For a second time she asked the conductor where she should get off.

'I've already announced it,' the woman replied matter-of-factly. 'Have you gone deaf?'

The passengers standing in the aisle didn't respond when Lyudmila asked whether or not they were getting out. They just stood there as though turned to stone, reluctant to make any movement at all.

When she was a child, Lyudmila had gone to the preparatory, 'alphabet' class of the Saratov girls' high school. On winter mornings she had sat at table, her legs dangling, drinking her tea while her father spread some butter on a piece of warm, white bread… The lamp had been mirrored in the samovar's fat cheek and she hadn't wanted to leave her father's warm hand, the warm bread, the warmth of the samovar.

It seemed as though there had been no November wind in this city then – no hunger, no suicides, no children dying in hospital, only warmth, warmth, warmth.

Her elder sister Sonya, who had died of croup, was buried in the cemetery here. Alexandra Vladimirovna had named her Sonya in memory of Sofya Lvovna Pyerovskaya. She thought her grandfather was buried here too.

She walked up to a three-storey school-building. This was the hospital where Tolya was.

There was no sentry at the door, which seemed a good omen. She found herself in the stifling hospital atmosphere. It was so sticky and viscous that however chilled you were by the frost, you wanted to go back outside rather than stay and enjoy its warmth.

She went past the washrooms which still had notices saying 'Boys' and 'Girls'. She went down the corridor, past the smell of the kitchens, and came to a steamed-up window through which she could see a stack of rectangular coffins in the inner yard. Once again, as in her own entrance-hall with the still unopened letter, she thought: 'Oh God, what if I drop dead this moment!' But she strode on, along a strip of grey carpet, past some bedside tables with familiar house-plants -asparagus and philodendrons – till she came to a door where a hand-written sign saying 'Registry' hung next to the board saying 'Fourth Form'.

Lyudmila pulled open the door just as the sun broke through the clouds and struck the window-panes. Everything in the room began to shine.

A few minutes later a talkative clerk was looking through a long drawer of filing cards caught in the sunlight.

'So, so, Shaposhnikov A. Ah… Anatoly V… So… You're lucky you didn't meet the commandant still in your outdoor coat. He really would have given you what for…! Now then… Shaposhnikov… Yes, that's him, that's right, Lieutenant.'

Lyudmila watched his fingers taking the card out of the long plywood drawer. It was as though she were standing before God; it was in his power to pronounce life or death, and he had paused for a moment to decide.

Lyudmila had arrived in Saratov a week after Tolya had been operated on for the third time. The operation had been performed by Dr Mayzel, an army surgeon. It had been protracted and complicated: Tolya had been under general anaesthetic for more than five hours and had had two intravenous injections of hexonal. This operation had never been carried out before in Saratov, neither by the doctors at the hospital nor the surgeons at the University clinic. It was known only from the literature: the Americans had included a detailed account of it in a 1941 army medical journal.

In view of the especial complexity of the operation Dr Mayzel had a long and frank discussion with the lieutenant after his routine X-ray examination. He explained the nature of the pathological processes that had been provoked by his grave wounds. At the same time he spoke very openly about the risks attendant upon the operation. The doctors he had consulted had not been unanimous in their decision: the old clinical physician Dr Rodionov had argued against it. Lieutenant Shaposhnikov asked Dr Mayzel two or three questions, thought about it for a moment and then gave his consent. Five days were then taken up with preparations for the operation.

The operation began at eleven o'clock in the morning and was not completed until nearly four in the afternoon. Dr Dimitruk, the director of the hospital, was present. According to the doctors who observed the operation, it was carried out brilliantly.

Without leaving the operating table, Mayzel solved several unexpected problems that were not envisaged in the published description.

The condition of the patient during the operation was satisfactory. His pulse was normal, with no prolapsus.

At about two o'clock, Dr Mayzel, who was overweight and far from young, felt ill and was forced to break off for several minutes. The therapist, Dr Klestova, gave him validol, after which he took no more breaks. Soon after the completion of the operation, however, when Lieutenant Shaposhnikov had been taken to intensive care, Dr Mayzel had a serious heart attack. Several injections of camphor and a dose of liquid nitro-glycerine were needed to bring to an end the spasms in the coronary arteries. The attack was obviously the result of the nervous excitement that had placed an excessive burden on an already weak heart.

Sister Terentyevna, who was on duty at Shaposhnikov's bedside, watched over his condition as instructed. Dr Klestova came into the intensive care unit and took his pulse. He was only semi-conscious, but his condition was satisfactory.

'Mayzel's given the lieutenant a new start in life and almost died himself,' said Dr Klestova to Sister Terentyevna, who answered: 'Oh,. if only Lieutenant Tolya recovers!'

Shaposhnikov's breathing was almost inaudible. His face was still and his thin arms and neck were like those of a child. There was a barely perceptible shadow on his pale skin – a tan that still remained from exercises in the field and forced marches across the steppe. His condition was half-way between unconsciousness and sleep, a deep stupefaction caused by the remaining effects of the anaesthetic and his general exhaustion, both mental and physical.

The patient spoke occasionally, mumbling separate words and sometimes whole phrases. Once, Sister Terentyevna thought he said: 'It's a good thing you didn't see me like that.' After that he lay quite still, the corners of his mouth drooping. Unconscious as he was, it looked as though he was crying.

About eight o'clock in the evening the patient opened his eyes, and asked quite distinctly – Sister Terentyevna was astonished and delighted – for something to drink. She told him he was not allowed to drink and added that the operation had been a great success and that he would soon recover. She asked how he felt. He replied that his side and back hurt, but only a little.

She checked his pulse again and wiped his lips and forehead with a damp towel.

Just then an orderly, Medvedev, came into the ward and told Sister Terentyevna that the chief surgeon, Dr Platonov, wanted her on the telephone. She went to the room of the ward sister, picked up the receiver and informed Dr Platonov that the patient had woken up and that his condition was normal for someone who had undergone a serious operation.

Sister Terentyevna asked to be relieved: she had to go to the City War Commissariat to sort out a muddle that had arisen over the forwarding of an allowance made out to her by her husband. Dr Platonov promised to let her go, but told her to watch over Shaposhnikov until he himself came to examine him.

Sister Terentyevna went back to the ward. The patient was lying in the same position as when she had left, but his face no longer wore such a harsh expression of suffering. The corners of his mouth no longer hung down and his face seemed calm and smiling. Suffering had evidently made him appear older. Now that he was smiling, his face startled Sister Terentyevna; his thin cheeks, his pale, swollen lips, his high unwrinkled forehead seemed not those of an adult, or even an adolescent, but those of a child. Sister Terentyevna asked the patient how he was feeling. He didn't answer; he must have fallen asleep.