"Cuentame (Tell me)," he said, and she did.

She sat across from him. I sat to the side. She was 19 years old with long black frizzy hair, a sharp pointed nose, and thin painted lips. Her face betrayed the boney ridges and the labyrinth of cartilage that lay beneath. With the suppleness of youth, her floating skin was still smooth and her smile was wide and wild. She was tall for a Mapuche and her young breasts defined a proud Figure beneath her one-size-too-small V-neck sweater.

"Nineteen days," he said, "How did that number arrive? When was your last bleeding?"

"In January ... January 29th".

He sat across the desk and stared at her. He had vivid blue eyes. There, in that South American countryside of short dark native people, his blue eyes were remarkable—they reflected the German blood of my Maestro. He sat, staring, and she clarified.

"The next time should have been February 28th and that makes 19 days," she said slowly, poised.

"Your last time of bleeding was January 29th—with nothing in between?"

"Yes, Doctor".

"That makes you 3 weeks late, more or less".

"Yes, Doctor".

"In a year, how many times are you late?"

"Never, Doctor".

"You have never been late?" he asked incredulously.

"No, Doctor".

He continued to stare in silence, never taking his eyes from her. Finally, he said, "Show me your hands".

She put them on the desk, palms down. She continued to smile.

"Turn them over," he said, while he took them himself and turned them over so that they lay supine in front of him. Surprisingly, he did not take the wrist between his thumb and middle finger as he usually did. Instead, he sat with his hands folded in front of him and inspected the soft, dark, dirty hands while they waited there to be told what to do. He said to her, "Take off your sweater and lie down," and then to me, "Please examine this woman's heart".

She did not hesitate to move. This visit was to be her moment of glory, verifying her great accomplishment. The Doctor wrote. While she undressed, I asked about her relations. She turned and said with modest playfulness, "I'm married," using the permanent form of the verb "to be". I had looked for a ring on her finger but of course she was not wearing one.

She had the type of heart murmur that comes from a narrowing of the outlet valve of the heart. The blood roared through this valve and the sound followed the rush of blood into the young woman's neck. But her pulse did not coincide. Instead of being weak and drawn out as in pure valve narrowing, it was sharp and transient. It was the pulse of a valve that does not close correctly, that allows blood to fall back into the heart. When I finished my examination, the Doctor listened carefully to her heart and neck, felt her pulse, and returned to his seat and continued his writing.

Finally, he turned his eyes to me and asked me what I thought. I explained what I had heard and the discrepant pulse and I offered my tentative diagnosis.

"Exactly," he said in English, the language he sometimes chose when speaking with me. Turning back again and looking at her, he said, "She has both aortic stenosis and insufficiency. but it is not so strange, they often occur together. This is probably from the infection. The mitral valve was clean to me". I nodded and he asked what I thought of the diastolic murmur.

"I didn't hear it," I said after a moment.

"Neither did I," he said in Spanish while he wrote, "but it is probably there. What thing told me she has an anormalidad?"

"The devil," I thought, but did not dare say. Many times he had shown a Faustian genius for observing physical characteristics but an insensitivity toward the less tangible of his patients' concerns.

"I don't know," I replied.

"What about this woman's body is urging us to examine her heart?" he asked with a patience that demanded an intelligent answer. Her face had changed to one that was stubborn about its happiness. "What tells you she has a defect?" he asked again, a little louder.

It had been there before, I had seen it before. "The pulsation in her sternal notch," I said.

"Perfecto. That pulse is not normal". He said this looking straight into me with those piercing blue eyes. "Never forget this. Your senses: Your eyes, your fingers, your ears and nose are finer than all the machines you will use. That is the truth". I made no reply.

He ripped the pink slip from the pad he had been writing on and offered it over the desk. He said to her, "I agree, you are probably pregnant. But there is a problem with your heart. It might be bad, it might not be. I doubt it will hurt your baby. I want it to be looked at by a specialist. Take that paper and have them make you an appointment in Temuco, then make an appointment to start your visits. Do you understand me?"

"Yes, Doctor," she said in the tone of a scolded school child. She stood up and carefully pushed the chair back into place.

"Listo (Ready)," he said.

"Ciao," she replied, her back to us as she left.