“Until the fall of Communism, private practice and physician-owned equipment was illegal. The only items I was allowed to use in my own office were those things abandoned by a hospital. You cannot imagine the battles we had among the hospital doctors over machines that were barely more than scrap. Even if we couldn’t use them, there was still a certain status associated with having your own equipment.
“Now all this has changed, and private practices are allowed. Doctors can charge clients for their services, which before was also illegal. And now doctors want to work at Western technological levels. Myself included.”
He led them out of the elevator and down the seventh floor hall to his room, still talking. “This is becoming urgent, because the hospitals are sliding into chaos. The social system has broken down. People keep going to the hospitals, but the government has no money for funding. The poor are now waiting days in hospital lobbies for an appointment with a doctor. I will not make you sick by describing what our emergency rooms look like. When patients are finally seen, they are inspected with equipment that has broken down and treated with drugs that are out-of-date. There is a desperate lack of needles and syringes and even the simplest of bandages. People who can afford it are going to private clinics for everything.”
He opened his door, ushered them into a room fitted with standard Western hotel furniture, and waved them toward the two seats. He perched on the end of his bed and continued. “If you’re retired, you get free medicine. Everyone else pays thirty percent for local, Polish-made pharmaceuticals. If you can afford it, however, you purchase drugs made in the West, and for them you pay the full price. The problem is, you see, there is a huge difference in quality.”
He went to his closet and pulled out two heavily strapped cases. “The government ran out of money to pay for medical treatment, which means that the pharmacies have not been reimbursed for the drugs they distributed free of charge or sold at subsidized prices. So what happens? The state-run pharmacies are cutting back on the number of drugs they keep and dispense to match the amount they received from the government the month before. Many of the poor are going without, or having to spend what to them is a month’s salary for one dose of imported antibiotics at an international pharmacy.”
The doctor opened the first case and began unfolding multiple layers of burlap wrapped around an ornate silver tureen chased in gold leaf. Jeffrey took the opportunity to whisper to Katya, “Do you remember our talk about tithing together and doing something for the people here?”
She turned and gazed with eyes that drank him in. “I remember,” she said quietly.
“I have a feeling this is it,” he said. “Could you ask him for an introduction to a hospital that’s in trouble? Maybe one that treats kids?”
CHAPTER 35
There was another snowfall that night, so the next morning they decided to take the train for their visit to the children’s hospital. A thaw had set in by the time they left for Wroclaw, which was good, because the heat on the train was truly feeble. It was an old Polish train, with PKP stamped on the side of each green smut-stained wagon.
The trip took seven endless hours. Jeffrey worked through all his notes, talked with Katya until the jouncing fatigue silenced them, watched landscapes roll by under a flat gray sky. He walked the passageway, saw young and old huddled under coats or swaddled in quilts and blankets, sitting with the patience of those who knew that however long the voyage took, it would take longer still.
With each stop, the compartments and passageways became more crowded. The train went from comfortable to overstuffed, with all seats taken and people standing in sardine-packed confinement in the passageway.
“It used to be like this all the time,” Katya said. “Train tickets cost pennies, and there were always delegations traveling everywhere. Even a visit to another factory was done by committee. Delegations meant extra eyes were open and watching.”
An hour outside Wroclaw, Katya told him, “Many Poles still consider this region to be a part of Germany. It didn’t belong to Poland until 1945. After the war, the Allied powers agreed to redraw Poland’s boundaries. The Soviet Union annexed almost a third of Poland, which was then attached to its border. In compensation, a slice of Germany, including parts of Silesia, was given to Poland on this side.”
“No one complained?”
“Who listened to a defeated Germany? As for Poland, the Soviets made sure no one made an official complaint. A lot of people, like Mama, protested with their feet. They moved West in hopes of escaping the spread of Russian troops. A few managed to escape. Most did not.”
She pointed out the window at a passing small village. “The architecture is very German here. You won’t find structures like this anywhere else in Poland.”
“Like what?”
“Wait until we arrive in Wroclaw. It’s easier to describe when you see a city.”
The ring of factories marking the outskirts of Wroclaw left the air tasting bitter. Within the city proper, the streets showed a hodgepodge of building styles. Communist high-rises mingled with prewar apartment and office buildings that would have looked at home in Paris or Vienna if only they had been painted. Lacy iron grillwork wove its way around breakfast balconies fronting tall French double doors. Walls were festooned with plaster bas-reliefs and stone gargoyles. Wrought-iron streetlamps from the age of gas and candles still stood guard over many street corners.
The station itself was tall and curved and walled in with glass, as were many European stations remaining from the steam-driven Industrial Revolution. The air smelled dry. Metallic. Sooty. It sucked the moisture from Jeffrey’s eyes and mouth and throat.
“Now it’s mostly Poles who live here,” Katya said as they walked through the echoing terminal. “The Germans left in waves of hungry refugees. Then Stalin forcibly resettled many families here from eastern Poland, which was incorporated into the Soviet Union after the war.”
They stepped out into a wind-driven mixture of sleet and slushy rain, and settled into a taxi that stank of the driver’s Russian cigarettes. After Katya had given him directions, Jeffrey asked, “What happened to the Poles who didn’t make it out of those eastern lands?”
Katya gave her window a tiny shrug. “From one day to the next, all contact was lost. I remember asking the family I stayed with in Warsaw that same question. They had relatives still there, or so they thought. But no communication was allowed. Now we know that some survived, but many were lost. Most, perhaps. Stalin sent wave after wave of those Poles to Siberia, never to return. He wanted to make those lands totally Soviet, to silence any former claim those people might have made for their homeland.”
The children’s hospital of Wroclaw was a grim, square-faced building stained gray by years of soot. It was fronted by what once had probably been a formal garden and was now a parking lot paved with cinders. Grimy windows gave way to prim cleanliness within as they passed through the entrance. The waiting area was lined with hard-backed benches and filled with parents and children waiting in patient silence.
Katya gave their names to the receptionist, and they were soon joined by the chief pediatrician, Dr. Helena Sova, an attractive blond woman in her mid-thirties. “Dr. Mirnik called from the opthalmologist’s conference to say you were coming,” she said in greeting. “He has been very kind to consult here when our small patients have eye troubles. Please come this way.”
She was very trim, very stately, with a happy face framing a pair of huge sad eyes. “We have seventy beds for children from birth to eight years,” she said, leading them down a very old yet absolutely spotless hall. She spoke excellent English with a most appealing lilt, her voice brisk and slightly breathless at the same time. Jeffrey noticed that her presence brought a smile from everyone they passed—doctors, nurses, parents, children. All smiled, all spoke, all received the blessing of a few quick heartfelt words. The process was so natural and continuous that it never interrupted their conversation.
“Our main p
roblem is lung disease, as the air pollution is extremely bad. Poland, you see, is the most polluted country on earth, and we stand at the edge of the most polluted region in Poland. From Cracow to Katowice and up to the edge of Silesia, that area is known as the Triangle of Death.” She gave them a smile in direct contrast to the look in her eyes. “Rather dramatic, don’t you think?”
She ushered them into her office, made the formal offer of coffee or tea, and continued. “In the sixties and seventies, the government borrowed billions from the West, gambling that they would be able to launch Poland into the future. They constructed massive factories, with absolutely no consideration whatsoever to the environment. They were desperate, you see, to use all this capital for output.”
“You heard such words everywhere,” Katya agreed. “Output and productivity and five-year programs.”
The doctor gave Katya a closer inspection, then spoke to her in Polish. Katya’s reply brought a new light to those sad, intelligent eyes. They conversed gaily for a few minutes, then Dr. Sova turned back and said, “Your fiancée speaks an excellent Polish.”
Fiancée. It was still a new enough thought to send shivers up his spine. “So I have been told.”
“As I was saying,” the doctor continued, “the government built these industrial behemoths all through Poland, but many were concentrated in this area because the Germans left behind an excellent infrastructure—roads, power stations, waterlines, and so forth. These factories were both extremely dirty and extremely inflexible, so large that they could not be adapted to a changing environment.”
“And out-of-date before they were built,” Katya added.
“Many of them,” Dr. Sova agreed. “Poland was forced to buy Russian technology at vastly inflated prices. The Russians simply told us what we were to purchase, and what the price would be, and that was all. But in some areas, such as steel and chemical production, the industries that are concentrated in this region, the technology dated from before the First World War.”
“There was a total disregard shown for worker safety and health,” Katya explained, “and the consequences are just now being understood. In the Nova Huta steel works outside Cracow, the average time a worker holds employment in the factory is four years. The major reasons for departures are accidents and lung disorders.”
Dr. Sova gave Katya the welcome look of a kindred spirit. “Such information has been released only in the past two years. Under the Communists, studies of this kind were outlawed, because they feared public reaction if the truth were ever known. But we knew. We saw the result of their attitude toward pollution here in our children.”
“This region has forty times what is considered to be the maximum safe level of dust in the air,” Katya told him, “and sixty times the level of lead in both the air and the water. Half of all rivers in Poland are so polluted that they are not even fit for industrial use; their water will corrode the intake pipes. Almost two-thirds of Cracow is without any sewage treatment at all; everything is simply dumped into the Vistula River. New studies show that the level of chemicals in the air has reached critical levels.”
“Sulfur dioxide,” Dr. Sova recited. “Carbon dioxide, carbon monoxide, heavy metals, iron, and just plain soot. This region has one ton per square meter of dirt fall from the sky each year, the highest on earth.”
“The effect on people’s health must be devastating,” Jeffrey said.
“Especially the children,” Dr. Sova agreed. “Within this region, ninety percent of all children under the age of five suffer from some pulmonary disorder at one time or another. One half of all four-year-olds suffer from some chronic disease, two-thirds of all six-year-olds, and three-quarters of all ten-year-olds. Again, these figures have only in the past six months become collected. Under the Communists, all records of our children’s health were classified top secret, and no such collation of data was permitted. All we could tell you was that too many of our children were ill for too long. Far too long.”
She stood and motioned toward the door. “Now that you have heard a bit of the background, perhaps it is time to show you the result.”
Reluctantly Jeffrey followed her into the hall. The walls were institutional orange and yellow, the floors mismatched strips of various linoleum shades. The air smelled faintly of disinfectant and soap.
“As I said, lung diseases are our single greatest problem,” she said, walking them by glass-fronted rooms filled with cribs and children of various ages. “Babies are born with symptoms inherited from their mothers, such as extremely irritated mucus membranes. This makes it very hard for them to draw breath. It also makes them vulnerable to infections, especially bronchitis and pneumonia.”
Many of the rooms also contained beds for adults. “This is a very new program for us,” she explained, pointing to where a father assisted a nurse in bathing his child. “Under the Communists, parents were not allowed into children’s wards at all. Nowadays we encourage it for all of our noncritical patients. We feel both the children and the parents are helped by being together.”
She passed by two rooms whose glass walls fronting the hallway were painted over. “Cancer ward here, and next to it leukemia,” she explained curtly. “I do not think we shall stop in there.”
“Thank you,” Jeffrey said quietly.
She glanced at his face. “This is hard for you?”
“Very.”
“And yet you wish to help us?”
He felt tender relief as Katya’s hand slipped into his. “If we can.”
“I have discussed it with my superiors, and we have decided that it would be best if we pinpoint one particular area of need—that is, if you are in agreement.”
He nodded. “Where did you learn your English?”
“Here and in America. I was able to do a year’s residency at Johns Hopkins.” She smiled wistfully. “It was very hard to leave there; so many new and exciting things were taking place every day. But I felt that I was needed more here.”
She pushed open a door at the end of the hall. “And here you see exposed the wound to my nation’s heart.”
The ward held a number of tiny cribs and glass-covered incubators. Dr. Sova marched purposefully toward one, unaware of the difficulty Jeffrey and Katya had in following her. When the incubator’s occupant came into view, Jeffrey felt the air punched from his chest. Katya responded with a very small cry.
“This baby is now in her thirtieth week,” Dr. Sova said, the professional briskness unable to hide her concern for her tiny charge. “With premature births we count from gestation, as you do in the West. This is now what we call an old lady, because she has survived the first critical ten days, and her weight is up over three pounds.”
“She’s so small,” Jeffrey whispered.
Dr. Sova’s smile was tinged with sadness. “This is a very big baby. Very healthy. She’s almost ready to go home. We have many premature births with weights at seven hundred grams, or about one and one-half pounds. Those are the ones who cause us the greatest worry.”
The baby was more than tiny. She was so small as to appear incapable of life. A rib cage smaller than his fist. A head that could have fit within the palm of his hand. Incredibly fragile arms and legs and hands and feet, like the limbs of a tiny china doll.
“The problem is not just one of survival,” Dr. Sova went on. “The problem is the quality of survival. Cerebral palsy. Blindness. Mental ability. All of these are unanswered questions with premature babies at this stage of their development.”
Wires and needles were taped to the baby’s head and abdomen and wrist and ankle. A tiny tube was taped inside her nostril. Monitors standing on a bedside table and hung from the wall hummed and beeped and drew electronic pulses.
“Today, one in five babies born in this region are premature. In the West, the rate is less than one in twenty. Here, placentas are affected by air and water quality—this is now documented fact.”
She placed a hand on the thick plastic incubator cover a
nd stroked it, as though touching the baby within. “We are still using incubators that are extremely loud for the baby—their ears are very sensitive at this stage. Some of those from Russia, the only ones we can afford, risk cooking the child because the temperature inside is not always the same as what is registered on the thermometer. We need new ones that both monitor the child’s safety and let it grow healthily through this dangerous period.
“Some of my patients who were preemies like this one are now children of seven or eight years of age. I’ve watched them grow, and I love them as my own. I want to give all these children not just the gift of life, but the gift of a quality life. If they wish to be violinists, I want to be sure that their ears are intact and their muscle coordination is precise enough to allow them to play as a virtuoso.”
“You need new incubators,” Katya said.
“We need everything,” Dr. Sova replied. “Our financial problems are crippling. We hold our doctors’ salaries to two hundred dollars a month and pray that they will not be stolen away by offers from the West at twenty times that amount. With the government’s finances in such disarray, we find our budgets being cut daily, while everything we require grows steadily more expensive. Light, coal, repairs to buildings and equipment—every week we wonder if next week we shall have enough to do what is required. One day we lack needles, the next syringes, another day something else, but up to now we have lost no child because of our lack. Of this we are very, very proud.”
Dr. Sova guided them around the ward and its tiny occupants. Everywhere were signs of a world far removed from the wealth of the West. The cribs were prewar metal types, heavy and painted white and sided with bars that rose and lowered with screeched protests. The bed sheets all bore hand-stitched repair jobs, as did most of the blankets Jeffrey saw. Machines and wirings wore heavy bandages of silver tape. In the corner station, two nurses were using their break time to crochet miniature bonnets and booties for their patients.
“Basically we need to outfit an entire new ward,” Dr. Sova explained. “We need Western-type incubators, which will ensure a stable environment for our little ones. IV pumps, monitors, X-ray machine, lung ventilator and compressor—all of these are desperately required.”
The Amber Room Page 28