Authors: Lara Vapnyar
The building that housed the radiology department of BR was two blocks away from the bus's second stop in midtown. It took Vica exactly six minutes and twenty seconds to get there. As always, there was a line of large gray vans by the entrance. They belonged to a company that brought in Medicaid patients from Brooklyn and Queens. All the drivers were Russian and they knew that Vica was too, so they liked to chat her up whenever she passed them. One of them, Tolik, always offered her a treatâa Russian candy or a handful of sunflower seeds, or once even a dill pickle.
There he was in the driver's seat of his van. Fat, sweaty, with a wide smile half hidden behind his long bushy mustache.
“Hey, Vicusha!” he yelled, blowing a raspberry in her direction. Tolik liked to behave like an idiot, but at times he would say something that made Vica think of it for days. He had once shown her the route map for his bus with the stops where he was supposed to pick up patients marked with black asterisks. “See what I got?” he had asked. “The cancer map of Brooklyn.”
This time he just gave her a candy called Belochka, Vica's favorite, chocolate and nuts with a little squirrel on the wrapper.
The lobby of BR radiology was enormous and filled with light. There was a fountain in the middle with a few little fish in it. In the corner behind the fountain was a small group of teenage girls in green cheerleader outfits practicing their routine.
Fight it,
Beat it,
Go all out to Defeat it!
Christine had told Vica that the girls were juniors from expensive private schools who thought that volunteering at a cancer hospital would look good on their college applications. They were part of the new emotional health program.
Vica winced at the girls and walked down the long hall to the elevator. Once inside she was greeted by the words
BING RUSKIN #1!
And her own smiling face. Last year, Vica had been picked as one of the eight employees to represent the diverse population of Bing Ruskin on a poster. Vadik said that they picked her because she was the prettiest one. But Vica thought it was because she was one of the few radiology technicians who was white. The administration didn't want to support the cliché that most of the doctors at Bing Ruskin were white, most of the nurses Hispanic, and most of the technicians black (even though this was certainly true), so for the poster they had decided to include one black and one Indian doctor, two Asian nurses, and Vicaâa white radiology technician. They were all holding something that looked like a blown-up business card that said
BING RUSKIN RATED #1!
Vica had to reach for the card from behind the substantial shoulder of Dr. Gupta, so it appeared as if she was pinching rather than holding it. Her smile didn't come out that great either. “You look rather menacing here,” Vadik said when she showed him the photo. “Vica Morozovaâthe face of cancer!” But then he asked her for a copy so that he could hang it up in his bedroom. Vica didn't know whether he was joking or not. Vadik had been acting weird lately. Reluctant to help her with Virtual Grave, annoyed when she asked him for dating advice, vague on the subject of Sergey. Not that she cared. Sergey was on his own now.
Sometimes the center's personnel or even patients riding the elevator with her would recognize her from the poster.
“That's you, isn't it?” they'd ask, excited, as if they had just encountered a celebrity. “Bing Ruskin number 1!” she'd respond and pump her fist in the air, and they would laugh with delight. Vica hated when that happened, so she tried to stand in the darkest corner of the elevator. But from there her stare would be inevitably drawn to the elevator's board where the passing floors were being lit with a soft neon glow, as if illuminating everything that might go wrong with a person. Cancers of the digestive system, urological cancers, gynecological cancers, and the scariest of them allâpediatric cancers. The radiology department was on the ninth floor, with medical radiology offices on the right side and diagnostic radiology on the left. The walls of the entire hallway were covered with inspirational quotes. Her least favorite was by Willa Cather: “Where there is great love, there are always miracles.” The quote itself was okay, but it struck Vica as cruel and unfair in this setting. What about terminal patients? There weren't any miracles for them. Did that mean that the love in their lives wasn't great enough?
Her favorite quote belonged to John Cheever: “My veins are filled, once a week with a Neapolitan carpet cleaner distilled from the Adriatic and I am as bald as an egg. However I still get around and am mean to cats.” Vica thought that if she ever got cancer she would find this sort of quote uplifting. She would make sure to be mean to cats.
It was hard not to become morbid at her job. Just the other day one of her patients said to her: “I used to think cancer was this singular tragedy, something exclusive, something shameful, like an embarrassing curse. Now I think it's kind of inevitable, like one of the expected phases in your life. You get born, you go to school, you get a job, you get married, you get cancer, you die.”
Vica shared it with Christine. “Well,” Christine said, “if that's how it is, then at least we're better off than most people, because we know what to expect.”
There weren't any patients yet. Early mornings were usually slow, but Vica knew that the hallways would get crowded by ten thirty and overcrowded right after the lunch break.
Liliana was sitting in an armchair in the waiting room, leaning over a stack of postcards.
“Hey, Vica, do you know how to spell
condolences, c-e-s
or
s-e-s
?”
“With the
c,
I think,” Vica said. “Why?”
“I'm writing Dr. Jewell's notes. To the families of the dead ones. They have to be handwritten. You know how people like a personal touch.”
“So she picked you to do her personal touch for her?”
“I have the best handwriting!” Liliana bit on the tip of the pen. “You know what, I don't trust
condolences,
I better stick with âSorry for your loss.'â”
Vica reached over to pour herself some coffee, but Liliana stopped her. “That one's empty. They have fresh coffee in the treatment lounge.”
The adjacent lounge was reserved for the patients waiting for radiotherapy. Vica peeked in hoping to see Ethan. It was mostly empty too, save for a Pakistani family and a thin young woman in a blue cancer hat slumped in a corner chair.
Vica finally found coffee at the machine right outside of Eden's beautiful office. She could see Eden at her desk going through some papers, taking tiny bites of something that looked like an almond croissant. Vica tried to pour her coffee as quickly as possible so Eden wouldn't notice her. It was important not to let Eden see her, because she might have yet another interpreter's job for Vica. They never had enough official interpreters, and the first place they looked for help was in radiology with its multi-ethnic, mostly immigrant staff. Vica was usually eager to be useful, always volunteered her services, but the last incident about five months ago was just too hard to bear.
Dr. MacEarchern from the fourth floor had been looking for a Russian speaker. A stately, patrician woman with the features and demeanor of a purebred horse, she was looming over her desk, casting shadows on the papers in front of her. She was also heavily pregnant. For some reason, Vica found this disturbing.
The two people sitting across from the doctor in the narrow armchairs moved very close together; they looked the very opposite of patrician. They were both in their late seventies, small, round-faced, dressed in clothes that seemed to be a mix of things they had brought with them from Russia and bought at discount stores here. The husband was squeezing a checked umbrella, the wife was holding a patent leather bag decorated with rhinestonesâVica's grandmother used to have a bag just like that. Both looked tired and frail, so Vica couldn't tell right away which one was the patient. Then she saw the purple chain of injection bruises on the wife's arm.
“Please introduce yourself,” Dr. MacEarchern said.
Vica told the couple that she was Vica Morozova from the hospital's staff and she would serve as the interpreter.
Both the husband and the wife seemed relieved to the point of tears to hear her accentless Russian. Here was a nice Russian girl. She was there to guide and protect them in this doubly foreign and incomprehensible world of America and medicine. The husband took Vica's hand, squeezed her fingers, and called her “daughter.” And the wife simply smiled and smiled at her.
“Let's start, then,” Dr. MacEarchern said and shuffled a thick heap of medical reports in front of her.
“Doesn't she look like a horse?” the wife whispered, pointing to the doctor. Vica couldn't help but snicker. “She speaks like a horse too. We know some English, but we don't understand her at all,” the old man added.
“Don't worry, I will translate every word,” Vica reassured him.
Dr. MacEarchern started to talk. She spoke in long but perfectly precise sentences, pausing at even intervals to let Vica translate. She looked directly at her patient while she spoke and only occasionally glanced at Vica to make sure she was following her. But the patient and her husband kept their intense gaze on Vica the whole time. Vica translated everything with diligence and precision, trying to copy Dr. MacEarchern's empathetic but businesslike tone. She listed all the tests and procedures the woman had undergone and waited until Dr. MacEarchern finished describing the clinical picture. Stage IV. Inoperable. Distant lymph nodes. Metastasis in the lungs. Metastasis in the liver. Secondary tumors.
“In the doctor's opinion,” Vica started to say when she suddenly stopped. She was about to deliver what was essentially a death verdict. She hadn't expected this. She'd thought it would be a routine appointment. Nobody had warned her about this! She couldn't. She couldn't do this to these people who looked like her grandparents, who were counting on her to protect them. They clearly hadn't expected anything like it or they wouldn't have made that stupid joke about the horse. Vica stared at Dr. MacEarchern as if willing her to say something else. She didn't.
Vica felt a painful constriction in her throat. She was afraid that if she opened her mouth she would start sobbing. And the old people were staring at her so intently. They must have noticed her shock. The old man put his arm over his wife's shoulders. They exchanged a long look.
“I think we understood,” he said to Vica. His wife nodded. “Metastasis is the same in Russian,” she said.
“She didn't say it was hopeless though,” Vica said. “They have very good chemo here.”
Good chemo? What was she saying? Quality carboplatin as opposed to subpar carboplatin around the corner?
“I know,” the old woman said. “I understand.”
Dr. MacEarchern saw that the verdict had been delivered. She put her hand on the box of tissues on her desk and gently moved it in the direction of her patient. The old woman's lips quivered, but she squeezed them into a thin white line and shook her head. Her husband moved the box back. They were too proud to cry in Dr. MacEarchern's presence.
There was more information that Vica was required to translate, but she saw that the couple had stopped paying attention. The wife was staring down, fondling the stupid rhinestones on her bag, and the husband was stroking her arm with one hand while continuing to squeeze his umbrella with the other.
They exited the office together. The old man shook Vica's hand and the old woman said, “Thank you, daughter.” Vica gave them her card and said that they could call her anytime with questions.
She never heard from them again.
It was only later that day, on the bus back to Staten Island, that Vica realized that it was the old people who had protected her, not vice versa. They had protected her from having to deliver the verdict.
By the time Vica made it home, she was shaking with sobs. Sergey sent Eric to play in the basement, walked her to the bedroom, then went to fix her some tea. He brought it in on a tray with some salami sandwiches. When she told him how they had called her “daughter,” he started to cry too. They had been fighting for weeks before that, but in that moment Vica felt that she had never felt as close to anybody and she never would.
And now Sergey was gone.
Patients started to flock to radiology around ten o'clock. There were so many of them that Vica stopped making distinctions. She glided and glided and glided her magic stick over their body parts, as if they were the same endless body. By the lunch break it was especially hard. Vica was physically tired, and her back started to ache, and she couldn't help but imagine herself trembling on that table while a cold slippery wand slid over her cancer-ridden stomach or chest.
As it always happened before lunch, some of the patients were getting hysterical.
“Don't you have, like, a shred of a soul?” one woman asked after she had begged Vica to let her husband cut the line.
“We need to see the liver doctor at one thirty. If we miss the appointment, they will reschedule and we will have to come again. From Scranton. Do you know where Scranton is? Do you realize what it's like for Peter to be in a car for two and a half hours?”
Peter was sitting right there, painfully thin, with a yellow tint to his skin and a permanent grimace of pain, ghostlike, and perfectly oblivious to the scene.
“I'm sorry, ma'am, but I don't make the rules,” Vica said.
And then the woman broke down sobbing and she kept saying through her sniffles and hiccups: “I understand that he has to suffer chemo, radiation, but why does he have to suffer these endless lines? Couldn't he be spared that at least? He has less than a year to live!”
No, he couldn't be spared that. When Vica had first started working at Bing Ruskin, Christine had explained to her the necessity for the lines. Everything at Bing Ruskin was designed to make the machinery of the hospital run most efficiently. Doctors and technicians were moving swiftly from one appointment to the next, the expensive equipment was working at its full capacity. The interns worked their endless shifts. The precise number of personnel was determined by the cost efficiency. And if that meant less efficiency and longer waits for the patients, so be it. The patients were thought of not as important clients to whom you were supposed to suck up for the benefit of your business, but as faceless insignificant consumers who should be grateful for the services provided.