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Years ago in Russia they had been equals, two talented young doctors who knew their worth. Here, thanks to Fima’s inability to get his tongue round this damned language, Berman had shot so far ahead that Fima could never catch up with him. Now with Alik they were equals as before, two doctors attending the same patient.

Their meeting that night in Alik’s kitchen was actually more of a consultation. Alik had turned first to Fima when his right arm started letting him down two years ago.

“It’s nothing, just professional exhaustion—tendonitis probably,” was Fima’s first diagnosis. He had to revise this opinion when Alik’s left arm also started to seize up. If it hadn’t happened so suddenly Fima might have suspected multiple sclerosis. As it was, major tests were needed.

The first set of tests were carried out by Berman, free of charge, naturally; he even paid for the isotopes. Nothing showed up on the computer.

“It’s American, it won’t work for nothing!” Berman grimaced. “Better buy yourself some health insurance old man, while you still look okay. It’ll be valid in six months, you’ll need it, I guarantee, these things don’t just pass.”

Alik had no money for insurance, and he never thought about what was going to happen in six months’ time. This, plus his dislike of queues, forms and officials left over from Soviet times, was the reason he had never had any American benefits. While some of his fellow-emigrés vied to cadge as many hand-outs as possible, from food stamps to free rent, Alik had managed to live for almost two decades as free as air, working away on his own and out of sight and giving many of those who didn’t know him well the impression that he merely improvised as he went along. The people he annoyed most were not the honest grafters but the inveterate scroungers.

In short, he had never had a regular job or any insurance either, and there was no prospect of him getting either now: this was no time for him to be queuing for days in endless corridors and collecting the necessary paperwork.

Fortunately the computerized, efficient American health service left a few gaps, and his first tests were on someone else’s papers. The blood analysis showed nothing.

His first hospitalization was organized on the sidewalk: a little spectacle was staged, an ambulance was called. The owner of the café across the street from Alik’s building called the hospital, saying that a man had collapsed unconscious by his door. Lying across three chairs, dangling his auburn ponytail and winking at his friend the café-owner, Alik waited five minutes for the ambulance. He was driven off, examined, and treated on Medicaid by neuropathologists, who attached him to tubes and prescribed drugs. The hospital was depressing, and Alik discharged himself. Fima shouted at him: the prescriptions were fine, they were treating the symptoms, what more could they do without a diagnosis? Fima insisted he go back, and the only way to do this was to cook something up. He quickly arranged a small fistula on Alik’s collar-bone, and Alik announced that his condition had deteriorated after his unsuccessful treatment. The city hospital, although not private, disliked lawsuits and took him back.

It dragged on. Alik returned to hospital and discharged himself again. It wasn’t clear if the treatment helped, or how he would have been without it. His right arm hung lifeless, with the left he could barely lift a spoon to his mouth. His gait changed. He became tired. He stumbled. Then he fell for the first time. It all happened with frightening speed. The following spring he was barely able to move.

Alik’s second hospitalization was more difficult. He was taken to Berman’s laboratory and Berman himself called for the ambulance, saying that he had a seriously ill patient at reception. The ambulance demanded a written undertaking that the patient wouldn’t die on the journey. Berman, who knew all the bureaucratic tricks in this country, had already written it and accompanied Alik to the hospital. By a stroke of luck the nurse in charge turned out to be a friend of his, an old Irishwoman, frowning, abrupt, and a perfect angel. She sent them to the Chinese hospital, which was considered the best of the city’s state institutions. This was a good move. As well as the usual drugs Alik was given acupuncture and moxa, and in the first week he perked up a little and it even seemed as though some of the feeling returned to his arm.

Now Fima sat with Berman in Alik’s dingy kitchen with the dirty cups and happy cockroaches. They had already run out of hypotheses: amyotrophic lateral sclerosis, a viral infection, some mysterious tumour.

Berman was rather good-looking, but there was something of the ape about him with his strong, stooping shoulders, his short inflexible neck and long arms; even his mouth was stretched tightly over his large teeth. Fima was all rough and gnarled; bright clear eyes looked expectantly at Berman out of his pitted face.

“It’s hopeless, Fima. There’s nothing to be done in these cases, just the oxygen mask.”

“Asphyxiation may progress slowly and painfully,” Fima frowned.

“Give him morphine, or whatever.”

“Right,” Fima muttered.

He had hoped clever Berman might know something he had forgotten, but such knowledge didn’t exist.

SEVEN

Father Victor arrived at about nine, without socks and in sandals, carrying an attaché case and a bulging plastic bag. He was wearing a baggy shirt tucked into light, shortish trousers and a baseball cap with the innocuous letters “N” and “Y” on it.

He took off the cap as he came in and rested it on the crook of his arm, greeting everyone with a smile which wrinkled up his short nose.

Because it was Saturday there was a large number of visitors: Valentina, Gioia with a little grey Dostoyevsky under her arm, Irina, Maika, Faika, Libin and his girlfriend, all the usual crowd. Also present were the Beginsky sisters, recently arrived from Washington, a woman from Moscow whom nobody knew, and who said her name so indistinctly they couldn’t hear it, Alik’s American artist friend Rudy, who had worked with him on some joint project, Shmuel from Odessa with a dog named Kipling which he was looking after for a few days for an old friend.

Alik was lifted from the bed and seated in his usual place in the armchair, propped up on all sides with pillows. Everyone circled around the room, talking loudly and drinking. On the table stood various offerings: a large pecan pie, some icecream. It was more like a private view than the room of a dying man.

Father Victor seemed lost for a moment. Then Nina grabbed his elbow which was supporting the baseball cap, and sat him down at the table.

“My heart, which longs so much for pea-eace …!” crooned Shmuel, almost drowning out the Paraguayan pipes and drums tirelessly banging away under the windows.

Faika clasped a long, limp puppet which represented Alik. This prophetic doll had been given to him once on his birthday by his friend Anka Kron, who now lived in Israel. Alik gave the puppet its lines: “Oy, don’t wink at me like that! In the name of God, Faika, have you been eating garlic?”

The priest smiled, took the puppet from Faika’s hands, and shook its pink hand: “Pleased to meet you!”

Everyone laughed, and Father Victor put the puppet back on Faika’s knee. Nina nodded. Shmuel was instantly silent. Libin lightly lifted Alik out of his chair and carried him like a child back to the bedroom.

The woman from Moscow shrank back: it was a pitiful sight. While Alik was sitting or lying down everything seemed normal, a sick man surrounded by his friends. But when he was moved from one place to another it was immediately apparent that something terrible was happening. The bright, lively eyes and the dead body. At the beginning of spring he had been able to move on his own from the studio to the bedroom.