Loss of Loss

by Reva Zerkalo

Loss of Loss

Serbsky Institute, Moscow 2009

Chapter 1          Doctor Pavlov Dog

Doctor Pavlov Dog crept into the room so silently, Izolda jumped when she saw him. The crêpe-soled creep.

‘Where's Kolya?'

Before he made a pronouncement, the curls in his red beard had a strange tendency of undulating ever so slightly. She watched them glisten under the fluorescent light before averting her eyes. ‘Izolda Alexandrovna, you're sabotaging your medicinal regime.'

‘Where is he?'

She'd got into the habit of counting the tiles on the walls during her sessions with Doctor Pavlov Dog. Why a psychiatrist's consulting room had to be clad from floor to ceiling in cracked, off-white tiles worthy of a mortuary was beyond her comprehension. They were laid in a brick-wall pattern and the grouting was filthy. It probably channelled bacteria. She imagined troops of germs marching up and across and down the grout lanes. The shortest distance between any two points along that wall was a zigzag parade.

‘Your lover is still being assessed. I'm not prepared to discuss it any further.'

Doctor Pavlov Dog released the suction of his diagnostic gaze. Izolda could sense this without looking at him; she felt lighter, an unanchored balloon. He'd stolen to a corner of the room and was rustling around.

What made the tile-counting exercise even more strenuous was the supersized portrait of Vladimir Vladimirovich on the wall. How to calculate the number of tiles concealed behind his scanty hair, his sneer, his botoxed brow? She felt his icy blue stare penetrate her: he did not approve of her questioning why such a small man took up so many tiles.

‘With your diagnosis, you have no choice regarding your prescribed medicine.'

A plasticky, ripping sound followed. Then more rustling.

‘Two thousand, seven hundred and sixty five.'

         ‘What did you say?'

Chort voz'mi. She'd spoken aloud. The number of tiles on the wall opposite the door, give or take the obstacle of the Putin portrait. She must exert more discipline and keep her thoughts to herself.

          ‘Oh, nothing, Doctor Pavlov.' Dog. ‘But I can't take any medicine in my condition. What about the baby?'

From the corner of her eye she could see him sliding up to her. He was holding something; wielding it, approaching with a hypodermic syringe.

‘With all due respect, a woman like you is unfit for motherhood. I would strongly suggest abortion.'

She forced herself to look at his face. A smirk twitched behind his bristling beard.

            ‘We held a Review of your case. I conveyed my opinion you're not taking your medicine as prescribed. So your symptoms are not alleviating. To the contrary, your psychosis is progressing.' 

Doctor Pavlov Dog tapped the syringe against his palm as he spoke. The armies of bacteria parading along the grouting had picked up speed and were waving fluorescent orange flags as they stampeded. She was having difficulty keeping up with them.

‘I recommended admission as an inpatient until such time as your schizophrenia is under control.' He was swooping the syringe in the air, a conductor in front of an invisible, silent orchestra. ‘However, Doctor Lebedeva, suggested you could trial our prolonged-release quetiapine treatment, as an outpatient.'

            She deliberated the hypodermic syringe, bubbles merrily suspended in its viscous liquid.


            ‘Izolda Alexandrovna, you're not in a position to say “no”. Without quelling your psychotic symptoms with a drug such as this,' he wagged the needle like an admonishing finger, ‘You'll be at risk of posing a danger to yourself and to society at large. I have co-signed this prescription.'


            ‘Are you qualified in psychiatry? Do you even hold a degree in medicine?'


            ‘You aren't and you don't. So it would be reasonable to assume you're not sufficiently competent to make an informed judgement.'

She studied the fountain pen on Doctor Pavlov Dog's desk and wondered about all the living-death sentences it had signed. Its nib was inordinately sharp. She picked it up. She could stab out his x-ray eyes with it.

            ‘Put that down, please.' Doctor Pavlov Dog's voice was burgeoning, generating echoes off the tiles.

He placed a hand on her shoulder; it felt as heavy as an elephant's foot. Sinking through the floor, she clutched onto the desk.

            ‘Look at me.' Doctor Pavlov Dog took hold of her head in both hands and slowly turned it so she faced him. He was so close to her, she could count the rusty hairs sprouting from his nostrils. She was overwhelmed with the desire to pinch hold of the longest nostril hair and tug. Doctor Pavlov Dog was crouching at eye-level, breathing heavily. He loomed closer, mouth half open. Was he on the brink of kissing her? Would the horror ever pass? She let go of the desk — it would be infinitely preferable to sink through the floor, and to whatever hell waited for her below, than to contend with Doctor Pavlov Dog.

            ‘That's better.' His breath stank. Her stomach turned. A reason for the tiles on the walls, she thought: vomit.

Doctor Pavlov Dog grasped her hands and pulled her to her feet.

            ‘Lie down on the consulting couch.' He led her to the couch, draped in a sheet; so starched and white, it hurt her eyes.  

            ‘Lower your trousers and lie on your stomach.'

            She must not let him stab her with that syringe. Once he'd injected her, she'd be a zombie for months. Incapable of escape.


            ‘You have no choice in the matter.'

            Doctor Pavlov Dog grabbed the waistband of her trousers. She wriggled, to slip his grasp.

            ‘You're trying my patience.' He wrenched her trousers down. Buttons popped and skittered over the linoleum floor. They reminded her of the Tiddlywinks she played with Mama and Papa, years ago, when life was new and uncomplicated... What was her favourite Tiddlywink colour? She had to remember. It was important to recollect the good things.

            ‘Yellow,' she said.

            Doctor Pavlov Dog pulled down her pants and pushed her, face down, onto the couch. She heard the metallic jangle of buckles as her arms were tugged above her head, wrists enclosed in soft fabric which whispered like clouds.

            ‘Blue. I liked the blue Tiddlywink best!'

            ‘Quiet. You're hallucinating.'

            His fingers were sausages sizzling their way up her. She thrashed around, trying to eject them.

            ‘Lie still, or I'll have to apply a four-point restraint. This is a medical examination. It won't take long.'

            ‘Papa always let me win.'

            ‘Calm down. Support yourself on your knees and I'll continue without further delay.'

            Doctor Pavlog Dog's asthmatic breathing rasped around the room. It had split into separate layers of sound, each thin layer chasing the other. He pulled his fingers out, dragging her entrails along with his fingertips. More rustling, followed by the itchy sound of a zip unzipping.

            ‘We played on the parquet floor. The different colours looked so pretty on the herringbone pattern.'  

            Doctor Pavlov Dog took hold of her hips and pulled her upwards.

             Something simultaneously soft and hard nudged against her buttocks. It was pulsating, leaking a slow, clammy liquid onto her skin. It reminded her of... Kolya. They'd made love. Like this, but not like this. Not like this. 


            A searing pain ripped through her as Doctor Pavlov Dog slammed into her. The pain travelled through her, up, up, up, spraying from her mouth in a piercing scream. Doctor Pavlov Dog clamped his palm over her mouth.

            ‘Quiet, suka!'  

            Tap, tap, tap: knocking on the door.

            ‘Everything alright?' a miniature voice enquired. It sounded so far away.

            ‘Blyad,' Doctor Pavlov Dog muttered, scrambling away from her. He yanked up her pants and pushed her so she was lying flat on her stomach.

            ‘Come in, come in.' Doctor Pavlov Dog's voice rang out, a parody of his real voice; brighter than bright.

            A creaking sound, followed by a clipclopping of high heels.

            ‘Anatoly Petrovich, what's going on? I heard screaming.' A woman's voice. It sounded familiar.

            ‘Lyudmila Ivanovna, I've been experiencing resistance from our patient. She refuses the injection.'

             A hand was placed on Izolda's arm. Its dry coldness was soothing.

            ‘There's no need for limb restraint.' The shackles were released from her wrists and tranquil fingers lowered her arms to her sides. ‘Izolda? It's Doctor Lebedeva.'

            She shivered, then a cloud of fabric drifted over her bare legs. She turned around in slow motion, wincing at the waves undulating inside her.

            ‘Doctor Lebedeva, your colleague tried to...' 

            Doctor Lebedeva's make-up was unfailingly immaculate. Izolda liked the way her lip liner described a perfect bow on her upper lip. It was a work of art. Her portrait should have graced the wall instead of Putin's.

            ‘Try to calm down. You've got to have this injection. Trust me. If you don't, you'll have to stay here for goodness knows how long. It won't hurt.' Doctor Lebedeva placed a healing hand on Izolda's thigh.

            Her voice was so calming, it segued into a lullaby. The golden Orthodox cross dangling around her neck twinkled celestially. She closed her eyes and capitulated as the needle slipped under her skin.

            ‘Where's Kolya?'

So dark. So quiet. So nothing. At last.