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22. The singers of Lavordin

I think that it was at Lavordin hospital that I first realised for sure that Larvartin was insane. I had known for a long time that he was a strange, cruel man, of course, but he had conducted his affairs with such ruthless but apparently rational cunning I had not realised that he was mad.

Of course, it all began with that undiplomatic report where the Italian said conditions at Lavordin were ‘Stone Age’. Larvartin always hated to be patronised or disparaged by foreigners, and he was especially sensitive about Italians; he had regarded them as especially arrogant ever since he had had a particularly vituperative interview with one of Mussolini’s agents just before the outbreak of the war. When he read the report, he was thrown into a state of complete rage, and he marched up and down his office shouting and throwing things at the walls. Finally he insisted that together with a detachment of the CPV we should go and see the place for ourselves.

I thought myself that although conditions were not literally those of the Stone Age, they were certainly not very good. In most wards the patients were crammed in two to a bed, one facing each way; most of them wore their normal outdoor clothes. We saw little use of any drugs apart from aspirin, and most of the staff were not qualified nurses or doctors but filthy servants dating back to the days when the place had been more or less a hotel, all of whom treated the patients with contempt and no doubt stole their belongings whenever they could. The place stank, and not of disinfectant. Larvartin stayed under control at first, although I could see the anger was building up inside him. We were shown round by a young doctor, haggard with fatigue, clearly at the lowest possible ebb; I found out afterwards that he had not slept for three days. He told the simple truth, quite frankly, whether from habit or because he didn’t care any more whether Larvartin killed him or not.

“The problem, Larvartin,” he said, “Is that this is not a real hospital at all. It was never a properly equipped hospital and now it’s just a stinking shed where the sick are shovelled in every day. Give it another few weeks and it will be a charnel house.”

“That will not happen, Comrade Doctor.” said Larvartin, with a menacing light in his eye, “But we must take steps. That patient – “ he pointed to a grey-faced man, “What is his illness and how can it be cured?”

The doctor raised his eyes momentarily.

“That patient has a serious heart problem,” he replied, “He will die soon. There is nothing we can do. We do not have an operating theatre of any kind, let alone one which could attempt heart surgery. We don’t even have any useful drugs beyond some basic analgesics. Frankly his only chance would have been to leave the country – abroad he could have been treated. Here, we can do nothing except leave him alone and let matters take their course. To tell the truth, we have other priorities.”

“Priorities? Yes, indeed. Prioritisation is the key here. I had not realised things had got so disorganised.” Larvartin said, pressing his lips together, “But we will change that. We will change it now”.

He called the hospital staff together. Some were depressed, unmoved, but I could see that others, the younger ones mostly, were in fear of their lives.

“We are going to manage our problem here,” he said to them all, “So that no-one can reproach us with inefficiency, you understand me? We cannot have people lying here day after day dying with nothing being done, it’s not acceptable. Our first step is address the priority cases. You – the doctor. I want you to go back to Ward One and pick out the ten sickest patients. Bring me a list of their names.”

Puzzled, but not without signs of hope, the young doctor left the room and came back after a few minutes with a clipboard, which he handed to Larvartin.

“This first patient has emphysema,” he began, “There isn’t much we can do, but if we had oxygen…”

“Enough: do you think I want his life story, really doctor, we have no time for gossip.” said Larvartin peremptorily, handing the clipboard to Captain Ventarin, the commanding officer of the CPV squad, “Here, Ventarin. See this list? Take these bastards outside and shoot them.”

For several moments no-one quite believed it; even I thought for a moment that it was a clumsy joke. Then Ventarin, who had enough experience of Larvartin to know that hesitation was dangerous, gathered his wits and left the room. Someone at the back let out a thin scream.

“Ward Two!” said Larvartin. Looking pleased with himself.

But now that he knew what was going to happen to them, the young doctor refused to identify further patients for liquidation. Larvartin ignored him and summoned another doctor, a grey-haired old consultant – but he would not help either. It was one thing to stand by and let murder happen, but to pick out the victims was more than any of the medical staff could stomach. In the end the job was deputed to the most brutish of the servants. Larvartin worked his way through the wards systematically. When it came to the children, however, not even the bestial servant would select the victims. There was an impasse for a few moments and I really thought Larvartin might have the entire hospital liquidated then and there, staff and all. But instead he finally smiled and stalked off to the children’s ward himself, with the CPV and the line of horrified staff trailing behind him.

“Alright,” said Larvartin to the sick children, as if it were a treat, “This is what we’re going to do, you’ll enjoy it. We’re going to have a singing competition. You must all sing as loud as you can. I’m going to walk round and listen. If anyone is too sick to sing really loudly, Ventarin here will give him his medicine, OK?”

The terrified children began singing at the top of their voices. Some, who were actually unconscious or genuinely too ill to sing, stood no chance, and others were paralysed by fear. Each of these, one by one, was pointed at by Larvartin and taken outside where they received a bullet in the head at point-blank range. Ventarin was forced to reload several times.

Larvartin was put into a good mood by the implementation of his plan; he seemed pleased with his own ingenuity in devising the singing test. He gave instructions that every morning all the patients must sing; the three weakest on each ward would die. I looked at him standing there with blood flecks on his suit, his eyes wide open, and I said to myself, this man, this man who clings to me like the Old Man of the Sea, his mind is gone. I thought someone would kill him: I thought Ventarin would finally sicken of slaughtering sick children and turn his gun on his master. But it did not happen. Instead Ventarin and his men seemed to be getting into their stride, getting used to the business. They began smiling again.

Now Larvartin applied himself to the building of a surgical ward. He had all the patients outside and forced them to attempt to dig foundations, whatever their illness or injury. There was no plan, and nothing worthwhile was accomplished that first day except the creation of a ghastly mud heap. On subsequent days, Larvartin send his men out to conscript people from nearby towns. It so happened that the young poet Georgi Versantin was caught up by one of these press-gangs. Brought to the chaotic scene of the building work, which now consisted of a series of irregular holes, not unlike rough graves, Georgi wiped his face with one hand and shouted in a trembling voice:

“Comrades; when Khrushchev said ‘we will bury you’, didn’t he mean the capitalists?”

No-one answered.

“You know, we should get Carl Mustin out here and make him show them how to dig.” said Larvartin with a grin, forgetting that Carl Mustin had been sent to the cellars of the Agraci Palace three weeks before and no longer had functioning limbs.

In the end, thank God, after staying near the hospital for a week, he grew bored and returned to Sescastri. The Minister of Health was able to restore some semblance of order and propriety at Lavordin, but he was not able to get rid of the CPV, who continued to arrange what they called singing practice every morning. They stopped shooting people, but they continued to check that the patients were in good voice.

The new surgery, by the way, was eventually constructed by a team of Italian workers brought in by the Minister of Health, who was terrified that Larvartin would come back to inspect progress. The cost was huge, and for the next three years Lavordin took up over 60% of the entire national hospital budget. The facilities and staffing really did improve in the end, albeit at the cost of plunging most of the other hospitals in Dubitania into crisis. We were even able to show the place to some international visitors, at Larvartin’s insistence. CPV men wearing white coats stood in every corridor, and the staff were effusively welcoming to their overseas colleagues, begging them to stay as long as they could: they knew that while the foreigners were there, no-one would be shot.

That was all bad enough, but it got much worse. My lasting memory of Lavordin Hospital is from many years later, when the Blumenite inoculation campaign was at its height and Larvartin and I undertook a visit. By then, I doubt whether there was a competent doctor in the place. Half the staff were Party placemen, half were Blumenite zealots, mostly with few genuine academic qualifications. If a handful of properly-qualified medical staff remained from the old days, they were so cowed and browbeaten that they were no longer of any use.

Most of the patients had begun by accepting the Blumenite injections as legitimate medicine, but as they gradually grew sicker, their doubts increased: then a new wave of patients appeared, people whose illness was solely a matter of the injections, victims of the workplace campaigns and ‘spontaneous’ street visits which the Blumenites had been running all over the country. There was no room for this new influx: they sat or lay wherever they could, and soon became as grey-faced and emaciated as the original inmates, whose beds they usurped as soon as the owners died, or indeed more often as soon as they weak enough to be thrown out on the floor.

I was told that some of the patients, at length, had tried to escape, though who knew where they could have gone. At any rate, they were easily intercepted and beaten back by the resident thugs, some of whom had spent nearly their whole careers at Lavordin by now. The miracle was that people still came to the hospital; but there was no longer any other hospital, however dysfunctional, in the whole of Puttonyi Province. I remembered the young doctor’s words from years ago and thought how much better an honest charnel house would be, compared to this horror.

Astonishingly, poor Sergi Scalapin, now well over ninety, was still there. Forced out of retirement at gunpoint to give the hospital some credibility, the old surgeon was no longer allowed to intervene in the care of any patient; he was kept locked in an office which served as his cell and marched round the hospital twice a day by the CPV men in a grotesque parody of a ward round. I tried to speak to him when Larvartin had left the room, but he would not raise his head or respond to me.

Larvartin, for his part, seemed delighted by everything, and when our visit was concluded by a ‘singing concert’ arranged by sniggering CPV thugs, he professed himself delighted at the progress which had been made.

“Comrade patients!” he said in a bizarre speech of thanks, “If anyone asks you who made Lavordin what it is, don’t tell them it was Marki Larvartin. Always remember that everything that happens here is your own doing!”

The CPV men laughed and applauded.

58,240. Two more chapters, but they won’t count towards the Nanowrimo total (not that it matters)

3. Lavordin Hospital

Reading some of those old stories I realised for the first time that my mother had perhaps embroidered and tidied them up a little. And in spite of my good resolutions, I realised that in places I was just as adulatory as my father’s official biography. So let me leap forward now many years to the happy days when my father was finally the President of a newly free country, but had not yet managed to introduce all of his reforms and regenerations and tell another story which illustrates in more sober terms the merits of his approach. This is the tale, much quoted, of Lavordin hospital.

Lavordin was a dark old building in the southern lakeside town of Oni-Litani. It had been a private sanatorium when the place enjoyed a brief spell of popularity as a spa, in the early part of the nineteenth century. Later, under Royal patronage, it had been converted into a charity public hospital but allowed to fall into disrepair; but when the modern hospital in the suburbs was hit by a bomb, it became the only place the local people could go for serious medical treatment. Overcrowded and lacking drugs and equipment it soon began to suffer severe problems. Finally an indiscreet surgeon who visited as part of an international research delegation issued a scathing statement to an Italian newspaper, describing the conditions as ‘Stone Age’ and contrasting the hospital’s performance with the grand speeches of Party officials.

My father was very upset by this, my mother said; not because of the bad light it shone on him and his regime, but because he had not been aware of how the patients at Lavordin were suffering. He immediately went and visited the hospital himself. The bureaucrats and doctors were in mortal fear, but my father seemed calm, asked questions, and criticised no-one.

“The problem, beloved leader,” ventured a doctor at last, “Is that this is not a real hospital. It was never a properly equipped hospital and now we’re simply improvising.”

“I understand, Doctor,” said my father, with a light in his eye, “But we must not focus our thoughts on what Lavordin is now, but on what it might become. That patient – “ he pointed to a grey-faced man in a bed across the way, “What would we do for him if we could?”

The doctor looked grave.

“That patient has a serious heart problem,” he replied, “There is little we can do. It needs some very advanced surgery, of a kind we have yet to perform in Twentyland. As it is, we do not even have a satisfactory operating theatre.”

“Where could we put such a theatre?” my father asked.

The doctor smiled, “Really, there is nowhere. We have no room as it is. We should have to build a completely new surgical wing.”

“Bring me a spade,” said my father, “and I’ll get the cement and the bricks.”

He called the staff together and made an impassioned speech. Here and there, especially among the younger nurses and doctors, he could see a gleam of hope returning.

“Tell me your problems.” he said.

This was no empty rhetoric. He asked what they needed, what they would do if they could, and wrote down a list on a blackboard.

“Comrades,” he said, “You talk of these things as though they were dreams, Christmas presents that St Nicholas might bring if we believe in him, which of course, being good materialists, we do not. No-one is coming to do these things for us. This is our hospital, it is in our hands entirely. But there is our hope, too; no one will help us, but no-one can stop us, either. No-one can stop us here. We can do whatever we will. We can make our hospital whatever we want. Listen to me. Believe me. I tell you these things on this board will happen. They will be done. They will be done here. Now. And what is more the point perhaps, by us.”

He spent most of a month at Lavordin, in the hospital and in the town: he made an appeal to the nation. People did, in fact, come to help; local people brought in some money and helped with the work; my father managed to transfer in some additional doctors. The building of the new surgical wing became a celebrated cause, and volunteers began to appear from all over the country. One day, to my father’s great amusement and gratification, the celebrated poet Georgi Versantin appeared, a pale, undernourished young aesthete with a beautiful silk scarf. Taking off his coat and casting it aside, Georgi shouted in a trembling voice:

“Comrades; the new slogan – Bring me a spade!”

“My God, comrades, if Georgi is going to dig our foundations, what will Carl Mustin have to do to save his face?” asked my father with a grin. Carl Mustin was the obese head of the Twentyland Miners Union.

A year later, my mother was sitting at a typewriter in the Palace when she overheard a French doctor speaking to the colleague who had come out to replace him on a long-term study of the Twentyland healthcare system.

“You must go out to Lavordin,” said the first doctor, “It’s an extraordinary place. I remember my first visit there: as I approached, by the line of poplars at the edge of the lake, I heard voices singing, like a rustic choir. Not at all sophisticated, not by any means great music, a simple folk song; half of them out of tune, some of them hoarse and old and cracked; but none the worse for that; perhaps more beautiful, more affecting. Human voices, very human; honest and full of the simple joy of singing. Coming through the trees on a sunny day by the lake, the effect was almost heavenly, like stumbling on some blessed Elysian field. It was the patients, of course. I asked whether the hospital organised this singing, but apparently it had begun quite spontaneously and was now an established feature of hospital life. I’ve never been anywhere that had such an atmosphere of serene confidence, such indomitable optimism. The way the younger doctors work there, such energy, such enthusiasm. All the time I was there, they were asking me questions about what we do in Paris, what techniques could I teach them, could I tell them about new research; anything they could learn from or copy. They were so quick to learn, so ready to try anything new that I could suggest, and so skilled at making it work. They begged me to stay, they insisted I come back as soon as I could.”

“And the things they do. It’s not a well-equipped place, you know, but you’ve heard how they put up a surgical theatre with their own hands, staff, local people, even some of the patients, working overtime; and they’re doing operations there I wouldn’t like to try back at home. Yet with tremendous results; it’s as if the optimism of the staff buoys the patients up, carries them on to recovery: when one of them gets better, there’s a feeling of shared triumph between staff and patients, as though they’d won a gold medal together, or something. I saw people who had left the hospital six months before, so excited by it that they still came back every day and helped in any way they could. I’ve never seen a hospital where I’d be happier to be a patient – but what a place to be a doctor!”

“You know,” he said wistfully, “Over the years you become cynical, and I’ve drifted into being more of an administrator than a practitioner. But those young doctors and nurses; being among them, I felt ashamed. I felt like a renegade. That place made me feel, more strongly than I had ever felt before, that it’s a high honour to be a doctor, one I had not valued enough; that there is nothing more wonderful than the practice of medicine; the gift of mending broken people. Those young doctors are so excited at what they’re doing, they can hardly bear to leave the hospital, and they hurry back as soon as they can. I was within an ace of throwing all these execrable papers away and promising to stay and help.”

“Lavordin?” said the other doctor, “I’ve heard some strange stories about that place. Huge death rate, people just being killed by the treatment. Something like that. Wasn’t that the ‘Stone Age’ hospital?”

“Yes, it was: but if you could see it now I really think you’d call it Golden Age.” said the first doctor, and then looked a little embarrassed at how his enthusiasm had carried him away.

Lavordin had that effect on others, however, notably on Sergi Scalapin, a respectable surgeon who had been a prominent member of one of the bourgeois parties, and had opted to retire from practice under my father’s regime. The stories which circulated about Lavordin became so extravagant – and it must be admitted that some of them were exaggerated – they annoyed him so much that he came to see for himself, determined to prove that it was all nonsense.

Once there, however, he fell under the spell of the place in much the same way as the French doctor; he took a job and went back into surgical practice. Not only that; in spite of his bourgeois sympathies, he was an innovative scientist and he soon collected around him a group of young doctors who began to create a radical new system of treatment which became known as the Lavordin Regime. One element in the Regime was a new approach to anaesthesia and palliative care based on techniques developed out of research into acupuncture. A visiting fraternal delegation from China had demonstrated acupuncture at Lavordin; Scalapin and his team took it up with enthusiasm, refining the method and replacing needles with a new technique of pulsed electrical charges. Not only was this a more effective way of dealing with pain; there were no side-effects or complications and recovery times were shortened by as much as 23%, according to Scalapin’s own report.

Of course, my father was often invited to visit the hospital, whenever they had a new ward to open, or were celebrating an anniversary. But for a long time he refused all these invitations.

“Why don’t you go?” asked my mother, eventually, “It seems as if you don’t like the place.”

“I don’t want them to give me credit for what the hospital has achieved,” said my father, “You know how it goes. They’ll make long speeches and say it is all owing to me. I don’t want that. I want them to realise it was all in their own hands, all the time. That is the whole point.”

“You have such a monstrous ego,” said my mother, sternly, “Who is going to say it is owing to you? Nobody remembers you ever went there, Nobody is going to give you the credit for anything. It’s just that as an internationally famous hospital, they think maybe it’s the President’s duty to come and cut some ribbons for them. But don’t trouble yourself.”

“Well, if you put it like that.” conceded my father wearily. So at last he accepted an invitation and went along to a grand gala dinner.

Unfortunately it proved exactly as he had said: every detail of his original visit was recounted, all the old stories were told again, and speaker after speaker rose to declare with emotion that all the hospital’s glittering achievements were the result of Marki Larvartin’s intervention. They had even found the hopeless heart patient, the grey-faced man about whom my father had asked; he had been the first to undergo open-heart surgery in the new theatre, had made a complete recovery, and was now back at work in the marble quarries. To my father’s dismay, he stood up in front of the dinner table and pulled open his shirt to show the great scar across his chest.

“Comrades,” said my father, responding at last to all the speeches which had been made, “Truly I am proud of what you have made of this hospital. All across the world the name of Lavordin is known; in our sister republics with pride, and in the capitalist countries with envy. But it is important that you understand how this has happened. It is because you took the hospital as your own. As a result, you were able to make of it whatever you chose. Remember that the hospital is entirely in your hands. And so, it seems, am I.”

This was typical of the way my father never shirked his obligations, although they soon became extremely onerous. On one occasion he arrived very late at our flat; the dinner my mother had prepared was long since spoilt.

“What on earth happened?” she demanded, “As if you weren’t away from us enough, now you’re late even when you’re here.”

My father explained that he had put in a long, gruelling day working through piles of administrative papers and proposals, and sitting through a three-hour meeting of the Council of the Twenty, the supreme Government body, always an arduous affair. He locked up his office and he and his shadow Lucas Stilin, cigarette always in the corner of his mouth, walked out to the waiting car. At that moment, an old woman seized his arm. The guard at the door stepped forward, but my father waved him away.

She had, it emerged, a long and complicated story of a problem concerning her son, and she was seeking my father’s personal intervention.

“Granny, I’m sorry, but I have had a long day, I am late already, and I cannot attend to this matter for you.” said my father, as patiently as he could, “Please speak to the Citizens’ Office tomorrow.”

“Is it not the President’s job to right injustices?” demanded the old woman, angrily.

“Yes, of course it is,” said my father,

“Are you going to right this injustice I have been telling you about?”

“Personally? Here and now? No,” admitted my father, becoming a little impatient with this rhetorical outburst.

“Then stop being President, personally, here and now, Marki Larvartin!” said the old woman.

So my father had gritted his teeth, gone wearily back into the building, heard her out, made some enquiries and after two hours succeeded in sending her away, if not satisfied, at least mollified.

“Stilin told me he would have had the guard kick her scrawny old arse into jail,” said my father, with weary amusement, “I told him that was obviously why he wasn’t President.”

I make that 8,753 words.