13
This time, the room to which Andrei is taken contains Volkov. He’s seated at the desk, like a man at work in his own office. His chair is larger and slightly higher than the empty chair on the other side of the desk. Volkov gestures to Andrei to sit, without greeting him.
‘Good afternoon,’ says Andrei, but Volkov plunges in without preamble.
‘You know why we’re here. The boy is worse.’
‘I heard that.’
‘He has a cough. He’s losing weight. He’s tired.’
‘And your own doctor has seen him, I believe?’
‘Yes. So, what do you think is wrong?’
‘It’s not possible for me to say that before he’s had a full range of tests. If he were my patient I’d arrange a chest X-ray and blood tests straight away, after the physical examination.’
‘So he’s not your patient, then? I thought we’d agreed that he was. Or is he only your patient when things are going well, is that it?’
The work has become the man, thinks Andrei. Even now Volkov can’t stop framing his questions like an interrogator. Keep calm. Don’t respond in kind. ‘As you know, I’m not an oncologist. I became involved in your son’s case because of an initial confusion over the symptoms with which he presented. I remained in close touch with the case at your request.’
‘ “The case”?’
‘Forgive me.’ Andrei feels himself flush. He’s done exactly the same as Volkov – lost his grip on where they are and what should happen here. A crass, clumsy blunder, worthy of a third-year medical student. He would never have believed he could speak to a parent like that. ‘We get used to using certain expressions, and we forget how they sound.’
Volkov’s anguish is obvious. He looks worn, and he has aged much more than the few months that have passed since Gorya was first diagnosed. Andrei notices that the nails on his left hand are bitten down and surrounded by raw, bulging flesh. That’s new; Andrei remembers noticing how well kept Volkov’s hands were, and that his professional life clearly didn’t disturb him.
Volkov is far too intelligent not to understand how ill the boy is. Perhaps the private doctor summoned up the courage to warn him about what Gorya’s cough and loss of weight might mean. Maybe he even did an X-ray. Volkov wouldn’t disclose that yet; it’s not his style. He comes in hard with questions, to make sure that the conversation is always on his territory. He finds out your weaknesses.
‘You recommended the surgeon, as I remember. What was her name? Brodskaya. Yes, that was it,’ Volkov continues, drawling out the syllables mockingly, ‘Riva Grigorievna Brodskaya. She performed the biopsy and then the amputation.’
‘We discussed the criteria for choosing a surgeon beforehand, if you remember. Dr Brodskaya had the necessary experience, and an excellent reputation.’
‘But she doesn’t seem to have been very successful in this “case”, as you put it. Why do you think that might be, given that she’s supposed to be so good?’
‘She’s a fine surgeon. One of the best.’
‘You think so? Let’s hope that that her patients in Yerevan think the same. You look surprised, Dr Alekseyev. Did you think we wouldn’t know that the bird had flown the nest? So. Let me tell you what really happened. She butchered my boy for nothing.’
‘It wasn’t like that. There was no alternative to the operation.’
‘An operation which has succeeded in spreading the cancer all around his body. His lungs are full of it, do you know that? What kind of surgery was that?’
So the X-rays have been done already. Either here, in haste, or before Volkov brought his boy back to the hospital.
‘I haven’t seen Gorya’s X-rays yet,’ says Andrei.
‘They show, apparently –’ Volkov’s hard, aggressive composure falters, but he clears his throat and carries on. ‘It seems they show that cancer has spread to the lungs. But you must have suspected that. Apparently, we’re now told, it’s not uncommon. Met-a-stas-is. Isn’t that the word you doctors use?’
‘It’s a terrible thing,’ says Andrei. He would like to remind Volkov that he has always been honest with him. He’d made it clear that osteosarcoma was a highly aggressive cancer. Volkov was told that amputation was the only possible treatment, but never that it was a cure.
It would do no good to say these things now. Out of common humanity, if nothing more, he has to keep quiet. Besides, he feels a corrosive sense of personal failure, as he always does when treatment doesn’t work and it becomes clear that medicine has nothing more to offer.
‘You remember how he was after the operation? All that,’ says Volkov, not raising his voice but striking with his fist on the desk so violently that the pen holder jumps and clatters to the floor, ‘all that for nothing. His mother was right. I should have listened to her, but I trusted you.’
No, thinks Andrei, you never did, not for a second. You trust no one. ‘Where is Gorya now?’ he asks.
‘Your Professor Borodin is doing an examination. It’s you that Gorya wants to see, though. He never liked Brodskaya. Didn’t want her to touch him. Well, she won’t be touching anybody for a while. She’ll have to shut up her butcher’s shop.’
‘She is a very good surgeon.’
‘When you keep on saying that, it makes me think you’re on her side. Maybe you two know each other better than I realized. Were you putting your heads together all the time?’
‘Naturally we conferred about Gorya’s care.’
‘Naturally.’ Volkov’s forehead is moist. Suddenly his features twist with rage. ‘Naturally birds of a feather stick together!’ he shouts. ‘Why don’t you answer me? What are you made of? Aren’t you a man?’
‘You’re the parent of a sick child, and I’m a doctor. It’s not my job to argue with you.’
‘You’ve already failed in your “job”,’ says Volkov, with a contempt that doesn’t quite ring true. Like his anger, it has something in it which is synthetic and theatrical. ‘Your job was to find out what was wrong with Gorya and then do everything in your power to restore him to health. Instead of that, you tell me you’ve got to cut off his leg, you persuade me that’s the only possible cure, and like a fool I believe you and allow you to –’ he swallows. Genuine emotion fights with the whipped-up anger for a moment, and then anger wins. ‘How many other patients have you done this to, eh? How many innocent, trusting workers have brought their children to this hospital, committing them to your so-called expertise and expecting the highest standard of care? The people demand such standards! Nobody is above the people’s vigilance! How many mistakes have been covered up? How many incompetents, murderers and saboteurs have been protected?’ With each sentence, Volkov slams the desk with his fist. Suddenly he picks up the table lamp, wrenches its cord from the socket, and hurls it against the wall. ‘How many?’ he shouts. ‘How many?’
There is silence, a long, strangely detached silence in which Andrei hears nothing but the race of his own thoughts. He doesn’t even glance round at the shattered lamp. These words are not his words. ‘Incompetents, murderers and saboteurs.’ They’re a language he’s never needed to speak, although of course he knows it, no one can help knowing it. It seeps across the face of the newspapers like a corruption. Volkov would have learned it all in his young days, when he still had to work at the coalface of interrogation. It’s second nature to him now. Outrage and fury are an essential part of the interrogator’s repertoire. People who’ve been ‘there’ and by some miracle have survived – they don’t talk about it. But once or twice, late at night, Andrei’s heard a few things. Lies are violent, he knows that. They have their own power.
He’s sure that Volkov can’t and doesn’t believe a word of what he’s saying, although the emotion that drives him is real enough. And yet he has the power to act on whatever he claims to suspect. If he follows his own claims to their logical conclusion, then doctors who believe they are there to do their work will have to admit that really they are butchers, liars and conspirators. He, Andrei, will have to admit it too. Everyone, even the biggest bigwigs in Admin, must understand that this is the delusion of a father who refuses to accept the awful, random fact of his son’s cancer. And yet Volkov will make his lie come true, because that is what he does. If he suspects evil, then evil has got to be found. That’s what they did to Vasili Parin. He thought he was correctly following his instructions about scientific exchange of research data with the USA. He didn’t realize that he was an American spy. Or perhaps Volkov does accept the truth of what’s happened to Gorya. He just wants to punish someone for it.
But how has it come about that I’m in this room, with this man? Andrei asks himself, as his clinical eye notes the pallor of Volkov’s face, his heavy breathing and the dilation of his pupils. Anna and I were always careful. We believed we’d thought of everything that could happen to us, but we never allowed for this. Is it just chance, or is it fate? If it’s fate, then this was coming towards me all my life, even when I was happy and completely unaware that there was any such child in the world as Gorya Volkov. I was here in this hospital, and Volkov was wherever such men have their offices. Anna has always said that the important thing is never to come to their attention. She and Lena thought the same.
Anna, he thinks, Anna. But for once he can’t see her face in his mind.
‘Gorya wants to see you,’ says Volkov. His face twitches. ‘He didn’t want to come back here.’
‘It’s very hard for him.’
‘Last night he couldn’t sleep. He said, “Are they going to cut my other leg off?” ’
‘Of course you told him there was no question of that.’
‘He understands.’
Their voices have dropped. There is nothing left but a few bare words to describe the truth. Volkov’s look is almost simple, almost intimate. Once again Andrei feels a disturbing closeness to the man.
‘He said, “Am I going to die?” – just as if it were any other question. He didn’t seem afraid.’
‘I’ve known children ask that. Usually they ask me when their parents aren’t around, because they’re afraid of upsetting them.’
The faintest shadow of pride crosses Volkov’s face. ‘I told him he needn’t even think about it,’ he says.
‘I understand.’
‘You’ll see him, then.’
Volkov looks away. The thread between them breaks. It seems that the very nature of Volkov’s face changes, as if a mask is coming down over it. Very quietly, so that Andrei can’t be quite sure that he’s heard the words correctly, Volkov murmurs, ‘There are saboteurs in every profession, but we always find them out.’
Polina Vasilievna looks so changed. The thick make-up has disappeared. Her hair is no longer jet black and tightly curled, but grey at the roots and twisted into a bun. She smoothes Gorya’s hair back from his forehead as she watches his face with anxious, devouring love. As Andrei enters the room she frowns, as if she doesn’t quite remember where she last saw him.
‘Dr Alekseyev,’ he reminds her.
Her face lights up in recognition. Whatever her husband may think about what the doctors have done to Gorya, he hasn’t shared those thoughts with his wife. To her, Andrei is simply that young doctor whom her son liked so much. Although of course he’s not so very young, not any more.
Gorya’s eyes are closed. Perhaps he’s asleep, but Andrei decides to say nothing the boy can’t safely hear. A cylinder of oxygen stands by the bed, but Gorya isn’t wearing a mask.
‘He got very tired with those X-rays, and then the doctor had to pull him about all over again.’
‘I’m sure it was necessary.’
‘They haven’t told us what’s going on, not properly. He’s had this cough. But it’s that time of year, isn’t it? Everyone gets coughs and colds once winter’s on its way.’ While she speaks, her eyes are fixed on him, wide with fear, begging him to agree.
‘Yes, it’s not the best time.’
Gorya’s head is raised high on a mound of pillows. His mouth is slightly open and there’s bubble of spittle at one corner. Andrei is fairly sure that he’s really asleep.
‘He gets his breath better when he’s propped up,’ says his mother. ‘It’s only with this cough. Normally it’s better for them to lie flat. More hygienic,’ she adds, as if the word were a talisman.
The boy has lost weight. His jawline is sharp, his skin waxen.
‘It’s good to make him comfortable,’ says Andrei.
‘He likes cloudberry juice. That’s good for him, isn’t it, cloudberry juice? I’ve got six bottles from last year that our Dunya bottled. He needs the vitamins. Once he’s out of hospital I’m going to build him up.’
‘Cloudberry juice is good.’
Again, she strokes the hair back from her boy’s forehead. His eyes roll under the veined eyelids, but the lids don’t even flutter. He’s deeply asleep. ‘His leg’s been bad as well. He even gets pain in his foot. He says, “I know it’s not there, Mum, but it hurts me so bad it wakes me up, and then I don’t want to go back to sleep.” ’
‘I’m sorry.’
‘I should have known. Well, I did know. As soon as they said “cancer”, I felt it go through me here,’ and she touched the place where people think their heart is. ‘I ought to have taken him back home with me there and then.’
She is raised up, too, he thinks, above everything but her child and his suffering. She can’t blame and she can’t hate. Everything petty has fallen away. He’s seen it happen before. It doesn’t last, though, and besides she has a husband with enough blame and hatred in him for two.
‘Stay until he wakes up. He’d be sorry to miss you. He was asking for you.’
‘I can’t stay too long.’
He must see Professor Maslov before he goes home, and explain his absence from the ward round. Check that all the notes are in order and discuss what’s been happening today. Maybe have a quick word with Lena to reassure her? No. Better for Lena if she knows as little as possible.
He sighs, looking at the child asleep in the bed. They have failed. He learned long ago that doctors don’t like failure, and he’s no different from any of them. The dying do better at home, if there’s a bed to put them in. People who are dying need an old granny who’s willing to sit by their side, watching for the tiny signals that mean thirst or pain in one who is too weak to talk. Old grannies aren’t afraid of death. They meet it on equal terms; they don’t believe that it’s their job to conquer it. Gorya’s mother will cope. If she’s allowed to. She surprised him today with the toughness of fibre that lay under all that entitled ‘high-up’ behaviour. She didn’t blame Andrei, but instead reproached herself for going against her instincts. She won’t fall to pieces as long as the boy needs her.
‘They won’t do any more operations on him, will they?’ asks Polina Vasilievna.
‘No.’
‘I never liked that surgeon. Cold, she was. No proper feeling. Jews. You know, they only care for their own.’
‘I must go,’ he murmurs. ‘Please tell Gorya I came to see him. I’ll call in again tomorrow.’
She nods, but already her attention has left him, because Gorya has stirred. He moves his hand, picking at the bedclothes, and then is still again.
‘Goodbye,’ says Andrei, and quietly leaves the room. He’s sweating. The boy is in a bad state. It’s all happened so quickly. Already Gorya has that old-man look of a desperately sick child.
The corridor is bright and empty but for the two policemen planted outside Gorya’s door. No change there. Andrei walks away down the corridor, half expecting to hear heavy footsteps behind him and feel a hand clamping down on his shoulder. But nothing happens. He turns the corner, beyond their gaze. It’s late, much later than he thought. It won’t be worth trying to find Professor Maslov now. He must get home quickly, to Anna.