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.

Saturday, July 29, 2017

Chapter 3-3

This concludes Chapter 3. Sorry to be a bit slow about it, but baby arrived the day after I posted the last installment, and somehow even with time off work the first couple weeks after a baby's arrival are not ideal writing time.

Chapter 4 will return to Jozef with the Austro-Hungarian cavalry.

Near Trzeszczany, Galicia. June 22nd, 1915. At normal times, with one surgeon handing off responsibility to another, the transition would have been accomplished away from the nurses’ view, between the two men. These were not normal times, and so Doctor Kalyagin arrived in the middle of the morning routine, escorted by Lieutenant Popov. The two men stood awkwardly in the middle of the ward as the nurses moved from bed to bed, checking dressings and temperatures. The orderlies carried away bedpans and dirty dressings. The housekeeping sisters brought food and changed sheets.

The doctor cut a rather unmilitary appearance next to the infantry lieutenant. His uniform tunic was clearly standard issue rather than the more expensive tailored versions most of the regimental officers wore. Its loose fit only served to accentuate a stomach which bulged above his belt. A rather thin mustache gave no military bearing to his broad, round face, which was boyish in its smoothness, though a receding hairline suggested he was no longer young.

Natalie broke off from her tasks and approached the two men.

“Doctor? We’re very glad to have you here.”

He started to extent a hand, as he would have to a colleague, then stopped himself, withdrew it, and gave a bow instead. Lieutenant Popov made introductions.

“I understand that you’ve been working without a surgeon for several weeks now,” Doctor Kalyagin said. “That must have been difficult.”

“It has. Particularly yesterday, when the fighting became heavy and we received a lot of casualties. There are some cases you’ll want to examine for surgery as soon as you’re settled. The most we could do was trim, stitch, and bandage.”

“Trim and stitch? Who was doing making incisions and performing sutures without a surgeon?”

Perhaps it was reasonable enough that the doctor would be against nurses going beyond their training, but she would at least make sure that any consequences were not unfairly focused on Sister Gorka, who had only been obeying her orders.

“We had casualties pouring in and no idea that we would have a doctor so soon. I gave directions that the minimum be done -- cutting away ruined tissue and suturing wounds before bandaging -- so that the patients would be able to survive the train journey to a regional hospital and receive better care. None of us have any desire to go beyond our training now that you are here.”

She met his gaze and held it. It had been the right thing to do. If he couldn’t see that, well, put that aside. He would have to see it.

He nodded. “Of course. Well, now that the hospital is staffed again, our first priority will be to set procedures and abide by them.”

“Yes, sir.” He was right, of course, but the words stung like a rebuke.

The flatness of her tone brought Doctor Kalyagin up short. He licked his lips. “With no trained staff, I can acknowledge that having nurses perform simple surgeries was the course most likely to save the most lives. Now, perhaps you can take me round the wards?”

The other two nurses joined them as Natalie guided Doctor Kalyagin through the stately rooms which they had so rapidly turned into a hospital. The two operating tables. The gas rings with their kettles for boiling instruments. There were no beds or cots -- the hospital’s had been abandoned along with the patients when they were forced to evacuate their previous field hospital on mere minutes of notice -- but the patients were laid out in neat rows on army blankets.

They finished back where they had started in the main ward. Doctor Kalyagin faced his three nurses, knowing they were waiting for some words -- about their work, about his plans for the hospital. It was these human moments which were so much more complicated than an operation. The clear necessities of saving lives and repairing bodies, works of skill and science, were more rational than the vicissitudes of human interaction.

“I’m glad to be here with you,” he said. That was the person touch. They would like that. It was the personal that he had lacked before when speaking with that lead nurse before. “You have all worked very hard while without leadership, and I salute you for it. My duty now I am here is to show you the most that modern medicine has to offer. There’s so much that science has learned. Proper wound drainage, for instance. Let someone without training suture and bandage a wound, and he might as well stitch a grenade into the poor man’s limb for he will lose it just as surely. But insert a proper drainage tube when suturing, just a little length of rubber pipe, and a man’s limb and livelihood can be saved. Written treatment protocols. Don’t let yourself be deceived into thinking it a mere checklist such as a wife might taking shopping. We are all by our natures forgetful and imprecise creatures. A written protocol saves us from our own failures.”

He let himself wax eloquent on the practices he intended to introduce. To be sure, it was a primitive place. This country house might have been well suited for hosting shooting parties but adapting it to a hospital was a clumsy affair at best for all the nurses’ obvious hard work. Still, there would be flexibility as well. No longer would he need to convince the entire board of senior surgeons about each change he wished to make. In a small hospital such as this real progress could be made.

“With modern procedures,” he concluded, “we can turn this hospital into an institution to be proud of.”

He stood looking back and forth between the three nurses facing him. Their faces were all expressionless. Had he said the wrong thing?

“Perhaps you’ve misunderstood.” He shifted on his feet. “I don’t mean to diminish what you’ve accomplished these last few weeks. You’ve done nothing of which you should be ashamed. You’ve worked without direction, without medical expertise, and without resources. And nonetheless you’ve done yourselves great credit. You should be proud. Really.” He looked around for the warmth this praise was meant to generate and saw none. “As I’ve said, I believe there is much that can be improved by implementing modern medical procedures. I expect your assistance and support, and I know that because you are professional nurses I can expect it.”

There. That would have to do it. With a little bow he turned and left the ward.

“Oh, we’ve nothing to be ashamed of, have we?” Sister Travkin asked. “We have no medical expertise? He’s been in his big city hospital with all the modern conveniences while we’ve traveled hundreds of miles in horse carts, and he would like to tell us that we have nothing to be ashamed of?” She snorted.

“I’ll be glad to have a surgeon back,” said Sister Gorka, her voice low. “Even if he is arrogant. If I never have to use another scalpel or needle I’ll be happy enough.” Natalie remembered the other nurse’s despair the night before, brought on by the work Natalie had told her to do. It didn’t matter what the new doctor was like, Sister Gorka would be glad of his presence.

“If he lasts,” warned Sister Travkin. “You saw that soft round face of his. And if looks are anything to go on he likes his food. We may not have him many weeks. Say what you will of Doctor Sergeyev -- and I have -- but he did have staying power. It took artillery to send him home.”

The morning had begun so well. As they had taken the new surgeon through the wards and showed him the men whom they had treated the day before, the other two nurses had left Natalie to lead, to explain, as if it were the most natural thing for her to be in charge. She had felt a pride of ownership as she pointed out each thing. This was her hospital, her nurses, her patients. And so she had also felt the deepest affront when Doctor Kalyagin began to speak of the need for modern practices, of retraining the staff, of re-organizing the wards to reduce infection. These were not things unfamiliar to her. These modern methods: sewing wounds up with drain tubes, using separate nurses for sterile and unsterile tasks, these and more had been her everyday work at the hospital in Kiev. She hadn’t ignored them in the field hospital out of ignorance. She had done so because here the doctors had scoffed at such practices, and because there had not been the resources to follow them here.

Her fists clenched and anger simmered up as she recalled Kalyagin’s casual superiority.

Looking at the other two nurses she felt balanced on the edge. Sister Travkin was affronted. Sister Gorka was relieved. Both had come to rely on her. Both were as much offended on her behalf as on their own. The three of them had no power to reject the doctor. But with the right words she could make his time in the hospital difficult, perhaps even so frustrating that he would leave.

And yet these practices, which she had known so well in Kiev, would save lives. The doctor might have no instinct for speaking to others, but that did not mean his medical abilities were not sound. If she could set aside her pride, if she put her support fully behind his innovations, he would get the credit, but she would have helped to improve the hospital.

“I’ll go and speak with him,” she said. “I’m sure he doesn’t mean offense. And I’ve seen these practices work in the hospital where I was trained.”

She found Doctor Kalyagin in the butler’s pantry which they had turned into the dispensary. He was examining the quantities of drugs and checking them against the ledger books.

“Who created this tracking system?” He asked the question with no expression, no indication as to whether its creation was a matter of credit or blame.

“I did.”

He turned a page, skimmed down the figures for dosage given and amount withdrawn. “This is very good. Exactly the system we used in my hospital in Vilnius. The fact that you require both an entry for the patient dosage with the date and time, and then a separate entry for the amount withdrawn from the stores, serves as a check against abuse.” He closed the book. “Very good.”

“Thank you. It’s how we managed drugs in the hospital where I was trained in Kiev.”

“Good, good.” His fingers drummed on the ledger for a moment. “Tell me, Sister…”


“Of course. Nowakówna. What must I do? I can see the staff at this hospital has worked hard. All I want to do is bring modern methods. Save lives. What have I done that offends the other nurses? I can see they aren’t happy with my presence.”

“They’re not unhappy, doctor. Indeed, we are all very relieved to have you here. We did not enjoy having to do work we were not trained but. If there is any hesitation, it is only a feeling that the work we have done and the methods we have followed up till now are being discounted. I’ve seen the modern methods work in Kiev. We’ve just never had the tools. And our previous surgeons were more traditional.”

The doctor was leaning forward, his elbows resting on the drug ledger. “Can you help me? If I can only get the support of all the staff, I know that we can turn this into a modern, model hospital.”

It seemed false to take the credit for supporting his methods when it was loyalty to her, along with their own wounded pride, which held the others back. Yet the others had not stepped forward to talk with the doctor. She had. And she did know the value of the modern techniques.

“Please,” he said. “We can save lives. I know it.”

“Yes. I will help as much as I can.”


It was no longer her hospital, but in some sense she still felt the credit for it as she urged the others to accept the new methods which Doctor Kalyagin proposed. The hours were punishing. In order to follow septic protocol, every bandage change now took two nurses instead of one, and so the normal routines of changing bandages and cleaning wounds took twice as long. An orderly who was particularly reliable in matters of spelling and handwriting was assigned to follow Doctor Kalyagin on his rounds and take down the treatment protocol for each patient, which was then pinned to the man’s blanket. While this made the doctor’s paperwork responsibilities manageable, however, it did nothing to relieve the nurses of the additional time required to update the protocol with the date, time and their initials every time they performed any task for a patient. Doctor Kalyagin promised to file a request for more nurses, but in the until this achieved any fruits, they worked more and slept less.

All this became more difficult two weeks later, when after two days of heavy fighting that sent a constant stream of wounded to the hospital the orders came that they must pack up the hospital and withdraw the next morning. The great retreat had resumed.

They were not, at least, forced to once again abandon their patients in order to hasten the retreat. At first they received orders to do so, but Doctor Kalyagin refused to do it. And it proved that he could harangue time and resources from the regimental command nearly as effectively as he could from his own staff. And hour and a half after he had set off in wrath to demand help, a supply sergeant had arrived on the steps of the country house and asked Natalie if this was the mad doctor’s hospital. On being told that it was, he had returned with two dozen hay wagons.

“There’ll be no more room for wounded once we meet up with the rail lines and get the next load of feed,” the sergeant warned her. “But that doctor of yours said his patients could be put on the train at that point.”

And so they began again the itinerant life of the hospital in retreat. Through July they set up hospital nine different times: in schools, in houses, once even in a convent, where the silent nuns in their brown habits moved silently through the bare halls and communicated with each other mainly in hand signals -- so unlike the chatty sisters with their well furnished rooms at the school where Natalie had been brought up. Several of the nuns had some rudimentary medical training, however, and the mother superior had put them at the hospital’s disposal for the length of their stay, allowing the nurses to gain some much needed rest.

They were traveling at angles to the tide now. The Third Army was retreating on a line due north, even as the German armies began to close the salient of Galicia from the west. Refugees streamed east. Lublin was threatened, and those who could not secure places on the overburdened trains had taken to the roads with carts and automobiles, wheelbarrows and baby carriages, all manners of vehicle piled with what possessions they could carry. But while the people followed whatever paths they could fine, the army fell back along lines chosen by the high command. These planners had decreed that the Third Army pass north, between Lublin and Chelm, before the invading armies cut them off, and thence north to Brest-Litovsk before crossing the Bug River. By that route they could avoid the Pripet Marshes, whose unimproved roads and buzzing clouds of midges would have slowed their progress and spread disease among the troops. This gave the army more than a hundred and twenty miles to cover before August, a relentless pace which seldom allowed them the chance to keep their field hospital in one place for more than a day or two.

It was a relief when they at last reached Terespol, and the fortresses guarding the westward approaches to Brest-Litovsk.

The original fortress was over three hundred years old, but there were no picturesque turrets. This was a product of the early gunpowder age, a squat, star-shaped structure with massive walls of stone set in cement and surrounded by a ditch twenty meters across. More modern military design had been at work beyond this. Another fifty yard beyond the ditch, soldiers had dug a trench, the fresh dug earth piled up outside it to form a parapet. Beyond the trench was line after line of barbed wire, strung between posts.

As they approached the fortress, they followed a path that passed through these obstacles in sawtoothed zigzags, blocked every so often by a gate strung with barbed wire and guarded by sentries. None of these seemed built to withstand any solid attack, but perhaps the purpose was simply to slow any would be attacker, making him a target to the soldiers in the trenches of the guns of the fortress. If so, the approach was well designed. It took the hospital staff and their vehicles more than an hour of stops and starts to wind their way through the gates and checkpoints to the fortress itself, where they passed within the big swinging gates of steel-bound wood.

The builds within the fortress walls retained the charm of age. They were assigned a barrack house with whitewashed plaster walls and wide plank floors. Metal bedframes with bare springs were already laid out in rows for the patients.

Doctor Kalyagin went to green the fortress commander. Natalie set the housekeeping sisters to washing down the walls and floors with antiseptic. The orderlies laid blankets across the bedsprings and then carried in the patients from the ambulances one by one.

“Do you think at last we stay in one place for a few days?” Sister Travkin asked as she unpacked the dispensary.

“If the looks of this place are any indication, the army isn’t prepared to retreat any time soon.”

“Surely we’ve had other forts,” said Sister Gorka. “They say Warsaw in surrounded. What good is a fortress if the Germans are on all sides?”

It was more than a year now, since that day in June when Natalie had met her father in his Warsaw house. It seemed even longer than that. Where was he now? Would that grand house with its marble floors and family portraits soon be in German hands?


It was a few days that a lone motor ambulance arrived with a screech of tires carrying several wounded men, one an officer with a torn tunic stained dark with blood. “Stomach wound here,” said the stretcher bearer. “A nasty one. Faulty shell exploded in an artillery pit. Killed three of the crew outright. This here is the gun’s commander.”

Natalie took a pair of scissors and began cutting away the tunic as soon as the officer was laid out on the surgical table. Sister Gorka held the rubber tube which dispensed antiseptic solution and reached in by turns to pour it over the exposed wound, washing away the blood. The roles of septic and aseptic nurse, the one who touched the unsterile clothes and fragments and flesh, and the one who only touched what had been disinfected, had already become so natural that they required no instructions.

Doctor Kalyagin asked for a retractor and probed the wound. The officer’s body arched back in pain, a scream breaking through clenched teeth.

“I’ll operate immediately on this one,” he said. “Sister Nowakówna, prepare the the chloroform mask, if you will.”

She counted the drops onto the mask’s filter, pressed it over his face. Was he able to hear and control himself, or was he helpless in the wash of pain? Just in case she leaned close. “This will put you to sleep. Just breath deeply. Count backwards with me. Ten. Nine. Eight.” If he tried to count along with her, she couldn’t distinguish it from the choked moans that were his breathing, but before she reached “One” those too were gone and he breathed deep and evenly.

The operation was extensive. Half burned powder and flecks of metal were scattered among the snaking folds of intestine which in places was torn and punctured. She helped the doctor unpack the coils, and Sister Gorka washed them with antiseptic solution. Then with precise calm Doctor Kalyagin cut and stitched, closing small tears and cutting away badly damaged sections and then suturing the clean ends back together.

As the septic nurse, her work was done first. The cavity was cleaned of dirt and splinters and spilled bile. The coils of entrail were in Sister Gorka’s sterile hands, as she began to carefully fold and pack them back into the stomach.

Natalie went to wash her hands. She scrubbed the dried blood from around her nails. Her apron would have to be changed, it was badly stained. Like a butcher shop. The phrase bubbled up, and of a sudden the enormity of the scene came home. She had been helping to unpack and repair the viscera of another, living human being, and had done so with no real shock or alarm.

She could remember, years ago in the convent school, the feeling of shock clenching at her stomach on the day another girl had fallen from climbing in a tree and broken her arm. She had felt dizzy, with white spots before her vision, at seeing the sick unnatural way the limb bent. And then there had not even been blood.

Had she lost so much natural feeling since that time? Would she still feel a normal revulsion if she saw blood or injury in some normal setting, in a home or on the street, somewhere unexpected and far from the hospital and battlefields? Or were those feelings gone forever?

“I don’t know,” Sister Gorka said, when Natalie asked her about it that night over the samovar. “I think perhaps if I weren’t in the hospital and weren’t wearing my nursing uniform, blood would still shock me. I like to think that there’s a normal life out there that I can go back to, where all these experiences will seem another world.”

For a moment they drank their tea together in silence.

“Would you like to come up on the wall?” Sister Gorka asked.

“What for?”

“I like to look around.”

“It’s dark.”

“You can see the fires. Sometimes artillery and flares. And the stars if it’s clear.”

Their nurse’s uniforms were sufficient pass for the sentry to wave them through.

“There’s a cool breeze tonight, Sisters,” was all the challenge the soldier at the top of the ladder offered. “Keep yourselves warm.”

The breeze was indeed chill enough that Natalie missed her wool coat.

“I’ll show you where I liked to go,” Sister Gorka said. “There’s some shelter from the wind there.”

It was a mortar emplacement, a flat round platform surrounded by a low wall. In the middle of it stood the squat mortar, a short, thick barrel, chest high, with a gaping hole where a ten inch mortar shell would burst forth when fired.

Sister Gorka ignored the artillery piece and went to stand on the stone step that allowed her to look out over the wall. Natalie joined her.

They were facing west. In the distance they could see occasional flashes, German artillery firing at the front with a rumble like far off thunder. There was a strange, round shape, fitfully illuminated by those flashes.

“It’s an observation balloon,” Sister Gorka said, in answer to Natalie’s question. “You can see it clearly in the daylight. It looks like a fat, floating sausage. An officer told me that artillery observers ride up to it with a basket on a pulley and watch to see if their shells are hitting where they are supposed to.”

“They’re filled with hydrogen,” said a male voice. “It’s lighter than air, but it’s a flammable gas. If we need to take away their eyes for at time we send an airplane with aerial torpedoes to shoot it down, and it bursts into flame. Soon enough, however, they send another one.”

Natalie startled and turned to see an officer with the insignia of a lieutenant on the shoulders of his overcoat.

“This is Lieutenant Serafin,” said Sister Gorka. “He also likes to look out over the walls. And he’s interested in photography,” she added. “He has a Bergheil.” She smiled with a softness of expression Natalie had never seen on the reserved nurse before. “Lieutenant, this is Sister Nowakówna.”

The lieutenant bowed. “Good to meet you, Sister.”

Behind them, the moon, just past half, broke from behind one of the scattered clouds and cast its pale light over the lines of trench and wire stretched out between the fort and the still distant enemy.

“How many men defend this fortress?” Natalie asked.

“A division, Sister. Give and take a few battalions here and there. And fortress artillery as well. Perhaps fifteen thousand men in all.”

“Surely here the retreat will stop for a time? That must be enough strength to hold them back.”

“Oh we don’t lack for strength here. Regiments have been falling back across the river for the last two weeks. If we wanted we could have fifty thousand here. But it doesn’t matter. The Germans may not even attack this point. All they have to do is cross the river to the north, get behind us, cut the rail lines. We’d have to fall back before then or we’d be trapped and have to surrender. Once upon a time, when armies were counted in tens or even hundreds of thousands, a fortress like this would have been a threat to the enemy’s rear that he would have been forced to pinch out. But now we count in millions. You’ll hear patriots who’ve read their Tolstoy speak of how we stopped Napoleon, but his army was only a spear, enough to wake the Russian bear and make it angry enough to snap it off and continue fighting. We face an ocean, and it’s more than I know how well this big, clumsy old bear can swim.”

“But if they have millions, don’t we have millions more?”

“We do. We have millions, but with fewer guns, less ammunition, feuding generals, and in the back of their minds the question: Would I, my village, my people be better off if we lost? You’re Polish, aren’t? What do you think? Is Warsaw really any worse off with the Germans and the Austrians than it was with the Tsar?”

These were not the sort of questions the Lutereks -- even Borys with his university ideas -- had discussed, nor the sisters in the hospital. Sister Maria-Grigori, back in the convent, had spoken of the old country as if Poland and Russia were two sides of the same coin. “Do you think it would be better for us to lose the war, Lieutenant?”

“No! No, I said nothing of the kind.” There was an edge to his voice that had not been there before.

Natalie felt Sister Gorka dig an elbow into her side. “He said nothing of the kind,” said the other nurse.

“I’m sorry,” said Natalie. Even in the staid atmosphere of the convent school and its patrons, it had been no great shock in France to hear people speak of the Republic’s illegitimacy, of the need for change. Raised outside the country, she could not know how shocking the turn from hints to plain words was to ears raised under Russian rule.

“All I am speaking of,” said Lieutenant Serafin, “is the necessity of reform, of the recognition of national identities. Surely the Tsar knows this too. If only he can break free of corrupt advisors. I’m sure he wants to give the nationalities a reason to fight.”


The officer with the stomach wound was conscious when Natalie made her rounds the next morning, his face pale under a stubble of dark whiskers.

“It’s good to see you awake. How are you feeling?”

He attempted something like a smile. “I don’t remember much, but I imagine it was bad.”

“It was a good surgery, but it will take time for your stomach to heal. You should sleep.”

“I can’t seem to.” This voice was taught but under control.

Natalie looked at the notes on the protocol. Sister Travkin’s initials were next to the approved dosage of morphine, but the time noted was six hours ago. “You poor man. That last dose of morphine must be wearing off. I’ll get you another injection.”

“Thank you, Sestritsa.”

She made the notes in the drug ledgers and drew the dose into a clean syringe.

“I’m putting it directly into the vein. It will take effect more quickly that way.” He looked away as the pressed the needle in. That was good. Still innocent of the desire that made some patients look hungrily at the needle as it delivered the relief to which they had become too much accustomed. “There. In ten or fifteen minutes you should begin to feel the effect. It may also make you sleepy.”

“That would be welcome too.”

He closed his eyes and she turned to go.

“Sestritsa. One more thing.”


“Some water?”

“I’m sorry, didn’t they tell you?”

He nodded. “But please. Just a little.”

“You need time to heal. The surgeon cut out the torn portions of your intestines and sewed them back together again. Anything that passes through, even water, increases the chance of infection. You have to wait. Tomorrow afternoon, you can have water.”

He ran his tongue over his lips. It would only make him feel worse, but always the patients did it. Forty-eight hours without water. Then another forty-eight with only water, during which they forgot the mercy of being able to drink in the suffering of hunger. By that time, if infection had not set in, broth and other fluids that would at least provide some nourishment. And at last food.

Shocking though it had seemed when she had first seen such operations done, men survived. They had heard back from the regional and base hospitals of patients slowly returned to normality, men who survived having their guts taken out and put back in. It was staggering that modern medicine could accomplish such miracles at all. And yet for those who did not survive, for the nearly half whose wounds became infected despite the attention to antiseptic discipline and the strict diet, those men died raving and feverish, while suffering all the more from the lack of food and water.

“What’s your name, Sestritsa?”

“Sister Nowakówna.”

“Lieutenant Ivan Ovechkin. Sister Nowakówna, would you… Please sit with me. Just for a little while. You said this will make me sleepy when it takes effect.”

“Yes, I’ll sit with you.” She went and got a wooden chair that stood against the wall near the entrance to the ward. His eyes tracked her as she returned and set it next to his bed. Then he closed his eyes.

“Thank you.” He held out a hand and she took it in hers. It was a large hand, but smooth skinned with neatly trimmed nails. A gentleman’s hand. “Our estate is near Odessa,” he said after a moment. “Not a large estate, but comfortable. My father died young. Thrown from a horse. A great rider, they said, but reckless. Now my mother and sister are there to watch over it. She’s a difficult woman, mother. But she cried when I left.”

He continued on, short sentences broken by pauses, speaking of his family and the countryside where he had grown up. At last one pause drew on and became a silence. His breathing was steady. Natalie carefully removed her hand from his and went back to her rounds.


“Sister! Sister Nowakówna!”

By the afternoon Lieutenant Ovechkin was calling to her every time he saw her pass.

“Please, Sister Nowakówna. Just a little water. Just enough to wet my mouth.”

“I’m sorry.” Twenty hours since the operation. Twenty-eight more before he could drink.

“Please.” His cheeks were flushed. She felt his forehead. Hot. It could simply be that he was upsetting himself. Or the stress upon the body of blood loss followed by dehydration. But nearly half the time it was infection. As soon as she could she gave him another injection of morphine and he lapsed into sleep again.

By night the fact was clear. He was feverish and sweating, which would only deplete the body’s store of fluid more quickly. She put a cloth soaked in cold water on his forehead, wiped his face to try to cool him down, but when she was called away for a moment she came back to find him sucking at the cloth for what few drops of water he could get from it.

She snatched the cloth away, then saw his jaw tremble. “I’m sorry, Sestritsa. I was just so thirsty.”

Again she wiped his face with the damp cloth. It was simply cruel now. Infection had clearly set it. What good was there in following the forty-eight hour regimen? All it would do is add the pain of thirst to the torture of infection. She had seen this play out in case after case. There was no hope after the infection set in.

“Wait a moment.” She went to the dispensary and drew another injection of morphine. It was an hour early, but what did it matter. Then she took a glass and filled it from the bucket the orderlies refilled from the pump for every shift.

The lieutenant’s eyes followed the glass as she approached him.

“Here. Drink it slowly. Just one glass. And then I have another injection for you to help the pain and let you sleep.”

His hands shook, and she helped him hold the glass so that he would not spill it. Obediently, he took small, slow sips. So slow that she found herself glancing back over her shoulder, wondering if someone would come in and see her breaking the protocol.

There was no reason to be ashamed. She was not hurting him. The infection had already set in. And yet, if she did not have to explain her choice to Doctor Kalyagin, it would be easier.

At last he finished, and setting the glass aside she gave him the injection. Immediately he closed his eyes. “Thank you, Sestritsa. Thank you.”

By morning the fever had Lieutenant Ovechkin deep within its grip. He did not recognize her, but called out to his mother for water. She gave him another glass, then another dose of morphine which left him murmuring in his sleep the rest of the morning. From there he moved into the last stage, the restless fever sleep which preceded death. He was still in that state of near-death when Doctor Kalyagin called her aside.

“Sister Nowakówna, I thought I could rely on you.” His voice was trembling with the effort to keep from shouting.

There was no point in pretending not to know what had angered him or asking how he had found out.

“Doctor, infection had clearly set in. He was dying. I only wanted to make him more comfortable.”

“Sister, we have protocols for a reason. We have them because they save lives. When we disregard our protocols, we kill patients. Is that what you want?”

“He was already dying.”

“That is not for you to decide. It’s not for any of us to decide. Our duty is simply to give care, the best care that we know how. And that is what is written down in our protocols. You, of all people should--” He was shouting, and now he made himself stop. He pressed his lips together, struggling to regain the calm which a doctor should have in front of his staff.

Natalie stood, her shoulders back, teeth clenched. It was the same way she had stood when absorbing a scolding when at school, waiting to see if the nun would strike her or let stinging words do their work alone. If she answered back now, her voice might tremble, and that she did not want to allow. So she stood in silence, and that silence tore at Doctor Kalyagin’s calm since the one thing which seemed like it would quench the betrayal he felt was to see her break down and admit that she had been wrong.

“I trusted you,” he said. “I respected you and I thought that you cared about our patients and our methods.”

She would not cry. She would stand here, with her hands folded, and accept what he said, but she would not speak, because she could not speak without losing control. She tightened her clasped hands until she could feel her nails digging into her palm.

“Get out. Get out for the rest of the day. The other nurses will have to do your work. And when you come back, I will have to watch you since I cannot trust you.”


Lieutenant Ovechkin died during the night. Sister Gorka came and told her in the pre dawn light. Since he was an officer, he would not be laid in the common grave where ordinary soldiers were placed in rows and sprinkled with lime. There was no place for new graves in the fortress, so the carpenters would put him in a rough coffin to be shipped by light rail to Brest-Litovsk, where he would join the rows of honored dead in a military cemetery.

His body was already gone when Natalie returned to the hospital the next morning.

Read the next installment.

Saturday, July 8, 2017

Chapter 3-2

It's been a long, long time. Some of that is because life intervened in various ways. Baby is due any day now. We finished the school year and the kids began their summer activities. We went to a writing conference at Notre Dame. But also, this section came out far longer than usual. It weighs in at 16,296 words, which is about four times the usual length of a section. There's a lot that happens, though, and I hope you'll find it interesting. I'll only add: all the worst things that happen in these novels are based on real events I found in letters, newspapers, or diaries. My imagination can't rival the darkness of the war itself for sheer invention.

Near Tarnow, Galicia. May 1st, 1915. The sound of artillery began on Saturday, as Natalie was changing Lieutenant Bogdanov’s bandages. It rumbled intermittently like a fitful thunderstorm some miles distant.

“Heavy artillery,” said the young officer, offering a tight smile to disguise teeth clenched as she sluiced antiseptic solution over the entry and exit wounds in his upper arm.

It was not a bad wound, the sort of neat example which would be drawn on a diagram for lady medical volunteers. The bone had not been touched. No arteries had been severed. The officer had ridden to the field hospital on horseback looking so pleased with himself that Doctor Sergeyev had greeted him with, “This is no time for social calls, young man. You’ll have to visit our angels of the sick wards later.”

“No, no, doctor, I have a proper calling card,” Bodganov had replied, holding up his right arm with a white linen undershirt tied around it as a bandage.

Four days later and the wound was healing nicely. There were some shreds of tissue that had the grey color of death around the edges of the wound, but this was a normal effect of the harsh antiseptics necessary to prevent infection. There was neither sign nor smell of infection or decay.

“Are we attacking the Austrians?” asked Natalie. The well born officers in particular all considered themselves amateur strategists, and talking would distract him from the wound cleaning process. It was a given that pain killers not be wasted on something as minor as a bandage change, especially for an officer. Soldiers might succumb to mere emotion, but an officer was expected to be in good control of his reactions.

Bogdanov laughed. “Not with heavy artillery, Sestritsa. We have perhaps two heavy guns for the whole division. No, what you’re hearing are the patriotic contributions of the firms of Skoda and Krupp.”

“Are they attacking us then?”

“Not by the sound of it. That’s just their gunners getting a little bit of exercise. If it were an actual attack, we’d know it.”

The lieutenant was right. The evening bombardment was only harassing fire as the artillery zeroed in its guns. At six o’clock the next morning, the guns opened up the real barrage, and they did indeed know it.

At first the hospital braced for a rush of wounded men, but none came. The field artillery rumbled on, a constant growl rather than the sound of separate explosions. At nine o’clock, as Natalie began to make her second round of the wards for the morning, a new deeper note was added to the cacophony. The heavy artillery had joined the field guns in the bombardment.

In the officers’ wound ward she found Lieutenant Bogdanov pulling on his tall leather boots in place of his hospital slippers.

“I’m going back to the front,” he said, in answer to her question. “I can get by well enough with this arm, and I can’t leave them alone in this attack.”

“But we’ve had no one come in wounded. Perhaps things aren’t very bad.”

“You’ve had no one come in because that barrage is so constant the men don’t want to leave their holes long enough to take their injured comrades to the rear. And did you hear that just now? Those are the heavy artillery coming in. Their infantry will probably attack soon, and I want to be there when they do.”

Natalie helped Bogdanov to gather this things. If the wounded of a major offensive were soon to be flooding their wards, there would be no room for someone as close to recovery as him. Outside, he made an awkward attempt at using his left arm to swing into the saddle but came up short. Then instead he gritted his teeth and did it with the right. Then Natalie handed him his bag, which he draped over the saddle in front of him.

“Leave the bandages on, since you won’t have the proper antiseptic for changing them,” she told him. “Keep it clean and dry, and don’t unwrap it for at least another week.”

The lieutenant dipped his head in a sort of bow. “Don’t worry, Sestritsa. If the Austrians don’t manage to get me, I’ll be careful enough that infection doesn’t do the job for them.”

He was not the only one leaving the hospital. Under Doctor Sergeyev’s orders, one group of the ambulance carts set off towards the rail line, bearing away all the patients that could be moved, clearing beds for what was to come. The remaining carts set off in the opposite direction, towards the front in search of wounded who needed to be brought in for treatment. Natalie and the other nurses prepared the operating theaters. The housekeeping sisters scrubbed the floors and walls with antiseptic solution. Doctor Sergeyev paced back and forth on the railed wooden porch which ran the width of the hunting lodge, his eyes always towards the west, waiting for the first sign of the surge of patients which this destruction must bring.

The battle came to the hospital before its victims did. The explosion of the shell sounded like a clap of thunder breaking right overhead, the floor shaking and the windows rattling at the same moment as the boom itself. Natalie saw the steel surgical implements dance on their tray with the vibration. One of the housekeeping sisters screamed, then invoked the saints angrily as she hurried to mop up the bucket of sanitizing solution she had accidentally knocked over.

A second shell exploded, setting the windows rattling and the glass jars and bottles on the shelves clinking.

“Are they trying to destroy the hospital? The monsters!” Sister Travkin was looking out the window at the smoke and dust rising from the newly formed crater just off the road, just a few hundred meters away.

Natalie ran a last eye over the surgical tools, then laid a sterile cloth over them lest the shelling cause any dust or plaster to sift down upon them.

There was a sound like a train rushing by as a shell passed overhead and then another jarring explosion as it hit to the east of them and on the other side of the road.

“I wonder if they even know the hospital is here. I think they are shelling the road,” said Sister Gorka.

They were indeed. These shells marked the time at which the enemy -- mixed regiments of German and Austrian soldiers under German command -- rushed from their trenches to attack the Russian lines. Following to the timetable laid out in advance by the German planners, at the moment for attack the gunners shifted their bombardment back several miles and focused upon roads and train tracks. No Russian reinforcements must be allowed to move forward while the assault troops fell upon the front lines.

Shells do not discriminate in their victims. They were sent to prevent fresh troops from rushing forward, but they also fell upon the wounded soldiers and ambulances trying to get away from the lines. It was, thus, not until more than an hour after the ground assault began that the tide of wounded at last swept into the field hospital.

After the morning of waiting in tense readiness, there was now more need for help than could possibly be met. The last moment when the nurses were together and quiet was when Sister Gorka called them to the window. The shelling and obstacles which had slowed the wounded in their escape had also forced them together. Rather than a scattered straggle of men coming down the road, there came a loose column. Some walked arm in arm supporting each other. Some struggled on alone. Some were carried astride horses or laying on carts. As they moved back down the road they formed a broken, ragged mirror image of the ordered columns which often marched up the road towards the front.

As the men reached the field hospital this loose formation began to scatter. They approached in twos and threes, some hurrying, some half carried.

“Sister Travkin, go out to the courtyard and sort the cases as they come in. Gorka and Nowakówna, you’ll attend the operating theaters,” ordered Doctor Sergeyev. Triage required experience and the willingness to make decisions which might mean life or death. Sister Travkin’s seniority suited her for the duty, and if this meant that she and Doctor Sergeyev would not be given the opportunity for strife, so much the better.

Just a few moments anxious waiting, neatening the surgical implements where they stood on their stainless steel trays, and then two orderlies came in bearing their first case upon a stretcher. Natalie waved them to her operating table. The patient shuddered and moaned through clenched teeth as the orderlies slid him off the stretcher and onto the table.

“Careful. Careful,” Natalie said, but the two were already leaving and she herself was focused entirely on her new charge.

The soldier’s eyes were wide and darted frantically from side to side. “Is it bad, Sestritsa? Will I lose it, Sestritsa? What will become of me? There’s no future for a farmer without a leg.” The words tumbled forth as soon as he was alone with her, the thoughts which had gnawed at him through the long, jouncing, painful ambulance ride from the front let loose now that he found himself in the comforting presence of a woman.

“We’ll do everything that we can. You’ll be all right.” Even as she spoke practiced words of comfort her eyes and her attention were moving over him, taking in the medical details. A card was pinned to the muddy wool of his overcoat. “Left Leg. Wound. Fracture. Blood loss,” it listed in Sister Travkin’s neat hand.

She turned to the leg. The blood and fragments of bone were a familiar sight to her now. What horrified her nurse’s eye was not these but the mud and gravel so liberally mixed in with the shattered flesh. Cleaning the wound enough for Doctor Sergeyev to operate would take time. Why had Sister Travkin not thought of this? Surely there were wounds more urgently in need of help and quicker to clean.

Looking around in frustration she saw that Doctor Sergeyev had already begun to work on the patient in the other operating theater, assisted by Sister Gorka. There was time, then. She gave the soldier an injection of morphine, noting the dosage on the card beneath Sister Travkin’s writing, and then began the process of cutting away the shredded uniform and washing both dirt and blood away from the wound with antiseptic solution.

All other distractions receded as she cleaned the wound, picking out fragments of stone, uniform, and bone with careful forceps. Sister Travkin’s choice to send this man for immediate treatment had been perceptive or fortuitous. Somehow the shell fragment which had shattered bone and laid flesh open had missed the femoral artery by the smallest of margins. With the wound clean she could see it pulsing beneath a thin sheen of tissue. Some small misstep, the breaking of this thin arterial wall never meant to be exposed to the outside world, and the man who was still telling her through his morphine haze about the difficulties facing a disabled peasant would bleed away his life here on the table within minutes.

At last the patient was ready, and Doctor Sergeyev began to work, setting bone, cutting away torn flesh and then stitching closed over the wound what skin remained. Afterwards Natalie wrapped the leg in bandages and splinted it.

Orderlies carried the patient away. A housekeeping sister appeared and scrubbed down the operating table. Then another patient arrived, this one with half his jaw torn away by a piece of shrapnel.

The hours passed uncounted. Patients came and went in an endless cycle. The light in the windows changed and dimmed, but the stream of broken bodies was constant.

Sister Travkin appeared in the operating theater, her apron stained with blood and grime, a mark dried to reddish brown on her forehead where she’d used a bloodied hand to wipe sweat away.

Doctor Sergeyev had just finished suturing a wound. He dipped his hands in the basin of antiseptic, dried them, then reached for his brown medicine bottle and took a swig which he rolled around his mouth as if washing away an unpleasant taste before swallowing.

“Are you finished with triage? No more wounded coming in for now, Sister?”

Travkin shook her head. “They’re still coming. This one,” she nodded to the operating table, “was the thirty-eighth you’ve taken to operate. I have over a hundred sorted and labeled outside. Those are the stretcher cases. I just told those who can walk to move on to the rail line.”

There was silence for a moment. The day gone in operations and still there were twice as many more again needing help. Doctor Sergeyev put his bottle away.

“I came to ask for morphine,” Sister Travkin said. “Some of the cases clearly can’t be treated till tomorrow, and I want to give them some relief.”

Doctor Sergeyev gave permission. Time, personnel, space, even beds -- there were a great many things they were short of, but there was plenty of morphine.

Mamushka stepped forward. “There are more of us housekeeping sisters. I can send a couple of the more experienced ones to help clean wounds and apply bandages to the less severe cases. Then perhaps they could be sent straight on to the trains, or they’d be in a better condition to wait for operation.”

The doctor turned to Sister Travkin as the senior nurse. Cleaning and bandaging was nurse’s work. In normal times the boundary between housekeeping and nursing sisters’ work was strictly observed.

Sister Travkin nodded. “Send them out. I’ll supervise them.” She took her morphine supplies and left.

Natalie and Sister Gorka returned to their own work. The orderlies carried away the patients who had been operated on and brought in new ones. Through the night the cycle continued.

Some time in the small hours of the morning Doctor Sergeyev told Natalie to go to bed.

“But you are still working.” For the last several patients she had felt her fingers becoming clumsy, her vision fogged. She barely knew what words of automatic comfort she offered now as she worked. But how could she leave while so many needed help and while the others still struggled on to provide it.

The doctor shook his head. “I can’t go from one surgery to another any more. Sister Gorka will carry on and I can take a brief rest while she prepares each patient. When you’ve had a few hours rest, you can come back and she’ll sleep.

Natalie was on the point of arguing but exhaustion tied her tongue. Perhaps it was as well. She organized her operating station one last time, putting everything in its place. Then while the housekeeping sister was still wiping down the operating table with cloths soaked in antiseptic solution, Natalie went out into the cool night air.

From the porch she could see Sister Travkin’s work, the many patients lying in neat rows across the courtyard, each man labeled with a card listing his condition and priority. The moon, a fat but waning gibbous, hung high in the dark sky, the stars around it gradually becoming visible as her eyes adjusted to the light. There were flashes on the horizon to the west, and as she watched them the rumble of far away artillery which had become an accustomed background to the day made itself present once again. There on the front lines more casualties were being created, men who over the following hours would make their way back to the field hospital and pass through their too few hands before being sent on to the rail line and the hospital trains which carried men to general hospitals in far away cities across Russia.

As from a distant time, memories bubbled forth of the rushes at the Prince Mikhailov Hospital in Kiev when a hospital train arrived. How they had scoffed, there in the well ordered wards, at the work of the field hospitals which had left men in soiled uniforms with bandages roughly applied to wounds that were already turning gangrenous. Now she knew all too well the desperation which had led to such work. Perhaps in a hospital in Lvov, Warsaw or Kiev shift nurses would shake their heads at the men Sister Travkin and the housekeeping sisters would label, bandage, and send walking on to the rail line. They would rebandage the men and see them through their surgeries, and when they were done with their shifts -- perhaps a double or triple shift, but still a shift with an end -- they would leave the hospital and talk of their long day over a steaming pot in a tea room before taking a tram back to some small flat with its soft bed.

Natalie made her way to the converted stable which served as the women’s sleeping quarters. She scrubbed her hands in a water basin, using the harsh brown soap they purchased from the peasants. But even as she rubbed the skin nearly raw the smell of blood still seemed to exhale from every pore when she dried them

Or perhaps it was her uniform she smelled. Looking down she could see the dark stains now only on her apron but on the dark wool nurse’s dress the apron was intended to cover. In her bedroom stall she stripped down to her shift. That at least was unstained, even if the smell of blood and antiseptic still seemed to hang everywhere around her. Tomorrow she could wear her second uniform while this would go in to be boiled in the laundry tubs by the housekeeping sisters.

It seemed mere moments filled with fitful dreams before she awoke to one of the housekeeping sisters shaking her.

“Sister Nowakówna. You’re needed.”

Her body felt leaden as she sat up.

“Here, I brought you some tea.”

“Thank you.” She held the warm cup in her hands and could smell it strong and sugary. “Is it morning?”

“Just before dawn. Mamushka said she’s sorry you’ve had only four hours but she wants to send Sister Gorka to get some sleep.”

“Are there still more patients coming in?”

“Yes. They just told the orderlies to clear out of their quarters to make more ward space.”

“I’ll be there as soon as I’m dressed.”

The housekeeping sister dropped a slight curtsy and left. Had she been a servant before the war? In this time and place the movement seemed to utterly incongruous.

In the pre-dawn light Natalie found the stable yard and grounds turned into an outdoor receiving ward, with rows of men laid out on the ground with their greatcoats or wool army blankets spread on beneath them. Pairs of housekeeping sisters were moving among them offering sips of water to those who were thirsty.

Sister Travkin was sitting on the stairs leading up to the lodge. Her stained uniform and bloodshot eyes made it clear she had not yet slept.

“Can’t you go get a few hours rest?” Natalie asked.

The other nurse shook her head. “Every little while another group of wounded comes down the road. If they can stay on their feet, I can too. In between, I get to rest by feet a little. Sister Gorka needs rest more than I. They’ve been doing one operation after another. Doctor Sergeyev at least gets to rest during preparation and clean up.”

For a moment they were silent together at the foot of the stairs. Then two soldiers appeared coming down the road, supporting a third between them. Sister Travkin roused herself from where she sat, and Natalie went up into the hospital. She found Sister Gorka preparing a man with a stomach wound for operation. The other nurse’s expression was one of dull exhaustion.

“I can take over,” Natalie said.

Sister Gorka nodded, set aside scissors and forceps, and wiped hands that finally begun to tremble on a damp cloth.

“You’ve done well. Get some rest.” She put a hand for a moment on Sister Gorka’s shoulder. It was a slight touch, but all the formality of the operating theater allowed.

A slight nod, teeth biting against lip. “Thank you.”

She knew the numbness of at last stepping away from the operating table, the tiredness which became absolute only when necessity was no longer there to stave it off. Lying alone in the dark of early morning, in the scant moments before sleep came, she had felt the as if she had been drained to the last drop of her humanity. If only there were some other to hold her close to give her warmth. But they were the ones who must give out comfort and assurance. There was no one to help them.

Taking up the scissors from the instrument tray where Sister Gorka had laid them down, Natalie resmed the work the other nurse had left of cutting the mud and blood soaked uniform away from the patient’s wounded stomach.

When the fabric of his tunic was pulled back, and she had sopped up the pooled, dark blood with sterile pads of gauze, she could at least see the wound. Pale fat, red flesh, yellow organ tissue, dark blood. The dirt and fragments were gone. The wound was ready for the doctor.

Before she could call to Doctor Sergeyev she felt an unexpected hand on hers. Looking down the patient’s eyes were on her, his hand gripping her with unexpected strength.

“Will I be all right, Sestritsa?”

The look which met hers pleaded for truth, but it also asked for comfort. Which should she offer? The prospects of a man with a stomach wound were not good.

“Please. I have a wife and daughter. Will I be all right? Will I see them again?”

She placed a hand on his. “We will do everything we can.” Still the eyes seemed to ask her. “You must be strong, and ask God to help you.” A nod, and whether it was the reassurance or the morphine dose which was noted on the patient card pinned to his tunic his eyes unfocused and his grip loosened.

She waited while Doctor Sergeyev put the chloroform mask over the patient’s face. A brief shudder, a tensing of the muscles, and he breathed more slowly. She moved his hand, now a limp piece of flesh, off hers and set to work, handing the doctor the probe with which he began to prod and search the wound.

So many cases had passed across their operating tables over the last day. It was impossible to feel for all of them. In the exhaustion of the work these man became a leg case, a stomach case, a head case. A bone to set and a skin to stitch. Yet each of these cases was in fact a man, one possessed of fears and hopes, of family and friends, of a home somewhere across this empire which they both in their different ways served though it was a thing so large, so diffuse, that it was as much an idea as a place. All these hopes and fears and loves which must be somehow sewn back into something like a whole body and sent out to whatever far corner of the world they had come from.

All morning they worked and into the afternoon. Sister Gorka returned from a few hours rest and took over the triage work outside the hospital from Sister Travkin. Doctor Sergeyev refused any offer of rest and continued at the surgery, laying his head down on the spare operating table while Natalie prepared the next patient for him.

As evening approached, the tide of soldiers coming down the road from the direction of the front became heavier, but few of them turned in to the field hospital. At first they came in ones and twos, then clumps of men, some with their packs and rifles, some with nothing but the clothes they wore. Carts rumbled by and officers on horses. Whole companies of soldiers came down the road, not marching as they had in days passed, but shuffling, ambling crowds.

“Do you think they are retreating?” Sister Gorka had been making the rounds, giving water and changing bandages.

Doctor Sergeyev joined her at the window, drying antiseptic solution from his hands after his last surgery. “Perhaps some of the spent units are being pulled from the line and replaced with fresh units.”

“I haven’t seen any units going the other way.”

The doctor shrugged. “This road is choked as it is. The staff must be using other roads to send in fresh troops.”

“If the enemy breaks through, how will we take all the patients to safety?”

“We’d have the ambulances evacuate the patients to the rail line to catch the next hospital train. We’ve been here so long, I’m sure if there’s any risk of a breakthrough they’ll be able to give us plenty of warning.”

When the warning came, however, it was last minute and accidental. A regimental staff captain rode into the hospital yard, looked around in obvious dismay, then demanded of Sister Travkin, who was again taking triage duty, “What are you doing here? The order for all support units to fall back was sent four hours ago.” When Sister Travkin stared mutely at him for a moment, the full meaning of his words not yet penetrating the physical and emotional exhaustion of the last two days, he swung off his horse. “Do you understand me? Surely you don’t intend to give yourselves up to the Germans? Are you alone? Is there other staff here?”

He clattered up the hospital stairs even as Sister Travkin called after him, “We’ve received no orders.”

Natalie heard the sound of riding boots echoing towards them, and instinctively her head turned towards the sound.

“Hold that rib up,” Doctor Sergeyev barked.

She fixed her attention on the wounded man on the operating table and pulled upwards with all her strength on the forceps with which she gripped one of his broken ribs.

“Yes, that’s right. Now don’t move.” The doctor reached his forceps into the wound cavity which the elevated rib exposed and gripped the piece of shrapnel embedded there.

“You need to leave immediately. All of you.”

“Wait.” Doctor Sergeyev did not look up. He pulled the jagged piece of metal carefully out, trying to avoid cutting the wound channel wider as he did so. For a moment Natalie could see the rising and falling of the lung. Then the wound channel filled with blood. “Gauze pad and apply pressure,” the doctor ordered. “Gently. Don’t re-compress the rib.”

Natalie obeyed. She could feel the blood welling up through her fingers. She added another gauze pad and continued to press it against the wound.

“You must get out immediately or you’ll be overrun. Evacuation orders were sent hours ago.”

Again Natalie felt blood welling up, slick between her fingers. “Doctor, he’s hemorrhaging.”

“More gauze. Press hard, never mind the rib.”

She added another thick wad of gauze and leaned in with all her weight to try to stem the bleeding. The patient was still unconscious from the chloroform. His breathing was slow. Was it slowing further? His chest sank. A long moment. It rose again.

Back in the hospital in Kiev there would have been a nurse assigned to monitor the patient’s blood pressure during an operation like this. She would have called out the two numbers at intervals, allowing all those working on the patient to hear if the Systolic pressure -- the higher number which represented the level when the heart was compressing and pushing blood through the body’s arteries -- began to fall down to the meet the Diastolic pressure, a sure sign that that heart was failing.

Here there were not enough staff to devote someone to tracking blood pressure, nor was there any adrenaline injection available for the doctor to try to restart the heart if it gave out. In Kiev she had even once seen a procedure demonstrated by a visiting doctor from St. Petersburg, where he saved a hemorrhaging patient by transferring blood from one of the orderlies directly into the patient through a set of needles and tubes. Doctor Luterek and the other surgeons had been much impressed, and her army nursing identity card had a neatly hand letter notation at the bottom corner “Donor Blood Type III”, but there were no such procedures here, and the entire staff would be bled white if they attempted to help a fraction of their cases that way. They could only wait, knowing that the patient’s blood was flowing out and unsure if they could stem the hemorrhage in time.

“Doctor!” The officer was standing next to the operating table, shouting.

“I am trying to save a patient, sir!” Doctor Sergeyev said without looking up. “Have the goodness to wait.”

“I am trying to save all of you from becoming German prisoners,” the officer replied. “Do you understand me, sir? You must leave now.”

Natalie’s attention was now on the officer. His uniform was the formal dress style favored by the staff, his riding boots were polished leather. But all of these were grimed with dust and spattered with mud.

“Is it as bad as that?” she asked.

“Goddamn it all!” Doctor Sergeyev was shaking the patient by the shoulders. He put his ear to the soldier’s chest. For a moment all were silent. Natalie did not feel fresh blood soaking through, but neither did she see the patient’s chest rise or fall. She reached out to check his pulse. Nothing.

The three of them looked at each other.

“I hope you’re satisfied with your interruption, sir,” said Doctor Sergeyev, turning away and reaching for his medicine bottle full of spirits.

“I’m here only to assure your safety,” the officer replied, with obvious affront. “If your aim is rather to give yourself up to the advancing enemy…” He left the accusation hanging in the air.

Doctor Sergeyev, leaning against the equipment table, let out a long sigh. “No. You’re right of course. If the army is falling back we must do the same. How quickly can you get us carts and support? My staff is reduced and we’ve spent the last two days overwhelmed. We’ll need far more than just the nurses and orderlies to get all the men loaded properly and evacuated to the rail lines. And then there’s the equipment to pack up.”

The officer shook his head. “You don’t understand. There is no time. There are no carts. There is no help. You must take what you can in a quarter of an hour, in the transportation you already have, and fall back as quickly as you can. I’m only just behind the front line. Very soon, the fighting regiments will be withdrawing along the road. And then soon enough it will come the enemy.”

“But the patients?” asked Natalie.

“There’s nothing to be done for the patients. We’ll have to leave them behind and trust ot the Germans providing them with care.””

“Our equipment,” said Doctor Sergeyev.

“Gather all that you can, but you must hurry. There is no time.”

It was at that moment that Sister Gorka, who had been seeing to the needs of the patients who had already been through surgery, bustled around the corner and into the operating theater. “You’re all very grave. Has something happened?”

“The patient died,” said Natalie, and then she added the words which still seemed wholly unbelievable. “We have to fall back, and there’s no time to load all the patients onto carts and ambulances. We must gather what we can and retreat within fifteen minutes.”

With these words she broke free of the shock which had seemed so paralyzing. Taking up a carton which had held bandages sent by some ladies’ aid society far away, she began to dump surgical tools into it. No matter, at this moment, what was sterile and what was not. They must have tools wherever they set up the hospital again.

Nurses, housekeeping sister, orderlies, and drivers all moved into feverish activity, loading supplies and equipment on the field hospital’s carts and horse drawn ambulances. Equipment, linens, supplies, and personal belongings were assembled.

Patients soon noticed the activity, particularly those -- most of them more lightly injured -- who were laid out on blankets in the open air of the courtyard.

“Where are you going, Sestritsa? What about us? Don’t leave us, Sestritsa!”

Several times she felt a hand plucking at her skirts as she walked past the wounded. She would not lie to them, and so she would not speak. She twitched her skirts away without looking. There was no room for patients as they tried to carry away all that they could of the hospital, nor would they have the facilities to care for patients while on the road.

She could brush past these entreaties with something like a good conscience as she oversaw the loading of the medicines and supplies. These were essential if they were to continue to provide their saving care to other soldiers. Guilt stabbed more deeply as she made one more, hurried trip, this time to the women’s quarters to collect her few possessions. All these men were being left behind, yet she must take her little suitcase of personal possessions?

It was not as simple as that, of course. She could leave her few treasured things behind -- the wooden doll which had been her companion when she left the Polish estate for the school in France, the little framed photograph of her infant self in her dead mother’s arms, the pearls her father the count had given her at their one meeting -- but it would not change the fact that the patients must be left behind. It was a decision beyond her power to change. This was no Tolstoy novel, and she was no Countess Rostova able to save the lives of deserving Russian soldiers by leaving behind her possessions.

The allusion came naturally to mind, and with it the afternoons spent in old Sister Maria-Grigori’s room in the convent school, learning Russian and Polish by reading the old nun’s novels. How fanciful had seemed Tolstoy’s world of battles and retreats and refugees: The Rostovs escaping Moscow, Princess Maria rescued from the French and the rebelling peasants by Nikolai, and at last the great French retreat from Moscow through the wastes of winter.

In some sense it was another world: Fifty years since the novel had been written and a hundred since the French invasion of Russia.

Yet had she not in many ways stepped into the pages of that novel she had read under Sister Maria-Grigori’s tutelage? Here she was, the natural daughter of a count, caught up in a great war that surged across the map of Europe: France, Austria, Prussia, and the Russian empire itself. All the elements sprung to life from the novel’s pages. Somehow, when she had read about such things, they had not seemed so unpredictable and without plan. There were no forces of history here, only chaos, guilt and fear.

The women’s quarters -- the wooden structure built as a stable for thoroughbreds and even that morning still so cozy for the purpose to which they had converted it -- were now in disarray. Some things were taken, others left, and in the process much had been strewn about. As Natalie entered she found Sister Gorka struggling out weighed down with her own trunks, not just the usual clothing and personal items but her camera, tripod, and film packed away.

Her own little area was exactly as she had left it that morning. It was a matter of moments to put all of her possessions back into her suitcase. The cot, the little table, the carpet, the washstand -- some items provided by the medical corps and others scavenged from the house -- these would stay behind for whatever use might come next to this structure. Surely the nobleman who had built the stable for his horses could not have imagined it would someday house nurses. She in turn did not know what use it would be put to next.

As she carried her one piece of luggage out to the line of carts, the first of which were already beginning to roll out of the yard, piled high with the hospital’s equipment, her eyes were drawn to the landmarks of what had been her world for the past four months. The little forest of crosses under which lay too many men whom she had helped to care for and comfort in their last days; the buildings which had housed sisters, orderlies, and patients; the lodge itself which had served nobly over the last half year as a house of healing.

She handed her suitcase to a Tatar driver, who stowed it among the pile of luggage on his cart. There were shouts and orders and soon the bearded man in his long coat and fur hat clucked to the horses and guided the cart out into the road, among the flow of vehicles and retreating soldiers.

Natalie stood looking back at the hospital. There waited hundreds of men, broken and fearful, waiting to see what would come to them next. There were the cots and operating tables there had been no time or space to load, where they had struggled to mend the wounds of war before life ebbed away. There was so much to leave behind at less than an hour’s notice.

She turned to join the stream of hospital staff walking down the road in the wake of the carts and ambulances that carried their possessions. As she did so, she nearly collided with Doctor Sergeyev, who had likewise been looking back at the hunting lodge which for half a year had served as a hospital. There were tears in his eyes which he dashed away with the back of his hand.

“I would never have thought it when I came to this place,” he said. “But some of the best hours of my life have been here. And some of the worst.”


They had set out late in the day, joining a road already clogged with men and vehicles falling back before the enemy onslaught. Their progress was slow, and the more frustrating for the fact that there were not enough places in the hospital vehicles for everyone to ride. By general consent, Doctor Sergeyev was given a place to lie down in one of the ambulances, the canvas curtains drawn to give him the better chance to sleep.

“He downed the rest of that bottle of vodka before laying down,” Sister Travkin said, as the three nurses walked along the grassy verge of the road to avoid the worst of the mud.

“If that’s what he needed to go straight to sleep, I’d say it’s just the medicine the situation calls for,” said Sister Gorka. “He hasn’t slept a wink since the wounded started to arrive yesterday morning. Thirty hours? The poor man needs his rest.”

“Oh, are you his defender now?” Sister Travkin asked. “Is this how we get a surgeon who drinks between operations? Because there is always some warm hearted woman willing to defend him?”

“We all know that the hospital could be better run,” Natalie said. “More modern methods, better wound hygiene protocols, proper shifts and enough staff. And of course, no alcohol while on shift. But the fact is, the doctors who would run things that way have chosen to stay in their city houses and city hospitals. And when it comes to the people who have chosen to work here, near the front lines, Doctor Sergeyev has given a great deal.”

Slow hour after hour they made their way out of the woods that surrounded the hunting lodge and among the fields of the small villages surrounding Tarnow. With Doctor Sergeyev asleep, and the rest of the divisional command too fractured to provide clear orders, it was fortune that carried them on the road they followed, but it was good fortune nonetheless. Tarnow itself was choked with men and horses and carts, and as the region’s one town of any size, marked clearly on all the enemy maps, it was already under heavy bombardment. They pursued an arcing path which led them north of the town, through outlying villages. Letowice, Biala, Brzozówka. By evening they were east of the town, and the artillery was nothing more than a rumble on the horizon several miles distant.

It was fully dark when they stopped, at something that could be called a village because there were a dozen peasant huts clustered near the road. The carts and ambulances were drawn up into a light cluster and the horses hobbled nearby. The orderlies laid out bedrolls on the ground, and the nurses and housekeeping sisters were preparing to lay out their own in the cramped privacy of the canvas covered ambulances when a regimental staff officer arrived and announced that one of the huts has been requisitioned for the women.

The three nurses and Mamushka exchanged glances.

“We really can be quite comfortable in the ambulances. They’re designed to hold several stretchers, so they can just as well be made up as several beds,” Natalie offered.

“Certainly not. The gentlemen of the regiment could not sleep well knowing that ladies were forced to sleep out of doors.”

“It promises to be a fine night,” Sister Travkin offered. “And including the housekeeping sisters there are fourteen of us.”

“Fourteen?” The officer’s young face betrayed shock for a moment. “But surely the housekeeping sisters…” He stopped before uttering the words, “are only servants”, but the meaning was clear enough.

“We all shared the same quarters at the field hospital,” Natalie said.

“Of course, of course. Well it shall be no trouble at all. We shall provide two huts. Please. Do not think of sleeping outdoors.”

There was nothing to do but accept, though when they were led to the low structured with their walls of rough-hewn logs and their roofs of thatched straw, they wondered if this courtesy did not leave them worse off than they would have been under the clean canvas of the ambulances or in the open air.

The air in the hut was close and heavy with smoke. The huge brick and plaster stove which stood against one wall -- so large that in the winter a bed was made up on top of it for those members of the household most in danger of cold -- clearly did not draw well. The living area was a single room, the only other being a lean-to shed normally used for storage into which the peasant family had been pushed for the night by the officers requisitioning the hut for army use.

“I’m so sorry. We did not mean to force you from your house,” Sister Gorka told the family, which consisted of two old women, the farmwife, and three small children.

“No. No. We are honored. Much better you ladies than army officers,” the farmwife assured them, her Polish a dialect which Natalie could understand only with difficulty.

The nurses laid out their blankets on the floor. The beaten earth of the hut’s floor was covered with a layer of straw, which crackled and gave off its smell of summers gone by.

She told herself it was the same as lying down in a grassy field, but in the dim light and close atmosphere of the hut, every little sound brought thoughts of fleas, mice, or other pests.

It was foolish to be frightened of a home which was doubtless little different from that which her mother’s family had lived in. Yet even knowing that she came of peasant stock, this was a world away from the convent of her girlhood, or the Luterek’s home Kiev. Even the field hospital, where the women’s quarters had been a converted stable, had offered a wooden floor covered by rugs scavenged from the hunting lodge.

Yet for all the alien surroundings, she had walked her share of miles that day and slept little enough the night before. Soon she drifted off to sleep, and thus rested until the half light of pre-dawn, when the first of the German heavy artillery shells screamed into the village.

The mission of the field hospital was to provide medical care just behind the front lines. A man might reach their operating table within two hours of being wounded. They were well used to dealing with the immediate effects of battle. And yet battle itself, and the habits for survival that came with it, had not visited the hospital before. They were now encamped with a regiment of soldiers, not set back from the front in a clearly marked medical station. And while the soldiers had, out of habit formed by six months service on the front lines, dug slit trenches or fox holes in case they came under artillery bombardment, no one had thought to tell the hospital staff to do the same.

The first explosion ripped natalie from an exhausted, dreamless sleep. For an instant her surroundings were unfamiliar. Dim light filtering through doors and windows illuminated the smoke-grimed interior of the hut. The strangeness was like waking to another dream. Then she recalled the night before and the peasant women whose hut they were sleeping in.

A second shell exploded. The loudness was beyond anything she had heard before and instantly set her ears ringing. A third explosion went off. She could feel in through the ground on which she lay and though the very air which reverberated right down into her chest.

She had never been trained in what to do under artillery bombardment, but there were deep human instincts which provided the answer. Just as a rabbit knows to seek its hole and a fox to retreat to its den, she knew with desperate urgency that she must seek some kind of cover. At first she grabbed what ineffective protection she had and pulled her woolen blanket over her head, her body working against the floor as if to dig into the sheltering ground by sheer desperation.

As the explosions continued to shake the ground below her and the air above, some remaining scrap of reason told her that the security offered by the blanket was an illusion. She pulled back the blanket enough to look around. She saw Mamushka crouched under the heavy wooden table, whether through presence of mind or simple because that was where she had found room to lay down. She crawled over to the other woman and joined her in the table’s shelter. There was little room, and she crowded against Mamushka, taking comfort in the warmth of another body, secure against hers. With each shell’s impact, she could feel Mamushka’s body convulse, and she knew that she likewise must be trembling with the shock of each explosion. She could see dust and debris sifting down from the thatched roof above with each shell burst, and the smell of smoke began to scorch at her nostrils.

The noise and concussion of the explosions had familiar dulled Natalie’s sense enough that reasoned thought became possible again, and now a new fear gripped her. If the sounds themselves were terrifying, the fact that she could hear a shell explode outside the house meant that it had already missed them. If a shell were to his the house itself, she would be crushed or burned or torn apart before the sound even came to her. Now even the silence between the explosions could be no relief. Death and maiming would come out of the silence, with no warning. The sounds, so brutally battering at all her senses, were taunting reminder: Not this time. But perhaps the next will be for you.

But their time never came.

At last the bombardment ceased. The silence stretched on and on. Both women were tensed in anticipation for the next explosion, but none came. At last, after what seemed a very long time, they crawled out from under the table and began to look around. This house was undamaged, but from the shouts they could hear from outside it was clear that not all had been so fortunate. The only clear words were, “Stretchers! Stretchers!”

Natalie crawled out from under the table. Sister Gorka was huddled against the solidity of the brick oven, her blanket pulled over her head. Sister Travkin was sitting, hugging her knees to her chest, her shoulders shaking. From the lean to where the peasants on whom they had been quartered has spend the night, she could hear quiet sobbing. She must help the wounded outside. She pulled herself to her feet. One step and her legs gave way, muscles trembling. Putting out her hands she caught herself on all fours, gasping out fear and tension on the straw that covered the floor.

“Any wounded here?”

A sergeant was standing in the doorway of the hut, peering into the dim interior. His tone was oddly calm after the cataclysm they had just gone through. Natalie had seen experienced front line soldiers turn away at seeing her unwrap and clean the wound of a comrade they had brought into the field hospital. Just as she had become able to look at all kinds of wounds without her stomach turning, perhaps some who had been on the front lines for a time had learned to go back to their activities calmly as soon as the shells stopped falling.

“No. We are all well,” she told him, getting slowly back to her feet.

“Good.” He stepped further into the hut and looked around. “You must be the nurses from the field hospital. We have wounded, if you can help. The headquarters was hit.”

If she had no experience as a soldier under fire she had much as a nurse faced with casualties. “We’ll be there immediately.”

The regimental staff had taken a larger hut, slightly set apart from the others in the village, as their headquarters. This clearly had been the target of the artillery barrage. It was reduced to a smoking ruin. Most of its occupants had managed to reach shelter in a slit trench dug outside, but even among these there were shrapnel wounds and several who were otherwise untouched were bleeding from split eardrums.

They began the familiar work of sorting the wounded into triage groups. One of the field hospital orderlies appeared as Natalie was directing soldiers to lay out the bodies -- living and dead -- they were pulling from the wreckage of the hut itself.

“Open some of the crates on our carts,” she told him. “We need bandages, antiseptic powder, and water. Get Doctor Sergeyev. He’s needed.”

The orderly shook his head. “The doctor needs you, Sister. The hut he was sleeping in was hit.”

She left Sister Travkin in charge of the headquarters casualties and followed the orderly to the hut which the surgeon had shared with a group of junior officers. A single shell had come in high, hitting the ridge pole and exploding. A section of that ridge pole now pinned Doctor Sergeyev’s left arm and shoulder against the ground. One of the officers was pinned by the leg. Several others had shrapnel wounds. The hut’s inhabitants -- young peasant man, two small children, and his heavily pregnant wife -- were picking through the ruins for what of their possessions could be saved.

Doctor Sergeyev bit back a scream as soldiers levered the heavy beam off him.

The arm was an ugly sight. Blood soaked the white linen undershirt in which the doctor had been sleeping. She could see the upper arm was fractured in at least one place, the shoulder dislocated, the collarbone broken. Even if there had been another doctor to set the bones, it would be months before Doctor Sergeyev was able to use it for the fine work of surgery again.

“It would be my arm,” he said, attempting something like a smile. “And this officer here gets his leg crushed. I could have operated with a splinted leg all day long, but he won’t be riding a horse any time soon, and I won’t be doing surgery. No. It’ll be back to Moscow and my wife.”

“Your wife?” Had Sister Usenko known that he was married? Surely she wouldn’t have had anything to do with him if she had. Would she?

“My wife. You don’t I’d be out here if it weren’t for my loving Countess at home, do you? Never marry for money. That’s my advice to you. Now would you look in my coat pocket over there and see if my bottle survived? I could use a drink.”

Natalie fetched the body and left Doctor Sergeyev dosing himself. He would need something to dull the pain on the jouncing ambulance ride to the next train station, where they could send him and the other wounded off.

Back by the headquarters hut Sister Travkin had finished organizing the wounded. The colonel had escaped untouched, but more than half the regiment’s staff officers were killed or wounded.

“Where’s your doctor?” he demanded.

“Wounded. A broken shoulder and left arm. I’ve just seen to him.”

The officer gave an angry swish of his walking stick but bit back any exclamation in the presence of the nurses, the curled tips of his mustache quivering with the effort. “Well. There it is, I suppose.” The tip of his tongue darted out, captured the curled end of his mustache, and pulled it in where he nibbled at it thoughtfully for a moment. Then, seeing Natalie’s eyes on him, he turned away and smoothed it back into place. “There’s no telling how long it is until the medical corps sends us a new surgeon in all this madness. The whole southern front is falling back. Will you ladies consent to remain with the regiment and continue operating the hospital in whatever limited fashion you can without a doctor until that time?”

Natalie looked over to Sister Travkin and Sister Gorka. A nod. A shrug.

By chance or temperament she had become their spokesman. “Of course, sir.”

“Good, then. Right.” The colonel looked around, spotted a young lieutenant, and waved him over. “These ladies and their field hospital will be attached to the regimental staff until further notice. See that they have anything they need, and send a request to the medical corps for a new surgeon to take command.” With a nod of dismissal the colonel turned away and on to his next concern. “Sergeant! Have you found any trace of the peasants from that headquarters house? No? I tell you, they must have betrayed us to the Austrians. These Poles aren’t to be trusted. How could the enemy have targeted us so precisely if they didn’t have news from the village?”

The colonel’s mind was firmly on other topics. Natalie turned to the lieutenant.

“We’ll need transport for all the wounded. Some we can take in our ambulances, but we’re also carrying all the hospital’s equipment.”

The lieutenant nodded, looking quickly around as if he expected to see the needed carts standing nearby somewhere. “How many will you need?”

Natalie looked around the area where Sister Gorka and Sister Travkin were still working on the triage cases. This one would be able to walk. That one would likely die within hours. That one over there would need to be transported. With a practiced eye she made a talley. “Four carts.”

“Four carts,” he repeated back. “I’ll speak to the supply officers, but it’s not as if any of the carts are empty.”

She shrugged. “Yet we have to move the wounded. You can’t abandon them.” As soon as she said the words she recalled the men they had in fact abandoned when they evacuated the hospital -- the men who had cried out or had plucked at her skirts as she passed, knowing they were being left behind. She pushed the memory away. There was nothing she could do for those patients, but for these it was essential that they get carts. “We’ll only need the carts as far as the next time we cross the rail lines,” she offered. “If you have to leave cargo behind temporarily, you could come back for it after getting the wounded on a train.”

In the end a compromise was found. The baggage train contained a huge number of hay wagons, carrying the fodder necessary to keep the horses for the officers, cavalry, and the wagons themselves well fed enough to keep up with the march. The wounded were laid out on top of hay bales or grain sacks, and by noon the regimental column was ready to resume motion.

The road was already jammed with slowly moving carts and men -- supply officers shouting and waving as they attempted to bring some order to the chaos -- when Natalie hurried back to the peasant hut were she and the other nurses had spent the night.

She had wanted only to make sure that the housekeeping sisters had collected all their things, and hoped as well to thank the peasant women who had been their unwilling hosts for the night. She found the peasant women arguing loudly with a group of soldiers who were using pitchforks to pull down the thatched roof of the hut. Seeing Natalie the peasant women rushed to her, talking over each other in their strange dialect of Polish.

Once she had untangled their anxious questions, Natalie turned to the soldiers. “They don’t understand. Why are you destroying their house?”

Several shrugs. “Orders, Sestritsa,” one of them said at last.

Natalie saw and officer passing by and approached him. “What are these men doing? They say they have orders to pull the house down.”

“Oh no, they’re just pulling down the outer wet layers of straw,” the officer assured her. “Then they will burn it. Much quicker. We won’t delay the regiment by pulling down all the houses.”

“But why? These people gave us shelter for the night.”

“Orders from the Colonel. Someone in the village went across the lines and brought down artillery fire on the headquarters. These are Galician Poles, not Russian subjects. They can’t be trusted and we can’t be leaving stores and shelter for the Austrians. So all houses and supplies that can’t be carried away are to be burned, and the peasants are to be relocated further into Russia. No men or material for the Russians.”

“But Lieutenant, if you let your men burn these women’s house, they will have nothing.”

The officer shrugged. “What can I do, Sestritsa? If we leave their farm intact, the Austrians will take everything instead. Better we get it over with now and protect Russia.”

Natalie turned to pass on the explanation to the peasant women. One of the older ones began to cry. The farmwife nodded quietly, went into the hut which until now had been her home, brought out Natalie’s bag, and gave it to her. “Thank you, Miss. I’m sure you did all you could for us.”

The calm sadness in her eyes was enough to bring a fog before Natalie’s own vision for a moment. She blinked hard. For this other woman, this was not the tragedy of a moment. A lifetime was entwined with this little village at which they had stopped by chance. A marriage. A family. Whatever lay ahead for this family, it was a life utterly severed from what had come before. In a few days, perhaps a week or two, she and the other nurses would set up a new field hospital in a new location. They would treat their patients as they had before. A new surgeon would come, replacing Doctor Sergeyev whose life was also changed today. But when would this family which had shared their roof with her regain anything like the life they had had before?

“Thank you,” she said, as she accepted the bag. She took what coins she had and offered them to her host, but the farmwife waved them away. There was nothing that she could do. She rejoined the field hospital and their ambulances, now full with wounded including Doctor Sergeyev. Soon the supply officer overseeing the departures granted them a space and waved them onto the road. The nurses walked alongside as the horse drawn carts and ambulances lurched unto the dusty and rutted road. From behind them, columns of smoke began to rise, black against the sky. The village was burning.


Two days later, the regiment’s path crossed the rail line. There was no proper hospital train and even after several hours of working the telegraph the station master was able to provide no news of one. But there was a train heading for Warsaw, and that was at least the right direction. They laid the wounded officers, including Doctor Sergeyev, across the seats of the first class compartments, and for the soldiers they laid wool blankets on the floor of two boxcars.

With the wounded safely on their way to Warsaw, the field hospital’s ambulances were once again empty, aside from equipment and the staff taking turns riding in the shade of the canvas covered vehicles rather than walking in the churned up dust of the marching regiment. With the military patients gone, however, another health crisis, less easily solved, was growing. Each day the number of peasant refugees moving along with the regiment increased and so did hunger and disease among them.

It was not fear of the enemy that drove them on, at least, not if the enemy was the Habsburg Empire. Little though these farmers had considered the doings of empires in their lives, they had spent their days under Austrian rule until the outbreak of war. What drove them deeper and deeper into Russian Poland was the standing order now in effect to destroy all shelter, food, and fodder as the army fell back. If it was impossible as of yet to stop the German and Austrian advance, the Russian army could at least force the enemy to carry all their supplies with them by denying them the value of the land.

However sound the military logic of this policy, it led to cruel scenes every time it was enforced. The peasants’ feelings toward the two warring empires might be ambivalent, but their huts, animals, and fields were all they had. In one village a boy barely in his teens rushed a pair of soldiers who were rounding up his family’s chickens. He succeeded in stabbing one of the soldier’s with a pitchfork before shots rang out. Now the soldier lay, sweating and moaning in one of the horse drawn ambulances. The wound itself had not been severe, but the pitchfork tines, fouled with dirt and manure, perforating the intestines had created the perfect conditions for infection. Under its bandages his stomach was now red and swollen, the three puncture wounds half healed and oozing puss. Each day she changed the bandages, Natalie became more sure that he would not survive.

His young assailant had never reached the hospital. The bullet that had struck the boy had left him thrashing on the ground like a wounded animal. A soldier had put a rifle to his head to finish him off, but a lieutenant had waved him away.

“He attacked one of our men. He’s a traitor. He has to hang.”

That was where the hospital staff saw him: a blood-soaked body gently swaying from a tree branch nearby as they worked to bandage up the wounded soldier.

While there were few incidents of such open violence, the resentment of the refugees was clear, and it was returned with disdain by the officers in particular.

“There is not enough food for the civilians,” Natalie told Lieutenant Popov, the officer whom the colonel had assigned to supervise the field hospital until a new doctor arrived to take formal charge. “Couldn’t the mobile kitchens provide them with bread? We’ve driven them from their own sources of food.”

Lieutenant Popov shrugged. “They have their carts and their animals that clog up the roads. They’re peasants: they always have food hidden away somewhere even as they claim they’re starving.”

“I’m a nurse, sir. They cannot fake the symptoms of starvation, and I tell you that the people who come to me for help are starving. There’s a pregnant woman who can barely walk because what little food she gets is needed for the baby she carries. Her husband pushes her in a hand cart. There are children with dull eyes and sunken cheeks. There are--”

“Please!” Lieutenant Popov waved the examples. “I am sure there are hard cases. Even among their own people, there is greed. They don’t share with each other. Yesterday I caught two of the bakers amusing themselves by throwing scraps of bread to the refugee children. Do you know why they found it so amusing? Because as soon as a piece fell among them the stronger ones would beat and kick at the weaker until they succeeded in taking all the food for themselves. If you wonder why the children and pregnant women are hungry, look to the strong ones.”

Nonetheless when she wrote up the list of food needed for the hospital’s patients that night, Natalie included four extra rations. Mamushka looked at the slip of paper, met Natalie’s eyes, and took the list to the mobile kitchen without a word. The head of the housekeeping sisters was not always comfortable in her reading or writing ability, but names and numbers were well within her power. She had known of Natalie’s deception, and if she had not agreed, she had at last consented.

The regiment stayed the night in another small Galician village. The field hospital was given the wooden church in which to set up for the night. As soon as she entered the building, Natalie could see that the priest must already have evacuated it. There were no candles, no brass or gold-plated candlesticks gleamed. The door of the tabernacle stood empty in the intricately carved wooden altar.

It did not bother the Russian staff. This Polish church was bare of icons and with its westernized statues offered no familiarity to them. But Natalie saw Sister Gorka stop herself as she began to genuflect.

They laid patients out where they could, and Natalie oversaw the changing of bandages on the pitchforked soldier and several others with wounds. Food arrived from the mobile kitchen, and Natalie set aside the extra she had ordered -- two loaves of heavy, brown army ration bread and a tin from which the label had fallen off, but which doubtless contained one of the meat or fish pastes which were staples of ‘iron rations’. Once she had seen to all the patients, she wrapped these items in a hospital sheet which was beginning to fray through near the foot, and took them with her out into the night.

The peasant refugees had formed an encampment a short distance from the regiment’s own. She could see the light of campfires and hear distant shouting and singing. Someone must have found a store of vodka. The sounds of men with drink were instantly recognizable. Drink was one of the few escapes the refugees has from the march. The peasants were as avid in their search for liquor as the soldiers, and because they had themselves once been farmers eager to conceal supplies from passing soldiers, they were considerably more skilled in finding their quarry.

But however understandable their need, the way in which the men looked at her when the bottle had been passed around a few times always made Natalie feel unsafe. She was glad to find the family she was looking for camped much closer than the fire around which the refugees were gathered.

The husband, Vitek, scrambled to his feet as she approached. He pulled his cap from his head and stood working it in his hands. His wife, Eva, lay on a blanket on the ground and did not rise, but while her husband looked down at the ground and did not meet Natalie’s gave, Eva’s tired, dark-rimmed eyes met hers. Her pregnant belly was huge. Surely the baby must come soon. With the rigors of the march and lack of food, her body would soon be consumed by the small life inside her if she did not give birth to it soon. Another child, perhaps four years old, all thin arms and legs and big, dark eyes looked up at Natalie from under a grubby kerchief.

“I brought you some food,” Natalie said, unwrapping her bundle and handing it to Vitek. She could see the little girl’s eyes following the food as it was put into her father’s hands.

“Thank you.” The peasant man was still looking down at the ground. “It’s not for me, you understand, Sister. I can wait until we reach a village where there is food for us. But Eva and the little girl…” His voice trailed off. He was turning the bread over in his hands, feeling it, weighing it. Then he shook his head, dismissing the thoughts that momentary revery had offered, and tore off a chunk of bread which he handed to the little girl.

“It’s for all of you,” Natalie said. “You need your strength too. There will be more miles to walk tomorrow.”

She had first noticed the family a week before, because Vitek pushed his pregnant wife and their daughter in a hand cart. Surely he could not do such work all day long without food.

“I’m not a beggar,” he told her, meeting her eyes at last. “I’ve worked my own fields. Now they leave us nothing.” The last word came with bitter emphasis.

She had heard bitterness and anger from patients in the hospital, but seldom so strong as this. Here was another kind of war casualty, not caused by guns and shells.

“I’ll try to bring more tomorrow,” she promised, and Vitek nodded, his eyes respectfully directed towards the ground again.

“Thank you, Sister.”

He used the formal term, not the diminutive Sestritsa which so many of the patients used.

How old was this man who treated her with the deference of social inferiority? How old was Eva, whose sunken, dark-rimmed eyes had met hers with wordless gratitude? Was that woman, already the mother of one child and struggling to bring forth another into a world turned to chaos by invasion, any older than she? Yet what was she? A year ago, she had been nothing more than the ‘old girl’ at the convent school, responsible for overseeing the young ones and helping with lessons. In a year, her nurse’s training and uniform had turned her into an authority, to soldiers who had borne arms in battle and to this small family which had married, raised children, farmed, and then been driven from their home by the very army she was enlisted to heal.

It was strange to think that her mother had come from a village not much different from theirs. In the world of the village, doubtless they were the more respectable: a married young couple, a farmer and a farmwife. And what had her mother been? An unmarried girl with a bastard child, rejected by her family. But because her father was the count, even though he was unwilling to see her again much less give her his name, she had the education, the clothes, the occupation which caused them to treat her with such respect. She was like these people, and yet a gulf yawned between them, as uncrossable as that between her and her titled father. Both distinctions were absolute, even though unearned.

She had been walking back towards the church turned hospital, paying only enough attention to her surroundings to avoid the patches of underbrush and fallen branches which punctuated the carpet of pine needles between the trees. Now a woman’s scream set her heart pounding in her ears and focused panicked attention on the surrounding shadows between the trees.

A girl, perhaps fifteen, ran out from the shadows. Her long, full skirt and blouse -- a dull cream color set off with edges embroidered in bright colors -- marked her as one of the peasant refugees, but her head was uncovered, revealing a long golden braid. She came up short before Natalie, breathing hard.

“Help me, Sister.”

“How? What is wrong?”

There was a sound of heavy movement in the underbrush. “Come back, bitch.” The voice was deep and ponderous, as if each word had taken work to form. A man, also in peasant clothes, middle aged, heavy, appeared from among the trees. In one hand he gripped a red woman’s headscarf.

Seeing Natalie, in her nurse’s uniform, veil and Red Cross armband, he stopped so suddenly that he lost his footing among the pine needles that covered the ground, staggered, then regained his balance and stood facing her.

He was a head taller than Natalie, with thick arms and huge hands in which the woman’s headscarf looked a foreign object. Her first instinct was to turn and run. What could she do against a man, and one to all appearances thoroughly drunk? Why had the girl appealed to her? Simply because she was there, the way a drowning person grabs at anyone else in the water and pulls them under? No, it must be the same authority of her nurse’s uniform which had caused Vitek to address her formally. In that sense it was no different than the trust which wounded soldiers put in her ability to treat their wounds. And in the moment that all those thoughts passed through her terrified mind, she knew that she must try to help.

“What is all this disorder?” she asked. Despite her effort to project command she could hear a high pitch and tremor in her voice. She took a slow breath. “Must I summon one of the officers?

“She…” The man hesitated, searching for words that would make his case before this unexpected authority. “She ran away.” He finished, looking down at his boots at he spoke.

“Is that her headscarf?” asked Natalie. A nod. “Return it to her.”

He held it out to the girl, who snatched it and retreated behind Natalie.

For a moment they all stood looking at each other. How could she end the encounter? “May I go, Sister?” the man asked.

“Yes. Go.” A phrase which one of the nuns in the convent school had habitually used when resolving cases of discipline suddenly recurred to her. “The matter is closed,” she said.

The peasant man turned and moved off into the forest, pushing through the underbrush with the sound of a large animal. Natalie turned to the girl, who was trying the headscarf tightly over her head, hiding her hair from view again.

“Thank you, Sister. Thank you.” The girl took Natalie’s hands and kissed them, in a gesture that startled Natalie so much that she snatched her hands away before she had time to think whether this would seem rude.

“You’re welcome. Do you have family to go to?”

“Yes, Sister.”

“Can you go back to them?”

The girl nodded. “Thank you.” She bobbed something like a curtsey and ran off.

Natalie turned to walk back to the hospital and staggered and she found her legs shaking and jelly like. She leaned against a tree and took slow breaths. At least her fear had not betrayed her until the confrontation was over. And yet, with the shaking fear was an unfamiliar uphoria. She had authority. She had faced down a drunken man nearly twice her weight, and he had respectfully done as she told him.


The next day the retreat continued. They loaded their patients back onto the ambulances and once again there were the alternating hours of dusty trudging along the road or being shaken by each bump and rut of the road while taking rest in one of the wagons. But the conclusion of the chance enter in the woods stayed with her and from it a new confidence. When Lieutenant Popov asked which building should be taken as the temporary hospital in another village at the end of the day’s march, Natalie directed him and he ordered it set aside for them. When she made up her the list of rations of the hospital patients each night, she included food for Vitek and Eva’s family, and Mamushka quietly obeyed.

One evening when she brought the food to them, she found Eva, even more pale and drawn than usual, but she held in her arms a bundle tightly wrapped in clothes. She showed Natalie the baby’s face, with its tiny nose and mouth quietly working in sleep.

“She came last night, and one of the old women from our village midwifed me,” Eva said. She lowered her voice to little more than a whisper. “Vitek said I mustn’t travel today, even in the hand cart. But the cossacks were driving all of us on from the village and setting fire to the houses. Vitek tried to argue with them, and they beat him.” She looked over to where her husband sat, a little away from his wife and child and with his back to them. “When the march stopped today, he went and bought a pot of liquor. He doesn’t drink often, Sister. But you know how men are. They’re not like us. They must have their pride.”

The next evening, Vitek was his usual self, deferential and courteous. But Eva was flushed and looked at her with glazed eyes. Natalie knew even before putting a hand to her hot forehead that she had a fever. The four year old girl held the baby, bouncing it gently in her arms and giving it a small, dirty finger to suck while Natalie examined Eva.

“When did the fever start?”

“Today. During the march. Vitek pushes me on the hand cart, but it’s so hot.”

“Is there pain in your stomach?”

“Only the after pangs when she nurses.”

“And at the birth, was there much bleeding?”

Eva nodded. “It took a long time to stop. I had to stuff full of rags to staunch the blood when we set off in the morning.”

Of course. What would she do for bleeding but treat it as she treated her time of month. And yet whatever rags the midwife or family had been able to use were surely easy carriers for infection. Natalie’s hospital training cringed against the use of anything other than sterile bandages and antiseptic wash for cleaning an open wound. And when it came to infection, was this tearing of the body any different from the battle wounds she treated? She tried to recall the brief section on female anatomy and childbirth in her Red Cross training manual. There had been no intention that the nurses assist at childbirths. That was work for doctors, or in the countryside for village midwives. And so the subject had been given only the briefest outline. She could remember no more of use other than the risk of bleeding and the importance of avoiding infection.

“The midwife gave me willow bark to chew for the fever.”

“That may help the fever, but it will not cure the infection. You must try to stay cool as much as possible. Bathe your forehead with a cloth soaked in alcohol if you find yourself sweating too much. It will cool you faster. And I will get you a bottle of antiseptic solution. You can use it to clean yourself.” She paused to see if Eva knew what she meant. “To clean inside. It may hurt, but it will fight the infection if it has not gone into your blood.”

“Am I going to die?” The question was asked so calmly. Natalie had heard soldiers cry those words so many times, but seldom had she heard them in such a quiet, gentle voice.

“I hope not. I’ll do everything I can. After all, you have this beautiful child to live for.” She took the swaddled infant from the little girl, and looked at the tiny red features for a moment before nestling the bundle into her mother’s arms.

She did bring the bottle of antiseptic solution later that night. Eva was sleeping, so Natalie gave it to Vitek and gave him instructions. He shifted awkwardly and looked away when she explained how to wash with the solution and sterilize rags with it, but nodded and promised it would be done.

The next two nights found Eva worse. The fever grew higher. Her mind wandered, and she had difficulty nursing the baby. The midwife, an old woman draped in a black veil, was sitting with her on the second night. Natalie could get no sensible words out of Eva, but the midwife told her that although she had stopped bleeding, the rags were now coming out soaked with a yellow discharge that smelled of putrefaction.

All though the next day’s journey, the sick young mother was in her mind. The sick mother, the nursing baby. Both seemed all too similar to the story her father had told her of her own mother’s death when she was only a few months old. The little silver framed picture was buried deep her in her bag where she could not get at it, but in her memory the little photograph of her infant self laid one last time in her dead mother’s arms was hauntingly clear.

Holy Virgin, please, among all this suffering, do not let this tiny child grow up without a mother.

When, in the afternoon, Lieutenant Popov rode up and told her that the the regiment had at last received orders to dig in and hold the line, ending the retreat for now, Natalie’s first thought was that at last Eva would be able to rest as a recovering mother should. Only after another moment did the military implications of his statement strike her. If they stopped retreating, there would be fighting. All this time, the Germans and Austro-Hungarians had been following just a day or two’s march behind them.

“We will need somewhere to set up the hospital that gives us space for casualties,” she said.

Popov had clearly been waiting for this to occur to her. He winked. “I have found just the place. Wait till you see it.”

The place he had found was a nobleman’s country house. This was no small rural retreat, like the hunting lodge in which the hospital had made its home through the winter and early spring, with its wooden walls and wide porch. This as a major estate, the main house built of white stone, with rank on rank of windows looking out upon the woods and gardens. The hospital’s ambulance wagons -- wooden vehicles covered in canvas and pulled by shaggy, ill groomed horses -- looked distinctly out of place as they made their way up the tree-lined drive to the front of the house.

An old woman, the retired housekeeper, met them on the steps and declared that she would report to Prince Uvarov if anything was stolen or damaged. Otherwise, however, the house was empty. Even the servants had fled.

Natalie gave orders and set the housekeeping sister and the orderlies to work turning several of the large ground floor rooms into wards. The house war far larger than they could ever need. The upper floors and the north wing would be completely shut off. They would touch as few rooms as possible. But those they needed must be tripped of their finery, both in order that the paintings, rugs, and furniture could be preserved, and so that the newly bare rooms could be scrubbed down with antiseptic solution.

It was late when she finally was able to go in search of Eva and Vitek. But although many refugees had encamped in the estate’s woods and outbuildings, she could not find their family nor any word of them. She returned to the house after midnight, exhausted and worried, but telling herself that surely Vitek must have found some place where Eva could rest along the way. Perhaps the Cossacks were at last employed in fighting the enemy rather than driving the peasantry ahead of them.

The housekeeping sisters had prepared a room for her. Just a small guest room by the standards of the house, but still grander than anything Natalie had stayed in since the hotel in Warsaw where her father had sent her after their meeting. She took a minute to revel in the canopied bed, the inlaid mahogany wardrobe, and the gilt mirror hanging over the dressing table. Then she sat down to take off her shoes and stocking so that she would walk barefoot through the soft pile of the oriental carpet.

At last she slipped between the clean sheets, soft, oft-washed linen against her skin. She felt a moment’s guilt that the availability of water had allowed for the washing only of hands, feet, and face the last few days. Surely this bed was used to more refinement. But for tonight it was hers, and she drifted quickly into a dreamless sleep within its softness.


The next day was one of constant activity. Guns could already be heard in the distance when one of the housekeeping sisters woke Natalie in the pre-dawn light. Wounded began to arrive in the mid-morning, even as the wards were still being prepared. It was the first time they had faced a major influx of casualties without a surgeon. Natalie called the other two nurses together as the first patient arrived.

“Sister Travkin, you have the most experience with triage. Can you take charge of receiving patients?” A nod. “We won’t be able to perform major surgeries, just clean, stitch and bandage, so adjust the categories as needed.” She turned to the other nurse, “Sister Gorka, you have the steadiest hand with wound preparation. Would you be willing to act as a surgical nurse and trim and stitch where needed to close up wounds?”

This was the part which she had almost been afraid to speak, the violation of all their training. Here they were treading upon doctors’ territory and without the necessary training. And yet, more casualties would survive the three to five day journey through ambulances and hospital trains to a hospital back in Warsaw, Kiev, or Moscow if they first received the most basic surgical care. The difficult cases might not survive anyway, but at least men would be less likely to die from blood loss or infection due to wounds that avoided the organs and bones.

Sister Gorka nodded slowly. “I will attempt it, but I will be much slower than Doctor Sergeyev.”

“Of course. Take all the time you need. Whatever you can do will be better than they would receive otherwise. And I will deal with wound cleansing and bandaging.”

They set to work, and the morning turned into afternoon and then evening, the time marked only by the stream of patients who filled the cots in the wards. Battle weary men lay looking up at the plaster medallions and chandeliers which in times past had looked down on balls thrown for the local nobility. It was as the windows began to darken with evening that one of the housekeeping sisters approached Natalie.

“I’m sorry to bother you, Sister, but there’s a little girl here who says she knows you.”

Natalie looked down and saw the four year old daughter of Vitek and Eva.

“What’s wrong? How is your mother?” What was the little girl’s name? Amid the pressures of the wound ward she could not recall whether she had known.

“She’s nursing the baby in heaven, and father is drinking. Do you have food for me? There’s been no food all day.”

Had Eva died? The baby had not seemed sick. Had something happened to her as well?

Natalie made her excuses to Sister Gorka and secured the chance to step away for a few minutes. She got a loaf of bread and a jar of the plum preserves they had found in the country house’s store room, then asked the little girl to show her where her family was.

The girl led her out into the parkland of the estate. Here and there, where the woods gave cover from the Cossacks and other authorities who might try to force them to move on, peasant families were encamped with their belongings among the trees. The girl picked her way among them, munching the piece of bread spread with preserves that Natalie had given her. Then the old woman Natalie recognized as the midwife who had been helping to treat Eva rushed towards them.

“Hannia! Where have you been? You bad girl!” She swung an open palm at the girl’s ear, which she deftly dodged.

“What’s happened? How is Eva? Where is Vitek?” Natalie asked while Hannia took shelter behind her skirts.

“Ah, it’s very sad.” The old woman clucked her tongue. “Poor Eva died last yesterday. She’d gone into convulsions on the road, the fever would not drop. Nothing she said was sensical. Poor child. Vitek stopped his cart and cradled her in his arms as she died. I offered her every curative I had, but when the Lord’s time comes, there’s naught that can be done. At least she went quietly in the end, poor soul.”

“But the baby?” Natalie asked, looking around. She spied the cart, and next to it Vitek lying prostrate and rumpled like a pile of dirty clothes. “Did she sicken as well?”

“That was the hardest thing. Her milk had given out all day, the fever burning her up so. And the baby cried till she could cry no more. Poor thing, it was a suffering to hear.”

“Where is she?”

“At peace, poor babe. Vitek dug the grave for Eva himself, dug it all night. And in the morning he laid her in it, and the baby at her breast. That calmed the poor creature. He wept as he put each shovelful of earth back over her, but what else could he do? With the mother dead, there was no way to feed the baby while driven through the country like this. It was that or watch the child suffer for days.”

“Are you saying he buried the baby alive?”

The old woman shrugged. “God has mercy on those who suffer. You’ve seen Vitek. He’s a kind man. How could he let the baby die in fear and hunger? It’s she and Eva that are at peace. Pity the living.”

Natalie turned away. She could not speak. The weight of the idea pressed down on her like so many feet of earth. Smothering. All the wounds they had treated in the hospital that day seemed honest and kind now by comparison. This was what it call came to. War. Destroying villages. Burning crops. Driving people from their homes. And now a man who in any other time and place would have been a doting father had laid his living infant daughter at her dead mother’s breast and shoveled earth on top of both of them.

Hope and love and life were buried, smothered by this war.

And that child, that little child who knew nothing but the need for food and touch, laid at the breast of her dead mother and buried alive.

The thought choked her. Who was she but the daughter of a peasant woman who had died young? She had the photograph, her infant self laid upon her mother one last time and photographed by the undertaker. She could have been that child, thinking that she was sheltered from all the world as the earth was shoveled over her.

She cried and couldn’t stop as she stumbled back towards the country house, whose beauty the night before had seemed like such a refuge. Now it seemed a whitened sepulchre that hid the rot inside.

Near the door she stopped and leaned against the wall. The stone was cool and rough against her forehead. She had to stop crying. The horror and despair had to be forced away into some quiet place within her until the patients and her fellow nurses did not need her any more. Then her bed could absorb her tears, if they must come.

Slow breaths went from ragged to smooth. She stepped away from the wall. Smoothed her skirts. Squared her shoulders. She could do nothing for Eva and the baby. There were others whom she could help.


The ambulances had stopped coming near sunset, and the sound of guns in the distance had died down for a time. Nevertheless it was nearly midnight when the last of the day’s casualties had been cleaned and bandaged by the nurses and laid in a cot by the orderlies.

In the kitchen one of the field kitchen cooks had kept stew hot for them, and there was a buzz of cheerful chatter from the housekeeping sisters and orderlies as they ate and talked in groups. Natalie hesitated in the doorway and realized that she had passed the point for eating that night. She turned away and went slowly up the curving marble steps of the main staircase and to her room. There she stood, he back against the door, looking at the bed and carpet which had seemed so welcoming and opulent the day before.

Were these some great injustice or fraud? How was it that the war took everything from Vitek and Eva, who had no part in it but to be in its way, and yet to her it gave a room that looked as if it might be in a palace.

In the silence of the room she felt tears begin to grip her again, her throat tightening. Then she heard a sound. Someone else was crying, long desperate sobs.

What was wrong?

The grip of her own pain loosened as she turned and let herself quietly back into the hall. Up and down, listening at each door, she found the room the sound was coming from and knocked softly. The crying stopped. A few loud sniffs, and then, “Come in.”

She opened the door and found herself facing Sister Gorka.

“It’s you.” The words were flat and lifeless. Sister Gorka sat back down at the chair in front of the dressing table. There was a bottle on the table. Sister Gorka poured pale brown liquid into a glass and took a sip. “Madeira. Whoever our hosts are, they kept a full cellar. The cook put it under lock and key for fear of the soldiers, but he got this for me. Do you want some?”

Natalie shook her head.

“It’s not ladylike, is it,” Sister Gorka said. “But I haven’t been a lady today, and here I am drinking like a real doctor.” She took another sip, and held her hand up and examined it. “Steady now. I was shaking like a leaf when I came in here. Maybe that’s why Doctor Sergeyev couldn’t leave it off.”

“I heard you,” Natalie said. “What’s wrong?”

Sister Gorka folded her arms on the table before her, laid her head down on them, and began to cry again. For a long moment her shoulders shook with the wailing. Natalie stepped forward and put a hand of Sister Gorka’s shoulder. She had never seen the other woman show such strong emotion.

At last the crying subsided and Sister Gorka raised her head again. “I don’t know how they do it. Every time I went to pick up the scalpel or the needle my hands shook. Whenever I cut flesh or pushed the needle through skin I felt my teeth on edge.”

Natalie’s hand was still on her shoulder. “Whatever you felt, you always looked calm and precise. You did good work today. You helped a lot of patients.”

“I know. I forced it down all day, but I hate it. I hate it so much.”

Another bout of crying. Then Sister Gorka started to pour another glass of madeira but slipped and spilled it.

“Here. I’m sorry I asked you to do it,” Natalie said, mopping up the spilled wine with a handkerchief. “You must be exhausted. Why don’t you come to bed?”

She guided Sister Gorka across the room to the bed, sat her down, and helped her take off her shoes. Then she settled her back in the pillows and tucked her in, like putting to bed one of the small girls back at the convent school.

The other nurse clung to her hand. “I don’t want to be a burden, but will you sit here a while, so that I’m not alone?”

Natalie sat down next to her in the bed, still holding her hand. Sister Gorka’s breathing slowed, and at last her grip on Natalie’s hand loosened in sleep, but by that time Natalie herself found her whole body, and particularly her eyelids, heavy with tiredness.

The two of them were awakened by one of the housekeeping sisters, who threw open the curtains to let in the pale light of dawn.

“There’s news!” she said, showing no surprise at finding the two nurses together, both still in their uniforms as they lay on the bed. “A new surgeon arrived during the night. He’ll be taking over the hospital.”

Read the next installment.