by Jody Shields
“Name the muscles.”
“Procerus, nasalis, depressor septi.”
“Good. What is unusual about the muscles in the lower face?”
“They are . . . looser than the muscles in the upper face.”
McCleary pointed to the corner of his own lips. “What does this muscle, the triangularis do?”
“It moves the sides of the lips down.”
“What emotion does it indicate?”
“Something unpleasant.”
“Exactly. Distaste.”
At the end of the lesson, McCleary closed Gray’s Anatomy. “You’ve done very well. Any questions?”
“No, sir.”
“Not a single question? There’s no shame in asking to have something explained again.”
Artis smiled earnestly. “I wouldn’t hesitate to ask you a question. You have my word.”
“A wish, then? What do you wish for?”
“When I’m a doctor I wish to repair the zygomaticus major.”
“Ah. The muscle of laughter and joy. The smile.” McCleary’s own lips swelled with involuntary pleasure.
FROM THE FIRST day of Kazanjian’s arrival, he and McCleary had established a companionable relationship, developing a shorthand of words and gestures. They habitually worked through a problem side by side, Kazanjian sketching on paper or any available flat surface as McCleary gently coaxed the patient through an examination. Once, they had improvised a jaw splint from a silver teaspoon and gutta-percha soaked in hot water.
Keeping muscle and skin in place during healing was a constant problem with face and head wounds, as without bony support, the tissue would shrink and contract. To treat an injury to the soft floor of a man’s mouth, Kazanjian had inserted small balls of tin secured by wires. The gentle pressure of this unlikely but flexible prosthesis preserved the shape of the mouth. Later the tin balls were replaced with a vulcanite denture.
Kazanjian’s most ingenious creation was a device that immobilized an injured man’s head for several weeks, allowing fractured bones to fuse. He soldered together a lightweight wire device that fit over the patient’s head, resting on his shoulders, imprisoning him like a bird in a cage. The man couldn’t move, wasn’t able to turn away, and only his eyes were free.
Pickerill and another staff member criticized Kazanjian for pursuing far-fetched ideas, but he mildly pointed out that the army had determined that men with one tooth on each jaw that occluded were not allowed to have dentures. “Now that is truly far-fetched,” Kazanjian said drily. “Although I have heard reports from across the channel of outlandish treatments devised by desperate surgeons.”
“Pont has fashioned a nose from what material?” McCleary was incredulous when Kazanjian described one of the foreign doctor’s prosthetics.
“Pont packs molten gelatin, glycerine, kaolin, Vaseline, and water into a greased wooden mold, carved to resemble the man’s missing nose. Or approximate his nose. After the mixture hardens, the gelatin nose is removed from the mold and attached to the face with mastic, ether, and dextrin.” Kazanjian tapped his own nose. “Then it is painted with gumlac madder and yellow ochre dissolved in mineral essence. I’ve never seen one of these creations, but they say once colored, the artificial nose looks very much like skin.”
“And does the gelatin wear well?” Doubt clouded McCleary’s voice.
Kazanjian shrugged. “The gelatin is soft. It won’t stand up to heat. The patient must recast and paint a new nose every day.”
“A prosthetic is a patient’s last option. Although there is plenty of precedent.”
“I sincerely hope artificial devices won’t always be necessary.”
“Anything to help a man live a normal life is a blessing,” McCleary observed optimistically. “There was a famous gunner in the Swedish army who had his jaw and chin blown off in 1832. Verschuylen of Antwerp made a solid silver mask for the lower part of the gunner’s face, set with gold teeth. Inside the chin there was a small cup and drain to collect saliva. Apparently the man’s luxuriant mustache hid the silver half-mask so he could pass scrutiny.”
DID YOUR FATHER leave for the war?” Julian asked Artis from his perch on the edge of the fountain.
“He’s not in the war. He left us to travel, Mum said.” Artis frowned at the anatomy book in his hand as if another version of his story could be read there. He was rarely without this book—McCleary’s gift—despite its weight.
“I’m sorry.”
The boy composed a nonchalant expression. “I don’t care what happened to him.” Unwilling to let the subject drop, he added, “No, I don’t care and I haven’t thought about him once.”
“My father left me too,” Julian said quietly. “His leg was infected. He decided to take the risk of an operation instead of allowing the leg to mend untreated.”
“What happened?”
“He died soon after the operation. I was about your age.”
“Oh.” Artis was momentarily bewildered. “But you’re free of worry about him. I worry about everyone. Will this make me a bad doctor?”
“Dr. McCleary would probably tell you a doctor must work around his worry.”
THE SECOND WEEK McCleary had set up operations at the estate, Catherine invited him to make a selection from the racks of wine bottles against the flint walls in the subcellar. He had picked up a dusty bottle and reverently slid the edge of his jacket over the label to clean it. Clos Vougeot, 1893. Another rack held hundred-year-old brandies and priceless bottles of green Chartreuse from 1869 and 1877. Surprised to find a favorite he’d enjoyed as a young man, he had chosen several bottles of Chambertin, 1878, and hid them in a supply closet under tightly rolled bandages.
Following an exhausting ten-hour day in surgery, McCleary greeted Kazanjian, shrugged off his jacket, and collapsed into a chair. The two men sat in companionable silence, soothed by the order of the Pink Drawing Room, dwarfed by the ceiling’s cavernous depth, which the fire in the grate struggled to illuminate. The weather was unseasonably chill. McCleary leisurely uncorked the Chambertin and poured it into two glasses, his last task of the day.
“Good evening, sir.” Kazanjian settled more deeply into his chair.
“I have had my measure taken today.” McCleary was obviously frustrated. “But I remind myself that in medieval times, surgeons and dentists were classified under the sign of Mars along with butchers, barbers, tinkers, castrators of animals, murderers, and hangmen.”
“How are we counted in such proud company?”
“Because we work with sharp instruments to wreak violence on the body.”
“Soldiers weren’t included on this sinister list?”
“Curiously not. Although we share knives and bloodshed.”
“Reason to give a patient pause.”
In the irregular light from the fire, the wine in McCleary’s glass appeared as thick and obstinate as blood. “One could almost imagine this was an ordinary evening with friends, good drink, and a fire. Is that apple wood burning in the fireplace?”
“Ah, could be. The boy laid the fire. It’s quiet tonight. At last.” Kazanjian yawned.
“The scent of burning apple wood takes me back to childhood. A room and a fireplace. The book I was holding. My mother calling for me.” Suddenly restless, McCleary stretched his long legs. “And curiously, one whiff of linden tree blossom and without effort, I’m in Heidelberg, sitting in class where surgery was taught. There were linden trees outside the window.” In truth, war had tainted this memory. The medical skills he’d acquired in Heidelberg now saved young men who might have been wounded by the sons of his former classmates. He was unable to demonize these classmates, was only faintly disturbed by his lack of remorse, like a letter left unfinished. But these days, even learning could be interpreted in unforeseen ways. A patient in a city hospital had been sent away for “observation” merely for reading a renowned foreign philosopher, now branded as an enemy. Perhaps the time would come when his own bookcase of medical tex
ts, also written in the language of the enemy, would be suspect.
McCleary cleared his head of this thought. “All the same, I’m glad to have a sweet scent as a memory of that time, rather than formaldehyde or chloroform.”
Kazanjian toyed with his glass; the dark wine swirled and tilted. “At the base hospital, the fragrance of the wild roses near a triage tent was so strong it was noticeable even inside. It was my belief that the scent eased the men’s suffering. Foolish, I know, to look for grace.” His voice asked for reassurance from his colleague.
“Not at all. I take great comfort from my reading of Mondeville. He wrote, ‘If the human mind believes in the usefulness of a thing, which is in itself quite useless, it can happen that the thing actually helps the body through the power of the imagination.’ ”
“Perhaps I drew more comfort from the fragrance than the patients did.” Kazanjian looked rueful.
“It has been my observation that the placebo and absolute faith in the doctor are strong medicine.” McCleary leaned forward confidingly. “I have heard the dental surgeon Morestin was driven to the front in a Rolls-Royce and performed dental work on high-ranking military personnel in the backseat. Now, I’m certain the officers were convinced they had the best dentist in the world.”
Kazanjian laughed. “Their mouths were rinsed with champagne.”
“Champagne or not, the setting of a Rolls-Royce must have had a positive effect.”
They drank in silence for a few minutes.
“Strangely, tonight I’m preoccupied with memory,” muttered McCleary. “When I was a young man, the Seine overflowed and flooded the wine cellars of the restaurant I frequented. I helped evacuate Voisin’s, carrying the vintage Bordeaux and Burgundies from their sawdust beds to safety. Even now, the smell of sawdust instantly provokes an uneasy feeling, and I remember the force of cold water against my legs in Voisin’s murky cellar. After we’d moved the most valuable bottles, we shared a superb wine, the sommelier’s gratitude for our work.”
McCleary pictured the ruby wine he had drunk that night, and his astonishment that he would be allowed to sample such a vintage. “The meals I enjoyed back then seem like a fable today. Rationing has robbed all the glory from menus. I remember a dish with woodcock and snipe, a specialty at Paillard’s restaurant. Durand’s had soufflé Pôle Nord. There was superb sturgeon at La Rue’s. I was once served gigot de sept heures that truly earned its name. My fiancée and I frequently supped at the Café Anglais near the old Opera House. After a performance, the Russian grand dukes, the Prince of Wales, and the Jockey Club members gave dinners in the first-floor room with its marvelous curved windows.” He stared into his glass, lost in thought.
“As I approach the end of my life”—he brushed aside Kazanjian’s murmur of protest—“I wish for one last feast. Although the ether in the operating theater has probably ruined my olfactory sense.”
Left unsaid was his desire to share this last pleasure of the senses with a certain woman and unwind a conversation of forty years ago.
REMEMBER ME, but forget my fate. Rehearsing her role as Dido, Queen of Carthage, for an opera, McCleary’s lover had turned to him, singing these words, her voice as brilliant as her smile. She sang the word fate again and again until the t was correctly enunciated, sharp as swords, precise as stitches.
He had known her body intimately, as if she were his to heal. But this conceit of ownership had been his undoing, as she escaped him with her music. He didn’t protest at the time, allowed her to leave, believing it was more important to take his gifts of touch and eye to his work. To cure his patients. He had sacrificed one passion for the other.
But even after all this time, his memory of her was exact; he could evoke her presence, her disciplined posture, her distant expression as she sang, which he secretly compared to her face when they were intimate. Recently, he’d thought of her more frequently than he had in years. Why was he preoccupied with her now? Was she still alive?
THIN WOOD-AND-METAL scaffolding bristled over many beds in the wards, rigged with ropes, pulleys, and weights that immobilized the patients’ broken limbs. At night, the red-shaded glass lamps on the bed tables emitted a thick dull light, a fog of dense color, obscuring all detail so the room appeared to be filled with ships berthed at an infernal wharf.
A trolley rammed the door, and the patients jerked in their beds, startled from sleep by the loud crash. At the far end of the ward, a patient threw his blankets aside and leaped to his feet.
“The enemy! The enemy!” he shrieked.
When the shouting reached McCleary as he prepped for surgery, he spun around and raced to the ward. From the doorway, it seemed the entire room was in motion: the black figure of a man jumped from bed to bed, pursued by two orderlies, the fearful patients twisting in their webs of scaffolding, trying to protect their faces. A lamp overturned on the floor, throwing its light into a corner of the room like a flare. Medicine bottles scattered and broke.
“Where is the lieutenant?” The crazed patient tore at the bandages over his face.
The orderlies hesitated, reluctant to tackle him because of his injuries. “There is no lieutenant here, sir. Just come along quietly,” they begged.
McCleary shoved his way across the room. Loose bandages trailed around the patient’s head, and a sinister jagged line at his neck bled from a recent operation. He knew the patient’s stitches would be rent, the slow work of surgery and healing destroyed. Was the man drugged or sleepwalking, insensitive to pain?
The patient ducked past the orderlies, toppled over onto a man huddled in bed.
“Get off! Get him off!”
“We’re under attack!” With unexpected energy, the patient heaved pillows at the pursuing orderlies, and feathers erupted in a dizzy pattern, stark white when they spun into the path of the lamplight.
The crazed patient shook the precarious scaffolding over another patient’s bed, and the man screamed as his suspended arms, cast in plaster, were violently rocked back and forth.
“Kill the enemy!”
The scaffolding creaked and collapsed; feathers flew around two patients and the orderlies as they wrestled the patient down. He banged his head on the floor, moaning and sobbing. No one could quiet him, since his mouth, or what was left of it, was a dark ragged hole. A nurse pushed the men aside and stuck a hypodermic in the patient’s arm.
There was nothing for McCleary to do. He slowly made his way to the operating theater, and it was some time before he was calm enough to pull on rubber gloves. During surgery, the clumsy operating lights, ill-balanced on tripod legs, appeared to be an apparatus of war. The open, unseeing eyes of the patient on the table were unnervingly blue. The man’s skin possessed a vulgar whiteness, a thick waxiness, like a plant grown with too little sunlight, and his injury, where it had been painted with iodine, was a gaudy, florid orangey scarlet.
McCleary spoke with Kazanjian as they washed up afterward. “This is all a performance, isn’t it? A rehearsal for a freakish play in a theater. An opera buffa.”
Kazanjian’s blink indicated agreement.
“I know you well enough to ask if I’m rambling.” McCleary kept talking as if he didn’t expect an answer. “I repair men’s faces, and it is only temporary. Time follows behind me, unraveling my work. Nothing remains.”
“As we all unravel. No one is spared.”
For the first time, McCleary was aware that his expression was raw and unguarded, exactly like the men in his care. “I begin to understand the concept of hell. Or the hell I’ve created,” he muttered. “It is endless change. Hope without end.”
EARLY IN THE WAR, bone grafts for the face were taken from the patient’s own rib; later the tibia and the crest of the ilium became accepted sources. McCleary had irreverently called this procedure “looking for lumber,” and Kazanjian objected, claiming that bones were holy, the body’s hidden foundation. Sometimes during supper or a rest period, the two medical men enjoyed mock debates about the indi
vidual merits of bone and skin, favoring the armchairs near the fireplace as the most congenial setting.
“To bones, your master.” McCleary saluted Kazanjian.
“To skin, your muse.” Kazanjian returned his smile.
“Friend, I am still of the opinion that bones are dull, stubborn things.” McCleary’s voice was as solemn as a headmaster’s for effect. “Mondeville claimed that bones held no mystery, since death exposed them wholly to view.”
“Skin is easily destroyed, leaves nothing behind. Like a footprint in sand. Less than sand,” Kazanjian said. “Bones and teeth are permanent. Saints of the church are memorialized with such relics. Splinters of holy bone.”
McCleary weighed his words. “But while we live, skin is our entire being. Skin isn’t a shell or peel. I am—we are—one surface. The Greeks knew this. In Metamorphoses, Apollo flayed the satyr Marsyas as punishment for losing a contest. Ovid described it wonderfully. ‘De la vagina de la membresue.’ ‘Marsyas was drawn from the sheath of his limbs.’ ” His voice was strong and musical as he recited from memory, “The unfortunate Marsyas cried, ‘Quid me mihi detrahis?’ ‘Why are you stripping me from myself?’ ”
He brought himself back to Kazanjian. “It is a marvel that of the five senses, only skin is never without awareness. You can lose vision, hearing, smell, taste, but touch is never muted. The sense of skin is unceasing.”
“Until death,” Kazanjian said softly.
“Until death.”
MCCLEARY SLEPT POORLY, waking into a no-man’s-land, an unidentifiable early hour, convinced the lowering pressure of the moon had pulled at him. Where had this come from? He traced it to his reading of Mondeville’s surgical instruction before falling asleep. “Never cut on a full moon, as its power negatively affects the body’s healing.” He must mention this to Kazanjian and the other surgeons.
Chapter Ten
AT THE WESTERN edge of the estate, a grotto had been built of grayish limestone tufa, spar, and crystals, its entrance situated to command a view of the largest lake. One hundred and eighty-two years later, Anna found the entrance collapsed, grown over with vines, green sinews that knit the rubble tight to earth.