Finesse

The dictator wanted to survive the operation. The surgeon wants to see her children again
August 19, 2002

Rumours that the dictator was ill were unfounded. He'd never been fitter. Nevertheless, the dictator considered it wise, from time to time, to confirm the robustness of his health by having X-rays made of his chest. On this occasion when the great man asked if the X-rays showed anything unusual, his personal physician hesitated to reply.

"You have a big heart," said the physician at last.

"I know that," smiled the dictator. "But how big?"

They stood in the dictator's office. The physician hugged the folder of X-rays unhappily to his breast.

"Bigger than..." he stuttered. "Bigger than is perhaps totally consistent with... with the size of heart that one might expect in a person who was... ah... in a state of health consistent with... sustained..."

The dictator sighed, impatient with this mealy-mouthedness. Sometimes it fell to a leader to rescue people from their own timidity.

"Bigger than is good for me, you mean?"

"Yes."

"I've often thought so," the dictator smiled. "But this big heart of mine: how much of a danger is it?"

"Danger?" The physician was perspiring in a manner that the dictator found, frankly, irritating.

"Friend, we have known each other a long time," he cautioned. "Can we not speak freely?"

The physician gulped. He and the dictator had known each other for 23 months. Was this long? It was ten times longer than some people lasted before falling out of favour. On the other hand, knowing the dictator for a long time didn't seem such a good idea, as his oldest friends and relatives were mostly dead.

"It appears from the X-rays that you... that your heart... that you have cardiac myxoma."

There, it was said. The physician waited for consequences, blinking behind his foggy glasses.

"Is that a cancer?" said the dictator.

"Yes, it's a cancer," said the physician.

"Cancers can go away by themselves, can't they?" The dictator sounded unconvinced; the notion went against everything he knew about politics.

"Not this one."

"Deadly, is it?" said the dictator, as if confirming the strength of his enemy.

"Well, actually, the myxoma itself is benign. But what it does to the heart is... ah..."

"Fatal."

"Yes."

The dictator turned and walked to the window. He peered out, hands clasped behind his back.

"A cancer can be cut out," he said.

"There are cancers of all sorts," squirmed the physician. "Some can simply be cut out. With others, the job is much more complicated."

The dictator nodded. This distinction conformed perfectly to his experience of politics.

"How soon can this kill me?"

"I am a humble all-rounder, no expert," pleaded the physician. "Books on the subject say that three months is usual. I don't know how they arrive at such a statistic. If it is an average, the figure of three months could be derived from one man surviving a week and another surviving... um... almost half a year." The physician grimaced: half a year didn't sound like much. Maybe he should have taken greater liberties with arithmetic; the dictator, for all his honorary university degrees, was famously uneducated.

"Can you do the job?" the dictator enquired.

The physician shook his head.

"I haven't the skill," he said.

"Not if I gave you a fortnight off to practise?"

"Not if I had a year," said the physician. "The affected blood vessels are tiny. With these big peasant's hands of mine..." He lifted one into the air.

The dictator frowned. The physician wondered if he'd overdone the peasant stuff.

At last the dictator said, "But I thought the problem was that my heart was too big."

"Yes," said the physician, "but it can't be solved by yanking the heart out like... like a turnip from the soil. This is a job that requires great... finesse."

The dictator returned to his chair and sat in it. There was a loud creak. He was a man of 72, overweight and moist-eyed, with thin hair the colour of hair-oil. On the wall behind him, a portrait hung in which he was ageless, in which he looked as if he could tear men apart with no help from anyone else.

"Find the doctor who can do the job," he said.

Two days later, the physician was back in the dictator's office. "I believe I have found the doctor," said the physician. "According to all those I've consulted, there is just one person."

"Excellent: what's his name?"

"It's a she, actually. A Mrs Gala Sampras. You will recall, she was one of 14 surgeons who shamefully defected in 1992 to America, to perform unnecessary surgery on rich Jewish women."

"This is no use to me!" exclaimed the dictator. "We must get her back!"

The physician bit his lip, nonplussed by the dictator's lapse of memory regarding the true circumstances of Mrs Sampras's disappearance.

"1992," he repeated helpfully. "You recall the incident, I'm sure. The surgeons were critical of your government; Jewish businessmen organised the getaway plane..."

"Yes, yes: filth and scum..." hissed the dictator, fists clenched on the desk before him.

The physician tried once more to fill in the gaps. "There was some suggestion," he mumbled, "...in a subversive newspaper... that the surgeons never left the country. That they were in fact detained in the Milleforte Labour Camp."

The dictator raised his shoulders in indignation, spring-loaded to refute a vicious untruth. Then abruptly he relaxed, his eyelids drooping.

"Ah," he said.

Having dismissed the physician, the dictator immediately telephoned the chief administrator of the Milleforte Labour Camp.

"I don't suppose," the dictator asked, "you know how Mrs Sampras is getting on in America?... Mrs Sampras, the surgeon... You don't say? That's good. You know, I was afraid she might have fallen victim to some drug-crazed nigger in New York... So she's in top form, is she? Fighting fit? Ha! Ha!" His chair creaked with the sheer verve of his relief.

The following day, the dictator received a letter which had been dashed off by Mrs Sampras.

Dear Mr President, I understand you have been enquiring after my health. My health is fair: how's yours? Well, enough small talk. I seem to be forever making confessions: here is another. I haven't been at all happy in America. In fact, the experience has taken away all my zest for surgery. I wish I had never left my husband and children for this pampered existence. But, I suppose we must all suffer the consequences of our bad decisions, and I am resigned to live out my life here, a traitor of no use to man or beast. Regretfully, Gala Sampras

Pouting thoughtfully, the dictator folded the letter. A word was eluding him, a word he'd heard for the first time only yesterday, although as a doctor of literature he must have known it all along. This, he thought, is going to require... finesse.

Before the guards allowed Gala to see the dictator, they made sure she was not concealing any weapons. Her doctor's satchel was emptied out, even though it had been hastily supplied by the president's own physician and contained almost nothing.

A young man unzipped Gala's overcoat and frisked her from armpit to ankle, his fingers gentle and thorough. He lifted her skirt and passed his finger over her underpants, against her vulva. Then he removed a pen from the breast pocket of Gala's jacket. He clicked the nib in and out, frowning, as if feeling himself required to make a complicated moral decision. Gala Sampras smiled despite herself. It seemed so absurd that she'd been brought all the way here to slice the dictator's chest open with a scalpel, but here were his bodyguards trying to make sure she didn't stab him through the heart with a cheap plastic pen. "Mightier than the sword, hmm?" she said.

The dictator welcomed Mrs Sampras graciously, extending his hand over the desk where he had signed the warrant for her arrest years before. He was smiling, with lips that were ever-so-slightly cyanosed from the cancer around his heart. A network of pale purple capillaries were showing on his nose.

"I'm honoured to have you here," he said. Mrs Sampras said nothing. Face impassive, she extracted her hand from his. There being nowhere for visitors to sit, she remained standing. While he looked her up and down, she avoided his gaze and took stock of his office.

It looked exactly as she'd imagined it might, as a child might draw a dictator's office. There was a massive mahogany desk, strewn with folders. There was an upholstered swivel chair for him to luxuriate in. There was an oil painting of the dictator on one of the walls. There was an uncurtained window looking out over the courtyard. And this was all. No bookcases, no golf clubs, no ornaments, no stag heads on the walls or Virgin Marys dangling from the ceiling. Nothing to indicate any undictatorly quirks. In speeches, the president liked to boast that he had no interests or pastimes, other than overseeing the welfare of his country. Now Gala could see that this was true.

"Would you like to see my X-rays?" he asked.

"Please," she said.

He handed the folder of silver-grey images over to her. She studied them one by one, holding them up to the sunlight streaming through the window behind his head. Surreptitiously, she cast her eyes downwards and examined his face through the transparent sheets of film. She fancied she could detect his fear.

"What do you think?" he said, clearing his throat.

"You are going to die very soon," she said evenly, still shielding her face behind the last of the X-rays, "unless you have a complicated and risky operation."

"I know that," he sighed, with an edge of irritation to his voice. "Do you have the skill to do it?"

"I have the skill," she replied, lowering the sunlit negative of the dictator's cancer-speckled chest. "But these are not the photographs I was hoping to see."

"Those photographs are on their way. You will see them tomorrow."

"Of all four?"

"Husband, two sons, daughter, yes."

Mrs Sampras placed the X-rays on the desk. She had a yearning to stand at the window and look out, but didn't want to expose her back to the dictator.

"This operation," said the old man, licking his bluish lips, "Can it be done in our country?"

"There is no limit to what can be done in our country," sighed Mrs Sampras. "You have proved that many times."

"Yes, yes, but if you felt that a little trip to the United States might be desirable..."

"I've had my trip to America, thank you," she said.

The dictator stared hard into her eyes.

"You must have the best tools, only the best."

Gala looked down at her hands, as if checking the state of her nails.

"I have the best here," she assured the old man. "In our own country." She ignored his glare, contemplating her hands all the while. They were pale and finely-formed, with an angry scar here and there.

"All being well," the dictator said at last, "how soon can you perform the operation?"

"You need to lose some weight first, if possible."

"A tall order," he smirked. "But I will stare the devil of temptation in the face."

Mrs Sampras clutched the handles of her satchel, suddenly white-knuckled with fury. She breathed deeply before replying.

"Which of your devils you stare in the face isn't my affair. You need to lose a quantity of fat, in order to have a better chance of recovery afterwards."

The dictator appraised her through her overcoat, estimating her measure.

"As a woman, you have a favourite diet, no doubt?"

Gala flinched, white as electrical flex. "Anxiety about one's loved ones suppresses the appetite, I've found. If this is not a possibility for you, you might try being raped."

An awful silence expanded to fill the room like methane gas. Mrs Sampras had overstepped the line; she knew it and the dictator knew it and Mrs Sampras knew the dictator knew it, and so on. A reckless blow had been struck to a frail and delicate balance. There was now a strong possibility that the dictator would have her tortured and shot, and that he himself would die under the knife of a lesser surgeon.

For a minute, both of them looked different kinds of death in the face. The vision of a benign future in which the dictator lived to an Old Testament age and Mrs Sampras vacationed with her family in the summer, trembled like a child's castle of blocks between them, ready to collapse at a single clumsy step.

At last the dictator spoke.

"Mrs Sampras. I am a rational man. I know that anxiety about loved ones is a very different thing from what is actually happening to them. The situation can be better than you fear-or much worse."

Mrs Sampras replied immediately:

"You are right, Mr President. But much as we strive to be rational, anxiety can defeat us. It defeats me, anyway. Sometimes I worry so much about my husband and children that I lose more than my appetite." She held up her hands to show they were trembling. "This is a terrible thing for a surgeon."

"You are tired," he said. "Let my staff show you to your quarters. When you've rested, we'll meet again."

And with that, he pressed a button for the door to open. A soldier glanced nervously into the room, confirming with a quick head count that both the president and the surgeon were, at this stage, still alive.

The dictator was not expecting to see Mrs Sampras again until the next day. Despite the cancer inside him, he was confident that he was not one of those weaklings who would die in a week, but rather that he had the full half-year. He did not understand statistics or the law of averages, but he had often achieved what experts considered impossible and would no doubt do so again.

Late in the afternoon, the dictator was surprised to learn that Mrs Sampras was ready to see him again. She'd had plenty of rest, she said, and the sooner the preparations were underway, the better.

In the golden afternoon light, Mrs Sampras looked subtly different. She had changed her clothes, washed and groomed her hair. The overcoat was gone, and she looked every inch a woman.

"Of course," she said, "you understand there are grave risks in any surgical operation."

"Of course," the dictator said. "For the surgeon no less than for the patient."

"More for the patient, I would have thought," suggested Mrs Sampras.

"Oh no, I'm sure the risk is equal," the dictator begged to differ. "A death affects not just the person him or herself, but spouses, children... It's a... what is the word I'm looking for? A knock-on effect."

Mrs Sampras was tired of standing. She half-perched on one corner of the great desk.

"What is your blood type?" she enquired coolly.

"Blood type?"

"Yes. A, B, B positive, O..."

The dictator shrugged and spread his hands, open-palmed. Such knowledge was a luxury too rarefied for one whose only concern was the good of his nation.

Mrs Sampras opened her satchel and extracted a disposable hypodermic.

"Your right arm," she demanded.

He tried to push the sleeve of his suit jacket up, but it was too stiff. So, he removed the garment, hanging it carefully over the back of his armchair. Despite the unhurried deliberateness of his exertions, Mrs Sampras noted he was breathing heavily, his lips paler and bluer, his nose more purple.

Seated once more, the dictator extended his bared forearm across the desk towards her. She took hold of it and stroked a vein, encouraging it to swell up for her.

"You have a touch like velvet," the dictator said. "And beautiful fingers."

Mrs Sampras removed the tiny plastic sheath from the needle of the hypodermic.

"Just a little, little prick," she said.

The next morning, the dictator's blood had been tested. "You are B positive," Mrs Sampras informed him.

"Is that unusual?"

"Common, very common," she said.

"Good," the dictator beamed. "That means the hospital will have it in plentiful supply, yes?"

"In our country," said Mrs Sampras, "blood of all kinds is in plentiful supply."

She did not look at his face to note his reaction. Instead, she stared at the vase of flowers standing on his desk, troubled by its presence there. Evidently the dictator had observed yesterday how the aridity of the office had struck her. So, today, he'd softened it with flowers. Especially for her. The vase was iridescent blue. Red, white and pink carnations sprouted up from the neck. They looked so ghastly and ill-at-ease, Mrs Sampras wondered if they were real.

"You're wondering if they're real," said the dictator.

"Yes," she said.

"Of course they're real," he purred. "Touch them."

"I believe you, Mr President.

"Touch them."

Mrs Sampras hesitated. She wondered if her future, the future of her husband and children, was hanging in the balance at this moment. In the labour camp she had sunk to the cowardice-or found the courage-to lick boots and worse, and yet just now she found it absurdly difficult to touch these flowers.

"Brighten up the place no end, don't you think?" said the dictator, letting the challenge go.

"Yes," she agreed. "But of course, as soon as they're cut, they begin to die."

The old man half-closed his eyes, as if weary of people with a poor grasp of realities.

"There are more where those came from." And, without warning, he leaned across the desk and handed Mrs Sampras an envelope.

Gala strove to remain calm as she examined the photographs of her family. She breathed deeply and blinked repeatedly. Her hands were steady as she shuffled the images over and over.

At last she said, "The photographs of my children are very good, very clear. One can see that they were taken recently."

"Well, they grow up so fast, don't they?" he said.

"Yes, by the grace of God they do," said Mrs Sampras. "But the photograph of my husband seems less recent. In fact, it could have been taken years ago."

There was a creak as the dictator leaned forward and interlocked his hands on the desk.

"I assure you it is recent."

She held the image close to her face, frowning.

"He doesn't look anywhere near as old as I would expect him to look."

The dictator laughed.

"Would that flatter him-or cut him to the quick?"

"I don't know," said Mrs Sampras. "I will have to ask him myself."

"I do hope you get your chance."

"Ah, yes... The question is when."

"The answer is, as soon as possible. It would gladden the heart of an old man to witness such a reunion. I'm looking forward to it enormously. I'm sure it will be a high point of my convalescence."

"You will still need to lose weight," Gala sighed.

The dictator sprang to his feet and swung his arms vigorously, as if running a marathon.

"See!" he teased, breathlessly. "I've begun already!"

A week later, on the morning of the operation, Mrs Sampras and the dictator met in his office once more. The dictator was identical in shape and appearance, but invited praise for having shed a number of pounds. Mrs Sampras praised him, reserving conflict for the arena where it mattered.

"You cannot have men with guns inside an operating theatre," she said, when they discussed the arrangements for the afternoon.

"They will stand well back," argued the dictator. "You will hardly notice they are there."

"One speck of dust from a rifle," said Gala, "contains a million germs, enough to rage through your body like a plague. A soldier's belt buckle can kill you, not just in the way that is usual in our country."

"Do you think I don't know that?" demanded the dictator. "I have a degree in these things. What I meant was, my men can watch you through the glass. It will be educational."

Gala looked the old man straight in the eyes.

"I hope they have not been instructed to shoot me if I appear to be harming you," she said quietly. "After all, I am going to cut a hole in your chest, open you up like a satchel and put a stop to your heart. They know, I trust, that all this is as it should be?"

If the dictator was discomposed, he didn't show it.

"It is your... gentleness they will be watching for," he said. "Your thoroughness, your keen concentration, your... finesse. You see, they've heard that when you apply yourself to the task, you do it with love, as if your very own child was lying there." His fat hand made stroking motions in the air, describing a crescent curve, like a half-moon, an infant's head, a woman's naked breast. "And of course," he continued, "they will be watching at the end, to see me wake up."

For the first time, Gala allowed herself to consider the possibility that, for all her skill, the sheer force of nature, of statistics, might dictate the outcome.

"Mr President," she pleaded. "You understand that this operation has been rarely performed, and usually on much younger men."

He laughed, throwing up one arm in the general direction of his portrait.

"Let's be optimistic!" he roared. "This country was built on optimism, after all."

Outside the window, a whistle blew. The dictator leapt to his feet, as if he'd already been granted a new lease of life. He motioned to Mrs Sampras to accompany him to the window. Rather than feel his hand grasping her arm, she hurried to comply.

They looked down into the courtyard. A teenage girl was walking uncertainly between two phalanxes of soldiers. Despite the fact that she had a young woman's figure, a fashionable haircut, and other features that made her almost unrecognisable as the child she'd been only a few years ago, she was unmistakably Gala Sampras's daughter.

"What is she doing here?" whispered Mrs Sampras.

"She is on her way to meet you," said the dictator. But, before Gala could recover from her sharp intake of breath, he added: "It's a shame she has arrived a little too early. I sometimes forget how fast our country's trains are nowadays."

He escorted Mrs Sampras to the door, laying his palm gently on her shoulder, for she seemed a bit bewildered.

"It's all right," he reassured her. "We'll keep her occupied until you and I are finished. I'm sure we can find some people her own age." And he smiled sadly, squeezing the surgeon's shoulder like an old friend.

In the operating theatre, everything was perfect and civilised and still. There wasn't a soldier to be seen. Four nurses and an anaesthetist stood waiting like nuns, glowing under the tungsten light. The equipment and the furnishings were as modern as Dr Sampras might have expected from the most up-to-the-minute hospital in America.

The dictator lay on the operating table. The oil had been shampood out of his hair, and a few wisps stuck out from beneath his disposable cap. Freed from the restrictions of his uniform, his flesh lolled grossly under the thin sheet. Horizontal, his circulation was improved, and his lips were as pink as a baby's.

"Hello, Mrs Sampras," he winked.

She approached him, not speaking. Her gloved hands were in mid-air, hovering in limbo, postponing the moment. Her face was shrouded in gauzy paper, a veil which allowed only her dark eyes to show.

"Is it you behind that mask?" persisted the dictator.

"Yes, it's me," she said emotionlessly.

"It covers your prettiest features."

The anaesthetist, a woman too by the shape of her eyebrows, looked to Gala and nodded. Colourless liquid began to trickle down a thin plastic tube into the cannula taped to the dictator's pale wrist.

The old man's face softened and grew infantile. Gala noticed for the first time that he had long soft eyelashes, like her own children. Those eyelashes were fluttering now, as if the old man were struggling against infant sleep at bedtime.

"If I should die before I wake..." he murmured.

"Don't worry about such things," Gala advised him. "We both have a long night ahead of us."