Last Call for Blackford Oakes (23 page)

“I'll give you your medical news on Tuesday.”

They exchanged a bear hug.

CHAPTER 42

At six-thirty, Titov arrived at the office of his doctor and friend, the red and gold hat tight over his head. On the phone, earlier in the day, Kirov had asked him to allow an hour or so. “I need to talk with you about another matter.”

“There is no other matter than my prostate.”

“I'll see you at six-thirty, Linbek.”

The analysis had been done. The prostate was cancerous. “There is always the possibility of metastasis, and that is something to be watched. My recommendation is that you submit to twenty radiation sessions. I would be wasting the time of the principal student of radiology in Moscow—perhaps in the world—to instruct you in the matter of radiation treatments. What I have here for your radiologist is a very precise location to bear down on.”

“Volodya, can I have … normal relations with my wife?”

“You certainly can, some weeks' time after the treatments. During the period of treatment you may not achieve satisfactory erections.”

“In that case I will have to keep Nina entertained with bulletins from my radiological institute. But Volodya, you had some other matter on your mind. What is it?”

Kirov had not been informed by Ursina on that Friday, two weeks earlier, about her scheduled ectopic operation later in the day. She hadn't even told her old friend that she was pregnant—or that she had a lover, let alone an American lover. But in a telephone call from a public site (he assumed) the previous Monday, she had told him, excitedly and defiantly, about her encounter with the culture minister.

“What exactly did you have in that speech?”

“Not much you'd approve of, my dear friend.”

“Maybe you should let me read it.”

“I'll do that, Volodya. In the next couple of days. I'm going to be … busy for a day or so.”

He loved Ursina Chadinov as he'd have loved his own daughter. He had taken Ursina under his wing when she was nineteen, at the behest of Dr. Roman Eskimov, his own, aging mentor, who was married to Ursina's aunt. Kirov had provided academic counsel, social direction, and warm company. There had been the brief estrangement. Ursina had invited Kirov, even though twenty years her senior, as her date at the medical students' end-of-second-year party. This party was, traditionally, unrestrained. The seventy students were tense from the ordeal of their examinations, anxious for a night's uninhibited relaxation.

Ursina, lively with wine, her eyes radiant with excitement, motioned to Vladimir—who was wearing a white shirt and his very best gray suit, his decoration from Moscow University prominent on his lapel—to follow her. Ursina led him to one of the rooms provided by the hostelry. “Then, Volodya”—she had never before used the diminutive with him, her mentor and professor—“I can express myself on how much I love you and owe to you.”

Kirov followed her into the little room and accepted her hot embrace. But he grabbed her hand at a critical moment. “No further, dear Ursina. I am, in these matters—different.”

She gasped, and in mere seconds was entirely sober. Her eyes were tearful. “I'm sorry, Volodya. But I love you just as much as if—”

“As if I were normal.”

She bit that one off deftly. “If you were normal, Volodya, I wouldn't feel the love for you that I do.”

The evening had ended on that conciliatory tone, but for some weeks, meeting each other in the corridors of the medical school, there hadn't been the old, easy intimacy.

Gradually, this returned, and when Ursina became a full doctor of urology, she was everywhere thought of as the special protégée of the learned Dr. Kirov, whom she had now informed of her disgrace with the culture minister.

Seated behind his desk, as if still talking doctor to patient, Kirov said to Titov, “I am personally and professionally interested in Dr. Ursina Chadinov.”

“Isn't she the professor who was to follow me as welcomer at the peace forum?”

“Yes. That's she, and the talk she had prepared was the cause of her political trouble. A lovely woman, gifted practitioner, and assiduous researcher.”

“What's her trouble?”

“She is dead. I learned only after her death that she was deeply in love with an American and had conceived a child, apparently very soon after they met. He flew back to Washington soon after she found out—”

“Oh, one of those. ‘I'll send you a Christmas card, dear—'”

“No no no. He loved her totally and intended to come back to Moscow—to do what exactly, one doesn't know. But Rufina Martins, who was Ursina's roommate for years, right until she married, became involved. She returned from Kiev, where she had gone to tend to her sick brother. She loved Ursina deeply and is ablaze with fury and indignation over her death.”

“Death from
what
, goddammit it, Volodya?”

“Her pregnancy was ectopic.”

“So? My wife had two of those. I've said that.”

“We are told that she telephoned to Dr. Shumberg—our classmate, Kirill Olegyevich Shumberg. I don't know how she got his name.”

“He's a big cheese, very involved with the government. I may have told you that he keeps a careful eye on my own research. But he is also a skilled practicing surgeon. He did the ectopic operations on my Nina.”

“Here is what I've pieced together, talking with her regular doctor and with the surgeon who was all set to proceed with the operation. Ursina apparently was told that Shumberg was very skilled and sometimes had succeeded in saving the life of the baby as well as the mother.”

“I have heard that that can sometimes be done. When he operated on my wife there was simply no question of doing any such thing. It is very unusual. But you told me Ursina was dead?”

“Yes. She died on the operating table.”

“But that is inconceivable!”

“No, Linbek, it is not inconceivable. I have done research on the matter. It can and does happen, every blue moon. What is inconceivable is that the mother should be permitted to die if the surgeon sees that there is no chance of saving the fetus.”

“Is that the same thing as telling me, Volodya, that Shumberg committed a very gross error?”

“That is one explanation for Ursina's death, Linbek.”

CHAPTER 43

Nina Titov, petite and lively, with short dark curly hair, was a full-time wife and mother. She had known from the beginning that her husband, Lindbergh Vissarionovich, was wedded to his laboratory work. She promised on their wedding night that she would not seek to understand what it was he was doing. He greeted this news gratefully. In odd mentions of his work, Linbek stressed less its confidentiality than its inscrutability. “To understand, Nina, you would have to be a fifth-year student.”

Nina did not probe the mysteries of radiology, but she paid close attention to Linbek's personal requirements, looked after his comforts, and worried over his occasional blue moods. Almost always these had to do with problems, direct or indirect, in getting on with his work, and in communicating his concerns to foreign scientists, getting from them their intelligence and insights, even as he sought to give them his own.

Their first-born son, Aleksei, was a surmounting joy for Nina. When he was three, she once again became pregnant, but this time, after a few weeks, she knew that something was wrong.

She called Linbek's old classmate, Kirill Olegyevich Shumberg, the prominent obstetrician. He diagnosed an ectopic pregnancy and performed surgery. She was very distressed over the lost child, and when, two years later, she had yet another ectopic pregnancy, she hesitated a few days before proceeding to surgery. In college she had studied Russian literature. She knew practically nothing about medicine or human biology, but she knew all she needed to know in order to do research in any field. She went the next morning to the university medical library to read about ectopic pregnancies.

She got little encouragement from her research on the question that most interested her, which was: Might her baby be saved? If the second Fallopian tube had to be severed like the first, and the fetus killed, that would be the end of the Titov household's hopes for a larger family. She did find a reference to one or two historical successes of surgeons in saving the child. These were so rare as hardly to offer a realistic hope. But they had happened, in medical history, and after taking notes she made the appointment with Dr. Shumberg.

“Ah, dear Nina Aleksandrovna,” said the polished surgeon, trained meticulously in his handling of patients, “you have again the cursed ectopic?” He did a physical examination and took blood and urine samples.

“It is not an immediate problem, not an emergency, you are not bleeding. But we will have to proceed to surgery.” He looked at his calendar and called the operating-room nurse. “Friday 8
A.M.
? Very good.”

“But, Kirill Olegyevich, I wish to talk to you about this.” She pulled out her notes from her purse. “There have been cases where the surgeon has saved mother
and
child.”

“Yes,” Shumberg said. “But for that to be even the remotest possibility requires that the fetus be specially situated and specially protected by the surrounding tissue.”

“Can you attempt to do this for me, Comrade Kirill Olegyevich?”

“Of course. In a way, that is always ‘attempted.' But incidences of success are so rare, we don't offer any hope to the mothers.”

“You are a great doctor, and I will hope and pray that you can save the Titov child.”

He did not succeed. Nina hadn't told Linbek about her research, or about her conversation with Shumberg. She didn't want him to have hope when none such realistically existed.

Seated at the dinner table back home after his meeting with Kirov, Linbek related what Kirov had just reported to him. He told Nina of the death of Ursina Chadinov.

Nina was perplexed. “Shumberg told me, when I raised the question of saving the baby, that there was virtually no chance of success. I wonder why this Ursina called him so specially? And when last did a mother die in an ectopic operation? According to my research, that would have been more than fifty years ago.”

Titov chewed on his chop and took a glass of wine. After giving the matter some thought, he said: “I'm going to find out what day Shumberg will be coming to the laboratory. He comes usually once or twice a week. I will ask him about Ursina Chadinov.”

Reaching the lab the next morning, he waited until nine, by which hour it was reasonable to expect Shumberg to be in his office and taking calls.

Linbek got through. “Kirill Olegyevich, are you coming today to the laboratory? There is something I want to talk to you about.”

That afternoon, Shumberg followed Titov to an empty classroom. “Kirill Olegyevich, I want to know about Ursina Chadinov, who was a friend of a dear friend.”

“Yes, that was very sad.”

“I know it's sad, Kirill, when a forty-one-year-old woman dies. But I think it is more than sad when she dies under the knife of a very competent doctor.”

“Linbek, staring hard at the tube when I had cut open her abdomen, I realized there was a critical difficulty with her breathing. I called out to the attendants. They did everything. But she was dead. There was no alternative than to assign shock as the cause of death.”

“Kirill, what could have brought on the shock?”

“Are you asking me a question fit for a medical-school quiz?”

“No, a question fit for a famous surgeon operating on a woman in apparently good health.”

“One can't always know what induces shock. It can have been a vessel suddenly blocked—”

“Is there anything you did that might have blocked an artery?”

“No. The incision in the abdominal wall went very smoothly.”

“Recount to me, Kirill, how it is that you got called into this case.”

“I had a telephone call from Chadinov herself.”

“Where?”

He hesitated for a moment. “At my dacha.”

“How is it she knew how to reach you at your dacha?”

“I cannot answer that question, Linbek. She would hardly be expected to take time telling me how she got through.”

“What did she say to you?”

“She said she was scheduled for surgery that evening at the university hospital and she hoped I could perform that surgery.”

“Why?”

“Because, she said, she had heard of my special skills.”

“Did you give her to understand that you might save the life of the child?”

“I certainly did not ‘give her to understand' any such thing. I did say of course that I would be willing to inspect the tube to see what could be done.”

“Did you speak to the surgeon you relieved about your conversation with her?”

“No.”

“Did you speak with her in the operating room?”

“She was already under anesthesia. I had told her I would come to her as quickly as I could, but could not guarantee my arrival in time for her 6
P.M.
deadline.”

“Why did you not recommend postponing the surgery?”

“There was some fear that damage was being done. She was already bleeding.”

“From whom did you know about that fear? Did you talk with the doctor you relieved?”

“No. It was clear that the operation would proceed. He had been told he would be replaced.”

“Told by whom?”

“An assistant from my office, whom I advised that I would proceed to act on Chadinov's wish for my services.”

“So your office heard from you, not from her, that you would be in charge? If she called you at your dacha, she must have had the number from your office. Is there a record of her conversation there?”

“My dear Linbek, you are being … well … intrusive.”

“I may be intrusive. You are responsible for a dead woman. Did you order an autopsy?”