Frederik Pohl - Chernobyl

And even the ones who had swallowed or inhaled radioactive material were not as frustrating as those who had merely been exposed to intense radiation. They were the hardest ones to diagnose. There wasn't any visible wound. They were weak, they felt nauseated, they vomited unpredictably; yes, very well, those were precisely the early symptoms of radiation sickness. They were also the symptoms of shock or overexertion or a hundred other things, even simple fatigue, and certainly every human being working to control the damage from the accident had every right to a great deal of fatigue. Including Tamara Sheranchuk herself.

So what Tamara had been doing, before she was ordered onto an ambulance to accompany four of the seriously wounded to Hospital Number 18 in Kiev, were the simple medical things she had always done for injured people: poultice and debride, sew and dress. It was not enough.

There wasn't really room for four patients in the ambulance, much less for Tamara herself and the stands that held the plasma and antibiotics that trickled into the bloodstream of two of the patients. There were not enough clamps for so many stands, and so, as the ambulance swayed, Tamara had to have one hand to steady a glucose drip and another to catch a stand of saline solution that was about to topple, and none at all to keep herself from bouncing about.

These particular patients had-at least, were thought to have had-only light doses of radiation, if any at all. Three of them were seriously burned. Unfortunately, only one of the three was unconscious. The other two could not help moaning and crying out as the ambulance lurched and Tamara fought to stay awake and steady the IV stands. There was a nasty smell in the ambulance, part vomit and part smoke and part what really smelled most of all like burned meat.

The fourth patient was a woman, with chest pains, perhaps the beginning of a heart attack. She was elderly and conscious; she lay there without speaking, watching Tamara as she tried to deal with the others. When Tamara sat back for a moment, brushing hair out of her eyes and wishing she dared close them for a moment, the woman spoke. "I've seen you before," she said, and when Tamara identified herself nodded. "Yes, to be sure. Don't you remember me? I'm Paraska Kandyba. Deputy Director Smin's secretary."

"Of course," said Tamara, letting go of the saline stand to reach for her chart. "Yes, and they've given you heparin and nitroglycerine. How are you feeling?"

"A headache. Nothing more now."

"Yes, that is from the nitroglycerine. It is unpleasant, but it's better if I don't give you anything for it until you reach the hospital."

"I don't want anything." The woman added apologetically, "I know it was very foolish of me to try to help out, at my age. But in such a terrible thing-"

Tamara saw that the secretary was weeping. Yes, certainly it had been very foolish; Paraska Kandyba had been near the plant all day, begging for the chance to get into the administration block to rescue her boss's papers, and what was the importance of that? But all Tamara said was, "It was very brave of you."

Paraska raised her head to stare at the doctor. "Brave? But not sensible. And Deputy Director Smin is also not sensible! He is not a young man. And yet I saw him in and out of the plant, right with the firemen, until they sent him off to the hospital in Moscow. Oh, he didn't want to go, I can tell you!"

"No, of course not," Tamara soothed, letting go of the chart to rescue the toppling saline stand again. "Tell me, Paraska," she ventured. "Did you by any chance see my husband today?"

But Paraska Kandyba only shook her head and continued weeping. It was obvious that her tears and her concern were all for Deputy Director Simyon Smin.

When they reached Hospital No. 18 in the city of Kiev, Tamara Sheranchuk dragged herself out of the ambulance for the transfer of the patients. She wasn't needed. She stood aside while the hospital's own orderlies took over, efficiently unloading the patients and wheeling them into the receiving room. She was looking forward to the ride back. It would be nearly two hours! Two hours in which she could stretch out in the ambulance and sleep. She leaned against the door of the ambulance, dreaming of that wonderful two-hour trip, when she realized the driver had poked her and said, "Look at them."

Tamara blinked. "Look at what?"

"Those people! Look, they are acting as if nothing had happened!"

It was true. She gazed around the streets of Kiev wonder-ingly. Here in Kiev, at least, it was, after all, a peaceful Sunday afternoon! People were strolling the wide streets, children were laughing as they played, a few early blossoms were on the chestnut trees, the bright posters were everywhere for the May Day celebration. How incredible, Tamara marveled, that all these people could be going about their normal lives, unaware of the hell that was raging less than a hundred and fifty kilometers away.

"They're lucky," grumbled the ambulance driver, and Tamara shook her head.

"Not really," she said. "No one is very lucky today. They simply have not yet found it out. Are we through here? Then let's go back to Chernobyl."

As the ambulance driver, who had had no more sleep than Tamara, wearily started to turn the vehicle around, a man came running out begging for a lift. He explained that he was a doctor trained in radiation sickness, called in from his weekend for the emergency. Tamara made herself stay awake; here was a chance to learn something useful! She asked him about the numbers. "Yes, exactly," he said, "above 500 rads the only hope is to somehow give them living bone marrow."

"And how is that done?"

"Fetal liver transplants," he said. "In some places they actually transplant bone marrow-this is done in America sometimes-but there are great problems. First of all, the patient's own bone marrow must be destroyed, otherwise the transplant will be rejected. Then there must be an exact typing match, and it is not easy to type bone marrow-and if that is wrong, the transplant will still be rejected. Of course, that itself is serious; a patient who might otherwise recover could be killed by the rejection process."

"And what is the fetal liver procedure?"

"In the embryo," he said, "it is the liver cells that perform the functions of the adult bone marrow in manufacturing blood cells. So from aborted fetuses we extract the liver, purify the cells, and inject them into the patient." He hesitated. "That, too, has a poor success rate," he admitted, "but for patients with more than 500 rads there is, after all, no choice."

"Ah, yes," said Tamara, "but how do you know what the exposure has been, since not all the victims are thoughtful enough to carry dosimeters?"

The young specialist said enthusiastically, "That is the key, of course. The doctor in Hospital Number Six in Moscow, where I trained, has developed a procedure. We take blood counts at two-hour intervals and compare them with a standard profile. We can see how rapidly the cells deteriorate, and from that we can determine what the exposure has been.…"

But by then Tamara was asleep beside him.

Tamara had almost allowed herself to hope that by the time she got back the fire would be under control, the emergency over. But it seemed it was worse than ever. Pripyat had been evacuated. (And where had her son, Boris, gone?) The ambulance was sent on to Chernobyl town, thirty kilometers away from the reactor. It was, it seemed, as near as was really safe, and so now there was talk that everyone, everyone, within that thirty kilometer radius of the plant was to be ordered away. And where would they find places for all these people to stay? There were a dozen villages and nearly thirty collective farms in the area; where would they all go?

It was not just the people now. Half the farms in the area raised livestock, cattle mostly, but any number of sheep, pigs, goats, even a few horses. Many of the animals came from the kolkhozists' private ventures, which made their owners doubly desperate to save them.