and a deep commitment to his patients. In the ten years she’d known him, she’d seen many bureaucrats make the error of underestimating him.
Yet he did love his food, and especially sweets. And simple khao tom mud was his favorite. The national dessert of Thailand, it consisted of small packets of sticky rice and coconut milk and syrup, neatly wrapped in a triangular banana leaf. Ladarat had witnessed the director consume a half dozen with an expansive enjoyment that was contagious, and which reminded her just a little of her late husband, Somboon.
Not today, though. As this large, exuberant man refused Sisithorn’s offer without any interest, Ladarat knew something was very, very wrong.
She shook her head at Sisithorn, who also looked suitably concerned. To her credit, she, too, was alarmed by the director’s refusal of khao tom mud and accorded it the significance it deserved. Without another word, she backed out through the door, closing it gently behind her.
In the moment of silence after the director glanced up again, Ladarat drew her conclusions quickly: The director is here to ask for my help.
And: This request for help is making the director very, very uncomfortable.
“You have heard,” the director asked hesitantly, “about the tragedy of the Americans?”
He offered a weak smile and the rattling skeleton of a laugh that would have been inappropriate anywhere else. But in Thailand, a laugh is provoked almost as often by embarrassment or sadness or anger as it is by humor. Over the years Ladarat had had many opportunities to wonder at her strange culture that could produce such an anomaly.
Ladarat positioned her yellow pad in front of her, turning to a fresh page and hoping fervently that this page would not be as interesting as the last. She wrote today’s date. Then: “Americans. ICU.”
Then, the most important word she would write today: “Elephant.”
She nodded. Of course she had heard about the sad story of the Americans. A young man and his wife. They’d just been married down in the Gulf of Thailand, at a fancy resort on the island of Koh Samui. Then they’d taken their honeymoon by going trekking with elephants in the Golden Triangle, northwest of Chiang Mai.
On their first day in the forest, the elephant on which they’d both been riding just a few minutes earlier turned violent. It trampled the man, damaging his spine and badly damaging his brain. His new wife had been hurt, too, with a fractured pelvis and other serious injuries. Hoping to avoid a tourism debacle, the Thai Air Force had intervened, sending a helicopter into the deep forest to airlift them both back to the best hospital in northern Thailand—hers.
They’d arrived here two days ago, on Saturday. Since then, the wife had woken up, but the man had not. Ladarat had heard, in fact, that there was too much brain damage, and that he was brain-dead. Or close to it. So sad.
She wrote: “Husband? Wife?”
“The man,” Khun Suphit said. “He will not be waking up.” He shook he head sadly.
“Ever?”
“Ever.”
They both thought about this for a moment. It was Ladarat who broke the silence.
“How is the wife?” she asked.
Khun Suphit brightened, just a little. “She is doing better, I’m happy to report.” Although truth be told, he didn’t look at all happy.
“But emotionally, how is she doing? The knowledge of her husband’s condition must be a terrible shock, no?”
Ladarat had always believed that how you feel determines, in large part, how well you do medically. And she was convinced that doctors and nurses needed to attend to a patient’s emotional health at least as much as they attend to his physical health. The good Professor Dalrymple offered wise counsel on this topic, which she credited to an American physician named Dr. F. W. Peabody: “In order to care for a patient,” she admonished, “you must care about the patient.”
Ladarat looked up from her notes at the director, who, she