Cancer Ward (64 page)

He hung her coat on one of the pegs of a long, dark, polished coat rack ready to receive any number of guests or visitors, and led her across the smoothly painted wooden floor. The corridor took them past the best and brightest room in the house. In it was a grand piano with a raised music stand, the pages of the score open and gay-looking. It was here that Oreshchenkov's eldest granddaughter lived. They walked across into the dining room. It had windows draped with dry grapevines and giving out onto the yard. In the room was a large and expensive radio-phonograph. After this they came to the consulting room, which had walls lined with bookshelves, a heavy old-fashioned writing desk, an old sofa and some comfortable armchairs.

“Well, Dormidont Tikhonovich,” said Dontsova, gazing round the walls and narrowing her eyes. “It looks as though you've got even more books than before.”

“Oh no, not really,” Oreschenkov replied, shaking his head fractionally. His head seemed to have been cast out of metal. He shook it very slightly; all his gestures were slight “Oh, it's true, I did buy a couple of dozen lately, and you know who from?” He looked at her merrily, just a shade merrily; you had to know him to notice all these nuances. “I got them from Kaznacheyev. He's retired, he's just turned sixty, you know. And on the actual day of his retirement it turned out he wasn't a radiologist at heart at all, he didn't want to spend another day of his life on medicine. He'd always wanted to be a beekeeper, and now bees are the only thing he'll take an interest in. How do these things happen, do you think? If you're really a beekeeper, how is it that you waste the best years of your life doing something else? Well now, where would you like to sit, Ludochka?” She was a grandmother with graying hair, but he spoke to her as he would to a little girl. He made up her mind for her. “Take this armchair, you'll be comfortable here.”

“I won't stay long, Dormidont Tikhonovich, I only dropped in for a minute,” said Dontsova, still protesting, but by now she had sunk deep into a soft armchair. Immediately she felt calm. She felt almost confident that in this room only the best possible decisions could be taken. The burden of permanent responsibility, the burden of administration, the burden of choosing what she ought to do with her life, had been lifted from her shoulders at the coat rack in the corridor. Now she was deep in the armchair her problems had finally collapsed. Calm and relaxed, she let her eyes travel slowly round the room which, of course, she know of old. It touched her to see the old marble washstand basin in the corner, not a modern washbasin but one with a bucket underneath it. It was all covered, though, and very clean.

She looked straight at Oreshchenkov, glad that he was alive, that he was there and would take all her anxiety upon himself. He was still on his feet. He stood upright without the faintest stoop, shoulders and head set as firmly as ever. He always had this look of confidence. It was as though, while he treated other people, he was absolutely sure he could never fall ill himself. A small, neatly cut silvery beard streamed from the middle of his chin. His head was not yet bald, not even completely gray, and the smooth part of his hair seemed to have changed hardly at all over the years. He had the kind of face whose features are not moved by emotion. Every line remained smooth, calm and in place, except for his habit of raising his eyebrows almost imperceptibly into archlike angles. Only his eyebrows expressed the full range of his emotions.

“If you'll forgive me, Ludochka,” he said, “I'll sit at the desk. It's not that I want it to look like a formal interview, it's just that I'm used to sitting there.”

It would be a miracle if he hadn't been. It was to this room that his patients had always come, frequently at first, almost every day, then more rarely. But they still came, even now. Sometimes they would sit through long, painful conversations on which their whole future depended. As the conversation twisted and turned, the green baize of the table, outlined by the margins of dark-brown oak, might engrave itself on their memories for the rest of their lives. So might the old wooden paperknife, the nickel-plated spatula which helped him see down throats, the flipover calendar, the inkpot under its copper lid, or the very strong tea he drank—the color of deep claret—which grew cold in the glass. The doctor would sit at his desk, occasionally getting up and walking toward the washstand or the bookshelves to give the patient a chance to relax from his gaze and to think things over. Dr. Oreshchenkov would never look to one side without good reason. His eyes reflected the constant attention he gave both patient and visitor; they never missed a moment for observation, never wandered toward the window or stared down at the desk or the papers on it. His eyes were the chief instrument he used to study his patients and students, to convey his decisions or wishes.

Dormidont Tikhonovich had suffered from persecution several times during his life: for revolutionary activities in 1902 when he and some other students spent a week or so in jail; again, because his late father had been a priest; then for having been a brigade medical officer in the Tsarist army during the First Imperialist War.
*
(It was not just because he'd been a medical officer; according to the testimony of witnesses, he had mounted a horse while his regiment was in panic retreat, rallied the regiment and dragged it back to take part in the imperialist slaughter of German workers.) The most persistent and oppressive persecution had been due to his stubborn insistence on his right to maintain a private medical practice in the face of stricter and stricter prohibitions. What he did was forbidden as a source of private enterprise and enrichment, as an activity, divorced from honest labor, that served as a daily breeding ground for the bourgeoisie. There were years when he had had to take down his copper plate and turn away every patient, no matter how much they implored him or how ill they were. This was because the neighborhood was full of spies from the tax office, paid or voluntary, and because the patients themselves could never refrain from talking. As a result, the doctor was threatened with the loss of all work, even with the loss of his house.

But it was precisely this right to run a private practice that he valued most in his profession. Without the engraved plate on the door he lived as if illegally or under an assumed name. He refused to submit either his Master's or Doctor's thesis as a matter of principle, on the ground that a thesis was no indication whatever of the success of day-to-day treatment, that it made a patient uneasy having a doctor who was a professor, and that the time spent on the thesis could be much more usefully spent picking up an extra branch of medicine. During Oreshchenkov's thirty years at the local medical college, quite apart from his other jobs, he had helped provide general treatment and also worked in the pediatric, surgical, epidemic, urological and even ophthalmological clinics. It was only after all this that he became a radiologist and oncologist. He would employ a one-millimeter compression of the lips to express his opinion about “Honored Scientists.” He claimed that if a man was called a “Scientist” during his lifetime, and an “Honored” one at that, it was the end of him as a doctor. The honor and glory of it all would get in the way of his treatment of his patients just as elaborate clothing hinders a man's movements. These “Honored Scientists” went about with a suite of followers, like some new Christ with his Apostles. They completely lost the right to make mistakes or not to know something, they lost the right to be allowed to think things over. The man might be self-satisfied, half-witted, behind the times, and trying to conceal the fact, and yet everyone would expect miracles from him.

Oreshchenkov wanted none of this sort of thing for himself. All he needed was a brass plate on his door and a bell which any passer-by could ring.

Luckily for him, Oreshchenkov had once happened to save a local VIP's son who was at death's door. On a different occasion he had saved another big shot, not the same one but a very important person nevertheless. There were several members of other important families as well who owed their lives to him. It had all taken place here in the one town, since he had never gone away. As a result, Dr. Oreshchenkov's reputation became established in influential circles and a certain aura of protection was built up around him. In a purely Russian city this might well not have helped, but the East was more easygoing and they were willing to overlook the fact that he had hung up his plate and was accepting patients again. After the war he no longer held a regular permanent appointment, but served as consultant in several clinics and attended meetings of scientific societies. So it was that after the age of sixty-five he began to lead the sort of unhindered life he regarded as right for a doctor.

“So, Dormidont Tikhonovich, I came to ask you to come down and give me a gastrointestinal examination. Any day that suits you, we'll arrange it.”

She looked gray and her voice faltered. Oreshchenkov watched her steadily, his glance never wavering and his angular eyebrows expressing not one millimeter of surprise.

“Of course, Ludmila Afanasyevna. We shall arrange the day. However, I should like you to explain what your symptoms are, and what you think about them yourself.”

“I'll tell you my symptoms right away, but as for what I think about them—well, you know, I try
not
to think about them. That is to say, I think about them all too much, and now I've begun not sleeping at nights. The best thing would be if I knew nothing! I'm serious. You decide whether I'm to go into hospital or not and I'll go, but I don't want to know the details. If I'm to have an operation I would rather not know the diagnosis, otherwise I'll be thinking the whole time during the operation, ‘What on earth are they doing to me now? What are they taking out now?' Do you understand?”

Whether it was the size of the armchair or the way her shoulders sagged, somehow she no longer looked a big, strong woman. She had shrunk.

“Understand? Well, perhaps I do understand, Ludochka, but I don't share your opinion. Anyway, why is an operation your first thought?”

“Well, we have to be ready for…”

“Why didn't you come here earlier, then? You of all people?”

“Well, you see, Dormidont Tikhonovich…” Dontsova sighed. “That's the way life is, one whirl after another. Of course I should've come earlier … But you mustn't think I've let it go too far.” She was protesting vigorously more to herself than to anyone else. She had regained her brisk, businesslike way of talking. “Why does it have to be so unjust? Why should I, an oncologist, be struck down by an oncological disease, when I know every single one of them, when I can imagine all the attendant effects, consequences and complications?”

“There's no injustice there,” he replied. His bass voice was measured and very persuasive. “On the contrary, it is justice in the highest degree. It's the truest of all tests for a doctor to suffer from the disease he specializes in.”

(What's just about it? Why is it such a true test? He only talks like this because he's not ill himself.)

“Do you remember that nurse Panya Fyodorova?” he continued. “She used to say, ‘Oh dear, why am I being so rude to the patients? It's time I went in as a patient again…'”

“I never thought I'd take it so hard,” said Dontsova, cracking her interlocked fingers.

Yet in these few minutes she had felt much less anguish than during recent weeks.

“So what have you observed in the way of symptoms?”

She began to tell him in general outline, but he wanted to know the precise details.

“Dormidont Tikhonovich, the last thing I want to do is to take up the whole of your Saturday evening. If you're coming to give me an X-ray examination anyway…”

“Well, you know what a heretic I am, don't you? You know I worked for twenty years before X rays were invented. And, my dear, you should have seen the diagnoses I made! It's like when you have an exposure meter or a watch, you completely lose the knack of estimating exposure by eye or judging time by instinct. When you don't have them, you soon acquire the trick.”

Dontsova began to explain, grouping and differentiating the symptoms and forcing herself not to omit any details which might point toward a crushing diagnosis. (But in spite of herself she was tempted to omit some of them, just to hear him say, “It's nothing serious, Ludochka, it's nothing at all.”) She told him her blood composition, which wasn't at all good, and her blood count, which was too high. At first he listened to her without interrupting, then he asked her some questions. Sometimes he nodded his head to indicate that something was readily understandable and frequently encountered, but he never said “It's nothing.” The thought flashed through Dontsova's mind that he must have made his diagnosis already, that she might as well ask him straight out without waiting for the X ray. But it was terrifying, the idea of asking him here and now and getting an answer, whether correct or incorrect or even tentative. She had to put it off, she had to soften the blow by a few days of waiting.

They talked as friends talk when they meet at a scientific conference. Yet having confessed to being ill was like having confessed to a crime: immediately they had lost the key to the equality they had once possessed. No, perhaps not equality; there had never been equality between her and her teacher. It was more drastic than that. By her confession she had excluded herself from the noble estate of medical men and transferred herself to the taxpaying, dependent estate of patients.

It was true that Oreshchenkov did not at once ask if he could feel where it hurt her. He continued to talk to her as to a guest. He seemed to be inviting her to join both estates at once. But she had been crushed, she had lost her former bearing.

“Quite frankly, Verochka Gangart is such a good diagnostician now that I'd normally have had complete confidence in her,” said Dontsova, firing out sentences in the rapid manner her crowded working day forced her to adopt. “But it's you, Dormidont Tikhonovich, I thought I'd…”