Now, though, with the month of September winding down, and the doors of Female Prison 22 bolted behind me, that Hollywood dream was in tatters. But still alive. I simply could not accept the possibility that I was going to rot in a Siberian prison, or undergo a mock trial followed by a real execution, or whatever the Russians had in store for me. I had to believe that help would arrive. Every minute of every day, as I went through the desultory motions of prison life, I was quietly waiting for my deliverance, in whatever form it might come, at whatever time.
At night, in the hour before bed when prisoners were allowed to talk, read, or write letters home, the dormitory of nearly sixty women was a noisy, crowded place. A fight might break out suddenly, accompanied by yelled curses and accusations. It was a time for petty thievery. With nothing to steal, I was spared that particular harassment, but I felt hostile eyes on me all the time. As a foreigner, an anomaly, I was closely watched. Eventually, there’d be a reckoning.
A woman named Yvonne slept in the bunk above mine. She was twenty-five years old with tightly curling blond hair, wide Slavic cheeks, and a deeply cleft chin. Sweet and open, she seemed younger than her years. She wore no make-up, but somewhere she must have had tweezers because her brows were plucked to pencil-thin arches that floated too high above her eyes. The women usually didn’t discuss their crimes and punishments, but Yvonne confided that she’d been caught with a few pills of Ecstasy on her and sentenced to five years. She’d done three so far and seemed proud of the fact, as if it were a legitimate accomplishment, which I supposed it was. Her mother and younger sister lived more than two thousand kilometers away in a village on the western edge of the Ural Mountains. The distance was so great that they couldn’t afford to visit, but they sent letters and photographs regularly. She stashed the photos under her pillow and took them out once in a while to gaze at them.
One night, she offered me half a chocolate bar her mother had sent. I thanked her sincerely for the little luxury, and we sat cross-legged on my bunk and ate the chocolate together rather solemnly. As we were licking our fingers, Yvonne offered me some advice.
“You must try to blend in more, Natalya You’re drawing too much attention to yourself.”
“Why? What am I doing?”
“It’s nothing specific. You just don’t act like everyone else.”
“How so?”
“It’s the way you are.”
“You mean I act like an American?”
“Maybe. I don’t know. You’re just very…um, confident. You walk with your head up all the time. You look straight at people, and ask too many questions. It seems pushy, arrogant. The worst thing is, you act more important than the guards. That’s a dangerous habit. They can do anything they want to you, Natalya. So let them think you’re afraid of them even if you’re not.” She paused. “Have you heard about Svetlana yet?”
“No. Who’s that?”
“She’s the boss. Like a mafia boss. She lives in another dormitory, but she works in the textile factory like we do, only in a different room. A lot of people work for her. You can never be sure who they are. If you have something she wants, she’ll take it. You have to let her, or they cut off your hair and take what they want anyway. They do worse things, too, much worse. So be careful, okay?”
Prisoners were paid three hundred rubles, a bit less than five dollars, a day for their labor, given not in cash but in credit at the prison canteen. I used my credits to buy stationery, stamps, and a pen. I’d been denied phone calls and internet access, but letters flowed freely in and out of the prison. I wrote to my mother, saying that I’d been detained by the authorities in a minor mix-up that would be straightened out soon. After asking Yvonne to procure the addresses for me online, I produced an avalanche of letters to the US State Department, my Washington, D.C. congresswoman, and the American Consulates in Moscow, Vladivostok, and Novosibirsk. The letters asserted my innocence, proclaimed the terrible injustice that had befallen me, and begged for their intervention. Since the letters would undoubtedly be read by prison officials before they were posted, I couldn’t say any more than that.
The temperature dropped day by day. Brisk winds shuddered the frail buildings. Bulbous clouds hung heavy, and drenching downpours turned the prison yards to mud. Field mice scrabbled under the perimeter fences, squeezed through holes in the floorboards and chinks in the pine walls. I spied them scurrying about in the sewing room, making off with scraps of fabric, which they ferreted away in hidden nests. Some women threw shoes at them; others put out precious crusts of bread.
One day, I saw the inmate at the sewing machine in front of mine cough up blood. She was old by prison standards—mid-sixties probably, but possibly much younger, as years of malnutrition and depression had undoubtedly taken their toll. Her back was narrow and stooped, the vertebrae a line of shallow knobs mounding under the dark green shirt. Her gray hair was cut short, nearly covered by a white headscarf, and the tendons of her scrawny neck stood out. She’d been coughing intermittently since my first day, the guttural hacking nearly drowned out by the clatter of dozens of sewing machines.
I noticed the blood when she stopped working for a few moments to wipe it quickly off the side of her sewing machine with a wad of the blue camouflage fabric that we were using to make army uniforms. I didn’t say anything. The medical staff was supposed to handle such issues, and I was determined to heed Yvonne’s warning and keep a low profile. But I watched the woman anyway; I could no more ignore the situation than I could cut off my own hand.
I soon realized that she was bringing up blood regularly, sometimes in large quantities. Most of the time, she successfully covered her mouth with her blue handkerchief, hunching over until the spasm ceased. Then she quickly stuffed the balled fabric, darkened and damp, into the patch pocket on the front of her tunic shirt, using it again within the hour.
After a few days of this, I couldn’t help myself: I got behind the woman on the march back from the factory, and made a note of where she went. It turned out that she was one of the sixty women in my own dormitory. Her bed was at the back end, close to the rear door. I slipped after her into the narrow space between the bunks. She looked surprised, then fearful, and craned her neck to see who might be watching.
“Don’t worry. I’ll make this quick. Have you seen a doctor?” I said.
“They told me I was fine.” Her dull eyes swam in gray-blue pouches of flesh. Her face was deeply lined, with long vertical creases around thin lips on which there was an uneven stain of red.
“Did you tell them about the blood?”
“Of course. What do you think?”
“And they said what?”
“That I have nothing to worry about.”
“Well, I’m afraid that isn’t true.”
“What do you know about it?”
“I’m a doctor. There’s a chance you have tuberculosis. You need to be tested right away.”
The woman gave a mirthless laugh that caught in her throat and erupted into another coughing jag. She reached for the blood-soaked rag in her pocket and hacked into it violently.
“Shut up, Olga,” someone said wearily from a nearby bed. “You keep us up half the night.”
Olga wiped her mouth roughly with the back of her hand and hissed, “I don’t need an American doctor to tell me I have tuberculosis.”
I was stunned, then angry. “All right then. If you’re so smart, you must know it could kill you. And that you’re exposing everyone around you each time you cough, spit, or exhale.”
Her expression remained stony. “I told you, didn’t I? They examined my lungs and found nothing wrong. What more do you expect me to do?”
On Sunday, the prisoners’ day off, I went to the infirmary, where the sharp tang of antiseptic sent up a wave of nostalgia. The lighting was good inside, bright and clean, and the temperature was comfortable—welcome changes from the dimness and perpetual chill of the buildings where I spent my time.
Six or seven pris
oners sat on benches near the door, looking like a row of aging, decrepit schoolchildren in their dark green uniforms and black shoes. I approached the nurse’s station, where a hawkishly thin nurse bluntly ordered me to go to the back of the line and wait. I explained that I wasn’t ill: I was there on another matter, and needed to speak to the doctor in charge. A brief, futile conversation ensued, and I ended up taking my place on a bench.
Almost three hours later, I was ushered into an examining room, where, over my protests, my weight and vital signs were recorded on a chart. The doctor who shuffled in a half hour after that—barrel-shaped and bosomy, with thick calves encased in nude hose and a pouf of orange-ish hair—appeared worn-out but efficient. Her name was embroidered in black thread above the pocket of her lab coat: Dr. Polina Chereshkevich. She picked up my chart and skimmed it. “What’s the problem?”
“I believe a woman in my dormitory has tuberculosis.”
Chereshkevich glanced up in surprise. “So why are you here?”
“Because she won’t come herself. Apparently, she was examined earlier and told she was fine.” If Chereshkevich was a true doctor, she wouldn’t get defensive; she’d be more interested in stopping the spread of the disease.
Her eyes lit up at the sound of my accent. “Ah. You’re the American. A physician, I was told.”
“You’ve heard of me?”
“You’re only the third foreigner we’ve had in the time I’ve been here. One Chinese and one German came before you. Both spies like you.”
I saw no point in correcting her. “What happened to them?”
She pressed her stethoscope’s cold disc to my chest. “The Chinese died of pancreatic cancer—a quick death, but very painful. The German spy was transferred to Lubyanka. You’ve heard about Lubyanka, no? The KGB prison in Moscow—very harsh. You’re lucky to be in this place instead. Here, the staff are local villagers who care mostly about collecting their pay, so things are easier for the prisoners. As long as you don’t make trouble, you’re left alone.”
She pocketed her stethoscope. “What’s your specialty?”
“General surgery.”
“Are you board-certified?”
“Yes, of course.”
She pursed her lips, holding back something she wanted to say, then she picked up a stainless steel tongue depressor and aimed it at my mouth. “Open.”
“Really, Dr. Chereshkevich. I’m not here for me. I only came to bring a possible case of TB to your attention.”
“You might as well let me look.”
I opened my mouth.
“Uh-huh. The beginnings of periodontal disease. Very common, given the poor nutrition. If I could make one change for the health of the prison population, it would be adding a vitamin supplement to the diet. But that will never happen. We don’t even have money for basic supplies.” She laid the tongue depressor on a tray, leaving me to wonder whether it would be properly sanitized before its next use.
“Now, what makes you think it’s tuberculosis?” she asked.
“I saw the woman coughing up blood.”
“Her name?”
“Olga. I don’t know her last name. She’s in my dormitory and sewing room.”
Crossing to a sink to wash her hands, Chereshkevich said without surprise, “It’s good that you came in. Tuberculosis has remained a problem for us. We have to be especially vigilant at a facility like this one, where there’s overcrowding and inadequate sanitary facilities.”
With damp fingers, she began to palpate my lymph nodes. “You probably find it alarming that a case may have slipped by us, but you have to understand the situation we face. All the prisoners want to have TB. They appear in the infirmary day after day, coughing pitifully and exaggerating their symptoms. One clever woman put menstrual blood on her handkerchief and claimed it came from her lungs.”
“Why would anyone do that?”
“Because a TB diagnosis gets them shipped to the hospital in Krasnoyarsk, where they rest in bed all day in a special TB ward. The food there is very good, I’m told—fruits, vegetables, meat, tapioca pudding—and they’re allowed to watch television for as long as they want.”
She picked up the chart and began making a notation. “Don’t worry. I’ll see to that woman, Olga. Now, do you have any symptoms you want to discuss?”
“Other than boredom and fatigue?” I wouldn’t admit to terror and despair.
Her reaction was humorless, but not unkind. “Medical problems, I mean.”
“No, nothing.”
“Then it seems we’re done here. Now, if you don’t mind, I’d like to have you look at someone.”
The patient was a woman in her forties with a tumor the size of a golf ball protruding from the side of her neck. The skin over it was pinkly inflamed, stretched to a thin, gleaming smoothness like plastic wrap.
“Petra, this is Dr. March, come all the way from America to examine you,” Chereshkevich said in the loud, falsely cheery voice that people use among the dying.
Petra looked at us with drowsing, pain-glazed eyes. Emaciated, a thin branch under the wool blanket, her hair a wispy halo on the pillowcase. She moved her hand slightly in greeting.
Chereshkevich stepped aside to let me examine her.
“Hello, Petra. I’m Dr. March,” I repeated, because it was better to make soothing noises than to be quiet. “I’d like to feel your neck for a moment. My hands might be a little cold. Any pain here?” I gently pressed the tips of my fingers against the top of the tumor, then around its sides, all the way down to its base. It was hard and round. It could be malignant, but, given its uniform structure and consistency, I suspected it was benign. In any case, it ought to be removed immediately, as there was a danger that it would obstruct the throat if it got any bigger.
Petra denied feeling pain.
“Good,” I said with a smile. Straightening up, I realized that a number of eyes were trained on me. Patients in nearby beds were watching curiously, and a young nurse who was feeding an elderly woman was gaping at the unusual sight of a prisoner examining a patient.
“Show’s over, everyone,” Chereshkevich said loudly, and we moved out of the ward and halfway down a corridor, where we could confer out of earshot. “Petra’s on a list for surgery at Krasnoyarsk, but they’re very backed up, and they put prisoners on the bottom rung. It could be months before they get to her. Meanwhile, her esophagus is narrowing. As it gets more painful to swallow, she eats less. By the time she gets to surgery, she may be too weak to endure it. I’d like to get that tumor out of there as quickly as possible. The operation, if you agree to perform it, will have to be done here, with the basic surgical supplies and medicines we have on hand.”
“Anesthesia?”
“Only morphine. I’ll be there to assist.”
“Risk factors?”
“High blood pressure and early stage congestive heart failure.”
“If something goes wrong?”
“She’ll be transported by prison van to the emergency room in Krasnoyarsk, and I will take full responsibility. No one will know you were involved.”
“Or that you enlisted the aid of a prisoner.”
“Correct.” Chereshkevich smiled slightly at having her daring exposed.
“Why are you doing this?”
“Because I’m a doctor first; a Russian second.”
I looked gratefully into Chereshkevich’s tired, intelligent eyes. It was a pleasure to join forces with someone who still had ideals and was willing to take risks for them. “When do you want to do it?”
“Early tomorrow morning. Nurse Latypova will be on duty then by herself. I don’t know what they teach in nursing school anymore—nothing, it seems like. She’s worse than useless, and takes no interest in learning. I’ll give her the night off, saying I have paperwork to catch up on and will sleep in my office, as it will be too late for me to drive home by the time I’m done. She’ll leap at the chance to spend the night with her boyfriend. The two of them riva
l Romeo and Juliet with all the sighing and yearning they do.”
The mention of Shakespeare, the way it connected us despite our differences, made me smile. I sensed that Chereshkevich was building a bridge on purpose, in order to enhance our teamwork in the operating room.
“What’s your plan for me? How will I get away from my barracks?” I asked, enjoying the conspiracy.
“I’ll give you a diagnosis now and put you in a bed overnight. What would you like—exhaustion? Pneumonia? Mental breakdown? You can stay in the ward afterwards for a few days’ rest. That will be your payment.”
My heart was banging against my ribcage in excitement. Merely to sleep and rest, undisturbed, in a clean, warm environment would be heaven after what I’d been through. But the chance to work in an operating room doing the work I was trained for and that I loved—that was even better. After so much degradation, it would go a long way toward making me feel whole.
She saw the answer on my face and smiled. “You like this good deal? Isn’t that what Americans say—let’s make a deal?”
“Yes, doctor. We’ve got ourselves a deal.”
I peered carefully into the incision and saw that I’d made a mistake. I’d cut too much of the patient’s hyoid bone. The relatively simple Sistrunk procedure to excise thyroglossal tumors required that I remove only a couple of millimeters in the bone’s mid-section, enough to allow removal of the thyroglossal duct. But, as the patient was merely heavily sedated, not unconscious, she couldn’t help making tiny movements in response to pain, despite the fact that Dr. Chereshkevich was holding her head steady, firmly turned to the side so that one cheek was pressed flat against the table. A single quiver of the neck muscle had been enough to make my tiny scalpel slip, and now the opening in the hyoid was too wide, with little bone left on either side.
FINDING KATARINA M. Page 23