MORPHINE
1
CLEVER PEOPLE HAVE LONG BEEN AWARE THAT happiness is like good health: when you have it, you don’t notice it. But as the years go by, oh, the memories, the memories of happiness past!
For myself I realise now that I was happy in that winter of 1917, that headlong, never-to-be-forgotten year of storm and blizzard.
The first blast of the snowstorm snatched me up like a scrap of torn newspaper and transported me from a practice in the depths of the countryside to the town. What, you may wonder, is so special about a country town? If like me you have ever spent the winters snowbound and the summers deep in a landscape of sparse, monotonous woodland, without a single day off in more than a year; if you have ever torn the wrapper off last week’s newspaper with your heart beating as though you were a lover joyfully ripping open a pale blue envelope; if you have ever driven twelve miles in a tandem-harnessed sleigh to a woman in labour, then you may realise what the town meant to me.
Kerosene lamps may be very cosy, but I prefer electricity.
And there they were again at last, those seductive little electric lights! The main street of the little town, the snow well flattened by the runners of peasants’ sleighs, was hung with red flags and shop signs that entranced the eye: a boot; a golden pretzel; a picture of a young man with insolent, pig-like eyes and a wholly unnatural haircut, signifying that behind those glass doors was the local Figaro, who for thirty kopecks was prepared to shave you at any hour of the day—except on holidays, in which this land of ours abounds.
To this day I shudder when I recall that Figaro’s towels, which reminded me forcibly of a page in my German textbook of skin diseases, illustrating with appalling clarity a growth of hard chancre on a man’s chin.
But even those towels cannot spoil my happy memories!
At the crossroads stood a real, live policeman, in a dusty shop window one could just make out tin trays packed with rows of cakes topped with orange cream. The square was carpeted with fresh straw, people were driving, walking about and chatting; there was a kiosk selling yesterday’s Moscow papers full of thrilling news, and from not far away came the sound of Moscow-bound trains hooting to one another. In short, this was civilisation, Babylon, the Nevsky Prospekt.
The hospital, I need hardly add, boasted separate surgical, medical, isolation and maternity departments. There was an operating theatre with a gleaming autoclave, plated taps and operating tables with ingeniously designed flaps, cogwheels and screws. It had a Medical Superintendent, three interns (beside myself), several feldshers, midwives, nurses, a dispensary and a laboratory. Just think—a laboratory, complete with a Zeiss microscope and a fine assortment of stains.
All this impressed me so much that I would shudder and turn cold. It took me several days to get used to it when, in the December twilight, the hospital’s single-storey wards would blaze with electric light as though at a word of command.
I was dazzled. Water splashed and roared in the bathtubs, and worn wooden-cased thermometers plunged or floated in them. All day long the children’s isolation ward reverberated with moans, thin plaintive weeping and hoarse gurgles. Nurses darted to and fro.
I had shed a heavy burden. I no longer bore the godlike responsibility for everything that happened in the world. It was not my fault if someone developed a strangulated hernia, and I did not shudder when a sleigh drove up bringing a woman with a transverse foetus, a case of epyema requiring operation was no longer my affair. For the first time I felt that there was a limit to my responsibilities. Childbirth? Over there, please, to that low building—the furthest window with the net curtains; there you’ll find our obstetrician, a charming, fat, balding man with a ginger moustache. That’s his business. The sleigh makes for the curtained window. A compound fracture? You want our chief surgeon. Inflammation of the lungs? Go and see Pavel Vladimirovich in the medical department.
Oh, what a splendid thing a large hospital is, with its smooth, well-oiled machinery! I fitted into the mechanism like a new screw dropping into its appointed slot and took over the children’s department; from then on my days were wholly taken up with diphtheria and scarlet fever. But only my days. I started sleeping at night, undisturbed by that ominous nocturnal tapping downstairs, which meant that I was likely to be roused and dragged out into the darkness to face danger or whatever fate had in store. I took to reading in the evenings (chiefly about diphtheria and scarlet fever, but I also developed an odd addiction to Fenimore Cooper). I appreciated to the full the electric light over my desk, the charred ash that dropped down on to the tray of my samovar, my cooling tea, and the chance to sleep after many sleepless months.
So I was happy in that winter of 1917, after my transfer to that town from a remote, snowswept country practice.
2
One month flew by, then another, and a third. 1917 receded and February 1918 began. I got used to my new life and gradually began to forget my far-off practice. The hissing, green-shaded kerosene lamp, the loneliness and the snowdrifts became just a blurred memory. Ungrateful as I am, I forgot about my front-line post, where alone and without the least support I had relied on my own resources to fight disease and extricate myself from the most hair-raising situations, like a Fenimore Cooper hero.
Now and again, I must admit, when I went to bed with the pleasant thought that I would shortly fall asleep, fragments of recollection would pass through my fading consciousness. A green flash, a flickering lantern, the creak of sleigh-runners … a moan and then darkness, the muffled howl of a snowstorm … then the memory would turn head over heels and vanish into oblivion.
‘I wonder who’s in that job now? A young man like me, I suppose. Ah well, I did my stint, Muryovo and then Gorelovo hospital … February, March, April and, let’s say, May as well—and I will have finished my probationary period. So I shall leave this splendid town at the end of May and return to Moscow. And if the revolution calls me to its service, I may yet have some more travelling to do … but at all events I shall never see my country practice again … Never again … Moscow … a clinic … asphalt, the bright lights …’
Such were my thoughts.
‘Still, it’s a good thing that I spent some time out there in the wilds. It taught me to be brave and nothing frightens me now … Is there anything I haven’t treated—literally anything? I didn’t have any psychiatric cases … or did I? No, that’s right … there was the farm manager who was drinking himself to death. I made rather a mess of treating him, though … delirium … Surely that’s a mental illness? I really ought to read up some psychiatry … still, what the hell … maybe later, in Moscow. Right now children’s diseases are my main concern, and especially the wearisome business of prescribing for children. Hell, if a child’s ten years old, for instance, how big a dose of aminopyrine can I give him? Is it 0.1 or 0.15 grammes? I’ve forgotten. And if he’s three? There are quite enough hideous, unforeseen problems in paediatrics alone, so it’s goodbye to my old general practice. But why does that place keep creeping back into my mind so insistently this evening? The green lamp … After all, I’m finished with it for the rest of my days … well, that’s enough of that … time for sleep.’
‘Letter for you. Someone who happened to come into town brought it.’
‘Let’s have it.’
The nurse was standing in my hallway. An overcoat with a moth-eaten collar was thrown over her white overall with its hospital badge. Snow was melting on the cheap blue envelope.
‘Are you on duty in Casualty Reception?’ I asked, yawning.
‘Yes, I am.’
‘Anyone there?’
‘No, it’s empty.’
‘If any cashesh come in …’ (I was yawning so hard my pronunciation was sloppy) ‘come and let me know. I’m going to sleep …’
‘Yes, doctor. Can I go now?’
‘Yes, yes. Off you go.’
She went out. The door squeaked, and I shuffled into the bedroom in my slippers, clumsily tearing open t
he envelope as I went. It contained a crumpled oblong prescription form stamped with the address of my old country practice … that unforgettable letterhead.
I smiled.
‘That’s interesting … I’ve been thinking about the place all evening and now this turns up … must have had a premonition …’
Beneath the letterhead a prescription was written in indelible pencil. Some of the Latin words were illegible, others crossed out.
‘What’s this? Some prescription gone astray?’ I muttered, then stared at the word ‘morphini’. ‘Well, what’s so unusual about this prescription? Ah, yes … a four-percent solution! Who’s been prescribing a four-per-cent solution of morphine? And what for?’
I turned the sheet over. On the reverse side was a letter, written in small spidery handwriting:
11th February 1918.
Dear Colleague,
Forgive me for writing on this old scrap. There’s no proper paper at hand. I have fallen seriously ill with something unpleasant. There’s no one to help me, and in any case I don’t want to ask help of anyone except you.
This is my second month in your old practice, and I know that you are in town and not too far away from me.
On the strength of our friendship at university, I implore you to come and see me as soon as you can—if only for a day, or even an hour. And if you tell me I’m a hopeless case, then I’ll believe you. Or perhaps I can still be saved? Perhaps there’s still a ray of hope? I beg you to tell no one about the contents of this letter.
Ever yours,
Sergei Polyakov.
‘Maria! Go down to casualty at once and fetch me the nurse on duty. What’s her name? I forget … I mean the one who gave me this letter just now. Hurry.’
‘Very good, doctor.’
A few minutes later the nurse was standing in front of me, wet snow on the moulting cat fur that had been used for the collar of her coat.
‘Who brought this letter?’
‘I don’t know who he was. A man with a beard. Said he worked for the co-op and was in town on business.’
‘Hmm … all right, you can go now. No, wait. I’ll just write a note to the Medical Superintendent. Would you take it to him, please, and bring his answer back?’
‘All right.’
This is what I wrote to the Medical Superintendent:
13th February 1918.
Dear Pavel Illarionovich,
I have just received a letter from my university friend, Doctor Polyakov. He is working in my previous country practice at Gorelovo, where he is completely alone. He appears to be seriously ill. I think it is my duty to go and see him. With your permission I should like to hand over the dept. to Doctor Rodovich for the day tomorrow and drive out to Polyakov. He has no one else to turn to.
Yours,
Dr Bomgard.
The Medical Superintendent replied:
Dear Vladimir Mikhailovich,
Go.
Petrov.
I spent that evening poring over the railway timetable. The way to reach Gorelovo was as follows: to catch the Moscow mail train at 2 p.m. the following afternoon, travel twenty miles by rail, get off at N. station, and then cover the remaining sixteen miles to Gorelovo hospital by sleigh.
‘With luck I should be in Gorelovo tomorrow night,’ I reflected as I lay in bed. ‘What’s the matter with him, I wonder? Typhus? Pneumonia? Neither, I should think … because if so, he would simply have written: “I have caught pneumonia”. His letter was too vague, even faintly evasive. “Seriously ill … something unpleasant …”
‘What could that mean? Syphilis? Yes, no doubt about it, syphilis. He’s appalled, he’s concealing it, and he’s afraid. But who, I’d like to know, am I going to find to drive me to Gorelovo? It would be just my luck to get to the station at nightfall and find there’s no one to take me. No, no, I’ll find a way. I’ll find someone at the station who has some horses. Should I send him a telegram asking to be met at the station? No use. The telegram won’t reach him until the day after I get there. It can’t fly to Gorelovo. It would sit at the station until someone was driving out that way. I know that place. What a godforsaken hole!’
The letter on the prescription form lay on my bedside table in the circle of light shed by the lamp, beside it an ashtray bristling with cigarette ends, the outward sign of nagging insomnia. As I tossed about on the crumpled sheet, irritation began to get the better of me, and I started to resent the letter.
After all, if it was nothing worse than, say, syphilis, why didn’t he come here himself? Why must I dash through a blizzard to go and see him? Was I supposed to cure him of syphilis or cancer of the aesophagus in one evening? Anyway how could he have cancer? He was two years younger than myself. He was 24 … ‘Seriously ill’. Sarcoma? It was an absurd, hysterical letter, enough to give the recipient migraine. There, it was starting: the nerve on my temple was starting to twitch; I would wake up in the morning to find that the tension in that nerve had moved to the crown of my head, half my head would feel as if it were clamped in a vice, and I would have to take pyramidon and caffeine. And where would I find pyramidon on a sleigh journey? I should have to borrow one of the hospital’s travelling fur coats; I would freeze to death in my own overcoat. What can be the matter with him? ‘… still a ray of hope’, indeed! People write that sort of thing in novels, not in sober doctors’ letters! Must get to sleep … stop thinking about it. It will all be clear tomorrow … tomorrow.
I turned the switch and darkness instantly engulfed my room. Sleep … that nerve was twitching. But I had no right to be angry with the man for his stupid letter without knowing what the matter was. The man was suffering and he had written to someone else in the way he thought best. And it was unkind to slander him, even mentally, simply because one was worried or suffering from migraine. Perhaps his letter wasn’t dishonest or overdramatic at all. I had not seen Sergei Polyakov for two years, but I remembered him perfectly. He was always a very reasonable man. Yes, obviously some disaster had befallen him … And that nerve of mine was giving less trouble. Clearly I would be asleep soon. What was the mechanism of sleep? I had read about it once during my physiology course, but I had found it obscure. I didn’t really know what sleep was. How did the brain cells fall asleep? To be honest, I had no idea. And I was almost certain that the man who wrote that textbook wasn’t really very sure either. One theory is as good as another. There was Sergei Polyakov standing in his green medical student’s uniform tunic with brass buttons, bending over a zinc-topped table, and there was a corpse on the table.
Hmm, I must be dreaming …
3
TAP, TAP … BANG, BANG, BANG … AHA … Who’s that? What is it? … Someone’s knocking—hell … Where am I? What’s going on? Ah, yes, I’m lying in my bed … Why are they waking me up? They’re allowed to because I’m on call tonight. Wake up, Doctor Bomgard. Maria has just shuffled across the lobby to open the door. What’s the time? Half past midnight. That means I’ve only been asleep for an hour. How’s the migraine? Yes, it’s there all right.
A gentle knock at the door.
‘What is it?’
I slightly opened the door into the dining-room. A nurse’s face was looking at me from the dark and I could see at once that it was pale, her eyes wide open with anxiety.
‘Who’s been brought in?’
‘The doctor from the Gorelovo clinic,’ the nurse replied in a loud, hoarse voice. ‘He’s shot himself.’
‘Polyakov? Impossible! Polyakov?’
‘I don’t know his name.’
‘I see … all right, I’ll come at once. Run to the Medical Superintendent and wake him up this minute. Tell him I want him urgently in Casualty.’
The nurse rushed off, disappearing in a flash of white.
Two minutes later on the porch a wicked blizzard, dry and stinging, was lashing at my cheeks, lifting the skirts of my coat and freezing my startled body. An unsteady white light was flickering in Casualty Reception. In a swi
rl of snow on the porch I bumped into the Medical Superintendent, who was hastening in the same direction.
‘Is this your friend Polyakov?’ he asked, coughing.
‘Apparently so. I don’t understand it,’ I replied as we both hurried inside.
A woman, warmly wrapped up, rose from a bench to meet us. Her eyes, familiar but now tear-stained, gazed at me from under the edge of a red-brown shawl. I recognised her as Marya Vlasievna, a midwife from Gorelovo and my devoted assistant in the labour ward of the Gorelovo hospital.
‘Is it Polyakov?’ I asked.
‘Yes,’ Marya Vlasievna answered. ‘It was so awful, doctor. I was shaking with terror all the way in case I might not get here in time.’
‘When …?’
‘This morning at dawn,’ Marya Vlasievna muttered. ‘The night watchman came running and said he’d heard a shot from the doctor’s quarters.’
Under the flickering, inadequate light of the lamp lay Doctor Polyakov. As soon as I caught sight of the stonelike rigidity of his feet I instinctively winced.
They took off his hat, to reveal his hair sticking damply to his scalp. The nurse, Marya Vlasievna, and I set to work on Polyakov and a white gauze bandage, with its spreading yellow and red stains, was revealed beneath his overcoat. His chest rose and fell feebly. I felt his pulse and shivered: the pulse was fading beneath my touch, slowing to a mere flicker and breaking off, then reviving in a cluster of fast, unsteady beats. The surgeon’s hand had already reached for his shoulder and was pinching up a fold of pale skin to make a camphor injection. At that moment the wounded man unglued his mouth, revealing a pinkish trickle of blood on it, and with a faint movement of his bluish lips he said in a dry, weak voice:
‘To hell with camphor. Forget it.’
‘Shut up,’ the surgeon retorted, injecting the yellow oil beneath the skin.
The pericardium seems to be damaged,’ Marya Vlasievna whispered, clutching the edge of the table and staring at the wounded man’s smooth eyelids (his eyes were shut). Greyish-violet shadows, like the shadows cast at sunset, showed more and more clearly in the hollows around his nostrils, and a fine sweat, like droplets of mercury, was forming in the shadows.