Free Six Months in Sudan by Dr. James Maskalyk

needle out. We do that so he doesn’t take a big gasp as the needle is pulling out, right? He could suck in a bunch of air through the hole, and collapse his lung and all that.”
    We clean his back. The white gauze comes away black with dirt. I listen to his back again, thump one of my fingers with the other until the sounds goes from hollow to dull, then make a mark with the hub of the needle. I inject a few cc’s of anesthetic into his back. It raises his skin up in a wheal.
    “You always have to go above the rib, right? Not below. That’s where the neurovascular bundle runs. You can hit an intercostal artery.”
    I take a large syringe and put on its tip an 18-gauge needle.
    “So landmark like this, just over the top. Is he doing okay? He’s okay? All right, he’s thin so we don’t have to go very far … You can kind of feel the lining of the lung pop as the needle enters it, then pull back on the syringe, and …”
    Blood.
    Shit.
    “Okay, tell him to breathe out.”
    I landmark one rib below, put in some anesthetic, get another needle, push it through, pop, pull.
    Blood.
    Damn.
    “Tell him to breathe out.”
    I’m sweating now.
    Why the blood? No way I hit a vessel twice. Maybe he bled into his abscess, or has an infected hemothorax … I don’t know. TB?
    “Okay. Tell him one more time. One more. Good. Great. And …”
    Blood. Dark blood.
    “Breathe out.”
    I empty the syringe into the garbage in a thin red stream. It hisses as it hits the plastic.
    “All right. I can’t find any pus. I don’t know. I think we should probably put in a chest tube. Basically, he’s going to get septic and die if he’s got pus in his chest and we can’t get it out. But we’ve got to try to find someone. A friend, an uncle. If it doesn’t work, we can’t transfer a ten-year-old to a hospital alone.”
    The boy sits stoically, three raised targets on his back, dried blood at their center. We wipe him clean, put on a dressing, then carry him back to his bed. He rolls over and faces the wall.
    Mohamed and I agree to meet in the afternoon to aspirate Mansood’s knee and try the chest tube. As he leaves to find lunch at compound 2, I return to the veranda that holds the measles patients. I smile at the families, and motion for the charts that are tucked again under their plastic mattresses. They give them to me. Beside “Amoxicillin,” where two hours before I wrote “Stop,” I write “Restart.”

26/02: today.
    today, i woke early, determined to run out of town and find a bit of space in the flatness that surrounds abyei. at 6:30 a.m., the sky was still dark. as i ran, past the trucks and buses leaving for el obeid or khartoum or juba, full upon full of beds and blankets on top of beds and blankets, dawn happened. but the sun never rose. not past the meniscus of dust along the horizon. a windstorm had lifted the sudan sand, and it covered not only my tukul and abyei, but the wide sky. by 8 a.m., the sun was only a gauzy ghostly hole, the color of beeswax.
    today, when i was doing rounds, and i was figuring out what to do with a young boy who developed a fever after a run with measles, a boy in whom i had already stuck a chest tube and three needles to try and drain a large collection of bacteria, as i was deciding whether to stick more things into his chest or send him to another hospital or if he was going to die, and heard from my translator that this boy, already ghostly, had refused food that morning, i looked down and beneath his bed was a butterfly struggling to right itself on the floor but instead, spinning in circlescirclescircles, its wings tracing round grooves in the dust.
    today, a whole rash of measles. i had it as a child. so did my brother. i have no memory of it. all i have are pictures showing how miserable we both were. i doubt they are in memoriam of this special time; more likely we just sat still for 30 seconds. people sit still with measles because they don’t want to move. their eyes get