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“Slit the throats,” says Lewis.

As Lewis shuts the back door, the driver pauses for a moment, then bashfully asks the question that, Lewis surmises, must have been on his mind all along: “A sam-to ty kto?” And what are you?

“I am a man,” replies Lewis, getting back into his Black Maria, and for a moment he forgets about his blood-soaked tunic and his cadaverous white face.

“What kind of man?”

“Nastoyashchiy chelovek.” Lewis throws his new friend the entire pack of Belomor. “Sovetskiy!” A real man. A Soviet man.

The soldier catches the pack with his left hand and, after Lewis’s words sink in, slowly raises his right hand in a salute.

Lewis returns the salute, raising his chocolate-colored right hand to his bleached temple.

4

At 4:39 a.m., Aleksandr Sergeyevich Kogan is sufficiently awake to be surprised when he hears the knock on the door.

Surprised because he was given reason to believe that he had a week to get his affairs in order. Could this be a mistake? Wrong door, perhaps?

Most people don’t get warnings, grace periods. Kogan thought he did. Perhaps their plans have changed. The fact that Kogan is still at large is a surprise to everyone — starting with Kogan.

Exactly one year, three months, and one week ago, Kogan was stripped of his administrative and academic titles — chief of surgery at Pervaya Gradskaya Bol’nitsa, Municipal Hospital Number One, and professor of surgery at First Medical Institute. He continues to practice as an ordinary surgeon, often at the emergency room. Sometimes he makes house calls at the regional clinic. Sometimes he rides with an ambulance, mostly because he wants to, and because no one cares enough to stop him.

After dismissal, Kogan allowed his wardrobe to drift toward simpler things, which hang sack-like on his short, broad frame. A heavy cotton shirt that buttons off-center—tolstovka—replaces his officious coat and tie. The fedora loses its purpose and is replaced by an old military hat. Not his karakul papakha of a colonel (his rank when the war ended), but a basic ushanka, the sort a private might wear.

Being in the streets, easing pain, maybe even saving lives on occasion agrees with Kogan. While taking care of a drunk in the ER, he made a promise to himself that when this political madness ends and his posts are offered back to him with apologies, he will simply reject them and return to the life of a simple doctor. Of course, there are advantages to being a colonel, but sometimes being a private feels cleaner.

“Cosmopolitism,” the reason for Kogan’s dismissal, is, of course, preposterous. By birth, he is a Jew, but he is Russian to the core, a hero of two wars, a partisan in the Civil War, a military surgeon in World War II. Yet he is also proudly cosmopolitan. Having trained in Berlin and Paris, he has the skills that would enable him to practice in any hospital anywhere in the world. He can easily lecture in German and French. Alas, over the preceding two decades, he has had no opportunities to do so. And he has family members in New York and Copenhagen.

The word “cosmopolite” has become another way of saying Yid. Before the Party’s hard line on cosmopolitism, a drunk in the street would call you “zhid porkhatyy,” a rootless Yid. Now, in the newspapers, the epithet of choice is “kosmopolit bezrodnyy,” a rootless Cosmopolite. It’s a simple word substitution, a way of saying the exact same thing without saying “Yid,” a way of making it official, acceptable. This nonsense is getting firmly implanted in the psyche of the people. Kogan feels it as a doctor. On house calls, patients call him bloodsucker, and accuse him of efforts to kill them. As a professional, Kogan doesn’t take this personally, but as a patriot he wonders: Does madness ever recede? Can it get better on its own, without therapeutic intervention?

* * *

Some events in life deepen the dimension of time, as though the brackets that define ordinary instants are spread apart.

The instant of the knock, like the instant of death, can be eternal, and here it is, at exactly 4:39 a.m.

What do we do when the knock comes? Is the final instant of freedom shaped by our past lives? How do we balance the practical considerations against the symbolic? Kogan’s thoughts rush in at once: “Should I remain in my pajamas? Should I put on street clothes? Is there time to change? Has my valise been packed?”

He is not torn by doubts about correctness of the Party line. He is past that. Consider the books that shaped him intellectually and spiritually: he is reading Akhmatova and Tsvetaeva, two poetesses described in the propaganda as “idealess” or worse. Akhmatova is cursed by the official ignoramuses as a “half-nun, half-harlot,” a hybrid heretofore unknown to mankind. “Reading” Akhmatova and Tsvetaeva means continuously, the way a believer reads a sacred text.

Kogan is in possession of Der Process, The Trial, by Franz Kafka, published in Berlin in 1925 by Verlag Die Schmiede, a full decade before the Moscow Trials. (Its original owner was a German medic shot near Stalingrad.) The opening lines were scarily applicable to Moscow of 1953, despite being written nearly four decades earlier: Someone must have been telling lies about Josef K., he knew he had done nothing wrong, but, one morning, he was arrested.

The ending — the execution of Josef K. — seemed even more shocking because it was so amateurish, so homespun: But the hands of one of the gentlemen were laid on K.’s throat, while the other pushed the knife deep into his heart and twisted it there, twice. As his eyesight failed, K. saw the two gentlemen cheek by cheek, close in front of his face, watching the result. “Like a dog!” he said, it was as if the shame of it should outlive him.

Most dangerous, Kogan has developed an obsession with clinical applications of psychoanalysis: interpretation of dreams. That’s about as far as you can depart from medicine based on “scientific Marxism-Leninism.” Rooted in class structure, it rejects the very idea of the significance of troubles of an individual. Mental health is achieved through belonging to a collective. Self-indulgent navel-gazing is harm. A man’s dream is just that. It’s not rooted in class, has nothing to do with his relationship to ownership of the means of production. And obsession with sex is, of course, a capitalist vice.

Something about the spirit of the times makes Kogan read every epidemiology book he can get his hands on at the library of the First Medical Institute. Indeed, he is starting to think of purges as epidemics that start out with a small, concentrated population, then expand their reach nationally, even globally. Once he picked up a blank piece of paper and started to jot down the fundamentals of a discipline he would call politico-historical epidemiology.

One of the models he gleaned from epidemiology is that epidemics of infectious diseases can reach the peak, but then inevitably start to recede. How is Fascism not an infectious disease? How is Stalinism not a plague?

Events outside the window and in his own life convince Kogan that the climax is still far away. Things can get much worse. But what are we dealing with? Is this outburst of ignorance and hatred akin to systemic disease? Alternatively, this disease could have a single source that sends pathogens throughout the system. What if you find a way to intervene and neutralize it?

Is a therapeutic intervention possible? Of course, Kogan knows what this means. Murder. He took lives in his pre-medical past, and he has no apologies, no regrets for having done so. Perversely, he hopes that his old friends, now under arrest, were plotting to kill that old brigand Stalin. Alas, they probably were not.