsed into a thick, sludge-like sleep.

The next morning, before he returned to the hospital, he called to tell Emily, his fiancée, that he was okay so far and had begun work.

“Did you hear about the elephants?” she asked. “Before the tsunami hit — I think hours before — they started acting strangely. Then they charged inland to higher ground. Like they knew, like they had a sixth sense.”

He smiled because he knew she was trying to cheer him up. “You might Google elephants and infrasound; they have a highly developed sense of hearing,” he said. “If they really did move inland ahead of the storm, maybe it was just because they heard the earthquake or the waves.”

Emily didn’t seem interested in a truth so mundane, so she asked instead about the hospital, the motel, and what Mullaitivu was like. She asked if she should send anything to him, if he’d forgotten anything.

Dr. Kala heard the warmth in her voice, but the phone call was frustrating. He could feel a gulf opening up between them; he couldn’t touch her, wouldn’t sleep next to her for three weeks. He looked at his watch. “I have to get to the hospital,” he said. “Love you, Em.”

“Love you too, Sai — don’t forget about the elephants,” she said.

In the following weeks, it was the chaos that was most wearing. The patients’ families had nowhere to stay and not enough to eat, and they joined the mayhem in the hospital’s hallways. No one had the heart to kick out people who had lost so much, who were suffering still. When the hospital ran out of antibiotics on day three, Dr. Kala learned that the Red Cross had delivered Mullaitivu’s supply to Thailand by mistake. On day four, a group of well-intentioned U.S. volunteers showed up — none of them trained, none of them with a place to stay or so much as a candy bar of their own to eat. (The medical director sent them to Colombo, where, she assured them, they were needed urgently.)

Every few days, Dr. Kala would phone Emily. “You know how electrical systems have a grounding wire?” he asked her. That was part of what she did for him, he thought; she grounded him.

“What?” she asked. “I can barely hear you.”

The words were already lost, adrift somewhere over the ocean. The calls were always disappointing, and he wondered what it was he sought. “I can’t remember the time difference,” he said. “Are you eleven hours ahead of Sri Lanka time, or eleven hours behind?”

“Sri Lanka is ahead,” she said.

It was hard to get the timing right for the calls and hard to explain the human plight — what a mass grave looked like, or the child he’d seen who had survived but whose parents and brother and sisters had not — or the bureaucratic tangles. He didn’t know how to describe the sense of certainty he found in the long hours of work and in the knowledge that, no matter what was going on anywhere else in the world, there was a crisis of historic proportions in the Indian Ocean, and he was here, tending to people’s suffering.

Each morning, he arose, drank a cup of bad coffee, ate a breakfast of curry and a noodlish pancake called a hopper, and headed over to the hospital, where he might be briefed about new patients and changed protocols, or he might plunge immediately into the work, as if it were simply a different kind of sleep from which he’d awake in ten or twelve hours when someone again came to say his shift was over, and then he’d return to the room and a night of dreamless sleep before waking up and doing it all again. He didn’t have to make any decisions about what to do with his spare time or what to eat or read or watch or think about. Existence was pared down, and he dwelt completely in the present.

“Sorry — I’m sort of on an assembly line here,” he said in their next call. Because if he weren’t, if he stopped, he’d fragment into pieces of himself. “Work, sleep, and eat.”

She was quiet a moment. “Is it okay if I tell you a story?” she asked.

“Of course.”

“I just heard it on the radio: This ten-year-old kid from England or somewhere was spending Christmas vacation in Thailand with her family. Anyway, she had just learned about tsunamis in her geography class — they were studying Hawaii and the teacher showed them some videos about tsunamis — and she recognized what was going on. So she got her family and a bunch of other tourists to leave the beach and climb to safety. It was one of the few beaches where nobody died. Because of a geography lesson.”

“Because of science,” he said. But he liked the story. Who would have known so many people would listen to a ten-year-old?

The only deviation Dr. Kala made from his schedule was to walk the mile from the motel to the hospital because it helped calm him before work or after, when he was trying to go to sleep. And that was how, on his way home one night near the end of his time in Sri Lanka, he happened upon the woman screaming.

She was sitting on a small mountain of broken rocks and mud, a small-boned woman with dark skin, dark eyes, bright teeth. Her arms were splayed carelessly next to her, and her head tilted at the sky. After three weeks in Mullaitivu, Dr. Kala had witnessed kinds of pain that he’d never seen before, even in his years in a hospital emergency room. But the screams escaping this woman were primal, as if she’d abandoned some part of herself, some deeply internalized awareness that makes us civilized or human, he thought. Her suffering was palpable, and it sent a chill down his spine. He wanted someone to take her in his arms, to hush her and guide her away, but he felt he could not. For the rest of his walk home, the echoes of her screams continued, scraping against his inner ears.

That night was the only night in Sri Lanka that he dreamed. In the dream, patients lay on the hospital’s floors and beds and windowsills, and what seemed like thousands more jammed the grounds and the street outside. Too many. In a frenzy, he began running desperately from patient to patient, checking a pulse, then charging on to someone else, trying to tend to them all at once. He grew dizzy and stopped for a moment, but when he tried to lift his stethoscope, something prevented him. He looked down at his arms — now he was on a rocky coast — and realized they were embedded in the hillside, hardened into rock like the limbs of a statue. His legs and torso had also turned to granite, and he felt like the figure on the bow of a ship, inanimate. He tried willing his arms free, thrusting his shoulders forward, yelling for help.

It was his own sudden grunt that awoke him, and he looked at the sheets, the bed, the wooden floor, and then slowly raised each arm and each leg. It was time to get up anyway, and he arose and dressed for work.

The dream stayed with him at the hospital, and the world seemed vague and blurred all day. Later that afternoon, just after he began a delicate surgery, a woman with a broken arm arrived at the hospital screaming. He dropped what he was doing to sprint down the corridor and tend to her, yelling for assistance, his yells increasing in volume and panic until they were almost shrieks.

A nurse gave the woman with the broken arm sedatives and the screaming stopped, and after a few minutes, Dr. Kala quietly returned to finish the surgery, his hands still shaking. Then the medical director gently ordered him to return to the motel, to rest his last day before heading back to the U.S.

He slept until noon and awoke feeling musty. After breakfast, he went for an aimless walk to the hillside overlooking the sea where he stared down at the blue-green water. The hillside was steep — almost a cliff — and he stood inches away from the edge. After the crowded hospital and the tiny motel room, he wanted only to feel the space of the sky and sea in front of him, and he closed his eyes. A wind rose up behind him, rustling his shirt and then whooshing by his ears. When he stretched out his arms to take it in, the gusts of air tugged them upward. He leaned forward onto the cushion of air, and felt his toes slip off the ground. For a second, he hovered in place, and then he dipped slightly down.

He was flying.

Holding his arms straight out like wings, he swung out and over the ocean, testing the air currents. His brain was already cooler, calmer. The air below buoyed him, as if he were floating in water, except he didn’t need to move his arms to stay afloat. By tilting his head slightly or pointing his toes, he could steer himself vertically or horizontally.

He could see an occasional boat and an oil rig beneath him, and he steered clear of these — he wanted nothing to do with people or civilization. Following a flock of pelicans, he plummeted down until he was almost touching the water, then skimmed just above the waves, breathing in the salty moisture. He veered off to trail a lone seagull as it flapped its wings and rose higher in the air, and he stayed with it until just before it landed on a tiny island.

Now, Dr. Kala left the seagull and turned inland, and the ruins and mud began to appear beneath him. He flew for miles, paralleling the coast. He saw a herd of elephants and remembered Emily’s story; they were moving slowly, like a tiny gray river. Night fell, and he kept flying, barely tethered to his body. At one point, toward dawn, he accidentally rolled over and the stars’ brilliance and their numbers took him by surprise because he’d never been so far away from the lights of cities.

The sky was reddening in the east when he finally landed — lightly and on his feet — at the place where he’d started. He returned to his room to pack, and then joined his team in the lobby to wait for a shuttle to the airport. When a nurse from his team asked him where he’d been, he implied, without actually lying, that he’d had a long night out on the town with some of the other volunteers.

On the flight, the motion of the plane felt comfortable in a new way, and he reclined his seat and slept a deep sleep that refreshed him as it hadn’t since he’d left.

At JFK, he called Emily to say he was back on U.S. soil.

“I’m so glad,” she said, and he could hear the relief in her voice. “I was worried, you know. Everybody knows the tsunami is traumatic for the victims, but it’s traumatic for doctors too — for anybody who goes to help.”

He nodded into his cellphone. He had been worried too. “It feels like the whole world slid a little, like the earth adjusted,” he said.

He could hear her breath intake. “It did — NASA says the tsunami moved the location of the North Pole, and that it changed the earth’s shape and its rotation. Just a little, but it’s enough so it shortened the earth’s days by 2.68 microseconds.”

“Em, it’s good to be back,” he said.

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