To steady himself, Thomas thought of his father who had been beaten by his mistress for being inadvertently in her way. He recalled wounds masters had inflicted on other servants: burns on the hands and legs, cuts, lashes. In Russia, he reminded himself, serfs were called ‘slaves’ for a good reason. Once, in Vilna, he had been asked to treat a man whose back had been broken by the lashes his master commanded. When the man died a few hours later, his master promptly ordered another serf to marry the widow.
‘What are you thinking of, Doctor Lafleur?’ the countess asked in a low, raspy voice that held a note of irony as if she had guessed his thoughts and already found fault with his reasoning.
‘You should not exert yourself, Madame la Comtesse,’ Thomas replied and he approached the bed. He tried not to look at her eyes but to observe. The shade of her skin, the spots on the pillowcase were all hints as to what her body was harbouring inside.
‘Yes, Doctor,’ she said, tilting her head slightly. ‘From now on, your words will be my commands.’
The smile she gave him lit up her face making him think of a child offered a rare treat, a reward long lost, despaired over, but never forgotten. In the morning light that swept over her, Thomas thought he had seen the secret of her attraction, the way she must have appeared to all those men Ignacy spoke about. Men who had loved her over other women. Yes, he had seen through her pale, luminous skin no longer fresh and supple; through her parched lips folding as if ready to grant him secrets revealed to no one else. You will be my saviour, her eyes said. There will be no one else, but you and me. You have all my attention, all my loyalty. Nothing and nobody else matters.
‘I’ve dismissed Doctor Horn, my Russian doctor. He was not helping me at all.’
‘Are you in much pain?’ Thomas asked, piqued by the casual reference to a hapless man who had, undoubtedly, tried his best.
The countess stopped smiling. Her beautiful eyes were dry.
‘They say that my womb is rotting, Doctor, and it hurts. Is that what you want me to describe to you?’
‘But Madame la Comtesse,’ Ignacy protested. ‘Courage! You are in the best of hands.’
‘Let Doctor Lafleur decide,’ the countess said.
The nurse stepped forward, placing her hand on the patient’s arm with a gesture of appropriation. A firm, steady gesture meant as a warning.
‘
Madame
slept well last night,’ she said. Her voice was pleasant, her French just slightly foreign. Foreign, Thomas would reflect later only because, in spite of its flawlessness, he could attach it to no specific region or city. ‘But today she complained of pain in her back. On both sides.’
A bit over twenty, the thought flashed through his mind, still considering the possibility (however slight) of an operation. Good solid constitution. There was no frailty about her, no threat of fainting spells. She would not be a nuisance.
‘Rosalia, my dear,’ the countess said. ‘Send everyone away. Let the doctor examine me.’
‘Everyone,’ she added, seeing how her daughter hesitated. ‘Only Rosalia and Dr Lafleur will stay. No one else.’
The countess was, indeed, in the last stages of the disease that had been ravaging her for years: her face a wax mask over the skull; her arms, hands transparent. Thomas could almost see the tendons clinging to her bones. She had prepared herself carefully for this visit. Her clothes
were of embroidered velvet, the kind maids were told to be careful with for their wages would never pay for the damage carelessness might inflict on the fabric. He had noted that the dress had been hastily altered to fit a thinning body. The lingering smell of musk and wild roses told him that she had bathed and oiled her body for this encounter.
As she stood up, she tried to hold herself straight, but the effort it required was obvious. Even in her slippers, flat and soft, she rested her arm on the day bed, to steady herself. The nurse jumped forward to hold her, but the countess shook her head.
Her eyes were now following his every move. She was, he decided, studying him very carefully: the way he stood, sat down, opened his bag, assembled his stethoscope.
He began to establish her medical history, the way he had been examining his patients at la Charité. She said she was fifty, but even though traces of obvious beauty were still visible, he could see she was not telling the truth. Closer to sixty, he would say.
‘How many children have you had, Madame?’
‘Ten.’
‘How many are still alive?’
‘Six.’
‘How old were you when your first child was born?’
‘Is it important?’
‘Yes,’ he said. ‘Your medical history is important.’
‘I was seventeen.’
‘Were there any complications?’
‘No, my children came easily to this world. They didn’t cause me trouble then.’
He asked if she remembered her childhood diseases, and she laughed. ‘In my childhood, Doctor, there were two kinds of diseases: those you survived and those you did not.’
‘How many of them did you survive?’
‘My mother told me of two times I was near death with fever. She prayed for me and the fever went away. I also had measles.’
He proceeded to ask her about her diet, her sleeping patterns, the ease of her bodily functions. She was frank and unembarrassed by his questions, a fact he noted with some pleasure for many female patients shied away from telling him about their bowel movements and gas. Many times it was their relatives who had to provide the information he needed for diagnosis. Countess Potocka said she ate very little, having lost her appetite quite some time ago. She was thirsty most of the time but couldn’t drink more than a few sips of water and found the simplest tasks tiring. The nurse was smoothing the folds of her patient’s dress, nodding as if to confirm her words.
‘When did you begin feeling the first symptoms?’
‘Five years ago,’ she said, ‘I was losing weight, but I didn’t think much of it. And blood.’
Blood stained her undergarments, but the Russian doctor maintained that this was normal for a woman of her age, clearly not a point of concern. It was as if her menses returned, she continued, and she felt a slight pain in her belly. At that time it was more of a thought rather than a feeling.
But this pain began bothering her. That mere thought, uneasiness, soon became a constant companion. She woke up aware of it, and it was with her until the time she fell asleep. This pain began interfering with her days, forcing her to come home earlier from a ball, a soirée, or even stay in bed for a day.
‘I’m so tired, Doctor,’ she said. ‘I cannot stand up without feeling faint.’
Thomas ascertained that the first haemorrhage had been almost five years before. The treatments did not work.
The dismissed Russian doctor bled her for five consecutive days, told her she had too much heat in her and that she needed cold baths. She was advised to take a water cure in Carlsbad, which she did. The haemorrhaging did not stop.
Thomas turned away as the nurse helped the countess take off her heavy velvet dress.
‘I’m ready,’ she said and when he turned back she was wearing nothing but a light, batiste nightgown. He asked her to lie down on the bed.
All there was to know, the evidence of her life was here, written on her body. He could see stretchmarks from pregnancies, dry patches of skin on her thighs and breasts. In her youth she must have been agile; the muscles, even in their deterioration, still preserved a shadow of their strength.
Her breasts were still relatively full and smooth. Obviously she did not breastfeed her ten children. On her thin thighs there were scars. A series of cuts on one, three burnt patches on the other. Two scars on the inside of her knees clearly were smallpox inoculations – round hollow pockmarks, whiter than the skin around them. He could also see scars on her back, long, white traces of something sharp slashing the skin. She closed her eyes often as he was examining her and breathed with difficulty.
Her disfigured, chafed belly was hardened by the mass growing over her uterus. Fixed. That realization alone was the death sentence. If it were mobile, he might have attempted an operation, but he would never operate on a fixed tumour. He agreed with Le Dran that cancer had commenced locally and was later spread by the lymphatic vessels to the lymph nodes and then into the general circulation. That’s why when he performed mastectomies, Thomas made sure that he dissected the associated lymph nodes in the axilla.
He put no faith whatsoever in various remedies that promised to dissolve the tumour. He had also seen disastrous effects of caustic pastes. As far as research into cancer was concerned he hadn’t seen much of value. Bernard Peyrilhe extracted fluid from a breast cancer and then injected it into a dog. But all he achieved was that the animal howled so much that his housekeeper objected and the dog had to be drowned.
‘The pain,’ the countess whispered. ‘It’s keeping me awake at night.’
He placed the stethoscope to her chest. Her lungs, he could tell, were clear. The difficulty with breathing was a sign of the general weakness of the body. Her pulse was fast and weak.
‘The bleeding,’ the nurse interrupted, ‘has never stopped.’ The pad she removed quickly from between the countess’s legs was stained with dark blood. He asked to see it and noted that the discharge was caked, clotted thick.
The children who died in infancy, Thomas ascertained, had no abnormalities. The countess had had the mercury cure a few times, but he could see no other evidence of syphilis than her weakened heart. When he pressed a fingernail on her index finger, he could see a pulsating vein, a sign of dilated aorta. This, however, was not what was killing her.
‘The pain,’ the countess repeated.
It was this pain that had made the journey impossible to continue and had forced them to stop here, in this Berlin palace so kindly offered by an old family friend. This pain took up all her thoughts, made travelling impossible.
‘It’s in my bones, Doctor. It is in my womb. I cannot move without crying.’
Carefully he disassembled his stethoscope, and put it
back inside its leather case. He wished Ignacy had not been ordered out of the room with the others, leaving him alone to pronounce his diagnosis. The nurse, no matter how capable, would not be of much help at the moment of truth. He expected a fainting spell, a fit of screaming. This was the time to talk of God, of afterlife, of grace and repentance. Of fate and resignation. Not his kind of talk.
‘Please, Doctor,’ the countess said. ‘I want to know.’
Ignacy would not agree with me, Thomas thought. What right do we have to take hope away, he would ask. Why cut off the flow of the vital force? Deprive the body of its only defence. But hope, as far as Thomas was concerned, was a fickle notion. He had come to value facts over feelings and so far, he had had little reason to doubt the wisdom of such an approach.
‘I cannot offer you any hope, Madame la Comtesse,’ he said, finally, defying Ignacy’s voice in his head. ‘The tumour emerges out of the womb. It feeds on your body. It is fixed. I cannot operate.’
She was silent. Her eyes followed the movement of his lips. The nurse, he had noticed, grasped the countess’s hand in hers. Two hands, one strong and smooth, the other like a claw of some starving bird.
‘Cancer is like an invasion,’ he went on. ‘Your body has fought bravely, but the battle has been lost.’ Encouraged by her calmness he told her that before death came she could expect a few better days. She would have more energy, not enough to walk, but clearly enough to take an account of her life and prepare herself for the end. He did not avoid her eyes as he said all this. Their beauty urged him on.
‘Thank you, Doctor Lafleur,’ she said when he put the rest of his instruments back into his leather coffer. ‘For telling me the truth.’
‘I’m truly sorry. All I can do is to try to diminish the pain.’
The countess closed her eyes.
‘I want to be alone now,’ she said.
She is standing behind Mana, waiting for Monsieur Charles Boscamp, the internuncio of the Polish mission in Istanbul. The study in the mission building is a big, bright room with an enormous gilded desk in the centre. The portrait of the Polish King hangs above it. In it, the King is holding a map and is looking at an hourglass. As if he didn’t have time for all he wanted to do, for his face is sad and withdrawn. There are wrinkles of sorrow on his forehead. In his eyes she sees an uncertainty that makes her wonder what has he seen in his life to doubt like that.
Don’t touch anything, Carlo has warned her. It is for him that Mana reddens her lips with carmine, and makes them shiny with walnut leaves. It is hard to tell if he is a guard, a valet, or a butler in this house, for he is vague describing his duties; but sometimes he makes it sound as if the internuncio could not take a step without consulting him. For weeks Carlo has been a frequent visitor to their house, growing more and more alarmed by Sophie’s presence. The Sultana has been making inquiries, sending her spies to find out where her little ungrateful wisdom lived. No house in Istanbul would be safe for long.
‘Don’t show your face to anyone,’ Carlo has warned her every time, bringing his gifts of food and wine. Right from my master’s pantry, he always says, drawing their attention to the internuncio’s fine tastes. What
he
doesn’t see,
he
doesn’t miss, he also says. It is this master who
will be Sophie’s salvation, her escape. Carlo has told him a story of a beautiful girl from Phanar who has to be saved from the ardour of a young, penniless
pasha
. It is Aunt Helena who lives in Phanar not them, but a little stretching of the truth never hurt anyone. A daughter of a friend of his, an honest Greek widow who wishes only for her daughter’s well-being. ‘A girl,’ he said, ‘worthy of a king’s bed.’
The internuncio is still not ready to see them, even if it is long past midday. The annual mission party to celebrate the King’s name day ended at dawn. Everyone had been there. The Russians, the French, the English. Diplomats and men of stature and importance. The whole house still smells of roasted meat and melted wax. Over a hundred candles, Carlo has said, all burnt to the very end.