by A J Allen
“If you are referring to Dr. Tortsov,” said Chevanin, “then he has not arrived yet. And when he does get here, he will be too busy to be making calls for no reason. So your journey had been wasted. Go away.”
The boy’s lips began to tremble. His eyed grew brighter still as he fought back his tears of frustration and anxiety. Balling his hands into little fists, he said starkly, “Muvver’s been sick.”
“Too sick to attend surgery herself like everyone else, I suppose? There’s nothing I can do.”
All at once, the boy’s face puckered and he began to blubber.
“Alright, alright!” said Chevanin testily, as the child wiped an overlong sleeve across his brimming eyes. “Tell your father that I will pass the message on to the Doctor. One of us will visit your mother later today. And tell him to have his visitation fee ready.”
He began bundling the sobbing child towards the door.
“Mind, if this a false claim the fee is doubled. Do you understand?”
Dragging the sleeve once again across his face, the boy nodded tearfully.
“Now get out, before you infest the surgery with lice.”
He held the outer door open for the ragged child. When the boy had gone, Anton Ivanovich walked back into the empty consulting room and moved the deep pan of now-boiling water to the edge of the stove’s plate. The boy had been a disappointment. He had wanted to appear busy when his employer arrived and now he had nothing to do. The hands of the surgery clock showed that it was nearly twenty past nine. Surely the Doctor could not be much longer?
As if in answer to his thoughts, he heard the outer door open again and the sound of footsteps in the waiting room accompanied by a familiar jangling of keys. The door of the consulting room opened. With a heavy heart, Chevanin looked up to see Doctor Tortsov standing in the doorway.
“Good morning, Doctor,” he said nervously.
“Good morning, Chevanin.”
His employer began to take off his hat and gloves and Chevanin hurried to help him remove his overcoat, surprised, as always, at how so frail a man could wear such a heavy garment. Leaving him to hang the coat up, the Doctor muttered his thanks and strode over to the stove.
Now I’m for it! thought the young man.
“Who do we have today?” the Doctor asked, warming his hands.
Nervously, his assistant crossed to his desk and, picking up the medical register in his trembling hands, scoured the appointment pages for that morning’s surgery.
“Madame Shiminski is due at ten o’clock with her sprained wrist,” he read out, “and you have told Vissarion Lepishinsky to come back today so that you could have another look at his neck.”
“Hmm. Well, we shall see. We shall see,” the Doctor said, half to himself. “I have to go out at eleven o’clock to speak to Colonel Izorov. So, if Lepishinsky calls in my absence you can deal with him. If all looks well, it’s just a matter of renewing the dressing and applying more of the Bohm’s ointment.”
Hearing the mention of the Chief of Police’s name, Chevanin turned cold with fear. Surely the Doctor was not thinking of making an official complaint? Even in his wildest imaginings he had never considered that his employer would exercise his legal right as a husband. It would mean his arrest; professional disgrace; possibly even the knout.
“Doctor, you mentioned Colonel Izorov… May I ask you if anything is wrong?”
Standing with his back to his assistant, Dr. Tortsov thought of the unsuccessful interview with the Mayor he had conducted the previous night at the Hotel New Century.
“I don’t know, Anton,” he answered slowly. “At the moment, I am completely in the dark. But I am concerned for the welfare of the town.”
It took Chevanin a few seconds to realise that the Doctor might be referring not to himself, but to the outbreak of typhus.
“Has the epidemic grown worse?” he asked hopefully.
Turning to face him Dr. Tortsov gave his assistant a puzzled look. If he had not known the boy better, he told himself, he would have been forgiven for thinking that he had sounded as if the outbreak was a blessing.
“No, but it could do,” he replied cryptically.
Their conversation was cut short by the sound of the latch on the outer door. Neither the Doctor nor his assistant referred to the matter again as they busied themselves attending to the first of their patients.
The morning’s surgery was uneventful. As case succeeded case, Chevanin methodically entered the treatment prescribed in the medical register, tending the dispensary under the Doctor’s supervision when it was necessary. To his great relief it was clear that Madame Tortsova had said nothing to her husband about his indiscretion. By the time the Doctor had pulled his watch from his waistcoat pocket and seen that the time was ten minutes to eleven o’clock, Chevanin felt enormous relief. He was the master of his own fate once more. Even Dr. Tortsov’s instruction to call upon him at home when he had completed the morning’s practice did not worry him. It was only as he was helping the Doctor on with his coat again that he remembered the small boy he had seen at the beginning of the day.
“I might be a little late,” he said. “I’ve promised that I would call in at Pyatkonov’s izba. Apparently, his wife has taken sick.”
“Goat’s Foot’s wife? It’s probably that dreadful stuff they drink,” snorted the Doctor as he reached for his hat. “Make sure that you get him to pay for a consultancy fee. That one is as sly as a fox.”
Chevanin confidently assured him that he had already told the boy to tell his father about the payment.
“Good,” said the Doctor. “And you had better chase up Pirogov’s bill as well. It’s best not to let these things slip for too long. Start as you mean to go on, that’s my advice. You will never get anywhere by not collecting your fees and Pirogov can afford it, whatever he says.”
With those parting words, the Doctor departed. Left alone in the surgery Chevanin brought his hands together with a loud clap. He had blown up the whole affair at the Tortsovs’ house out of all proportion, he told himself. After all, what had he done but paid Yeliena Mihailovna a clumsily phrased compliment? He had given himself a scare and that was the end of it. The worst she could think of him was that he had acted like a fool. Knowing that to be the truth, he could only agree. Nothing remained for him to do but to complete the surgery, do battle with Goat’s Foot and his wife and then he could take his place once again at the Doctor’s table as if nothing had ever happened. He felt as if an almighty weight had been lifted from his back. Life was suddenly worth living again.
Chapter Two
Monday 5th February 1907
Berezovo
Unbeknownst to either the Doctor or his assistant, that morning’s market had been enlivened by the noise of bugle practice rising from behind the high walls of the barracks. Startled by the staccato fanfares, a draught pony had reversed the flat topped cart to which it was harnessed into a makeshift stall, spilling the stall’s stock of pinched root vegetables across the icy square. The sudden jolt had unbalanced the cart’s driver, who had been unloading the sacks of dried beans that he had been delivering to Nadnikov’s general store, causing him to fall from his cart. More seriously the cart had trapped the stallholder and run over his foot. As a result, and less than five minutes after Dr. Tortsov’s departure, the waiting room had become crowded with curious and sympathetic onlookers as the two men were brought to Chevanin to see what could be done for them.
Having listened to the accounts of what had happened, Chevanin determined that the stall holder was the more seriously injured party. White faced and moaning from the pain, the man was helped to the couch by his friends. Stepping back, they stood in a circle and waited, their rough fur hats twisting in their hands out of respect both for the status of the medical assistant and their comrade’s agony. Methodically, Chevanin set to work, instructing them to hold the man down as he began cutting the blood sodden boot from the mangled foot. The stall holder began to pant rapidl
y as the boot became looser, and then bellowed twice in pain as Chevanin drew away the severed leather shell.
Ordering the man to lie still, Chevanin viewed the foot with horror. Months ago, the stall holder had wrapped a piece of cloth around his feet to protect his toes from the cold. The folds of the rag were stuck together with sweat, dirt and now blood, and the man’s flesh, what he could see of it, was pale and filthy. He decided that he had no choice but to cut the foot cloth off also. Nodding to the men to hold him down again, he set to work. For a moment the stall holder lay motionless then, flinching as he felt the cold metal of the scissors graze the instep of his foot, he began to snort and bellow again. Unable to bear the sound one of his friends thrust his own hat into the man’s mouth, muffling his cries. Distressed by the pain he was causing the man Chevanin felt a wave of panic rise within him.
I don’t know I’m doing! he thought. I’m not a surgeon. They are all expecting me to help this man and I don’t know what to do!
A memory of Dr. Tortsov’s earliest advice swam into his mind. “Don’t lose your head. Relax and rely on your training. Do what you can, and what you can’t do leave to others.” Perspiring, he worked as fast as he could, cutting away the grimy cloth along what appeared to be the least damaged side of the foot and teasing it away from the bloody pulp underneath. Beneath his hands the man bucked and writhed with amazing strength, trying to pull his injured foot away, but two of the men held the leg steady and kept it pressed firmly onto the couch. Now, the cloth remained attached only to a wide flap of loose skin at the top of the foot. Anticipating the agony he would cause, Chevanin ordered the man to hold on to the sides of the couch. Then, gritting his teeth, he tore the remnants of the rag free from the foot with one brisk movement. Shaking violently, the man screamed and began banging his head frantically against the worn leather upholstery. With a sharp hissing intake of breath, the men tightened their grip on the injured man and peered into the wound.
There was a short pause while Chevanin disposed of the bloody rag. Turning away, he felt faint and feared that he was about to collapse. Only the knowledge that he would be judged more by his demeanour than his skill prevented him from flight. With his back to the group clustered around the examination couch, he took the moment of dropping the soiled cloth into the stove as an opportunity to collect his wits and to take two deep breaths.
You are a qualified physician, he reminded himself. You are in charge. The others are ignorant and know nothing of medical practice.
Bracing himself, he turned back to face the group. On the couch the stall holder, with upward jerks of his head, was trying to sit up and look at his foot but there was a forest of arms in the way and too many hands holding him down. The man’s eyes widened in alarm as he saw Chevanin return holding a small sponge, steaming from the sterilising pan, clamped between the claws of a pair of forceps. As the first drops of scalding water fell into the open wound, the man mercifully fainted.
Chevanin’s young face frowned in concentration as he examined the crushed instep. The iron shod wheels of the cart had demolished the media longitudinal arch; blood was pumping spasmodically from the dorsalis pedis artery. Beneath the severed sinews of the tendons, embedded splinters of bone from the metatarsals and cuneiforms winked slyly in the glutinous pulp and he could see the exposed edge of the boat shaped navicular bone. Pressing a pad of cloth firmly against the artery, Chevanin began skilfully to bandage the foot. When he had finished tying off the bandage he pulled a rough blanket from the beneath the couch, and placed it gently under the damaged foot. Raising his eyes, he saw that the men were looking on despondently. He shook his head. There was nothing more he could do; the man was a case for the hospital.
Going to his desk, he wrote two notes: the first to Dr. Tortsov, care of Colonel Izorov at the uchastok; the second to the admissions clerk at the hospital, printing it in large capitals so that the dvornik could read it.
ln all probability, he told himself, with such a severe trauma the man will lose the foot. I have done the best anyone could do. Now he’s a job for the regimental surgeon.
Thrusting the notes into the hand of the man nearest to him he despatched him on his errand. Pointing towards the stretcher that stood against the wall behind the consulting room door, he instructed the other men to lift the injured man onto it. As they obeyed, he went into the dispensary and began preparing a solution of laudanum to dull the man’s pain.
The men worked with a minimum of fuss. The foot was bad: they could see that. As gently as they could, they lifted the unconscious man up and slid the stretcher underneath him. Following Chevanin’s instructions delivered through the hatch in the wall, they took a second blanket and covered him with it, folding it neatly under his chin as if he were a sick child. The man groaned and began to regain consciousness. Working quicker now, they began to fasten the leather restraining straps over the blanket, leaving the one nearest the damaged foot unfastened. Bringing the laudanum through from the dispensary, Chevanin gently lifted the man’s head and poured it between his chattering teeth. The man’s eyes looked up at him and creased in gratitude. With a final nod of thanks, the men bent their backs and carried their unlucky friend out of the consulting room, the buckle at the foot of the stretcher jangling gaily as they passed the curious gaze of a small crowd that had gathered outside the surgery door.
Once they had gone, the dray driver stood up and, throwing away the handrolled cigarette he had been smoking, walked unaided into the consulting room, his left arm hanging uselessly by his side. Motioning the man to strip off his top clothes, Chevanin began to write up his notes. When the man was standing in his trousers and boots, Chevanin pointed towards the single chair that was reserved for the use of patients.
The carter was well built, with the broad chest and strong forearms of a man accustomed to controlling teams of ponies. He sat easily in the chair, his feet spread flat on the ground in the manner of a pugilist resting in his corner between rounds. Chevanin began to circle, his eyes taking in the man’s wide back and short stubby fingers. The man was as silent as a dumb beast; his thick bearded face turned towards the warmth of the stove in the corner of the room. He was content to let the younger man do his work. When Chevanin asked him to waggle his fingers of his left hand he did so uncomplainingly. When the Doctor’s assistant extended his own hand and told him to grip it, he obeyed; his rough, calloused palm easily enveloping Chevanin’s pale smooth fist. Only when Chevanin asked him to raise his arm above his head did the man hesitate and look at him thoughtfully. Then, slowly, he began lifting his arm and at once the pain showed in his eyes, making his nostrils flare and his head jerk to one side as if he were imitating one of his own horses.
Satisfied that he had located the injury, Chevanin motioned him to lower his arm and began probing the man’s shoulder, guided by the man’s grunts of pain. Once he was certain that his diagnosis was correct (a fractured left clavicle) he told the man to dress. By the time he had prepared a sling for the man and had taken his seventy-five copecks, the hands on the clock were pointing to a quarter to twelve. Knowing that it would take him at least another twenty minutes to close up, sweep the surgery and lock everything away, Chevanin decided that Goat’s Foot’s wife would have to wait. He would visit her after calling at Ostermann Street. If he were lucky, he might even have an opportunity to make a proper apology to Yeliena Mihailovna and so finally absolve himself of his offence.
But when he arrived at the Tortsovs’ house in Ostermann Street at almost half past twelve, one glance at the maid’s agitated features told him something was wrong. Red from crying, Katya’s eyes were more than usually distended, her cheeks the colour of uncooked pastry. Pushing past her, he made straight for the sitting room but it was empty. Through the ceiling he could hear the quick movements of footsteps and the heavy creak of furniture as drawers were pulled open and closed.
His earlier fears now returned with a rush. Yeliena Mihailovna had told her husband after all. No soone
r had the thought crossed his mind than he dismissed it. If his employer had been looking for him they could hardly have missed each other between Ostermann Street and the surgery. A host of other reasons to account for the atmosphere of crisis hanging in the air immediately sprang to mind. The Doctor had had a stroke. He had been arrested (with Colonel Izorov anything was possible). Yeliena Mihailovna had received bad news…
He turned to face the distraught maid who had followed him into the room. But, before he could speak, a particularly loud thump above their heads made both of them raise their eyes to the ceiling.
“Katya?” Madame Tortsova called down.
Guiltily, the maid ran out of the room and stood at the foot of the staircase.
“Yes, mum?” she called out.
“Who was that at the door just now?”
“Anton Ivanovich Chevanin, mum.”
“Is he still there?”
“Yes, mum.”
Anton Ivanovich started to move towards the door but with one outstretched palm Katya motioned silently for him to remain where he was.
“Tell Anton Ivanovich I cannot see him now. Give him my apologies, but I must not be disturbed.”
“But mum…”
“Do as you are told, Katya!”
Helplessly the maid turned to face him. Chevanin beckoned her to return to the sitting room and to close the door behind her. Once she had done so he took her trembling hands and led her over to the sofa.
“What on earth is the matter, Katya?” he whispered urgently. “What has happened here? Where is the Doctor?”
His questions only made the girl begin crying again. He had to offer her his handkerchief and wait until her tears had ceased before he could make sense of what she had to tell him.
“The Doctor’s gone to the hospital, sir, and Madam is upstairs packing her travelling case.”
“I know about the hospital,” he assured her, “but why is your mistress packing her case?”