She was adamant about the pain and would gag involuntarily every now and again, sometimes in midsentence. When this happened, though, it barely interrupted her speech. She was unshocked at the reactions of her body, adapting to them.
It was her first stay in a hospital, but there was no sign of nerves. She had a faith in professional procedure, she clearly understood the precautions they would take, trusted in the skill of the surgical staff. Usually he would leave this type of job for one of the registrars, but he had volunteered to do it himself. After he’d spoken with her, a part of him wanted to repay her faith in them. She expected them to be expert and so he would match that, bringing his personal talent and experience to bear. And, besides, he welcomed the easing in. Doing something routine would be a way of warming himself up for the larger tasks of his day.
On the operating table Maya Petrovna Maximova lay on her side, anesthetized, her lips fitted around a mouthpiece with a hole in the centre, ready to take in the tube of the endoscope. Patients always looked so different in their vulnerable state; the personality she had shown the night before was all but erased.
The viewing screen was placed just above her head, to her right. Stanislav Nicolaevych, his new junior surgeon, stood beside him. Not that there was any need for his presence here, he too could practically do the procedure in his sleep, but it was his way of marking his territory, reminding Grigory that he was more than capable of it.
The tube was handed to him, and Grigory began to feed it through the plastic hole in the patient’s mouthpiece. He pushed it forward slowly and steadily, careful to maintain a slight momentum but cautious also not to puncture any tissue. The insides of her mouth filled the screen and the short journey began, past the flap of the epiglottis at the back of the mouth as he gently forced the tube downwards. Maya, although unconscious, gagged, her muscles doing their job. Past the opening of the larynx and the two protrusions of the vocal chords, like small internal fangs, and into the oesophagus. He slowed here, searching for a foreign body. And finally he could see it, a tiny piece of grey gristle that had embedded itself in the wall. Using the pincers attached underneath the camera he plucked it out, drawing a pinprick of blood. He pulled the tube back out, released the fragment into a steel dish, and entered once more, checking to see if there were any ancillary pieces, but he found nothing.
Job done, he handed the tube back to the attending nurse and took his leave, moving on to another patient in the adjoining theatre.
He liked the quick satisfaction that came from routine procedures. No thinking to do and minimal risks involved. The patient would be freed from all discomfort. In a couple of days, she will have forgotten all about that area of her throat, forgotten about him, free to go about her normal days. Nothing in this job was mundane. And it never bored him. Every tiny element had a purpose.
The next hour was taken up with placing a catheter in a man in his midforties with subclavian-vein thrombosis. Grigory let Stanislav close this one up to show him that taking on the endoscopy wasn’t a judgement on his competency.
Finally, before lunch there was a stent insertion. Usually he played music at this time, but he wasn’t in the mood today. The change in routine had an effect on his junior surgeons and nurses though; they were left to guess why there was silence.
He ate a large lunch in the canteen with his old friend Vasily Simenov, an endocrinologist. Grigory rarely ate much, but today he indulged himself because of the day that it was. He and Vasily had served in the military together: ran and cleaned their guns and ran and stripped them down and put them back together and ran some more. They forged their friendship by holding each other up as they scaled the snowy climbs of the Urals, half their bodyweight strapped to their backs.
When a position had become vacant in his unit Grigory had seen to it that Vasily was transferred in. It was one of the few times he had used his influence to sway things. He needed someone in the hospital who he could be himself with, who knew him before he was who he was. Of course there were mumblings from the rest of the staff, but they quietened over the passing months as Vasily proved his expertise.
After lunch there was a triple bypass that took almost four hours, which Grigory struggled through, feeling bloated after his meal and sweating through the later stages of the operation, the nurse constantly swabbing his brow and offering up the drinking straw attached to his bottle of tepid water.
Until finally, he left the hospital and made his way to the baths.
SO GRIGORY NEEDS this swim even more than usual. From the middle of the afternoon he has looked forward to this immersion in the chilled water. And now that he’s standing on the edge of the pool, he savours the moment, drawing it out.
He’ll swim and then go back for some night reading. It’s his favourite part of the day, his mind cleared of practicalities, his body placated by exercise.
The curve of his spine is pulled sideways with idiopathic scoliosis, a condition he’s had since childhood. It acts as a personal weather system, dictating his mood and tone with its fluctuating activities, and this is another reason for the routine. He thinks of it as a peace offering, a plea for respite, a secret pact with his troublesome vertebrae. Raising his arms above his head, he traces a wide circumference through the air. He relishes this moment, the moment before entering into a new state, from air to water. Fine blond hairs riffle along his limbs. He dips his back into a concave curve and lowers his head into his shoulders, bending his thick legs as he does so. Grigory cuts through the air until he feels the wholeness of the water sluicing around him. A body of water. He’s always liked this phrase; on the news, when snowmelts flood the regions; or in geography exams, when he was asked to compare the size of lakes and seas and channels. We inhabit bodies of water—he thinks when he hears the term—with all our fluids and juices. We have an aquatic mass of our own: tides, maelstroms, undercurrents.
Once submerged, he takes aggressive strokes, lengthening his arms to their limit, stretching his fingers, tearing through the undulating surface, wanting to temper the water or for it to temper him.
He reaches the far wall and tumbles in expert fashion, flipping his heels over his head, his legs shooting him through the pool, torso corkscrewing to right himself, bulleting underneath the surface.
In the first years of his career, when Grigory was gaining experience as a physician, the pool was a great source of inspiration for him. Often, if a patient had remained undiagnosed for more than three days, he would dive in and wait for the water and motion to provide an answer, which, invariably, it did.
And he’s an exceptional swimmer, a fact that has spread among his acquaintances. A story surfaced in the hospital recently about his time in the military, when he and his comrades showed up at a grand party in a dacha somewhere near Zavidovo. Grigory got so drunk that he couldn’t stand upright, so his comrades threw him into the swimming pool for safety and Grigory floated there, unaided, for the rest of the night. He couldn’t remember the party, a fact which, considering the circumstances, didn’t make the story any less true.