“Hold her down,” FrannyB barked at me. I kneeled and dropped down over her, holding her shoulders to the mat, while Doña Antonia pinned her down at her hips. Anna sat at her feet, pressing them down and together. Strange but somehow right, the three of us joined in this task. “Don’t let go until I say so, no matter what happens. Got it?”

I nodded yes, my full weight pressing down on FrannyA’s shoulders, her sickness-fouled breath in my face, her pale blue eyes gazing through me.

“And don’t look at what I’m doing, all right? Keep your focus on her.”

I said nothing.

“Answer me, Lily.”

“Okay, all right.”

But I kept glancing down anyway. I couldn’t help myself. With a dozen swift, small jabs, Beya pricked the skin just below FrannyA’s rib cage; she winced but made no sound. Dosing the other palm spines briefly and lightly against the frog, Beya slid them in again and again on opposite sides of the tiny missionary’s gut, circumscribing a circle on the pale skin.

FrannyB palpated the shivering iodine-stained skin under her hands. “Do you feel that? Do you feel anything?”

“Just pressure.”

“Okay, that’s good. Really good.”

“I love you, B.” A few more tears rolled down the sides of her face, pooling in her ears.

“I love you too, A,” FrannyB said quietly, a note of embarrassment in her voice. She nodded at Doña Antonia, who with bamboo tongs fished the knife, tweezers, sewing needle, and scissors from the bubbling water and spread them out on the cloth.

FrannyB began her incision at the top left side of her abdomen, just below the rib cage, and continued in the shape of a smile down below her belly button and back up the other side. With a scrap of cloth, Doña Antonia soaked up the line of blood at the cut. A few of the young girls who had brought water waved palm fronds over the wound, whisking away the gathering flies.

As she lifted the flap of skin, FrannyB snipped at a thin membrane of white tissue. A firm nest of intestines lay glistening in the candlelight.

“Now, Beya. Call them.”

Beya’s mouth dropped open. A bass rumble rolled out of her, the lowest sound I’d ever heard emanate from a human being. Only when she paused for breath did the pain in my eardrums ease. I felt it in my bowel; my teeth thrummed with it. The floor of the hut vibrated beneath my knees where I crouched, my face inches from the sick missionary’s. But the part of her that could speak up and object was gone: oblivious, she’d switched back to humming, even singing snatches of hymns.

The thrumming noise deepened in round bellows, booming out of the shaman’s chest, a living instrument. The sound came from above me, beneath me, from inside me. Forehead pearled with sweat, FrannyB never took her eyes off the opened gut as her bloodied gloves—knife in one hand, scissors in the other—hovered over the coiled purplish ropes.