I can think of no honorable answer. Why must some of us deliberate between brands of toothpaste, while others deliberate between damp dirt and bone dust to quiet the fire of an empty stomach lining? There is nothing about the United States I can really explain to this child of another world. We leave that to Anatole, for he sees it all clearly in an instant. He laughs aloud at the nearly naked women on giant billboards, and befriends the bums who inhibit the street corners of Atlanta, asking them, detailed questions about where they sleep and how they kill their food. The answers are interesting. You might be surprised to know how many pigeons roosting in the eaves of Atlanta’s Public Library have ended up roasting over fires in Grant Park.

I find an extraordinary kindred spirit in Anatole. We are both marked, I suppose. Freaks at first sight, who have learned to take the world at face value. He was marked early on by his orphaned state, his displacement, his zealous skeptical mind, his aloneness. I have noticed that he, too, reads things backward: what the billboards are really selling, for example. Also where poverty comes from, and where it goes. I shall not covet my sister’s husband, but I shall know him, in my way, better. Anatole and I inhabit the same atmosphere of solitude. The difference between us is he would give up his right arm and leg for Leah, whereas I already did.

Will I lose myself entirely if I lose my limp?

How can I reasonably survive beyond the death of Ruth May and all those children? Will salvation be the death of me?

Here in the hospital I have too much time for questions like these. It occurs to me I have access to an infinite variety of narcotic drugs. Sleep is an absolute possibility. God can’t see you when you’re asleep, Ruth May used to insist. Evil peels no eye on sleep. Live!

Die.

They see a great deal of Mother. Mother last year gave up her floral hermitage in Bethlehem and moved to an apartment in Atlanta, having found a new church of sorts. She marches for civil rights. They pay her to work in an office, but I know she lives for the marches. She is very good at it, and impervious to danger. She came over to my apartment one night, having walked nearly a mile through tear gas, so that I could check her eyes for damage to the cornea. Her eyes were not even red. I think bullets would pass right through her.

It crosses my mind that I may need a religion. Although Mother has one now, and she still suffers. I believe she talks to Ruth May more or less constantly, begging forgiveness when no one is around.

Leah has one: her religion is the suffering.

Rachel doesn’t, and she is plainly the happiest of us all. Though it could be argued that she is, herself, her own brand of goddess.

I am sorry to say I do not see Leah and Anatole as much as I might. Being a medical student, of course, I have an inhuman schedule, and everyone makes allowances for that. Also I am in a different region of the university altogether from married student housing. They are making babies over there, while over here we merely save them.

It has been a difficult month: a rotation in neonatal intensive care. We lost two babies in the last week. And in this past day, Christmas Eve, while the clock made two complete rotations of its own, I watched over three tiny creatures whose lungs struggled like the flat, useless wings of butterflies prematurely emerged. Triplets. I considered Nelson’s view of what ought to be done with twins, and the dreadful consequences of ignoring that tradition. What we had here was worse: a triple calamity fallen on the house of these poor parents. I spoke with the father, a boy of sixteen or so, who gave the clear impression, through the use of the conditional tense when speaking of the parental care required for these damaged children, that he might not stick around. So a plague on the mother alone. While the machines hummed softly in our hospital and white-soled shoes whispered up and down the halls, a catastrophe was roaring down upon this child of a mother. This is her Christmas gift. She will be indentured forever. Never again will her life be free of travail and disappointment in her three blind mice. She may cut off their tails with a carving knife, this husbandless wife, whose school friends are still promenading through their girlhoods.

Who is to say she should not have run to the forest with her hair and umbilical cords flying, and knelt to deposit each of these three at the base of its own pine tree? Who will argue that my drips and incubators are really the wiser plan?

Who could blame Mother if she had chosen to leave me so?

After midnight I fell asleep on my cot in the interns’ lounge, but was battered by dreams. Entubed, damaged children of all colors danced on my head and arms and hands. Live or die, live or die? they chorused. Mother May We?

Africa has slipped the floor out from under my righteous house, my Adah moral code. How sure I always felt before, how smug, moving through a world that desired to cast me into the den of ear-pulling Crawleys. Adah the bridled entitled, Adah authorized to despise one and all. Now she must concede to those who think perhaps I should have been abandoned in the jungle at birth: well, they have a point. What I carried out of Congo on my crooked little back is a ferocious uncertainty about the worth of a life. And now I am becoming a doctor. How very sensible of me.

I struggled half awake and half asleep, and then suddenly, in the middle of my fevered, stolen nap, utterly awake. In dread, trembling. Lying on my side with my eyes open. I felt my cold hands. I was afraid. This is the new awful thing I cannot bear to feel. Afraid. This is my letter to the World That never wrote to Me-The simple news that Nature told-With tender Majesty. Her message is committed to hands I cannot see-For love of her, sweet countrymen, judge tenderly of Me!

In spite of myself I have loved the world a little, and may lose it.

I sat up on my cot, ran a hand through my damp, tangled hair, felt bruises all over my arms in the shape of small footprints.The second hand on the wall clock made its steady, ludicrous progress: stuff, sluff, sluff…

Afraid of what, exactly?

Suicidal idyll fratricidal. Afraid. That. Mother would choose Leah.

Perfect Leah with her adorable babe and husband. In a few hours it will be morning, they will dance around the tree with their little gifts from Mother, and they will stay, they will, after all. And the lure of grandsons will be too strong to resist, and Mother will be theirs. And then I will have to go to sleep. Sleep oh sleep thou certain knot of peace.

For many tedious seconds I sat on the edge of my cot, swallowing indecision and tears.Then I got up, wiped my face on the sleeve of my hospital coat, walked to the physicians’ lounge, and dialed the number I knew by heart. I called her. It was the dead-flat middle of the night. The night before Christmas and all through the house I am Adah who expects no gifts, Adah who does not need or care what others say. Yet I woke up my mother and finally asked her why she chose me, that day at the Kwenge River.

Mother hesitated, understanding that there were many wrong answers. I did not want to hear that the others could take care of themselves, nor that she felt she had no other choice.

Finally she said, “After Ruth May you were my youngest, Adah. When push comes to shove, a mother takes care of her children from the bottom up.”

That is the bedtime story my mother made up for me. It was not a question of my own worth at all. There is no worth. It was a question of position, and a mother’s need. After Ruth May, she needs me most.

I find this remarkably comforting. I have decided to live with it.