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Cancer Ward
By Aleksandr Solzhenitsyn, Nicholas Bethell, David Burg Farrar, Straus and Giroux
Copyright © 1968 Alexander Solzhenitsyn
All rights reserved.
ISBN: 978-1-4668-3960-1
CHAPTER 1
No Cancer Whatsoever
On top of everything, the cancer wing was Number 13. Pavel Nikolayevich Rusanov had never been and could never be a superstitious person, but his heart sank when they wrote "Wing 13" on his admission card. They should have had the ingenuity to assign number 13 to some kind of prosthetic or intestinal department.
But this clinic was the only place where they could help him in the whole republic.
"It isn't, it isn't cancer, is it, Doctor? I haven't got cancer?" Pavel Nikolayevich asked hopefully, lightly touching the malevolent tumor on the right side of his neck. It seemed to grow almost daily, yet the tight skin on the outside was as white and inoffensive as ever.
"Good heavens, no. Of course not." Dr. Dontsova soothed him, for the tenth time, as she filled in the pages of his case history in her bold handwriting. Whenever she wrote, she put on her glasses with rectangular frames rounded at the edges, and she would whisk them off as soon as she had finished. She was no longer a young woman; her face looked pale and utterly tired.
It had happened at the outpatients' reception a few days ago. Patients assigned to a cancer department, even as outpatients, found they could not sleep the next night. And Dontsova had ordered Pavel Nikolayevich to bed immediately.
Unforeseen and unprepared for, the disease had come upon him, a happy man with few cares, like a gale in the space of two weeks. But Pavel Nikolayevich was tormented, no less than by the disease itself, by having to enter the clinic as an ordinary patient, just like anyone else. He could hardly remember when he had been in a public hospital last, it was so long ago. Telephone calls had been made, to Evgeny Semenovich, Shendyapin, and Ulmasbaev, and they rang other people to find out if there were not any VIP wards in the clinic, or whether some small room could not be converted, just for a short time, into a special ward. But the clinic was so cramped for space that nothing could be done.
The only success he had managed to achieve through the head doctor was to bypass the waiting room, the public bath and a change of clothing.
Yuri drove his mother and father in their little blue Moskvich right up to the steps of Ward 13.
In spite of the slight frost, two women in heavily laundered cotton dressing gowns were standing outside on the open stone porch. The cold made them shudder, but they stood their ground.
Beginning with these slovenly dressing gowns, Pavel Nikolayevich found everything in the place unpleasant: the path worn by countless pairs of feet on the cement floor of the porch; the dull doorknobs, all messed about by the patients' hands; the waiting room, paint peeling off its floor, its high olive-colored walls (olive seemed somehow such a dirty color), and its large slatted wooden benches with not enough room for all the patients. Many of them had come long distances and had to sit on the floor. There were Uzbeks in quilted, wadded coats, old Uzbek women in long white shawls and young women in lilac, red and green ones, and all wore high boots with rubbers. One Russian youth, thin as a rail but with a great bloated stomach, lay there in an unbuttoned coat which dangled to the floor, taking up a whole bench to himself. He screamed incessantly with pain. His screams deafened Pavel Nikolayevich and hurt him so much that it seemed the boy was screaming not with his own pain but with Rusanov's.
Pavel Nikolayevich went white around the mouth, stopped dead and whispered to his wife, "Kapa, I'll die here. I mustn't stay. Let's go back."
Kapitolina Matveyevna took him firmly by the arm and said, "Pashenka! Where could we go? And what would we do then?"
"Well, perhaps we might be able to arrange something in Moscow."
Kapitolina Matveyevna turned to her husband. Her broad head was made even broader by its frame of thick, clipped coppery curls.
"Pashenka! If we went to Moscow we might have to wait another two weeks. Or we might not get there at all. How can we wait? It is bigger every morning!"
His wife squeezed his hand in an effort to transmit her courage to him. In his civic and official duties Pavel Nikolayevich was unshakable, and therefore it was simpler and all the more agreeable for him to be able to rely on his wife in family matters. She made all important decisions quickly and correctly.
The boy on the bench was still tearing himself apart with his screams.
"Perhaps the doctors would come to our house? We'd pay them," Pavel Nikolayevich argued, unsure of himself.
"Pasik!" his wife chided him, suffering as much as her husband. "You know I'd be the first to agree. Send for someone and pay the fee. But we've been into this before: these doctors don't treat at home, and they won't take money. And there's their equipment, too. It's impossible."
Pavel Nikolayevich knew perfectly well it was impossible. He had only mentioned it because he felt he just had to say something.
According to the arrangement with the head doctor of the oncology clinic, the head nurse was supposed to wait for them at two o'clock in the afternoon, there at the foot of the stairs, which a patient on crutches was carefully descending. But the head nurse was nowhere to be seen, of course, and her little room under the stairs had a padlock on the door.
"They're all so unreliable!" fumed Kapitolina Matveyevna. "What do they get paid for?"
Just as she was, two silver-fox furs hugging her shoulders, she set off down the corridor past a notice which read: "No entry to persons in outdoor clothes."
Pavel Nikolayevich remained standing in the waiting room. Timidly he tilted his head slightly to the right and felt the tumor that jutted out between his collarbone and his jaw. He had the impression that in the half hour since he had last looked at it in the mirror as he wrapped it up in a muffler, in that one half hour it seemed to have grown even bigger. Pavel Nikolayevich felt weak and wanted to sit down. But the benches looked dirty, and besides, he would have to ask some peasant woman in a scarf with a greasy sack between her feet to move. Somehow the foul stench of that sack seemed to reach him even from a distance.
When will our people learn to travel with clean, tidy suitcases! (Still, now that he had this tumor it didn't matter any longer.)
Suffering miserably from the young man's cries and from everything that met his eyes and entered his nostrils, Rusanov stood, half leaning on a projection in the wall. A peasant came in carrying in front of him a half-liter jar with a label on it, almost full of yellow liquid. He made no attempt to conceal the jar but held it aloft triumphantly, as if it were a mug of beer he had spent some time lining up for. He stopped in front of Pavel Nikolayevich, almost handing him the jar, made as if to ask him something, but looked at his sealskin hat and turned away. He looked around and addressed himself to a patient on crutches: "Who do I give this to, brother?"
The legless man pointed to the door of the laboratory.
Pavel Nikolayevich felt quite sick.
Again the outer door opened and the matron came in, dressed only in a white coat. Her face was too long and she was not at all pretty. She spotted Pavel Nikolayevich immediately, guessed who he was and went up to him.
"I'm sorry," she said breathlessly. In her haste her cheeks had flushed the color of her lipstick. "Please forgive me. Have you been waiting long? They were bringing some medicine, I had to go sign for it."
Pavel Nikolayevich felt like making an acid reply, but he restrained himself. He was glad the wait was over. Yuri came forward, in just his suit, with no coat or hat, with the same clothes he had worn for driving, carrying the suitcase and a bag of provisions. A blond forelock was dancing about on his forehead. He was very calm.
"Come with me," said the matron, leading the way to her little storeroom-like office under the stairs. "Nizamutdin Bahramovich said you'd bring your own underwear and pajamas. They haven't been worn, have they?"
"Straight from the store."
"That's absolutely obligatory, otherwise they'd have to be disinfected, you understand? Here, you can change in there."
She opened the plywood door and put on the light. In the little office with its sloping ceiling there was no window, only a number of colored-pencil diagrams hanging from the walls.
Yuri brought in the suitcase silently, then left the room. Pavel Nikolayevich went in to get changed. The matron had meanwhile gone off somewhere, but Kapitolina Matveyevna caught up with her.
"Nurse!" she said. "I see you're in a hurry."
"Yes, I am rather."
"What's your name?"
"Mita."
"That's a strange name. You're not Russian, are you?"
"No. German...."
"You kept us waiting."
"Yes, I'm sorry. I had to sign for those ..."
"Now listen to me, Mita. I want you to know something. My husband is an important man who does extremely valuable work. His name is Pavel Nikolayevich."
"I see. Pavel Nikolayevich, I'll remember that."
"He's used to being well looked after, you see, and now he's seriously ill. Couldn't he have a nurse on duty with him permanently?"
Mita's troubled face grew even more worried. She shook her head. "Apart from the theater nurses, we have three day nurses to deal with sixty patients. And two night nurses."
"You see! A man could be screaming his head off and dying and no one would come!"
"Why do you think that? Everyone gets proper attention."
("Everyone" — what is there to say to her if she talks about "everyone"?)
"Do the nurses work in shifts?"
"That's right. They change every twelve hours."
"This impersonal treatment, it's terrible. My daughter and I would be delighted to take turns sitting up with him. Or I'd be ready to pay for a permanent nurse out of my own pocket. But they tell me that's not allowed either."
"I'm afraid not. It's never been done before. Anyway, there's nowhere in the ward to put a chair."
"God, I can imagine what this ward's like! I'd like to have a good look at it! How many beds are there?"
"Nine. Your husband's lucky to go right into a ward. Some new patients have to lie in the corridors or on the stairs!"
"I'm still going to ask you to arrange with a nurse or an orderly for Pavel Nikolayevich to have private attention. You know the people here; it would be easier for you to arrange it." She had already clicked open her big black bag and taken out three fifty-rouble notes.
Her son, who was standing nearby, turned his head away in silence.
Mita put both hands behind her back. "No, no! I have no right...."
"I'm not giving them to you!" Kapitolina Matveyevna held the fan of notes into the front of the matron's uniform. "But if it can't be done legally and above board. ... All I'm doing is paying for services rendered! I'm asking you to be kind enough to pass the money on to the right person!"
"No, no." The matron felt cold all over. "We don't do that sort of thing here."
The door creaked and Pavel Nikolayevich came out of the matron's den in his new green and brown pajamas and warm, fur-trimmed bedroom slippers. On his almost hairless head he wore a new raspberry-colored Uzbek skullcap. Now that he had removed his winter overcoat, collar and muffler, the tumor on the side of his neck, the size of a clenched fist, looked strikingly ominous. He could not even hold his head straight any longer, he had to tilt it slightly to one side.
His son went in to collect the discarded clothing and put it away in the suitcase. Kapitolina Matveyevna had returned the money to her purse. She looked anxiously at her husband.
"Won't you freeze like that? You should have brought a nice warm dressing gown with you. I'll bring one when I come. Look, here's a scarf." She took a scarf out of her pocket. "Wrap it round your throat, so you won't catch cold." In her silver foxes and her fur coat, she looked three times as strong as her husband. "Now go into the ward and get yourself settled. Unpack your food and think what else you need. I'll sit here and wait. Come down and tell me what you want and I'll bring everything this evening."
She never lost her head, she always knew what to do next. In their life together she had been her husband's true comrade. Pavel Nikolayevich looked at her with a mixture of gratitude and suffering and then glanced at his son.
"Well, are you off then, Yuri?"
"I'll take the evening train, Father." He came toward them. He always behaved respectfully in his father's presence. He was not by nature an emotional man, and his goodbye to his father now was as unemotional as ever. His reactions to life all ran at low voltage.
"That's right, son. Well, this is your first important official trip. Be sure to set the right tone from the start. And don't be too soft, mind. Your softness could be your downfall. Always remember you're not Yuri Rusanov, you're not a private individual. You're a representative of the law, do you understand?"
Whether or not Yuri understood, it would have been hard at that moment for Pavel Nikolayevich to find more appropriate words. Mita was fussing about and anxious to be going.
"I'll wait here with Mother," said Yuri, with a smile. "Don't say goodbye, Dad, just go."
"Will you be all right on your own?" Mita asked.
"Can't you see the man can hardly stand up? Can't you at least take him to his bed, and carry his bag for him?"
Orphan-like, Pavel Nikolayevich looked back at his family, refused the supporting arm Mita offered and, grasping the banister firmly, started to walk upstairs. His heart was beating violently, not at all, so far, because of the climb. He went up the stairs as people mount — what do they call it? — a sort of platform where men have their heads cut off.
The matron ran on upstairs in front of him carrying his bag, shouted something from the top to someone called Maria, and before Pavel Nikolayevich had finished the first flight was already running past him down the other side of the staircase and out of the building, thereby showing Kapitolina Matveyevna what sort of solicitude her husband could expect in this place.
Pavel Nikolayevich slowly climbed up onto the landing — a long, wide one such as is only found in old buildings. On this middle landing, but not obstructing the traffic, were two beds occupied by patients, with two night tables beside them. One of the patients was in a bad way; he was physically wasted and sucking an oxygen balloon.
Trying not to look at the man's hopeless face, Rusanov turned and went on, looking upward as he climbed. But there was no encouragement for him at the end of the second flight either. A nurse — Maria — was standing there, her dark, icon-like face lit by neither smile nor greeting. Tall, thin and flat-chested, she waited for him there like a sentry, and immediately set off across the upstairs hallway to show him where to go. Leading off the hall were several doors, just left clear by more beds with patients in them. In a little windowless alcove, underneath a constantly lit table lamp, stood the nurse's writing table and treatment table, and nearby hung a frosted glass wall closet with a red cross painted on it. They went past the little tables, past a bed too, and then Maria pointed her long, thin hand and said, "Second from the window."
And already she was rushing off. An unpleasant feature of all public hospitals is that nobody stops for a moment to exchange a few words.
The doors into the ward were always kept wide open, but still as he crossed the threshold Pavel Nikolayevich was conscious of a close, moist, partly medicinal odor. For someone as sensitive to smells as he, it was sheer torment.
The beds stood in serried ranks, with their heads to the wall and narrow spaces between them no wider than a bedside table, while the passageway down the middle of the ward was just wide enough for two people to pass.
In this passageway stood a thickset, broad-shouldered patient in pink-striped pajamas. His neck was completely wrapped in thick, tight bandages which reached almost to the lobes of his ears. The white constricting ring prevented free movement of his heavy block of a head, overgrown with a fox-brown thatch.
He was talking hoarsely to his fellow patients, and they were listening from their beds. On Rusanov's entry he swung his whole body toward him, the head welded to it. He looked at him without sympathy and said, "Well, what have we here? Another nice little cancer!"
Pavel Nikolayevich saw no need to reply to such familiarity. He sensed that the whole room was staring at him, but he had no wish to examine these people whom chance had thrown in his path or even to exchange greetings with them. He merely waved his hand at the fox- haired patient to make him get out of his way. The other allowed Pavel Nikolayevich to pass, and again turned his whole body, head riveted on top, to look after him.
"Hey, friend, what have you got cancer of?" he asked in his throaty voice.
Pavel Nikolayevich had already reached his bed. He felt as if the question had scraped his skin. He raised his eyes toward the impudent lout and tried not to lose his temper. All the same his shoulders twitched as he said with dignity, "I have cancer of nothing. I have no cancer whatsoever."
(Continues...)
Excerpted from Cancer Ward by Aleksandr Solzhenitsyn, Nicholas Bethell, David Burg. Copyright © 1968 Alexander Solzhenitsyn. Excerpted by permission of Farrar, Straus and Giroux.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
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