The old woman turned to the doorpost and began praying, while the little girl continued to breathe with a snake-like hiss. The feldsher said:

‘That’s what they’re all like. These people!’ And he gave a twitch of his moustache.

‘Does that mean she’s going to die?’ the mother asked, staring at me with what looked like black fury.

‘Yes, she’ll die,’ I said quietly and firmly.

The grandmother picked up the hem of her skirt and wiped her eyes. The mother shouted in an ugly voice:

‘Give her something! Help her! Give her some medicine!’

I could see what was in store for me and remained firm.

‘What medicine can I give her? Go on, you tell me. The little girl is suffocating, her throat is already blocked up. For five days you kept her ten miles away from me. Now what do you want me to do?’

‘You’re the one who’s supposed to know,’ the old woman whined by my left shoulder in an affected voice which made me immediately detest her.

‘Shut up!’ I said to her. I turned to the feldsher and ordered the little girl to be taken away. The mother handed her to the midwife and the child started to struggle, evidently trying to cry, but her voice could no longer make itself heard. The mother made a protective move towards her, but we kept her away and I managed to look into the little girl’s throat by the light of the pressure-lamp. I had never seen diphtheria before except for mild, forgettable cases. Her throat was full of ragged, pulsating, white substance. The little girl suddenly breathed out and spat in my face, but I was so absorbed that I did not flinch.

‘Well now,’ I said, astonished at my own calm. ‘This is the situation: it’s late, and the little girl is dying. Nothing will help her except one thing—an operation.’

I was appalled, wondering why I had said this, but I could not help saying it. The thought flashed through my mind: ‘What if she agrees to it?’

‘How do you mean?’ the mother asked.

‘I’ll have to cut open her throat near the bottom of her neck and put in a silver pipe so that she can breathe, and then maybe we can save her,’ I explained.

The mother looked at me as if I was mad and shielded the little girl from me with her arms, while the old woman started muttering again:

‘The idea! Don’t you let them cut her open! What—cut her throat?’

‘Go away, old woman,’ I said to her with hatred. ‘Inject the camphor!’ I ordered the feldsher.

The mother refused to hand over the little girl when she saw the syringe, but we explained to her that there was nothing terrible about it.

‘Perhaps that will cure her?’ she asked.

‘No, it won’t cure her at all.’

Then the mother burst into tears.

‘Stop it,’ I said. I took out my watch, and added: ‘I’m giving you five minutes to think it over. If you don’t agree in five minutes, I shall refuse to do it.’

‘I don’t agree!’ the mother said sharply.

‘No, we won’t agree to it,’ the grandmother put in.

‘It’s up to you,’ I said in a hollow voice, and thought: ‘Well, that’s that. It makes it easier for me. I’ve said my piece and given them a chance. Look how dumbfounded the midwives are. They’ve refused and I’m saved.’ No sooner had I thought this than some other being spoke for me in a voice that was not mine:

‘Look, have you gone mad? What do you mean by not agreeing? You’re condemning the baby to death. You must consent. Have you no pity?’

‘No!’ the mother shouted once more.

I thought to myself: ‘What am I doing? I shall only kill the child.’ But I said:

‘Come on, come on—you’ve got to agree! You must! Look, her nails are already turning blue.’

‘No, no!’

‘All right, take them to the ward. Let them sit there.’

They were led away down the half-lit passage. I could hear the weeping of the women and the hissing of the little girl. The feldsher returned almost at once and said:

‘They’ve agreed!’

I felt my blood run cold, but I said in a clear voice:

‘Sterilise a scalpel, scissors, hooks and a probe at once.’

A minute later I was running across the yard, through a swirling, blinding snowstorm. I rushed to my room and, counting the minutes, grabbed a book, leafed through it and found an illustration of a tracheotomy. Everything about it was clear and simple: the throat was laid open and the knife plunged into the windpipe.