The Betrayal

by Helen Dunmore

  By the same author

  Zennor in Darkness

  Burning Bright

  A Spell of Winter

  Talking to the Dead

  Your Blue-Eyed Boy

  With Your Crooked Heart

  The Siege

  Mourning Ruby

  House of Orphans

  Counting the Stars

  HELEN DUNMORE has published eleven novels with Penguin: Zennor in Darkness, which won the McKitterick Prize; Burning Bright; A Spell of Winter, which won the Orange Prize; Talking to the Dead; Your Blue-Eyed Boy; With Your Crooked Heart; The Siege, which was shortlisted for the 2001 Whitbread Novel of the Year Award and for the Orange Prize for Fiction in 2002; Mourning Ruby; House of Orphans; Counting the Stars; and The Betrayal. She is also a poet, children’s novelist and short-story writer.

  The Betrayal

  HELEN DUNMORE

  FIG TREE

  Published by the Penguin Group

  Penguin Books Ltd, 80 Strand, London WC2R 0RL, England

  Penguin Group (USA) Inc., 375 Hudson Street, New York, New York 10014, USA

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  Penguin Books Ltd, Registered Offices: 80 Strand, London WC2R 0RL, England

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  First published 2010

  Copyright © Helen Dunmore, 2010

  The moral right of the author has been asserted

  All rights reserved

  Without limiting the rights under copyright reserved above, no part of this publication may be reproduced, stored in or introduced into a retrieval system, or transmitted, in any form or by any means (electronic, mechanical, photocopying, recording or otherwise), without the prior written permission of both the copyright owner and the above publisher of this book

  A CIP catalogue record for this book is available from the British Library

  ISBN: 978-0-141-94603-0

  Contents

  Chapter 1

  Chapter 2

  Chapter 3

  Chapter 4

  Chapter 5

  Chapter 6

  Chapter 7

  Chapter 8

  Chapter 9

  Chapter 10

  Chapter 11

  Chapter 12

  Chapter 13

  Chapter 14

  Chapter 15

  Chapter 16

  Chapter 17

  Chapter 18

  Chapter 19

  Chapter 20

  Chapter 21

  Chapter 22

  Chapter 23

  Chapter 24

  Chapter 25

  Chapter 26

  Chapter 27

  Select Bibliography

  To Patrick and Alexa

  1

  It’s a fresh June morning, without a trace of humidity, but Russov is sweating. Sunlight from the hospital corridor’s high window glints on his forehead. Andrei’s attention sharpens. The man is pale, too, and his eyes are pouched with shadow.

  It could be a hangover, but Russov rarely drinks more than a single glass of beer. He’s not overweight. A touch of flu then, even though it’s June? Or maybe he needs a check-up. He’s in his mid-forties; the zone of heart disease.

  Russov comes close, closer than two people should stand. His breath is in Andrei’s face, and suddenly Andrei stops diagnosing, stops being at a comfortable doctorly distance from the symptoms of a colleague. His skin prickles. His body knows more than his mind does. Russov smells of fear, and his conciliating smile cannot hide it. He wants something, but he is afraid.

  ‘Andrei Mikhailovich …’

  ‘What is it?’

  ‘Oh, it’s nothing important. Only if you’ve got a moment …’

  His face is glistening all over now. Drops of sweat are beginning to form.

  Suddenly Russov whips out his handkerchief and wipes his forehead as if he were polishing a piece of furniture.

  ‘Excuse me, I’m feeling the heat … I don’t know when they’re going to get around to turning off these radiators. You’d think our patients had all been prescribed steam baths.’

  The hospital’s radiators are cold.

  ‘I wanted to ask your advice, if you’ve got a moment. As a diagnostician there’s no one whose opinion I respect more.’

  Now why is he saying that? Only last week there was an idiotically petty and irritable ‘professional disagreement’ over a little girl with an enlarged spleen following a serious fall. Russov had gone on about ‘scientific accountability’ while he tapped his pen scornfully on the table. He hadn’t appeared very impressed by Andrei’s diagnostic skills then. Andrei always spent far too much time with his patients. This was a clear-cut case of splenic trauma following an abdominal injury. The only question was whether it could be treated non-operatively, or whether an immediate operation was advisable.

  When it turned out that the child’s swollen spleen had indeed nothing to do with the accident, and was due to undiagnosed leukaemia, Russov muttered about ‘flukes’ and ‘all this hands-on mumbo-jumbo’.

  But all the same, Russov is a reasonably good physician. Hard-working, responsible and extremely keen to write up as many cases as possible, in the hope of raising his research profile. He’s certainly getting noticed. One day no doubt he’ll produce that definitive research paper which will unlock the door to a paradise of conferences and the golden promise of a trip abroad. Andrei’s gift for diagnosis annoys him. It isn’t classifiable and it hasn’t been achieved in the correct way, through study and examination. The two men have never become friends.

  ‘So what’s the problem, Boris Ivanovich?’ asks Andrei.

  Russov glances down the corridor. A radiographer is wheeling a trolley-load of X-ray files towards them.

  ‘Let’s go outside for a breath of air.’

  The courtyard is large enough to be planted with lime trees and rose bushes. It’s good for the patients to look out and see living things. Andrei remembers the time when they grew vegetables here: onions and carrots and cabbages, rows and rows of them packed together. Every green space in Leningrad became a vegetable plot, that first summer of the siege. Strange how close it still feels, as if those times have such power that they still exist, just out of sight.

  These limes are young trees, less than ten years old. The former trees were all chopped up for the hospital stoves in the winter of’41/2. But the wood ran out at last, no matter how much they scavenged. Andrei’s fingers still remember the icy, barren touch of the unlit stoves.

  Two paths run criss-cross through the courtyard. In its centre there’s a circle of gravel, and a bench. Russov remains standing. His feet shift, crunching the gravel, as he takes out a packet of Primas and offers it to Andrei.

  ‘Thank you.’

  The business of lighting the cigarettes draws them close. Russov seems calmer now. Although his fingers fumble with the lighter’s catch, they don’t tremble.

  ‘Good to get a breath of fresh air.’

  ‘Yes,’ Andrei agrees, ‘but you’ll have to excuse me in a minute. I have a patient going into X-ray at two,
and I need a word with the radiographer first –’

  ‘Of course. This won’t take a moment.’

  But still he won’t come to the point. Just keeps on dragging at his cigarette and blowing out jerky puffs, like a boy who is smoking for the first time. Like Kolya.

  ‘It’s a new patient. A tricky case.’

  Andrei nods. ‘Would you like me to take a look?’

  Russov’s face twitches into a smile. ‘It’s not a question of diagnosis precisely,’ he says, with an attempt at his usual manner of lofty certainty, ‘but of defining exactly what tests ought to be carried out at this stage.’

  ‘So what are the symptoms?’

  ‘In a case such as this … Well, in such a case one needs to be a hundred per cent certain before one takes the next step.’

  ‘I’m not sure I understand you. What are your initial findings?’

  Russov gives a sudden harsh bark of laughter which transforms his face completely. He looks almost savage. His short hair seems to bristle.

  ‘My “initial findings” are that this patient is the son of – of an extremely influential person.’

  ‘Ah. And how old is the boy?’

  ‘Ten.’

  ‘And so it’s a joint problem, is it? Is that why you’ve come to me?’ Why doesn’t Russov get to the point?

  ‘He’s Volkov’s son,’ says Russov abruptly.

  ‘Volkov’s?’ My God. It’s one of those names you only have to say once, like Yezhov or Beria. Andrei’s heart thuds, and he has to clear his throat before speaking. ‘The Volkov, you mean?’

  Russov just nods, and then rushes on. ‘A joint problem, yes, I’m pretty sure that’s what it is. There’s swelling and redness and so on, pain on articulation, heat to the touch. That’s why I’ve come to you. All the symptoms point to juvenile arthritis and you’re the man for that. I haven’t ordered tests yet, it’s pure guesswork,’ he adds hastily.

  ‘You’d like me to take a look.’

  ‘If you would. If you would, my dear chap, I tell you, I’d be eternally grateful.’

  My dear chap? Eternally grateful? Sweat is still leaking from the pores of dry, competent Russov. He never talks like this. What the hell is going on?

  The breeze is warm and sweet, but ice touches Andrei. There’s much more here than he’s being told. Russov fears that this child is seriously ill. He wants Andrei to see the boy, take on the case, order the tests and then give the verdict to the family. Russov will do anything not to be the bearer of bad news to Volkov. It won’t be Russov’s face that Volkov will remember with the cold, hard rage that such a man will feel for anything he can’t control.

  Russov drops his cigarette butt, grinds it into the path and then smoothes clean gravel over the spot with his heel. Andrei says nothing. He finds himself staring at the lime leaves as if he’s never seen them before. They are so fresh and vigorous. Amazing how trees always look as if they’ve been there for ever, even when you can remember the women stamping down earth over their bare roots.

  Russov clears his throat. ‘It struck me as just possible that there might be something I’ve overlooked. There’s a risk of setting off in the wrong direction – ordering the wrong tests, for instance. In a case of such significance for … for the hospital, we can’t afford any margin of error.’ And he actually has the nerve to look at Andrei self-righteously, as if Andrei is the one who has neglected to think about the greater good of the hospital community. Andrei stares back blankly. Russov’s eyes drop. ‘For example …’ he mumbles. ‘For example, you’ll recall the little girl with the spleen.’

  How the man is abasing himself. He will hate Andrei for it afterwards, once all this is over. No one makes a better enemy than a man who has had to beg for your help.

  But perhaps Russov really has missed something. He’s thorough, but he goes by the book. It’s also just conceivable that he’s aware of this – that he’s not as self-satisfied as he always seems … In which case he might be doing exactly what ought to be done in such a case: seeking a second opinion.

  ‘You still haven’t told me anything about this child,’ says Andrei.

  Another throat-clearing. Russov’s hand strays to his jacket pocket, where he keeps his cigarettes, and then falls to his side. His eyes stare into Andrei’s, but remain opaque.

  ‘My thinking was that it would be best for you to come to the case quite fresh.’

  A rising breeze makes the lime trees shiver all over. Hold back, thinks Andrei. Don’t commit yourself. Not instantly, like this. He recognizes it already as one of those moments that has the power to change everything. Perhaps he won’t be able to avoid it. If you put everything else aside, there’s still a sick child here, and he needs the best possible treatment. What if Russov gets it wrong again?

  But Andrei has Anna to think of, and Kolya.

  Their faces rise up in his mind, oblivious. There’s a knot of tiny lines on Anna’s forehead, but when she looks up and sees him that knot will clear. And there is Kolya, tall and thin, narrow-shouldered because he hasn’t grown into his height yet. Kolya frowning at his homework, then suddenly jumping up and crashing across the living room because he’s spotted a mouse under the table. Or claims he’s spotted one – Kolya wants a cat, and Anna isn’t keen.

  Kolya, lunging between child and man, and out of step with both.

  Andrei’s heart beats hard. Whatever happens, these two mustn’t be touched.

  But Russov didn’t want any of this, either. He’s just a trapped, ordinary man. Reasonably competent, reasonably conscientious. And now quite reasonably afraid.

  ‘So, you’ll see the boy?’ asks Russov.

  ‘Have you got the case notes with you?’

  His colleague hesitates.

  ‘It was just a preliminary examination, you understand. I’ve done no tests. There’s been no possibility of making any sort of diagnosis. The boy was brought in last night with certain symptoms, that’s all. By private ambulance,’ he adds, as if this hopelessly irrelevant detail will make up for all the blanks.

  In a flash, Andrei does understand. The bare minimum has been put into writing.

  ‘But you must have ordered tests. You must have thought about what would be needed.’

  ‘I don’t want to prejudice your own examination.’

  Andrei feels himself recoil. Even here, out in the courtyard where surely nobody can be listening, his so-called colleague won’t talk. He’s studied hard all right, in the unwritten subject that runs through every other course of study. Keep your tongue and your hands still, unless you are absolutely sure that it’s safe to move them. Don’t take risks. Don’t stand out. Be anonymous and average; keep in step.

  ‘It was Doctor B. I. Russov, of course, who made the initial examination and first suggested the diagnosis that was later confirmed …’ He’ll do anything to avoid that. Much better for Russov to be able to say: ‘I asked a colleague – a first-rate general paediatric physician and one of our finest diagnosticians – if he would examine the patient. Dr Alekseyev has a particular interest in juvenile arthritic disease, and given that my own caseload does not permit me to take the special interest in this case which it requires, it seemed the best course of action to hand over the case as soon as possible. Consistency of care, you understand, is of the utmost importance.’

  That’s how it will be.

  What does Russov take me for? Does he think I’m a complete idiot?

  Russov looks down at the gravel. His shoulders sag. He thinks he’s lost, thinks Andrei. He thinks I’m going to tell him to sod off. And of course that’s what I’ve got to do. Let Russov carry his own can. He’s always trying to make himself conspicuous, and now fate has found a way. He’ll ‘raise his profile’ with Volkov all right …

  Russov got the case. That’s all the difference there is between us.

  He could say yes. That’s what he always says. Andrei has never been one of those doctors who keep their expertise only for their own patients. He doesn
’t spare his energy either. Sometimes it seems that the more he uses up his energy, the more he has, as if he’s got access to some secret principle of acceleration that overrides the normal rules of fatigue. Everybody knows they can count on Andrei. Russov will be counting on that.

  ‘You want me to take on the case,’ says Andrei.

  ‘I didn’t say that.’

  ‘Listen, Boris Ivanovich –’

  ‘I’m only asking you to take a look at the boy.’

  ‘Not today. It’s impossible. I’ve got two clinics, and then a meeting until nine.’

  ‘But you will?’

  ‘I can’t promise. I’ve got to go, my patient is waiting, and the radiographer. I’ll speak to you tomorrow.’

  Russov puts a hand on Andrei’s sleeve. Shadows flicker on the dusty brownish-grey cloth. ‘I appreciate your cooperation,’ he says. He wants to sound as a man should sound after a normal professional discussion with a colleague, but in spite of himself his voice pleads.

  ‘These trees have done well,’ says Andrei.

  Russov looks up impatiently. Trees! For heaven’s sake, aren’t there more important things to talk about? His grip tightens on Andrei’s arm, then he recalls himself, and says with forced civility, ‘Splendid things, trees.’

  Anna worked from first light to darkness on the big October tree-planting day, the year the war ended, Andrei remembers. He didn’t take part, because he was on duty all day. She came home exhausted – she had certainly ‘fulfilled her norm of unpaid labour’. He was annoyed with her for doing so much – all that slog on top of a week’s work. Surely she could have come home earlier, look at her, she was going to make herself ill. But Anna said, ‘It’s trees, Andryusha. Something for the children. Just think, one day Kolya will be able to take his children out to the new parks and walk under the shade of the trees we’ve planted today.’

  *

  Andrei walks down the corridor towards the Radiology Department. He can feel the tension in the back of his neck. He pauses for a moment, drops his shoulders, rotates them, lets them fall. Sick children are very quick to spot signs of adult anxiety.

  ‘Hello, Tanichka, how’s Mama behaving herself today?’