We return to Natalie in a field hospital on the Eastern Front. The installment is a bit longer than usual (which in part explains why it took a while to get done) but I hope people will find it worth the wait.
Near Tarnow, Galicia. March 26th, 1915. For most of the Russian Third Army, the fourth week of March, 1915 was remembered because on the twenty-second the Austro-Hungarian fortress of Przemyśl finally surrendered. Situated in the Habsburg half of Poland, the stronghold on the River San had been completely surrounded by Russian forces since October, yet its garrison of a hundred and twenty-five thousand men had held out all through the winter. A symbol of the tenacity and disfunction of the empire it defended, the garrison had withstood artillery bombardment and increasing starvation while issuing its daily orders in fifteen different languages: Poles, Austrians, Ukrainians, Hungarians, Czechs, Slovaks, Slavs, and Jews united only in their willingness to resist the Tsar’s army. And yet at last, supplies had run out and the hundred thousand surviving defenders had been led into captivity. Before the Russian army, the way was open to march south across the Carpathian Mountains into Hungary, or West into the heart of German Silesia towards Breslau and Dresden.
At the seventh field hospital’s first unit, however, that week was recalled as the week during which Doctor Sokoloff collapsed with pneumonia and after several days of feverous delirium was sent home on the next hospital train to recover his health. This left the field hospital to be run by four certified nurses, including Natalie as the newcomer; the staff of orderlies, nurses’ aides, and housekeeping sisters who did much of the work but provided little of the medical expertise in the hospital; and one surgeon: Doctor Sergeyev.
Sokoloff had always been the more reclusive of the two doctors, deferring to the eminence of Sergeyev’s Moscow training and retreating to his room with one of his small collection of books whenever he was not on duty. And yet the mere fact of the second surgeon had been enough to provide balance.
“I’ve done with him,” announced Sister Travkin. She poured herself a cup of tea from the samovar. The field hospital had remained in the same place for more than five months now -- a result of the winter weather and the lack of success achieved by either side’s winter offensives -- and during that time all that could be made comfortable had been. The nobleman’s hunting lodge which had been requisitioned for their use had been well furnished, yet there was no place for upholstered chairs and Persian rugs in operating theaters and ward rooms that must be scrubbed clean with carbolic solution every day.
The women’s dormitory had originally been a stable for the owner’s thoroughbreds. Its floor planks were now scoured as clean as any kitchen floor, and the common sitting area was made comfortable with rugs, chairs, and tables taken from the house.
“What’s wrong?” asked Natalie.
“He must go to bed. There’s nothing more to be done about the wards. We are quite capable of seeing to the patients for the rest of the night and there are no more expected. But he’s prowling around like an angry cat finding fault with everything, and I’ve simply done with him. He’s had more than enough out of that medicine flask of his and it’s making him more surly by the hour.”
However critical Sister Travkin might be in the privacy of the women’s sitting area, it was unthinkable to question the surgeon’s behavior to his face. The field hospital had a hierarchy as rigid as any army command, and the surgeon sat untouchable and unquestioned at its top.
This had been the advantage of having another surgeon on the staff. The diffident Doctor Sokoloff had never taken the approach of criticizing or disagreeing with his fellow surgeon. But when Sergeyev became too difficult or went too far in his self dosing using the medicine flask of vodka which he always had with him, a quiet word from one of the sisters had always been enough to get the reclusive doctor to appear and say that he felt he might as well start his shift. Whether or not he realized that he was being managed, this had always been sufficient to encourage Doctor Sergeyev to take himself off to his room and sleep off the day’s exertion, worry, and alcohol.
But now, at least until Doctor Sokoloff returned or a new doctor was sent in his place, there was no alternate authority figure within the hospital and no respected colleague who could offer to take Doctor Sergeyev’s place.
Natalie and Mamushka exchanged a glance from across the room. Then they both, with a flurry of excuses to Sister Travkin, got up and left for the hospital building to see what could be done.
As they reached the steps of the lodge they met Sister Usenko, who was descending with one of the large porcelain-finished pots which were used to carry away the waste collected from bedpans.
“Are there no housekeeping sisters or orderlies on duty?” Mamushka asked, shocked to see a certified nurse doing work which was reserved for those lower in the medical hierarchy.
Sister Usenko gave a sort of sideways nod, a substitute for the shrug that would have risked spilling the container she was carrying. “I don’t mind. It will only take me a minute.”
Mamushka stepped forward and took the bowl from her hands. “You’ve duties enough in the wards. I’ll take this. Go see to the doctor.” She left, bearing away the container towards the waste trench across the yard. For a moment as she passed Natalie caught the scent of warm urine hanging in the cold March night air.
“I know I shouldn’t, but he was so urgent to see it done,” Sister Usenko said, watching the retreating housekeeping sister.
The admission seemed to invite a sort of intimacy. “Is it bad tonight?” Natalie asked.
Sister Usenko’s face seemed to close. “Bad? I don’t know what you mean. The doctor would like to see the wards in proper order before he ends his shift. That’s all.” She turned and led the way back up the stairs with Natalie following in her wake.
They found Sergeyev on the second floor. The bedrooms of the lodge had been stripped of their old furniture and the bare rooms filled with cots, spaced just far enough apart for the nurses to get between them to turn the patients and make the beds.
Three of the rooms had bright yellow cards tacked to the door, marking them as infectious disease wards. These were the rooms which were currently most full, with cases suffering from the various diseases of poor sanitation and exposure to the elements. Through the winter, pneumonia and influenza had predominated. Now, with the thawing of the spring, cholera and typhoid sprang up among the soldiers even as the wildflowers poked up from the tortured earth in which they lived.
The other two rooms, marked with red cards, were for those suffering from battlefield injuries. With the front mostly settled into quiet siege warfare along the established lines, there were few enough of these and most of the beds stood empty.
Looking around from the top of the stairs the nurses saw that the door to one of the infectious disease rooms stood slightly open.
“Who left that door open?” Natalie asked, hurrying to close it. Leaving the door open violated the very purpose of having an infectious ward.
Sister Usenko made a hushing noise. Before she could speak, Doctor Sergeyev pulled the door open and stepped out into the passage, nearly colliding with Natalie as she went to close it. He stumbled to the side to avoid her, and in the awkwardness of the movement she could see that he had indeed had much to drink already.
“Sister Nowakówna. Are you responsible for the state of this ward?” The doctor thrust a regulation grey woolen blanket at her. “Look at this.”
“Sir!” She caught the blanket rather than let it fall from her hands, but only out of habit. This was from the infectious ward. When those blankets and sheets were changed they were carefully gathered into a laundry bag and sealed up before being taken out of the ward. The housekeeping sisters in charge of the laundry boiled them in big copper kettles for half an hour, and those who were responsible for changing the linens in the wards turned their uniforms in for similar treatment and washed their own bodies down with antiseptic solution when they went off shift. With few effective medicines to actually treat such diseases, stopping their spread was the first and most essential line of defense. And here was the doctor, plucking out a blanket which had been steeped with infection since the laundry day last week and thrusting it into her arms. “If there is some fault with the blanket, I can get a new one, but anything from the infectious ward must be collected and laundered properly.”
“Is it proper laundering?” Doctor Sergeyev demanded, “to leave an officer, a cavalry captain, with a blanket so worn it is fraying at the foot?” He stabbed a finger at the area where the threads were thinned with wear and had begun to come apart.
“I can speak with the laundresses, if you desire, sir. But there are only so many supplies that we have.”
“Sister, do not seek to put blame on the laundresses. These are your wards. Both of you.” He pointed an accusing finger first at Natalie and then Sister Usenko. “You. I. All of us are responsible down to every sheet and medicine bottle. I’m aware that we have limited supplies, but where do you think that supplies come from? They come from the support and goodwill of officials and of leading nobles. Does it not occur to you that a captain of the cavalry in particular is likely to be well connected? If he tells Princess This or Countess That we have treated him shabbily, do you think she will be inclined to outfit another hospital train or hold another fete to raise supplies for the troops? Eh? Will she?”
The two nurses remained silent in the face of this speech.
“We will inspect the bedding in every officer ward until I am satisfied that you are treating our patients properly.” Turning on his heel, the doctor started for the next door, one of the wards identified by a red card as for the wounded rather than infectious diseases.
“Doctor!” called Natalie. The words came out so loudly that he drew back just before he grabbed the doorknob.
He turned to face her, and the annoyance was so clear in his expression that Natalie found herself momentarily without words.
“Well, Sister Nowakówna? What is it?”
“I--” Why had she spoken? He was a doctor. He was her superior in training and rank. And he was a man, with all the authority and unpredictability of that sex. But he was going to infect her patients. “I’m sorry, sir, but could you wash your hands at the antiseptic station outside the infectious ward before going into the wound ward, sir? The injured men are more susceptible to infection, sir.”
He glared at her, and with a struggle she held his gaze, though at every moment she wanted to look away. “I don’t spread infection, Sister,” he said, drawing out each word separately and clearly. “I heal infections.” But he did walk back to the basin of carbolic solution which stood outside the infectious ward and dip his hands into it. As he dried his hands off, he turned his gaze back on Natalie. “Do not presume, sister, to tell me what is right to do in my own hospital.” Then he strode to the first wound ward and pushed the door open.
Sister Usenko gave Natalie a shrug and hurried after the doctor. Left alone on the landing, Natalie closed the door to the infectious ward, got a laundry bag from the linen closet, and stuffed the offending wool blanket into the laundry bag. Then she washed her own hands and arms down with carbolic solution.
Doctor Sergeyev’s ad hoc inspection worked through all the officer wards, then out to those for the enlisted men in their large canvas tents. At last, he seemed to run out of energy and could be persuaded to take himself to bed.
Natalie and Sister Usenko looked at each other.
“He cares so much,” said Sister Usenko. “That’s what it is. The idea that anything is undone just tears at him.”
Natalie shrugged, too exhausted to continue the polite facade now that he was no longer in front of them. “He’s not the only one who cares. And he’d do better to express his caring by laying off the vodka and leaving when his shift is over, not harassing the rest of us.”
“He only takes the vodka because he cares so deeply.” Sister Usenko seemed to be pleading as she said it.
Natalie watched her. Love? Admiration? Sister Travkin had muttered darkly about what connection there might be between these two. Perhaps she did love him, at least in some sense. But was there a relationship between these two in this most unromantic of places? Or was it simply that Doctor Sergeyev encapsulated for this woman what it meant to care for the patients to whom they were both devoting all their efforts. Did she love the man or the devotion?
There was no answer in the brown eyes with the dark rings of tiredness below them, the strand of brown hair beginning to slip out from beneath the other nurse’s white veil, the hollow contours of her cheeks. If Sister Travkin could see some illicit dalliance here, to Natalie there was nothing visible but a woman like her, tired from the daily work of caring for the suffering.
No single pattern shaped the days. On some, Doctor Sergeyev remained calm, diligent, and almost courtly in his dealings with the four nurses. One day in early April, when the departure of a hospital train bearing the sick and wounded back to Kiev for further treatment had left the wards nearly empty of patients, he arranged a picnic day. The officers of the nearby regimental staff offered up their mess cooks to prepare a table laden with delicacies, served under white canvas canopies, and for a cool but sunny spring afternoon the nurses in their white uniforms rambled through the tall grass of the hills collecting wild flowers. Eating fresh berries and lemon ice while receiving the gallantries of the officers in their dress uniforms, it was almost possible to forget that on another day they might be required to wield the ether mask and antiseptic solution while the surgeon cut off the limb or patched the bowels of one of these same officers.
Even here, however, the tensions of the hospital were not left behind.
“Look at those two,” Sister Travkin said to Natalie in an undertone, inclining her head to where Doctor Sergeyev kept pace with Sister Usenko was she filled a basket with flowers. “If eyes were off them for a moment, you can see what they would be doing. It’s revolting to see a nurse flaunt herself that way.”
Natalie shrugged. “I don’t see any flaunting.”
“I’m sure you’ve seen it. She constantly defends that drunken oaf and covers for his behavior. He’s a danger to every patient. You’ve seen how he drinks between every operation. How long before he slips and cuts an artery or perforates an intestine? He’d have been sent home long ago if she didn’t make excuses for him.”
“Sent home by whom?” It was true that Doctor Sergeyev’s behavior would not have been allowed to last a day back at the Prince Mikhailov Hospital in Kiev where Natalie had received her training. He drank while on shift. He forgot to bathe his hands in carbolic solution between patients. He walked through the infectious ward as if it were any other room. And yet, as she had quickly learned, the rules of the big city hospital did not apply here in the field hospital. Who was to enforce them? There was no authority above the surgeons, and Doctor Sergeyev was now the only surgeon. Whatever his faults, he was a doctor willing to live for months on end in these primitive conditions, working with short supplies among tents and buildings temporarily converted to hospital use.
Perhaps his many faults were of a piece with his willingness to serve the wounded here. If the soldiers in the trenches were the front lines of the army, field hospitals were the front lines of medical care. When an attack was launched against the Austrian army, they could feel the artillery reverberating in the air. Even as the line of battle wavered forward and back over the weeks and months, it was never more than a half dozen miles distant. The stretcher bearers and supply wagons brought the wounded directly from the lines to their field hospital, and here the casualties received their first (and occasionally their last) care. Those who could be returned to active duty within a few days remained until they were sent back. Those who needed longer treatment were send on the next hospital train to the district or city hospitals. And those for whom there was no hope remained to die.
It was not an easy duty here, and perhaps it was only one like Doctor Sergeyev who was willing to fulfill such duty, or else this duty turned a doctor into a man like Sergeyev.
“Don’t throw your hands up and ask, ‘By whom?’” Sister Travkin said. “There are standards to be enforced, even here. You know that. I see the way you cringe when he doesn’t clean his hands or reapplies an old bandage. But her. She gets that soft womanly look in her eyes and says, ‘He works so hard.’ I’ll tell you what it is. I hear he comes from a rich family back in Moscow. She looks at him and she sees gold trinkets and fur wraps.”
Natalie turned away and went to seek the company of Sister Gorka. As the conflict between the two most senior nurses escalated, Sister Gorka’s quiet had ceased to seem sullen or remote and become instead a welcome calm. A Pole from Lublin, she too spoke French and Polish as well as Russian, and in her little corner of the women’s quarters, Natalie had seen a familiar looking picture of the Virgin dressed in pink and blue rather than the dark Madonna depicted in the icons of the Orthodox.
She found Sister Gorka struggling with her tripod. The ungainly wooden structure with its hinged and telescoping legs required the help of at least one other person to assemble. It was, however, a constant at the field hospital, brought out for occasions great and small. Later Sister Gorka would retreat to a darkened room to develop her negatives and make her prints, and pass around the black and white images for members of the hospital to keep. Natalie herself had, tucked away with her keepsakes, a picture from shortly after her arrival of the four nurses standing together under the hunting trophies in the hospital’s entrance hall. The smiles of that picture seemed from another time now.
“Let me help you.” She pulled one of the tripod legs out to full length and began to work the screws which tightened it in place.
They worked together in silence for some minutes until the tripod stood upright and chest high. Then Sister Gorka unlatched the wooden case in which the camera rested, carefully padded. She screwed into the bottom of the camera the brass fitting which would hold it to the tripod. The camera, with its body of black enamel and silver fittings and its glistening glass eye looking out at them, looked like a visitor from some future world.
“Take a seat for me, in the entrance to the tent,” said Sister Gorka “I want to test the focus.”
Natalie obediently sat down on a folding stool which stood near the entrance to the white canvas awning where the refreshments were being served.
Sister Gorka bent her eye to the viewfinder, gently twisted the focus ring of the lens, and then pressed a button on the side of the camera, which gave a mechanical click.
“I’ll make a print for you,” she promised. “Your white uniform looks very striking against the dark background.”
Suddenly conscious of her hair escaping from underneath her veil, Natalie belatedly reached up to tuck the stray locks away.
“You look fine,” Sister Gorka assured her. She worked the crank on the side of the camera to advance the film and turned, looking for another subject. Two of the officers were standing beneath a tree, their hands resting casually on their sword hilts, chatting and watching as Sister Usenko continued to collect flowers with Doctor Sergeyev by her side.
Natalie remained silent until after she heard the click of the camera, then spoke. “I can’t imagine the work it’s taken to carry the camera and all the supplies for it with you ever since the hospital deployed.”
Sister Gorka shrugged. Conversation with her did not always flow easily. If she was blissfully neutral in the strife between Sister Travkin and Sister Usenko, she also had a peculiar talent for letting conversation die. But after a moment she did respond. “I had the camera before the war but it was only an occasional diversion. My father was a pharmacist with interest in photography, and when I was a girl he let me help him develop and print. That was in the old days of glass plates, you know. I think he was fascinated by the chemistry of it. It had been years since I’d touched a camera, but after he died, when I helped mother clean out the flat and paged through the old albums full of pictures, I found I wanted one, so I took some of the money that came to me and bought the very newest model. Learning about focal lengths and exposure times, and taking the train out to the countryside on my day off to take pictures of the villages and countryside, I could feel Father was still near me.
“When the war came, and all of us nurses in the hospital volunteered for field service, it seemed natural to bring the camera with me. They said the war would only last a few months. It would be history, and I was going to be in it. I’d never been in history before. What better way to document it than with the camera. I’m sure that’s important, but as the months stretched on what made me continue to seek out the film and chemicals was the time I spend in the darkness developing the film and prints. It’s solitary and precise. If I just measure the the chemicals correctly and follow the timer they turn out well. Our hospital work is so much more important, but I can do everything right and have a patient hemorrhage or take an infection. I’m so grateful to have something I can do with my hands which only depends on skill and accuracy. And it’s so quiet. The process doesn’t demand anything of your feelings.”
It was the most that Natalie had ever heard Sister Gorka speak at one time, and now she felt she knew the often silent nurse perhaps better than the others. There was a warmth to this newfound intimacy which was precious. Could it be extended? Could this other woman become a friend and confidant?
Natalie reached for something that she could share, to continue the moment of closeness and show that she appreciated it.
“You’re fortunate to have an activity which connects you to your father.” Stumblingly, she described her girlhood in the school for girls, the letter which had come from her father, her one precious meeting with him, and the discovery that because she was his natural daughter she must never meet him again. In honor of her promise, and for fear of sounding as if she put on airs, she did not name the Count or give his title. Just, My Father. “I wish that there were something which connected me to my father. Or my mother,” she finished.
She waited for the return of confidence from Sister Gorka, but the other nurse’s face remained expressionless. For a long, painful moment the silence drew out between then. Then Sister Gorka shrugged. “I’m sorry.”
She returned to adjusting her camera.
“Excuse me, Sister.” One of the officers, his face aglow, a wine glass in his hand, had approached them, providing a welcome interruption. “Would you take a picture of the whole party?”
The officers and nurses gathered where the rolling fields could serve as a backdrop to the picture. Sister Usenko held her basket of flowers, a riot of bright colors against the dark brown of the wicker basket. The other nurses were luminously monochromatic in their white uniforms, which the sinking sun made to glow against the greens and browns of the landscape. The officers stood around them, the sun glinting off polished leather straps and brass buttons, even amidst their drab brown uniforms. And just to one side of the group, as if an afterthought, stood Sister Gorka, her hand blurred in the picture as she reached to straighten her veil after running to stand amongst them. She had set the mechanical timer of the camera and then rushed to stand by the others as the gears whirred before triggering the shutter.
In the days after Sister Gorka made prints for all who had been in the picture. After the war her copy sat in a little gilded frame on the mantle of her flat back in Lublin, and she would tell visitors about the subsequent histories of all the people in it.
“There was Lieutenant Nikolaev. He was killed by an artillery shell in the May offensive, poor man. And Captain Zelenko, he caught a bad case of cholera and had to be sent to Kiev to recuperate. Lieutenant Bogdanov, the one holding the wine glass, he was the son of a prince. He came through the hospital with a bullet wound in his arm, but he recovered and fought with the Whites during the civil war. Sister Usenko is holding the basket. She sickened in the same cholera outbreak. Sister Travkin, she was a difficult one for all of being so skilled. And Sister Nowakówna. She was quite a woman. I don’t know what would have happened to me if it hadn’t been for her.”
During the last weeks of April, the thoughts of the hospital were all of cholera. The warmth of spring had at first seemed a welcome relief after a bitter winter, offering scenic moments such as they enjoyed at Doctor Sergeyev’s picnic. But with tens of thousands living out of doors in poor sanitation, the spring warmth and spring rains led to the tainting of the water supply and all that came with it. The yellow-carded infectious wards filled with cases, and even the hospital staff were not immune to the scourge. Several of the orderlies and housekeeping sisters fell ill, but the worst case was Sister Usenko. Her face was pale and sunken, and they carried her bed from the women’s quarters to a little attic room room in the hospital building. It would not do to have her share the infectious ward with the men.
Down the stairs went the housekeeping sisters, emptying the chamber pot of the reeking white diarrhea which was characteristic of the disease, and up the stairs they came again with bowls of gruel or hot broth, desperately trying to return to her system the fluid and nourishment of which the disease was so ruthlessly purging it.
Doctor Sergeyev visited whenever there was a moment to spare during the double and triple shifts that he assigned himself.
“He must know,” observed Sister Travkin darkly, “that the infection is particularly dangerous to a woman who is in a certain condition.”
Sister Gorka turned away and left silently at this implication. Natalie was on the point of doing them same, but then turned back to Travkin.
“That’s a vile thing to say about a fellow nurse. Especially when she could easily die.”
Sister Travkin shrugged. “I don’t believe telling the truth is ever vile. If it’s an ugly deed the truth reveals, it’s the fault of the person who did it, not the one who tells.”
“Do you know for a fact that...” It seemed wrong to even put the accusation into words. “That this is true? Or are you just telling us your guesses?”
“It’s clear enough to those with eyes to see.”
“Do you know?”
For a moment the two women held each other’s gaze, their mouths set into tight lines. Sister Travkin was the one who looked down first.
“I came into the supply room one night and saw him kissing her,” she said.
“Kissing? Is that all?”
“It’s wholly inappropriate for a nurse to behave that way with a doctor.”
“It is, but children are not begotten by kissing.”
“The begetting follows naturally enough.”
Again for a tense moment their eyes met. This time Natalie turned away. “It’s wrong to accuse her of what you don’t know.”
The accusation ate at Natalie’s mind through the rest of the day, as she changed the bandages of those wounded by war and the bedpans of those brought low by its attendant disease. To have kissed a doctor, and not in some place away from the hospital where they could meet as man and woman rather than as doctor and nurse, but rather in the inner sanctum of the profession. The violation was such that she could understand Sister Travkin’s fury. And yet she could all too easily recall the times when Madame Luterek had considered her a loose woman: Because of Konrad’s unwanted affection. Because of the moment in which she had allowed Borys’s embrace to shelter her from the sorrows of the day.
Might Sister Usenko be similarly accused, held in contempt for a moment that was misunderstood?
She knew how possible it was, and yet to be on the outside, to hear the accusation rather than to be accused, was to see all the ugliness and none of the reason. There was no peace from these thoughts until at the end of her shift Natalie herself took one of the bowls of hot broth and took it up the narrow stairs to the room in the attic where Sister Usenko lay. There the reality of suffering overcame all other thoughts.
Her body lay, pale and hollow, on the narrow bed. Natalie sat next to her and spooned broth into the lips which were cracked from her body’s effort to expel all fluid from it.
Sister Usenko leaned into her as she received the nourishing liquid. This body was not a nurse, with all the professionalism and distance that vocation required. It was not a temptation or a sin. It was the frail body of a child, which asked only for food and warmth and affection which might perhaps keep it alive.
For a long time, even after she had given her all of the broth, Natalie sat with her arm around the other woman, holding her close. Then at last she lay Usenko down to sleep, descended the stairs, and went to the little room where she gave herself the washing down in carbolic solution which the infection protocol required. She went to bed, exhausted but at peace.
The next day brought the turning point. Cholera was a vicious but quick disease. Sister Usenko was able to hold her fluids; the bouts of diarrhea stopped. She was able to sit up on her own and eat normal food. But her strength was gone. It was clear that her convalescence would be long. The field hospital, with its heavy load and few resources, was no place for it. She left on the next hospital train, bringing the field hospitals staff down to three nurses.
Sister Travkin seemed to gain a new balance from this ending, but although she was now the most senior nurse there was little trust between her and the other female staff.
Doctor Sergeyev also became quieter. He no longer took his accustomed double and triple shifts. When his time for the day was over, he went to his room, or for a long walk among the woods.
Thus things continued through the last days of April until the May offensive began.