Life & Death

In July 1984, a Brazilian winter month, I was working in a favela of Rio de Janeiro which, ironically, commanded a magnificent view of the Atlantic Ocean. I was talking with a number of children about their lives, their hopes and worries, their beliefs and fears. I also met their parents and grandparents, and soon enough would hear them, too, speak about their daily struggles — terrible poverty, marginality, and vulnerability as a way of life. Death haunted every shack in that one hillside slum — miscarriages; babies dying of one or another untreated disease; children chronically ill, and often telling me of the “departure” of this or that age-mate, a friend or neighbor; and, of course, parents who were sick, and near the end of their lives, not to mention grandparents.

“To die,” a 10-year-old girl told me, “is what can happen to you any day — that we know.” When I heard her say that I thought to myself, initially: yes, of course — pure common sense. But then I remembered her face, the resigned shrug of her shoulders, and I realized that most of the children I’d worked with as an American doctor did not speak such words, ever; nor did they spend their time having such thoughts, as that girl most assuredly did. Nor do many of us who live comfortable lives in this country know whereof we speak on the subject that child addressed, as she most certainly did: “My father died before I was old enough to call him by his name. I was a year old, I think. My mother will soon join him, she says. She wanted to stay with us [seven children, fathered by two men, of which she was the second eldest] but she tells us she’s also counting the days until she leaves our home for the last time — because there is so much pain she has to carry, from the moment she gets up to the second before she nods off. At night, we hear her; we should be asleep, but we worry about her, and we listen to her crying. But she doesn’t want us to worry about her. She says she wants to let out her tears in the dark. All day she smiles, and talks with us, and tries to teach us all she can. I’m a better cook since she got sick! I’m better with my little sisters and my brother. I’m better — well, I’m better all the way around! I don’t mean to brag, though; that is just what has happened. My mother tells us: She has one more thing to do before she says good-bye — leave us with her words and a picture of her in our heads!”

There was much more, long descriptions by her about what was happening to her, to her mother, to her sisters and brothers and her stepfather, who would show up, hang around a day or two, then, inexplicably, pick himself up and take off. She once summarized her own remarks (her colloquial, earthy Portuguese was wonderfully translated for me by a half-American, half-Brazilian physician friend, who accompanied me and my sons on many of our expeditions up to that favela). I had asked her if there was some “central message” she had for us Yankee visitors — some way of describing the gist of her life. She wasn’t sure how to answer. She asked me a question meant to clarify: “You want me to send my heart’s signal?” I couldn’t understand what she meant. I tried asking my question again — edging nearer to my own “heart’s signal,” as she had poignantly put it: “I was wondering whether there’s some message that you’ve learned, going through all this — in your life; one message, maybe, your mother has taught you that means a lot to you.” Now she understood; now she could smile as an indication that she was aware of what the visitor had in mind, and could reply with ease: “Oh yes — I can give you what you want to hear; I can tell you what our mamma tells us — she says there is life, our visit here, and then we leave. She says you should be glad to be here — but don’t forget: We’re only here to visit, and so, be prepared, every day, to say good-bye. She says she’s doing that now, and each second more she has — that’s good, because the longer we remember her, the stronger she’ll be, her memory, in us. She says the pain is terrible but when she sees us she’s proud, because she sees us loving her, and then she knows why she was born — so that we’d be born, and then there will be our kids [little ones] one day.”