The Betrayal

by Helen Dunmore

  But now, suddenly, when he’d given up expecting it, she had conceived. From the day she told him she thought she was pregnant, he’d been struck by how certain she seemed. After so much anxiety – so much grief, if he were honest – he thought she might have been tense and fearful, in case things went wrong. But she seemed quite calm. His own joy was so overwhelming that he became afraid. Something would go wrong. He had spent too many years telling himself that it didn’t matter, because he and Anna were happy and they had Kolya. He thought he had convinced himself.

  He won’t change towards Kolya. The boy won’t notice any difference. He vows this to himself, in silence.

  A child. His child. He hurries onward, swinging through the main doors of Radiology.

  ‘Is Sofya Vasilievna about?’ he asks one of the nurses.

  ‘No, she’s got a group of students,’ replies the nurse, and pushes her trolley away. He hesitates. Probably better to come back later; she might be a while. But as he’s hovering outside one of the doors with its warning sign, Lena rushes up to him.

  ‘I need to talk to you. Come on.’

  ‘But, Lena –’

  ‘Quick, this way.’ Something in her tone makes him follow her without further questions, out of the department, down one of the long wards that are waiting for refurbishment. Lena stops outside a door, and glances both ways before opening it. ‘Hurry up!’

  ‘But, Lena, it’s a cupboard.’

  ‘I know it’s a cupboard, for heaven’s sake!’

  They are inside. Lena feels for a switch and he hears it click before a feeble light comes on, showing shelves up to the ceiling, piled with hospital linen. It’s a big cupboard and there’s space for three or four people to stand upright inside it.

  ‘Isn’t this a bit melodramatic, Lena?’

  Lena shrugs. ‘If you like. But we can’t waste time, I’ve only got ten minutes.’ For a bizarre instant he thinks she’s offering him sex, but of course that’s impossible. Not Lena; not him, either. ‘Listen,’ she carries on, ‘I’ve heard something about the Volkov boy. He’s coming in later today.’

  Whoever is in charge of this cupboard seems to like their job, thinks Andrei. The sheets are ranged immaculately, with all the sharp, starched edges matched. He can see the double line of sewing by the seam, where they’ve been turned sides to middle. Nothing wasted. That’s how it should be. Only people are to be wasted.

  ‘For a check-up?’ he asks, fending off what he already knows.

  ‘No. He’s developed further symptoms. They’ve been to their private doctor, and now he’s coming in for a chest X-ray. Persistent cough and shortness of breath.’

  ‘I see.’

  ‘There’s a hell of a panic on in Admin. My friend works there.’ Lena, so discreet. Even to him she doesn’t name the friend. ‘Borodin or Ryazanova ought to see the boy,’ says Lena, naming the paediatric respiratory consultants. ‘It’s not your area. It was bad enough the way you got dragged in last time. Besides, it may just be flu. It’s that time of the year.’

  But from the first moment she mentioned the boy’s name, certainty plumbed him like a lead weight. ‘Further symptoms’; ‘chest X-ray’. Of course he sees, and so does Lena. Osteosarcoma is one of the cancers which is most likely to produce secondaries in the lungs. Four months since the operation; that would be quick, but not impossibly quick. There may even have been some nodules at the time of Gorya’s earlier treatment, but they were still too small for the X-rays to pick them up then. Tumours in the lung can grow so fast, especially in a child of that age.

  It’s a while since he last saw Gorya. The boy’s done very well in rehabilitation. Andrei’s abiding memory is that of Gorya swinging himself on his crutches down an endlessly long corridor. His face was unchildlike in its grim determination. He was being fitted for a prosthesis, but then there were problems with residual swelling and tenderness in the stump and so Gorya continued on crutches for the time being. What an expert he became, in no time. Children were like that.

  ‘Thanks for letting me know, Lena.’

  He sees her hesitate. She’s got something else to tell him and she doesn’t know quite how to say it.

  ‘What is it, Lena?’

  ‘My friend in Admin said Volkov asked for your file to be sent to him again.’

  ‘I see.’

  ‘You should have got out!’

  ‘It’s not so easy. Anyway, it’s too late for all that now.’

  ‘Probably it won’t come to anything. After all, things are better – they aren’t like they used to be. It’s not as bad as that.’

  ‘ “Life has become better, comrades, life has become more cheerful,” ’ quotes Andrei savagely. Only to Lena, out of all his colleagues, would he dare to say such a thing. Lena gave him her own hostage to fortune long ago, when she told him that she hadn’t seen her father since she was seventeen. ‘He was taken away, in ’37, and we never saw him again. By some miracle the rest of us weren’t touched. Of course, my mother had to denounce him – that was a long-standing agreement between them, for the sake of the children. If she’d been arrested, he’d have done the same.’

  ‘Pity we can’t smoke in a linen cupboard,’ says Lena now, ‘I could kill for a cigarette.’

  ‘Me too.’

  If there are secondaries in the lungs, there’s nothing more that can be done for Gorya. They can offer palliative care, that’s all: morphine, sedatives, physiotherapy and draining away of the fluid that will collect as the tumours grow.

  All that child’s pain and fear and mutilation and slow recovery might as well never have happened. Sometimes it makes you doubt what you’re doing.

  ‘Don’t,’ says Lena.

  ‘What?’

  ‘You had no choice. He had to have the amputation.’

  ‘Are you a mind-reader, Lena?’

  ‘No. Just good at reading your face.’

  He looks away, confused. The cupboard really is very small. He can smell the clean linen, and also Lena herself. Skin, hair, flesh. A warm human being, close to him, her eyes full of concern.

  Fear squeezes his heart again, driving out all other thoughts.

  ‘Well, I can’t spend the rest of my day in a cupboard with you, more’s the pity,’ says Lena, with a smile that fails to deceive either of them.

  ‘Lena – thank you. If I don’t see you –’

  ‘Don’t talk such rubbish.’

  ‘No, listen. If anything happens, you must go to Anna. Tell her to do what your mother did, for the sake of the baby and Kolya. You know what I mean. I can’t talk to Anna about it now, not when she’s pregnant. Will you promise me that, Lena?’

  For the only time, and with shame, Andrei makes use of what he knows Lena feels for him.

  ‘All right,’ says Lena, ‘although she probably won’t listen. I wouldn’t, if it were me.’

  After this, everything happens quickly. An hour later, Andrei is intercepted on the way to his ward round.

  ‘You are requested to come immediately to Medical Personnel.’

  ‘But I’m doing a ward round with Professor Maslov.’

  ‘He has been informed.’

  Andrei follows the clerk’s trim, bouncing figure along the corridors. He doesn’t know her. A new girl perhaps, or a transfer from another department. She is very young, but she gives him the message with a look of cold, smug disapproval. For some absurd reason he is hurt by this, as if he expected her to smile.

  She turns aside before she reaches the main office of Medical Personnel, and opens a door to her left. The small room is empty. She gestures for him to go forward.

  ‘But there’s no one there,’ says Andrei.

  She looks at him as if he is stupid to have expected there to be anyone in the room.

  ‘Please wait,’ she says, and he finds himself grateful for that much politeness, as she closes the door on him. He listens to her heels tapping away down the corridor. Well, at least she hasn’t turned the key on him, he thinks, and sm
iles to himself, a little grimly. She can’t be more than twenty. Just a few years older than Kolya. Why let the attitude of a chit like that get to him?

  The minutes lengthen. His nerves crisp with irritation as he thinks of Professor Maslov on the ward round without him. He’ll have the notes, of course, but not the detailed exchange of views and findings that mark his relationship with Andrei. Maslov is a fine physician, one of the very best. Close to retirement now but unsparing in his efforts to pass on decades of expertise. And what is even more remarkable, given his age and status, he is always open to the latest ideas and research. He treats Andrei more as a colleague than as a junior. Andrei considers himself fortunate to have the chance to work with Maslov, and now, with no warning, he’s failing to turn up for the ward round. What the hell is Maslov going to think?

  He glances at his watch. Quarter to five. He’s been waiting half an hour at least. He should sit down and try to relax. Why doesn’t he just walk out of the door? It isn’t locked. ‘You should have got out,’ Lena had said. Perhaps there is still a chance, if he is prepared to take it.

  He hears a distant clang. A nurse dropping a bedpan, no doubt. What a catastrophe, magnified by the long, bare corridors. Admin can’t protect themselves entirely from the sounds and smells of the hospital, although they keep themselves safely out of sight most of the time. Even here in this little bare room, the hospital breathes around him like a huge organism of which he is a part. He cannot separate himself, not by his own choice. If they force him, that’s another matter. But no power on earth will make him say, of his own volition, ‘I don’t belong here.’

  The door opens. The pert little face of the clerk looks round it. She frowns on seeing Andrei, as if she expected him to disappear or to turn into someone else.

  ‘You are to come with me,’ she says.

  As he follows her for a second time, Andrei is sure she’s taking him to Volkov, and he gets the measure of what Volkov has already done. He has turned the hospital into his own place, running by his own rules. A doctor can miss a ward round and cool his heels in an empty office for half an hour. People can be sent for without explanation and even without reason. There is a larger reason, which is that they must learn that they have now entered Volkov’s world.

  Well, thinks Andrei, perhaps. But what if I refuse? What if I continue to believe that the man I’m going to see is the father of a sick child, and that he’s full of anger and vengeance because he dreads what’s coming next? You’re the parent, Volkov, and I’m the doctor. Nothing’s going to change that.

  13

  This time, the room to which Andrei is taken contains Volkov. He’s seated at the desk, like a man at work in his own office. His chair is larger and slightly higher than the empty chair on the other side of the desk. Volkov gestures to Andrei to sit, without greeting him.

  ‘Good afternoon,’ says Andrei, but Volkov plunges in without preamble.

  ‘You know why we’re here. The boy is worse.’

  ‘I heard that.’

  ‘He has a cough. He’s losing weight. He’s tired.’

  ‘And your own doctor has seen him, I believe?’

  ‘Yes. So, what do you think is wrong?’

  ‘It’s not possible for me to say that before he’s had a full range of tests. If he were my patient I’d arrange a chest X-ray and blood tests straight away, after the physical examination.’

  ‘So he’s not your patient, then? I thought we’d agreed that he was. Or is he only your patient when things are going well, is that it?’

  The work has become the man, thinks Andrei. Even now Volkov can’t stop framing his questions like an interrogator. Keep calm. Don’t respond in kind. ‘As you know, I’m not an oncologist. I became involved in your son’s case because of an initial confusion over the symptoms with which he presented. I remained in close touch with the case at your request.’

  ‘ “The case”?’

  ‘Forgive me.’ Andrei feels himself flush. He’s done exactly the same as Volkov – lost his grip on where they are and what should happen here. A crass, clumsy blunder, worthy of a third-year medical student. He would never have believed he could speak to a parent like that. ‘We get used to using certain expressions, and we forget how they sound.’

  Volkov’s anguish is obvious. He looks worn, and he has aged much more than the few months that have passed since Gorya was first diagnosed. Andrei notices that the nails on his left hand are bitten down and surrounded by raw, bulging flesh. That’s new; Andrei remembers noticing how well kept Volkov’s hands were, and that his professional life clearly didn’t disturb him.

  Volkov is far too intelligent not to understand how ill the boy is. Perhaps the private doctor summoned up the courage to warn him about what Gorya’s cough and loss of weight might mean. Maybe he even did an X-ray. Volkov wouldn’t disclose that yet; it’s not his style. He comes in hard with questions, to make sure that the conversation is always on his territory. He finds out your weaknesses.

  ‘You recommended the surgeon, as I remember. What was her name? Brodskaya. Yes, that was it,’ Volkov continues, drawling out the syllables mockingly, ‘Riva Grigorievna Brodskaya. She performed the biopsy and then the amputation.’

  ‘We discussed the criteria for choosing a surgeon beforehand, if you remember. Dr Brodskaya had the necessary experience, and an excellent reputation.’

  ‘But she doesn’t seem to have been very successful in this “case”, as you put it. Why do you think that might be, given that she’s supposed to be so good?’

  ‘She’s a fine surgeon. One of the best.’

  ‘You think so? Let’s hope that that her patients in Yerevan think the same. You look surprised, Dr Alekseyev. Did you think we wouldn’t know that the bird had flown the nest? So. Let me tell you what really happened. She butchered my boy for nothing.’

  ‘It wasn’t like that. There was no alternative to the operation.’

  ‘An operation which has succeeded in spreading the cancer all around his body. His lungs are full of it, do you know that? What kind of surgery was that?’

  So the X-rays have been done already. Either here, in haste, or before Volkov brought his boy back to the hospital.

  ‘I haven’t seen Gorya’s X-rays yet,’ says Andrei.

  ‘They show, apparently –’ Volkov’s hard, aggressive composure falters, but he clears his throat and carries on. ‘It seems they show that cancer has spread to the lungs. But you must have suspected that. Apparently, we’re now told, it’s not uncommon. Met-a-stas-is. Isn’t that the word you doctors use?’

  ‘It’s a terrible thing,’ says Andrei. He would like to remind Volkov that he has always been honest with him. He’d made it clear that osteosarcoma was a highly aggressive cancer. Volkov was told that amputation was the only possible treatment, but never that it was a cure.

  It would do no good to say these things now. Out of common humanity, if nothing more, he has to keep quiet. Besides, he feels a corrosive sense of personal failure, as he always does when treatment doesn’t work and it becomes clear that medicine has nothing more to offer.

  ‘You remember how he was after the operation? All that,’ says Volkov, not raising his voice but striking with his fist on the desk so violently that the pen holder jumps and clatters to the floor, ‘all that for nothing. His mother was right. I should have listened to her, but I trusted you.’

  No, thinks Andrei, you never did, not for a second. You trust no one. ‘Where is Gorya now?’ he asks.

  ‘Your Professor Borodin is doing an examination. It’s you that Gorya wants to see, though. He never liked Brodskaya. Didn’t want her to touch him. Well, she won’t be touching anybody for a while. She’ll have to shut up her butcher’s shop.’

  ‘She is a very good surgeon.’

  ‘When you keep on saying that, it makes me think you’re on her side. Maybe you two know each other better than I realized. Were you putting your heads together all the time?’

  ‘Naturally we
conferred about Gorya’s care.’

  ‘Naturally.’ Volkov’s forehead is moist. Suddenly his features twist with rage. ‘Naturally birds of a feather stick together!’ he shouts. ‘Why don’t you answer me? What are you made of? Aren’t you a man?’

  ‘You’re the parent of a sick child, and I’m a doctor. It’s not my job to argue with you.’

  ‘You’ve already failed in your “job”,’ says Volkov, with a contempt that doesn’t quite ring true. Like his anger, it has something in it which is synthetic and theatrical. ‘Your job was to find out what was wrong with Gorya and then do everything in your power to restore him to health. Instead of that, you tell me you’ve got to cut off his leg, you persuade me that’s the only possible cure, and like a fool I believe you and allow you to –’ he swallows. Genuine emotion fights with the whipped-up anger for a moment, and then anger wins. ‘How many other patients have you done this to, eh? How many innocent, trusting workers have brought their children to this hospital, committing them to your so-called expertise and expecting the highest standard of care? The people demand such standards! Nobody is above the people’s vigilance! How many mistakes have been covered up? How many incompetents, murderers and saboteurs have been protected?’ With each sentence, Volkov slams the desk with his fist. Suddenly he picks up the table lamp, wrenches its cord from the socket, and hurls it against the wall. ‘How many?’ he shouts. ‘How many?’

  There is silence, a long, strangely detached silence in which Andrei hears nothing but the race of his own thoughts. He doesn’t even glance round at the shattered lamp. These words are not his words. ‘Incompetents, murderers and saboteurs.’ They’re a language he’s never needed to speak, although of course he knows it, no one can help knowing it. It seeps across the face of the newspapers like a corruption. Volkov would have learned it all in his young days, when he still had to work at the coalface of interrogation. It’s second nature to him now. Outrage and fury are an essential part of the interrogator’s repertoire. People who’ve been ‘there’ and by some miracle have survived – they don’t talk about it. But once or twice, late at night, Andrei’s heard a few things. Lies are violent, he knows that. They have their own power.