My reminder of mortality came in early 2010, and I found the narrative that followed raw but completely engrossing. For the present, but only for the present, it is behind me.

When cancer was diagnosed and I found myself facing lengthy treatment, I discovered I was by no means the only one. Several friends had had oncological or other life-threatening diseases before me, others were still ill and yet another received the diagnosis while I was undergoing treatment and was able to offer advice. Vera Millionshchikova and Galya Chalikova will never read this essay, having passed away, taking their own unique insights with them.

There are important things to know. I will list my insights for those who will face the exam in years to come.

 

A prelude

 

In the autumn of 2009, the owner of an art gallery came to see my husband. He said, ‘Andrey, I’m staging an exhibition. It’s going to be called Half.’

‘Half of what?’ Andrey asked.

‘Just the concept. Half of anything.’

Andrey shrugged.

When I arrived later, he told me about it.

‘Oh,’ I said, ‘the bright ideas of these curators are such a pain,’ and went back to my half of our apartment. But I thought about the question of how you could physically represent a half. I love solving other people’s problems for them, so I went to my chest of drawers, found a pretty French brassiere, took a pair of scissors and cut it in half. I carried it through to the studio.

‘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 outpouring 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 making 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.

Lika with me all day. She came at seven in the morning and sat with me until eight in the evening. She is an angel. Lyuba peeped in. An unimaginable comfort in these circumstances. Most importantly, analysis found no carcinoma in the lymph nodes. My armpit is left alone. In a week’s time a histological check before deciding how to proceed.

My neighbour in the ward is a kindergarten teacher from the north, on a pension. She was supposed to have her operation in Haifa but wanted Dr Zamir. Theoretically she should have to pay 18,000 shekels, but insurance covers 15,000, leaving her just three thousand to pay – less than one thousand dollars. In effect, everything is free. This is socialised medicine. My neighbour too had that very latest injection and is not in pain.

I am here privately, but special. Dr Lesha Kandel is a friend, and Vladimir Brodsky, the chief anaesthesiologist, is a friend of his. All the Russian doctors are coming to me for book signing. VIP! Aside from the interest in my books, everybody else gets exactly the same treatment, only without paying.

Poor Russia! 145 million people going under the knife without anaesthetic, rolled in the dirt and infected in hospitals with God knows what. Poor Alla Belyakova. They found she had bowel cancer. The Blokhin Centre said, ‘Go away, it’s too late!’ She was admitted in Troitsk, south of the Urals, and is delighted. It is a horrible cancer, and poor Andrey, her son, is autistic. What will become of him?

My breast is completely absent: there is even a dent. It has been interred in a special burial ground at the Givat Shaul Cemetery. Lesha Kandel buries all the amputated Jewish appendages from his orthopaedic department there. ‘For some reason, Muslims and Christians seem totally unconcerned where their removed organs or body parts lie,’ is what he said.

My left breast is at rest in the land of Israel. Perhaps only a first instalment!

I am staying with Lika. A strong draught blows through the apartment. Something slithers, and then falls, in the kitchen. I go in and close the window. On the floor is a picture that had been on the fridge. It is by an Israeli artist, Miriam Gamburd, exhibited in Paris in 2001. Fleshy, busty women are taunting an Amazon who is central to the composition. She has her hand on one breast. The other, the left breast, has been amputated. We are stunned. The picture had been there for ages but we only noticed it today.

So many mysterious, significant happenings. My world is protecting me: my friends, friends of friends, their relatives, the doctors. Everyone is looking after me, and pride of place goes to Lika.

In spite of everything, it has come together wonderfully. There is so much joy here. I should have a small ex-voto silver breast made and hang it in church on an icon of St Panteleimon or someone, even if the breast was not actually saved. Good Lord, it has been done already – Andrey’s ‘half’ was my ex-voto!

Poor breast! It took me such a long time to get round to saying goodbye. Of course, it had behaved very badly, but I have a lot more to apologise for. Seventeen years of hormone replacement therapy!

Why am I writing all this? Because I need to develop a new relationship with my body, and primarily with my breasts. As I approach three score years and ten, I have all sorts of things to feel guilty about, but right now I feel worst about what I have done to my poor body. How odd, that after a lifetime of being offhand, even cruel, with my blameless body, I have only realised it now!

This whole story is beyond belief. It looks as if I am going to get away with it, but even if I do not, so much here has been wonderful.

I heard yesterday that Galya Chalikova has stage 4 ovarian cancer with metastases, and ten litres of fluid in her abdomen. I phoned and asked her to consider the Hadassah. The third catastrophe in the last few months: Alla Belyakova, Vera Millionshchikova and now Galya. My own gnat bite hardly merits mention. It is all just heartbreaking.

I am reading Conversations with Alfred Schnittke. Brilliant, in places astounding: ‘After my stroke there is a lot I do not understand, but I know more now.’ Intuitive knowledge. I can allow myself to cry over that. Jerusalem is a city with plenty of places where you can go to weep, but it is not obligatory.

 

Ten days later. I hear I will need a second operation because a cancer cell has been found in one of the five glands, where the analysis had shown nothing. It is scheduled for 3 June. It will take slightly less time, but the basics are the same: general anaesthetic, drainage, healing. It may hurt more. Afterwards the likelihoods are: five years of hormone treatment, for sure; local irradiation, possibly; and, the worst option, eight courses of chemotherapy at intervals of two weeks, over four months. I am obsessive about making contingency plans, but it seems even the worst option means everything will be done by October. There are, however, more dire possibilities. I am at stage 3 by the Russian definition, but with metastases in the axilla.

It is Trinity Sunday and tomorrow is Monday of the Holy Spirit. It is four in the morning and the megaphone-voice of the muezzin broadcasts the call to prayer. I willingly join him.

I am waiting for it to be morning, and hoping to see Zamir today so I can fit in a lightning trip to Moscow before chemotherapy.

I am writing away at the novel but it shows no sign of coming to a conclusion. I am on edge and tired, I feel unwell, but very happy. In fact, full to overflowing. I discover Gidon Kremer and two other musicians on YouTube clowning about with themes from classical music. Like Nabokov writing about Chernyshevsky, the priest’s son playing quite unselfconsciously with his father’s censer. Young people amuse themselves by playing with things that are sacred. They are in their element.

 

A week in Moscow. Hard going. Lots of people, things to do, none of it really necessary. I visit Vera Millionshchikova. She is in remission. Her skin is peeling, her nails growing back, new hair appearing. She is settled in a hospice, on the understanding that she will die.

 

Jerusalem. I fly back with one day to spare. What do I feel? Nothing. Tomorrow, 3 June, I have the second operation.

The operation was yesterday. I feel all right. My arm is not painful if I do not move it, but is if I make sudden or sideways movements. I will be discharged tomorrow. It is hot, the light is strong and I have an extraordinary sense of clarity, although quite what is clear I cannot express.

 

Ein Karem

 

I have been living for over three months in Ein Karem now, and it is one of the most magical places on earth. Until 1948 this was an Arab village, and it became Jewish overnight, as it had been two thousand years ago, when the Arabs left for Jordan on the day Israel declared independence. John the Baptist was born here, and this is where the two most famous Jewish women met, Mariam the mother of Jesus and Elisheba the mother of Johanaan. Mary and Elizabeth. There is a spring where they are said to have met, and a nearby well, where they are also said to have met. You are shown a cave which supposedly housed the dwelling where John the Baptist was born.

Everything here proliferates. Several places claim to be where the mothers met, and there is more than one monastery: St John in the Mountains, the Sisters of Zion, the Sisters of the Rosary and the Russian Orthodox Gorny Convent. From my favourite, the Sisters of Zion Convent, you have the best view towards Jerusalem. I was there yesterday, on the Feast of the Transfiguration of Our Lord. There was no service, because the Orthodox and Catholic calendars are different, and it was too difficult to go up the hill to Gorny. Yesterday the temperature was a record forty-three degrees.

I went into the empty chapel, and then out into the orchard. The fruit is not consecrated, but the trees looked beautiful and seemed none the worse for it. Nearly all the lemons were green. A pear tree had fruit scattered over it like light bulbs. There were a lot of pomegranate trees, the loveliest of all. Most of the pomegranates had a crimson-lilac hue, although some were still green. Others were no longer green but had yet to turn purple. They gleamed like gold in the sun.

Alphonse Ratisbonne, a baptised Jew from France, founded the convent 150 years ago.

The village is in a valley, with the vast Hadassah Hospital above it. Apart from my left breast buried in Givat Shaul, the rest of me is alive, feeling very well, and looking forward to continuing for some time yet to explore the world, to rejoice and reflect on the magical and interesting way that life is arranged.

I have time now to think about what has happened to me. I am undergoing chemotherapy, with radiotherapy to follow. The doctors are optimistic and have decided I have a good chance of coming out of this alive, but of course I know that, ultimately, nobody gets out alive. A strikingly clear and simple thought has occurred to me: illness is a matter of life, not of death. What matters is how we comport ourselves as we walk away from the last home we live in.

There is also the major topic of suffering, which I am thinking about all the time but so far without reaching a conclusion. My ideas would not go down well with any Orthodox priest. It seems to me that suffering simply should not exist. The fact that it can evoke heroic endurance and courage is beside the point.

I am renting a small, single-room Arab house built on the roof of another house, large and incredibly beautiful, one of the most beautiful houses I have ever seen. How the Arabs who had to leave all this behind, almost without warning, must grieve for it still.

Israel inclines you to reflect. The story of this land is all about insoluble problems. It is a minefield of peoples and ideas, a minefield of history. Dozens of tribes have been exterminated, hundreds of languages and ancient communities have been lost. It is a cradle of love, and a place where people choose death. It is the land of revelation (as I do not doubt), but revelations occur in other places too, anywhere. History begins at any point in time.

The Big Green Tent is still not done. I cannot remember a time when I was just writing it – I seem always to have been trying to finish it.

After my third bout of chemotherapy I could work no longer. I could neither read nor sleep. It was extremely hot in Israel, but in Moscow and the rest of Russia the heat was even more unbearable. My son Petya and his family stayed in Moscow, unable to leave because there were no tickets, or because they had no strength, or because they had nowhere else to go. With two small children at home, they barely went outside the apartment. They installed an air conditioner. The smog was so dense they could not see the next apartment block. It was very distressing. I would have liked them to come to Israel, but they had no passports for foreign travel.

There were three-week intervals between the injections. I was all for flying back to Moscow to see to the children, but everybody advised against it, so I spent another month and a half in Ein Karem. During the worst weeks I hardly came down from my roof. Friends visited me, bringing food I could not bear to look at. Everything lost its taste – eating was like chewing cotton wool.

A miracle occurred. For the past few months I had been listening a lot to music, partly as a professional obligation. The protagonist of my novel is a musician, and I needed to live through this aspect of his inner life. I read a lot of books on music, but by now the drugs had so flattened me that I could only lie there like a dead fish, incapable of doing anything other than listen to it. I began doing so, almost twenty-four hours a day.

I always knew my limits, having given up music school at the age of ten. For many years that joyful sense of liberation defined my relationship with the piano. It was an instrument for torturing children and I avoided it. My happiest memory from those years is the wonderful musical discord I heard walking down the school corridor. Music emanated from every door, merging into a marvellous noise of everything playing at once, new every time.

Ten years passed before I listened to music again. Not Beethoven and Schubert, but Scriabin and Stravinsky, Prokofiev and Shostakovich. I went to concerts at the Scriabin Museum and listened to Mahler. It was great, and very much the in thing, but music was only one cultural component of my life and there was much else besides. Nevertheless, I always knew I was skirting the edge of a dense forest, not venturing into the depths.

Here, in Ein Karem, something happened. New possibilities of perception opened up. Perhaps one side effect of the poisonous chemicals permeating me was to break down a membrane preventing music getting through to me. It was a dramatic change. In the night, up there on my baking hot roof, I listened and listened. Sasha Okun kept me supplied with excellent CDs and I could not have wished for a better guide through the forest. Lika brought a player, which sounded wonderful in Israel but when I moved back to Moscow, it seemed fairly indifferent. Were my ears sealed again?

Seemingly not. I do not know how many times I listened to the Art of Fugue played by Samuel Feinberg, better than Richter in my estimation. Just as many times I listened to the sonatas of Beethoven, Schubert and Haydn, and to so much else. Music was flushing the poison out of my system.

I had more radiotherapy, and in those weeks, bald, weak but in good heart, I again set about finishing my novel.

 

Hadassah

 

I moved to another apartment, still in Ein Karem. Now I have a separate house next to the Greek church. On the other side of my fence is the cottage of the caretaker and the priest, apparently the same person. The windows of the church are wide open and I can follow the service from my balcony. My landlord is a devout Jew born in İzmir in Turkey. His wife is from Australia and works at the Hadassah Hospital as a nanny for very small children, of which she has plenty of her own. They are loving parents, not strict, but the children are respectful and cheerful and do as they are told. They invited me one time to Shabbat, a busy table with teenaged sons, daughters and their young friends, a single lady who was a neighbour and me, the tenant. Our host is Sephardic so there was none of that nostalgia for the herring, potatoes and pickled cucumbers of East European Jews. It was Middle Eastern fare, bread and wine – an unfamiliar style, quite different, but with the same prayers and blessings.

Five times a week I went to the hospital, as if I worked there, to be irradiated by the electron gun. An uphill path took me from the village to the hospital and the oncology department. A helicopter pad on the roof can be seen from afar. In wartime the wounded are brought here, delivered within two hours from any part of the country. Israel is small and wars and terrorist attacks are frequent. The hospital is enormous, with as many storeys underground as above. The bottom floor is a locked surgical department, fully operational in case of war. This country respects and takes good care of its soldiers. That is another topic, and any comparison of the lot of Russian and Israeli service personnel can only bring tears and recrimination. We have a lot to learn from the Israelis about how to organise our health services, as well as about the relationship between the army, the government and society.

But I digress. I now have a detailed knowledge of Hadassah Hospital. I know its doctors and nurses, its long passages and corridors covered in plaques with the names of benefactors. ‘This chair, piece of equipment, office, department was donated by so-and-so’ in memory of a deceased grandmother, grandfather, mother, sister. On the ground floor is a synagogue with stained glass by Marc Chagall, donated by the artist.

This is a state hospital, the largest in the land, and it attracts huge donations from Jews in Israel and all over the world. The traditional tenth of your income paid as a tithe is now most often donated not to a temple but to charity. Scientific research benefits particularly.

The hospital is full of volunteers. Jewish women in wigs push trolleys with drinks and pretzels, or take wheelchair-bound patients for a walk. All citizens of Israel are treated here, Jews and Arabs alike, and the doctors too are both Jewish (half of them from Russia) and Arab. After my surgery I witnessed a comical scene: two patriarchs were wheeled down the corridor towards each other. One was Jewish, wearing a black velvet kippah and Hasidic robe, followed by his wife in a wig and a posse of children, from teenage to very small; the other was a handsome sheikh, resplendent in white cap and robes, with his wife behind him in a richly embroidered dress, and also with a whole brood of children. Both had had surgery for cancer. They drew level, nodded to each other without making eye contact and moved on. Hadassah is a zone if not of peace then of truce. It is like a watering hole: when it is a matter of life and death, passions subside, ideology takes a break and territorial disputes become meaningless. A person needs very little space in a cemetery.

At the hospital, doctors fight for people’s lives, and the value of every life is the same. The patient should not suffer pain: that is a principle of all civilised medicine. Ten times a day, during every procedure, you are asked, ‘Does that hurt?’ One time I replied without thinking, ‘It’s fine. I can put up with it.’ ‘What? You are in pain? But that is bad for you! We must stop the pain immediately.’

This is what they are taught at medical school: pain must be prevented. Mine has been the Soviet experience: dentists only recently began anaesthetising their patients. Throughout my childhood and youth they drilled teeth, tore them out by the roots, changed dressings and removed stitches regardless of pain. Unfortunately, I know only too well how difficult it is to get painkillers in Moscow, even for patients in the terminal stages of cancer. Imagine the situation in the provinces. And then there are the maternity hospitals where staphylococcus is endemic. They cannot be sterilised with ultraviolet light from quartz lamps because nothing is capable of sterilising ruins.

These thoughts usually come to me on the way back from radiotherapy. Of course, you do sometimes suffer radiation burns here too, but they protect you as much as possible. A lead shield is moulded specifically for each patient in accordance with their anatomy, to prevent the radiation from damaging the heart and lungs.

Cancer is a cruel disease and, despite the doctors’ best efforts, patients are by no means always cured. People die even in the best clinics of America, Germany and Israel. But the situation is far worse in Russia.

I really cannot imagine what it would take to raise our Blokhin Centre to the level of Hadassah.

I walk back down the path, past the accommodation for the medical staff, past the car park, and every rock is familiar, every tree. The wall of the Franciscan monastery is to my right. I go on past, down to the spring where the road divides, up to the Gorny Convent or down to the bus station, with the kindergarten on the left. Here is the turning to the Museum of Biblical History, invariably closed, and then I am back at my house. One wall is built of ancient stones, another of plasterboard, a third of brick. It has been thrown together like the house of Cobbler Pumpkin. The windows are different sizes and the door does not lock. It is getting hotter by the day. I still have not finished my novel. But there is only a little more to write.

Artwork © Andrey Krauslin, from Half, 2009