Or so he claimed over vodka one night. Imagine a surgeon infected by belief in his own inferiority.
“Now, Abram, this is my mother, understand?” said the admiral.
“Yes, Comrade Admiral. I understand this. Now I will measure her heart rate and listen to her heart.”
Arkady let the slur pass. He picked up the old woman’s right hand, the one not affected by the stroke. It felt limp.
“Ol’ga Petrovna, can you squeeze my hand?” he asked, knowing that she couldn’t.
While her hand was in his, Arkashka took her pulse. It was around 120 beats per minute, about twice the normal. Respiratory rate was about thirty-six breaths per minute, about six times the normal. Blood pressure was eighty over forty, reptilian low.
“There are many of your brothers in Kremlyovka,” said the admiral as Arkashka grabbed the stethoscope out of his doctor’s bag. “You’d feel at home there.”
Through the stethoscope, Arkashka heard scattered, rattling noises. That was the sound of rhonchi, a fancy way of saying junk in the airways.
“May we discuss the status of the patient, Comrade Admiral?”
“Kaplan, Kaplan. Abrasha.”
The admiral pronounced the r in an exaggerated way intended to mimic Yiddish. It came out on a spectrum between r and h. “And during the war, where were you, Kaplan?”
“I was in Stalingrad, Comrade Admiral.”
Arkashka’s pronunciation was clear, as Moscow as it gets.
“Stalinghad…,” repeated the admiral in mocking accent. “I’ll tell you where you were! In Kazan’, behind the Ural, drinking Russian blood.”
He was drunk, of course, but Arkashka was no stranger to drunks. The only thing to do was to go through the case, make the decisions that needed to be made, and get the fuck out.
“Comrade Admiral, I know this is very difficult…,” Arkashka carried on. “Your mother is breathing the way she is because her body isn’t absorbing oxygen the way healthy bodies do. As carbon dioxide builds up, she compensates by breathing more rapidly. This is called Cheyne-Stokes respiration. I know it’s difficult to accept, but this is how death begins.”
“Molchat’!” shouted the admiral. Silence!
“The situation may not be hopeless, however,” Arkashka soldiered on. “Your best course of action would be to take Ol’ga Petrovna to the Kremlin hospital, where they will be able to do a chest X-ray, do blood work. If appropriate, they may use a respirator, a machine that will help her breathe, at least for a while. Municipal Hospital Number One, where I work, doesn’t have a respirator. My ambulance can transport her to Kremlyovka. You can come with us in the ambulance while your staff makes appropriate arrangements.”
The admiral’s hand grabbed Arkashka by the lapels of his white coat. The hand was strong, beefy. The palm was so large, it seemed to cover half of Arkashka’s chest.
“Now you listen to me, Rabinovich. This is my mother. Mother! Understand?! She will not be going to Kremlyovka. Who do you think got her paralyzed to begin with?”
“There are excellent doctors…”
“Yids! Bloodsuckers! Murderers!”
Clearly, a calm, professional approach was failing Arkashka. He was alone in a room with a man whose grief was fueled with alcohol.
Yet, the bit about the Kremlin hospital couldn’t be ignored. The idea that this man would deprive his mother of access to a ventilator was starting to make sense. He believed the Yids at Kremlyovka would kill her.
That was consistent with what was being published in the newspapers. The stories were mostly about Kremlyovka. The list of arrested doctors includes Stalin’s personal physician, Vinogradov, one of the few non-Jews on the list.
Arkashka realized that the admiral was confused, alone, unclear about what his next strategic move would be. Unable to trust anyone as his mother lay dying, he had commandeered an ambulance much like he had commandeered the railroad cars to bring his loot from Germany.
This was madness, of course. What was Arkashka to do? Was there a way out of this trap?
He threw the question to the admiral.
“What do you suggest we do, Comrade Admiral?”
“We cure her right here.”
Abrikosov slowly got out of his chair and brandished a short dagger that was hanging on his belt. It was a shiny ceremonial weapon, called kortik in Russian and a dirk in English. This weapon had an ivory handle. It was gold plated. Unsheathing it, the admiral placed its point against Arkashka’s nose.
Arkashka didn’t blink.
“Now, Abramovich, this is the kortik of a Soviet admiral. By this kortik I swear that nothing will stand between my mother and full recovery. You will stay here for as long as it takes to improve her breathing, and I will sit here with you for as long as it takes to make sure that this fine Russian woman walks again.”
With these words, the admiral placed the unsheathed kortik across his knees.
Often you need time to make an irrational family member come to his senses, Arkashka decided.
He must do something, anything, to create an appearance of a therapeutic intervention.
He reached into the bag and produced a glass bottle containing saline solution, connected it to a catheter, and carefully inserted the needle into the woman’s vein. Then he placed the bottle on the table next to the bed, well above the patient.
“Ol’ga Petrovna is severely dehydrated. This should help her for the time being.”
The admiral’s gaze remained focused on the kortik.
“Comrade Admiral, please understand that you called an ambulance. We would be happy to stabilize Ol’ga Petrovna and transport her. This is our job. But we are unable to stay here, because this woman needs to be in a hospital. We cannot give her the hospital care she needs. We need to make a decision.”
He sat down and looked at the admiral, whose face remained placid. Arkashka looked at his watch. Family members frequently threaten doctors. Making good on the threat is something completely different. If this man had any sanity left in him, he would not act on impulse. He would recognize the consequences. He would recognize that killing doctors was still punishable by law, almost certainly, even if they were Jews, even now. Arkashka decided to give the man enough time to decompress. If this didn’t work, nothing would.
Exactly fifteen minutes later, Arkashka looked at his watch again, got up, and, saying nothing, headed toward the door.
“By the honor of a Soviet officer,” said Admiral Abrikosov, rising from the armchair and, before Arkashka reached the door, inserted the kortik in the doctor’s back, then calmly returned to his mother’s bedside.
Arkashka walked into the kitchen, where Spartak was drinking tea served to him by the maid.
“There is a knife in my back,” he said.
* * *
Kogan was on service that night. His notes from that surgery are unusually detailed, even by his standards:
Preoperative Diagnosis: Right hemothorax due to penetrating trauma with exsanguination.
Postoperative Diagnosis: Same with intraoperative death.
Findings: Massive hemothorax with stab wound to the pulmonary hilum primarily affecting the right superior pulmonary vein adjacent and into the pericardium. The wound was inflicted with a ceremonial dagger, 19.5 cm. long. The dagger has an ivory handle bearing the inscription: “To Admiral Abrikosov for bravery and inventiveness in the defense of Leningrad, I. Stalin.”
The hilt of the dagger is cast in gold. On both sides, the hilt is marked with the words: “In Reward.”