De Esta Salimos

“¿Vamos a salir de esta?” Camila asked.

It didn’t feel like it, but Dayana nodded and touched her shoulder.

“De esta salimos.”

She turned before Camila could see that she did not believe it and followed the boots ahead of her.

La Loma de la Muerte lay less than a day’s journey ahead. Dayana could not see it through the canopy, but every warning she had heard ended the same way: once the climb began, there was no turning back.

Thirty people moved in single file through the rain. Mateo led them with a machete in one hand, cutting through vines and branches that had fallen across the trail. Whenever a gap opened in the line, a voice came back through the forest.

“¡Dale! ¡Dale! ¡Te vas a quedar atrás!”

Close the distance. Keep the person ahead of you in sight. If you lost the line, no one would come looking.

Dayana picked her way uphill, planting her boots among the roots hidden beneath the mud. Camila followed close behind, tugging at the neck of her yellow poncho. Finally, she pulled it over her head and stuffed it beneath the straps of her pack, revealing a black Minnie Mouse tank top.

Camila spoke only to Dayana. She was nineteen and had entered the Darién alone. Dayana had not told her that she had come alone too.

The trail steepened. Camila began breathing through her mouth. Twice she reached for branches to pull herself upward, and once Dayana had to catch her beneath the arm when her boot slid backward through the mud.

“Estoy bien,” Camila said.

Dayana knew how often those words meant the opposite. She shortened her stride and let two people pass ahead of them.

Everything she still owned rode on her back: two shirts, one pair of trousers, four pairs of socks, a toothbrush, a cheap poncho, a one-person tent, and a plastic envelope containing her passport, medical diploma, and the papers she had carried from Mayarí. Her clothes were sealed inside garbage bags, and the envelope was wrapped separately. In the outer pocket were cough drops and a tube of lip gloss her mother had given her.

At Las Tecas, Dayana had held the tube over a trash barrel, wondering why she was carrying something so useless into the jungle. Then she remembered her mother pressing it into her hand beside the bathroom mirror, and she slipped it back into her pack.

She wondered whether her mother had eaten that day. If Dayana reached Texas, she would make certain there was food in the house. Even if she could no longer sit at her mother’s table, she could at least see that the table was not empty.

The line pulled away from them again.

“Go,” Camila said. “I’m behind you.”

Dayana hurried forward, watching the boots ahead of her sink into the mud and rise dripping from it. By the time she closed the gap, the rain had thickened into a gray curtain between the trees.

Mateo raised his fist.

Everyone stopped. The line contracted behind him, the migrants standing almost heel to toe beneath the pouring rain. Water streamed from the plastic brim of his hat and ran down the blade of his machete. He tilted his head and listened to something beyond the wall of leaves.

Dayana turned to check on Camila.

No one was behind her.

“Camila?”

She called louder. “¡Camila!”

Mateo looked back at her and raised one finger to his lips. For several seconds no one moved. Then something cracked in the forest below them.

“One of the guides saw armed men from the Clan del Golfo on the trail behind us,” Mateo said. “Stay close and do exactly what I tell you.”

“Camila is missing.”

Mateo looked past Dayana into the rain. “How long?”

“She was behind me.”

“How long?”

“I don’t know. Five minutes. Maybe ten.”

“We cannot wait.”

“She may have fallen.”

Mateo lowered his fist and motioned for the people behind him to move. “We have to reach camp before dark.”

“I’m a doctor. If she’s hurt—”

“If you go back, I will not stop the others for you. You are on your own.”

Dayana stared into the trees. The trail behind them had already begun to disappear beneath the rain. Somewhere below, Camila was alone, perhaps injured, while armed men moved through the same forest.

“Stay with the line,” Mateo said.

She had been given that order before in other words. Stop asking about the missing antibiotics. Stop demanding sterile gauze for the clinic. Stop writing letters no one intended to answer. In Mayarí, they had told her that a doctor’s duty was to follow the government’s instructions. Dayana had insisted that her duty was to her patients.

Her insistence had not put food on her mother’s table or medicine into the little girl’s veins. It had put the papers in Dayana’s pack and the Darién beneath her feet.

Mateo turned and continued up the trail. One by one, the others followed.

There’s no going back now. Not after the promise she had made.

She stepped out of the line. The others filed past her. Near the rear, an old man stopped and touched her arm. He removed the headlamp strapped around his cap and held it out to her.

“Niña, aquí tienes una luz,” he said. “Búscame más tarde y devuélvela.”

Dayana took it. By then, daylight was draining from the forest, and the people ahead had become shadows moving between the trees.

“Gracias.”

She strapped the lamp around her forehead and turned it on. The beam opened a narrow path through the rain, and Dayana followed it into the darkness.

***

The blue string tied around the tree trunks was nearly invisible, even in the headlamp’s beam. Dayana tried to quiet her mind as she had learned to do at the clinic when working with her hands, but she could not stop thinking that she would lose the path.

Beyond its light, the forest seemed to rearrange with every sound.

“Camila!”

Something moved below. Dayana held still, listening, but heard only rain beating against the canopy. She called again.

This time there was a voice.

“Aquí.”

Dayana stepped off the trail. The ground fell away more sharply than she expected, and she slid several feet before catching hold of a ceiba tree.

Camila sat against the trunk of another ceiba twenty feet below. Her pack hung from a low branch, one strap still twisted around her shoulder, and her left foot was trapped between two exposed roots.

Dayana lowered herself beside her and carefully freed her foot from the roots. She asked Camila her name, where they were, and whether she had lost consciousness. Camila answered each question, although she could not remember falling.

When Dayana touched her ankle, Camila cried out and seized her wrist.

The ankle was swollen but not deformed. Camila could move her toes, and the foot remained warm. It might only be a sprain, but Dayana could not be certain. Whatever the injury was, Camila would need help to walk.

Camila looked past her toward the trail. “They left us.”

“We’ll find them.”

“You don’t know that.”

“I know.”

Somewhere above, a branch snapped.

Dayana extinguished the lamp.

They remained motionless beneath the tree. Camila’s breathing came fast against Dayana’s cheek. Through the rain came the murmur of men’s voices, low and indistinct, and then the metallic rattle of something being dragged or carried. Dayana could not tell whether the sounds came from the trail or deeper in the forest. She placed one hand over Camila’s mouth and felt the girl’s lips moving against her palm in silent prayer.

The voices faded. Dayana waited until she could hear only rain before turning the lamp on again.

She removed a shirt from her pack and tore it into strips. After loosening Camila’s boot and examining the ankle, she wrapped it over the sock, eased the boot back on, and laced it snugly enough to provide support.

Camila watched her work.

“You really are a doctor.”

Dayana tightened the final knot. “Yes.”

Camila leaned her head against the tree. “Then you can fix it.”

The trust in her voice was more painful than the fear had been.

In Mayarí, another girl had once looked at Dayana that way.

***

Yanelis Infante had been nine years old, with a fever of forty degrees and one fingernail painted blue. She had arrived at the clinic holding her mother’s hand, believing that doctors were people who had medicine.

“Yani painted it herself,” Caridad said when she noticed Dayana looking. “She spilled the rest on the floor.”

“I was going to finish them,” Yani said.

“When you are well,” Dayana told her.

The girl had been sick for three days. Her head hurt behind the eyes, and that morning she had vomited twice. There had been dengue in the neighboring province, although the official reports still described the cases as “seasonal fever.”

Dayana sent a blood sample to the polyclinic and wrote an urgent request for a dengue test and blood count. The courier returned that afternoon with the sample still inside the box. The laboratory could perform neither test.

The pharmacy had no oral rehydration salts. Dayana gave Yani two of the clinic’s last six acetaminophen tablets; the others had to be saved for two children waiting outside with fevers of their own.

Caridad stood beside the examination table, twisting the handles of her purse.

“Is she going to be all right?”

“Keep giving her water. A little at a time. If she begins bleeding or has pain in her stomach, bring her back immediately.”

Caridad waited.

“De esta salimos,” Dayana said.

The next morning, Yani’s fever was gone. She ate half a piece of bread and asked whether she could return to school. Caridad sent word through a neighbor that the girl was recovering. Dayana sent back instructions to watch for bleeding, pain, or vomiting and asked Caridad to send word again before noon. No word came.

A fever disappearing did not always mean that the illness had passed. Sometimes it meant that the dangerous part had begun.

When the clinic closed, Dayana went to see Yani herself. Yani lay beneath a sheet in the back room, awake but strangely quiet. Her skin was cool and damp. There was dried blood along her gums, and when Dayana pressed a hand against her abdomen, the girl drew up her knees and began to cry.

Dayana called the hospital in Mayarí.

The ambulance had no fuel.

“She needs intravenous fluids,” Dayana said.

The nurse on the telephone told her to send another transport request. Dayana had already sent three.

Caridad found a man with a horse and coche. They carried Yani outside wrapped in the sheet and laid her across the narrow seat. Dayana climbed in beside her and held the girl’s head in her lap while the wheels dropped into every rut along the road to Mayarí.

“Am I dying?”

“No.”

The answer came before Dayana could stop it.

Yani closed her eyes. The blue fingernail rested against Dayana’s wrist. At the hospital, two orderlies carried her inside, but there were already patients on beds along the corridor and others sitting on the floor. By the time a doctor examined her, Yani’s pulse had grown faint.

She died before nightfall.

Caridad sat beside the bed and wiped the dried blood from her daughter’s mouth with the corner of the sheet. For a long time, she said nothing.

Then she looked at Dayana.

“You told me the fever was dangerous. I should have brought her sooner.”

“No,” Dayana said. “You did what I told you.”

“But it went away.”

“The fever broke. The illness was still there.”

Caridad bent over her daughter. “My little girl.”

Dayana put her arms around her. Caridad’s body shook against hers. Dayana looked at the child’s painted fingernail. She had spent years learning the names of diseases, the ways they entered the body, and what must be done to stop them. None of it had taught her what to say to a mother whose daughter had died waiting for what the doctor already knew she needed.

***

The next morning, Dr. Carlos Enríquez placed the official case report on Dayana’s desk and handed her a pen.

The cause of death was listed as complications from an unidentified viral infection. There was no mention of dengue, the missing reagents, or the ambulance without fuel. According to the report, Yani’s condition had worsened because her family failed to seek medical treatment in time.

“This blames Caridad.”

“It states when the child arrived at the hospital.”

“She brought Yani to me three days earlier.”

Enríquez sat behind his desk with his white coat buttoned to the neck despite the heat. On the wall above him, the Minister of Public Health smiled beside a chart showing that childhood mortality had fallen again.

“There was no positive dengue test,” he said.

“Because there were no reagents.”

“Then you cannot say it was dengue.”

“I know what killed her.”

“What you know and what you can prove are different things.”

Dayana pushed the report back across the desk.

Enríquez did not pick it up. “The clinic inventory shows that you received oral rehydration salts last month.”

“We received the boxes. They were empty.”

“The boxes were signed for.”

“Then have the boxes sign the report.”

He looked toward the open door and lowered his voice. “You are young, Dayana. You still believe the truth excuses everything. Put dengue in that report without a positive test and the provincial directorate will open an investigation.”

“Good.”

“Into us. They will ask why supplies listed in our inventory cannot be found and why we diagnosed an outbreak without laboratory confirmation. They will send inspectors, not medicine.”

“She was nine years old.”

“And an investigation will not bring her back.”

“No. But this report will keep you from having to explain why she died.”

Enríquez turned the pen so that its point faced her. “Sign it.”

Dayana thought of Caridad wiping the blood from her daughter’s mouth. She thought of Yani asking whether she was dying and the answer that had escaped before Dayana could stop it. She had lied to comfort a frightened child. This lie would comfort only the people who had let her die.

“I won’t.”

Enríquez removed his glasses. For a moment, he looked less angry than tired.

“Then you will no longer work at this clinic.”

By afternoon, Dayana had surrendered her keys and patient register. A week later, two officials from the provincial health directorate came to her mother’s apartment and asked why she had accused the state of concealing a dengue outbreak. Dayana told them she had made no accusation. She had only refused to sign her name.

That was accusation enough.

When a medical assignment in Venezuela became available, Enríquez advised her to accept it. By then, Dayana understood that it was not an offer.

Her mother helped her pack in the bathroom with the faucet running so the neighbors would not hear them crying. Before closing the suitcase, she took a tube of red lip gloss from the cabinet and pressed it into Dayana’s hand.

“You will come home when the assignment is over.”

“Yes.”

At the airport, Dayana boarded the flight to Caracas with eleven other doctors. She carried two dresses, her medical books, and the last official paper she would ever sign in Cuba. It promised that she would return.

***

At first light, Dayana found Camila a sturdy branch to use as a walking stick and pulled her to her feet. The blue strings disappeared whenever the trail bent, and twice they had to turn back. Camila leaned against her so heavily that before long Dayana felt every step in her back and thighs.

“Do you think they waited?” Camila asked.

“I don’t know.”

Camila stopped.

“But I’m not leaving you here.”

They climbed through the morning. When Camila could no longer put weight on the ankle, Dayana carried her pack and counted twenty steps at a time. The mountain gave them mud, roots, and false summits. It gave nothing back. Near the top, Camila fell to her knees and said she could not go farther.

Dayana said nothing. She sat beside Camila and gave her the last of the water. She waited until Camila was ready.

A figure came crashing down the trail with a machete raised. Dayana pulled Camila behind her. Then Mateo shouted Camila’s name.

Behind him the others appeared between the trees. They had delayed the canoes as long as they could.

By afternoon, Dayana and Camila sat together in a dugout bound for Bajo Chiquito. The jungle opened around the river, bright and indifferent, while Death Mountain receded behind them.

They traveled north for weeks, sometimes together and sometimes only toward the same border. In Texas, Dayana declared that she was seeking asylum. Camila had been released to join a bus north, but Dayana remained behind to be processed.

“Occupation?” the processing officer asked.

“Doctor.”

He looked at her for a moment. “Sure,” he said, and returned to his screen.

Outside, the bus began to move. Camila turned in the last row and searched the processing-center windows until she found Dayana. She raised one hand against the glass.

Dayana raised hers. The man could write whatever he wanted on his form.