The professor held out his hand to Sheremetev for the charts. He made a show of minutely examining the notes on Vladimir’s behaviour. After a while he began to rub at his nose as if he had an itch, a habit he had, Sheremetev knew by now, whenever he was trying to disguise his procrastination.
The dilemma was the same dilemma that confronted Professor Kalin each month, and everyone in the corridor – not only Kalin himself, but Sheremetev and Andreevsky as well – knew it. The tranquilliser that the professor had prescribed to reduce the rages when Vladimir still had insight into his condition had numerous potential side effects, which included, paradoxically, delusions, hallucinations and agitation. Right now, that was exactly what Vladimir had. Reducing the dose of tranquilliser might therefore solve the problem. On the other hand, these delusions, hallucinations and agitation might have nothing at all to do with the medication, but be due to Vladimir’s dementia, and it might be the medication that was keeping them in check – in which case, increasing the dose might solve the problem. The only way to tell for certain would be to reduce the dose and see what happened, but the one thing one could say for certain about reducing the medication after so many years of use was that there would be severe withdrawal effects, which might well include… delusions, hallucinations and agitation. All in all it was an unholy mess and it would take months and months to sort it out, months in which the medication would have to be reduced in gradual, tiny steps and during which Vladimir would need to be monitored closely and assessed, ideally, once a week.
It took a good half a day out of Professor Kalin’s schedule to come to the dacha outside Odinstovo, half a day in which he could otherwise be attending to his eye-wateringly lucrative private practice, for which there was already a waiting list of over three months – coming even once a month was already costing him a small fortune. Coming once a week would cost him a large one. Naturally, Professor Kalin was as patriotic as the next man, and was truly grateful – as were his British-educated children – for the health system presided over by Vladimir, in which people would literally crawl out of public wards in fear for their lives – he had witnessed it with his own eyes, not once, but twice – to get themselves into private hospitals, in a number of which the professor held considerable shares. But even so, there were limits to what could be expected from him. And really, looking at this chart, it was only every few days that Vladimir had an episode of agitation, and only every second or third of those was so extreme as to require an injection, and just this month there had been almost three full weeks in which he had been injection-free…
‘It really isn’t that bad,’ said Kalin.
‘No,’ said Sheremetev.
‘You could almost say it’s improving,’ said Andreevsky, peering over Kalin’s shoulder at the chart.
Kalin glanced at him suspiciously, then turned back to Sheremetev. ‘It’s always this Chechen, is it?’
‘When he’s fighting, yes, it’s always him.’
‘And he really fights him? I mean, he physically gets up and fights him?’
Sheremetev nodded.
‘Who is he? Someone he knew? Someone he worked with?’
‘I have no idea.’
‘You could increase the dose if you want to,’ said Andreevsky. ‘His heart could take it.’
‘I thought you said it was improving!’ said Kalin.
Andreevsky shrugged. ‘Up to you, Vyacha.’
Kalin studied the charts again and rubbed at his nose. Andreevsky stole a glance at Sheremetev and grinned. Kalin had no idea what to do but couldn’t bear to show it in front of a colleague or a nurse. The nose-scratching was a sure sign. In the end, Andreevsky and Sheremetev both knew, he was going to do nothing, as he always did, and say that he would review things in a month.
‘Does he wander?’ asked Kalin suddenly.
‘Wander?’ said Sheremetev.
‘Vladimir Vladimirovich! Does he wander?’
‘No.’
‘At night?’
Sheremetev shook his head.
‘Do you keep his door locked?’
‘He never wanders.’
‘Never?’
‘Never.’
‘Still, you should lock his door, Nikolai Ilyich.’
Sheremetev had no intention of locking Vladimir’s door. He hated the idea of such a thing unless there was really no alternative. It was a momentous betrayal of trust, to confine someone like an infant. And it wasn’t necessary. First, Vladimir didn’t wander. And second, if he did, Sheremetev would surely hear him through the monitor.
Kalin gave his nose a final scratch. ‘In my opinion, it’s best to leave things as they are for now,’ he said sagely, handing back the charts. ‘I’ll review the situation next month.’
‘I agree,’ replied Andreevsky in his gravest, most professorial voice.
‘Be sure to make a note of every episode, Nikolai Ilyich,’ said Kalin, holding up an admonitory finger. ‘I’ll need to make a full assessment.’
‘Every episode,’ said Andreevsky.
The two professors walked to the stairs, Sheremetev following a step behind.
‘Does anyone come to see him?’ asked Kalin, glancing over his shoulder.
‘Not much,’ said Sheremetev. ‘Three days ago President Lebedev was here to take photos with him.’
‘I saw in the paper. How was he?’
Sheremetev shrugged. ‘He was what he was. They wanted him to give the president his blessing, but he refused to say anything.’
‘Did he say why?’
‘I got the feeling that he and President Lebedev didn’t like each other much.’
Professor Andreevksy laughed.
‘Do you think he knew what was going on?’ asked Kalin.
‘I think he knew more than you would think. At first he thought Lebedev had come to make a report to him, that he was still some kind of minister. Then I think he realised that something else was going on.’ Sheremetev smiled. ‘He liked the cameras. As soon as he walked in the room, you could see him stand taller.’
Kalin glanced at Andreevsky and chuckled. ‘Vanity. It’s like I always tell my students: the deepest part of a person’s character is the one that goes last.’
They went down the stairs. The security guard in the entrance hall stepped forward from his post and opened the door for the two professors. Outside, their car was waiting.
‘Do you still take him on his walk each day?’ Kalin asked Sheremetev.
‘Yes. Every morning. If not, in the afternoon. No matter how bad the weather, we try to go. Occasionally he resists, but not usually. He enjoys it.’
‘How long does he walk for?’
Sheremetev shrugged. ‘Half an hour. Longer if he wants. If he’s had a disturbed night, if he’s tired, it might be less. I have to watch that. We have problems if he gets too tired.’
‘And away from the dacha? Do you ever go out anywhere else?’
‘Not for a long time.’
‘Maybe you should take him out, Nikolai Ilyich.’
‘Do you think I should?’
‘Why not?’ said Kalin. ‘Have an outing. Somewhere different.’
Andreevsky nodded. ‘It’ll be good for him.’
The two professors headed for the door. ‘Shame his heart’s so strong,’ Sheremetev heard Andreevsky saying. ‘He could go on for years.’
THE VISIT OF THE doctors left Sheremetev feeling dejected. Andreevsky was right – it was a shame that Vladimir’s heart was so strong. Better to keel over with a heart attack and be gone than to linger in this twilight for so long, neglected, abandoned by family and friends, cared for only by strangers who were paid to do the job.
Over the years, Sheremetev had seen the visitors to the dacha slow from a flood to a stream to a trickle that by now had dried up almost entirely. The horde of parasites which had hummed around Vladimir when Sheremetev first arrived had flown off the moment they realised the ex-president no longer exercised any influence with his successor. At the start they had been everywhere – a year later not even their echoes were heard. Official visits from Russian politicians and foreign dignitaries who felt obliged to pay their respects lasted longer, but came to an end when Vladimir’s condition had become so obvious that the visits were an embarrassment to the government and word was discreetly put out that the former president had retired from all public duties to enjoy his richly deserved retirement. As for his private visitors, the old cronies who might have felt some loyalty to Vladimir, if not affection, were mostly themselves either ill or dead, and those who weren’t too frail to visit found little pleasure in coming to see a man who no longer recognised them. After a while, even a lingering sense of duty wasn’t sufficient to bring them out to the dacha. That left only Vladimir’s family. His first wife was dead, but the second one, the one Vladimir had married in secret, was very much alive, thirty years his junior and constantly linked with one billionaire or another. She had left him in reality, if not officially, even before he stepped down from the presidency. In earlier years, his children and grandchildren had come from abroad to visit at Christmas or Easter, but nowadays an excuse invariably arrived in their place. Thankfully, thought Sheremetev, Vladimir had no awareness of the feast days and didn’t know the extent to which he was neglected.