Cancer Ward (54 page)

This is exactly what he did when he and Vera emerged simultaneously from the corridor in different directions and met at the foot of the staircase. “I'm so glad you're back,” she said, “we really missed you.”

His smile widened. His dangling hand caught her by the elbow and turned her toward the staircase. “Why are you so happy?” he asked her. “Make me happy too.”

“Oh no, it's nothing really. Well, how was your trip?”

Lev Leonidovich sighed. “It was all right, but a bit upsetting. Moscow's a disturbing place.”

“You can tell me more about it later.”

“I brought you some records. Three.”

“Did you? Which ones?”

“Well, you know, I'm never too sure about Saint-Saëns and those people … they've got a new LP record department in GUM
*
now. I gave them your list and they wrapped three of them up for me. I'll bring them in tomorrow. Verusya, let's go to the trial today.”

“What trial?”

“Didn't you know about it? They're putting one of the surgeons on trial. He's from Number 3 Hospital.”

“A real court?”

“No, it's a comradely court
*
so far. But the investigation took eight months.”

“What's be charged with?”

Nurse Zoya was coming down the stairs, having just finished her night duty. She said good morning to them both, her golden eyelashes flashing in the light.

“A child died after an operation … I'd better go while I've got a bit of Moscow energy in me. I want to make a hell of a fuss. A week in this place and you're back with your tail between your legs. Shall we go?”

But Vera didn't have time to reply or to make up her mind.

It was time to go into the conference room. There was the same bright blue cloth on the table and round it some little armchairs covered with sheets.

Vera put a high value on her good relationship with Lev. He and Ludmila Afanasyevna were closer to her than anyone else in the clinic. The most precious thing about their relationship was that it was one that hardly ever existed between an unmarried man and woman. Lev never gave her that special look men give, he never dropped any hints, never overstepped the mark, never staked out any claims—and of course neither did she. They had a harmless, tension-free friendship. There was one subject they always avoided, never mentioned and never discussed: love, marriage and the rest. It was as if these things did not exist.

Lev Leonidovich presumably guessed this was the type of relationship Vera needed as well. He had married once, stopped being married, then had a “friendship” with someone else. The female part of the clinic (which meant the whole place) loved talking about him. At the moment they suspected he was having an affair with one of the operating-theater nurses. One of the young surgeons, Angelica, emphatically declared that this was the case, but some people suspected she was after Lev herself.

Ludmila Afanasyevna spent the five-minute conference drawing angular figures on a piece of paper which she managed to tear with her pen. On the other hand, Vera sat more quietly than ever before. She felt an unfamiliar steadiness in herself.

The conference ended and Vera began her round in the big women's ward. She had a lot of patients there and always took her time. She would sit down on each bed, examine the patient and talk softly to her. She did not insist on complete silence in the ward during her rounds because it was impossible to stop the women from talking for so long. One had to be even more tactful and circumspect in the women's wards than in the men's. Her status and distinction as a doctor were not accepted so unconditionally here. She only had to turn up in a slightly better mood than usual or be a bit too cheerful about promising them that everything was going to be all right—trying to apply the principles of psychotherapy—and she could feel the women staring at her blatantly or enviously looking sideways at her. “What do you care?” the glances seemed to say. “You aren't ill. How can you understand?” The same principles that made her advise these diseased women, frightened out of their wits, not to let their appearance go to pot. She made them do their hair and put on make-up. But if she spent too much time on her own make-up, the women would not have given her a particularly warm welcome.

Today was the same as ever. She moved from bed to bed, looking as modest and collected as she could, ignoring the general noise in the ward and attending to the patient she was examining. Suddenly a particularly coarse and unrestrained voice reached her ears from over by the opposite wall: “Don't talk to me about patients! Some of the patients here are on the job morning, noon and night! You take that scruffy one, the one with the belt round his middle—every night duty he gives that nurse Zoya a bit of a cuddle!”

“What's that? What did you say?” Gangart asked the woman she was examining. “Will you say that again, please?”

The patient started to repeat it.

(Zoya had been on duty
last night!
So last night, while the green dial was burning …)

“Excuse me, would you mind repeating that, please? Right from the beginning and in detail!”

26. Superb Initiative

When is a surgeon (not a new one, but an experienced one) nervous? Not during operations. During an operation he works honestly and openly. He knows what he is doing, his task is merely to remove what has to be removed as cleanly as possible, so that later on there are no regrets about an unfinished job. True, there are sometimes unexpected complications. There may be a rush of blood and he may remember how Rutherford died while having a hernia repaired. But basically a surgeon's nervousness begins
after
the operation, when for some reason the patient's temperature refuses to drop or a stomach remains bloated and one has to open it not with a knife, but in one's mind, to see what has happened, to understand and put it right. When time is slipping away, you have to grab it by the tail.

This was why Lev Leonidovich was in the habit of dropping in on his postoperative cases before the five-minute conference, just to have a look. As usual before an operation day the ordinary rounds would last a long time, and he could not go another hour and a half without knowing what had happened to his stomach case and how Dyomka was. He called on the stomach case, who wasn't doing too badly. He told the nurse what drink to give him and how much. Then he looked into the next room, a tiny one for only two people, to see Dyomka.

The other patient in the room was already on the mend and due for discharge, but Dyomka was lying there on his back with the blanket pulled up to his chest, looking very gray. He was staring at the ceiling, only it wasn't a calm, relaxed stare. He was straining all the muscles round his eyes as though there was a minute object up there which he wanted to see but couldn't. He looked alarmed.

Lev Leonidovich stood in silence, legs slightly apart and arms dangling, just to one side of Dyomka. He looked sullen. He even appeared to pull his right arm back slightly, as if measuring what would happen if he gave Dyomka a right-handed hook to the jaw.

Dyomka turned his head, saw him, and burst out laughing.

The surgeon's stern, threatening expression soon turned to laughter as well. Lev Leonidovich winked at Dyomka, an understanding, man-to-man sort of wink. “All right, then?” he asked him. “Everything under control?”

“Under control?” There was plenty Dyomka had to complain about, but when it came to a man-to-man exchange there were no complaints at all.

“Does it hurt?”

“Yeah.”

“In the same place?”

“Yeah.”

“And so it will for a long time yet, Dyomka. You'll still be clutching at it next year, even though there's nothing there. But when it hurts you, try to remember:
It's not there!
It'll make you feel better. The most important thing is you're going to live now, see? As for your leg—to hell with it!”

Lev Leonidovich made it sound so easy. He was right, to hell with the nagging painful thing! He felt better without it.

“Well, we'll call and see you later on.”

Leonidovich rushed off to the five-minute conference, clearing the air like a shell. (He was late, the last one to arrive, and Nizamutdin Bahramovich didn't like latecomers.) His white coat hugged him tightly. It had no opening in front, while at the back its two edges were pulled tight across his jacket but still wouldn't meet. When he walked through the clinic on his own, he always went fast and took the stairs two at a time, moving his legs and arms boldly. It was these positive, rapid movements that made the patients realize he didn't hang about the place killing time.

The five-minute conference began and lasted half an hour. Nizamutdin liked to conduct the proceedings with dignity and without undue haste (or so he thought). Obviously he loved listening to the sound of his own voice. Every time he made a gesture or turned toward someone, it was plain he was regarding himself. He thought he looked like a man of authority, reputation, education and intellect. Legends would be springing up about him back in the
aul
where he was born. He was well known throughout the town too, and even occasionally got a mention in the newspaper.

Lev Leonidovich was sitting on a chair he had moved slightly back from the table. He crossed one long leg over the other and stuffed his splayed paws under the white tabs tied tightly round his belly. He wore a crooked frown under his pilot's cap, but since he almost always frowned in his boss's presence, the senior doctor didn't guess the frown was meant for him.

The senior doctor viewed his position not as an unremitting, exhausting job, but as a constant opportunity to parade himself, to gain rewards and a whole range of special privileges. “Senior doctor” was his title, and he believed that the name really made him the most important doctor, that he knew more than the rest of the doctors (well, not perhaps down to the last detail), that he was fully aware of every treatment his subordinates were administering and that only his guidance and corrections prevented them from making mistakes. This was why he had to spend so long presiding over his five-minute conferences, although of course everyone else seemed to enjoy them well enough. The privileges of the senior doctor were fortunately much greater than his duties, which meant he need not be over-particular about choosing administrative personnel, doctors or nurses to come and work in his clinic. He could hire people recommended by telephone calls from the regional health services or the city Party committee or the medical college where he hoped soon to be submitting his thesis, or people he'd promised to take in some moment of dinnertime bonhomie, or members of the same branch of his own ancient clan. Then when the heads of departments came and complained about some new man who knew nothing and was thoroughly incapable, Nizamutdin Bahramovich would be even more surprised than they were, “Well, teach them, comrades,” he'd say. “What do you think you're here for?”

He had a head of white hair, the sort of hair that gives a man of a certain age, whether genius or fool, saint or rascal, man-of-action or idler, an aura of calm nobility. He had the impressive, soothing appearance which is nature's reward to those who have not suffered the pangs of thought, and the even, dark complexion that goes particularly well with gray hair. Nizamutdin Bahramovich was telling his medical staff what was wrong with their work and how they should intensify their struggle for precious human lives. Thus he was wont to hold the attention of the men and women who sat behind the peacock-blue tablecloth in their straight-backed official sofas, armchairs and hard-backed chairs, the staff he had already managed to appoint, as well as those he had not yet managed to get rid of.

Lev Leonidovich could see curly-haired Halmuhamedov particularly well from where he sat. He looked like an illustration from the travels of Captain Cook, a savage straight out of the jungle. His hair was a dense mat, his bronzed face was spotted with jet-carbon blackheads, his ferociously gleeful smile revealed a set of large white teeth—there was only one thing missing: a ring through his nose. Of course it was not his appearance that mattered, or the neatly inscribed certificate he had received from medical college, it was that he could not carry out a single operation without bungling it. Lev Leonidovich had let him operate a couple of times, but now swore he would never let him do it again. To fire him, however, was equally out of the question. That would be called undermining the policy of training native personnel. So the man had now spent more than three years writing case histories, only the simple ones of course. He went on doctors' rounds and looked important, visited the dressings room and did night duty (during which he slept). Lately he'd even started drawing his salary on a time-and-a-half basis, even though he left the hospital at the end of the ordinary working day.

There were also two ladies in the room with surgeons' certificates. One was Pantyokhina, an extremely plump lady of about forty. She was always in a state of anxiety. Her worry was that she had six growing children by two different husbands, and there was never enough money for them or time to look after them. These cares never left her face, even during so-called working hours, which meant the hours she had to spend inside the clinic to get her pay. The other one was Angelica, a young woman qualified for only two years. She was small, reddish-haired and rather pretty, and she hated Lev Leonidovich for cot paying her enough attention. She was the one mainly responsible for the intrigues against him in the surgical ward. These two women could do no more than receive outpatients and they could never be trusted with a scalpel, yet there were weighty reasons why the senior doctor would never fire either of them.

On paper the department had five surgeons, and the number of operations was calculated on the basis of five.

Yet only two were actually capable of operating.