Granta 131 Page 3

  ‘How about that, Andrey? A half.’

  He put a canvas on a stretcher and pinned the half brassiere to it. I have to say the form was ideal, though it was a pity the bra was so old.

  Months passed before the irony of my metaphor could be appreciated.

  Anamnesis

  I am descended, on my mother’s side, from generations of sumptuously endowed women. Although most people have been nourished at a woman’s breast, this was especially true in our family. While my grandfather was gainfully occupied in Stalin’s prison camps, my grandmother taught herself to sew bras. Her day job was bookkeeping, but her night-time profession was bra-sewing. She was the big-bosomed mainstay of our family, the epitome of human nobility and dignity. Her bovine proportions (not those of some scrawny cow on a Soviet collective farm) and the truly regal bosoms that preceded her were a focus of my flat-chested, prepubescent, intense admiration.

  By the time I was twelve I had reached puberty, and it was already clear that I was not to inherit the buxomness of the matrons of my family. Grandmother made my first bra, although there was precious little in need of support.

  She viewed my maidenly breasts with surprise and a degree of envy. We small-breasted women know nothing of carrying a burden of many kilograms that can never be set down. We know nothing of the impress of the broad straps of a mammary harness, or the damp patches of irritation beneath a perspiring udder in summertime.

  My breasts were an inheritance from my paternal grandmother, a woman who, in her youth, had been an avant-garde dancer and disciple of Isadora Duncan. I did inherit more from her, but relatively little: my hands, my feet, bad handwriting and a vague inclination towards the arts. As a Pisces, I passionately want incompatible things: one part of my nature is attracted to rigorous scientific research, the other to the arts. My first profession was genetics, my second putting pen to paper. The bohemian element emerged the victor, but deep down the scientific side of me feels disdain for it. And, as befits those born in the Tibetan year of the goat, I need good pasture, and will pay almost any price to escape being inconvenienced.

  When, in due course, menopause arrived, it brought a major inconvenience: hot flushes. Day and night I was flooded with waves of heat, weakness and sweating. No way was I going to put up with it. An American friend who had been working for over twenty years in a laboratory dealing with fertility problems offered me hormone replacement therapy. Two days after I began taking it, the hot flushes disappeared and I forgot all about them.

  I remembered ten years later, and again five years after that, when I tried to stop the treatment. The hot flushes returned instantly, and I resumed taking my favourite pills. The reader will appreciate that as a biologist by training I was fully aware that hormone replacement therapy was rumoured to be dangerous for people with a predisposition to cancer, but I have such an aversion to inconvenience!

  And I did have a predisposition to cancer. Nearly all my relatives of the preceding generation had died of cancer: my mother, father, grandmother, great-grandmother and great-grandfather. They had died from different types of cancer and at different ages: my mother at fifty-three, my great-grandfather at ninety-three. I knew the risks. As a civilised person, I went for screenings at the recommended intervals. In our God-given fatherland, women under sixty are given an ultrasound scan, while those over sixty get a mammogram. I attended these screenings conscientiously, despite the casual attitude to health so deeply rooted in Russia: the national fear of doctors, our fatalistic attitude towards life and death, lethargy and a peculiarly Russian sense of irresponsibility. For completeness, I should mention that the Moscow doctors who carried out the screening failed to notice my tumour for a good three years, but that I learned only after the operation.

  Biopsy!

  In Moscow, I kept trying to go for a check-up, and rang the Ministry of Defence clinic a dozen times. It is within walking distance of where I live, but I couldn’t get an appointment. The doctor there was very pleasant, but she was either away on holiday or not on duty. I had been going to her for screenings for several years. It is not a specialist clinic, but I was reluctant to go to the Radiology Institute, of which I had bad memories and which, in any case, was far away. I finally got to see this doctor, who first examined my breasts, then did an ultrasound, then a mammogram, and then pulled a long face. Has it been like this for long? ‘Yes,’ I said.

  I knew, of course, that an inverted nipple was a worrying sign, but when I had come to see her eight months before it had been no different. She had made no comment about it then and neither did I. The tests had shown nothing and I did not want a lot of unnecessary hassle. But now the tests were showing plenty. The doctor wailed, ‘Get an urgent appointment with an oncologist! You need a biopsy!’

  By now it was March, and I was into a second year of trying to finish a highly recalcitrant novel. How urgent was ‘urgent’? I was going to a book fair in Israel in early May, so why not get examined and treated there? I had no wish to return to the Radiology Institute, where my mother had worked for twenty years and where she had died from reticulum cell sarcoma. Neither did I fancy the Blokhin Cancer Research Centre, where two of my friends had died and where they seem to do everything they can to make bad situations worse. I had also heard rumours of bribery and extortion. I do not mind paying at a cash desk, but I refuse to pay under the counter.

  I phoned Lika, a friend in Jerusalem. She found a surgeon she said was very good, at Hadassah, the largest hospital in the city. It was sorted, then: I would go there, not tomorrow, of course, but next month, when I would be there anyway for the book fair. I was still living my life in the old way, where plans are adjusted so everything fits in conveniently. I was in denial about who was outside, knocking on my door.

  At this point, my friend Lyalya took me in hand. She had a relative who was in charge of immunology at the Blokhin. He would arrange for their oncologists to examine me. It was the end of March and I categorically did not want to go anywhere near the Blokhin Centre but, as an accommodating sort of person, I went anyway.

  Lyalya’s relative was agreeable enough. He had a luxuriant moustache that reminded me of an animal whose name I could not for the moment remember, and took me to see his friend, a surgeon. This gentleman was quick on the uptake, but cold-blooded. He squeezed my breasts and said he would do a biopsy. Right now. He took a needle practically as thick as a finger and stuck it into me. It hurt, but that was the least of my problems. They examined the slides two hours later and the lab technician gave me a crumpled piece of paper the size of a tram ticket with the word ‘Cancer’ scrawled on it. A typical Russian detail was that after the word ‘Cancer’ there were some numbers. I asked what they stood for and was told by the lab technician, who had informed me of her conclusion for a trifling two thousand roubles, that this was a code number for the type of cell. So what cell was that? I asked. She narrowed mulish eyes and declared it a secret she could divulge only to a doctor.

  What power she was enjoying! Well, I would be in Israel within a month and a half. I was not going to go berserk and start rushing around seeing doctors. I was scheduled to give a talk in St Petersburg before that, and I did. One night on the train there and one night back.

  The new train was amazing. An orthopaedic mattress, a washbasin … they all but served dinner in bed! It was as if I was starting life again. I remembered a trip to Pushkin Hills in Pskov Province with a crowd of student friends in the train’s corridor, and a hotel in Mikhailovskoye with unspeakable sanitation in the form of a shit-caked drainpipe topped with a commode. How quickly life changes. Everything just gets better and better.

  Actually, I now found myself in miraculous surroundings where everybody took great pains to be nice and to look after me: my husband, my children and all my friends! Everybody was offering lifts, looking out for me, eager to protect me. A wonderful circle of friends: I was very happy. How many people loved me! How I loved them! Never in my life had I known such a concentrated outpouri
ng of love. All mine! I had heard I was even being prayed for by those who knew how to do it.

  When it was finally time to go to Israel, Marina Livanova got me to Domodedovo Airport with the help of her student Sasha. The things she brought me for the journey! A CD player with CDs, comfortable headphones, sunblock, a little envelope with Florentine notepaper (which could really only be used for writing love letters), a big apple and more besides. A Theatre of Life! How beautifully she does these things. And then she thanked me for giving her so much pleasure. Good heavens!

  Vera Millionshchikova, meanwhile, was in intensive care, recovering from a medical overdose, a doctor’s error. You do not pay for medical treatment in Russia. You do not pay for behaving irresponsibly. In fact, nobody pays for anything.

  From my notebook

  Landed in Israel. Lika took me to her doctor at Hadassah Hospital, Dr Zamir. In Hebrew the name refers to a bird which is like a cross between a skylark and a nightingale, only bigger. Actually, he looks more like a Canada goose. Palpates: ‘I am not convinced there is cancer.’ These doctors’ fingers are repositories of sensitivity, a different kind of organ from those of ordinary mortals (which are also wonderful, when not used for killing). Sends me for tests. A young, inexperienced nurse repeats the mammography three times. Then on to another doctor, whose name I do not remember, from South Africa, in a skullcap, with a stubbly white beard. He smells like my great-grandfather: old age, decrepitude, orderliness, old books. More palpating, but no call for a biopsy. Says, ‘I can’t see anything’ (with his hands) ‘other than a haematoma.’ Also not convinced there is cancer, but sends the optical microscope slides from Moscow to a friend in Haifa who still remembers how to read them – virtually the last doctor in Israel familiar with this antediluvian methodology. I was taught to make histological sections for glass slides at the Institute of Paediatrics forty years ago. Nobody does it nowadays.

  Surprise at the diagnosis ‘Cancer’, a term no longer used here. Cancer cells now have a first and last name (concealed, in Russia, behind those secret numbers). A strange feeling that all this must unquestionably be happening. I pretend everything is only what I was expecting all along. At the same time I seem to be watching from the sidelines, observing what this elderly Russian woman is saying and how she is behaving. She completely refuses to act her age, feels fine, feels lucky, sees herself surrounded by a crowd of close, much-loved family, friends and admirers. It is not self-possession: cancer is like a flavour enhancer in cooking, showing me how wonderful life around me is.

  I am looking from a distance at an amazing picture composed of the beauty of this wonderful spring: Jerusalem, my doctors and my amazing friends. Who needs a Wailing Wall? The diagnosis has not been quashed, but suspended. My cancer does not hurt. I will die soon anyway, but not tomorrow. I see as never before what Yevgeny Popov dubbed the ‘beautifulness of life’. What an expression!

  Another undeservedly beautiful day. Sasha Okun drives me to Haifa, telling me about his trip to Munich. He saw an exhibition of Rubens who, out of sheer boredom, made copies of the paintings in the Escorial when he was in Spain. We talk about all sorts of things on the way. A delight. I am really interested because I have not read much and Sasha knows more about art than anyone else, from the inside, intimately. He is a major artist himself, but not like Andrey. A different lineage. He has some affinity with Lucian Freud, but combined with a great sense of humour and vitality. Profoundly versed in philosophy and literature.

  Rambam Hospital in Haifa. The doctor a ginger-and-grey-haired Russian speaker. About forty-five and a top man. A pleasure just to watch him focusing the microscope. He confirms cancer, a carcinoma, in the Moscow slides. At last I know! Two punctures, quite painful, but nothing found on the new slides. The haematoma still not resorbed.

  Back to Jerusalem, and preparations get under way: computer tomography very unpleasant, involving two litres of some revolting liquid and then having dye injected into a vein. Main thing is for them not to find any metastases. Meanwhile, the opening of the book fair, with interviews, meetings, rushing about. I am so tired, ready to drop. Things are moving quickly: a new biopsy shows a carcinoma fairly resistant to chemotherapy and seemingly more aggressive than adenocarcinoma. Breast cancer, labile, ductal, making diagnosis difficult.

  The imaging is not ready, and I expect more bad news when it is. Everything has become more serious. The surgeon sends me back to the oncologist in Ein Karem. I am working in all my spare time. The Lord seems to have heard my remark that I dread longevity. Be that as it may, I have a novel to finish.

  Last days of April. My dreams are very powerful. There are grimy chalices with dull glass in them. Cleaned up, it turns out to be jewellery: pendants, earrings, diamond and coloured red, green and blue. An elderly woman comes and says, ‘Those are mine!’ ‘No problem,’ I say, handing them over without regret.

  In another dream there is a strange, rounded metal object of uncertain purpose, half the size of a fist and pleasant to touch. I hold it in my hand, showing it off.

  2 May. After the oncologist, the fair. I fit everything in, get everywhere on time. Tomorrow, a preoperative consultation.

  A talk: the left breast is to be removed. What happens after that we have to wait and see. If the express analysis reveals cancer cells in the lymph glands, all the nodes will be removed. If not, we can avoid chemotherapy.

  The cells are hormone-dependent, so if there is chemotherapy, it will be a new, targeted variety, blocking receptors. The patient must be kept informed. I like knowing.

  The plan is to operate, then take a break. After two or three weeks of recovery, chemotherapy, depending on what is found. It probably will be needed.

  Dr Zamir says he finds my sangfroid disquieting. He has not seen it before. Normally the women who sit in this chair cry. Then, by taxi to Mishkenot Sha’ananim (Refuge of the Carefree: I am right at home here). Memorise that word. Do not forget it! The centre is near the nineteenth-century Montefiore Windmill. All the writers at the book fair are put up here.

  At 9 p.m. I go to bed, this time in a hotel room. I will get up early and look out from the gallery over the Old City. I may even go for a walk. At two in the afternoon I have to be at the hospital for nuclear magnetic resonance imaging. At seven thirty a meeting with the writer Meir Shalev. A packed programme: half book fair and half medical tests.

  6 May. A round table with three authors. ‘Humour and death’. Ironic, given the circumstances. Andrey Kurkov, Michail Grobman and me. Grobman highly illogical. Introduced as a representative and theorist of a second avant-garde movement. Starts off with a lot of nonsense about how the new kills the old. Naive, old-fashioned drivel. Next he reads his monstrously racist anti-Arab poem. It is a disgrace. In case that is not enough, he adds that anyone who still says they like Bulgakov is an idiot. We clash primly. He insists on the primacy of ideology in literature, on a new, higher level, so to speak. We’ve been there and done that already.

  All my free time I spend in The Big Green Tent. For the first time, the title came to me before the novel. All sorts of things are happening in it now. Liza reappears at the peak of her career. She has a duet with Richter, a tour, competitions. The misery of the Brezhnev era. We are in a place not even music can reach. The death of Mikha, deep depression. Liza marries a conductor, a German, a Bavarian probably. Pierre sends a messenger, his American fiancée, after Sanya. She sobs on his shoulder: ‘I do not need a fur coat, I do not need money.’ Based on the saga of Gennady Shmakov.

  I almost forgot a trip with Okun to the Monastery of St John in the Desert. A touching icon of Elizabeth with him as a child. A very old, very poor little Greek church made of bricks. We see no monks, but visit the cave of St John and the springs, the kind of place where you have no doubt something did happen. No sense of emptiness.

  On the way back, we eat at an Indian cafe. It was closed but they give us the leftovers from a tourist group they had catered for. Two mothers with babies. While they are maki
ng coffee for us, I hold one of the babies, which is quite lovely.

  Okun is in and out of hospital now with lung trouble. For his wife it is her bladder. Sasha’s mother is ninety-six, also a kind of terminal diagnosis. Everybody is ill, not just me. But Vera Millionshchikova is feeling better.

  8 May. I almost slept through last night. Hot flushes receding. My left breast will be removed soon. An uneasy feeling of something disagreeable going on in my armpit. It is worrying. Sensations in my left breast and left armpit. Feels like something growing. Not too much, I hope, in the three days remaining before the surgery. After that I will learn to live without a left breast, at the very least. And who knows for how much longer. I am anxious to finish that book.

  They continue palpating my armpits. ECG, another blood test. Everything depends now on the express analysis. I am in a very good mood. Tomorrow they will put a marker in my breast, for the surgeon. I am battling with Tent.

  An X-ray, not diagnostic but to indicate the position of the glands for the benefit of the surgeon, expertly done by an Arab doctor or male nurse. I sit in the university park, among bushes and flowers, on a secluded bench where it is shady and cool, waiting. The temperature is thirty-eight degrees but you do not feel it here. Today is Jerusalem Day, the anniversary of the liberation of the city in 1967. The Arabs are not celebrating much, understandably.

  13 May. Today my left breast was removed. Technically, it was brilliant: no pain at all. This evening I am lying in bed, reading, listening to music. Incredible anaesthetic plus two spinal injections in the roots of the nerves leading to the breast. No pain. To my left is a bag for vacuum-suction drainage. 75 ml of blood. To my right a cannula for transfusion. Antibiotics as a precaution.