by Steven Conte
It was only when the huts began to thin out that Bauer realised they had already passed whatever counted as the centre. If there was a store of any kind he had missed it. A few hundred metres further on Winkel turned left onto a snowy track that led up to a hut and a cluster of small outbuildings. Bauer tugged off his gloves and unbuttoned his holster, fingers clumsy with cold.
‘Stop here,’ he told Winkel as they drew nearer the hut. Winkel obeyed and Bauer stepped out onto the snow. ‘Keep the engine running. I’ll let you know when it’s safe to come in.’
‘It’ll be all right, sir. I’ve been here before.’
A dog was barking at them – a Samoyed chained to a snow-capped kennel. ‘Just do as I say, Corporal,’ Bauer said, then to soften the rebuke slapped the vehicle’s front mudguard. He set off for the hut. A bitter cross-wind was blowing, stripping smoke from the flue of a squat brick chimney, as the Samoyed barked at him in a patriotic frenzy, lunging on its chain. The hut’s door twitched open and in the entrance Katerina appeared.
‘Thank you for coming,’ she said. ‘Nothing’s changed. Come inside.’ She gestured at the Kübelwagen. ‘The corporal, too.’
‘He’s waiting.’
‘For what?’
‘For you to kill me. Or not.’
‘Oh, that. Then you’d better hurry up and find out. Quickly now, you’re letting in the cold.’
He stepped past her into the comparative gloom of the hut, its only sources of light one small window and a feeble fire. A little table and beside it two chairs. Smells of woodsmoke, damp wool, boiled cabbage. In front of the fire a small woman with pronounced kyphosis of the spine was adjusting a pot on a hook above the flames.
‘This is Agrafena Viktorovna,’ Katerina said, ‘Daria’s mother.’ Bauer greeted the old woman in Russian and she responded with a nod, then Daria herself emerged from a curtained-off area at one end of the hut, tearfully thanked him and pressed both his hands.
‘Kto tam?’ a woman cried behind a curtain. ‘A doctor,’
Katerina answered in Russian, the kind of simple exchange Bauer was equipped to understand. ‘That’s Irina Petrovna,’ Katerina said to him in German. ‘As you see, you’re in no danger here. Better get your corporal before he freezes to death.’
‘A German?’ yelled the patient.
‘Here to help,’ called Katerina.
‘I’d prefer to die.’
‘What about your baby?’
‘Fuck off and go away.’
‘She’ll come around,’ Katerina said, switching back to German.
Bauer asked who else was behind the curtain.
‘Good grief, how suspicious you are,’ Katerina said. ‘The girl’s aunt, Daria’s sister. Here,’ she said, and reached out and drew back the curtain, revealing a small alcove almost entirely filled by a bed. Irina Petrovna was kneeling on the floor with her arms flung over the bed, her fists twisting the sheets. Holding her was her aunt, a thinner woman than Daria but unmistakably related to her. The labouring girl looked exhausted, shivering and pale. She caught sight of him and snarled abuse of some kind.
‘Pay no attention to her,’ Katerina said. ‘It’s the labour talking.’
‘Not only the labour, I think.’
‘Her husband was killed in the first week of the war. But the labour’s not helping.’
At this moment Irina clawed the bedding to her chest and emitted a long, unearthly groan. Her aunt pulled her close, as if to relieve the pain, while with his watch Bauer timed the length of the contraction. Thirty-nine seconds. When it was over Irina let go of the bedding but stayed slumped across the mattress, shoulders heaving, head lolling, her hair sweat-darkened on the sheets.
‘She’s a good girl, strong,’ Katerina went on. ‘And though you wouldn’t know it from that foul mouth of hers, educated. A university student.’
‘I’ll bear it in mind as she gouges my eyes.’
‘Just do what you can. I’ll hold her down if it comes to that.’
‘Have her waters broken?’ he asked.
‘Nyet!’ Irina wailed.
‘She understands German?’ he asked.
‘No, just doesn’t like hearing it,’ Katerina said. ‘Her waters have broken. Hours ago.’
‘I’ll need to examine her.’
‘Of course. I’ll speak to her. Call your man in.’
Bauer went outside and beckoned Winkel, who jumped out of the Kübelwagen and lugged their equipment over. ‘Ether?’ he asked, lifting the heaviest of the bags.
‘Just in case,’ Bauer said, and led him inside.
‘Shouldn’t we have brought Lieutenant Hirsch along, sir?’
‘It wasn’t his affair.’
‘But if we need to do an anaesthetic?’
‘It might not come to that.’
‘But if it does?’
‘Then I’m sure you’ll do an expert job.’
‘But, sir!’
‘Don’t worry, Sepp. At least not yet. As things stand she won’t even let me examine her.’
In the alcove Irina Petrovna was abusing Katerina, her mother and even her aunt. They were traitors, fascist lackeys; they deserved to be shot. Wisely Winkel refrained from greeting Daria and instead busied himself with unpacking their equipment. Bauer gazed about, taking stock of their surroundings: a dingy hovel, a humpbacked crone by a steaming pot, an infuriated woman in labour. It was as if he’d stumbled into a Dostoyevsky novel, the only character missing a despairing, tubercular youth playing Russian roulette with a flintlock pistol.
‘This is pointless,’ Katerina said, coming away from the bed.
‘We’ll have to force her.’
‘Ideally she’d be calm.’
‘Tranquillity has failed. Thirty hours she’s been at it.’
‘And if she doesn’t want my help?’
‘She’s in no state to judge. And there’s her baby to consider.’
‘True,’ he said, still hesitating. He’d had soldiers resist examination, crazed by pain and sometimes fear of how it might be relieved, yet he had never had to treat a woman against her will.
‘Look, if it’s your conscience bothering you,’ Katerina said, ‘I absolve you. It’s my decision.’
‘All right then. Let me wash my hands.’
With his usual efficiency Winkel had prepared a basin of hot water and beside it placed soap and a hand towel. By the bed Katerina and the aunt were trying to haul a screeching Irina Petrovna onto the mattress, her mother pleading with her in rapid Russian. Bauer hooked his stethoscope around his neck, washed and dried his hands.
‘Nyet,’ the young woman yelled, ‘nyet.’ Though fighting hard she was weakened by her labour, and soon they had her on her back.
‘Let me speak with her,’ he said.
‘Nyet,’ cried Irina Petrovna, as between them the women wrenched up her nightdress and prised her thighs apart. Bauer glimpsed pubic hair, dark and dense, and registered an undoctorly shock that was part sexual, part childlike, a jolt of primal surprise.
‘Let me speak with her,’ he repeated, this time getting Katerina’s attention, which in turn allowed Irina to wrench down her nightdress. Katerina yelped with annoyance.
Bauer went to the bed and in his stilted Russian told the young woman his name. ‘I’m a doctor,’ he added, and because in the search for sincerity the only tense he could muster was the present he went on, ‘I am sorry your husband is dead. This trouble, I am sorry. This war.’
She had an arm flung over her face, and with her other hand was clenching her nightdress by the hem.
‘I’m a doctor,’ he repeated lamely. ‘I can help you.’
Irina screwed up her face, as if angry again, but then shuddered as the next contraction took hold, forcing another long moan from her throat. Six minutes had passed since the previous one, Bauer noted. Too long. Its duration was much the same. Throughout it her aunt massaged Irina’s belly, and then, cooing endearments, released the young woman’s grip on her nightdress.
‘Could you describe to her what I’ll need to do?’ he said in a hushed voice to Katerina. ‘Check her abdomen first, then her cervix.’
Katerina relayed this message, and though Irina said nothing she did not resist when Bauer placed a hand upon her, slid back her nightdress and gently palpated her belly, his mental probity fully restored. ‘Khorosho,’ he said, ‘good’, though in fact he was not reassured. Methodically he repeated his examination, this time with his eyes on the ceiling, the better to see with his hands.
‘You’ve done this before, I take it?’ Katerina said.
‘Of course. Though not often,’ he admitted. ‘And not recently. There’s not much call for it in the Wehrmacht.’
‘Only in its wake,’ said Katerina.
Ignoring this jibe he leaned forward and addressed Irina. ‘Now inside?’ This made her tense and he pressed for an answer. ‘Da?’
‘Da,’ she said irritably, her face still turned away.
‘Good,’ he said, ‘good.’
As gently as possible he examined her internally, probing with his middle finger for the cervix, thinking that contrary to the innuendo of certain poets a woman’s genitals were quite unlike a wound, which was typically macerated and weak and not at all like this muscular tube. He found the cervix and assessed its dilation as no more than five centimetres, which was disappointing but at least clarified what had to happen next. He went to the basin, removed his gloves and washed his hands. Katerina appeared at his side. ‘Well?’
‘I’ll have to operate,’ he said. Poor Winkel froze.
‘You’re sure?’ Katerina asked. He nodded. ‘You’re not biased towards surgery? Doing what comes naturally?’
‘It’s a breech presentation, plus the cervix hasn’t dilated enough. If we don’t operate she’ll die. The baby too.’
‘I see. Then you’d better operate.’ As if on cue Irina Petrovna groaned at the onset of another contraction, drawing her aunt and mother to her in a flurry of support. Katerina went on, ‘What can we do to help?’
‘Explain to her what’s going to happen and why.’
‘And?’
‘Have someone shave the upper portion of her pubic hair.’ He peered around the hut. ‘God knows we need to do all we can against infection.’
‘You have a razor?’
‘Winkel will give you one.’
From their equipment Winkel handed her a razor, and with the soap and warm water she took it to the bedside, drawing the curtain behind her. Winkel, a veteran of countless gruesome operations, was staring at him in obvious fright. ‘Sir, I can’t deliver an anaesthetic, I’m not qualified.’
‘Sepp, in the land of the blind the one-eyed man is king. You’ve seen it done a thousand times. I have every confidence in you.’
‘God in heaven.’
‘Good man. Now clear and swab down this table for me. If you can, find a way to extend it a little.’
Bauer knew how to look more composed than he felt, in this case not only for Winkel’s sake but also his own, years having passed since he had last done a caesarean, though before leaving the hospital this afternoon he had taken the precaution of reading up on the procedure. Behind the curtain Katerina was explaining what was going to happen. Daria Grigorievna started sobbing again, as her daughter continued to gasp and groan, either resigned to the news or too exhausted to object.
‘She’s agreed,’ said Katerina, emerging from behind the curtain.
‘Good,’ he said. ‘Now, how squeamish are you?’
‘Not very. Not since the Civil War.’
Somehow this part of her biography had slipped his mind. ‘How would you feel about acting as my operating assistant? Swabbing blood, passing instruments? At times I’ll need you to hold the incision apart. Can you do that?’
‘Of course.’
Good girl, he almost said but didn’t. He would have hesitated, he suspected, had she been twenty years his junior, her age in the Civil War.
Ten minutes later, with the women’s help, the patient was lying on clean hospital drapes, washed and shaved and her abdomen painted with antiseptic. Bauer told her that all would be well, that they were putting her to sleep and that when she woke up she would be a mother. Another contraction began. When it was over, Winkel put a cannula in her arm, then, as if to overcome his misgivings, swiftly injected her with Pentothal. Three minutes later she was under.
‘That wasn’t so bad now, was it,’ Bauer said to him. In reply Winkel grunted; they both knew that the harder part would be monitoring the ether: too much of it and both the mother’s and baby’s lives would be endangered, too little and Irina Petrovna might wake up mid-procedure, with or without the capacity to signal she was conscious. Accordingly, Winkel placed the mask on her with exceptional care and then grew absorbed in her respiration and the release of the ether, making Bauer aware of how heavily he would be relying on Katerina. Dressed in scrubs she certainly looked the part.
‘Ready?’ he asked her, and she nodded. A little behind him and to one side stood Daria’s sister, whose job it would be to shine an electric torch wherever he asked her to. Daria had retreated into the room, where her mother remained on hand with her pot of heated water.
Bauer took up his scalpel and commenced a transverse incision above the pubic bone, only to realise immediately that the patient’s muscles were too tense. ‘More ether please, Corporal. We have to get her deeper.’
Poor Winkel – having witnessed Hirsch accidentally kill a patient, he was rightly terrified of overdoing the gas, but when Bauer tried again the incision was easier, a runnel of blood a reassuring sign they were underway. Having parted the skin he cut through the peritoneum, releasing more blood, which Katerina quickly swabbed. In Russian he checked if the aunt was feeling all right. She nodded. He put the same question to Katerina.
‘Fine thanks. And you?’
Smiling, he said, ‘No impertinence in theatre. I need you to part the incision.’
‘Like this?’
‘Exactly.’
Between the dilated lips of the wound was the uterus, visibly flexing.
‘She’s keen to get out,’ Katerina said. ‘Poor thing.’
‘She?’
‘I’m guessing.’
‘Can you be ready to take her when she’s out?’
‘Of course.’
‘Good,’ he said, and checked again on the aunt, who assured him she was fine.
‘They’re bred tough around here,’ Katerina said.
‘And born that way,’ he said, repositioning his scalpel. With exceptional care he cut through the uterine wall, spilling amniotic fluid and blood, making an incision approximately eight centimetres long. Ordinarily this would have revealed the baby’s head, but here it was the legs that appeared. Bauer seized them and, in one controlled movement, delivered the baby and with it the umbilical cord in a mess of amniotic fluid, vernix and blood.
‘A boy!’ the aunt marvelled. ‘Mal’chik! Mal’chik!’
‘Oh,’ cried Daria from behind the curtain. ‘Oh.’
Bauer cut the cord and handed the boy to Katerina, who in seconds had him swaddled. He was black-haired, bawling.
‘So much for my powers of divination,’ Katerina said, laughing and to Bauer’s surprise shedding tears.
Behind the curtain Daria was weeping uncontrollably, while the aunt, too, was crying. By God, even Winkel’s cheeks were wet, though his eyes stayed riveted on the ether dial.
‘Makes a change from digging out shrapnel, eh, corporal?’
‘That it does, sir, that it does.’
Only himself, the old lady and the unconscious mother were dry-eyed, yet even as he noted this his emotions welled, so that with a finger he had to clear the corner of one eye.
Katerina smiled at him. ‘Are you all right?’
‘Yes, thank you,’ he said, and motioned at the baby. ‘Sorry to spoil the moment but it’s time to hand him on. We’ve more to do here.’
‘Of course,�
�� she said, and passed the baby to the aunt, who in turn delivered him to Daria. Bauer asked Katerina to wash her hands again, rewashed his own, took the end of the umbilical cord and, like some surgical Theseus, traced it through the incision and into the wound until he reached the placenta. This he also removed, taking care not leave behind any tissue that might subsequently fester. In the background Daria was walking to and fro, softly singing to the now placid newborn.
‘Now we tidy up,’ Bauer said, and with a suture needle began stitching the breach in the uterus.
‘Will she be able to have more children?’ Katerina asked.
‘If all goes well, yes.’
‘Including naturally?’
‘Certainly, if luck is with her. Though there ought to be a surgeon on call.’
‘And those stitches?’
‘Catgut. Her body will absorb them.’
With a second layer of sutures he repaired the peritoneum; with a third he closed the skin. He sluiced the wound with antiseptic and then demonstrated to Katerina and the aunt how to inject it with sulphonamide. He applied a dressing. Finally he explained to the women in Russian the importance of keeping Irina Petrovna’s wound clean. ‘If you have to touch her, wash your hands. And make sure she washes hers. Keep the baby clean. I will leave you some soap. This is . . .’ He turned to Katerina. ‘Crucial,’ he said in German, ‘I want to say it’s crucial. Can you tell them that? It could save her life.’
Katerina relayed this message, sounding suitably severe, getting each woman in turn to confirm she understood.
Bauer turned to Winkel. ‘How’s our patient doing?’
‘So far so good, sir.’
‘Excellent. You’ve done well, Sepp. If it were up to me I’d give you the job permanently.’
‘Thank you, sir, but my heart would give out.’
‘I doubt that. Yours isn’t the type to fail. Still whirring like a dynamo at a hundred, I bet.’
‘Not the best way to circulate blood, sir, your dynamo.’
‘Pedant. Now pack up while I go and check on the baby.’