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“Good boy. You still have some fight in you. Let’s see what we can do.”

He reaches his hand towards the neck again, asking the animal’s permission through the slow deliberation of his movement. He slides his fingers into its thick coat and moves downwards, feeling the strong pulsing of its heart, never taking his eyes from those of the dog, which are searching now, darting to various points in their circumference, showing tentative trust; placing its hopes in this stranger. Grigory moves his hands nearer the wound and the dog releases a moan, a sound as stark and elemental as its surroundings.

He looks up to the driver.

“Its pelvis is broken.”

“This is your dog? It’s smashed my headlight, it’s damaged my bumper. This fucking dog, coming out of nowhere. This is your dog? Someone will be paying, I assure you.”

“It’s not my dog.”

“Of course you say that. ‘Not my dog.’ But you come and look after it. Why do you care? Coming out of nowhere. Of course it’s your dog.”

“Please. It’s in a lot of pain.”

“Who are you? A hero? A vet looking for animals to save?”

“I’m a surgeon.”

“Good. Then you can afford to pay for my headlight.”

Grigory stands and takes in the car, a black Riva. He walks nearer the man and looks him in the eye, a bullfrog wobble of skin under the man’s chin.

“I don’t know who owns the dog. I do know that it’s in a lot of pain. I live in those buildings back there. If you take me home we can look after the animal and then ask around.”

The driver steps back, his gaze spiralling downwards in short, sharp bursts. His voice is now so muted that Grigory has to strain to hear him.

“I tell you what, you keep your dog. I’ll pay for the damage myself.”

He steps into the car and drives off. There’s a rattle from the front bumper as it drags along the ground.

Alone on the road with a shattered dog.

Grigory looks back to the settlement, the buildings taking on a deeper light by now, incandescent; then turns to the animal.

“You’re a brave one, aren’t you?”

He kneels once more and scoops the dog into his arms. The animal wails softly, but doesn’t resist, recognizing the authority of its new master. Grigory walks back over the puffed snow, struggling under the dog’s weight, its heart beating close to his.

EACH NIGHT after his walk he enters once again the few low rooms of the clinic. Returning to hear the breath of sleeping children, all of them waiting to pass under his knife. Grigory knows he has a weaker will than any of them, and there are nights when he lies amongst them, hoping that their courage, their thirst for life, might pass into him, replenishing him.

Children who have already undergone thyroid operations and are regaining their strength sleep on thin mattresses laid out in rows along the floor. In the morning they rise and roll them into a wheel, tie them up with string, and place them in the corner. There is a playground outside with a high net strung across it. They’ve received a batch of tennis balls as part of an aid consignment, and the children invent complicated rhythmical games with them. In the breaks between surgery Grigory watches them and tries to decipher their rules, but they change daily, hourly, and so he pays attention only to the fluid motion of these children, identical scars running horizontally across the base of their necks. These are the healthier ones. The weaker ones lose consciousness while standing. They buckle to the ground, marionettes whose strings have been cut. Nosebleeds break out all the time. At any moment he can look across the yard and see half a dozen children pinching their noses, looking up to the sky, unperturbed by the spontaneous flow from their nostrils.

There are those for whom the sickness has spread to the lungs or pancreas or liver. They lie sweating in the few beds available. Many are placed back with their families in their accommodation, where they are guaranteed somewhere to rest and a visit by a nurse. In the past few months, infants have emerged from the womb with fused limbs, or weighed down with oversize tumours. There are children whose bodies have no sense of proportion, football-size growths on the back of their skull or legs as thick as small tree trunks, or one hand minuscule and the other swollen to grotesque dimensions. Others have hollowed-out eye sockets, lined with flat patches of skin: it looks as though the human eye is an organ that has yet to evolve. For many, there are tiny holes where the ears should sit. A child, a girl, was born two weeks ago with aplasia of the vagina. Grigory couldn’t find any references to such a thing in his textbooks. He had to improvise by creating artificial holes in her urethra through which the nurses would squeeze out her urine.

During these nights, he gazes at them in their cots. Nothing is so unimaginable that it cannot be true, this is what he thinks, beauty and ugliness resting within the single body of a diseased infant, the two faces of nature brought into stark relief.

No officials have made their way here, despite his daily entreaties. He wants them to walk into this room, a place where ideology, political systems, hierarchy, dogma, are relegated to mere words, belonging to files, banished to some dusty office. There is no system of belief that can account for this. The medical staff know that, in comparison, nothing that has gone before in their lives has any significance. There are only these months, these rooms, these people.

When they bury the dead, the corpses are wrapped in cellophane and placed inside wooden coffins, which in turn are wrapped and placed inside zinc caskets and lowered into concrete chambers. The families are never allowed to accompany their loved ones on this final journey. Instead they stand gravely by the door of the mortuary as the sealed van holding their dead disappears into the distance.

GRIGORY REACHES his quarters, still carrying the injured dog, and lays him on the floor beside his single armchair, dark horsehair drooping from its seams, in the narrow space between his bed and the wall. His room has a single bed that dips heavily in the middle, a locker overrun with medical books and some detective novels that have long since outlived their purpose of staving off the penetrative boredom. On the wall opposite the door are a small wardrobe and a washbasin. Grigory leaves the room and returns with a bowl, which he fills with water and places beside the animal’s head. The dog is in too much pain to right itself in order to drink, and so Grigory cradles its neck in his arms and brings it gently to a position where it can lap the water freely, its tongue folding around the liquid, gathering it. Grigory is coated in sweat from the journey, and this is now turning cold, clinging to him, and as he peels the shirt from his body his own odour rises up strong and sour.

He wipes off the sweat with his bedsheet and puts the shirt back on—he hasn’t any clean clothes at the moment, he finds he’s never in the mood to do laundry—and he walks across the yard, which is silent now, an occasional TV set in the surrounding windows throwing patches of throbbing blue light onto the ground. A boy stands at the gable end of one of the buildings, bouncing a tennis ball between wall and ground, the bounce creating a pleasing double rhythm before the ball comes to rest in the boy’s hand. Grigory walks to the supply room of the clinic, gathering all he needs to treat the animal, and on his return, he pauses to watch.