This Is How It Always Is

Rosie and Claude arrive in Bangkok. Though the airplane ride is cold and boring, Claude quickly discovers that he prefers the plane to the heat and lack of personal space in the city. However, in Bangkok, he starts to notice “people—women—like him. Like Poppy” (249). Claude cannot keep his eyes off these beautiful creatures, with their curated femininity. He is amazed that they can live their secret out in the open. Rosie and Claude begin the drive to the clinic—which is deep inside the jungle—for the first time.

Rosie and Claude meet K, who serves as the clinic’s mechanic, ambulance driver, and midwife. The clinic is made of cinder blocks with barred windows and curling linoleum floors. Patients wait outside in lawn chairs. They are treated on wooden platforms instead of beds. Rosie attempts to deliver a baby whose mother had a heart condition due to scarlet fever. The baby is born healthy, but the mother soon experiences trouble breathing. Rosie asks K for oxygen, but the clinic has none. Rosie soon realizes that the clinic has none of the tools she needs to save the mother’s life. Rosie asks K what they do. K replies, “We watch, help ease, be witness” (260). The mother dies, and Rosie and K move on to treat the next patient. After a hectic first day at the clinic, Rosie starts to miss Penn.

While Rosie works at the clinic, Claude volunteers at a school. The head of the school asks him to teach the children English. Because his head is shaved, the children think he is a monk. They also call him pretty. Claude reflects, “At home, you did not call boys pretty. Pretty meant girl” (265). The students ask Claude why he shaved his head, and Claude admits that he was angry. The children agree that anger is a good reason. To teach the students, Poppy asks them what they want to be when they grow up. After answering, they ask Claude the same question. Immediately, in his head, Claude answers, “Poppy” (267). Though the children are eight years old, many of them are attending school for first time due to family obligations or financial constraints. After volunteering, Claude speaks to his father via Skype about the possibility that the students might have identified him has a girl. Penn confirms that this is a central question in Claude/Poppy’s life. He also says that the students probably see Claude as American, white, and healthy before they see gender. Penn encourages Claude to see himself the way he wants. “I see nothing,” Claude replies. “I am unforeseeable” (270).

Rosie worries about Claude’s happiness in Thailand and ask if he wants to go home. He immediately says no. Rosie makes progress at the clinic despite a lack of supplies. She learns to replace antibiotics with honey and use crushed papaya seeds to treat worms. She finds that her talent for improvising serves her well. Rosie learns more about K’s multiple roles at the clinic, seeing that she serves as a physical therapist as well. When a pregnant woman with a broken leg is wheeled into the clinic, Rosie realigns her bone by hand. Rosie reflects on her inability to find these replacement remedies to ease Claude’s pain; she “didn’t know what that trick was yet, but she was getting a crash course in looking for it” (275).