Andrew Williams - To Kill a Tsar

‘They’re waiting for you,’ the boy said, pushing roughly past the old lady. A young man rose from a bench and rapped on a door at the far end. A moment later, Anna Kovalenko was striding across the floor to meet him, the sharp purposeful click of her heels echoing through the hall. She was wearing a white pinafore over her skirt and blouse and her hair was pulled back in a severe bun. The deep frown he remembered so well from their first meeting at the political salon creased her brow and he felt ashamed he had lingered long over coffee and a cigar when sick people were waiting to see him.

‘Doctor Hadfield,’ she held out her little hand to greet him, ‘thank you for coming.’

‘I’m so sorry I’m late. I…’

But before he could make an excuse she dismissed it with a wave: ‘Can we begin?’

Evgenia Figner was waiting in the treatment room. She restricted her disapproval to a sharp look and small shake of the head. The room was rectangular in shape, lit by two sash windows in the short wall opposite the door. A narrow white table stood in the centre with enamel bowls, scissors, strips of cotton cloth and medicine bottles on its scratched and pitted surface. A white bucket for medical waste had been placed on the rough boards beneath it. In one corner of the room a Russian stove, and along the wall a low table for patients’ clothes and belongings.

‘Is there anything else you need?’ The note of apology in Anna’s voice to explain there was nothing else.

‘No.’ He opened his medical bag and took out his coat: ‘All right, let’s begin.’

The first of the procession: the elderly and the very young, a pregnant woman with severe abdominal pain, a young bargeman with a knife wound to a forearm, a Tajik with infected gums. Burns, cuts, suppurating boils, and the sicknesses of poverty — rickets, malnutrition and a man with the telltale skin lesions of pellagra. Some patients he could refer to Anna and Evgenia for cleaning and bandaging, but most he was obliged to treat himself. At a little before five o’clock, he saw a boy of six with the acute onset of flaccid paralysis in his right arm. His face was pinched, the skin pulled tightly over his cheekbones, and he looked at Hadfield with careless eyes.

‘Where’s this boy’s mother?’

‘In the waiting room with her other children,’ Anna replied.

‘I think he has poliomyelitis. Ask everyone to leave the treatment room and bring her in. And I should look at her other children.’

It was Anna who spoke to the boy’s mother using the simple language of the village. The woman was dressed in a grubby purple and white striped dress, her full dark face framed by a red scarf, buxom, no more than twenty-five years of age, new to the city. Her boy was very sick, Anna explained, stroking the woman’s face tenderly with the back of her hand. He should be kept from other children, even his little sisters, clinging to their mother, their faces buried in the folds of her dress.

‘Do you have something to make him better?’ the woman asked, turning to Hadfield. ‘You’re a doctor, aren’t you?’ Her lips and chin were twitching with barely suppressed emotion.

‘Do you have a room where the boy can sleep on his own?’ Hadfield asked.

She shook her head and looked away, but not before Hadfield could see she was biting her lip in an effort to hold back the tears. Anna touched his elbow and took a confidential step closer: ‘There are several families in one room. She shares a corner with her sister and her sister’s children.’

‘And the father?’

‘She hasn’t seen him for months.’

What could he do? The contagion would have to run its course. It might leave the boy a cripple for life or carry him away, but with nursing and good food there was a chance too of a full recovery. Lifting his medical bag on to the stool beside him, he took out a slip of paper and a pen and wrote a short note.

‘Take the boy to the Nikolaevsky Hospital tonight. Will she find it?’ he asked Anna.

‘I will send someone with her.’

Turning to the boy’s mother again: ‘Ask for one of my assistants, Anton Pavel, and give him this,’ and he handed her the note. ‘He will take care of your son. Be sure to ask for Anton.’

They worked on into the gloom of evening, the smoky light from the oil sconces casting Gothic shadows upon the walls. By seven it was clear there would not be time for the many still waiting patiently on the hard benches in the hall and he sent Evgenia to take some simple notes to identify the priority cases. Anna worked beside him in the treatment room and he was impressed by her dexterity; she was an able nurse, sensitive and quick to learn. As he was reaching for scissors to cut a dressing, he touched her cold hand and she looked up at him with a twinkling smile that left him trying to remember the task he was supposed to perform. They were treating their last patient of the day — a man in his twenties with the first bloody signs of consumption — when there was a loud knock at the door, and without waiting for a summons, Grigory Goldenberg walked into the treatment room.

It was more than an unwelcome intrusion. Hadfield felt as if a cold wind had swept in with him, lowering the temperature in the room. Goldenberg was at the clinic to treat no one. He was there to talk of revolution, dressed theatrically for the part in the belted red chemise and high black boots he had worn at the political salon. But Anna was not in the least surprised to see him and offered him her cheek and a warm smile in greeting.

‘We haven’t been formally introduced, Doctor,’ said Goldenberg, offering his hand. ‘Such valuable work.’

‘Thank you. We’ve almost finished,’ he said, turning to soap his hands in the bowl of water Anna had brought him.

‘Then join us for some tea.’

‘Yes, Doctor, you must,’ said Evgenia from the door. Hadfield turned to reach for a cloth and glanced over at Anna but her back was turned to him, her head bent over a box of dressings.

‘Perhaps just for a few minutes,’ he said.

The samovar was set at the edge of a rough table in a long low-vaulted room that looked and smelt like a refectory. Evgenia explained that the building was a poor school but the church had given permission for it to be used as a clinic on Sunday afternoons. What would the priests say if they knew why these ‘good women’ were administrating to the corporeal needs of their flock, Hadfield wondered. But perhaps that was unduly cynical. Goldenberg’s presence was acting as a dark prism, distorting his perception of the work they were doing.

‘No milk, I’m afraid,’ said Goldenberg. He filled a tarnished pewter pot with water from the samovar, poured a glass and pushed it towards Hadfield. ‘We drink tea the Russian way.’

‘And so do I,’ said Hadfield, settling at the edge of a bench.

‘Would you like something to eat, Doctor?’ Evgenia asked. ‘Thank you, but I’m not hungry.’

‘Grigory?’ Reaching down to her bag, Evgenia removed the remains of a loaf and some sausage and slid them across the table to Goldenberg, who set about them with gusto.

‘Do you intend to make St Petersburg your home, Doctor?’ Goldenberg asked between mouthfuls.

‘I think of it as home already. I was born here.’

‘Dr Hadfield was a close friend of my sisters in Switzerland,’ said Evgenia.

‘Lydia?’ Goldenberg gave a little shake of the head, showering wet crumbs on the table. ‘Poor Lydia.’

‘I must go,’ Hadfield replied and he swung his legs over the bench to rise.

‘So soon? Have a little more tea,’ said Evgenia.

‘My medical bag is in the treatment room.’

‘I’ll fetch it,’ said Anna.

‘No, no, that’s perfectly all right, I know my way.’