The Kukotsky Enigma: A Novel

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BESIDES THEIR HEREDITARY COMMITMENT TO MEDICINE, the men of the Kukotsky family shared another peculiar trait: they took their wives as if they were spoils of war. His great-grandfather had married a captured Turkish woman; his grandfather—a Circassian; and his father—a Polish woman. According to family legend, all these women were exquisite beauties. The addition of foreign blood did little, though, to alter the hereditary looks of these big men with their high cheekbones and premature baldness. An engraved portrait of Avdei Fedorovich by an obviously German-trained anonymous artist, treasured to this day by Pavel Alekseevich’s descendants, testifies to the power of their blood as the conduit over the centuries of the family’s traits.

Pavel Alekseevich Kukotsky also had a wartime marriage—hasty and unexpected. Although his wife Elena Georgievna was neither a captive nor a hostage, he first saw her—in November 1942 in the small Siberian town (of V) where the clinic he headed had been evacuated—on an operating table, her condition such that Pavel Alekseevich realized fully that the fate of this woman, whose face he had not yet seen, lay beyond his powers. She had been brought in by ambulance, late. Very late . . .

Pavel Alekseevich had been summoned in the middle of the night by his assistant, Valentina Ivanovna. She was a fine surgeon and knew that he trusted her entirely, but this case was special—for reasons she herself could not explain. She sent for him, woke him up, and asked him to come. When he entered the operating room, hands scrubbed for the operation and suspended in the air, her scalpel had just begun its incision into the pretreated skin.

He stood behind Valentina Ivanovna. His special vision switched on by itself, and he saw not just the surgical area Valentina Ivanovna worked on, but the female body in its entirety—a spinal structure of rare proportions and fineness, a narrow thorax with slight ribs, a diaphragm set slightly higher than usual, and a slowly contracting heart illuminated by a pale-green transparent flame that throbbed along with the muscle.

It was a strange sensation no one could have understood and he could not have explained: the body he saw was one he already knew well. Even the shadow along the top of the right lung—the vestige of juvenile tuberculosis—seemed as dear and familiar to him as the outline of the old spot on the wallpaper near the head of the bed one falls asleep in every night.

Looking at the face of this young woman who was so perfectly structured internally was somehow awkward, but he nonetheless cast a quick glance over the white sheet that covered her to the chin. He noticed her narrow nostrils and long brown eyebrows with a fluffy brush at their base. And her chalky pallor. But his sense of discomfort scrutinizing her face was so strong that he lowered his eyes to where the undulating form of her nacreous intestines should be. The worm-shaped pouch had burst, streaming pus into the intestinal cavity. Peritonitis. That was what Valentina Ivanovna saw as well.

A languid yellowish-pink flame that existed only in his vision and seemed slightly warm to the touch and gave off a rare flowerlike smell illuminated the woman from below and was, in essence, a part of her.

He also could see how fragile her coxofemoral joints were, the result of an insufficiently globular femoral head. Actually, quite close to dislocation. And her pelvis was so narrow that childbirth would likely strain or rupture the symphysis pubis. No, the uterus was mature and had given birth. Once, at least, she had managed . . . Suppuration was already enveloping both strands of her ovaries and her dark stressed uterus. Her heartbeat was weak but steady, while that uterus emitted disaster. Pavel Alekseevich had known for a long time that different organs can have different sensations . . . But how could you say something like that aloud?

Well, no more childbirth for you . . . He had yet even to imagine who exactly might give the woman dying right before his eyes cause to give birth. He shook his head, driving the haunting images from his mind. Valentina Ivanovna had resected the large intestine and reached the worm-shaped pouch. Pus was everywhere . . .

“Clean it all out . . . Remove everything . . .”

They had to hurry. “Damned profession,” Pavel Alekseevich thought before taking the instruments from Valentina Ivanovna’s hands.

Pavel Alekseevich knew that Ganichev, the head of the military hospital, had several bottles of American penicillin. A thief and a crook, he nonetheless was obligated to Pavel Alekseevich . . . But would he give it to him?