Grandma came in this morning to the satellite clinic for follow-up and dressing change on her burned right foot. Two days ago, she had a pan of boiling water that she had placed on a side table, but the side table was unstable and collapsed, spilling the water all over the top of her foot. The area right around where the metatarsals meet the phalanges was hugely blistered, I’m talking a one-inch tall blister full of fluid, and she had several other such huge blisters on her foot as well.

The impressive thing is that the blisters were still perfectly intact, and there was no sign of infection in her foot at all. She had been putting silvadine on her feet herself and changing the gauze herself, and it looked wonderful, as far as burns go — she could even walk well, albeit with a cane and a slight limp. She had done a great job.

Still, our provider wanted to see the blisters herself, so I unwrapped the foot, and, through a translator in the room, asked her about pain and mobility and other such assessment questions. Then my translator had to leave, so I started to gently clean the burn with sterile saline while waiting for the provider to come in and assess the burn herself.

I irrigated the foot as gently as I could. “Nez geish?” I asked. Does it hurt?

She smiled. “Cold. Little cold,” she replied, and I looked up at her and grinned. “Little English,” she said, indicating “little” with her fingers.

I indicated an even smaller space with my fingers. “Little little Navajo,” I replied, and she laughed.

I pointed, Navajo-style, to her foot. “Did you go in the ambulance?” She had burned her foot at night and had been seen in Kayenta.

“Degah.” No. She pointed across to the small town we were in. “My daughter, in her N-U-T-A truck.” She mixed the letters of the Navajo Tribal Utility Authority, but I knew what she meant. She continued, “One daughter, in Kayenta, near the red light.” Then she pointed south. “One daughter, in Phoenix, working working.” Then she pointed north. “One son, in South Dakota, working.”

“How many daughters do you have?”

“Six.”

“And how many boys?”

“Three.”

“Nine children!” I was suitably and honestly impressed. She laughed. I asked, “How many grandchildren?”

She looked up at the sky and counted for a moment. “Twenty-two? Twenty-three? I think. Many.” She frowned. “They speak no Navajo.” Then her whole face became incredibly animated as she mimicked her small grandchildren, turning her head from side to side as small children do when they’re confused. “‘What she say? What Grandma say now?’ Bah.” And she waved her hand. I grinned; it had been a wonderful impression.

She paused for a minute and smiled. “One granddaughter coming from South Dakota, tomorrow, with my son.”

“They’re coming tomorrow? To help you with your foot?”

She nodded. “Granddaughter, she is half-Navajo, half-Belaganna, married a South Dakota indian.”

Now I laughed. “She’s very complicated!” The grandmother nodded. I grinned. “Your English is MUCH better than my Navajo. I only know a few words.” I counted them off on my fingers.

“Yaahteeh, Oha, Belaganna, Degah, Dohdah, Aheehee….ummmm….Yaahteeh beneh, Yaahteeh ee ee ah – ”

She interrupted me. “Yaahteeh beneh,” and she pointed her finger to the east. “Yaahteeh ah-glhee-na-ah,” and she pointed straight up. “Yaahteeh ee ee ah,” and she pointed to the west.

I laughed. “Yaahteeh ah-glhee-na-ah, that’s the one I always forget!”

She smiled. “You write them down.”

I nodded. “You’re right, I should.”

We sat in silence for a few minutes.

Suddenly, she said, “My husband, he gone now twenty-one years.”

“Oh,” I said, and suddenly the language gap loomed like a chasm before me. “I’m so sorry.”

She nodded. “He…uranium cancer.”

“He was a uranium miner?”

She nodded again, then said, “He was a good man.” She looked angry for a moment. “They say, here, money money money, and I say no. No use, he’s gone.” She shrugged.

I said, “You must miss him.”

She sighed, and said slowly, “I miss him every single day.” Then she looked down and said, “My sister, she gone now October 27.”

“Oh, no, she died just in October.”

She nodded. “October 27. Oldest. Just us two sisters, one brother.”

“Did she live here?”

“No, Monument Valley.” She looked devastated, as if October was only yesterday. I choked on the dozens of passive listening words that I usually use to speak to grieving patients, because it was above the level we were communicating at.

Finally, struggling to let her know, in some way, that I cared, I said, “Nez geish,” and I pointed to my heart.

She nodded. “Oha,” and she started to weep.