With swift, well-rehearsed movements, Sonja inserted IVs of glucose and Polyglukin into the man’s arms. She pulled a surgical saw from the cabinet and disinfected the blade as Deshi called out blood-pressure readings. At seventy over fifty, she injected Lidocaine just above the tourniquet. Deshi anticipated her requests, and the clamps he’d boiled were in her reach before she asked. She worked without looking at the man’s face or hearing his cries as though her patient were no more than his most grievous wound. Blood reached her elbows but her scrubs remained white. The man, and he was a man, it was so easy to forget that with all his insides leaking out, had graduated from architecture school and had been searching for employment when the first bombs fell. When the land mine took his leg, he had already spent nine years searching for his first architectural commission. Another six and three-quarter years would pass before he got that first commission, at the age of thirty-eight. With only twenty percent of the city still standing, he would never be without work again.

“Come here,” Sonja called. Akhmed looked over his shoulder to summon a more capable ghost from the Brezhnev-beige wall. “Akhmed, come here,” she repeated. He stepped forward, wiggling his toes in his boots. One step and then the next, with an immense gratitude for each. The skin was peeled back toward the knee. The calf muscle, cut away. The bone wasn’t wider than a chair leg.

She gestured with her scalpel. “For a below-the-knee amputation, you want to keep in mind that stumps close to the knee joint will be difficult to fit for a prosthesis. Long stumps are also difficult to fit and can lead to circulation issues. First, you’ll need to make a fish-mouth incision superior to the point of amputation. You want a posterior flap long enough to cover the padded stump and to ensure a tensionless closure when sutured.” She described how to isolate the anterior, lateral, and posterior muscular compartments in dissection. She showed him how she had ligated the tibial, peroneal, and saphenous veins, and noted that the blood pressure always rose after the peroneal artery was tied off. She transected the sural nerve above the amputation line and let it retract into the soft-tissue bed to reduce the phantom limb sensation. With a clean scalpel she incised the dense periosteum. She gave directions in the flat, bored tone of a carpenter teaching a child to measure and cut wood, and Akhmed heard her without listening. All her Latin words and surgical jargon couldn’t mitigate the helplessness he felt while watching her finish what the land mine had begun.

“Leg amputations are normal business here,” she said, and handed him the saw. He held it, expecting her to ask for it back. She looked to it and nodded. No, she couldn’t be serious. She didn’t expect him to do that, did she? She barely trusted him to fold bedsheets properly. “You should get comfortable with this procedure as soon as possible.”

He gazed from the blade to the bone. The bone was a disconcerting shade of reddish gray; he’d expected it to be white. He had been six years old when he first realized that the drumstick he slurped the grease from was, in principle, the same as the bone that allowed him to walk, run, and win after-school soccer matches. He hadn’t eaten meat again for two years, so great and implacable was his fear that another carnivore would consume his own leg in reprisal. “I’m not qualified for this,” he stammered.

“This is the deal,” she said calmly. She reached for his hand. That grip held more of her compassion than the past two days combined, and then it was gone, replaced by hard pragmatism, and her fingers wrapped his around the foam grip. “This is what we do. This is what it means for you to work here.”

His hands shook and hers steadied them. The last leg surgery he had performed had been after the zachistka, on a boy named Akim. He had tried his best, he really had, but he couldn’t be faulted for his lack of supplies and experience, for the lack of blood in the boy’s body and the great abundance drenching the floor, for the bullet he didn’t shoot, or for the war he had no say in; if anyone had bothered to ask his opinion, he would have happily told them that war was, generally speaking, a bad thing, to be avoided, and he would have advised them against it, because had he known that not one but two wars were coming, he would have dropped out of medical school in his first year, his reputation be damned, and gone to art school instead; had he known a domineering, cold-hearted Russian surgeon would one day ask him to cut off this poor man’s leg, he would have studied still-life portraiture, landscape oil painting, sculpture and ceramics, he would have sacrificed his brief celebrity within the village, if only to safeguard himself from this man’s leg.

“There’s only one amputation now, but what about next time?” Sonja said. “There could be five, ten.”

He exhaled. Sweat pasted his surgical mask to his cheeks. Sonja pushed his hand forward. The blade grated against the bone. The vibration of each thrust ran up the blade, through the handle, to his hand, and into his bones. The name of the bone was tibia and it was connected to fibula and patella. He had studied the names that morning, but what he knew wouldn’t push the saw.

“Press harder,” she instructed, steadying the bone for him. “This isn’t a delicate operation.”

Halfway through, the blade unexpectedly went red with marrow. He stopped sawing.

“What’s wrong?” Sonja asked.

He could have answered that question several different ways, but he shook his head, and kept sawing. “I didn’t know human bone marrow is red. I thought it would be golden. Like a cow’s.”

“The marrow of a living bone is filled with red blood cells. If we were to shake a little salt and pepper on this bone and roast it in the oven, the marrow would turn golden in about fifteen minutes,” she said.

He feared he might vomit.

“Fine work,” she said, as he sliced through the tibia. “Just one more bone to go.”

He set the blade on the fibula and his quick hard saw-strokes spat into the air a fine white bone dust that drifted toward him, drawn by his breath, eventually dissolving into his damp surgical mask. Sonja’s dark eyes leered at him in his periphery, and he pushed the saw harder, faster, wanting Sonja to see in him more than his helplessness, wanting to finish before he fainted. A dozen strokes later the foot dropped to the table. He held the remnant by the ankle, and without pause or consideration, he flipped it on its end, and blood and marrow coated his fingers as he counted six shards of glass glinting in what was left of the man’s sole.

“Set that aside,” she said. “We’ll wrap it in plastic and give it to the family for burial.” She showed him how to round off the amputated bone and pad it with muscle. She pulled the posterior flap over the muscle-padded stump, trimmed the excess skin, and sutured it with black surgical thread.

When they finished, he peeled off his latex gloves and massaged the pink soreness of his right palm, where the skin between his thumb and forefinger had swollen from the handle’s pinch. Sonja noticed, smiled, and when she raised her right hand he wanted to be back in bed with Ula, where he could pull the covers over their heads and in the humidity of their stale breaths hold the one person who believed he was knowing, capable, and strong.

Calluses covered Sonja’s palm.

CHAPTER 5

KHASSAN GESHILOV COMPLETED the first draft of his Chechen history on the one day in January 1963 when it didn’t snow. The manuscript was 3,302 pages. When he submitted it to the city publisher in Volchansk he was told he needed to send it to the state publisher in Grozny, and when he submitted it to the state publisher in Grozny he was told he needed to send it to the national publisher in Moscow; and when he submitted it there he was told he needed to send three typed copies. Tears leaked from the corners of his eyes as he looked at his poor, battered fingers. But he purchased the postage, paper, typewriter ribbons, and cigarettes such a monumentally monotonous activity required, and eighteen months later he received a phone call from the head editor of the history section, Kirill Ivanovich Kaputzh.