The first sign had been a watery spot on his underpants noticed during his Black Sea vacation the previous summer and attributed to a scratch on an underwater rock. The little lesion didn't heal and some days its stain was not quite so tiny; but Alyosha ignored it—and, except for a passing wisecrack, the slight diminishment of his energy—until a month before Nixon's arrival last spring, when he saw blood on his sheets. The wound seemed to be growing deeper and there was a lump in his groin.
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This combination was finally enough to overcome his distaste for medical assistance.
Diagnosing piles, his local clinic's duty doctor arranged an operation in a municipal hospital, whose chief surgical consultant confirmed the diagnosis and signed the final papers when Alyosha's turn before him came several weeks later. By then, the other groin also had a sore nodule, and he could feel the first growing from morning to evening. He consulted a medical encyclopedia, then called a brilliant young internist whose father he'd once helped on a case.
He lowered his trousers and lay on the daybed. After a minute's examination, his friend went white and looked up at his face. He called contacts to arrange Alyosha's immediate acceptance by the Advanced Training Institute, and treatment began as soon as the biopsy had verified malignancy. . . . This story, the details of which I heard only now, laid me low for weeks. Alyosha had cancer ever since I knew him — during the entire time I was glorying in his energy and health! And he could have recovered easily if we hadn't been so blind. The doctors all agreed that it began with a relatively mild skin disturbance, with over a ninety per cent chance of complete cure.
The diagnosis was cancer spinocellulare. Sorting out his bureau drawers months later, I saw it written as such on a postcard he'd never sent me, probably because its tone was downcast and chief message a request for more medicines. The main tumor encircled the anus, with one hundred per cent metastases to the lymph nodes of both groins. Major surgery was planned for next month; meanwhile, the X-ray assault continued as before, and on the lower intestine too for prophylactic purposes, even though it was uncertain the malignancy had reached there.
On the days I hadn't slept over, I arrived at the apartment for breakfast. At eleven o'clock, we drove toward the Hippodrome along a route I already knew without instructions. His clinic was in a cluster of medical institutes something like the grander one on Manhattan's East River. We were admitted with almost no formality and made our own way to the radiology department. It was excellently equipped, but the building itself had the curious Russian plainness of research laboratories and technical insti-
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tutes, which can give the mistaken impression that the scientific apparatus is also obsolete. I felt I was back in my old high school.
Despite our purpose there, its genial efficiency had a calming effect. Only the chief administrator compressed his lips as if cancer sufferers were an inconsiderate burden, and pursed them when I identified myself. Otherwise, the novelty of professional courtesy instead of the elbows and nyets of most public institutions lifted our spirits, at least until Alyosha's turn under the machine. When he was summoned inside for this, I continued waiting in the anteroom alongside patients with appointments after his. A man with the hands of a half-century of manual labor was often there, confused by the elaborate attention awarded him at this late hour of his life, craving a cigarette despite his deathly wheeze. And a nine-year-old girl whose mother couldn't decide whether to spoil her appetite for lunch by letting her open Alyosha's chocolates or to spoil her in the other sense because the doctors couldn't guarantee she'd live to be ten. To young and old, the staff was unpatronizingly gentle. Even teenage nurses whose contemporaries were already snarling from behind store counters spoke in the tones that allow the hospital sick to feel slightly less useless.
One morning, I was alone in the anteroom. Through the wall, I heard the hum of the rays penetrating Alyosha's intestines— "trembling vectors of electric and magnetic fields, unimaginable to the human mind." I was trying to think of a drive he'd enjoy in the afternoon when the door opened and I felt my face being studied. Then the disapproving chief administrator entered, choosing the inches next to me on the bench to seat himself in the otherwise empty room. I stiffened. Things had too long been too friendly here; this was my time for being thrown out.
Quite the contrary, he had taken this moment to express concern for my friend. Life's tragedies united people in a larger loyalty, he said. People of every kind. He leaned closer. Americans once helped him greatly; one day he'd explain—but Alyosha was the priority now. Soviet medicine's utter humaneness was a matter of record, but some remedies inevitably outperformed others. Especially with carcinoma, the newest ones couldn't be widely prescribed until they'd been exhaustively tested and, frankly, because of their expense. However, in certain
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clinics, patients died only if nothing on earth could prevent it.
He admired Americans. He knew a certain professor who had saved . . . well, some extremely important people. He couldn't promise anything, but was I willing to give Comrade Aksyonov this chance?
He took my telephone number at the dormitory and volunteered to approach the specialist. Meanwhile, it might be kinder not to arouse my friend by talking of mere possibilities. Good-bye, but hopefully not farewell.
Alone again, I thought of how little I had learned in life. To have judged the chief administrator, the one man who both grasped the scale of the tragedy and was in a position to help, by his homeliness—as if I hadn't had enough examples of saintly souls in scrawny physiques. His only increased my new tenderness toward him.
Alyosha emerged from his session, teasing a nurse about her surer skill in dropping than raising underpants. I drove to lunch at the Hotel Moscow's fifteenth-floor cafe where we'd had our vernal equinox meal. Looking down at the scurrying, scarf-wrapped pedestrians, I felt even higher and happier. All afternoon, I saw him as a patient who had passed his crisis. If I could be the middleman who procured the expertise for his cure, I'd never again feel cheated by Providence. This one break would be enough to explain why I was in Moscow; to justify my existence.
Like commandos cautious not to jinx a raid, we hardly mentioned the operation. The doctors had made clear that this would be the do-or-die assault, for which X-rays were mere preliminary bombardment. Wholly calm on the surface, Alyosha revealed through stress lines across his temples how much he wanted to survive his battle.
For a week, I had my own strain of waiting for the chief administrator's call without telling Alyosha, and of trying to find out why he had disappeared from the clinic after our conversation. Then a two-day hailstorm descended, which seemed to bury forever the queer waiting-room encounter with him. The raising of my hope was no more cruel than the news itself of the cancer in May; the promise of a magic cure no odder than the warnings,
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entreaties and riddles whispered to me last year by an assortment of strangers. All helped stipple the Russian scene with that occasional weirdness I would never be able to fathom. Alyosha and I lived out our strangely peaceful days, with some unhurried work on the kitchen and a meal in an out-of-the-way restaurant to avoid the fuss of being seen at the better places. Evenings, we were at home in candlelight, and some visitors were convinced enough that nothing serious was amiss to complain of the slack entertainment.
At this level, the entire experience of sickness and treatment was an elaborate charade we had undertaken to act out for inexplicable reasons. Or, when confronted by the smell of his charred skin, it was someone's tedious practical joke. How to make real to yourself that your best friend may be mortally ill?