Zmudowski appeared with an ether mask and bottle, positioning himself at the head of the table. By afternoon, she had removed two feet and a hand with Lucius at her side, watching as she tied the limb off with a tourniquet, incised the skin and retracted the muscle, and with a single, fluid motion, sawed off the bone. She threw loose loops into the muscles and drew them together before setting the flap. To a patient with a shrapnel wound to the thigh, she asked, “How long ago did this happen, Private?” The answer was January. When he went under, she began to carve it away, murmuring as she went along, her voice like someone praying, cutting back the dead tissue until only pink, fresh bleeding flesh was left. By then, most of his thigh and hamstring were gone. The soldier stirred. They gave him more ether and cut off his leg.
By then, darkness had come, and Zmudowski returned with his lantern. Hopeful, Lucius wondered if they might break to eat, but then rounds had begun, as before, at the east end of the nave: the Austrian cavalryman, the Hungarian officer, the Czech sniper, and on. It was swifter now, the need for introductions gone. Halfway along the first row, flies circled above a soldier, an Austrian dragoon. She pointed. “God made flies to tell us where the rot is, Doctor.” She knelt to inspect the stump of his arm. “There,” she said. “It’s beginning. Can’t you see?”
He nodded.
“Now smell it,” she said. He hesitated a moment. “Closer, Doctor, with your nose.” And he leaned in, the sharp odor making his stomach turn. They brought the man back to the table, exposed an abscess reaching almost all the way to his axilla, and amputated the rest of his arm. An hour later they were back in the nave. Gruscinski, Redlich. Czernowitzski, docile as a lamb. Then into Fevers and Medical and Heads.
There she stopped suddenly, walked the length of the church, and returned with a shovel. “Move,” she said to a patient, his head wrapped in gauze. As if in drill, he rolled to the side, and she brought the shovel down hard upon his pillow of straw. She stirred it, and a pair of pink little heads rose up, twisting in the air. She brought the shovel down hard again.
“Szczur,” she said, as if it needed naming. Rat.
Zmudowski hurried off to get a pan. There were three more cases to see in Heads, and then the six men in Dying, down from eight the day before.
That night, Lucius slept again in his greatcoat, too exhausted now to be afraid. When dawn broke, there was a knock at his door, and they began again.
The next days were the same.
The ambulances arrived out of the black night, out of snowstorms, out of sun-glittering fields of ice. In his quarters, in the crossing, rounding in the church, he would hear the whistle, or the shout, “Incoming!” and the orderlies would deploy to help the stretcher crews while Margarete, in her two coats, breath steaming, directed them to the quarantine. They came from the mountains or the snow trenches dug into the sloping hills, many already dead from their wounds or from the cold, the others crying or staring out with terrified eyes as they were stripped and disinfected, as clods of frozen dirt and blood were dissolved in water, and tourniquets applied.
In the beginning, Lucius only watched. But by the end of the month, his hand strong enough to grip a scalpel, he began to assist Margarete with the simplest cases. Yes, a butcher’s work, he thought, this carving out of necrotic flesh, as Zimmer had promised. Yet it was extraordinary to think that he was allowed to do this, that he had been given permission, that there was no one there to ask him questions designed to humiliate him before the others, no famous professor to scold him for greeting the patient, no crowd of other students with whom to compete.
The first amputation he carried out was on the hand of an Austrian rifleman. A frostbitten purse of crushed bone, a single violet finger remaining, the hand had held together in the field by the simple virtue of having frozen, and once in the church it began to melt apart.
“A deep breath, Doctor.”
Margarete stood close to him as his scalpel pressed the forearm and finally broke the skin. He prepared the flap as she had shown him, dissecting back the muscle from the bone. But as he went to get the saw, she stopped him.
“Perhaps this is how it is done in Vienna, but in Galicia, you’ll need to cut a larger flap. In Galicia, that flap will never reach across the stump.”
“Of course. Like this?”
“More.”
“This?”
“No: more. Don’t be so shy.”
“Like this?”
“Like that.”
He looked up, glad his mask now hid a silly grin.
She handed him the saw. “Now go. Don’t stop. Zmudowski will hold him down if he awakes.”
But in Galicia, Pan Doctor…
Perhaps in Vienna they cut their suture knots too close; perhaps in Vienna, they let their dirty sleeves dangle in a wound; perhaps in Vienna they forgot cotton in a wound after they closed it, or left tourniquets on when they were no longer necessary and the patient was writhing.
But in Galicia, it’s done like this.
Perhaps in Vienna they took off the whole foot when only a toe was needed.
Perhaps in Vienna they are stingy with their drains, and make messes out of everything.
Perhaps in Vienna they didn’t step away to sneeze.
But in Galicia…
He learned.
Good, Pan Doctor.
Yes, that’s right. Stick your finger in, explore it. If you don’t do it, no one else will. Get the bullet out.
Good. Now tie off, Pan Doctor. Go.
Good. Very good.
Lovely.
Yes. Good. There.
Who taught you, Doctor? They should really be honored with a decoration.
There. Yes.
Go.
5.
February turned to March.
New storms swept through the mountains. Outside, the fighting slowed. The snow blew steadily across the valley. Inside the church, it grew so dark they fashioned torches from pitch and rope hemp. Above, the murals glistened with frozen condensation from their breath.
Between rounds and cases, he took his meals with Margarete at a small table that had been set up at the edge of the bomb crater. She had initially brought him his meals in his quarters, as regulations dictated that officers should eat apart from the enlisted men. But Lucius hardly considered himself a real officer—to him, an officer was someone like his father—and, regardless of rank, he didn’t want to be alone.
The room grew quiet as the men ate, their voices low as if in deference, their spoons clinking against tin. Like the soldiers, Margarete attacked the food, ate hunched so as not to lose anything to the floor, always saved her bread to wipe up her soup, and unapologetically cleaned up any missed drops with her fingers.
“One must hurry, Doctor—we might be bombed during a meal.”
At first they spoke mostly of their cases, of who was getting well enough to leave with the next convoy returning over the passes, and who—in lower voices now—would die. They reviewed their supplies obsessively: how much morphine was remaining, how much catgut, how much iodoform, how much lime. As the weeks went on, however, and he came to know the patients and their wounds, he found their conversation shifting. She had opinions about everything, not simply how to prepare antiseptic solutions or apply a dressing. She thought it a great mistake that the army had pushed forward in winter. The generals didn’t understand the snow, she said. One did not defeat the snow; one let it come and waited, like a bear in hibernation, one did not send soldiers where they didn’t belong. And how did they make their decisions to dress men in cotton socks and such absorbent puttees? And, oh, the shoes they gave them! And then to think that they had the nerve to send conscription officers to canvass the wounded! The last had come shortly before Lucius’s arrival, a horrid man who had taken any soldier he thought could march another step. Men with fevers! Missing fingers! Headaches that wouldn’t go away. She cursed him. May his feet be eaten by maggots, May he lose his teeth on stale bread, May his family die of plague!