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sick.

‘How long has he had symptoms for?’ she asked Jed as he moved closer.

‘Seven months.’

Seven months? She could see the fear in his eyes from across the room. Sarita was holding a small wooden bowl in her hands, but she had seemingly forgotten she was holding it, her gaze pinned to Tara.

She swallowed down her alarm. ‘What were his initial symptoms?’

Jed thought back. ‘Uh . . . his stomach hurt. His fingers as well. And he kept scratching his skin. The Awa says it is his liver.’

‘Awa?’ She remembered. The shaman. ‘Oh, right.’ She looked back at Paco again. He was regarding her as though from a great distance, his gaze focused but blank. ‘May I examine him more fully?’

Jed translated for Sarita and she nodded, her hands going trepidatiously to her mouth.

Tara checked his glands.

‘Paco, can you breathe in for me?’ she asked him, and though he didn’t understand her words, he innately caught her meaning, copying her exaggerated inhale. Gently, she slid her hands over the right side of his abdomen, palpating for the liver. It felt enlarged, the spleen too. She looked for yellowing to the whites of his eyes but the light was too dim to see clearly. What she could see were some dark stains blooming like old roses on the sheet by his head. She looked back at him with concern. She had various suspicions, but there was little more she could do without running diagnostic tests. She needed a full battery of blood screens, ideally a liver biopsy.

She smiled at him as reassuringly as she could, clasping his hands in hers. ‘Well done. You are very brave.’ Her Spanish was rusty and not particularly idiomatic but she hoped he could read her meaning in her eyes, her intention to do no harm.

She rose slowly, knowing she needed to convey her concern with calm.

Sarita rushed towards her, pressing the cup into her hands, as though the hospitality would be inducement to alter her findings, as though this was something to be negotiated.

‘Gracias,’ Tara said softly. And she took a long sip of the drink. It was some sort of juice, sweeter than she anticipated. ‘Mmm. Bueno, gracias.’

Sarita smiled, loosening with the compliment.

‘Jed, Sarita . . .’ She looked at them both. ‘Paco is very sick. It is my opinion that he should be taken to hospital so that they can run further tests.’

Jed translated her words quickly. Sarita looked away, pained herself.

‘It is not possible. He is too weak to travel,’ Jed said after a silence, speaking for his wife, knowing her wishes. ‘He cries in pain every time he moves.’

Tara blinked, knowing there were no easy options. The trees were too dense for a helicopter to land, and if he couldn’t move without anguish, she didn’t see how he could cope with being stretchered for thirty minutes, before then enduring the rough car journey along those roads.

‘Jed, I understand the pain of moving might hurt him – but it wouldn’t kill him.’ She stared at him, willing him to understand what she wasn’t saying: that just lying here might. ‘He needs to be in hospital.’ She hated seeing the anguish on her old friend’s face. ‘I’m sorry. I know what I’m asking is hard. But it is for his benef—’

The door behind Jed opened and a man came in. He was not big but he had presence; he was not wizened, but she knew he was wise. He looked like a coffee or plantain farmer, wearing plain trousers and a shirt, but she instinctively knew he was important.

Sarita immediately began speaking to him in a language Tara didn’t understand – Bribri? – gesticulating with her arms towards Tara. She understood who the man was just from the way they deferred to him.

After several minutes of indecipherable back-and-forth conversation, Jed turned to face her.

‘Tara, this is Don Carlo, the Awa. He has been treating Paco for us all these months.’

Tara nodded respectfully. ‘It is a pleasure to meet you, Don Carlo,’ she said in Spanish.

Don Carlo nodded slowly in return, regarding her intently, and she had a sense of being absorbed, like she was ink and he was blotting paper.

Jed began speaking again in Spanish and Tara noticed that wasn’t the language the Awa used when he spoke to Sarita. Even Jed was an outsider here.

The Awa looked back at her again; there was no malice in his gaze as Jed continued to speak. Then he fell quiet.

There was a prolonged hush and Tara wondered whether she should step into the void and just get the ball rolling. It was clear they came from opposing medical disciplines.

But the Awa spoke first, his voice deep and low and sonorous. Sarita repeated his words in Spanish to Jed, and Jed looked back at her. ‘He says there are over fifteen hundred plants in the jungle he can use as medicine. That there are fifty in the gardens right here.’

‘Great. Okay.’

‘He trained as an Awa from his uncle. From the Guetares tribe.’

‘Oh, really?’ She was interested, of course. But how was this relevant?

‘Their ancestors have been living in the Alto Uren mountains for three thousand years. Their wisdom and knowledge has been passed down through their families. It has never been written down. What the Awa knows, cannot be found in a book.’

‘I’m sure. And it is something I would love to know more about. I’m personally very interested in natural medicines and the botanical world and where that could intersect with Western medicine.’ She realized she was using her ‘work’ voice, the one she used for communicating terrible news to strangers, when she had to be a doctor and not a flesh-and-blood human too. ‘But Jed, your son needs urgent help that can get guaranteed results. He needs a thorough diagnostic workup and probably some full immunosuppressive therapy. I can’t say for sure without running complete tests but from his history and presenting symptoms, he could very well be suffering with—’

‘Hepatitis.’

The word had come straight from the Awa. He spoke English?

‘Hepatitis, yes, it’s

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