A Constellation of Vital Phenomena

CHAPTER



4





A SHADOW APPEARED against the white horizon, filling the sleeves of a familiar navy overcoat. Two mornings earlier, Akhmed would have waved and walked to greet his friend. He would have walked until the shade dissolved from Khassan’s face and then walked farther, to raise his voice, without fear or hesitation, had this been two mornings earlier. But these were afterthoughts as he ran into the forest and hid behind a gray trunk only half his width. He crouched at the base of the trunk and gulped the dawn air and hoped Khassan, a sharpshooter in the Great Patriotic War, hadn’t seen him flee. He cradled his jaw in his palms. Was this how he would live now? Fleeing into the forest at the slightest rustle?

Three taps sounded on the birch trunk. “Is anyone home?” the old man asked. Akhmed stood and turned ruefully. His footprints led right to the tree trunk. From the wrong ends of binoculars, Khassan could have tracked him here.

“It’s cold to be out so early,” Akhmed said. He couldn’t raise his gaze above Khassan’s shoulders as they walked back to the service road. The old man’s frame still filled his overcoat and he held a two-kilogram weight in each hand. At the age of seventy-nine—a full twenty years past the life expectancy of the average Russian man, as he often pointed out—Khassan maintained the exercise regimen he had begun in the army a half century earlier. Fifty squats, sit-ups and push-ups, plus a five-kilometer run that had slowed to a saunter over the decades.

“My balls have frozen in Poland and in Nazi Germany and in Kazakhstan. They have frozen in nine different time zones. But now?” He sighed and gazed sorrowfully at his crotch. “Now I’m too old to need them, so why should I care if they freeze?”

As a child and an adult, Akhmed had been captivated by stories of Khassan’s sixteen-year odyssey. To a man who had never even been to Grozny, Khassan’s travels rose to the realm of legend. In 1941, the Red Army gave him five bullets and an order to find a gun among the dead. With a rifle pried from frozen fingers in Stalingrad, he shot a path through Ukraine, Poland, and Germany. He pulled two bullets from his left thigh, lost three friends to hypothermia, killed twenty-seven Nazis by bullet, four by knife, three by hand, fought under five generals, liberated two concentration camps, heard the voices of innumerable angels in the ringing of an exploded mortar, and took a shit in one Reichstag commode, a moment that would forever commemorate the war’s victorious conclusion. After his years of service he returned to a Chechnya without Chechens. While he had fought and killed and shat for the U.S.S.R., the entire Chechen population had been deported to Kazakhstan and Siberia under Stalin’s accusations of ethnic collaboration with the fascist enemy. His commanding officer, a man whose life Khassan had twice saved, was to spend the next thirty-eight years working as a train porter in Liski, where the sight of train rails skewering the sun to the horizon served as a daily reminder of the disgraceful morning he shipped Khassan, the single greatest soldier he’d ever had the pleasure of spitting orders at, to Kazakhstan on a train packed with Russian physicians, German POWs, Polish Home Army soldiers, and Jews. Khassan’s parents hadn’t survived the resettlement, and in 1956, when—after the death of Stalin three years earlier—Khrushchev allowed Chechen repatriation, Khassan disinterred their remains and carried them home in their brown suitcase.

“From what you told me,” Akhmed said, “they weren’t cold from disuse.”

Khassan smiled. “Thank goodness the borders are closed. Who knows how many frauleins might otherwise track me down for dowries?”

Violet light veined the clouds. Akhmed searched for something to say, a sentence flung to pull them from the sinkhole of Dokka’s disappearance. “How’s the book?”

Khassan winced. Not the right sentence. “I’m giving up on that,” he said.

“It’s not writing itself?”

“History writes itself. It doesn’t need my assistance.”

“But it’s your life’s work.”

“Your life’s work could be scrubbing piss from a toilet bowl. Work isn’t meaningful just because you spend your life doing it.”

For four decades Khassan had drafted and redrafted his six-volume, thirty-three-hundred-page historical survey of the Chechen lands. Akhmed was a child when he had first seen the pages. After cancer had put his mother in the ground, he and his father had received weekly invitations to dine with Khassan in the three-room house built by Khassan’s father in a time when men were expected to grow their own corn, raise their own sheep, and build their own homes. A partial draft, kept in eight boxes beneath Khassan’s desk, was written in the careful cursive of a condolence letter. Akhmed found it one afternoon while his father and Khassan sat outside, gossiping like married ladies beneath a June sun. Each afternoon, while Khassan taught at the city university, Akhmed snuck into the living room and stole a single page. He read it at night, after completing his homework, and exchanged it the next afternoon for the following page. Khassan had begun his history in the time before humanity, when the flora and fauna of Chechnya had existed in classless egalitarianism. In a twenty-page account of Caucasian geology, Khassan proved that rock and soil adhered to the same patterns of dialectical materialism proffered by Marx. A seven-page explanation of natural selection compared kulaks to a species that failed to adapt to environmental changes. Akhmed read seventy-three pages in total, only reaching the Neolithic period before Khassan realized pages had gone missing: the three Akhmed had lost, the two he had turned into paper airplanes, and the one, a description of Eldár Forest before man invented chainsaws, that had been too beautiful for him to return. Believing the culprit to be a secret police informant, Khassan had burned the pages in his wood stove.

“But you need to finish it,” Akhmed urged, unsure if Khassan was serious. The Khassan obsessed with a history book that, even if published, no one would read was the only Khassan he knew. Khassan could renounce his legs and sound no more ridiculous.

“You’re right,” Khassan said. His parted lips revealed a row of teeth the color of cooking oil. That city dentist had been so in love with the teeth of his young women patients, he couldn’t look inside the mouth of an old man for more than a few moments without feeling a wash of revulsion and betrayal; he had never told Khassan to floss. “And I’m sorry, Akhmed. For Dokka.”

“Was he taken to the Landfill?”

Khassan’s shoulders sloped in a shrug. They both knew the answer but that didn’t make it any easier to admit. “I don’t know. I don’t know anything.”

“Can you ask Ramzan …” Ask him what? Ramzan had no answers; the blindness he walked through was a shade darker than theirs. “Can you ask him to let the girl be? She’s gone.”

“Ramzan hasn’t heard my voice in the one year, eleven months and three days since he began informing. I’ve counted every day of silence. It’s stupid, I know, but silence is the only authority I have left.”

Each looked past the other, into the woods stretching on either side of the road, uncomfortable and ashamed. “I’m a pariah. The father of an informer,” Khassan continued. “You and my son are the only people in the village willing to speak to me, and I can’t speak to him. In one year, eleven months and three days the only conversations I’ve had have been with you. You still speak to me. Why?”

Akhmed focused on the trees. He didn’t know. He didn’t know that when Khassan returned home that morning he would write down what he remembered of their conversation in a shorthand his son couldn’t decipher, or that later Khassan would read it quietly, without speaking a single word aloud, and even on the page their exchange would lift that blanketing silence like tent poles. What he did know was that Khassan was his friend, a decent man, and that was as rare as snowfall in May.

“You ran away from me just now,” Khassan said, before Akhmed could answer. “I understand. My son is weak and cruel. That’s fine. You know, I’ve been thinking of the Festival of the Sacrifice recently. In the resettlement camps we celebrated in secret, slaughtering a wild dog in place of a lamb. I wonder if Ibrahim’s palms were damp as he walked his son to the summit. Did he tell him they were going on a hike? Did he take water? I think he must have glared at the knife until his reflection was part of the blade. I think relief must have replaced his horror when he unsheathed his knife and recognized his face. He must have known that what he was to do was of such significance it had already become who he was, and so he offered both his son and himself to the kinzhal’s edge.”

Hunched over, Khassan pressed his bare hands into the snow. He sank them to his forearms and left them there in what a stranger might take to be a demonstration of endurance, but what was, Akhmed knew, a private ritual of contrition. His face was broken in a way Akhmed couldn’t look at, let alone understand, let alone mend. “Walk on both sides of the service road so my footprints can’t be followed,” Akhmed said. “I’ll be gone all day. Make sure no one knows where I’m going. Do that.”

Khassan’s head bobbed. He scooped two palmfuls of snow and pressed them to his eyes. Melting rivulets circled his wrists. “Ibrahim’s willingness to sacrifice his son isn’t hard to believe. His son was an innocent. It’s so much harder when you know what your son would do to you if he survived. When you know just what would happen if an angel was to grab the knife from your hand.”


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.

He folded the sheet and set it beside the others. How long since he’d last changed Ula’s sheets? Ten days, at least. She rarely rolled from her side of the bed, and when he carried her to the living room divan and stripped the linens from the mattress, he found her tawny silhouette sweated into the fabric. That musky darkening was so particularly, irrevocably Ula that he would hesitate to wash it. But then, scolding himself for being sentimental, he would fill the basin with soapy water and submerge her outline and watch her disappear. He was losing her incrementally. It might be a few stray brown hairs listless on the pillow, or the crescents of bitten fingernails tossed behind the headboard, or a dark shape dissolving in soap. As a web is no more than holes woven together, they were bonded by what was no longer there. The dishes no longer prepared or eaten, no more than the four- and five-ingredient recipe cards stacked above the stove. The walks no longer walked, the summer woods, the undergrowth unparted by their shins. The arguments no longer argued; no stakes, nothing either wanted or could lose. The love no longer made, desired, imagined, or mourned. The illness had restored to Ula an innocence he was unwilling to pollute, and the warmth of her flesh cocooning his was a shard of their life dislodged from both their memories.

It had begun in late spring 2002, a year after the zachistka that claimed the lives of forty-one villagers, on the morning she slept through breakfast. “I feel sick,” she mumbled, and he carried her tea to the nightstand. Had he known the cup was the first of hundreds he would take to her bedside, he would have made a more bitter brew. He took her temperature, pulse, and blood pressure: all normal. Her eyes were clear, her skin colored. When asked she couldn’t provide a coherent description of her pain. It was like a loose marble tumbling around her insides, migrating from her ankle to her knee to her hip, and back down. Some days her toes contained all her hurt. Or her fingers. Or elbows. Or kidneys. Eventually it settled somewhere between her chest and stomach, only leaking into her legs on Mondays. Pain is symptomatic rather than causal, even he knew that, and the only reasonable conclusion was that the sickness was seated in her mind. But while he didn’t believe she was physically sick, he couldn’t deny the reality of her suffering. A year earlier the zachistka had leveled a third of the village. Angels descended. Prophets spoke. Truth was only one among many hallucinations.

For the first few weeks he had resisted taking her to Hospital No. 6. He may have graduated in the bottom tenth of his class, but he was still a licensed doctor, and a decent one, even if he didn’t always know what he was doing. What would people say if they knew he couldn’t diagnose his own wife? Already his patients rarely paid their bills; if news of his ineptitude spread, they would starve. But a month passed without decline or recovery and this static state, this purgatorial non-progression, finally convinced him that his wife’s illness exceeded his abilities. He tried to take her to the hospital. Three times they ventured to Volchansk in Ramzan’s red pickup, but army cordons blocked all roads into the city. He dreamed up and in his notebook drew ways of conveying her: a sedan chair, a tunnel, a kite large enough to lift her bed. After the fourth attempt, when an unspooled shell casing popped Ramzan’s tire ten meters past the house, he gave up. What would the hospital doctors say anyway? With so many real injuries to tend to, they would dismiss Ula and her phantom sickness. The thought of her forced to defend her pain made his fingers curl into fists.

For eight and a half months he cared for her with paternal devotion. But each morning as he set the teacup on the nightstand, he wondered if physical deprivation might revive her ailing mind, and so, ten days before Dokka lost his fingers, Akhmed left her teacup in the kitchen. As the day wore on she called his name in cries more confused and desperate with each iteration, until his name was no longer his but a word of absolute anguish. Unable to stand the call of his name, he stayed with Dokka’s wife and daughter for three nights. On the fourth morning he returned and found her on the bedroom floor. The beginnings of bedsores reddened her shoulder blades. In that moment he came to understand that he would spend the rest of his life atoning for the past three days, and that the rest of his life wouldn’t be long enough. He lifted her from the floor and set her beneath the sheets. He took her a glass of water from the kitchen, then five more. “You never have to get up again,” he promised her. He laid his head on her chest and her heart pattered against his temple. “Akhmed,” she said. “Akhmed.” His name was now a lullaby.

He never again tried to coerce Ula into health. It would end. Everything did. But when he emptied the bedpan in the backyard, or brushed her teeth despite her protestations, the afterglow of resentment still smoldered. She was gone but still there, the phantom of the wife the war had amputated from him, and unable to properly mourn or love her, he cared for and begrudged her. And so the previous day, when he had offered to work at the hospital until other accommodations could be found for Havaa, he had hoped Sonja would agree for his sake as much as the girl’s. That morning, when he left Ula alone with four glasses of water and a bowl of lukewarm rice on the nightstand, he double-locked the door and entered the dawn chill with the confidence that Havaa’s future meant more than his wife’s, and he trudged eleven kilometers through a broken obligation that only a child’s life could justify.

When he folded the last sheet he ducked beneath the clotheslines and opened the cupboard. His trousers lay folded on the bottom shelf. Along the left leg inseam he found a familiar bulge in the stitching. If he were to die away from home, he hoped a kinder soul than Deshi would find him.


“Tomorrow we’ll go to Grozny,” Sonja announced as she strode through the canteen doorway, stopping at the counter to inspect the scalpels he’d boiled.

“Did Deshi tell you that?” he asked, unable to mask the panic building behind his eyes. “I was only kidding. Of course I’d use the plane ticket to go somewhere else. Tbilisi, even Istanbul.”

“You boiled these for ten minutes?”

“You’re joking, right?”

She gestured toward him with the scalpel blade, a little too casually for Akhmed’s comfort. “About ten minutes in boiling water? I’ve never been more serious.”

“No, about Grozny.”

“Did you or did you not boil these for ten minutes?”

“Yes, but are we going to Grozny?”

She frowned, seeming to think he was the one talking in circles. “You don’t get to ask any more questions,” she said. “A question mark in your mouth is a dangerous weapon.”

“So are we?”

She gave a defeated sigh. “Yes.”

“Why?”

She pulled a cigarette lighter from her pocket. “Do you smoke?”

“I am an excellent cigarette smoker.” It had been seven weeks since his most recent cigarette, and two months more since the one before that, and technically those had been papirosi, capped with a filterless cardboard tube and jammed with coarse tobacco that left him violently nauseous for the rest of the day.

Perhaps inspired by his earlier display of professionalism, she waited until they reached the parking lot before lighting up. She passed him the square pack. He knew the Latin alphabet, but hadn’t used it in years. “Duh …”

“Dunhill,” she said.

He selected one from the two erect rows and leaned it into Sonja’s lighter. The first drag slid into his lungs without the paint-scraper harshness of his two most recent cigarettes, and he stared at the slowly burning ember, admiring the quality of the tobacco and the quality of the flame, pleasantly surprised that he didn’t feel ill. “Where did you get these?” he asked.

“Grozny.”

“We’re going there to get cigarettes?”

She smiled. “I can’t believe you’d really use that plane ticket to go there.”

“I’ve never been.”

“It’s something else.”

“So why are we going?”

Farther down the street the side of a building had crushed all the cars in a parking lot. He was thirty-nine years old and had hoped to own a car by this age.

“I go once a month to pick up supplies,” Sonja said. “Not just cigarettes. About everything in the hospital comes through a man I know in Grozny with connections to the outside. I also call a friend of mine who lives in London and updates me on what’s been going on in the world.”

“What’s happening out there?” he asked. By now the wider world was no more than a rumor, a mirage beginning at the borders. Thirty-two years earlier, in the rancid air of his primary school—built on a block bookended by a sewage treatment facility and a lumberjack brothel—his geography teacher had expected him to believe that the world was the same shape as a soccer ball. He had been the first of his classmates to accept it, not because he knew anything about gravity, but because the air was more nauseating than usual that afternoon, and he wanted to leave. For the rest of her career that geography teacher would pride herself on being the first to recognize Akhmed’s aptitude for the sciences.

“Last month he told me that George Bush had been reelected,” Sonja said.

“Who’s that?”

“The American president,” Sonja said, looking away.

“I thought Ronald McDonald was president.”

“You can’t be serious.” There it was again, condescension thick enough to spread with a butter knife. His mother was the only other woman to have spoken to him like that, and only when he was a child—and only when he wouldn’t eat his cucumbers.

“Wasn’t it Ronald McDonald who told Gorbachev to tear down the wall?”

“You’re thinking of Ronald Reagan.”

“English names all sound the same.”

“That was fifteen years ago.”

“So? Brezhnev was General Secretary for eighteen.”

“It doesn’t work like that over there,” she explained. “They have elections every few years. If the president doesn’t win, someone else becomes president.”

“That’s ridiculous.” The wind lifted the ash from his cigarette and scattered it across the empty parking lot.

“And you can only be president for ten years,” she added.

“And then what? You become prime minister for a bit and then run for president again?”

“I think you just step down.”

“You mean Ronald just stepped down after ten years?” he asked. She had to be putting him on.

“He just stepped down and George Bush became president.”

“And then George Bush shot Ronald Reagan to prevent him seizing power?”

“No,” she said. “I think they were friends.”

“Friends?” he asked. “It makes me wonder how we lost the Cold War.”

“Good point.”

“And so George Bush has been president since Ronald Reagan?”

“There was another guy in there. Clinton.”

“The philanderer. I remember him,” he said, pleased. “And then George Bush became president again?”

“No, the George Bush who is president now is the first George Bush’s son.”

“Ah, so that’s why they don’t shoot the previous president. They’re all related. Like the Romanovs.”

“Something like that,” she said distractedly.

“Then who is Ronald McDonald?”

“You know, Akhmed,” she said, looking to him for the first time in several minutes. “I’m beginning to like you.”

“I’m not an idiot.”

“You used the word, not me.”

A blast rippled from the east, a long wave breaking across the sky.

“A land mine,” she said, as if it were no more than a cough. “We should get going.”

He dropped his cigarette without finishing it, the first time he’d done so in six years, and was careful to avoid the glass shards as he followed her back to the entranceway.

“Sew the pockets of your trousers before you come in tomorrow,” she advised. “We’ll pass a dozen checkpoints to reach Grozny and with that beard you look like a fundamentalist. I don’t want the soldiers to plant anything on you.”

Akhmed looked to the clouds before following her into the corridor. It wouldn’t matter even if he had found a plane ticket. Ten and a half years had passed since he had last seen commercial aircraft in the sky.


The man dragged into the waiting room wasn’t the first land-mine victim Akhmed had ever seen, not the first he’d seen accompanied by an incomprehensible woman, not even the first he’d seen dragged on a tarpaulin along a slick scarlet trail; he wasn’t the first man Akhmed had seen writhing like a lone noodle in a pot of boiling water, not the first he’d seen with half his shin hanging by a hinge of sinew. But when Akhmed saw this man it was like seeing the first man for the first time: he couldn’t think, couldn’t act, could only stand in shock as the air where the man’s leg should have been filled the floor and the room and his open mouth. The woman tugging at the corner of the tarpaulin spoke a language of shouts and gasps and looked at him as if he could possibly understand her. What a volume her chest produced. The true color of her dress was indistinguishable for the blood. When he finally remembered how to use his feet, he walked right past the woman and the writhing man, to the corner chair, where he draped a white lab coat over Havaa’s head.

Then the man’s pulse was a haphazard exertion against his finger. The woman was asking one question after the next. Her dress was showing the curves of her legs. Her breath was on his left cheek. An artery was severed. His face was pale yellow. Sonja was there. She was strapping a rubber tourniquet below the knee. She was rolling him on a gurney and into the hall. The gurney was turning into the operating theater and Deshi was taking the man’s blood pressure. “Sixty over forty,” she was calling out. The blood pressure meter was velcroed to the young man’s arm. The bulb was swinging above the gurney wheel. The wound was wet with saline.

With swift, well-rehearsed movements, Sonja inserted IVs of glucose and Polyglukin into the man’s arms. She pulled a surgical saw from the cabinet and disinfected the blade as Deshi called out blood-pressure readings. At seventy over fifty, she injected Lidocaine just above the tourniquet. Deshi anticipated her requests, and the clamps he’d boiled were in her reach before she asked. She worked without looking at the man’s face or hearing his cries as though her patient were no more than his most grievous wound. Blood reached her elbows but her scrubs remained white. The man, and he was a man, it was so easy to forget that with all his insides leaking out, had graduated from architecture school and had been searching for employment when the first bombs fell. When the land mine took his leg, he had already spent nine years searching for his first architectural commission. Another six and three-quarter years would pass before he got that first commission, at the age of thirty-eight. With only twenty percent of the city still standing, he would never be without work again.

“Come here,” Sonja called. Akhmed looked over his shoulder to summon a more capable ghost from the Brezhnev-beige wall. “Akhmed, come here,” she repeated. He stepped forward, wiggling his toes in his boots. One step and then the next, with an immense gratitude for each. The skin was peeled back toward the knee. The calf muscle, cut away. The bone wasn’t wider than a chair leg.

She gestured with her scalpel. “For a below-the-knee amputation, you want to keep in mind that stumps close to the knee joint will be difficult to fit for a prosthesis. Long stumps are also difficult to fit and can lead to circulation issues. First, you’ll need to make a fish-mouth incision superior to the point of amputation. You want a posterior flap long enough to cover the padded stump and to ensure a tensionless closure when sutured.” She described how to isolate the anterior, lateral, and posterior muscular compartments in dissection. She showed him how she had ligated the tibial, peroneal, and saphenous veins, and noted that the blood pressure always rose after the peroneal artery was tied off. She transected the sural nerve above the amputation line and let it retract into the soft-tissue bed to reduce the phantom limb sensation. With a clean scalpel she incised the dense periosteum. She gave directions in the flat, bored tone of a carpenter teaching a child to measure and cut wood, and Akhmed heard her without listening. All her Latin words and surgical jargon couldn’t mitigate the helplessness he felt while watching her finish what the land mine had begun.

“Leg amputations are normal business here,” she said, and handed him the saw. He held it, expecting her to ask for it back. She looked to it and nodded. No, she couldn’t be serious. She didn’t expect him to do that, did she? She barely trusted him to fold bedsheets properly. “You should get comfortable with this procedure as soon as possible.”

He gazed from the blade to the bone. The bone was a disconcerting shade of reddish gray; he’d expected it to be white. He had been six years old when he first realized that the drumstick he slurped the grease from was, in principle, the same as the bone that allowed him to walk, run, and win after-school soccer matches. He hadn’t eaten meat again for two years, so great and implacable was his fear that another carnivore would consume his own leg in reprisal. “I’m not qualified for this,” he stammered.

“This is the deal,” she said calmly. She reached for his hand. That grip held more of her compassion than the past two days combined, and then it was gone, replaced by hard pragmatism, and her fingers wrapped his around the foam grip. “This is what we do. This is what it means for you to work here.”

His hands shook and hers steadied them. The last leg surgery he had performed had been after the zachistka, on a boy named Akim. He had tried his best, he really had, but he couldn’t be faulted for his lack of supplies and experience, for the lack of blood in the boy’s body and the great abundance drenching the floor, for the bullet he didn’t shoot, or for the war he had no say in; if anyone had bothered to ask his opinion, he would have happily told them that war was, generally speaking, a bad thing, to be avoided, and he would have advised them against it, because had he known that not one but two wars were coming, he would have dropped out of medical school in his first year, his reputation be damned, and gone to art school instead; had he known a domineering, cold-hearted Russian surgeon would one day ask him to cut off this poor man’s leg, he would have studied still-life portraiture, landscape oil painting, sculpture and ceramics, he would have sacrificed his brief celebrity within the village, if only to safeguard himself from this man’s leg.

“There’s only one amputation now, but what about next time?” Sonja said. “There could be five, ten.”

He exhaled. Sweat pasted his surgical mask to his cheeks. Sonja pushed his hand forward. The blade grated against the bone. The vibration of each thrust ran up the blade, through the handle, to his hand, and into his bones. The name of the bone was tibia and it was connected to fibula and patella. He had studied the names that morning, but what he knew wouldn’t push the saw.

“Press harder,” she instructed, steadying the bone for him. “This isn’t a delicate operation.”

Halfway through, the blade unexpectedly went red with marrow. He stopped sawing.

“What’s wrong?” Sonja asked.

He could have answered that question several different ways, but he shook his head, and kept sawing. “I didn’t know human bone marrow is red. I thought it would be golden. Like a cow’s.”

“The marrow of a living bone is filled with red blood cells. If we were to shake a little salt and pepper on this bone and roast it in the oven, the marrow would turn golden in about fifteen minutes,” she said.

He feared he might vomit.

“Fine work,” she said, as he sliced through the tibia. “Just one more bone to go.”

He set the blade on the fibula and his quick hard saw-strokes spat into the air a fine white bone dust that drifted toward him, drawn by his breath, eventually dissolving into his damp surgical mask. Sonja’s dark eyes leered at him in his periphery, and he pushed the saw harder, faster, wanting Sonja to see in him more than his helplessness, wanting to finish before he fainted. A dozen strokes later the foot dropped to the table. He held the remnant by the ankle, and without pause or consideration, he flipped it on its end, and blood and marrow coated his fingers as he counted six shards of glass glinting in what was left of the man’s sole.

“Set that aside,” she said. “We’ll wrap it in plastic and give it to the family for burial.” She showed him how to round off the amputated bone and pad it with muscle. She pulled the posterior flap over the muscle-padded stump, trimmed the excess skin, and sutured it with black surgical thread.

When they finished, he peeled off his latex gloves and massaged the pink soreness of his right palm, where the skin between his thumb and forefinger had swollen from the handle’s pinch. Sonja noticed, smiled, and when she raised her right hand he wanted to be back in bed with Ula, where he could pull the covers over their heads and in the humidity of their stale breaths hold the one person who believed he was knowing, capable, and strong.

Calluses covered Sonja’s palm.