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Excerpt of The Betrayal by Helen Dunmore
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'Thank you.'

The business of lighting the cigarettes draws them close. Russov seems calmer now. Although his fingers fumble with the lighter's catch, they don't tremble.

'Good to get a breath of fresh air.'

'Yes,' Andrei agrees, 'but you'll have to excuse me in a minute. I have a patient going into X-ray at two, and I need a word with the radiographer first - '

'Of course. This won't take a moment.'

But still he won't come to the point. Just keeps on dragging at his cigarette and blowing out jerky puffs, like a boy who is smoking for the first time. Like Kolya.

'It's a new patient. A tricky case.'

Andrei nods. 'Would you like me to take a look?'

Russov's face twitches into a smile. 'It's not a question of diagnosis precisely,' he says, with an attempt at his usual manner of lofty certainty, 'but of defining exactly what tests ought to be carried out at this stage.'

'So what are the symptoms?'

'In a case such as this... Well, in such a case one needs to be a hundred per cent certain before one takes the next step.'

'I'm not sure I understand you. What are your initial findings?'

Russov gives a sudden harsh bark of laughter which transforms his face completely. He looks almost savage. His short hair seems to bristle. 'My "initial findings" are that this patient is the son of - of an extremely influential person.'

'Ah. And how old is the boy?'

'Ten.'

'And so it's a joint problem, is it? Is that why you've come to me?' Why doesn't Russov get to the point?

'He's Volkov's son,' says Russov abruptly.

'Volkov's?' My God. It's one of those names you only have to say once, like Yezhov or Beria. Andrei's heart thuds, and he has to clear his throat before speaking. 'The Volkov, you mean?'

Russov just nods, and then rushes on. 'A joint problem, yes, I'm pretty sure that's what it is. There's swelling and redness and so on, pain on articulation, heat to the touch. That's why I've come to you. All the symptoms point to juvenile arthritis and you're the man for that. I haven't ordered tests yet, it's pure guesswork,' he adds hastily.

'You'd like me to take a look.'

'If you would. If you would, my dear chap, I tell you, I'd be eternally grateful.'

My dear chap? Eternally grateful? Sweat is still leaking from the pores of dry, competent Russov. He never talks like this. What the hell is going on? The breeze is warm and sweet, but ice touches Andrei. There's much more here than he's being told. Russov fears that this child is seriously ill. He wants Andrei to see the boy, take on the case, order the tests and then give the verdict to the family. Russov will do anything not to be the bearer of bad news to Volkov. It won't be Russov's face that Volkov will remember with the cold, hard rage that such a man will feel for anything he can't control.

Russov drops his cigarette butt, grinds it into the path and then smoothes clean gravel over the spot with his heel. Andrei says nothing. He finds himself staring at the lime leaves as if he's never seen them before. They are so fresh and vigorous. Amazing how trees always look as if they've been there for ever, even when you can remember the women stamping down earth over their bare roots.

Russov clears his throat. 'It struck me as just possible that there might be something I've overlooked. There's a risk of setting off in the wrong direction - ordering the wrong tests, for instance. In a case of such significance for... for the hospital, we can't afford any margin of error.'

And he actually has the nerve to look at Andrei self-righteously, as if Andrei is the one who has neglected to think about the greater good of the hospital community. Andrei stares back blankly. Russov's eyes drop. 'For example...' he mumbles. 'For example, you'll recall the little girl with the spleen.'

The Betrayal © 2010 by Helen Dunmore; reprinted with the permission of the publisher, Grove/Atlantic, Inc.