A strap of bark soaks curled up in a bucket of red liquid beside a man outside the Hospital Adolfo Guevara Velasco. Next to him an old woman sits with a top hat on, beside a blanket piled high with dead cicadas. Their thoraxes glow golden yellow behind papery wings. We step closer. They’re not insects but a type of fruit. The woman offers us a stuffed bag full. I shake my head. Through the cement struts of the walkway I can see snow on the distant mountains that surround Cusco: the place the ancients called The Navel of the World.
Floor polishers in grey overalls swing their machines back and forth over the foyer linoleum, and gardeners tend to fairytale roses in the internal courtyards. This hospital is for people with insurance incorporated into their employment contracts. The destitute go to the Hospital Antonio Lorena on the city’s edge.
The woman at the computer terminal at Modulo Four takes Jane’s identity card and confirms her ten-thirty appointment. We are directed to stand in the corridor outside the oncologist’s office. There are no chairs. The floor tiles are burnt orange and we have to press against the wall to let the polishers pass. The swirling mat buffs the edges of our boots.
The oncologist says the chemotherapy is no longer working. Jane knows this from the increase of piss-coloured ascites she’s been draining from her stomach into plastic bags every three days. Her chemotherapy has a silly cartoon name. Topotecan. I tell Jane it’s a perfect name for the Inca ruler that let the Spanish march in and take over with just 168 conquistadors. Jane laughs.
The oncologist wants her to try a combination of three other chemotherapies: Cisplatin, Gemzar and Betrapone. These drugs sound like alien invaders from another planet and Jane is enthusiastic. He wants to start treatment the following day but Jane must pick up her medicines from the Farmacia and deliver them to the oncology ward. That’s the way things work. There are no internal mechanisms for the distribution of medicines, and patients line up in the Farmacia from all over the hospital.
We’re the only gringos and the other patients stare. Their faces are all high ledges and sheer drops. Eyes like the small dark caves their ancestors hid bodies in. Jane’s rank in the queue is stalled while several old people and pregnant women take her place.
Jane looks sicker than all of them.
“Why are they pushing in?”
“Old people and women with little kids are served first here,” Jane says. “It’s the Peruvian way.”
How quaint, I think, but Jane looks sicker than all of them and there is something aggressive in the way they push past.
An obese man sidles up. He looks barely fifty.
“Say something in Spanish!” I say.
“No, I don’t want to sound like an entitled gringo.”
Do these people think she should go back to her own country for treatment? Jane did go back. She rented a place near her mother’s in Brisbane and I flew up to see her. We walked the same suburban streets we knew in high school: the hot blonde girl and the fag. Jane helped me survive.
The Brisbane doctors said Jane’s ovarian cancer was Stage Four and she only had three months to live. As a parting gift they fitted a tap into her stomach. Jane returned to Peru and back to her café. She’s been paying medical insurance for herself and her staff since 2001. She has every right to be here.
The diagnosis was in February, and now it’s May. I’ve timed my visit to coincide with her final days.
I watch a woman at the back of the queue whisper to a mother who has just been served. She borrows her sleeping baby and charges to the front.
“That’s not her child,” I say to Jane. “She borrowed it off that other woman.”
The Farmacia has no Cisplatin.
Jane squares her shoulders and calls her on it. It’s a toss up who’ll win – the woman pretending to be a mother, or the woman who is forty-eight but who suddenly looks ninety. The whole Farmacia watches. The woman shrugs and steps back. Jane wins the battle but not the war. The Farmacia has no Cisplatin. She is told the Hospital Antonio Lorena has some. We have to go there.
We walk back up to the roadway past the fruit seller with the golden fruit and the man with the bucket, and hail a taxi. It takes us past a statue of a golden Inca warrior on a pedestal, his arms spread out in a gesture of appraisal.
“There’s Topotecan,” I say. “That useless bastard.”
“That’s Pachacutec,” Jane says. “He established the Empire. There are statues to him all over Cusco.”
“Don’t you think it’s weird that Cusco means ‘The Navel of the World’?” I say, looking at her against the backdrop of the rushing city, “and you move here and get ovarian cancer?”
“I think it’s the perfect place,” she says.
The Hospital Antonio Lorena is a series of blue demountables, like something out of MASH. The entrance is lined with street sellers under colourful umbrellas. It’s festive. Behind the hospital is a high ridge of land that juts into the city. A huge statue of an Inca warrior kneels on the prow.
The Farmacia is open to the elements and protected only by shade cloth roofing. The floor is concrete. Jane joins the queue while I stand off to the side and keep watch in case the patients here decide to launch an all-out offensive. She is about to take medicine from the poorest of the poor.
No one pushes in.
“They don’t have Cisplatin either,” she says, coming back.
Read the piece in full in The Lifted Brow #24: The Medicine Issue.
Queenslander David Owen Kelly, essayist, short story writer and author of the novel Fantastic Street, lives in Newcastle with Jason.