Hektoen International

A Journal of Medical Humanities


Nam Nguyen
Palo Alto, California, United States


I led her well into the center of the Russian Market, holding her hand behind me so that I could navigate the two of us around curious eyes. I was careful to stay in the dark, aware that the market had not yet been entirely vacated. A group of drunken tourists remained. As I waited, crouched behind a rickshaw, profanities began to echo into the empty market stalls. My hands were quick enough to cover my sister’s ears; I had asked her earlier that evening not to come. Tonight’s hunt would be her first.

Gently, I turned her head towards mine, searching for what I thought would be hesitation. I nodded as she raised her eyebrows in recognition, slipping into a smile as if to reassure me that we could continue. The soft warmth of her smile could not belie her disquieting fear. She had begun playing with her hands the moment our shadows disappeared into the darkness. I knew my sister well—the churning of her palms was her way of telling me she wanted to escape, to run away from the market’s repugnant smell of piss and spoiled fruits. I whispered a verse from “Inside Bravery,” one of her favorite poems, into her ear. I did what any older brother would do; I tried to comfort her.

When the tourists, their walking stuttered by drunkenness, could no longer be heard, I relaxed my muscles and reached into a soiled backpack my sister had been carrying. Two makeshift crossbows appeared, and I handed one to my sister. She grasped the wooden crossbow cautiously, avoiding the dry blood marks and rusted nails. “Vannat,” she called out to me while I inspected my own crossbow. A small pebble was lodged in the slot of the crossbow’s stock. I turned the bow upside down and shook the piece of shit up and down and then sideways before turning to my sister. “Do we really have to kill the rats?” she asked me, her eyes fixed deeply on her crossbow. I could tell her heart was heavy. The sound of a pebble joined our conversation. I took in a deep breath and closed my eyes. I would need to choose my next words carefully.

I thought back to my first hunt four years earlier. Back then, I killed the rats the same way my dad managed to. Using a large stone with a sharp edge, we smashed and smashed their bodies until blood dyed our forearms red. The worst part, and the part that really pulled at my soul, was that, once I managed to kill one rat, I wanted to kill more. “Look Souphy,” I said curtly, before stopping to readjust my tone. I continued, “We have to kill these rats, well, because they pay for mom’s health. They pay for dad’s disability. And they’ll one day pay for your schooling too.” I paused again as if waiting for my words to dry before continuing, “Souphy, they pay for our spot in the future.” A look of comprehension crossed her face, and she was silent for a while. I looked beyond her, my eyes fixed beneath a row of wooden benches as my ears traced the sound of some critter. Suddenly, a light came into Souphy’s eyes, and with a smile she turned around, pointing her crossbow in the direction I had been looking.

“Keep your eyes low and remember to soften your footsteps,” I reminded her as we stepped around broken glass, feces, and sharp rocks. I patted my pants and jacket pockets before finding my flashlight in my chest pocket. “Vannat! Do you hear that? The sound’s getting louder!” exclaimed my sister. I quickly asked that she stay quiet and handed her my flashlight. My sister aimed the faded yellow light below the benches. A collection of mangosteen and rambutan seeds appeared momentarily and then disappeared. Afraid of what she had seen, my sister had dropped the flashlight. Her right foot, now bathed in the yellow light, was covered in blood. She had not been as careful as I had hoped. I reached near her foot, placing the flashlight into her hand and guiding the light to the dark shadows beneath the benches. A small group of black and scraggly-coated rats froze momentarily, staring blankly at us as though we had met before. I lifted my crossbow upwards, took a few steps forward, closed an eye to aim, and prepared to release the lever that would send an arrow forward. I was interrupted. I felt a damp warmth approach my ear, “Vannat, how do you know which one to kill? I see so many,” whispered my sister.

“Try to kill the older ones. You let the younger ones live, so they can breed,” I explained, gesturing towards the rat currently in my line of shot. “Make sure you’re paying attention. You get the next kill, little sister!” I said with a kind of sarcastic generosity. I slid my thumb against the trigger, releasing the makeshift arrow. A moment later all that remained was a wrinkled carcass surrounded by a bed of fruitful seeds.

Every time I hunted, I would fill up a book bag with bloody rat corpses. A book bag of rats sells at the market for about thirty thousand riels, about twice the amount an American tourist spends on a White Russian cocktail at any of the bars here in Phnom Penh; it was enough to feed my family for a few days. The merchants at the market prefer wild rat—the rats that subsist on fruit, leaves, caterpillars, and roots. City rats on the other hand eat just about anything— garbage and feces, for example. I have even seen some eat the dead flesh of other animals. Most tourists and even locals, however, aren’t able to tell the difference, especially because I clean and prepare the rat meat myself.

* * *

Souphy and I had spent the better half of the previous night preparing the pâté paste, vegetables, and meats for our sandwich sales. Over the years, I’ve learned that tourists would balk at the thought of consuming rat meat, so Souphy and I would grind the rat meat in with ground pork and advertise the meat as purely pork. In doing so, we could sell the sandwiches at pork’s higher market price. We guarded the secret closely.

Sitting with a group of other market vendors, I took a break from my pâté sandwich stall and joined in a game of grop kur harm, a traditional Khmer card game. I left Souphy in charge of the sales. As I sat down, I quickly picked up the group’s conversation. They had been talking about a foreign doctor who was regularly visiting every food stall in the Russian Market. “Ah, yes—are we talking about the doctor who works at the clinic on 51 street?” asked Bunlong, a grandfatherly man with a singular mark deeply interwoven in his left cheek, a painful reminder of the Khmer Rogue. Phnom Penh was a practicing home for many doctors, and when Bunlong recognized the vagueness of his question, he elaborated, “I gave him a ride yesterday to central market’s food stalls, in fact. ” He paused to raise his fragile fingers and pointed towards a brightly colored food stall, behind which Souphy stood. “I dropped him off right next to that pâté sandwich shop, actually.” I felt a certain nervousness, a tightening of my chest and weakness in my hands, surface, and I excused myself from the game.

I walked briskly, weaving around traffic and crossing a small bridge before finding my walk back delayed by heavy rains. The monsoon season had just started, and I had left my only umbrella back at the pâté sandwich shop with Souphy. “At least one of us will be dry,” I whispered to myself. I lowered my head and began to walk at a greater pace, but heavy winds forced me to find shelter. I found a vacant tuk-tuk near the side of the road and jumped in. I tried to clench my fists together, but could not find the strength.

* * *

I opened my eyes slowly. The added humidity from the rain made my eyes sticky. I had fallen asleep while waiting for the rain to pass. I quickly glanced at my watch and surroundings to help orient my senses. I stepped out of the tuk-tuk, stretching both arms outwards to reestablish my balance. The late night excursions into the markets had finally caught up with my body.

When I reached the pâté sandwich shop, I could not spot Souphy. She was neither behind the food stall nor at the serving tables. She had left the portable gas stove running and had also forgotten to cover our meat stock with a large plastic basket strainer. Market flies were quick to make themselves comfortable. I waved my hand and a black snowstorm lifted. Still bothered by the tightness, I pressed against my chest with both palms. I took a few steps away from the food stall before turning around to see a notice of some sort taped to the inside of the stall. The notice was from the International SOS clinic and was titled, “Food Poisoning Complaint.” I quickly perused the entire notice and learned that the complaint originated from Dr. Ladenheim. Questions soon accompanied my nervousness. Was my sister at the International SOS clinic? Did they take her to the clinic to question her? What about the closely guarded secret—do they know about the mock pork?

The ground outside was wet, but at least the rain had subsided. I waved my hands towards a group of middle-aged men crowded around parked motorbikes. Soon enough, a motorbike appeared, and the driver offered to take me across the city to the International SOS clinic for 1000 riels—the standard price for locals, while tourists often get charged five times as much. I offered him a pâté sandwich instead and mounted the motorbike. The driver fumbled with his keys momentarily before giving his engine life. I kept thinking that my own nervousness was somehow contagious.

The sun was beginning to set now, and as I made my way into the lobby of the International SOS clinic, my mind turned to the lobby’s bright white lighting. My pupils shrunk in size, and I thought about the contrast to the candle lighting that furnished my family’s home. “Can I help you?” the receptionist asked me suspiciously. She had been glaring at me the moment I walked in.

“I’m looking for my sister,” I replied quickly; when the receptionist said nothing I elaborated, “She’s a little shorter than me and has dark brown eyes and black hair.” The receptionist sifted through some binders and pulled out a stack of folders pinched together by a large paperclip. I wasn’t able to tell if the receptionist was helping me or working on another matter. “Does your sister have a name?” the receptionist asked. “Her name is Souphy Nuom,” I answered back. “Ah yes, she’s with Dr. Ladenheim. They are over in clinic room three right now,” the receptionist announced while gesturing with her hands how to get to clinic room three. Her gesturing looked like some sort of hand game to me, but I nodded as though I understood and proceeded down the hallways. I walked for some time before hearing my sister’s soft voice. I followed her voice to a door adorned with a large number three. I pressed my ear against the door to be sure. The delicacy in her voice always reminded me of Khmer sweets. I knocked and then opened the door. I could not wait.

Inside the room, my sister lay on a bed furnished with some type of white paper, cheerfully chatting in Khmer with a man I presumed to be Dr. Ladenheim. She seemed to be doing well, except that her right foot was dressed in bandages. “Vannat!” she cried out excitedly as I walked into the room. I extended my arms out to pat Souphy on the head before turning my focus towards the doctor.

“Why did you take my sister?” I asked protectively as my eyes filled with suspicion.

“Your sister has a cut on her right foot that was not properly cleaned. I noticed red streaks extending from the wound, and thick drainage as well. I feared a bacterial infection and so brought her in,” answered the doctor in almost fluent Khmer. “Here, make sure you give her these,” the doctor said. He tossed me a pouch filled with pills. He explained, “The pills are antibiotics—they are your friends. They will help her fight the bacteria. Have your sister take one pill a day.” I nodded slowly and hesitantly.

Still, none of this explained the food poisoning complaint from Dr. Ladenheim and the International SOS clinic. I reached into my pocket and showed the doctor the notice left at the pâté sandwich shop. Souphy had fallen asleep by this point, lying on her side, her knees pulled up near her stomach. “I’ll be frank with you, Vannat. As a representative of the clinic, I am going to ask that you and your sister stop selling your pâté sandwiches,” said Dr. Ladenheim. He continued, “We’re not sure what you’re putting into the sandwiches, but I’ve visited almost all the food stalls in the Russian Market this past week and have taken food samples from each. We found your pâté sandwiches to be the culprit in eight of ten food poisoning cases this past week, and seven of nine the week before.” A long silence ensued. Souphy’s heavy breathing filled the room. I wondered how much Souphy had told Dr. Ladenheim. I always knew that city rats were moderately dangerous to eat, but I was convinced that the meat was safe to eat with careful cleaning and preparation. Dr. Ladenheim broke the silence, “Vannat, you are hurting innocent people—you do understand this, right?”

I thought about the question for a moment. I tried to explain, “I don’t want to hurt these people . . . I just don’t have a choice.” I could tell from Dr. Ladenheim’s expression that he wanted me to go on. “I have been doing this for so long. My dad taught me how to hunt city rats. My grandfather hunted too. You can’t just ask us to stop. We will have no future, nothing at all . . . ” I paused to collect my thoughts. “I’m not the only one hunting city rats. A lot of other families hunt too. You can’t stop all of us. Asking me to stop won’t fix anything. You’ll make my family starve. My sister’s trying to go to school. You’ll mess that up too.”

Again, the room turned quiet. Dr. Ladenheim walked contemplatively with both hands behind his back towards a chair near Souphy’s bed. He sat down, resting his elbows on his knees, and brought up both hands to massage his forehead. He began talking again, speaking more personally than before. “You know, where I come from, what you’re doing is the type of rubbish that is considered unacceptable. I have been living in Phnom Penh for fifteen years now. I have Khmer friends. I even speak Khmer. But I don’t know shit about the way Khmer people think and live.” In the midst of his self-reflection, Dr. Ladenheim had kicked over a wastebasket out of frustration, spilling empty vials and soiled bandages onto the floor. Dr. Ladenheim had realized what he was: “I’m a medicine man . . . trapped in my own fucked up little fantasy!” he cried out.

I would spend a few hours that night building a third crossbow.



NAM NGUYEN is a recent graduate from Stanford University where he studied human biology with a concentration in social entrepreneurship. His career interests center around entrepreneurship, particularly in the field of predictive health care analytics. Nam also has a passion for assisting and empowering underserved populations and has worked in two free clinics and an array of youth empowerment groups.

In his free time, you can find Nam carving hills with his long-board, dabbling in event photography, and putting finishing touches to his home-cooked Vietnamese dishes!

Highlighted in Frontispiece Summer 2013 – Volume 5, Issue 3
Summer 2013  |  Sections  |  Fiction

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