‘Well, indeed,’ she replied, sighing as if she understood only too well. ‘Women of your generation have suffered a lot. There was the war, for one thing.’
‘Yes, the war,’ said Zoya, nodding thoughtfully. ‘There have been many wars, in fact.’
‘Doctor,’ I said, interrupting her to speak now for the first time. ‘Ovarian cancer, this is curable? You have some way to help my wife?’
She looked at me with a certain degree of pity, understanding of course that the husband might be the most terrified one in the room. ‘I’m afraid the cancer has already begun to spread, Mr Jachmenev,’ she said quietly. ‘And as I’m sure you know, at the moment medical science is unable to offer a cure. All we can do is try to alleviate some of the suffering and offer our patients as much hope for a continued life as we can.’
I stared at the floor, feeling a little dizzy at these words, although in truth I knew that this was what she would say. I had already spent weeks at my usual desk in the British Library researching the disease that Dr Cross had spoken to us about and knew only too well that there was no known cure. There was always hope, however, and I clung on to that.
‘There are some additional tests that I would like to run, Mrs Jachmenev,’ she said, turning to my wife again. ‘We’ll need to do a second pelvic exam, of course. And some blood tests, an ultrasound. A barium enema will help us to identify the extent of the cancer. We’ll take some CAT scans, of course. We need to determine how far the cancer has spread beyond the ovaries and into the pelvic area, and whether it has travelled towards the abdominal cavity.’
‘But the treatments, doctor,’ I insisted, leaning forward. ‘What can you do to make my wife better?’
She stared at me, a little irritated, I felt, as if she was accustomed to dealing with devastated husbands but they were outside of her concern; she was interested only in her patient.
‘As I said, Mr Jachmenev,’ she replied, ‘the treatments can only slow down the progress of the cancer. Chemotherapy will be important, of course. There will be surgery, almost immediately, to remove the ovaries, and it will be necessary to perform a hysterectomy. We can take biopsies at the same time of your wife’s lymph nodes, her diaphragm, her pelvic tissue, in order to determine—’
‘And if I don’t have treatment?’ Zoya asked, her voice low but determined, cutting through the cold granite of these medical phrases which Dr Crawford had no doubt uttered a thousand times in the past.
‘If you don’t have treatment, Mrs Jachmenev,’ she replied, clearly accustomed to this question too, which shocked me; how simple it was for this lady to discuss such terrible notions, ‘then the cancer will almost certainly continue to spread. You will be in the same amount of pain that you are in now, although we would be able to give you some medication for that, but one day it will take you quite unawares and your health will deteriorate rapidly. That will be when the cancer has advanced to the later stages, when it has passed out of the abdomen to attack your organs – the liver, the kidneys and so on.’
‘We must begin the treatment immediately, of course,’ I insisted and Dr Crawford smiled at me with the tolerance of a doting grandparent towards a half-wit grandchild, before looking at my wife again.
‘Mrs Jachmenev,’ she said, ‘your husband is right. It’s important that we begin as soon as possible. You do understand that, don’t you?’
‘How long would it take?’ she asked.
‘The treatment would continue indefinitely,’ she replied. ‘Until we could control the disease. That might be a short time, it might be for ever.’
‘No,’ said Zoya, shaking her head. ‘I mean, how long would I have left if I don’t seek treatment?’
‘For pity’s sake, Zoya,’ I cried, staring at her as if she had lost her reason entirely. ‘What type of question is that? Didn’t you understand what—’
She held a hand in the air to silence me, but did not look in my direction. ‘How long, doctor?’
Dr Crawford exhaled loudly and shrugged her shoulders, which did not fill me with confidence. ‘It’s difficult to say,’ she replied. ‘We would of course need to run these tests anyway to determine exactly what stage the cancer is at. But I would say no more than a year. Perhaps a little longer if you were lucky. Although there is no saying how the quality of your life would be affected during that time. You could be healthy until near the end, and then the cancer could attack quite quickly, or you could begin to deteriorate very soon. It really is for the best that you take action immediately.’ She opened a heavy diary that lay in the centre of her desk and ran a finger along one of the pages. ‘I can schedule you for the initial pelvic exam for—’
She never got to finish that sentence, interrupted by the fact that Zoya had already stood up, taken her coat from the stand beside the door, and left.
Originally, we planned to go no further east than Helsinki, but then, on a whim, we travelled on towards the harbour town of Hamina, on the Finnish coast. The Matkahuolto bus drove us slowly through Porvoo and just north of Kotka, names which sixty years before had been as familiar to me as my own, but which had slowly dissolved from my memory over the intervening decades, replaced by the experiences and recollections of a shared adulthood. Reading those words again on the bus timetable, however, pronouncing their lost syllables under my breath, jolted me back to my youth, the sounds echoing with the regret and familiarity of a childhood nursery rhyme.
Zoya and I were offered seats at the front of the bus owing to our advanced years – I had celebrated my eightieth birthday four days before leaving London and my wife was only a couple of years younger than I – and we sat together quietly, watching the towns and villages pass us by, in a country which was not home, which had never been home, but which made us feel closer to the place of our birth than we had been in decades. The landscape along the Gulf of Finland reminded me of long-forgotten sailing trips along the Baltics, my days and nights filled with games and laughter and the sound of girls’ voices, each demanding more attention than the last. If I closed my eyes and listened to the cries of the seagulls overhead, I could imagine that we were dropping anchor once again at Tallinn on the Northern Estonian coast, or sailing northwards from Kaliningrad towards St Petersburg with a light wind behind us and the sun burning down on the deck of the Standart.
Even the voices of the people who surrounded us offered a sensation of familiarity; their language was different, of course, but we could recognize some of the words, and the harsh guttural sounds of the lowlands blending with the soft sibilant language of the fjords made me question whether we should have come here many years before.
‘How do you feel?’ I asked Zoya, turning towards her as the sign for Hamina indicated that we would arrive there in no more than ten or fifteen minutes. Her face was a little pale and I could see that she was moved by the heartbreaking experience of travelling east, but she gave nothing away in her expression. Had we been alone, perhaps she might have wept out of a mixture of sorrow and joy, but there were strangers sharing the bus with us and she would not confirm their prejudices by allowing them to observe the weakness of an old woman.
‘I feel as if I don’t want this journey to end,’ she replied quietly.
We had been in Finland for almost a week and Zoya was enjoying particularly good health, a fact which made me wonder whether it might not be a good idea to relocate to the climate of the north indefinitely if it meant that her condition would improve. I was reminded of the biographies of the great writers whose lives I had studied during my retirement at the British Library, of how they had left their homes for the frosted air of the European mountain ranges in order to rally against the illnesses of the day. Stephen Crane, allowing tuberculosis to extinguish his genius in Badenweiler; Keats staring out at the Spanish Steps as his lungs filled with bacteria, listening to the voices of Severn and Clark bickering with each other as they consulted over his treatment. They went there to look for revitalization, of course. To live longer. But all they found was their graves. Would it be different for Zoya, I wondered? Would a return to the north offer hope and the possibility of extended years, or a crushing realization that nothing could defeat the invader which was threatening to take my wife from me?