Small Trade Tubes

Amitabh was late and the fish knew.

Amitabh held back some brine shrimp until the pinkbar goby, a wedding present Shruti hadn’t cared for, swam to the surface in a flash of pink and silver. With Shruti home and the baby due any day, Amitabh was late and the fish knew. He retrieved the cash tray from the safe, and when it wouldn’t fit into the register, he reached into the drawer and pulled out a bangle, a stick of kohl, and a leaking tin of kungumam. He missed the clink of Shruti’s bracelets as she rang up prescriptions and the tempting mints and gum placed near the register. The photograph above the charge card machine showed Shruti, framed by marigolds in her red wedding sari. Beside this was the picture of his sister, who upon hearing that Shruti wouldn’t consider moving back to India, said a baby might change that.

Miss Margaret Swanson jangled the door just after ten, on schedule fresh from her most recent appointment with Dr. Dan. She waved a chapped hand over the fish tank glass, and the fish tracked her as they did anything that might provide food. Amitabh greeted her, and an orange line chromis poked out from a coral cavern. She bent to study its iridescent scales, her dress the dull brown of the bicolor blenny. She wore cotton socks, sandals, a sunhat. Few patients, Amitabh reflected, followed their physician’s recommendations so carefully and to such little effect. She approached the counter and handed Amitabh her latest prescription.

He interpreted the scrawl and smiled. “This is a very new brand of ointment, but I have it if you would be so kind to wait.” He felt her eyes follow him down the aisle where he slid a number of drawers open and closed for her benefit before locating the Aclinate, a new compounding of old ingredients. Dr. Dan had written to dispense one small trade tube with two refills. Amitabh read this shorthand to mean, “I am prescribing another steroid cream for this patient that will work no better than the last half dozen. I do not know the size tube this drug comes in, nor does it matter. Please dispense the smallest tube. There is no need for further waste.”

Amitabh had learned a great deal about Miss Swanson’s skin over the last few years. As a child, she remembered deep cracks between her toes. She told sorrowful tales of having her feet slathered with creams at bedtime and wrapped in suffocating plastic bags to increase the cream’s absorption. When she could no longer bear greasy feet trapped under hot blankets, she loosened the ties at her ankles and wiggled her toes in the cold room.

To rid herself of eczema, she changed her life, her soap, her detergent, her clothes. She wore thick gloves in the garden and gave up knitting when the wool snagged on scaling skin. Dr. Dan tested her for allergies and found no triggers. Despite this, Miss Swanson dreamed of renting a house at the ocean for not less than a month and learning to paint in watercolors.

Dr. Dan knew there was no cure; Amitabh knew there was no cure. He plucked a forty gram tube of Aclinate from the drawer. If Miss Swanson knew, it was unclear that she understood. Amitabh knew that the defect lay in the imperfect barrier that her skin made with the outside world. Ointments filled the gaps between skin cells without correcting the faulty union. Miss Swanson would always need to apply some cream or another, and it was her faulty knowledge or refusal to understand that helped to keep the pharmacy afloat.

Amitabh applied the adhesive label to the tube and slipped it into a white paper bag. “Will you make an ocean reservation for the summer?” he said.

She handed him a credit card, studied the back of her hand and shook her head. She knew her skin would break out as soon as she got there from the heat, the water, the harsh detergents used on guest sheets and towels. She fingered the bag. “When I find the right cream, I’ll rent a cottage on the beach and sit on my porch with a cup of tea and paint the sunrise,” she said. “Then I’ll walk the beach and collect shells for a still life. If the water is warm, I’ll swim and then lie in the sun on a plush cotton towel.”

“Miss Swanson,” Amitabh gestured to the rows of prescriptions pills and creams stacked on shelves and compressed into tubes behind him, “there are hundreds if not thousands of creams and ointments for dermatologic conditions. I mean no disrespect, but you could try a new cream every week and not exhaust the modern pharmacopoeia.”

She looked doubtful.

“Why not take a house at the beach?” he said. “For most eczema is a winter disease, so now is the time.” Unable to interpret her expression, he continued. “I could transfer your prescriptions to a local pharmacy in case of need.” He stapled the receipt to the prescription bag with authority. “An extended stay at the beach with water and the moist sea air may prove an excellent cure.”

Amitabh spent the later part of the morning compounding tuna-flavored prednisone for a cat with inflammatory bowel disease. For this he had studied pharmacology at home and took a chance on a job in the United States that had once seemed exotic. He ate his lunch of daal and curry from the tifin Shruti had packed while paging through the fish catalog. He planned to buy another fish for the tank, native to the Indian Ocean, to celebrate the baby’s birth. A son, he knew by the accident of an open chart. He had not told Shruti.

After the busy lunch hour he straightened the store as best he could before the rush at closing. He would have to hire a cashier. It made little sense to hire an ayah for the baby so Shruti could work in the pharmacy. He fed the fish and cleaned the aquarium glass while the fish, striped white, yellow, red, like the foreheads of his uncles in Madurai, fed. He might even find an Indian cashier whom he would instruct to dust everything except the fish tank.

On the drive home, he passed the community pool for their dry, white suburb before pulling in. One of his uncles had returned to a new neighborhood like this back home where the monsoon would soon quench the summer heat.

Shruti sat folding shirts and slacks and a sari she had worn last weekend to a party. On the TV, no dancing, no color. Amitabh kissed her cheek and smelled the coconut oil on her thick, dark plait. Her perfect hands smoothed the knit top that covered their growing baby. He went to change, his hand hovered over the folded lungi he’d abandoned at the back of the drawer before plucking out a polo shirt. He was not going to argue with Shruti again. He knew how it would end.

“How will our baby grow up Indian here?” he had said. “We could move to one of the developments they have now in India..”

“Why return to India,” she had said, “where water does not run, electricity goes out, and bribe is required for the simple acts of life?”

After dressing he’d lit a candle in front of the Shiva adorned with sandalwood paste and marigold petals, before applying the tilak Shruti discouraged him from wearing to work. In America, she had said, customers would be suspicious of a pharmacist with his face painted like a witch doctor.

Miss Swanson was back the next week. “I cannot tell if this cream does not work, or if I do not believe in it.”

“You must believe in something,” Amitabh said. “Fully one-third of patients respond to placebo alone.” He showed a flawless brown arm. “When I was a child we used turmeric on cuts and scrapes.” He reached over the counter and plucked a tube from the shelves next to the register. “Have you heard the theory Similia similibus curentur? ‘Like cures like’ is the principle of all homeopathy: when you have one symptom, you counter it with something with the same properties. It is like the movie star Botox craze.”

She wrinkled her brow.

“Botox,” he said, waving down the aisle of “b” medications, “uses the botulinum toxin which in large doses paralyzes muscles. In very dilute amounts it was used to control muscle spasms for the lame before its use for wrinkles became famous.”

“Calendula cream is a well known treatment for skin made from a flower similar to the marigold,” he said. He waved the tube for her to read. “I give you this tube with my compliments, if you promise to book your cottage.”

She handled the silver tube.

“I have your word?” he pressed.


He opened the cash drawer, pulled out Shruti’s tube of red paste, squeezed a small amount onto his right index finger and touched it to the space between Miss Swanson’s eyes.

“Red is the color of strength,” he said wiping his finger and recapping the tube before handing it to her. “I wish that you apply this daily as needed.”

The new lionfish was floating in its water-filled plastic bag when the postman brought the envelope. The watercolor from Miss Swanson showed a basic understanding of water color and wash. She had painted a cool, blue ocean under an orange-red sun. He pictured her on the beach, her hands perhaps in cotton gloves, an empty tube of cadmium red beside her pallet. Once released, the fish swam, its fierce black and red spines strong and beautiful. Amitabh had insisted Shruti apply kohl between their son’s eyes to protect him from harm. The baby, who shook his bangled arms and legs at the tank, would soon ask about the fish, and Amitabh would tell him about the Indian Ocean.