Kolyma Stories

by Varlam Shalamov

  I managed to bend the patient’s head forward, and he spat out the pus straight onto the skirts of my gown.

  “Well, that’s it. Now change your gown.”

  The next day Loskutov sent me off to the “semi-outpatient” clinic where the invalids lived, entrusting me with taking everyone’s blood pressure. Taking my Riva-Rocci manometer with me, I took all sixty men’s pressures and recorded them on paper. They all suffered from high blood pressure. I spent a whole week measuring blood pressure, ten times for each person. Only after that did Loskutov show me the patients’ cards.

  I was glad to be taking these measurements on my own. Many years later I realized that this was a deliberate way of letting me learn my job calmly. My first case, which demanded quick decisive action and a bold hand, had required me to behave differently.

  Fiodor Yefimovich never exposed malingerers or exaggerators.

  “They only think,” he said sadly, “that they’re exaggerating or malingering. They are far more seriously ill than they themselves believe. Malingering and exaggerating when you have the dystrophy and dementia that come from camp life are problems that have not been described, just have not been described.”

  Aleksandr Aleksandrovich Malinsky, who lectured us on internal disease, was a well-scrubbed, well-fed, sanguine man, a cheerful man who was clean-shaven, gray-haired, and beginning to put on weight. His lips were dark pink and heart-shaped. On his bright-red back he had an aristocrat’s long-stemmed moles, and they shook—we sometimes saw him in the sauna of the hospital bathhouse. He was the only Kolyma doctor, and I think the only Kolyma inhabitant, to sleep in a specially tailored long nightshirt that went down to his ankles. This was revealed when there was a fire in his department. The fire was successfully extinguished right away and soon forgotten about, but Dr. Malinsky’s nightshirt was a subject of gossip in the hospital for many months.

  Formerly a lecturer in Moscow giving postgraduate courses for doctors, Malinsky found it hard to adapt to the level of the students’ knowledge.

  There was always a chill of alienation between the lecturer and his audience. Malinsky would have liked to break down this barrier, but he didn’t know how to do it. He devised a few rather vulgar jokes, but this did not make his subject matter any easier to take in.

  Visual aids? But even in anatomy lectures we dispensed with skeletons. Umansky used the blackboard and chalk to draw the bones we needed to know about.

  Malinsky gave his lectures, trying his hardest to give us as much information as possible. He knew the camps very well, having been arrested in 1937, and his lectures gave us a lot of important advice about medical ethics in their distorted camp version. “Learn to trust the patient,” Malinsky passionately urged us, as he bounced up and down by the blackboard, tapping the chalk. He was talking about bullet wounds, lumbago, but we understood that this appeal was about more important matters, about the way real medicine should be carried out in the camp, telling us that the monstrosity of camp life must not divert medicine from its proper paths.

  We owed a lot—information, knowledge—to Dr. Malinsky and, although his constant instinct to keep a significant distance between himself and us unfortunately left us out of sympathy with him, we did recognize his merits.

  Dr. Malinsky put up well with the Kolyma climate. Even after being rehabilitated he voluntarily stayed on and lived for the rest of his life in Seimchan, one of the Kolyma vegetable farms.

  Dr. Malinsky regularly read the newspapers, but never shared his opinions with anyone: that was because of his experience, experience. . . . The only books he read were medical ones.

  The course director was a free contract worker, Dr. Tatiana Mikhailovna Ilyina, the sister of Sergei Ilyin, the famous soccer player, as she personally liked to introduce herself. She was a lady who tried in every small detail to adopt the top bosses’ mannerisms and tone. She had had a great career in Kolyma. Her moral sycophancy had almost no limits. Once she asked for something decent to read. I brought her something valuable: a volume of Hemingway with The Fifth Column and 48 Stories. Ilyina turned over the cherry-colored volume and leafed through it.

  “No, take it back. This is fancy stuff, and we need black bread.”

  Those were obviously someone else’s words, the words of a sanctimonious hypocrite, but she enjoyed uttering them, even though they didn’t quite fit the occasion. After such an affront I abandoned my role as literary adviser to Dr. Ilyina.

  She was married. She had come to Kolyma as a wife following her husband, bringing her two children with her. Her husband was an army officer who signed a contract after the war with Far East Construction and brought his family to the northeast. Here he kept his officer’s rations, ranks, and privileges: having two children meant that he had a big family. He was appointed chief of the political section of one of Kolyma’s mine administrations, quite a major post, almost a general’s, and with promotion prospects, too. But Nikolayev, Dr. Ilyina’s husband, was a keen observer, conscientious and not in the least a careerist. When he had seen for himself the arbitrariness, speculation, denunciations, thieving, scheming, self-serving, bribe-taking, and embezzlement, and all the cruel acts committed by the Kolyma bosses at the expense of the prisoners, Nikolayev took to drink. He understood and condemned deeply and irrevocably the demoralizing effect of people’s cruelty. The most terrible pages of life, far more terrible than his years at the front, were revealed to him. He wasn’t a bribe-taker, he wasn’t a scoundrel. He took to drink.

  He was very soon removed from his post as head of the political section. In a very short period, no more than two or three years, his career went into reverse and he ended up with a sinecure, the badly paid and unimportant job of inspector of the Culture and Education Center of a prisoners’ hospital. He was compelled to make fishing his passion. On the banks of a river deep in the taiga he felt better and calmer. When his contract period was over, he left for the mainland.

  Dr. Ilyina did not follow him. On the contrary, she joined the party and laid the foundations for her career. They split the children between them: the daughter went to her father, the boy to his mother.

  But all that happened later. At this time Dr. Ilyina was a caring and tactful director of our courses. She was a little apprehensive of prisoners, and tried to have as little to do with them as she could. Apparently she wouldn’t even have prisoners as servants.

  •

  General and specialized surgery was the subject taught by Meerzon, who had studied under Spasokukotsky, and he was a surgeon with a great future and a major place in science. But Meerzon was married to a relative of Zinoviev, so that in 1937 he was arrested and sentenced to ten years as the head of some terrorist anti-Soviet organization of wreckers. In 1946, when the paramedic courses started, he had only just been released. (He had gotten away with doing less than a year of manual labor, and was a surgeon throughout his imprisonment.) At that time, “lifelong restricted residence” had begun to be fashionable, and Meerzon too was forced to stay on for life. Having been released very recently, he was extremely cautious and extremely formal and extremely unapproachable. His great career had been smashed to smithereens, and his resentment needed an outlet, which he found in jokes and sarcasm. . . .

  He was a superb lecturer. For ten years he had been deprived of his beloved teaching work—casual chats with the operating theater nurses did not, of course, compensate. For the first time he could face an audience, students in these courses, eager for medical knowledge. Even though the students were a very mixed bunch, Meerzon was not dismayed. To begin with, his lectures were entertaining and fiery. But his first test was a bucket of ice-cold water poured onto an overheated lecturer. His audience was too primitive: words like “element” and “form” needed to be explained, and explained in detail. Meerzon realized this and he was extremely disappointed, but he hid his feelings and tried to adapt to the students’ level. He had to put himself at the level of the worst, the Finnish girl Aino, the shop manager Silantiev, and
so on.

  “A fistula forms,” said the professor. “Who knows what a fistula is?”

  Silence.

  “It’s a hole, a hole like this. . . .”

  The lectures became less exciting, but they never lost their useful content.

  As befits a surgeon, Meerzon treated all other medical specializations with open contempt. He took the staff’s concerns for sterility in his department virtually to metropolitan levels, demanding that the requirements of surgical clinics be scrupulously met. But in other departments he behaved with deliberate casualness. When he attended a consultation, he never took off his jacket and hat, and he would sit on the patient’s bed wearing them, regardless of what therapeutic department he was in. This was done on purpose, and it looked insulting. The wards were, in fact, all clean, and the grumbling hospital porters had to spend a lot of time mopping up the wet traces of Meerzon’s felt boots after he had gone. This was one way in which Meerzon amused himself: he had the gift of the gab and was always ready to let a general practitioner have the benefit of his bile, his resentment at and dissatisfaction with the world.

  He didn’t let himself do this in his lectures. He expounded everything clearly, exactly, and exhaustively. He was able to find examples that anyone could understand, live illustrations, and if he saw that the audience was taking it in, he was pleased. He was the hospital’s chief surgeon and later became its chief doctor. His opinion had a decisive role whenever there was a question affecting our courses. Every action of his that we observed, and all of his conversations, were carefully thought out and to the point.

  The first time we witnessed a real operation we were crowded into a corner of the operating theater, wearing sterile gowns and fantastical gauze half-masks, and it was Meerzon who was operating. His permanent operating theater assistant nurse, Nina Dmitriyevna Kharchenko, was helping him. She was a contract worker, the secretary of the hospital’s Komsomol. Meerzon gave curt orders: “Kocher forceps . . . ! Needle!”

  Kharchenko snatched the instruments from a little table and gingerly placed them into the surgeon’s hand, which was stretched out to one side. He wore tight-fitting bright yellow rubber gloves.

  Suddenly she handed him the wrong instrument. Meerzon swore coarsely and, with a wave of his hand, threw a pair of tweezers onto the floor. The tweezers clanged, Nina Dmitriyevna blushed and meekly handed him the right instrument.

  We felt offended on her behalf, and angry with Meerzon. We considered that he shouldn’t have behaved like that. At least for our sake, even if he was such a ruffian normally.

  After the operation we offered Nina some words of sympathy.

  “Guys, the surgeon is responsible for the operation,” she confided to us gravely. There was no embarrassment or resentment in her voice.

  As if he had understood everything that was going on inside the minds of his neophytes, Meerzon devoted his next class to a particular topic. It was a brilliant lecture about a surgeon’s responsibility, his willpower, about the need to overcome the patient’s will, about the psychologies of doctor and patient.

  This lecture delighted us all, and afterward we gave Meerzon a higher rating than any other doctor.

  Just as brilliant, in fact outright poetic, was his lecture on “A Surgeon’s Hands,” in which his discussion of the essence of the medical profession, the concept of sterility, became incandescent. Meerzon delivered the lecture as if for himself; he barely looked at his audience. The lecture contained a lot of stories. They included the panic that came over Spasokukotsky’s clinic when patients mysteriously became infected after clean operations—thanks to a wart, finally discovered on an assistant’s finger. This was a lecture about the structure of skin and on a surgeon’s intolerance of imperfection. It explained why no surgeon, theater nurse, or paramedic in a surgical department had the right to take part in camp “shock work” or in any manual labor. This revealed to us Meerzon’s many years of passionate battling, as a surgeon, with the ignorant camp bosses.

  Sometimes, on days devoted to testing what we had taken in, Meerzon managed to finish the questioning earlier than he had anticipated. The rest of the time was devoted to very interesting stories apropos of prominent Russian surgeons: Oppel, Fiodorov, and especially Spasokukotsky, whom Meerzon idolized. It was all witty, clever, useful, and it was all completely authentic. Our view of the world was changing. Thanks to Meerzon we were becoming medics. We were learning to think like doctors, and we were learning well. Every one of us was different after these courses that condensed a two-year syllabus into eight months.

  Afterward, Meerzon moved from Magadan to Neksikan in the western region of Kolyma. In 1952 he was suddenly arrested and taken off to Moscow. An attempt was made to stitch him up in the “Doctors’ Case.”[23] Together with the other doctors, he was released in 1953. He returned to Kolyma and worked for a short time, afraid to stay any longer in such an unstable and dangerous area. He left for the mainland.

  •

  The hospital had a club, but the students didn’t go there, except for the girls, Zhenka Kats and Borisova.

  We thought it was a sacrilege to spend even an hour of our free time on anything but study. We studied day and night. At first I tried to make a fair copy of all my notes in a new exercise book, but there was not enough time or paper to do this.

  The camp hospital was now overcrowded with people who were there because of the war—Russian émigrés from Manchuria, Japanese prisoners of war, who were given rice instead of bread, and many hundreds of people condemned as spies by military tribunals. But none of this had yet taken on the enormous dimensions that came with the repressions a little later, toward the end of the shipping season in 1946, when five thousand prisoners, brought over on the steamship KIM, were hosed down with water from the ship’s fire pumps during a sea journey that had taken longer than it should have. The work of transporting these people and amputating their frostbitten fingers and toes was something we carried out as fully qualified paramedics, and not only in Magadan.

  •

  Every day we were tormented by doubts: were the courses going to be closed down? The rumors, each one more frightening, stopped me from sleeping. But our classes continued, little by little, and finally the day came when even the worst moaners and unbelievers could breathe more easily and feel relieved.

  Three months had passed, and the courses were still going on. New doubts appeared: would we pass the final examination? After all, the courses were an official initiative, and they gave one the right to treat people. True, in 1953 the health administration of Far East Construction explained to the town health authorities in Kalinin (Tver, today) that those who had taken these courses could treat people only in Kolyma, but local authorities paid no attention to such strange limitations on the use of medical knowledge.

  What disappointed us greatly was that the program was curtailed and gave its graduates only the rights of a qualified nurse. But that was a matter of secondary importance. The worst aspect was that no certificates were handed out to us. “Certificates will be inserted into your personal files,” Ilyina explained. It turned out that there was not a single trace of our medical education in our personal files. After we were released, quite a few of us had to collect testimony, which was certified by teachers in the courses.

  After three months of study, time began to move very, very fast. The approach of the examination day gave us no joy. The examination would be the final summary of our wonderful life at kilometer twenty-three, and we knew that life would get no better than that. So we were anxious and we were sad, even if only moderately so, for Kolyma had taught us not to count on the future more than one day ahead.

  The examination day loomed. People were now saying openly that the hospital would be moved five hundred kilometers deeper into the taiga to the settlement of Debin on the left bank of the Kolyma River.

  A month before the courses ended, a mock examination in all subjects was staged. I didn’t think this occasion was important an
d only after the final examination did I realize that all the questions that the students had to answer at the real examination were, in all subjects, a repetition of the questions at the preliminary examination. Of course, the members of the examination board, the top bosses from the health department of Far East Construction, were able to ask, and did ask, supplementary questions. But the basis for an examinee’s confidence and the basis for the impressions formed by the examiner were already there in an auspicious, familiar, question paper. I remember my question for surgery was on the “varicose widening of veins.”

  Even before the examination there was a reassuring rumor that everyone, absolutely everyone, would pass, that nobody would be deprived of their modest medical rights. This made everyone happy; the rumor turned out to be true.

  Gradually our circle of acquaintances grew stronger and wider. We were no longer outsiders, we were initiates, members of the great Order of Medicine. Both doctors and patients saw us in this light.

  We had stopped being ordinary people. We had become specialists.

  For the first time in Kolyma, I felt I was needed—by the hospital, by the camp, by life, by myself. I felt I was a person with full rights, whom nobody could shout at or taunt.

  Although many bosses put me in solitary confinement for infringements, real or imaginary, of the camp rules, even in solitary I remained a human being whom the hospital needed. When I came out of solitary, I went back to being a paramedic.

  My smashed self-esteem now had the necessary glue and cement to make it possible to restore what had been shattered to pieces.

  The courses were coming to an end, and the young men found themselves girlfriends: everything was as it should be. But the older men would not allow any feelings of love to interfere with their future. Love was too cheap a stake in the camp game. We had been taught over the years to restrain ourselves, and the lessons were not wasted.

  I developed a supersensitive self-esteem. If anyone else gave an excellent answer in any class, I took it as a personal insult, I was offended. It was I who should be able to answer any question put by a teacher.