- © 2007 Canadian Medical Association or its licensors
Borodin's alarm went off at its long-set 5:20 am time. The renowned vascular surgeon bolted upright in his single bed and was overcome with a sense of acute, profound dread. Should he get out on the right side or the left side? And with which foot? Wear slippers or not? Shower or bathe? For every decision he had previously made with no hesitation, now presented itself as a critical dilemma. He had heard of streptococcal throat infection in children causing an instant form of obsessive–compulsive disorder. Had the venison he had eaten the night before been tainted? The rye bread been tinged with the mouldy precursor of LSD?
His mind had long worked by way of differential diagnosis (“a systematic elimination of possibilities in search of the truth,” is how he presented it to his rather awestruck students). Only once had he been dead wrong in his powers of deduction. He had accused his long-suffering wife Ada of having an affair. And she had left him at once. Bad enough to have lived 20 years with his absence, how dare he invoke another loving presence for her that did not even exist.
It occurred to him then that one never knows what straw will break the camel's back.
Borodin padded to the bathroom and fretted whether to lift the toilet seat or not. Was the discomfort in his abdomen a sign that he needed to defecate or urinate? (He sat in terror and did both.) He brushed his teeth until his gums bled, as at least this act posed no alternative. Until he remembered his dentist's injunction to floss, which he felt compelled to do immediately.
But wait, should he not have performed this ritual after his breakfast?
The kitchen was yellow and defiantly cheerful, a remote act of will on Ada's part.
Should he lift the blind or not? Coffee or tea? Oatmeal or eggs? Paper or cloth napkin? These choices now mocked him and made him weak in the knees.
Ada had made so many of them when she lived there. But surely these dilemmas could not be attributed to her absence! She had already been gone 6 months. Being completely unsentimental, Borodin had not realized that Sept. 13 (that very day) was the anniversary of their wedding in the Rostow countryside. How many times had he forgotten it and disappointed Ada? Now he had seemingly forgotten it for himself.
There had been a stillborn along the way as well. Also in September. But as a routine medical event, it registered not even a small blip on his radar.
Borodin gulped some instant coffee, having put on the kettle for tea. He carried his cup (not mug) to the door and fetched the morning paper. What if he were to read it right to left or back to front? What would happen then? What if he didn't read it at all or read only the sports section, which he detested, having been completely unathletic as a child? But was it not too late to take up squash as his young protégé Horowitz had prodded? But then there would be the question of which club. Club A had once been the haunt of communist bigwigs and still reeked of their corruption. Club B had been anti-Semitic long before the war. Club C's membership comprised crass nouveaux riches and super-Natashas (impossibly beautiful girls looking for rich husbands). C had its appeal — but it was hard to remember what he liked. Redheads? Blondes? Brunettes? He shuddered at his indecision even in things erotic.
Borodin went to his closet where his many conservative ties seemed to laugh at him while his tailor-cut suits snubbed him. His shoes were neatly arranged as to black or brown and this now seemed preposterous.
Let us remember that this was a man who cut human flesh for a living. How many times had he told his residents that a surgeon's first incision was the most radical act ever posed by man?
Soldiers pull triggers, gamblers pull the handles of slot machines and priests raise chalices invoking God. But the surgeon's hands are his real instrument; he needs no other. And his gambles rescue lives rather than end them, and without ever even calling upon the supernatural.
Borodin looked at his watch, then compared the time with the oversized clock on his wall. A discrepancy of 2 minutes. Which to believe? He pulled out clothes at random and dressed quickly, though he was held up by the selection of socks.
He rushed out the door of his flat, locked 2 of its 3 bolts then dashed to the garage. He felt his stomach churn as the keys in his hand started to shake. Which of 5 possible routes would he take to the hospital?
He would simply have to take a taxi. Borodin rushed to the surface, but was paralyzed as to which corner to stand at. He remained inert, but fortunately a blue taxi interpreted his paralysis as a need for passage and screeched to a halt. “The Kinzer Institute of Surgery, please,” he gasped. Even breathing involved choice — nose or mouth?
“Which entrance?” asked the cabbie. Borodin could not find words and was thus left at the northeast entry point, which was at a complete diagonal to the cardiac wing. He had not entered the building there since his student days. Right-straight-left or was it straight left-right?
He began to sweat until Kiryl, an old classmate, spotted him, rushed forth and slapped him on the back.
“Borodin, old man! To what do we owe the honour of your presence? Why, as chance would have it, I'm heading over to your neck of the woods to perform a urology consult. Some old chap in urinary retention post-op. Let us walk there together.”
Kiryl was a man of too many words — had always been. But Borodin remained perplexed by which of many words he could select to answer the most rudimentary of questions. A simple affirmative could be subsumed under “Certainly. Of course. Yes. More than likely. Without a doubt. Indeed. Absolutely.” He began to consider these options but opted for a simple nod of the head — no language at all — when asked a direct question by his affable colleague.
“I'll leave you here, old chap. Lovely to see you. Say hello to Ada. Nadia is off on safari in Kenya. What they do with our money, eh?” News of the divorce had not yet travelled from the hospital's heart to its bladder.
Kiryl took his leave, but not without glancing back at his frozen confrere. He remembered with fondness the awkward youth who had been the gold medallist of their class 25 years before. How little had changed!
Borodin barely noticed the departure of his colleague, and followed the signs on fading green walls to his destination.
Perhaps this is a stroke or transient ischemic episode, Borodin thought as he made his way to the scrub room. His favourite nurse was prepping the operating theatre. His resident Sergey was whistling as he scrubbed vigorously at the sink. “Good morning Chief!”
“Salutations,” Borodin replied, wondering why on earth he had chosen such an anachronism.
He looked at his hands, then at the dispenser of green antiseptic. Right first or left? Borodin held both arms in the air, like a just-washed duck.
“See you in there, Chief. Chewed-up mitral valve in a 29-year-old man. Collapsed on the squash court,” his resident gushed.
Borodin felt a wave of nausea, then a chill up his spine. He welcomed these sensations. Perhaps it was just food poisoning after all!
“All ready,” Ilona shouted cheerfully.
Klinghoff, the best anaesthetist in the place, was at the helm of the cot in the small green room. “Bach or Brahms?” he asked.
Borodin, who was being helped into his robe and gloves nodded, which Klinghoff took to mean Brahms. Would Borodin pirouette right or left to approach the table? This back-to-back dance (so as to keep sterile surfaces sterile) had amused him from his very first day in the operating theatre. But today he was panicked, not amused.
Borodin stared at the young man on the table and contemplated his radical act. This would be his 300th valve repair if he was not mistaken. He had not felt this uncertain, even for his first.
Ilona handed him the scalpel and he held it, both admiring and dreading its gleam. The others looked on at their maestro, their philosopher king, waiting for the performance to begin.
Borodin considered his options. He could hand the scalpel to Sergey, a generous gesture to be seen as a vote of confidence and collegiality. He could throw it down, whereby Ilona would undoubtedly select a better one, as she had done many times when the chief was in a pique. Or else he could ignore his fluttering heart and make the 5-cm cut that would lead to the slice into the failing muscle of the young carpenter.
Suddenly, one word entered Borodin's mind. He uttered it without hesitation, like a long lost prayer into his paper mask. A first prayer.
“Ada.”
Then he made the incision.
Footnotes
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Allan Peterkin is completing a collection of short short fiction.