“You know, Eva,” Aleksei Gavrilovich said to his wife, “I am afraid Pavlik will become a physician, but he has too good a head for that. He ought to go into research . . .”
Aleksei Gavrilovich himself had spent his entire life bearing the double burdens of teaching and clinical work: as head of the Department of Field Surgery, he continued to perform operations. In the short interval between the two wars—Russo-Japanese and the war with Germany—he labored as if possessed to create a modern school of field surgery, while attempting simultaneously to direct the attention of the Ministry of War to the obvious (for him) fact that the impending war would alter the nature of war in general and that the incipient century would witness wars of a new scale with new weapons and demanding new military medical practices. According to Aleksei Gavrilovich, the system of field hospitals needed a complete overhaul, with priority given to rapid evacuation of the wounded and the creation of centrally directed specialized hospitals . . .
The war with Germany began earlier than Aleksei Gavrilovich had anticipated. And so he departed, as they said in those days, for the theater of war. He was appointed chief of the very same commission he had lobbied for in peacetime, and now he found himself torn in all directions, because the stream of wounded was enormous while the system of specialized hospitals he had devised remained merely a plan on paper: he had not had enough time to surmount bureaucratic barriers before the war began.
Following a fierce clash with the Minister of War, he resigned his commission, maintaining responsibility solely for the mobile hospitals. Set up in Pullman coaches, these operating rooms on wheels retreated through Galicia and Ukraine along with the debilitated army. In early 1917 an artillery shell struck one of the mobile operating rooms, and Aleksei Gavrilovich perished along with his patient and a nurse.
That same year Pavel matriculated to the medical faculty of Moscow University. The next year he was expelled, due to his father having been no less than a colonel in the tsar’s army. A year later, at the behest of Professor Kalintsev, his father’s old friend and head of the Department of Obstetrics and Gynecology, he was reinstated as a student. Kalintsev admitted him to his own department and took him under his wing.
Pavel pursued his studies with the same passion with which a gambler gambles and a drunkard drinks. His obsession with learning earned him the reputation of an eccentric. Unlike his mother, a spoiled and capricious woman, he hardly noticed material hardship. After his father’s death there seemed to be nothing else to lose.
In early 1920 the Kukotskys’ living space was “consolidated”: three more families were moved into their apartment, leaving only the former study to widow and son. The university professoriate, surviving the best it could under the new regime, could do nothing to help. They too had been reduced to tight quarters, and the scare of the revolution had not passed: the Bolsheviks had already demonstrated that the human life these putrefied intellectuals fought to preserve was not worth a kopeck.
Eva Kazimirovna, Pavel’s mother, had an attachment to material things and a knack for keeping them. She managed to stuff almost all her Warsaw furniture, dishes, and clothing into the study. His father’s venerable office, once spacious and orderly, turned into a warehouse, and no matter how Pavel pleaded with her to dispose of the clutter, his mother only cried and shook her head: this was all that remained of her former life. Ultimately, though, she was forced to sell, and gradually she bartered away her things at the street market, shedding tears of farewell over every item from her countless trunks of shoes, collars, and handkerchiefs . . .
Relations between mother and son cooled, then soured, and one year later, when his mother married the indecently young Filipp Ivanovich Levshin, a petty railroad bureaucrat, Pavel left home, reserving the right to use his father’s library.
He managed only rarely, though, to make his way over to his mother’s place. At the same time he attended classes, he worked at a clinic where he spent long hours on duty, sleeping where he could, usually in the linen room, with the permission of the old linen-lady, who remembered not only Pavel’s father but his grandfather as well . . .
He had already turned twenty-one when his mother gave birth to a new child. Her adult son only underscored her age, which aggravated the mutton-dressed-as-lamb Eva Kazimirovna. She let Pavel know that his presence at home was not desirable.
At that point relations between Pavel and his mother ceased.
After a while the Medical Faculty was made independent of the University, and appointments were reshuffled. Professor Kalintsev died and was replaced by another man, appointed by the party, with no reputation whatsoever as a scientist. Oddly enough, he supported Pavel and allowed him to remain in the department for his residency. In medical circles the Kukotsky name was no less well known than Pirogov or Botkin.
Pavel’s first research project focused on certain vascular disorders that caused miscarriages in the fifth month of pregnancy. The disorder affected microcapillary functions, which interested Pavel because at the time he was fixated on the question of how to influence processes in the peripheral regions of the circulatory and nervous systems, which he considered more tractable than higher-order functions. Like all residents, in addition to his hours at the clinic Pavel did rounds in the lying-in hospital and saw patients twice a week at the clinic.
Precisely that same year, while examining a female outpatient who suffered from systematic miscarriages in the fourth and fifth months of pregnancy, he realized that he could see a tumor in her stomach as well as metastases—one quite visible in her liver and a second, less conspicuous, in the mediastinum. He completed his examination of the patient as if all were normal, but referred her to a surgeon. Afterward he sat for a long time in his office before summoning his next patient, trying to make sense of what had happened and where that full-color schematic image of fully developed cancer had come from . . .
That day Pavel Alekseevich discovered his strange but useful gift. To himself he referred to it as “intravision,” and during the first few years he made cautious inquiries to determine whether any of his colleagues possessed a similar capacity, but found no traces thereof.
Over the years his inner vision strengthened, intensified, and acquired a high image resolution. In some cases he even saw cell structures, tinted, so it seemed, with Ehrlich’s hematoxylin. Malignancies had a deep purple tint; areas of active proliferation flickered with tiny crimson granules . . . Embryos in the earliest stages of gestation appeared to him as shining light-blue clouds . . .
There were days and weeks when his intravision would recede. Pavel Alekseevich continued working, seeing patients, and performing operations. His confidence in his professional qualifications never abandoned him, but deep inside he felt a subtle anxiety. The young doctor was, it goes without saying, a materialist with no tolerance for mysticism. He and his father had always made fun of his mother’s proclivity for attending high society séances with magical table-spinning or dabbling in mystical magnetism.
Pavel Alekseevich regarded his gift as if it were a living thing separate from himself. He did not trouble himself with the mystical aspect of this phenomenon, but accepted it as a useful professional tool. Gradually it became apparent that his gift was an ascetic and a misogynist. Even too hearty a breakfast might weaken his intravision, and Pavel Alekseevich acquired the habit of going without breakfast, not eating until lunchtime or—when he had afternoon hours at the clinic—in the evening. Physical contact with women temporarily deactivated the slightest transparency of his patients.