Amazonia

Nathan turned to direct Takaho toward a section of open riverbank. He found the Indian staring in horror at the city, his oar clutched tightly to his chest.

"It fills the world," he mumbled.

Nathan glanced back to the small township. It had been two weeks since his last supply run to Sao Gabriel, and the noise and bustle were a rude shock to him. What must it be like for someone who had never left the jungle?

Nathan nodded to a spot to beach the canoe. "There is nothing here that a great warrior need fear. We must get your daughter to the hospital:"

Takaho nodded, clearly swallowing back his shock. His face again settled into a stoic expression, but his eyes continued to flit around the wonders of this other world. He guided the canoe as directed, then helped Nathan haul out the stretcher on which Tama's limp form lay.

As she was shifted, the girl moaned, and her eyelids fluttered, eyes rolling white. She had paled significantly during the ride here.

"We must hurry."

Together, the two carried the girl through the waterfront region, earning the gawking stares of the townies and a few blinding flashes from camera-wielding tourists. Though Takaho wore "civilized" clothes, his monkey-tail headband, the sprouts of feathers in his ears, and his bowl-shaped haircut marked this fellow as one of the Amazon's indigenous tribespeople.

Luckily, the small single-story hospital was just past the waterfront region. The only way one could tell it was a hospital was the flaking red cross painted above the threshold, but Nathan had been here before, consulting with the doctor on staff, a fellow from Manaus. They were soon off the streets and guiding their stretcher through the door. The hospital reeked of ammonia and bleach, but it was deliciously air-conditioned. The cool air struck Nate like a wet towel to the face.

He crossed to the nurse's station and spoke rapidly. The pudgy woman's brow wrinkled with a lack of understanding until Nathan realized he had been speaking in the Yanomamo dialect. He switched quickly to Portuguese. "The girl has been attacked by an anaconda. She's suffered a few broken ribs, but I think her internal injuries might be more severe:"

"Come this way." The nurse waved them toward a set of double doors. She eyed Takaho with clear suspicion.

"He's her father:'

The nurse nodded. "Dr. Rodriguez is out on a house call, but I can ring him for an emergency."

"Ring him," Nathan said.

"Maybe I can help," a voice said behind him.

Nathan turned.

A tall, slender woman with long auburn hair rose from the wooden folding chairs in the waiting room. She had been partially hidden behind a pile of wooden crates emblazoned with the red cross. Approaching with calm assurance, she studied them all intently.

Nathan stood straighter.

"My name is Kelly O'Brien' " she said in fluent Portuguese, but Nate heard a trace of a Boston accent. She pulled out identification with the familiar medical caduceus stamped on it. "I'm an American doctor."

"Dr. O'Brien' " he said, switching to English, "I could certainly use your help. The girl here was attacked-"

Atop the stretcher, Tama's back suddenly arched. Her heels began to beat at the palm fronds, then her thrashing spread through the rest of her body.

"She's seizing!" the woman said. "Get her into the ward!"

The pudgy nurse led the way, holding the door wide for the stretcher.

Kelly O'Brien rushed alongside the girl as the two men swung the stretcher toward one of the four beds in the tiny emergency ward. Snatching a pair of surgical gloves, the tall doctor barked to the nurse, "I need ten milligrams of diazepam!"

The nurse nodded and dashed to a drug cabinet. In seconds, a syringe of amber-colored fluid was slapped into Kelly's gloved hand. The doctor already had a rubber tourniquet in place. "Hold her down;" she ordered Nate and Takaho.

By now, a nurse and a large orderly had arrived as the quiet hospital awakened to the emergency.

"Get ready with an IV line and a bag of LRS," Kelly said sharply. Her fingers palpated a decent vein in the girl's thin arm. With obvious competence, Kelly inserted the needle and slowly injected the drug.

"It's Valium," she said as she worked. "It should calm the seizure long enough to find out what's wrong with her."

Her words proved instantly true. Tama's convulsions calmed. Her limbs stopped thrashing and relaxed to the bed. Only her eyelids and the corner of her lips still twitched. Kelly was examining her pupils with a penlight.

The orderly nudged Nate aside as he worked on Tama's other arm, preparing a catheter and IV line.

Nate glanced over the orderly's shoulder and saw the fear and panic in her father's eyes.

"What happened to her?" the doctor asked as she continued examining the girl.

Nathan described the attack. "She's been slipping in and out of consciousness most of the time. The village shaman was able to revive her for a short time:"

"She's sustained a pair of cracked ribs and associated hematomas, but I can't account for the seizure or stupor. Did she have any seizures en route here?"

No.

"Any familial history of epilepsy?"

Nate turned to Takaho and repeated the question in Yanomamo.

Takaho nodded. "Ah-de-me-nah gunti."

Nate frowned.

"What did he say?" Kelly asked.

"Ah-de-me-nah means electric eel. Gunti is disease or sickness."

"Electric eel disease?"

Nate nodded. "That's what he said. But it makes no sense. A victim of an electric eel attack will often convulse, but it's an immediate reaction. And Tama hasn't been in any water for hours. I don't know . . . maybe `electric eel disease' is the Yanomamo term for epilepsy."

"Has she been treated for it? On medication?"

Nate got the answer from Takaho. "The village shaman has been treating her once a week with the smoke of the hempweed vine:"

Kelly sighed in exasperation. "So in other words, she's been unmedicated. No wonder the stress of the near drowning triggered such a severe attack. Why don't you take her father out to the waiting room? I'll see if I can get these seizures to cease with stronger meds:"

Nate glanced to the bed. 'lama's form lay quiet. "Do you think she'll have more?"

Kelly glanced into his eyes. "She's still having them:" She pointed to the persistent facial twitches. "She's in status epilepticus, a continual seizure. Most patients who suffer from such prolonged attacks will appear stuporous, moaning, uncoordinated. The full grand mal events like a moment ago will be interspersed. If we can't stop it, she'll die:"

Nate stared at the little girl. "You mean she's been seizing this entire time?"

"From what you describe, more or less:"

"But the village shaman was able to draw her out of the stupor for a short time:"

"I find that hard to believe:" Kelly returned her attention to the girl. "He wouldn't have medication strong enough to break this cycle:"

Nate remembered the girl sipping at the gourd. "But he did. Don't discount tribal shamans as mere witch doctors. I've worked for years with them. And considering what they have to work with, they're quite sophisticated:"

"Well, wise or not, we've stronger medications here. Real medicine." She nodded again to the father. "Why don't you take her father out to the waiting room?" Kelly turned back to the orderly and nurses, dismissing him.