The Invisible Life of Ivan Isaenko

by Scott Stambach

  The Three-Monthers

  In my seventeen years at the asylum, the most important piece of information I’ve gathered from faking comas is that the children here fall into two categories: six-monthers and three-monthers. This is because medications are prescribed in either six- or three-month supplies. For the vast majority of us, six-month supplies are prescribed, since they are cheaper and require fewer prescriptions. We are, of course, the six-monthers. However, when a doctor deems that there is little chance that a child will make it more than a couple of months, one final three-month supply is ordered to cut down on costs. In the tatters of an Eastern Bloc economy, every penny counts.

  When you live in a place where nothing changes, even morbid change is entertaining. Thus, one of my favorite activities is guessing three-monthers before med day. One of the few things I pride myself on is how good I am at this game. In fact, until a month ago, I had correctly called every new three-monther over the last fifty months.

  The more spiritually inclined nurses have argued that my radiation poisoning gave me psychic powers pertaining to death, but I reject this because it would violate the Three Tenets of Ivanism (see below). The simple truth is that after seventeen years of watching kids die slowly, I have gotten good at picking up all the telltale signs. Every disease has its own classic omens, a fingerprint of mortality. For example, the leading cause of death here at the asylum is thyroid cancer. When a thyroid kid is still a six-monther, he looks just like any other cancer patient (i.e., bald-headed, pale, thin, frequent trips to the restroom, a bit spacey—also known as chemo brain). But when he becomes a three-monther, you can expect an onslaught of much more interesting symptoms. I got so good at recognizing these symptoms that Nurse Natalya once asked me to create a diagnostic assessment document (DAD) for the other nurses, in the hopes that it would streamline care and also make me feel useful. Here are a few sample pages (as you can see, in another life I would have made an excellent diagnostician):

  A thyroid kid is a three-monther if he/she exhibits four of the following five symptoms:

  (1) His/her neck swells up so big it looks like the kid swallowed a rabbit, which then became lodged in his/her throat.

  (2) It takes him/her thirty minutes or more to get through a single bite of food.

  (3) When he/she asks for an injection of Aloxi and it sounds like his/her vocal cords have been replaced by an Apple Computer–style voice generator.

  (4) He/she keeps the entire hospital up all night coughing.

  (5) His/her ordinary breathing sounds like a fat kid after walking ten flights of stairs.

  A leukemia kid is a three-monther if he/she exhibits any five of the following six symptoms:

  (1) His/her smile looks like he/she flossed with barbed wire.

  (2) Every one of his/her standard white hospital T-shirts is stained with blood from daily nosebleeds and eye bleeds.

  (3) His/her bones ache too much to walk.

  (4) He/she begins to resemble Olive Oyl from famed American cartoon Popeye.

  (5) He/she stops showing up to breakfast hour, lunch hour, and dinner hour.

  (6) He/she begins sleeping through his/her favorite Russian TV shows.

  A Marfan syndrome kid is a three-monther (more like three-dayer) if any of the following events take place:

  (1) His/her heart stops, he/she has a heart attack, or his/her heart otherwise explodes.

  (2) He/she is blind.

  An amyotrophic lateral sclerosis* kid is a three-monther when:

  (1) His/her face becomes droopier than mine, and

  (2) He/she is poor (for some reason the rich ones seem to hang around longer).

  A diabetes kid is a three-monther if:

  (1) Two or more of his/her appendages have been amputated, and

  (2) He/she is blind.

  These are just the diseases that have names. There’s an abundance of maladies that make their way through the halls of our hospital that stump the best in the medical profession.† Still, I’m clairvoyant when it comes to these blokes’ three-monther status. After a while, I can just smell when a kid has given up because something in his body tells something in his brain that no amount of fighting is going to keep him alive. In the end, calling any three-monther can be reduced to two simple symptoms:

  (1) A light leaves his/her eyes, and

  (2) He/she has a posture that looks like someone stole half his/her bones.

  Nurse Katya (not known for her tact) once asked me if I thought I would be able to tell when I became a three-monther. My first instinct was to tell her to fuck off. My second instinct was to tell her that she would be a three-monther living alone in the Mazyr Hospital for the Gravely Old long before I was ever a three-monther. Nurse Katya (also not known for her wit) did not have anything clever to say back to me, but once the satisfaction wore off, I actually started to think about whether I would be able to predict the day that my own three-month bag would be dropped in front of me. Then it occurred to me that I would never let myself become a three-monther.

  IX

  The Staff of the Mazyr Hospital for Gravely Ill Children

  Polina, myself, and the other misfits are tended by four nurses at the asylum: Nurse Lyudmila, Nurse Elena, Nurse Katya, and Nurse Natalya. It is their job to read our blood pressure, change our sheets, wash our clothes, clean our toilets, take our blood, change our diapers, clean our asses, cover our wounds, deliver our meds, serve our food, forge our prescriptions (there are no permanent doctors on staff), turn on our TV, take our temperatures, and diagnose viral versus bacterial infections in order to determine antibiotic needs.

  This is where the job description ends for the nurses at the Mazyr Hospital for Gravely Ill Children. The more optional traits of a good health care provider, such as empathy, humanity, honesty, respect, professionalism, and human decency, are not mandatory. I know this because I’ve made it a point to eavesdrop on every nurse interview in the last eight years, of which there have been two, in order to feel like I was a participant in the hiring process.

  Nurse Natalya is the one exception, of course. One day, while she was scrubbing my toilet with bright pink rubber gloves, I asked her:

  “Can we talk about the elephant in the room?”

  “I’m not sure what you’re talking about. There are many elephants in many rooms at this hospital,” she said.

  “Exactly,” I said.

  “Ivan, are you trying to stir up muddy waters?”

  “The water is already muddy.”

  “It is, but I’ll never admit it.”

  “Just tell me why I love you and I hate them.”

  She stopped scrubbing, pulled off her pink gloves, and hugged me awkwardly because I’m in a wheelchair. This was my third hug ever and second from Nurse Natalya (the first came from the narrator of an American documentary, who seconds later wiped her arms of me).

  “You know my husband is dead, don’t you, Ivan?” she asked.

  “No, you never told me. How would I know if you never told me?”

  “Because you figure everything else out.”

  “When did he die?” I asked.

  “Eighteen years and nine months ago.”

  “That was a year before I met you.”

  “We had just decided to have a baby, and then he died.”

  “How?”

  “Guess.”

  “Some variety of uncontrolled cellular reproduction?”

  “Yes.”

  “Obviously.”

  “After he died, I had a choice. I could stay faithful to him for the rest of my life, or I could find someone else to give me a baby. I tried to find someone else, but I couldn’t touch another man. So I became a nurse, and now I have more babies than I ever wanted.”

  And like a sweet cosmic revelation, it occurred to me that while the other nurses were just curmudgeonly women, Natalya was a mother.

  “Are you happy?”

  “Yes.”

  “But we’re all so wrong.”

/>   “You’re exactly what you’re supposed to be.”

  “Why can’t they at least pretend?”

  “Ivan, you lose your patience over cold cabbage. What kind of nurse would you be in this place?”

  Touché, Natalya.

  X

  The Jungian Archetypes

  Carl Jung, the esteemed psychologist and protégé of Sigmund Freud, is the only man who could tell me something I didn’t already know about my own head. Like every other author I read, I challenged every point, mostly because I’m clinically stubborn. In his book Archetypes and the Collective Unconscious (1969), Jung argues that every person is made from an archetype or hybrid of archetypes, which are basically cosmic personas that existed well before you or I were born. I spent the first fifty pages deconstructing and demolishing his thesis sentence by sentence. By the hundredth page, I couldn’t argue anymore. Currently, Jung’s archetypes are the only method I have for understanding the characters who populate my world. A few of my favorites include the Trickster (clearly my dominant), the Mother (Natalya), the Child (Max), and the Goddess (Polina).

  The rest of the nurses have their archetypes too. Nurse Elena is the Addict. By my current count, there are seven bottles of vodka of varying brands hidden in cupboards and sofas throughout the hospital, though I’m not sure why she even hides them anymore, since the Director and every nurse at the asylum know where they are. Luckily, alcoholism is a widely accepted vice in Belarus.

  Nurse Katya is the Bully. She is large, imposing, and highly black. She is also an unhappy woman with eight kids and only a half of a husband (and I mean that literally—he lost both of his legs in an industrial accident; I know this because he comes to the hospital every few months to have fluid drained from his stumps). Carl Jung would say that Nurse Katya uses her size and exotic appearance to exert control over a world that often leaves her feeling out of control.

  Nurse Lyudmila plays the part of the Insecure Vixen (I prefer Bulimic Adulterer, but Jung failed to coin that term). She is also the Enforcer, since she rigidly and uncompromisingly adheres to the rules, even in an environment where rules hardly matter. Furthermore, while the nursing staff of the Mazyr Hospital for Gravely Ill Children includes its share of dubious characters, she is the only one who inspires a deep, abiding fear in me. This is because she is a complete sociopath, and I’m fairly certain that, like Dennis, she was born without a soul. To dispense with the obvious first, she is engaged in a long and nauseatingly sexual affair with the Director, Mikhail Kruk. I know this because the hall often smells of erotic play on Tuesday and Thursday mornings and also because Lyudmila can’t remain quiet during orgasm. But her maleficent ways extend far beyond the Director’s office. The only reason she works at this hospital is because she was transferred here five years ago from a mental asylum after one of her old patients shot himself in the head. Apparently, he was playing a game called Russian roulette with several other patients. Furthermore, during her tenure at the hospital, I’ve seen her steal money from every nurse, take a bar of shoko away from Alex only to toss it in a trash can seconds later, and systematically cut her inner thigh with a collection of kitchen knives she hides behind the laundry detergent. There was also a patient named Dimitri, who I was almost friends with because he was almost as smart as me, but Nurse Lyudmila psychologically tortured him until he left the asylum without saying good-bye.

  There is one more character in my story worth mentioning: the secretary, Miss Kristina. She spends her business days filing paperwork and robotically greeting nurses and patients as they pass by. She plays the part of the Submissive Servant, though I prefer the Pincushion. In seventeen years at the asylum, I’ve only ever seen her follow orders. The Director and the nurses bark, and she moves. Jung would say that early experiences with an emotionally absent father and an unpleasable mother conditioned her to believe her only value was service. I know this because her mother is Nurse Elena.

  Currently the clock reads 2:08 in the P.M.

  I’ve been writing for more than fourteen hours.

  It is the third day of December.

  The year is 2005.

  I hadn’t even known I was asleep until I felt Nurse Natalya shaking a nub.

  “Ivan,” she whisper-yelled.

  “What?”

  She sniffed my breath and shook her head disapprovingly.

  “You gave it to me.”

  “I have some news.”

  “What news?”

  “There will be a funeral.”

  “What?”

  “Yes.”

  “A religious one?”

  “Yes, Orthodox.”

  “I thought there wasn’t any money.”

  “The city will pay for it.”

  “The city has never paid for someone to be buried.”

  “They want to make an exception in this case given the circumstances.”

  “What circumstances?”

  “Her youth. And her dead parents.”

  “You’re paying for it, aren’t you?”

  A silence that answered the question for me.

  “You don’t have money.”

  “If I didn’t have money, there wouldn’t be a funeral, would there? But there is a funeral, so I must have money.”

  “You’re doing this for me.”

  “And her.”

  “We all deserve to be buried.”

  “Since when are you moved by moral arguments?”

  “Since now.”

  “I’m taking you with me.”

  “No.”

  “Yes.”

  “I won’t go.”

  “I thought I couldn’t either when he died. But I did.”

  “Why?”

  “Because if I didn’t, it would be like dropping a big turd on his grave.”

  “I’m not going.”

  “Stop making this about you.”

  “She’s dead, so by definition nothing is for her ever again.”

  Then I rolled over.

  She got up to leave.

  “Three days, Ivan. Be ready.”

  XI

  Dr. Mikhail Kruk, the Director

  Mikhail Kruk is the perfect composite character. First, and foremost, he is the Thief. His job amounts to accepting money from the Orthodox Church earmarked for fixing kids, but in reality, he spends less than half of it fixing kids. I know this because when I’m catatonic the nurses rant on about having to make adjustments to his accounting reports.

  He also plays the part of the Casanova. Twice a week, he has secret sexual rendezvous with whoever is the youngest—and typically largest-breasted—nurse on the staff, in spite of having your standard wife and three kids.

  He is also the Most Mediocre Man in the World, which I suppose makes him the Everyman too: he is smart, but not too smart. He has charisma but only enough to run a run-down hospital. He is fat, but not preposterously so. He is mediocre in the worst possible way.

  I’ve spoken to the Director twice in seventeen years: once about my penis, and once when I was drunk on his vodka. After twelve years of watching him get drunk from behind the curtains, I just got too curious, shakingly so, and resolved to take my first sip. I snuck into his office on his next scheduled late-night rendezvous with Nurse Nika, the youngest largest-breasted nurse of that year, and opened the desk drawer he always pulled his bottle from. I removed the bottle, and underneath, I noticed a picture of his family standing outside by a lake, with rolling hills covered in evergreen trees in the background. For the most part, they looked happy, and Mikhail smiled innocently. Incidentally, I could see why Mikhail copulated with women who were not his wife. Objectively speaking, she resembled a proboscis monkey I had once seen during TV hour.

  When you’re used to consuming tasteless cabbage on a daily basis, a sip of vodka can be quite shocking, so of course I spewed my first mouthful all over the Director’s desk, leather chair, and pen jar. I spent the next hour using toilet paper to soak it up from every corner of his desk and th
e insides of two of his pens. When the mess was gone, I conjured up all the gumption in my gut and resolved to take another sip, only this time I swallowed it so fast there was no time to spew it out.

  My first thought was, why would someone ever put himself through this? But by the time that first thought ended, the ethanol hit my blood-brain barrier, and I had my second thought, which was, why doesn’t everyone do this all the time? So I took a third sip, only to realize that I weighed approximately thirty kilos and didn’t have all my body parts. This meant that I had already consumed what would amount to half a pint for the average Belarusian, and my world and words started to swirl together in a cosmic dance. So I quickly put the bottle away, which made me see the picture of Ole Mikhail’s family again, which made me want to get to know him, which was perfectly convenient because just then the doorknob turned and the Director himself walked into the room. Before he could say hello, I picked up the picture and told him he had a beautiful family. Then I vomited all over his desk. The next thing I remember was waking up in my bed with a note on my chest that said:

  Let this be the last time.

  —Mikhail

  XII

  My Therapist, Dr. Arkady Yakovlev, M.D.

  (and also Dr. Leonti Ivanov, Ph.D., Valery Lagounov, M.S., Ph.D., Roma Pavlov, M.S., Dr. Vitaly Maksimov, Psy.D., Igor Polzin, M.S., Moisey Sokolov, M.D, Dr. Mikhail Anders, Ph.D., Dr. Lazar Vasilyev, Ph.D., Dr. Naum Berkinov, M.D., Dr. Daniil Trotsky, M.D., Dr. Alyosha Konstantinov, Psy.D., Dr. Marlen Dubov, Ph.D., and Tikhon Andreev, M.S.)

  Ever since declaring its independence from Mother Russia in the year 1991, the government of Belarus has been generous enough to pay for a psychologist, psychiatrist, and/or social worker to come once every month to try to fix our heads. In my seventeen years at the asylum, I have had a total of fourteen different mental health specialists assigned to me. I was seven years old when I had my first evaluation by Dr. Leonti Ivanov (or Dr. Leon for short). Our first conversation sounded like this: