To read the novel in start-to-finish order, click the Volume Two link and consult the Table of Contents links at the bottom of the page.

Sunday, January 24, 2016

Chapter 17-4

This closes out Natalie for Volume One, as we see her get a leg up on her new duties as a Red Cross nurse in a field hospital.

There are three more chapters to go, but they're all single installment chapters so just three more installments to put up: Henri, Walter and Philomene in that order.

Near Tarnow, Galicia. January 10th, 1915. The Tatar driver clucked to his two horses and the horse cart turned back onto the road, where frozen ruts caused the vehicle to bounce viciously. Natalie turned and craned her neck to see Anna. For a moment the other nurse looked after them, then with a last wave she turned and started towards the cluster of buildings and tents which marked the 7th Field Hospital’s second unit.

The wind bit, and Natalie pulled the blankets, still warm from covering both nurses for the last few hours, around her more tightly.

“How long until we reach the first unit?” she asked.

The driver shrugged, but after a moment he answered anyway, “Perhaps an hour if there’s no trouble.” His Russian was strongly accented but understandable.

“What sort of trouble?”

“Shelling. Broken axle. Drunken soldiers.”

If the previous week was any indication, the last of these might be the most likely to appear, though surely they could be little real danger while Natalie sat next to the large, sober Mohammedan with his coiled horsewhip resting across his knees.

When he had arrived at the medical depot that morning to drive Natalie and Anna out to the two field hospital units, Anna had demanded to know why someone had not come to get them sooner, her tone colored with the sense of outraged order which Natalie had become so familiar with over the previous week.

In reply the Tatar had offered his characteristic shrug. “Christmas. All the Christians have been drunk. Now the Austrians attack, so time to sober up maybe.”

It was a strange, drawn out, increasingly lonely Christmas which had dogged Natalie throughout her last days in Kiev and now into her first week in occupied Galicia, a Christmas muddled by the clash and mixture of East and West.

The Lutereks, as Poles and Roman Catholics, celebrated Christmas on December 25th of the Gregorian Calendar, a reform of the ancient Julian Calendar which the pope had introduced in the 16th century and all Western nations had adopted by the middle of the 18th. Not so Mother Russia, which still abided by the calendar introduced by Julius Caesar. Thus when the Lutereks went to the Roman Catholic Cathedral of St. Nicholas to celebrate mass on the night of Christmas Eve, and the doctor stayed home from the hospital the next day to spend the holiday together with Borys before he left to join his regiment, for their neighbors and the Orthodox Church Christmas was still thirteen days away.

For Natalie too it had been Christmas, but though as a little girl living in the convent school she had often imagined what it would be like to live in a real house with a family on Christmas, now she had slipped quietly up to her room as soon as she got back from Christmas Eve mass, determined to avoid causing any scene by discomforting Madame Luterek as she prepared to send her second son to war. Remembering the joyous shouts and scrambling from bed to bed in the convent school dormitory as the girls came back from Christmas mass and opened the ‘charity bundles’ containing candy, illustrated cards, and little toys piously assembled by the ladies who supported the convent -- the hugs and confidences and best wishes for the coming year scribbled in autograph albums on that night of the year during which the sisters’ tolerance was nearly limitless -- Natalie for the first time in many weeks took the miniature of her mother and her old wooden doll, Lalka, into bed under the pile of blankets which kept her warm in the upstairs bedroom.

In the days leading up to the holiday, she had been waiting for a letter, hoping that perhaps the spirit of the season and the letter she had sent to her father’s lawyer, telling him that she was leaving her work as a governess and joining a field hospital, would inspire her father to write to her himself. Even if it remained true that she could not see him again just one letter, a few sentences written with tenderness, would be a treasure. But no. The letter which had arrived in that morning’s post was a formal one written by a legal clerk, expressing approval for her service to the Motherland and providing a credit draft which she could take to a bank in Kiev to get money for the clothing and equipment she would need.

And so she had spent her first Christmas like many other days: a full shift worked at the hospital and then a meal with Elena at an inexpensive cafe. Remembering her Christmas Eve night, alone, huddled under the blankets with her tokens of family, she had been particularly reluctant to say goodnight to Elena, who had just accepted a certified nurse’s position at a new military hospital on the outskirts of the city, and when the waiter began to make it clear to them that customers with such a paltry bill must cease lingering over their empty plates, the two had gone back to Elena’s little flat to make tea and sit next to the gas heater with blankets around their shoulders.

It had been late when she returned to the Luterek’s, stealing up the stairs in hope of disturbing no one, but Sara had appeared on the landing and drawn her into the nursery for a last goodbye with the three young people, before Borys caught the morning train to the front.

A week later, Natalie had boarded her own train, and had found herself turning misty eyed from the window as she looked out and saw, standing next to Sara and Lena on the platform, Elena waving to her as well. So much had passed since she had arrived in this same train station from Warsaw nearly six months before, a woman with a father at last but still without his name. Often, as on that terrible night in the dacha when she had locked the door of her room and leaned against it shaking, she could have wished that she had never left the convent school in France. There, if she had been lonely and known nothing of her family, she had at least been safe and unafraid. And yet, three people had come to wave goodbye to her after six months, three people who would miss her. And then there was Borys, who in their awkward conversation Christmas night had promised to write to her and always think of her as part of the family.

No one, after all those years, had come to wave goodbye to her as she left France.

She had wanted to wave to them until the last moment and yet also to hide the tears so eager to run down her face. She had found friends, and she was leaving them.

There was a boom like a single thunderclap, and Natalie jumped under her blankets and looked at the driver to see if he was alarmed. His expression was impassive, specs of snow accumulating on his downturned mustache and the big round fur hat he wore.

Of course, they must be near the front. Field hospitals were located five to ten miles behind the lines, safe from direct attack but close enough that the ambulance trucks and wagons could bring wounded men back for treatment quickly. The army medical manual she had studied for her certification stated that they were to treat the lightly wounded and send them back to their units after at most a few days recovery in the field hospital. More serious cases they would give immediate care, cleaning wounds, making emergency surgeries, and then dispatch them to a regional hospital for recovery. Those likely to die within the first few days, they kept and made as comfortable as possible. The duty of the field hospital was to provide immediate treatment, not long term care.

Again she heard the splitting boom, and now she realized that in a lower register, obscured by the rattling and bouncing of the horse cart, there was an intermittent undertone of rumbling, like more distant summer thunder.

“Is that artillery?” she asked, trying to give her voice a tone of light curiosity.

The driver nodded. “They’ve been attacking off and on for a day now. The big ones, those are 120s. Not much left to clean up after those, they say.”

The land around them had the particular drabness of winter. The stubble in the fields was relieved by only the slightest dusting of snow from the flurries that were in the air. The pastures were a dull brown and in places cropped so short by hungry animals as to be little more than frozen mud. And in the swaths of forest between farms, trees reached skeletal branches towards the grey sky. The only relief in the landscape was the scattering of human marks upon it: cottages, haystacks, a church steeple in the distance. Was the land of the front the same as this? Were Austrian shells smashing into haystacks and garden sheds while Russian soldiers struggled to find shelter amid frozen pastures? Were the men living without shelter in this weather? Surely the hospital, at least, would be in some sort of building.

It was indeed. The first unit had set up its hospital in a nobleman’s hunting lodge, a square, two story structure of darkened wood with covered porches that wrapped all around both stories. Across a fenced yard from the lodge itself was a stable nearly as large as the lodge itself.

The road had been passing through woods for the last fifteen minutes before they reached the lodge. Around the two buildings there was a large clearing and filling it nearly to the tree line, scattered everywhere except the fenced yard between the two buildings, were tents, wagons, and piles of crates.

“Women’s quarters are in the stables,” the driver said, halting the horse cart in front of that building. He offered Natalie a hand as she descended, then hoisted her trunk onto his back and led the way into the long, low building.

Though the structure and its straw-covered dirt floor clearly showed the building’s original purpose, the stable was as clean as the efforts of a score of women trained in a medical sanitation could make it. The walls had been painted white. A pair of kerosene heaters blunted the chill of the air.

A woman in the grey wool dress and red cross armband of a housekeeping sister hurried up to them.

“Ildus, is that the new nursing sister’s trunk?” He nodded. “Very good. Take it to her room and put it down. Then check in with the ambulance dispatcher. We’re to expect a busy afternoon.”

She turned to Natalie and held out her hands in greeting.

“My name is Marya, but as I’m the head housekeeping sister and old enough to be everyone’s mother the sisters all call me Mamushka.” Her accent was identifiably less educated than those of the nurses Natalie had worked with in Kiev. Housekeeping sisters were often volunteers without any education. But there was both authority and kindness in her manner, and Natalie could at once see why she was called Mamushka.

She took the older woman’s hands and clasped them tightly. “I’m Sister Nowakówna. Natalie.”

“We’re glad to have you. The medical sisters have been very short handed. Several had to go home after the cholera in the fall and then Sister Litov left us with pneumonia. Let me show you your room.”

The ‘room’ was in fact a stall which had once housed one of the nobleman’s pure bred horses. A hanging blanket formed a door, which Mamushka drew back to show the surprisingly cozy living space. A brightly colored rug covered much of the floor. The wood plank walls had been freshly whitewashed. The cot stood against one wall and her trunk had been set against the opposite, where it could serve as either a table or a seat. A tiny round table of polished wood stood against the narrow back wall, a piece clearly taken from some fine sitting room, and on it was a candle in front of a little icon.

“I hope you like it. We did all we could to make it cozy. We’ve had this same place for almost two months now, which is a mercy when it comes to small comforts.”

“It’s wonderful. Thank you.”

Outside a bell began to clang loudly.

“That will be more ambulances arriving. You’d best get your working uniform on. The hospital is in the main house and they’ll be needing you.”

Mamushka hurried away. Natalie hung her coat and hat on one of the hooks and shivered as she changed into her uniform and veil. Surely it would be warmer in the hospital, and she would be too busy to feel the cold.

The air outside bit through the thick grey wool of her dress as she hurried across to the lodge. Two motorized ambulances had already pulled into the fenced yard, their tail pipes putting out clouds of steam and diesel smell as they idled. Orderlies in bloodstained aprons were unloading the stretchers from their canvas covered backs.

Natalie followed a pair of orderlies as they carried a stretcher up into the lodge. It was warm inside, especially after crossing the freezing yard. Indeed, it was almost stifling. Several big kerosene heaters were going full blast, and the smell of kerosene mixed with the smell of blood.

They had laid the stretchers in rows on the floor of the big main room. From the walls, ranks of antlers and other hunting trophies looked down on the carnage with memories of happier times when it was animals who were shot and carried here, not men.

A nurse was moving among the stretchers, briefly looking at each man and directing the orderlies where to put them. She paused as Natalie came in.

“You’re the new nurse?” The other woman was taller than Natalie and thin, her cheek bones standing out sharply and her eyes sunken, but the hair which could be seen slipping out from under her white veil was black with not a speck of grey.

“Yes. Sister Nowakówna.”

“Sister Travkin. We’re glad to have you. They’ll need your help preparing for surgery.”

She waved in the direction of the hall door and went back to her triage.

Natalie went down the hallway. She could hear screaming and the sounds of struggle ahead. The hallway ended with two open doors, one opening on what had been a dining room, the other on what had been a sitting room. Both were now operating theaters, and in the sitting room a surgeon was removing the leg of a man who had not been put under anesthesia. Though strapped to the table, the patient was bucking and struggling while two orderlies held him down. A nurse handed the doctor tools and irrigated the cut at intervals with antiseptic.

The surgeon put aside his scalpels and picked up a saw. There followed the sound which still always put Natalie’s teeth on edge, this time emphasized by the patient screaming around the rags one of the orderlies had forced into his mouth. At last, after a crescendo, the patient lost consciousness with a final spasm and the surgeon finished his cut in silence. After he had folded and sewed the flesh and skin over the new cut, he turned aside while the nurse dipped her hands in a basin of carbolic solution and began the bandaging.

Where was the aseptic nurse? Were they too short handed for basic precautions against infection? The doctor seemed see nothing wrong with this and left her to it, approaching Natalie instead.

“You’re the new nurse?”

“Yes, Doctor. Sister Nowakówna.”

“Good.” He dried his hands on his already bloody apron, then picked up a dark brown bottle -- the same type used for antiseptics but unlabeled -- and took a swig from it. “Get the second operating theater ready while Sister Usenko finishes that patient. I’ll start the next case as soon as you have it ready.”

Before there was any time for Natalie to reply he left, going down the hall to the main room where Sister Travkin was sorting the patients. Still, he had been clear in his orders, and she knew how to prepare an operating theater. It was strange after the ordered world of the Prince Mikhailov Hospital not to have someone show her how things were done at this new place. Still, it was precisely so that she could act independently that she had been trained.

Nothing had been done yet to prepare the other room. There was still blood on the table. The instruments were dirty. She look looked for the clean cloths. For the sterilizing solution. For the store of clean instruments while these were being sterilized. Nothing. There were only some towels that showed clear signs of having been used to clean up after the previous surgery, and a basin of antiseptic which people had clearly washed their hands in. She opened the cupboards in the sideboard, lifted the lid from every crate, but unless she was to use sterile bandages to clean up or break into the sealed bottles of antiseptic for wound irrigation, there was nothing. The supplies must be stored in some other room, and since she had been rushed into work without being grounded in where things were kept and how things were done here, she did not know.

Two orderlies were carrying the patient from the sitting room operating theater out on a stretcher. She would ask Sister Usenko. Natalie crossed the hallway and found the other nurse washing her hands in the basin of carbolic.

“I’m sorry, Sister. The doctor asked me to prepare the other operating theater, but I don’t know where you keep the clean cloths and sanitizing solution.

Sister Usenko sighed. “You’re just in from a city hospital, aren’t you?”

It sounded like an accusation, though there was no reason why the Prince Mikhailov Hospital should be looked down on, it was one of the best in the province.

“Yes. I just finished my certification.”

“Well we can’t always do things as it says in the textbooks. Part of field work is knowing what you can safely skip and what you can’t. Come, I’ll show you.”

Natalie followed her back into the dining room operating theater. Sister Usenko dipped the used towel in the basin of carbolic and wiped the operating table down with it until the table was visibly clean. Then she began to rinse the surgical instruments in the same basin and lay them back out on the table.

“The attack has been going on for thirty-six hours and we’ve had casualties steadily throughout that time. We’re much more respectful of standard procedures when we’re dealing with our usual trickle of casualties. But there’s never enough of anything except bandages. We must have enough bandages to wrap the whole army up like Egyptian mummies. It’s the one thing every patriotic noblewoman and ladies association sends. Right now it’s carbolic that we’re short of. And chloroform. Cleaning the wounds is the one thing that can’t be stinted at all, so we make do as best we can with the other sanitizing and save all the bottled carbolic for flushing out the wound before bandaging. There, that’s the lot of it. Let’s go pick out the next one.”

The doctor had reappeared in the doorway at that moment, bottle in hand.

“What’s this? Why is Sister Usenko doing your work for you?” he demanded.

“I was just--” Sister Usenko began to answer.

He cut her off. “I asked her. If she’s supposed to be our replacement nurse, I want to know if she can nurse or not.”

Old instincts from the convent school cause Natalie to give a sort of nod and half curtsey at the sound of the raised voice. “Sister Usenko was kindly showing me how things are done here.”

“One of the ways things are done here is two operating theaters at a time. That means nurses have to work, not stand around being angels of the sick room afraid to get their hands dirty. If you can’t clean an operating theater and prepare a patient, at least make yourself useful. Get that leg out of there,” he waved at the room across the hall, “and get the room ready to be used again. Usenko, get the next patient in here and be quick about it.”

He turned and left again, they could hear his footsteps echoing down the corridor. Sister Usenko gave Natalie a tight lipped smiled and followed after.

The leg was lying on the operating table in the sitting room, partly covered by the cut-away remains of the soldier’s uniform. She could see the ragged gash in the outside of the thigh, cutting right down to the bone which was crushed and splintered. The clean black and white lines of the diagrams they had studied during training came to mind, providing a rational distraction from the tortured meat on the table. There were major arteries running through the thigh. How had he survived to reach the field hospital without bleeding to death?

Out in the corridor two orderlies were carrying a new patient into the dining room operating theater. There was no time to stand and think. She had to clear this leg away and prepare the next patient before she caused another explosion of anger from the doctor.

The amputation had been just below the hip, and the man had been a large one. Nothing before this had caused her to think about the size of a leg, nor the difficulty of carrying one which was not attached to a person. She started to pick it up by the undamaged end, still wearing its calf-high leather boot, but it was impossible to get enough leverage. If she carried it crossways in her arms like a piece of firewood, she would not be able to get through the door. At last she hugged it to her chest with both arms and hefted it up.

Struggling under the weight and awkwardness of it she lurched out the door with her burden and down the hallway. A housekeeping sister was coming up the steps into the lodge carrying two steaming buckets of water and a mop tucked under one arm.

“Where do we dispose of the limbs?” Natalie asked her.

“There’s a pit over there.” The sister pointed: across the fenced yard and beyond the tents and parked ambulances.

Natalie nodded and tried to shift the leg into a more comfortable position, but there was no easy way to carry it. When she lifted it higher the hairy skin of the thigh touched her cheek. It was still warm, and something in that caused her to shudder so that it nearly slipped from her grasp.

Why had she come here, to this godforsaken place where the doctor drank between operations and things were not cleaned properly and there was not proper help? She had never had to carry an amputated limb back at the hospital in Kiev. A pit, the housekeeping sister had said. She’d never even had to think at the Prince Mikhailov Hospital about what happened to the limbs that were cut off. They were disposed of properly by the orderlies.

But while she was standing in the doorway of the field hospital with a leg in her arms was not the time to pause and contemplate the deficiencies of the posting. How to get down? She turned and edged down the stairs sideways, holding her burden tight against her and feeling for each step with her foot. At last she gained the ground and started across the fenced yard, but it was the rutted, frozen mud of the yard that at last betrayed her. She put a foot on ice, it slipped, she twisted, and it was only as she was falling that she overcame the instinct to hold onto what she was carrying and managed to put a hand out to catch herself. Her hip hit the ground painfully, but by dropping the leg she at least managed to avoid hitting her head.

For a moment she sucked a knuckle from which she had barked the skin and allowed herself a full serving of self pity, but then the cold of the ground began to bite at her. She struggled to her feet.

“That’s a heavy load, sister. Let me help you.”

It was Ildus the Tatar driver who had brought her from Tarnow. He stooped and picked up the thigh end of the leg. Natalie took it by the foot, and was surprised at how easy it was to carry it between the two of them. They hauled it past the line of tents and the parked ambulance wagons and found the pit: a trench fifteen feet long and five deep, in which other amputated limbs lay jumbled and twisted at obscene angles like a stewpot of the damned. She started to heave the leg in, but Ildus tugged the other way, throwing off her balance.

“Wait, sister! Don’t toss it yet. That’s a good boot.”

She dropped the leg, and he turned it over, braced his foot against the inside of the knee, and pulled the boot off, exposing the foot in its dirty leg wrappings.

“There, see? Lots of wear left in that boot. It’s impossible to get them off once the leg is frozen hard.”

He reached down and rolled the leg over the edge into the pit.

Natalie looked down at it in horrified fascination. “Is there anything else we need to do? Or do we just leave it?”

“Not this time of year. The cold is a blessing, you see? If it were hot, we’d need to shovel lime. And even so it would smell something awful. Cold is much better.”

Back in the hospital she wiped things down as Sister Usenko had shown her, had the next patient brought in, and began to clean and prepare his wound for surgery. Doctor Sergeyev continued to be short with her and to swill from his bottle between each surgery. At last the other doctor, who had been sleeping after doing surgeries all night and through the morning, came back down, and Doctor Sergeyev ascended with careful and deliberate steps, his brown bottle tucked in the crook of his arm, to take his own turn at rest.

It was fully dark when the stream of ambulances ceased. The attack was over.

When they had settled all the patients in their proper places -- officers in the upstairs rooms of the hospital and common soldiers in the tents which surrounded the fenced yard -- the sisters and orderlies went to clean up and gather in the dining tent.

Natalie changed her dress and apron. There was dried blood, brown against the grey wool of her dress, where the amputated leg had rested on her shoulder.

The others were eating. She was hungry, and it was cold standing in her shift and wool stockings, staring dumbly at the bloodstains on her dress. But all of it was suddenly too much, too hopeless, too foreign, too hostile and squalid. She let the soiled clothing fall in a pile on the rug and crawled onto the cot, wrapping herself in the thick blankets laid out for her. It was warm here, and she didn’t have to see anyone, and why, why had she left the only people who cared about her and come to this terrible place?

She had been crying, soundlessly, into her pillow for some minutes when there was a breath of air and a soft step, then a gentle hand that rubbed her back.

“There, there. It’s all right. It won’t always be like this, little one,” said Mamushka. Her soothing tones showed her peasant origins much more clearly than her businesslike talk when they had first met. “Today was a hard day, but God willing tomorrow is another one and won’t be so hard.”

“It’s as if all my training is useless here. I’m no use.”

“That’s the darkness talking. It will look better in the morning. How many could have plunged in as you did today, with Doctor Sergeyev in one of his black moods, and not a word of complaint?”

“I’ll have to learn everything again.” Already the sharp taste of despair was receding, but Mamushka’s comforting felt so good that Natalie wished it would continue. And there was a strange, unfamiliar relief to being able to lay out all her problems and fears, however unreasonably. Perhaps this was almost like having a mother.

“Well, there’s time for that,” said Mamushka. “The war isn’t going anywhere.”

Read the next installment.

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