by John Boyne
‘I was thinking further north,’ she said, and I knew by her tone that this was no idle conversation, but something that she had been considering for some time already. She knew exactly where she wanted to go and would settle for nowhere else. ‘I was thinking of Finland,’ she said.
‘Finland?’
‘Yes.’
‘But why Finland, of all places?’ I asked, surprised by her choice. ‘It’s so … well, I mean, it’s Finland, isn’t it? Is there anything to see there?’
‘Of course there is, Georgy,’ she said with a sigh. ‘It’s an entire country, like anywhere else.’
‘But you’ve never expressed any interest in seeing Finland before.’
‘I was there as a child,’ she told me. ‘I don’t remember it very much, of course, but I thought … well, it’s as close to home as we could get, isn’t it? As close to Russia, I mean.’
‘Ah,’ I said, nodding slowly and considering it. ‘Of course.’ I pictured the map of northern Europe in my head, the long border of over seven hundred miles that stretched the length of the country, from Grense-Jacobsely in the north to Hamina in the south.
‘I’d like to feel that I was close to St Petersburg once again,’ she continued. ‘Just one more time in my life, that’s all. While I still can. I’d like to look into the distance and imagine it, still standing. Invincible.’
I breathed heavily through my nose and bit my lip as I stared into the fire, where the last of the coals were turning to embers, and considered what she had asked. Finland. Russia. It was, in the most literal sense of the phrase, her dying wish. And I confess that the idea excited me too. But still, I was unsure of the wisdom of such a journey. And not just because of the cancer.
‘Please, Georgy,’ she said, after several silent minutes had passed. ‘Please, just this.’
‘You’re sure that you’re strong enough?’
‘I am now,’ she said. ‘In a few months’ time, who knows? But now, yes.’
I nodded. ‘Then we will go,’ I told her.
There was a range of signs to predict Zoya’s illness which, taken together, should have been warning enough to me that she was not well, but separated by several months as they were, and appearing alongside the typical aches and pains of old age, it was difficult to recognize the connections between the symptoms. Added to this was the fact that my wife kept the details of her suffering private for as long as possible. Whether she did this because she didn’t want me to know of the agony she was enduring or because of a reluctance on her part to seek treatment to alleviate it is a question I have never asked her, for fear of being wounded by the answer.
I did notice, however, that she was more tired than usual and would sit by the fire in the evenings with a look of sheer exhaustion on her face, her breathing a little more laboured, her countenance a little more pale. When I asked her about this fatigue, she shrugged it off and said it was nothing, that she simply needed to get a better night’s sleep, that was all, and that I shouldn’t worry about her so much. But then her back began to trouble her too and I could see her wincing in pain as she put a hand to an area at the base of her spine, holding it there for a moment until the agony passed, her expression contorted with distress.
‘You need to see a doctor,’ I told her when the pain seemed to be lasting for longer than she could possibly cope with. ‘Maybe you’ve pulled a disc and it needs to be rested. He could give you an anti-inflammatory or—’
‘Or maybe I’m just getting old,’ she said, making a determined effort not to raise her voice. ‘I’ll be fine, Georgy. Don’t fuss.’
Within a few weeks, the pain had begun to spread towards her abdomen and I noticed a distinct lack of appetite as she sat at the table, pushing her food around the plate with her fork, taking only small morsels into her mouth and chewing on them carelessly before pushing the dish away and claiming that she wasn’t hungry.
‘I had a big lunch,’ she said to me, and fool that I was I allowed myself to believe her. ‘I shouldn’t eat so much in the middle of the day.’
However, when these symptoms continued for several months, and she had started not only to lose weight but to be unable to sleep with the agony of her condition, I finally persuaded her to visit our local GP. She returned to say that he was running some tests on her, and two weeks later my worst fears were confirmed when she was referred to a specialist, Dr Joan Crawford, who has been a part of our lives ever since.
It seems a curious thing to me that I took the news of Zoya’s illness worse than she did. God forgive me, but she seemed relieved, almost happy, when the results came through, imparting them to me with consideration for my feelings but without any fear or devastation for her own condition. She didn’t cry, although I did. She didn’t seem angry or frightened, both of which emotions poured over me throughout the days that followed. It was as if she had received … not good news exactly, but a piece of interesting information with which she was not entirely dissatisfied.
A week later, we sat waiting for Dr Crawford in her office. Zoya appeared perfectly at ease but I was restless in my chair, fidgeting nervously as I stared at the framed certificates that hung on the walls, convincing myself that someone who had been trained in this disease and had received so many qualifications from famous universities would surely be able to find a way to combat it.
‘Mr and Mrs Jachmenev,’ said Dr Crawford when she arrived, late but brisk, her manner entirely businesslike. Although she was not unsympathetic towards us, I felt immediately that she lacked a degree of compassion, which Zoya put down to the fact that she was dealing with patients suffering the same illness every day and it was difficult to view every case as tragically as the relatives of its victims would. ‘I’m sorry to have kept you waiting. As you can imagine, it gets busier and busier here every day.’
I wasn’t entirely reassured to hear that, but said nothing as she studied the dossier which lay on the desk before her, holding an X-ray up to the light at one point, but betraying nothing in her expression as she examined it. Finally, she closed the folder, placed her hands on top of it and looked at the two of us, her lips pursed in what was an approximation, I thought, of a smile.
‘Jachmenev,’ she said. ‘That’s an unusual name.’
‘It’s Russian,’ I said quickly, not wishing to entertain any small talk. ‘Doctor, you’ve examined my wife’s file?’
‘Yes, and I had a conversation with your GP, Dr Cross, earlier this morning. He’s spoken with you, Mrs Jachmenev, about your condition?’
‘Yes,’ she said, nodding her head. ‘Cancer, I was told.’
‘More specifically, ovarian cancer,’ replied Dr Crawford, using both hands to smooth out the papers before her, a habit which for some reason put me in mind of bad actors who never know what to do with their hands on stage; perhaps this was my way of not entering the conversation entirely. ‘You’ve been suffering for some time, I expect?’
‘There were symptoms, yes,’ replied Zoya cautiously, her tone suggesting that she did not want to be chastised for her tardiness in reporting them. ‘Some back pain, fatigue, a little nausea, but I didn’t think anything of it. I’m seventy-eight, Dr Crawford. For ten years now I’ve woken every day with a different complaint.’
The doctor smiled and nodded, hesitating for a moment before speaking in a more gentle tone. ‘This is not uncommon, of course, in women of your age. Older women are more at risk of ovarian cancer, although typically they will develop it between their mid-fifties and mid-seventies. Yours is a rare, late-in-life case.’
‘I’ve always tried to be exceptional,’ said Zoya with a smile. Dr Crawford smiled in return and the two women stared at each other for a few moments, as if they each understood something about the other one of which I was necessarily ignorant. There were only three of us in the room, but I felt terribly excluded from their company.
‘Can I ask, do you have any history of cancer in your family?’ asked Dr Crawford after a few moments.
‘No,’ said
Zoya. ‘I mean yes, you can ask. But no, there is none.’
‘And your mother? She died of natural causes?’
Zoya hesitated for only a moment before answering. ‘My mother did not have cancer,’ she said.
‘Your grandmothers? Any sisters or aunts?’
‘No,’ she said.
‘And your own medical history – have you suffered from any major traumas during your life?’
There was a moment of vacillation on her part and then Zoya suddenly burst out laughing at the doctor’s question and I turned to look at her in surprise. Seeing the look of hilarity on her face, the fact that she was doing all that she could to stop herself from shaking with a mixture of amusement and grief, I didn’t know whether to join her in her laughter or bury my face in my hands. I wanted to be elsewhere, suddenly. I wanted none of this to be happening. It had been the most unfortunate choice of words, that was for sure, but Dr Crawford simply stared at her as she laughed without any comment; I suspected that she witnessed any number of bizarre reactions during conversations such as this one.
‘I have suffered no medical traumas,’ said Zoya finally, composing herself and stressing the penultimate word in her sentence. ‘I have not had an easy life, Dr Crawford, but I have been in good health throughout it.’
‘Well, indeed,’ she replied, sighing as if she understood only too well. ‘Women of your generation have suffered a lot. There was the war, for one thing.’
‘Yes, the war,’ said Zoya, nodding thoughtfully. ‘There have been many wars, in fact.’
‘Doctor,’ I said, interrupting her to speak now for the first time. ‘Ovarian cancer, this is curable? You have some way to help my wife?’
She looked at me with a certain degree of pity, understanding of course that the husband might be the most terrified one in the room. ‘I’m afraid the cancer has already begun to spread, Mr Jachmenev,’ she said quietly. ‘And as I’m sure you know, at the moment medical science is unable to offer a cure. All we can do is try to alleviate some of the suffering and offer our patients as much hope for a continued life as we can.’
I stared at the floor, feeling a little dizzy at these words, although in truth I knew that this was what she would say. I had already spent weeks at my usual desk in the British Library researching the disease that Dr Cross had spoken to us about and knew only too well that there was no known cure. There was always hope, however, and I clung on to that.
‘There are some additional tests that I would like to run, Mrs Jachmenev,’ she said, turning to my wife again. ‘We’ll need to do a second pelvic exam, of course. And some blood tests, an ultrasound. A barium enema will help us to identify the extent of the cancer. We’ll take some CAT scans, of course. We need to determine how far the cancer has spread beyond the ovaries and into the pelvic area, and whether it has travelled towards the abdominal cavity.’
‘But the treatments, doctor,’ I insisted, leaning forward. ‘What can you do to make my wife better?’
She stared at me, a little irritated, I felt, as if she was accustomed to dealing with devastated husbands but they were outside of her concern; she was interested only in her patient.
‘As I said, Mr Jachmenev,’ she replied, ‘the treatments can only slow down the progress of the cancer. Chemotherapy will be important, of course. There will be surgery, almost immediately, to remove the ovaries, and it will be necessary to perform a hysterectomy. We can take biopsies at the same time of your wife’s lymph nodes, her diaphragm, her pelvic tissue, in order to determine—’
‘And if I don’t have treatment?’ Zoya asked, her voice low but determined, cutting through the cold granite of these medical phrases which Dr Crawford had no doubt uttered a thousand times in the past.
‘If you don’t have treatment, Mrs Jachmenev,’ she replied, clearly accustomed to this question too, which shocked me; how simple it was for this lady to discuss such terrible notions, ‘then the cancer will almost certainly continue to spread. You will be in the same amount of pain that you are in now, although we would be able to give you some medication for that, but one day it will take you quite unawares and your health will deteriorate rapidly. That will be when the cancer has advanced to the later stages, when it has passed out of the abdomen to attack your organs – the liver, the kidneys and so on.’
‘We must begin the treatment immediately, of course,’ I insisted and Dr Crawford smiled at me with the tolerance of a doting grandparent towards a half-wit grandchild, before looking at my wife again.
‘Mrs Jachmenev,’ she said, ‘your husband is right. It’s important that we begin as soon as possible. You do understand that, don’t you?’
‘How long would it take?’ she asked.
‘The treatment would continue indefinitely,’ she replied. ‘Until we could control the disease. That might be a short time, it might be for ever.’
‘No,’ said Zoya, shaking her head. ‘I mean, how long would I have left if I don’t seek treatment?’
‘For pity’s sake, Zoya,’ I cried, staring at her as if she had lost her reason entirely. ‘What type of question is that? Didn’t you understand what—’
She held a hand in the air to silence me, but did not look in my direction. ‘How long, doctor?’
Dr Crawford exhaled loudly and shrugged her shoulders, which did not fill me with confidence. ‘It’s difficult to say,’ she replied. ‘We would of course need to run these tests anyway to determine exactly what stage the cancer is at. But I would say no more than a year. Perhaps a little longer if you were lucky. Although there is no saying how the quality of your life would be affected during that time. You could be healthy until near the end, and then the cancer could attack quite quickly, or you could begin to deteriorate very soon. It really is for the best that you take action immediately.’ She opened a heavy diary that lay in the centre of her desk and ran a finger along one of the pages. ‘I can schedule you for the initial pelvic exam for—’
She never got to finish that sentence, interrupted by the fact that Zoya had already stood up, taken her coat from the stand beside the door, and left.
Originally, we planned to go no further east than Helsinki, but then, on a whim, we travelled on towards the harbour town of Hamina, on the Finnish coast. The Matkahuolto bus drove us slowly through Porvoo and just north of Kotka, names which sixty years before had been as familiar to me as my own, but which had slowly dissolved from my memory over the intervening decades, replaced by the experiences and recollections of a shared adulthood. Reading those words again on the bus timetable, however, pronouncing their lost syllables under my breath, jolted me back to my youth, the sounds echoing with the regret and familiarity of a childhood nursery rhyme.
Zoya and I were offered seats at the front of the bus owing to our advanced years – I had celebrated my eightieth birthday four days before leaving London and my wife was only a couple of years younger than I – and we sat together quietly, watching the towns and villages pass us by, in a country which was not home, which had never been home, but which made us feel closer to the place of our birth than we had been in decades. The landscape along the Gulf of Finland reminded me of long-forgotten sailing trips along the Baltics, my days and nights filled with games and laughter and the sound of girls’ voices, each demanding more attention than the last. If I closed my eyes and listened to the cries of the seagulls overhead, I could imagine that we were dropping anchor once again at Tallinn on the Northern Estonian coast, or sailing northwards from Kaliningrad towards St Petersburg with a light wind behind us and the sun burning down on the deck of the Standart.
Even the voices of the people who surrounded us offered a sensation of familiarity; their language was different, of course, but we could recognize some of the words, and the harsh guttural sounds of the lowlands blending with the soft sibilant language of the fjords made me question whether we should have come here many years before.
‘How do you feel?’ I asked Zoya, turning towards her as the sign for Hami
na indicated that we would arrive there in no more than ten or fifteen minutes. Her face was a little pale and I could see that she was moved by the heartbreaking experience of travelling east, but she gave nothing away in her expression. Had we been alone, perhaps she might have wept out of a mixture of sorrow and joy, but there were strangers sharing the bus with us and she would not confirm their prejudices by allowing them to observe the weakness of an old woman.
‘I feel as if I don’t want this journey to end,’ she replied quietly.
We had been in Finland for almost a week and Zoya was enjoying particularly good health, a fact which made me wonder whether it might not be a good idea to relocate to the climate of the north indefinitely if it meant that her condition would improve. I was reminded of the biographies of the great writers whose lives I had studied during my retirement at the British Library, of how they had left their homes for the frosted air of the European mountain ranges in order to rally against the illnesses of the day. Stephen Crane, allowing tuberculosis to extinguish his genius in Badenweiler; Keats staring out at the Spanish Steps as his lungs filled with bacteria, listening to the voices of Severn and Clark bickering with each other as they consulted over his treatment. They went there to look for revitalization, of course. To live longer. But all they found was their graves. Would it be different for Zoya, I wondered? Would a return to the north offer hope and the possibility of extended years, or a crushing realization that nothing could defeat the invader which was threatening to take my wife from me?
A small café in the town offered us a traditional lounas and we took a chance and sat outside, swaddled in overcoats and scarves as the waitress brought us warm plates of salted fish and seed potatoes, replenishing our hot drinks whenever they ran low. As we watched, a group of children ran past us and one of the boys pushed a smaller girl over, sending her toppling backwards into a mound of snow with a terrified scream. Zoya sat forward, prepared to remonstrate with him for his cruelty, but his victim quickly recovered herself and took her own revenge, which brought a satisfied smile to her face. Families passed by, on their way to and from a nearby school, and we settled back with our thoughts and our memories, peaceful in the knowledge that a long and happy relationship negates the need for constant chatter. Zoya and I had long perfected the art of sitting silently in each other’s company for hours on end, while never running out of things to say.