Rock, Paper, Scissors

by Maxim Osipov

  The above-average level of phenol in the local water was an issue that, the executive said, the workers had raised correctly—it would be discussed in Parliament. He was already in his car as he said this, sitting sideways, shaking off his boots: the winter had been long, snowy. And he promised, by the by, to help out with the fuel oil—the entire town’s heat depended on the mill. And one final thing: as he drove past the church, he was seen crossing himself.

  •

  At that point Sashka, too, was on the executive committee. He chewed his way through the assembly. He was always chewing gum, or at least had been for the past few months: he’d quit smoking, they said, that was why. And, once the trial was over (percentages, loans, in short—complete bankruptcy, so much so that people started to pity Sashka: despite everything, he was still one of us), a man showed up in a pinstriped jacket, his hair slicked back into a ponytail. A crisis manager. He brought Sashka money—just under a million dollars—to, you know, go quietly—and transferred the mill over to its new owners, along with the affiliate businesses. But Sashka—apparently enraged by this man’s presence—took the chewing gum straight out of his mouth, and pressed it into the man’s chest pocket. This happened in his waiting room; his secretary saw it all. He didn’t take the money. Instead, over the May holidays he gave some cash to a few of his boys, and they shredded all of the fabric in the paper machines. None of it could be glued or sewn back together, nor in any way replaced. He only gave them about five hundred rubles each for the job, but his boys were glad even of that. And that was that. The machines, ruined, still stand there to this day.

  “But how could you, Uncle Zhenya?”

  Uncle Zhenya was one of the guys who shredded the fabric. What else was he going to do? It was boss’s orders.

  After that, an entirely different group of men arrived—no ponytails—and Sashka made off to “Japan.”

  What else is there to remember? Sashka would shoot at his neighbors’ goats from an upstairs window if they ever strayed onto his property, but he never hit them; he probably just shot to scare them. His portrait remained—enormous, about three meters tall: Alexander Yurievich Oberemok in an ermine robe. And his date of birth. Everyone knew the year Sashka was born anyway: he had a tattoo of his name across one set of knuckles, across the other set, the year of his birth. But the portrait is a poor likeness. You can see for yourself—they say there are still photos of Sashka online.

  Almost three years have passed. The town lives. It’s nothing to rave about, but still, we’ve never had it so good. The state supplies our fuel oil, the boiler house works, and homes have heat—hot water, even. Some of the boys from the mill have found jobs in security, some in taxis. Uncle Zhenya’s registered at the job center. And so the mill, Sashka Oberemok—that’s all in the past. And the present? In the present, a young woman, Alya Ovsiannikova, lies hooked up to a ventilator in the intensive-care unit of Liebknechtsk’s hospital. Every day her husband comes to the hospital, but he isn’t allowed inside, and he doesn’t ask the doctors for anything, either. Alya’s husband’s name is Tamerlan; her doctor is Viktor Mikhailovich.

  • • •

  Viktor Mikhailovich is held in good regard. First, he doesn’t drink, and second, he is a man of advanced years, experienced. He is careful behind the wheel and keeps his car in good condition: always clean and in working order, as it has been for the eight years that Viktor Mikhailovich has lived in this town.

  “Today’s cars are no less complex in their composition than human beings.”

  When Viktor Mikhailovich talks about his car, his face lights up: “This car holds seven different types of liquid alone: brake fluid, cooling fluid . . .” He knows what all of these seven liquids are, and he refills and changes them precisely when he should.

  He had initially been recruited to Liebknechtsk because of his certification in intensive care and anesthesiology, at a time when the town could still offer him an apartment. Had he not moved here, they might as well have closed the hospital: it wouldn’t have met its licensing requirements, and the entire mill complex would have had to go God knows where for treatment. They do hardly any operations here, and anesthesia is administered by an anesthesiology nurse, but naturally nothing is possible without that license.

  “If it’s necessary, it’s necessary; quite correct. The men who made these laws must surely know better than us.”

  Viktor Mikhailovich is paid a part-time wage as an intensive-care physician in addition to a full-time wage as a therapeutist. The latter is his primary occupation, although over the course of his life Viktor Mikhailovich has tried his hand at a number of different disciplines. He holds certificates in many specializations, including public health management. His indicators are some of the best in the entire province: the health plan is being implemented—exactly the right number of patients, staying exactly the right length of time; the mass health examinations have been carried out; and his department is even in good working order. He himself is never absent during working hours, and he is always sober, even on public holidays. Visiting hours are normally between six and eight p.m. Naturally, no visitors are allowed into the intensive-care unit.

  His preferred treatment method is anything that can be administered through an IV drip: this is both easier on the grannies—they feel they’re getting the treatment they deserve—and adaptable to the needs of the health plan. Simply lie back, take in the medicine for a while, and then you can get back home to your TV. In six months’ time, come in for some more repairs. He once heard someone call them dripairs. They’re good for any illness. The grannies he treats here have the full gamut.

  “What else do you want? As far as I can tell, a diagnosis of ‘old age’ has never been reversed.”

  Yes, the grannies come to him—who else do they have? There are two other district therapeutists, both women, but they’re never at work past lunchtime. They’ll say they’re being called out, but no one is fooled by these calls of theirs. Both are of retirement age: the hospital is starved for staff, but that’s the case everywhere nowadays.

  “Doctors used to have to come here on placements,” Viktor Mikhailovich explains, although he prefers not to elaborate on general topics of conversation.

  In the past, Viktor Mikhailovich had notions of what was bad and what was good, but over the years he’s gotten used to it all—to life, to himself. Like anyone else, he tries to avoid unpleasantness. If he is asked to prescribe one medication or another, to run a particular test, or to send a patient into the city, he will ask: “So that’s what you need, eh?” But as a rule he always complies: if you don’t, they might dash off a complaint. And while complaints in themselves are nothing terrible, the smooth road is always preferable to the one with potholes.

  His working day runs from eight a.m. to four p.m. After that, any questions go to the duty doctors. Viktor Mikhailovich dislikes being pestered with questions: So-and-so and such-and-such—how can we treat it?

  “Look on the Internet. There is a lot of information there.”

  Viktor Mikhailovich doesn’t use computers himself. And the new ventilator the hospital received—the one sent to all hospitals as part of a recent presidential modernization program—remained unassembled until just last week. “You can’t teach an old dog new tricks” is his favorite saying. Another favorite: “Get your head out of the clouds.”

  •

  Ovsiannikova is critically ill. Critically ill patients—especially young ones—are sent to the city, if they can make it that far. If not, they are sent across the road instead, to a red building behind the garages. Every unfavorable outcome causes some level of distress, particularly if it involves a person of working age. Of course, with the elderly, it isn’t so complicated: at seventy, eighty, why bother resuscitating?

  Whenever a nurse informs him that you-know-what has happened, Viktor Mikhailovich will resort to the same stock phrase: “That’s the patient’s right.” He will fish out the records and set about filling them ou
t. But he won’t go to look at the body—hasn’t he seen enough dead people?

  Ovsiannikova, however, is a special case. Viktor Mikhailovich has calculated that she will live just over one more month. Five weeks, to be precise. Although her brain has been damaged irreversibly, her heart still beats, and the ventilator keeps her breathing. Her condition, as they say, is critical.

  “Critical, but stable,” Viktor Mikhailovich tells Tamerlan, Ovsiannikova’s husband—if he can’t get the nurse to speak to him instead. No one likes to have to deal with the relatives.

  •

  Ovsiannikova was brought to the hospital to give birth last Friday. It was urgent; there wasn’t enough time to get her to the city. Births are a rarity in this hospital, and thus not particularly well coordinated. Viktor Mikhailovich didn’t oversee the birth: there’s always someone else capable of running around and barking out orders. He only saw Ovsiannikova towards the end of the working day, after she had given birth. The child had already been taken into the city, but Ovsiannikova had been moved upstairs. He hadn’t wanted to give her a bed: Call the city hospital, get them to send their emergency-response unit—all I have is a therapeutics department. But in the end he took her in: If she hadn’t held out until their ambulance arrived, whom might he have had to answer to? After all, Viktor Mikhailovich was a certified intensive-care physician, and here was a young woman whose blood pressure was up to three hundred, whose body was in convulsions—as soon as one seizure ended, another would begin.

  As he walked up and down the stairs between the two floors, Viktor Mikhailovich started to feel a pain in the nape of his neck. Ovsiannikova was given one drip, and then another, and Viktor Mikhailovich administered a number of different treatments while waiting for the city’s medics to arrive. Initially, Ovsiannikova’s blood pressure would not drop, but then, after she vomited, it dropped completely. This happened just as the emergency-response unit’s yellow Volkswagen pulled up, these new mobile ICUs another result of the government’s modernization program.

  He should, admittedly, have called them sooner. But Viktor Mikhailovich calls for backup in only the most serious of cases: in they drive, casting their aspersions, trying to teach him medicine. And that would be fine, if it were only his authority that took the hit, but you can never leave while they’re still in the department, and on top of that you have to host them, put out a spread, as they say. And Viktor Mikhailovich almost never drinks, no: he has hypertension.

  Some newbie stepped out of the ambulance—a redhead, about thirty by the looks of things. Viktor Mikhailovich had never seen him before. He was wearing a down jacket and a short doctor’s coat, a set of keys dangling from his neck.

  “Right, hit me,” he called out to Viktor Mikhailovich from the doorway.

  Hit me? Is that any way to address a colleague?

  “Well, high blood pressure, convulsions,” he replied.

  “I see. Eclampsia then. And your treatment?”

  Viktor Mikhailovich was finding it hard to keep his composure. “Did we bring down the blood pressure? Yes, we did,” he thought to himself. “So why are you looking at her records? Next you’ll be wanting me to get out the used ampoules too!”

  “How could it be eclampsia if she’s already given birth?” he asks—aloud, this time.

  “It happens. In the first forty-eight hours. Hold on—she’s not breathing!”

  Viktor Mikhailovich doesn’t quite recall what happened next: his legs turned to jelly, his eyes clouded over. But he did help; he participated. The youngster inserted the tube, fitted the ventilator, and initiated artificial respiration. Watching the young man’s hands flit deftly over the flashing buttons of the ventilator screen, Viktor Mikhailovich couldn’t help but mutter: “You youngsters have it easy,” he said. “You know foreign languages. In my day we had to figure it all out for ourselves.”

  What was so funny about that?

  They finished up, took off their gloves and went into the staff room. It had been a hard day; time to relax. Edik or Erik—Viktor Mikhailovich didn’t catch the young man’s name. He filled the man’s shot glass to the brim, but gave himself only a few drops.

  “So what now?” Viktor Mikhailovich asked. What he actually meant was: Can you take her? It was clear the youngster wouldn’t. “And if she wakes up? We should probably immobilize her arms, no?”

  The youngster shrugged. “That’s hardly likely. Her brain’s probably already gone.”

  That was that then. Nothing to be done.

  “So who is she? Looks like a well-raised young lady to me.”

  Who knows? By the looks of things, yes. Best not to give such matters much thought.

  “And what’s your normal demographic? Grannies mainly, I’ll bet?”

  Who else?

  “Grannies, yes. And the working class.”

  The youngster laughed again.

  “The working class. I thought they only existed in books nowadays.”

  They sat for a while, chatting about this and that, nothing work-related. Things like when they would actually get some proper roads. Oh, yes, on that note, there was something Viktor Mikhailovich had been wanting to find out for some time: “Is it true that those Volkswagens of yours have a boxer engine?”

  The young man looked at him, his expression unreadable.

  “Online,” he advised, “look it up online, I’m sure it’s all there. As for her,” he said, nodding in the direction of intensive care, “call me.” He gave Viktor Mikhailovich his phone number.

  How can anyone drive a car and not have the slightest interest in its cylinder configuration? Although tired, Viktor Mikhailovich stayed even later, filling out the records. Best to do it straightaway; by Monday it would have slipped his mind. So, eclampsia. Why not. He looked up its code: O15. No other extraneous thoughts. Otherwise you’ll drive yourself mad. Burn out emotionally.

  •

  At the start of this week he called—the youngster from the city.

  “How is she—I don’t suppose she woke up? Oh. So that’s it, then?”

  Of course not. Viktor Mikhailovich is going to try to keep her going. For forty-two days.

  “Forty-two? Why forty-two?”

  Oh, young academician, is it possible that you could be ignorant of something so simple? Forty-two days is six weeks. Death in the six weeks after childbirth is considered a maternal mortality; after that, it isn’t. That’s the system. What, don’t they write about that in your Internets? Get your head out of the clouds. And done.

  •

  Alya Ovsiannikova was born in 1991. Her mother died in childbirth; no one knows what happened to her father. Uncle Zhenya is her only relation, so it’s his name that she bears as her patronymic: Yevgenievna. But asking him about her parents is a pointless pursuit—Uncle Zhenya doesn’t even remember his time in Poland, where he served. It’s not that he drinks so very much—only as much as anyone else—but something has changed in him lately. Tamerlan thinks it’s because he broke the machines at the mill that time. But he also says that Uncle Zhenya is a truly good man for not sending Alya to an orphanage when she was little—the nineties were tough on everyone. It had never even occurred to Alya that she might have ended up in a home.

  What’s her first memory? Oh yes: Uncle Zhenya bathing her in a basin in front of a hot wood-burning stove. They used to have to stoke the stove regularly; Alya’s job was to tear the bark off the firewood. Of course you can also pack the stove full of newspaper, but bark’s much more fun to burn. What else? Alya used to have a knack for finding mushrooms; she had a special book about them—she learned to read in kindergarten—and she still knows all of their names.

  How did she get by without a mother? Another one of Tamerlan’s questions. She hasn’t known anything else. Tamerlan often asks her questions she doesn’t quite know how to answer. Alya isn’t used to talking about herself. And all the people around her—her neighbors, teachers, classmates—also speak rarely, as though they find it difficult. Fo
r the most part, people aren’t rude, they’re shy—at least that’s how she sees it. Alya isn’t rude either; she’s soft-spoken, although towards the ends of sentences she does sometimes raise her voice unexpectedly. She also holds her head high, as though in some act of defiance, but then again, that’s just appearances.

  At school she was neither a good nor a bad student, nor particularly interested in her grades—especially after a run-in with a math problem about a caterpillar in a well: “If the caterpillar climbs three meters during the day, but slides down two meters at night, when will it get out of the well, if the well is five meters deep?”

  Alya ponders this caterpillar’s movements as she sits in her darkened room. Uncle Zhenya is already back from his shift; she can hear the sound of onions frying from the other side of the net curtain. This means it’ll be buckwheat kasha with onion for dinner. Uncle Zhenya calls her.

  “Coming!”

  She pictures that little caterpillar: one meter at the end of the first night, two at the end of the second, two plus three is five . . . So it’ll get out of the well on the third day.

  The teacher is checking the class’s workbooks. Alya shows hers. Five, five; everyone except Alya has come to the same conclusion. To Alya’s surprise, the teacher says: “Excellent, top marks for everyone, except you, Ovsiannikova—you get a three.”

  “But Olga Yurievna, if it’s wrong then why not a two?” Alya asks chirpily.

  Olga Yurievna doesn’t want to mar her grade book with twos—the mark of failure. The school has an inspection coming; they now make regular checks of grade books. She checks the back of the textbook in case; it also gives the answer as three. Oh dear, must be a typo. Ovsiannikova should have thought for herself, not simply copied from the book. She doesn’t actually believe that the rest of the students are idiots and that she’s the only one with brains, does she?