Consumption (60 page)

I remember eating caribou roast with Isabelle, and listening to her stories about her first years in the Arctic, and I imagined for a moment that I chose to stay with her. I imagined reading long-anticipated mail in the dining room of the old hospital underneath kerosene lamps, baking bread and doing surgery and delivering children. I imagined forgetting all about trees and cities and coming to love the formidable taste of seal meat. I imagined focus and devotion on a scale that I have no experience with. For just a few moments I had a sense of what might have sustained her. And then it passed. A few days later I flew south, to New York. I rented a resort cabin on Long Island and slept late and then went swimming in the ocean every day.

(ii) to oneself

I met my brother on an island near Seattle. He went there after his marriage dissolved, in order to heal himself, he said. “You mean put it all behind you?” I said. He thought I was oversimplifying things.

He was staying on a farm that seemed to be maintained for precisely this purpose. When I got off the little float plane that deposited me on the dock, he met me with a taller bearded man who wore what looked for all the world like a Nehru jacket. My brother shook my hand and introduced his companion as Yogi something. “You’re kidding,” I said. They both smiled at me.

Over tofu and wheat grass that night we talked about our recent difficulties. His daughter had taken the departure of her father badly, had got involved with boys who came to a bad end. In the wake of all that, I flew to the city where she lived and the two of us lived together. She was pregnant, we subsequently learned, with twins, and she delivered her babies and I helped her with the diapers and the feeding and all that. It was a difficult few years, and for a long time I felt like I was much too old to be doing infant care. But it was necessary. And later, only the shortest time later, Amanda and her daughters became most of what I woke up in the morning to see.

Matthew asked me about his daughter. It was a delicate point. Amanda remained angry with him for having been so weak—the drinking, the being subsumed by her mother. He and Amanda haven’t been close. It has felt like he has become her uncle, and I something rather more involved than that.

When the meal was finished, we both helped gather the dishes and then wash them. I made a joke about not having been able to pay the cheque, but nobody laughed. They all smiled, of course. They hardly ever stopped smiling, I noticed. My brother did, when I told him how angry his daughter was with him. But otherwise he was implacable. It was smile-o-rama, there among the tofu. None of them could have made, or recognized, an actual joke to save their lives. But they remained determined to smile.

(iii) to the individual

The striking thing about the coastal Inuit communities of Hudson Bay is their size—these are tiny places. Repulse Bay has five hundred people. Rankin Inlet, the regional megalopolis, twenty-four hundred, Baker Lake, eighteen hundred. Anonymity is inconceivable here, and the notion that it could be something sought, incomprehensible.

I first came to Repulse Bay about thirty years ago. In Inuktitut, the name is Naujjut, “the place where the seagulls lay their eggs.” The town clings to the sea, in a shallow rind around the bay. The nurse there knows every single person in town. When she goes walking in the evening, if she spots an unfamiliar face among the children playing by the sea, she approaches them and establishes whose cousin they are, from which of the nearby communities they come. The children crowd around her, grinning.

Nearby is a relative term. The closest town is Pelly Bay, a hundred and fifty miles to the north. Coral Harbour is the next, on Southampton Island two hundred miles to the east. Baker Lake, to the south, is three hundred miles. In the spring, which is glorious here, the people travel on snowmobiles between these communities, for days out on the tundra, just to visit with one
another for a few days before heading back. The distances involved and the spareness of the land seem not to make community more tenuous here, but rather more necessary and altogether more potent.

This story is the best way I can think of to illustrate what I mean:

Once, a woman suffered a ruptured ectopic pregnancy in Repulse Bay. She was brought to the nursing station and my friend, the nurse, started IVs on her. She called the doctors in Churchill, hundreds of miles to the south, and they flew north immediately, but between the weather and refuelling stops it was six hours before they would get there. She ran fluid into the woman through IVs that lined her arms from her fingers to her shoulders, but her blood pressure fell steadily. I was in Rankin Inlet at the time. As soon as any of us heard what was happening in Repulse Bay, we all thought the same thing: Oh no.

There happened to be someone in Repulse Bay with hemochromatosis—a blood disease that was treated by regular phlebotomy, bleedings, essentially. My friend had a stack of blood bags in the supply room to do this with. As we flew north, she got these bags out and had the janitor sort through the records of every woman who had given birth within the last year or two—all of whom would have been tested for hepatitis and HIV, and whose blood type she would know. She had the janitor get on the CB radio and call them in to donate blood. The town fanned out across itself to bring these people to the nursing station. They lay down, one after the other, and my friend started draining their blood into the phlebotomy bags. As soon as the bags were full she hung them above the sick woman and ran them into her.

When I arrived the whole town was standing around the nursing station, looking terrified, many of them weeping. The whole town, as in everyone over the age of twelve. They all had their sleeves rolled up. The janitor was arguing with an especially determined knot of people who were insisting that their blood be collected too.

This time of year, in the late summer, the tundra’s beauty is easy to appreciate. The cinnamon-brown low hills that ripple across Kivalliq catch the sun
and shine like old rope. The narwhals surface in the bay, waving their tusks in the air; only a few miles out of town, the last of North America’s great herding land mammals, the
tuktu
, caribou, paw the grass and the moss by the many thousands and shiver collectively when they smell predators approaching. Contained within this beauty, and perhaps its necessary consequence, are the people here—who huddle similarly close and watch for one another’s peril.

My thanks to Anne Collins, who watched over and guided
Consumption
as it made the transition from a collection of essays about cultural change and epidemiology to a novel, over the course of four years and many, many meticulous line edits. I could not be more grateful; nothing like this book would have been possible without her insight and patience. My thanks also to Nan Talese, who was similarly patient. My agent, Anne McDermid, and Jane Warren, her assistant, have given helpful advice through this adventure as well.

The people of Kivalliq—with and for whom I have worked over the course of the last ten years—told me the stories that inspired this novel and have helped me with the Inuktitut. On the language front, Andrea Sateanna White and Sam Aliyak have been especially helpful. The doctors and nurses I have met and have learned from while working in the north are too numerous to list, but I must mention my friend and mentor, Dr. Bruce Martin, the director of the University of Manitoba J.A. Hildes Northern Medical Unit, who has been a tremendous support. Sue Lightford, Scott Bell, Doug Manuel, Nikki Stilwell, Pam Orr, Maria Fraser, my brother Michael Patterson, Martha Keeley, Mark Viljoen and Megan Saunders have taught and inspired me. If there are clinicians reading this who have any interest in working in the most beautiful place in the world, among the finest people, please call Dr. Martin at the University of Manitoba at
(204) 789-3711
. He will take care of you in every way imaginable.

Thank you to Ellen Reid for twenty years of unflagging friendship, advice and hospitality.

And finally, thank you to the lovely and patient Shauna Klem, and to Molly Patterson for her shining smile and steady stream of crayon drawings.

VINTAGE CANADA EDITION, 2007

Copyright © 2006 Kevin Patterson

All rights reserved under International and Pan-American Copyright Conventions.
No part of this book may be reproduced in any form or by any electronic or mechanical means, including information storage and retrieval systems, without permission in writing from the publisher, except by a reviewer, who may quote brief passages in a review.

Published in Canada by Vintage Canada, a division of Random House of Canada Limited, Toronto, in
2007
. Originally published in hardcover in Canada by Random House Canada, a division of Random House of Canada Limited, Toronto, in
2006
. Distributed by Random House of Canada Limited, Toronto.

Vintage Canada and colophon are registered trademarks of Random House of Canada Limited.

www.randomhouse.ca

LIBRARY AND ARCHIVES CANADA CATALOGUING IN PUBLICATION

Patterson, Kevin,
1964
– Consumption / Kevin Patterson.

eISBN: 978-0-307-37582-7

I. Title.
PS8581.A7886C65 2007         C813’.6         C2007-900744-9

Versions of the essays on pages
337–344, 378–387
, and
394–396
appeared in
Mother Jones
(March
2003
), the
New York Times Magazine
(May
5, 2002
) and the
Globe and Mail
(September
8, 2001
) respectively.

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