‘That’s all very well, but what are you going to do about a hernia?’ The voice of Fear continued to pester me.
‘I’ll put them into a bath,’ I defended myself in exasperation, ‘and try to reduce it.’
‘What if it’s a strangulated one, old boy? Baths won’t be much use then, will they! A strangulated hernia!’ Fear chanted in a demoniac voice, ‘You’ll have to cut it out …!’
I gave in and all but burst into tears. I sent out a prayer to the darkness outside the window: please, anything but not a strangulated hernia.
Weariness then crooned:
‘Go to bed, unhappy physician. Sleep on it. Calm down and stop being neurotic. Look how still the dark is outside the window, the fields are cold and sleeping, there is no hernia. You can think about it in the morning. You’ll settle down … Sleep … drop that book of diagrams, you won’t make head or tail of it anyway … hernial orifice …’
I don’t remember him arriving. I only remember the bolt grating in the door, a shriek from Aksinya and a cart creaking out in the yard.
He was hatless, his sheepskin coat unbuttoned, his beard was dishevelled and there was a mad look in his eyes.
He crossed himself, fell on his knees and banged his forehead against the floor. This to me!
‘I’m a lost man,’ I thought wretchedly.
‘Now, now—what’s the matter?’ I muttered and pulled at his grey sleeve.
His face twisted and he started mumbling a breathless and incoherent answer:
‘Oh doctor, sir … sir … she’s all I’ve got, she’s all I’ve got, she’s all I’ve got,’ he burst out suddenly in a voice so young-sounding and powerful that the lampshade trembled. ‘Oh, sir, oh …’ He wrung his hands in misery and started knocking his forehead against the floorboards as if trying to smash them. ‘Why? Why am I being punished? What have I done to deserve God’s anger?’
‘What is it? What’s happened?’ I cried out, feeling the blood draining from my face.
He jumped to his feet, rushed towards me and whispered:
‘Anything you want, doctor, sir … I’ll give you money, take as much money as you want. As much as you want. We’ll pay you in food if you like. Only don’t let her die. Don’t let her die. Even if she’s to be a cripple, I don’t mind. I don’t mind!’ He shouted to the ceiling. ‘I’ve got enough to feed her, I can manage.’
I could see Aksinya’s pale face in the black rectangle of the door. I was overcome with anguish.
‘Well, what is it? Speak!’ I cried irritably.
He stopped. His eyes went blank and he whispered, as if telling me a secret:
‘She fell into the brake.’
‘Brake … brake? What’s that?’
‘Flax, they were braking flax, doctor,’ Aksinya whispered in explanation, ‘you know, brake, flax braking …’
‘Here’s a fine beginning. This is it. Oh why did I ever come?’ I said to myself in horror.
‘Who?’
‘My daughter,’ he answered in a whisper, and then shouted, ‘Help me!’ Once again he threw himself to the floor and his hair, cut like a mop in peasant fashion, fell into his eyes.
The pressure-lamp with its lopsided tin shade burned with hot beams of light. She lay on the operating table, on white, fresh-smelling oilcloth and when I saw her all thoughts of hernia vanished from my mind.
Her fair, almost reddish hair hung down from the table in a matted clump. She had a gigantic plait which reached to the floor.
Her calico skirt was torn and stained with blood in various shades from brown to oily scarlet. The light of the kerosene lamp was a lively yellow in comparison with her paper-white face, and her nose was beginning to sharpen. On her white face, motionless as a plaster cast, a truly rare beauty was fading away before my eyes. Seldom in life does one see such a face.
The operating theatre was completely silent for about ten seconds, but from behind the closed doors came the muffled sounds of someone shouting and banging his head over and over again.
‘Gone out of his mind,’ I thought. ‘The nurses must be seeing to him. Why is she so beautiful? Though he does have good bone structure; the mother must have been a beautiful woman. He’s a widower.…’
‘Is he a widower?’ I whispered automatically.
‘Yes, he is,’ Pelagea Ivanovna answered quietly.
Then Demyan Lukich, almost as if in anger, ripped the skirt from hem to waist, baring her instantly. I looked, and what I saw was even worse than I had expected. Strictly speaking there was no left leg. From the smashed knee down there were just bloody shreds, battered red flesh and splinters of white bone protruding in all directions. The right leg was fractured at the shin so that the tips of both bones had punctured the skin and her foot lay lifelessly on its side, as though disconnected.
‘Yes …’ the feldsher pronounced softly and that was all he said.
Thereupon I regained my wits and started feeling her pulse. Her cold wrist registered nothing. Only after a few seconds did I detect a barely perceptible, irregular ripple. It passed and was followed by a pause during which I had time to glance at her white lips and nostrils, which were turning blue. I already felt like saying ‘It’s all over’, but fortunately controlled myself … there was another hint of a beat.
‘The end of a mangled human being,’ I said to myself. ‘There’s really nothing more to be done.’
But suddenly I said sternly, in a voice that I did not recognise:
‘Camphor.’
Anna Nikolaevna bent over to my ear and whispered:
‘What for, doctor? Don’t torture her. What’s the point of smashing her up any more? She’ll die any minute now … you won’t save her.’
I gave her an angry look and said:
‘I asked for camphor …’ in such a way that she flushed, marched resentfully to the little table and broke an ampoule. The feldsher obviously did not approve of the camphor either. Nonetheless he deftly and swiftly took hold of a syringe and the yellow oil went under the skin of her shoulder.
‘Die. Die quickly,’ I said to myself. ‘Die. Otherwise what am I to do with you?’
‘She’ll die now,’ whispered the feldsher as if guessing my thoughts. He glanced meaningfully at the sheet but apparently changed his mind. It seemed a pity to stain it with blood. But a few seconds later he had to cover her. She lay like a corpse, but did not die. Suddenly my head became quite clear, as if I were standing under the glass roof of the anatomy theatre in that faraway medical school.
‘Camphor again,’ I said hoarsely.
And once again the feldsher obediently injected the oil.
‘Is she really not going to die?’ I thought in despair. ‘Will I really have to …’
Everything lit up in my mind and I suddenly became aware without any textbooks, without any advice or help (and with unshakeable conviction), that now, for the first time in my life I had to perform an amputation on a dying person. And that that person would die under the knife. She was bound to die under the knife; after all, there was no blood left in her body. It had all drained out through her shattered legs over six miles and there was not even a sign that she was conscious. She was silent. Oh, why didn’t she die? What would her maddened father say to me?
‘Prepare for an amputation,’ I said to the assistant in a voice that was not my own.
The midwife gave me a fierce look but the feldsher showed a spark of sympathy in his eyes and began busying himself with the instruments. A primus-stove started to roar.
A quarter of an hour passed. I raised her cold eyelid and looked with superstitious fear at the expiring eye. It told me nothing. How could a semi-corpse stay alive? Drops of sweat ran uncontrollably down my forehead from under my white cap and Pelagea wiped away the salt sweat with gauze. What remained of the blood in the girl’s veins was now diluted with caffeine. Ought it to have been injected or not? Anna Nikolaevna was gently massaging the swellings caused by the saline solution. And the girl lived on.