The Last Hiccup

by Christopher Meades

  Sergei swallowed hard a mixture of saliva and pride. “It appears I’ve needed your help all along, old friend.” He offered his hand to Alexander. “Shall we work on this together?”

  Alexander, who was neither Sergei’s friend nor in the practice of helping others, surprised himself by accepting his rival’s handshake. And, despite his skepticism, he agreed to help. “Together we will cure this boy.”

  A smile formed on Sergei’s face. “Then let’s get started. We have a great deal of work to do.”

  four

  Initially, Sergei and Alexander’s working relationship was professional, at times bordering on courteous. All those years of animosity had fostered a mutual tolerance for each other’s skills as physicians. They got along so effortlessly at first that their tolerance morphed into something resembling respect. Their first order of business was to make a detailed list of all ailments that might be afflicting Vladimir. A rigorous testing schedule was arranged and they began examining the boy for signs of the following illnesses — scurvy, rickets, guinea worm pestilence, shingles, gonorrhea, the Egyptian plague, gravidity, whooping cough and, finally, the common cold.

  The boy was poked at, prodded and pricked with needles. His blood was taken so many times that the nurses eventually had difficulty finding an unspoiled vein each time more tests needed to be run. On two separate occasions he was made to endure a lumbar puncture. His glucose level was checked. The roots of his hair were examined under suspicion he was succumbing to advanced aging syndrome. Through it all, Vladimir never complained once. He endured tubes sliding down his throat, spinal taps and enemas with a sedate pragmatism far beyond his years; his attitude owed partly to his obedient nature and partly to the aftereffects of the drugs that kept him asleep at night. He was simply too exhausted to complain.

  After five long months of tests, Alexander approached Sergei while he was strolling down the cobblestone path between the hospital’s main building and the mental health ward. This trail was lined with the most beautiful trees in all of Russia. They stood seven times taller than a man, and their branches reached over the heads of passersby. Even the perpetual winter could not disturb the landscape’s beauty. The crisp white blanket of snow had crystallized the branches, leaving the trail protected by thousands of dangling icicles.

  “It appears there is nothing physically wrong with the boy,” Alexander said.

  “So you’re telling me there’s nothing we can do?” Sergei stared straight down and followed a set of footprints in the snow.

  “I’m not suggesting we should abandon all hope.”

  “Then what exactly are you suggesting?”

  The two men were being coated by a light, languid fall of snow. Alexander found it infuriating. Sergei considered it the most peaceful feeling in the whole world.

  “Have you considered that Vladimir’s condition might stem from something other than a physical ailment?” Alexander said.

  Sergei kept walking. That possibility had always been in the back of his mind. Late at night as he lay awake recollecting the timeline of the escalating injustices his ex-wife had incurred upon him, Sergei would often consider the idea that young Vladimir was indeed quite mad.

  Alexander continued. “I’m not suggesting that he’s somehow fashioned this illness in his clever little brain or that he’s experiencing some kind of psychosis. I haven’t yet identified all the factors at play, but there’s something unique happening here. I’m starting to believe there is a battle raging in the young boy’s soul — a battle between his conscience and his most base impulses, between the seraph and the devil’s sprite, between good and evil.”

  Sergei stopped in the snow. Strangely preoccupied, he hadn’t quite heard what Alexander said. Even now, as his rival kept talking, all Sergei could focus on was how he suddenly felt far too warm in his large scarf and fur hat. He shook his head slowly, then looked at the ground. This snow hadn’t been touched since it fell. A blank sheet of paper lay out before him and Sergei could write anything on it he wished. He ignored Alexander and stood mesmerized by the pure white glory.

  Alexander took two long strides into Sergei’s line of vision; he dragged his feet across the blank page and sullied Sergei’s inner peace in the process. “Have you listened to a word I’ve said?”

  Sergei was so lost in thought, he’d only picked up fragments of words fluttering in the air. Finally he looked up from the snow and was met by Alexander’s frustrated expression. What has he been going on about? It’s no matter, Sergei decided. He knew what Alexander must be getting at.

  “I will handle this.” Sergei pushed past his rival and turned off the path to head down a snowy slope. Alexander watched from the cobblestone as Sergei marched off into the distant courtyard.

  Sergei removed his fur hat and ran his fingers through his hair. He’d been preparing for this for weeks, even months now. It was only as Alexander blathered on about God knows what that he decided to accept the truth. The possibility was no longer remote. If Vladimir was to be saved, it had to be confronted directly.

  “The poor boy,” Sergei said to himself. “He may very well be insane.”

  five

  The next day Vladimir was transferred from the hospital’s main wing to the mental health ward. An attendant carried the heavily sedated boy along the same snow-covered cobblestone path where the doctors had taken their walk. Sergei could hardly bear to watch them remove his patient. He stood at his office window, partially shielding his eyes, partially looking straight on in defiance as young Vlad was taken through the front doors of the psychiatric unit. Secretly Sergei feared that Vladimir might not make it out of that building alive.

  During the course of Sergei’s residency, the mental health ward had been the least organized, worst funded and most chaotic department in the entire hospital. Patients, some of whom were severely demented and quite dangerous, were allowed to roam the halls free of supervision. Violent incidents in that ward were nearly a hundred times more common than in the main building. Several times when the drugs used to sedate the lunatics were in short supply, the inhabitants had attempted a coup against the hospital staff. Outnumbering their captors thirty to one, the patients had the means to overtake the ward. Yet they could never manage to organize themselves well enough. Inevitably, each fracas would end with a single inmate screaming in frustration over the inability of the others to complete even the simplest of tasks. After all, how difficult is it to behead a nurse? Sergei shook his head. The hospital simply did not have the funds to properly equip or staff the building. He said a silent prayer for Vladimir, then left for the night, hoping to find the boy alive tomorrow.

  When Sergei arrived at work the next morning, Vladimir had already been returned to his bed in the main wing. Apparently, the sound of his hiccupping had caused an uproar in the asylum. The inmates, even those who had no history of violence, became enraged when Vladimir would not stop yelping. A chair was thrown through a glass partition. Next a garbage can was set on fire. This was followed by young Vladimir being stuffed headfirst into a second garbage can. Several of the schizophrenics were planning to light Vladimir on fire. Severely outnumbered, the hospital staff were powerless to intervene. Mere moments before he was set ablaze, the boy was saved by a rogue faction of patients, some who believed his hiccupping was a communication from God and others who appreciated the pure musicality of the noise. A full-blown violent conflict erupted. When it was finally over and Vladimir had been rescued, a number of the victors declared him their divine savior while others simply wanted to dance to his beat. In total, there were eleven broken limbs, seven critical injuries, one beheaded nurse and a litany of damages totaling the equivalent of the mental health ward’s annual budget.

  Sergei rushed to Vladimir’s bedside in the main wing to find the child sitting cross-legged on a cement floor besieged with nonsensical chalk scribblings and a large drawing of a hangman’s noose. Deep in concentration, the boy was intently focused on a piece of twine he w
as twirling in the air. Bruised, chafed and fatigued, Vladimir had a long scrape along his forehead. He still wore the bright blue hospital gown the psychiatric unit used to distinguish its patients from the sane green-robed patients in the main ward. Ragged burn marks ran up the side of his gown while fragments of its hem and sleeves were singed off entirely. Vladimir’s bare feet were covered in soot, his legs stained charcoal gray. Otherwise, he was undamaged.

  Sergei sat down on Vladimir’s bed and took a long look at the boy. He wondered — had Vladimir been scarred by this incident? Would this be the one defining experience that would perpetually plague his patient’s dreams or had it just been another unspeakable torment in a long list of unspeakable torments the boy had been forced to endure? Sergei could glean nothing from Vladimir’s expression. It was at once stoic, inquisitive, apathetic and haunted by despair. Close to three minutes had passed and still his patient hadn’t acknowledged that Sergei was in the room. Young Vlad needed his help now more than ever. Sergei had failed him too many times. He failed in curing him of the hiccups. He failed by allowing Alexander to subject the boy to a random series of painful, invasive tests, each more unnecessary than the last. And finally he failed the boy by exiling him to a land of lunatics solely because he couldn’t decide what else to do with him. Sergei brought his hands up to his face and rubbed his eyes hard.

  “Vladimir?” he said.

  The child’s eyes remained fixated on the spinning twine.

  “Would you like to go on a field trip?”

  Young Vlad looked up and, for the first time since Sergei could remember, the boy smiled.

  Two hours later the doctor and his patient were on the other side of Moscow, sitting in a windowless room lined by hundreds of old, unopened books. After his night in the asylum, Sergei ordered Vladimir to be bathed, clothed and deloused (although not necessarily in that order), and with his combed hair and hospital-provided dress attire he now looked like any other normal child. The only indications of his condition were his abnormally pale skin, a macabre reddening about his eyes and, of course, the persistent, inexhaustible hiccups.

  Vladimir reached over to the stack of books resting between him and Sergei on the plump leather sofa. The first was a medical textbook, the second a history of witchcraft. The third one, which Vladimir opened and flipped through with interest, was a graphic, picture-laden account of human mating practices in antediluvian Europe.

  “Put that down,” Sergei said. He took the book away, glanced at it himself and then tucked it in the nearest bookshelf.

  “Are we meeting Dr. Afiniganov here?” Vladimir said.

  “No. I didn’t tell Alexander where we were going.”

  Young Vlad looked up at Sergei. For a brief moment, Sergei thought he saw a fleeting apprehension in the child’s eyes.

  “What is it, Vladimir?”

  The boy paused.

  “It’s okay, you can tell me.”

  “Are you going to sever my phrenic nerve?” Vladimir said.

  “No!” Sergei exclaimed. “Of course not. Who told you this?”

  “I heard Dr. Afiniganov talking about it with a nurse.”

  “Do you even know where your phrenic nerve is located?” Sergei said, adjusting his tie.

  Slowly the boy looked down at his lap.

  Sergei let out a hearty laugh. “Vlad, my boy, that’s not your phrenic nerve.”

  This was not funny to Vladimir. “I don’t care. I don’t want them to take my phrenic nerve away.”

  “If you don’t know where it is or even what it is — how could you miss it?”

  “I just would.”

  Sergei stopped laughing and leaned in close to where he could feel Vladimir’s hiccups against his skin. “Listen to me carefully,” he said. “I don’t care what Alexander said. I will never allow that to happen. No one is going to cut you up. I promise you that. You aren’t just my patient, Vladimir — I think of you as my son. And I take direct responsibility for the fact that your affliction continues to this day. I’ve made it my life’s work to cure you. One day you will sleep through the night without drugs. You will run and play like the other boys and you will grow up to be a strong, important man. In my search for a cure, I’ve put you through agony. I suppose at the time I thought it was necessary. But I want you to know that if I could, I would switch places with you in an instant. I’m sorry for everything you’ve been forced to endure. And I swear I’ll never let anyone hurt you again.”

  Sergei looked into Vladimir’s mirrorless eyes. There was no reaction to his passionate speech.

  Across the room, the door swayed opened, sending a rush of musty air against the bookshelves. A diminutive, troll-like creature emerged from the other side with canes in both hands and giant bushy eyebrows. The light silhouetted him from behind and Vladimir couldn’t quite see the creature’s face. Its shadowy outline approached.

  “Sergei!”

  “Markus!” Sergei stood up to embrace the silhouette.

  Now Vladimir could see the face of this man. It was more horrible than he could have imagined. Markus had a long, crooked nose centering two crossed eyes, which were small on his face yet impossible to ignore, so wide were his pupils that no discernable trace of white was visible on either side. The hands holding his canes contained an uneven number of fingers; three digits plus a thumb on his left and just an index finger and half a thumb on the right. His hair too was a peculiar sight. Entirely bald on one side, the other side was divided into two sections — thick brown strands in the front and long, shiny gray locks toward the back. Despite Markus’s impeccable dress (his shirt was pressed and clean, his tie knotted properly and the right length for his frame), the man smelled faintly of moldy cheese. When he spoke, his words were coated with a drawl-affected accent the likes of which Vladimir had never before heard. This creature’s startling visage was an assault to sight, smell and hearing. Not even in the deepest recesses of Vladimir’s mind could he imagine what harm this creature might inflict on his other senses.

  Sergei held his friend by the shoulders and took a long, admiring look at him, then turned to Vladimir.

  “I would like to introduce you to my dear friend Markus.”

  The dwarfling offered his hand to the boy.

  Vladimir refused to shake it.

  “Where are your manners?” Sergei said. “Shake the man’s hand.”

  Vladimir reached out and touched the flaccid, malleable skin on Markus’s hand. This was not good. Touch had been established. Could taste be that far behind?

  “Markus is British,” Sergei said.

  “He’s a capitalist then,” Vladimir said.

  “In my former life, I suppose I was.” Markus breathed directly on the boy. Vladimir recoiled as though the creature was billowing flames from its nose. He took two solid steps back and yelped as he moved. “It seems this boy has a case of the hiccups,” Markus said. “Would you like me to get him a glass of water?”

  “Oh, my friend,” Sergei sighed. “It’s much more complicated than that.”

  “Nonsense,” he said. “I know how to solve this quickly and effectively . . . Boo!” Markus screeched. He flared his nostrils and threw his canes in the air.

  Young Vladimir stood in place, unfazed. His only reaction was to close his eyes and plug his nose, so wary was he of letting this hirsute gnome’s air inside his own body.

  Markus scratched the hairy side of his head. “Strange,” he said. “That usually does the trick.”

  Sergei leaned down and whispered a long sentence in his friend’s ear. When he finished, the look on Markus’s misshapen face was one of astonishment. He leaned forward to examine Vladimir more closely.

  “Really?” he said.

  Sergei nodded.

  “What forms of treatment have you attempted?” Markus said. “Did you try electroshock? What about temporary suffocation?”

  “I think,” Sergei said, “that it’s best we discuss the details of this case in private.”
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br />   Vladimir was left alone in the stuffy room while the two men engaged in an extended conversation on the other side of the door, their words dampened by the thick wall. Scarcely an audible sound slipped through the crack where the door met its frame, but from what Vladimir could discern, Sergei was asking Markus for help. “I need this from you, old friend,” Sergei was saying. Vladimir quickly lost interest and busied himself by retrieving another graphic text from the shelves. Entitled Attack Patterns of the Female Tiger, this book contained pictures of a series of human carcasses, each torn apart and partially consumed by the great ravenous cat. While at first only moderately intrigued, as the minutes went by, Vladimir flipped through the pages with eager glee, the sight of each ghastly corpse sending a flush of endorphins rushing to his brain where, in a pang of delight, the opiate receptors swelled to near-euphoric levels. Finally he settled on one picture, that of a man’s half-eaten torso entangled in a mesh of barbed wire. Between each convulsive yelp, Vladimir contemplated this man’s last desperate moments, how fraught with distress they must have been, how his innate urge for self-preservation must have sent a surge of adrenaline through his body so powerful that had he survived, his life would have been forever changed. Vladimir lifted his small hand and placed it on the page. He closed his eyes and leaned his head back, wondering in his rapidly evolving, child-sized brain which it was better to be — the carnivore or the dying man.

  Fifteen minutes later, Sergei and Markus emerged from the other side of the door. Quickly, young Vladimir wiped away the froth from the edges of his mouth. He shut the book as though he’d been caught looking at something scandalous and perverse.