Adarich said, “The medical administrator is an MVD captain named Lavrenov. He’s a drunk but not a bad guy in some ways. You’ll have to get on his good side. He’s agreed to meet you, and I’m afraid I’ve given him some quite high expectations, my boy, so 1 hope he doesn’t ask you anything we haven’t covered.”
I said, “What’s his specialty?”
“Oh, he’s not a physician. He’s an army feldsher. I think I can brief you on the kind of stuff he’ll want mostly. Injections, a bit of anatomy, nothing you can’t handle. But the important thing is, you’ve got to give him a present.”
“A bribe?”
Adarich winced. “You’d better be very sure it doesn’t look like a bribe. You have to find something he would like to have and give it to him in a way that looks completely innocent. You’ve got a few days. I’ll have you in here for quite a while, you know. But you’d better start thinking about it.”
I had a Parker 51 pen and a Ronson lighter in my little sack in the storeroom, along with my civilian clothes. If it had not been for Valentin Intellighent’s befriending me, they would have been gone long ago, but miraculously I still had them. I told Adarich about them and he agreed that they would be ideal.
By now he could see from my face that the postoperative pain was getting very lively. “I’ll get you some morphine,” he said, and got up to go for it.
I said, “No, Dr. Adarich. I don’t want to become addicted to that stuff!” I was quite indignant. He just laughed. He said, “Have it your own way, my boy. But I’m going to get you on your feet in the morning whether you’re howling with pain all night or not!”
I was shocked at that thought.
He added,. “By the way, my name is Yevgeni Petrovich. You might as well begin to use it. I think we shall be seeing a great deal of each other.”
Adarich was one of the jolliest men I ever met in camp. He was stocky and bald with great Ukrainian moustaches that hung right down to the line of his jaw. Although he had been in camp since 1934, eighteen years now, for expressing sympathy for Trotsky, he had suffered relatively little, even in some of the hideous Siberian camps he had been in, because his skill as a physician was so much in demand. He was a powerful man, and in the morning when he came to get me up and I protested, he just lifted me out of bed, gently but irresistibly, and set me on my feet. I was doubled up with the pain of it. “Alexander Mikhailovich, we have to keep you moving so your thick American blood won’t clot, my boy, and end up blocking your famous pulmonary artery. So pick the right one up, my boy, and put the left one down, and let’s get moving!”
He made me walk all the way to the end of the hall and back. Several times a day he came and bodily pulled me to my feet. Pretty soon I learned there was no point resisting. Although my belly was protesting with sharp hot pains, I began to get up on my own and start walking before he got to me. “That’s better, my boy,” Adarich said, smiling broadly.
At the end of six days he took out the sutures and warned me to walk carefully but to keep on walking. On the twelfth day he let me go out of the hospital, and I walked stiffly and carefully, expecting something to unzip at any moment, to the storeroom to claim my pen and my lighter. That afternoon we spent going over all the material that Adarich expected Lavrenov to quiz me on, and so by the end of the second week I felt confident enough to meet the administrator.
I had seen Lavrenov two or three times already, and once he had looked in on me in the ward and asked in a friendly way how I was getting along. One night I overheard him arguing with Adarich about some pure alcohol. Lavrenov always issued more alcohol for operations than was really needed and then would come around at night to claim the unused portion for his private use. That night he was drunk already and pretty abusive to Adarich, who was trying to jolly him out of taking the spirits because alcohol was always in short supply and Lavrenov was very far gone already. But Lavrenov just cursed Adarich and grabbed the little flask and stormed out.
But when I met Lavrenov walking in the Zone a few days later he was easygoing and almost friendly. I walked right up to him in a very straightforward way. “Grazhdanin Nachalnik,” I said, meaning Citizen Chief, “could I have a word with you?”
“What is it, zeklyuchyonny [prisoner]?”
I said, “I have found it very interesting to be a patient in your hospital. It seems very well supplied and managed compared to the hospital I worked at in the previous camp.”
He accepted the compliment noncommittally. Adarich had made it clear that I should not come right out and ask for a job, just indicate my background and get a conversation going. Lavrenov began to ask details of Atsinch’s facilities and I told him, with some exaggeration, the kind of work I had been doing there, and while praising Atsinch managed to suggest that the administration under Lavrenov was better than under Atsinch’s MVD boss. Which was true enough. I gave him the impression that I was a person of some prominence in Moscow, but of course I did not mention the U. S. Embassy or my connection with it. In any case, he was interested only in my experiences with Atsinch, and asked a lot of questions to explore my understanding of routines, of basic hygiene, surgical procedures, post-operative care, and so on. I felt I was doing pretty well. Then I said, “Citizen Chief, I want to ask you a small favor.”
His face darkened a little.
I said, “I brought with me from Moscow a couple of cherished items that I am afraid are going to be stolen if I try to keep them here. I would be sorry to see them go, but I would rather give them to someone who knows how to appreciate them than have them stolen. I wonder if you would accept them rather than have them just disappear. I feel sure you would appreciate them.”
I told him what they were.
He was very good about it. He looked around carefully to make sure nobody was watching, because it would have been a very serious offense for him to accept a gift from a prisoner, and then he said he would be glad to have them, took the pen and the lighter, and pocketed them quickly, and said that he appreciated the gesture very much. He was very polite. His manner was that of one professional to another.
In three days he turned up in the hospital and told me to come to the operating room. There he quizzed me in detail about injections, sterilizing instruments, the uses of intravenous glucose, and so on. Fortunately most of the questions Adarich had anticipated, and many of them touched on procedures I had experienced as a patient. Then he called in the patients due for injections that morning and made me demonstrate.
I felt quite confident. I had developed a knack for working very fast, never deliberating or probing. A split second after I had sterilized the area with alcohol I had the needle in fast, and the patient hardly felt a thing. I would rub very hard with the alcohol, which numbed the area a little, and then bang! jam in the needle, joking all the time with the patient to distract him. Lavrenov nodded with approval as I worked.
Then he took me to the morgue. This was harder. A patient had died of TB and he told me to begin the autopsy. Now, I had never done one on my own, but I had watched both Atsinch and Adarich and had had some instruction from my English-speaking friend Kask. I was very nervous but I put on the best show I could and acted as if I did this sort of thing all the time. I thanked God that I had at least been trained in incisions by Atsinch. I grasped the scalpel in the proper way and made the first incision from the neck to the pubis. I had some trouble opening the chest, but I managed to make it seem that it was because of the pain from my own belly. I managed to extract the lungs, the heart, the liver, and so on, and even remembered some Qf Atsinch’s remarks about what he would look for in the way of pathological indications. I kept moving as quickly as I could. I was determined not to show any hesitation.
It went well. I peeled the scalp forward and called an orderly we referred to as nye Russki chyort, “the non-Russian devil,” because of his fierce Cherkess nationalism and denial of all things Russian. He was a serious Christian. He spoke poor broken Russian and always said, “I’m not a Russ
ian devil!” So that is how he got his name. Nye Russki’s duty in autopsies was to wield the skull saw. He started to saw away, but Lavrenov said, “Never mind. I’m satisfied.”
And that was it. I was a feldsher! I had a real pridurki job and I was going to learn some real medicine.
At first I was assigned to Vasya Kargin to learn the routines of the duty shift. Then after a few days I took my first full assignment, which was, for reasons I never understood, a twenty-four-hour shift. I took one day, 8 A.M. to 8 A.M., Vasya took the next. We could usually grab a little sleep in the afternoon, but we were on duty for the full period. From midnight until 4 A.M. it was usually quiet. Adarich and Kask and the others slept in the hospital and I could call them if there was an emergency. If there was nothing doing I would practice my guitar for a while, and then systematically read through every medical text in the place. Every half hour a quick inspection of the ward, particularly to see that the mental patients were quiet.
Sometimes there would be sulfa to administer every two or three hours.
At four thirty I went over to the small adjoining outpatient clinic to meet the first hopefuls looking for rest, for a chance to malinger, or for more serious help.
Sympathy and the chance to spend a few days in bed were the biggest draws. There was an outer room where I, as the feldsher, was trained to put iodine on scrapes and cuts, bandage light wounds, hand out aspirins and stomach powders. If it was something more interesting than that, I had to refer the patient to the doctor, who usually arrived at about 5:30. I wore a white lab coat and all the prisoners called me “Doctor” automatically, unless they were my friends. My friends praised my cunning at getting such an easy job and expressed either envy or good wishes or both.
By 8 A.M. we had seen the outpatients, supervised breakfast, made rounds, and sometimes even started in the operating room. Then my replacement would come in, and I would go for a walk in the Zone to get some air, if it was not too hot, and then back to my old barracks, where I had been reinstalled, to sleep or do pretty much what I wanted until eight the next morning. Once the work brigades were counted out in the morning and the Zone locked up again, whoever was legitimately left behind was free to wander around the Zone as he pleased, as long as he kept well away from the fire zone.
On the second or third day that I was on my own in the outpatient clinic, a patient walked in as soon as I had opened the place. He was a hard-looking man with strange eyes and a grim expression. There were tattoos on almost every centimeter of exposed skin. A professional.
“Doctor,” he said grimly, “I have a terrible stomachache.”
“Where?” I said, sympathetically.
He motioned me to come close. “Here!” he whispered fiercely, pulling back his shirt. His right hand was inside his shirt, holding a wicked curved knife like a miniature scimitar. “I want opium. I am always treated very well here. You’re new. You might as well know that if I don’t get my opium, you get the knife.”
We used tincture of opium for extreme diarrhea. I had often had it. Five or six drops in a glass of water—very bitter.
I was in a quandary because I knew if I refused him, he would try to kill me and probably succeed, and if I gave him what he wanted, I would never get rid of him and he would have a certain amount of power over me. I was thinking furiously. I got out a cone-shaped beaker and told him to show me how much he usually took. He indicated a little, over a centimeter. I quickly reached in and grabbed an iron solution we used, tincture “ferri pomati”, and threw in a few drops of bitters that we kept for appetite, and then stirred in some water and gave it to the addict. I moved as quickly as I could so that it would seem as though I was very sure of myself. I moved to put the table between me and him as he drank it, and felt behind me for a scalpel in case he should pull his knife.
But he just tossed the mixture back and said, “Very nice, Doctor, thank you very much,” with a big mischievous grin that transformed his grim features, and went out.
I thought, I’ll see him again. So I made up a bottle of my spurious mixture and put a Tincture of Opium label on it, and shoved it to the back of the case where no one would use it by mistake. I told Leonid, the other feldsher, about it. He knew the addict. The same man came back the next time I was on duty and told me that after the last dose he had felt great all day. I poured him another out of the fake bottle. He looked a little puzzled when he drank it. I still remember the lilies and snakes and hearts and diamonds all over his arm and the name VANYA on one hand. The next time I saw him he complained that he wasn’t getting much of a lift from opium anymore. He looked at the label closely and then asked for a triple dose. After I poured it he walked around the dispensary for several minutes looking disconsolate. I let him alone. Finally he heaved a big sigh and said, “Well, I don’t know...”
Then he went out. I never saw him again.
Much later I had a visit from a guard named Zavyalov. He was a terror to the prisoners, a brutal man who enjoyed violence. He walked in and demanded ether. “What for?” I asked him.
“I drink it,” he said, with a happy smile.
I said, “You’ll blow up. That stuff is the most volatile liquid there is!”
“No, I won’t,” he said. “I keep my whole esophagus open. Give me some and I’ll show you.”
I thought it was crazy but I did not want any trouble. I gave him 10 cc. in a little medicine glass.
He threw his head back like a sword swallower. Then he threw the ether straight down with a sudden motion. There was a kind of deep rumble from within as the ether boiled up from the heat of his gullet and stomach. Then a terrific rush of vapor as it came back up again. The whole dispensary stank of it.
The guard got up from his chair. His grin was even broader, but his eyes looked very strange. He said, “Thank you! Thank you, Doctor!” in a very loud voice. I saw him head for the door with strange, unsteady steps as if his legs were mounted on universal joints. He missed the first few steps and crashed down into the yard on his face. He never came to me again for ether and the next time I saw Zavyalov, years later, he was a much changed man.
Those mornings in the outpatient clinic when the camp was coming to life were like an old movie in slow motion: the lights still on in the Zone at four thirty and the shadows just beginning to gray out at the edges. People began to emerge from the barracks, silent, slow-moving, making their way to the toilets; the brigade bread men making their way to the bakery, heads down, rubbing sleep out of their eyes, caked with dust, moving like sleepwalkers. Th wind had not started up yet and at first the silence was broken only by faint noises of doors opening around the barracks and the muffled calls of guards rousing out the persistent sleepers. Pretty soon though, the pace picked up. The line began to form outside the outpatient clinic. Sleepy, grumbling, still pretty subdued.
Most of them were trying a dodge. The physician had to discriminate carefully between those who really needed help and those who were faking. When someone was caught out, he usually just grinned sheepishly and said, “Maybe I’ll make it next time!” The commonest dodge was an artful raising of the temperature, and we had to check carefully to see whether the pulse rate had also gone up its necessary twelve beats per minute for each degree of fever. Normal pulse rate, you threw the guy out.
There was a Lithuanian quarry worker who always complained about his stomach and had a reputation of being a dogged malingerer. One night they brought him in on stretchers screaming his head off and, as usual, clutching his belly. I was all set to dismiss him again, but I did a routine examination first and to my surprise found that his abdominal muscles were drawn tense in a board-like hardness. This means that something serious is going on. I put him to bed and took a blood sample to Kask. The white blood count was a whopping high one, so we knew something was wrong.
Adarich diagnosed a perforated stomach ulcer, and that is what it proved to be.
I assisted Adarich in the operation to close it up and had my first experience at
extensive cleaning of the abdominal cavity and the subsequent suturing, much of which I did myself under Adarich’s cheerful direction.
In that case I had been perfectly certain that the man, even though he had such a long history of faking illness, was in bad shape. Often it was more difficult.
Whenever we had more legitimate sick than we could accommodate, Lavrenov had to make the hard decision.
It took a lot to get you into bed. Later in the winter when we cut off a lot of toes for frostbite, we would send the man back to his barracks right after the amputation unless there were extensive complications from infection.
I did a lot of practicing on toes and fingers in the morgue, making lateral incisions in a wedge shape so that there would be skin to close over the end of the stump, then cutting neatly through the joint itself, imagining which tissue would be healthy and which destroyed by the frostbite, and then closing up with the skin flaps. Soon I was quite adept at this, and often helped Adarich with these minor amputations, either cutting or suturing or cleaning away diseased tissue and bad skin. Eventually, during the depths of the winter, this became almost a commonplace procedure and Adarich asked me to do it by myself. At first he stayed with me to help me over the anxiety of being responsible for a living patient, but soon he was satisfied and after that I did a couple entirely on my own. Normally these amputations were done quickly in the evenings when the returning convoys came in with their inevitable cuts, scrapes, bone fractures, and other accidental results of the day at work.
One evening two men came out of the shadows helping a third they supported between them. He was Borodin, a one-legged former navy captain who had a bad reputation as a stool pigeon. Borodin limped along on his peg leg and whimpered softly as he came in. There was a trickle of blood oozing from a dark spot on his forehead. When I looked closely I was terrified. There was a triangular hole straight through the skull and clear fluid and bits of brain tissue were oozing out. There were fragments of bone around the wound but it was a clear, perfectly formed triangle.
An American in the Gulag Page 35