A Constellation of Vital Phenomena (8 page)

Distal phalange, proximal phalange, metatarsus, medial cuneiform, navicular, talus, calcaneus
. Akhmed recited the bones composing the big toe and followed the Latin north to the ankle as he walked to the hospital. Before leaving that morning he had torn a half dozen diagrams from his old anatomy textbook and he studied them as he hiked, glancing up every few seconds to check for land mines. He’d be ready for any more of Sonja’s quizzes. The sun had fully risen when he entered the hospital and the guard, whose left arm ended at the elbow, stopped him.

“Here?” he asked, exasperated. “I’ve walked nearly to Turkey avoiding checkpoints.”

The cuff of the guard’s left jacket sleeve was sewn to his shoulder. The slender beard descending from his chin looked like the tail of a squirrel hibernating in his mouth. “You need to pull the glass shards from your boots,” the guard instructed.

“Don’t worry,” Akhmed said. “I’m the doctor.”

“No, Sonja is the doctor,” the one-armed guard corrected. “You are the idiot with glass shards in his boot soles. Now have a seat on that
bench and take those pliers and pull out the glass if you want to enter the hospital.”

No one could walk through the city without lodging a full pane of glass shards in his shoe soles, and the guard, who had for eighteen arduous months fought with the rebels and had witnessed and participated in all manner of horrors, was afraid of Sonja and what she would do if she found glass shards tracked into the hospital. He watched Akhmed pry out fourteen shards and deposit them in an ashtray.

Akhmed sighed, crestfallen. His first day as a hospital doctor wasn’t beginning well. “Tell me,” he asked, nodding to the guard’s missing arm. “Do they pay you half rate?”

The guard, thirty-one years old, had never received a paycheck, and wouldn’t have known what to do with one if he had; in three years, when the hospital issued paychecks again, beginning with a whopping nine years of back pay, the guard would frame his in glass and hang it on his wall without ever depositing it. For the rest of his life, he wouldn’t trust the numbers people put on paper. “They should pay me more than they pay you,” the guard said, smiling. “Even I know better than to give an unresponsive patient a questionnaire.”

Akhmed’s flush hadn’t faded when he pushed open the double doors. The cannonball of Havaa’s head crashed into his stomach.

“You came back!” she exclaimed, breathless from her sprint across the room. He raked his fingers through her almond-brown hair, a shade shared by the back of his hand. He had been so concerned with Latin nomenclature he’d forgotten about her, and as her arms formed a tourniquet around his waist, the tight press slowed his breaths. She hadn’t forgotten him for a moment.

“Of course I came back. Where else would I go?”

“Has he—” she began, and he squeezed her shoulder as consolingly as he was able.

“We’ll both be here a little longer, okay?”

“I guess,” she said. She loosened her embrace and stepped back as the enthusiasm of the prior moment drained from her face. Her blue suitcase stood by the folding chair where she had been sitting.

“Planning on going somewhere?”

“In case we were going home,” she said. Again Akhmed squeezed her shoulder, but the gesture was small and futile, and reasserted the helplessness she seemed to foist upon him.

“How was your night?” he asked, hoping to cheer her up. “Did Sonja turn into a bat after the sun went down?”

She shook her head.

“Are you sure?”

“Yes,” Havaa said, dropping her voice to a whisper. “She just became boring. She wouldn’t stop talking about her ice machine. And she called me a solipsist.”

Akhmed followed her across the waiting room to the perimeter of paint-chipped folding chairs and sat down beside her. She lifted the blue suitcase to her lap and wrapped her arms around it. “Do you want me to carry that back to your room?” he offered. She gave a slow, dejected shake of her head, raised the suitcase on its side, and hugged it. “You know what you should do,” he said, turning to her. “You should teach the guard downstairs to juggle.”

“But he only has one arm.”

“But he really wants to learn. He’s embarrassed by his arm so he’ll refuse at first. But you need to be persistent.”

“I can be persistent,” she said.

“Yeah?”

“My father says persistence is a polite way of being annoying.”

“You’re good at that, aren’t you?”

With a slight smile, she acknowledged her considerable expertise. But the smile he had worked for wilted when the trauma doors swung open and Sonja walked in. Each step produced a rattle from her bleached-white scrubs. Pink veins cobwebbed her eyes. “You’re late,”
Sonja snapped, completely oblivious to the important work happening there, on the waiting-room chairs, between them.

He raised his eyebrows to Havaa and then followed Sonja into a corridor cloaked in curtains of pungent ammonia. She turned into the staff canteen, where, in the corner, the notorious ice machine brooded. Sheets and towels draped from clotheslines and silver instruments shifted in pots of boiling water. Duct tape covered the windowpanes and the overhead emergency lights cast a dull blue glow across the walls. Even in war conditions he had expected Hospital No. 6 to be more glamorous than this.

“Was everything all right with Havaa last night?” he asked.

Sonja didn’t turn to him. “Let’s say she’s an inexperienced house-guest,” she said, and felt the hanging sheets for moisture. She handed him scrub tops from the farthest clothesline. Still damp.

“What about the ones I wore yesterday?” he asked. “I left them in a cupboard down the corridor.”

“No, they need to be clean. And just as important, they need to be white.”

“Why white?”

She leaned against the wall and slid her hands into the cavernous pockets of her scrub bottoms. He concentrated on her face as if preparing to draw her portrait—the angles, ratios and proportions of her features—all so he wouldn’t have to meet her eyes.

“Our appearance is as important as anything we do. Our patients need to believe we operate no differently from a hospital in Omsk,” she said, and, elbow deep, pulled a cigarette from her pocket.

“So the perception of professionalism is more important than being professional?” It was an idea he could stand behind.

She raised her chin and blew a line of smoke at the ceiling. “We’re three people running a hospital that requires a staff of five hundred. We need to appear to be consummate professionals because it’s the only way we’ll fool anyone into thinking we are.”

“So, right now, because you’re smoking a cigarette and I’m not, I’m the more professional of us two?”

Her laughter rang more pleasantly now that it wasn’t at his expense, and he watched with satisfaction as she dipped the ember into a puddle collecting beneath the clothesline, and flicked the butt into the waste-basket. “You’re walking two steps ahead of your shadow.”

“About that, I was thinking that since this is my first day, it might be better if I didn’t begin working one-on-one with patients immediately.”

“That might be the best idea you’ve ever had,” she said, and handed him the rest of the scrubs. When he began to undress, she took her time looking away.

Patients funneled into the trauma ward—a young man with a deep tubercular cough, an elderly woman whose hair had caught on fire, two teenagers who had beaten away half their faces as they negotiated the ownership of a supposedly lucky rooster’s claw—and Akhmed, thankful, attended to none of them. It might feel good to be back between the earpieces of a stethoscope, but it felt much better to be in the canteen, where no calamity greater than a cross word from Deshi befell him. He spent the morning following her, nodding politely as she denounced the Russians for various earthly ills, and a few—volcanoes, winter, her arthritic hips—that fell within God’s jurisdiction.

“If we could, we’d blame constipation on the Russians,” he said.

“I already do. Roughage is so rare.” She picked a pair of brown trousers from the pile on the floor and emptied its pockets on the counter. A scatter of folded paper, loose change, keys, plastic cards, and lint fell out. She slid all but the identity card and loose change into the trash.

“Anything good in this one?” he asked. It was the fourteenth pair of trousers Deshi had laid on the counter that morning, the fourteenth she had searched for money, cigarettes, whatever else the dead man hadn’t thought to use before he went on his way. “Maybe a plane ticket?”

“A plane ticket.” She waved her hand to dismiss the very breath that carried so stupid a question. “Where would he go, anyway?”

“I don’t know. Grozny.”

“Grozny?” She gaped at him. Every Saturday from 1976 through 1978 Deshi had met the seventh of her twelve great loves, an oil geologist, in the suite of the Grozny Intourist Hotel, until the Saturday night she walked in to find him occupied with another nurse; she would never forgive the city for harboring that man. “Is he serious?”

“I’ve never been to Grozny,” Akhmed said.

“If he could go anywhere, he’d choose Grozny?”

“I’ve never been there before,” he said softly. In the decade and a half since he’d left medical school, he’d forgotten just how wide the world stretched beyond his village, just how provincial and unremarkable his little life was when compared with nearly anything. Deshi, who, judging from her tone of disapproval, would be impressed with nothing short of a circumnavigation of the globe, was quick to remind him.

“Unbelievable,” she sighed, and turned her back to him. She glanced at the identity card to see if the trousers belonged to an acquaintance, then tossed it into a shoebox filled with several dozen others. It was a simple gesture, no more than a flick of her fingers, performed without malice or contempt, but with complete disinterest, and it cut through Akhmed like a fin through water. In her indifference he saw the truth of a world he didn’t want to believe in, one in which a human being could be discarded as easily as pocket lint. But Deshi was no longer paying attention to him. “Grozny,” she muttered. “Small-minded and an idiot doctor. He’d probably prescribe
kalina
berries for pneumonia. And that gargoyle squatting where his nose should be. Long enough to keep the tips of his toes dry in a rain shower.”

She turned the trouser legs inside out and spread them on the counter; a pouch protruded from the inseam, just below the knee, where it was sewn in with black thread. She ran a razor blade across the stitching, and removed a few crumpled bills and a folded sheet of notepaper. Akhmed’s stomach clenched as she reached toward the trash can with the note. “Wait,” he said. He knew what was written on it, knew the
time had passed to provide for any final request, but asked anyway. “What does the note say?”

Deshi frowned. “ ‘
90 October the 25th Road, Shali
,’ ” she read. “ 
‘Return me for burial.’
Too late, my friend. You should have stitched your note to the outside of your trousers.”

“Where is the body?”

“Already in the clouds. It’s sacrilege, I know, but they burn nearly every body that isn’t claimed. Can’t come by a body bag these days. The Feds requisition them to make field
banyas
while on patrol. The strangest thing I’ve ever seen, three hundred soldiers, naked as the day they were born, huddled within black plastic bags that trapped the steam of cold water poured over stone fires. Only a Russian could find pleasure inside a body bag.”

As she refolded the note and dropped it into the trash can, he wanted to reach out, to snatch the tumbling rectangle before it landed and was lost among the last words of two dozen others who died far from their villages, who were pitched by strangers into furnaces, who were buried in cloud cover and wouldn’t return home until the next snowfall. Akhmed’s own address was written on a slip of folded paper and stitched into his left trouser leg, where with every step it chafed against his leg, awaiting the decent soul that would one day carry him, should he die away from home.

“What’s his name?” he asked. That man had a sister in Shali who would have given her travel agency—now no more than a once prestigious name—her parents-in-law, and nine-tenths of her immortal soul to hold that note now lying at the bottom of the trash can, if only to hold the final wish of the brother she regretted giving so little for in life.

In the shoebox the identity cards were layered eight deep. She held a card to the light and set it back down. “He’s one of these,” she said.

While Sonja spent her afternoon in surgery, Akhmed spent his in the canteen, folding bedsheets into rectangles that soon filled the wicker laundry baskets. At first he had protested, complaining it was the duty of a maid, until Sonja reminded him that those were the only duties he was qualified to perform. While folding he imagined his wife lying on a grayer bedsheet, her head propped on her favorite of their two pillows, the thick foam one that cramped his neck on those nights when they fell asleep sharing it. If she had the energy, she might lift one of his art books from the stack beside the bed. Those hard clothbound covers held worlds of marble statues, woodblock prints, lily pads, bouquets, long-dead generals, and placid landscapes where aristocrats in funny hats pranced around. At night he narrated the scenes to her as if he knew what he was talking about, inventing biographies for every portrait, intrigues for each glance within a frame. Since he had first started skipping first-year pathology to audit still-life drawing classes, he had maintained an abiding interest in art, and for a man who had never been to Grozny, he had amassed a respectable collection of art books. Each morning he reordered the stack so that the first book she reached for was new to her.