by Daniel Mason
She paused. For the last word, she had spoken in German—Laus—and with it her face contorted briefly in disgust.
“You are familiar with the Louse, Doctor. I had known Her too well as a child, and indeed from the very first days of the war She was with us. But never have I known Her in such abundance as in this house of prayer. As the war drew on, we found ourselves confronted with ever greater infestations. Never, never dear Doctor have I seen such extraordinary fertility in any beast; indeed, in my moments of least faith I have wondered if it was the Louse that is God’s favored child. For it seemed at times that one could subtract all matter from our worldly domain but the Louse, and still Earth’s contours could be seen. Oh, Doctor, as a child I had imagined the animals of Noah to be tame, clean creatures, with soft, sweet-smelling hair and soft noses. No! Now I realize that they all must have been infested, not only the rat, but the lion and weasel, the vicious giraffe: veritable arks themselves, for worm and tick and louse.
“For you cannot imagine the infestations of our men. Everywhere! On every layer of clothing, in every stitch and seam. In churning clumps, they teemed, they stirred, like embers. They came out upon our combs, grainy, like wet meal. Oh, sir, the Devil has had time to practice since poor Job! For if the Beast truly wished to try that man’s faith, he would have given him a field dressing in Galicia. No, there is nothing that arouses a louse like the moist, warm dressing of a wound, nothing that heightens their incest. A dressing applied one week prior in Lemberg would be teeming with so many rutting creatures that one could hear the soft thumps of the clots as they fell onto the floor.”
She took a deep breath.
“Of course, the Louse might torture, but as I’ve learned, She doesn’t kill alone. The first case of typhus appeared in December, Doctor. I still remember the boy, the warmth of his skin, the rash as it spread across his chest and limbs, the peculiar thoughts that entered his mind and made him cry out. Try as we may, we couldn’t save him, and it was not long before a second soldier, there”—and she pointed to the far corner of the room—“and a third—there—and a fourth—there—came down with the disease. Night and day we worked to save them, but no amount of lime or cresol could clean them. No quarantine could stall its advance. And no matter how tight we made our clothing”—and her eyes traced the edges of her wimple—“it did not matter. In the evenings, when I inspected the skin of Libuše, and Libuše Elizabeth, and Elizabeth Klara, and Klara myself—we would find the creatures on our very own flesh.
“Oh! Such was the state of affairs, Pan Doctor Lieutenant, when fear of Her first entered the heart of the good Hungarian doctor Szőkefalvi. Even now, I feel such love for Szőkefalvi—with his books and his patient lessons in nursing, with his innocent jokes of how he might like to join in our hours of delousing. He did not succumb at first, brave soul! I know so well the terror that seized him as he stood at the operating table and felt Her upon him. I saw him fight to direct his thoughts back to the case beneath his hands. Yet once you feel Her, you can’t escape; once the itching begins, you cannot stop it, no, Pan Doctor Lieutenant: the slightest hair, the slightest tickle of wool is enough to conjure armies crawling across your skin. Even now if I am not strong, I can imagine Her crawling upon my knee, rising, her little prickling legs, her probing tongue. No! Oh, no, no, no! No, Pan Doctor Lieutenant Krzelewski: to survive, one must learn to fight such fantasies. But not so poor Szőkefalvi. In the middle of surgery, gloves wet with gore, I would see him twitch. Not a great motion at first, I tell you, just a pause with the knife, but I knew that he had felt Her. That deep within his woolens She had begun to crawl. Up his leg, or foot or belly, and he would start to cut again, and She would crawl, and he would stop, and start, and stop, and all of a sudden put down his knife and tear off his gloves, the once steady hands trembling as he tore at his clothes for the offending itch. At first this man respected rules of modesty, moving swiftly into the vestry to disrobe. But as the weeks passed, he became so panicked, so harried, that he forgot my very presence, baring those parts that shouldn’t be seen.”
Her eyes bore into him. “Can you imagine the shock? I too feel Her crawling, Doctor, but I am of a nursing order, and if it is my fate to fall by Her bite, then it is so. I do not lose my dignity. Saint Catherine ate the scabs of the afflicted, and so I remain strong before my wards. This is my duty. Looking at a crushed skull, I feel no fear. I do not falter before gangrene. No! I see not death before me, Doctor, I see the glimmer of my heavenly crown. I do not hear screams, but the chorus that will greet me. And when I feel the Louse upon me, I do not thrust my hands into my habit like some Orang-utang of Portugal, but turn my thoughts to my Father on his throne. But Szőkefalvi, Doctor, gripped by such fear, was not so strong. Nowhere was he safe. Even in the fields, on his walks, I saw him tearing at his clothes, stripping madly in the cold. At night, I heard him weeping, begging our pest to leave him alone. So often did he wash himself with cresol that his skin began to peel away, which made matters worse still, for then it was impossible to know whether it was the Louse or his own mortified flesh that tickled in his brain. Yet no words could get him to change.”
She stopped. Now she seemed to be awaiting his response.
He said simply, “And this other doctor, Szőkefalvi, he left?”
“In December.” She lowered her voice. “If you will excuse your servant in venturing an opinion, I think he lost his mind. One morning I awoke and he was gone. But what do I know? You have studied in the great city of Vienna. Perhaps there you have heard of such a madness?”
But Lucius was looking over the vastness of the room. “And the other nurses?”
“The other nurses, Pan Doctor Lieutenant?”
“They fled, too?”
“Oh, no. Sister Maria died of typhus and Libuše died of typhus and Elizabeth of typhus, too. All save Sister Klara are with the Lord. She will be judged. Oh! It has been weeks since I have had a companion. I must apologize for talking too much—it has been a vice since I was a child, worsened by the loneliness. There are the orderlies and the cooks, and I have the patients, of course—all these men are companions, but one must be careful, being the only woman, not to let affections develop, lest one follow the sad fate of Sister Klara, and be caught simulating married life in the vestry.” Now a blush passed over her face, visible even in the very low light. “Must I say everything at once! You wish to rest. Can I show you to your quarters?”
She looked at him. It was a simple question, but at that moment Lucius could think of nothing other than going home. How exactly was beyond him—the hussar was gone, and two days of winter lay between him and the railway station. But certainly there were some means by which he might extricate himself. It was only a matter of explaining: he was not a true doctor yet, the Medical Service had made an error, perhaps with other doctors, he could return and help. But alone? No…he couldn’t. Certainly, she would understand. Certainly, she was well aware of the incompetence of the High Command, of the growing debacle of a war; certainly she had heard of the entire Third Army sent against the wrong front; certainly she had seen the shoes made of cardboard, the summer coats given to alpine patrols. And if he didn’t tell her now, his inexperience would soon become apparent, she would realize it the moment he touched a scalpel…
“Sister…” A pause. But what could he say? My heartfelt apologies? There has been a mistake? I’ve never operated, I’ve cured two patients in my life, one of impacted earwax and the other of a gonorrheal stricture? Now, standing in the dim light, he could feel not only her eyes upon him, but also the eyes of the soldiers on the floor. Primum non nocere. But what did that mean here? Certainly he would do more harm to leave?
They, too, have not asked for this, he thought. They did not ask to be sent into winter without coats. They, too, were not prepared. Closest to them, he could see a young man with his head bandaged, staring at him with a single open eye filled with such pleading that Lucius had to look away.
Hope, gratitude, bu
t there was also something else. It was hard to recognize it at first, but then he saw it: a demand—no, an expectation, perhaps even a threat. What would so many injured soldiers do when he told them he couldn’t help?
“Pan Doctor?”
He turned back to her. Now his words seemed to come from someone else. “It is important that the patients not be disrupted in their schedules. What was Szőkefalvi’s custom at this hour?”
“Rounds, Pan Doctor. If there were no emergencies, he would make evening rounds.” Her voice soft, her relief palpable, a little constellation of candle lights flickering in what seemed to be her brimming tears.
“Then we should waste no time.”
“You will stay then? Even if you feel Her, you will stay?”
Lucius already felt Her. From the moment Margarete began to describe Her, he had felt his skin crawling and had done everything in his power to keep from tearing off his clothes. “We each have our appointed hour,” he mumbled, aware it was something she might say. Something, before this moment, he would never have believed at all.
He shouldered his bag and she led him along one of the paths between the patients. She spoke as they walked. “They are provisionally organized into wards. The nave is where we keep the lesser injuries—the fractures and amputations. We operate within the crossing—the light is best. The south transept is where the dying men are kept, out of sight of the others. The head wounds are in the chancel, where they can be watched.” Lanterns hung at even intervals. He was aware now of the walls, painted with scenes from the Bible. An ark, a serpent, crucifixions set amid what seemed to be Carpathian villages, entwined with Latin verse. Gilded saints above the colonnades. A Last Judgment on the sacristy partition, its tree of fire ornamented with monks and hog-tied sinners, marching on a devil’s tongue.
At the end of the nave, beneath the Annunciation, they stopped. In the floor of the north transept was a crater, nearly a meter deep. A light dusting of snow covered its walls and the steps of a pulpit. Now he realized that the light he had seen earlier was coming from a jagged hole in the high ceiling, poorly patched with wood and tarpaulin. Sister Margarete said nothing.
“What happened?” he asked, pointing.
As she smiled, the wimple pressed into her cheeks. “What happened, Pan Doctor! Well, there is a hole in the ceiling and a crater in the floor.” And she started to laugh as if this was the funniest question she had ever heard.
When he set his bag down by the pulpit, she began to speak again. There were approximately sixty patients in the church of Our Lady of Lemnowice. Most came from the Third Army, though with regiments garrisoned across the mountains, there were others there as well. The most recent truckload of men had arrived the week before—sixteen soldiers, three dead on arrival, five with wounds requiring immediate amputation. Since then it had been silent. The war had moved off, she said. This was its way. Sometimes the fighting was very close and they could hear gunshots, sometimes only distant shells. Once, the Russians had taken the town. Other times, she wondered if they had been forgotten. What a blessing that would be! The town still had a few people left—women only, Ruthenians whose allegiance likely had once been to Russia, until the Russians had taken all the men when they withdrew. The hospital had enough food to last the winter; in addition to the rations last delivered in mid-January, the church had stores of grain and turnips, sunflower seeds, potatoes, beets. As long as supplies continued to come, they could make it through spring, that most difficult of seasons, and come summer there would be apples and pears, and they could work their own fields, and grow wheat…
But Lucius had stopped listening. “Doctor Szőkefalvi left in December?”
“December, Doctor.”
“Two months ago.”
“Yes, two.”
“But you just said there have been amputations?”
“Since December, there have been forty amputations, on twenty-three men, Pan Doctor. Eight legs above the knee, fifteen below. Ten arms above the elbow and six below. One jaw that did not survive.”
Lucius looked at her, his heart beginning to beat faster. “And who, Sister Margarete, has performed the amputations?”
“He has, Pan Doctor,” and she rolled her eyes beatifically toward the hole in the north transept.
Lucius did not drop his gaze. “And whose hand was He directing, Sister?”
She held up her little hands, scarcely half the span of his.
“And are those patients here?”
“Yes.”
“All of them?”
“All that have survived, yes, who have not been evacuated.”
“How many have survived, Dear Sister?”
“Fourteen have survived, Pan Doctor.”
“Fourteen…of twenty-three.” He paused, thinking of the regimental hospitals in Kraków, the daily removal of corpses. “That is not a bad survival rate.”
“No, Doctor.”
“And God has worked by those hands alone?”
A pause, a little smile, as if she understood the impact of what she’d said.
“Sister?”
“God has given us morphine and ether, Doctor.”
“Yes,” said Lucius, staring. “Yes, yes. He has.”
Then she said, “One last thing, Doctor. I have given the men permission to use firearms on the rats, but they must shoot into the floor and not at one another. The typhus, thank God, has abated for now, and we have our procedures for keeping it away. But the rats! Pan Doctor, we are at the mercy of the rats. I have boarded up all the holes in the walls of our church. Sometimes they fall from the hole in the transept, though with winter, this has stopped. Traps have been laid in all corners, but still the creatures come, like mushrooms after a rain, everywhere. You will not be frightened by the occasional shot.”
He thought back to her heaving the crossbar in the narthex.
“Is this why you barred the doors, Sister?”
“Oh, no, Pan Doctor. I barred the doors because of the wolves.”
They made their rounds that night by lantern light.
She announced him, briefly, from the pulpit, with the brevity and authority of a field marshal: this was the new medical officer, Krzelewski, from Vienna; there would be no change to procedures, they would continue to round twice daily when not attending to new casualties; questions should, as before, be directed to one of the orderlies, or to herself.
They started in the nave, near the door, in Fractures and Amputations. Traction ropes hung from the roof beams, and little towers of wooden scaffolding with rope and counterweights had been set up on the floor. They were joined by one of the orderlies, Zmudowski, another Pole, with a heavy, red-orange beard. Like Margarete, he wore a greatcoat in the cold of the church. He followed her closely, hovering behind her as she knelt by the first soldier, an Austrian cavalryman crushed beneath his horse the week before. She had amputated his leg above the knee and reset a wrist fracture, and kneeling, she inspected the wounds quickly, showing them to Lucius. She was clearly proud of her stitches, and Lucius, who had never seen a healing amputation site, and certainly not by lantern light, pretended to appraise it with a studious air. Then on, to the next patient, another Austrian, from the Graz fusiliers, shot through the shoulder. She had done little other than stabilize the fracture and suture the exit wound. What else was one to do with a shoulder fracture? But it was healing beautifully, she said affectionately, didn’t Lucius agree?
“Beautifully, yes.”
She looked down again with pride. Then: “Earlier, I heard you can speak German?”
He nodded.
“Please tell him that I saw him playing cards. This is fine. But he is not to use that arm unless he wants to tear the wound open again. We are short of suture material. Next time I will have to use thread from his coat.”
The man nodded somberly as Lucius translated. Then to Margarete, in Polish, Lucius asked, “We are short of sutures?”
“Sutures, no. At least not yet. But the men are
like little children. They would eat their laying chicken, as the saying goes. There is no self-restraint. One must be strict.”
They moved on.
“This is Brauer, Pan Doctor Lieutenant, of Vienna, frostbite, both feet; this is Czerny, of the Hungarian Fourteenth Fusiliers, gunshot wound to the left femur, amputated last week; this is Moscowitz, also of Vienna, a tailor, he has been quite helpful to us, bilateral foot amputation, also frostbite, now healing beautifully, as you can see. This is Gruscinski—a Pole. Gangrene of the feet, quite ugly, but God was on his side despite his habit of making pleasure with the whale oil. Kirschmeyer, shell-strike. This is Redlich, a professor in Vienna. He believes a monkey gave birth to a human woman—”
“Ahem,” began the man, who was lying on his belly, wincing as he turned. “Not exactly. I told you there was a process, a slow process of variation and natural selection—”
“Yes, of course, Professor. A monkey, Doctor, can you imagine? Anyway, he was shot by Cossacks. In the rear. Next to his tail.”