I confess to a fascination with bibliographies and acknowledgments that often appear at the end of contemporary novels. What leapt out at me at the conclusion of Anthony Marra’s debut novel were two titles in the author’s research list, though I should not have been surprised by the time I’d finished reading his haunting narrative: “Amputations of the Lower Extremity: Treatment and Management,” by Dr. Janos Ertl; and “Osteomyoplastic Transtibial Amputation: Technique and Tips,” by Dr. Benjamin Taylor. Given the current number of conflicts spread across the world, amputations have become a growth industry.
In an unsettling scene filled with tension, two of the main characters in Marra’s novel use a saw to perform an amputation on the victim of a landmine (another growth industry, in spite of international restrictions). Sonja, a Russian woman and the remaining doctor in a hospital in Volchansk, instructs Akhmed how to perform the operation. He’s more squeamish than the reader and described as “the most incompetent doctor in Chechnya, the single least distinguished physician ever to graduate Volchansk State University Medical School….” Later, he will confess to Sonja that he was at the bottom ten percent of his class because he was more interested in becoming an artist than a doctor. The two of them will parry for the several days of the story’s brief narrative, though eventually be drawn together by their mutual needs.
Sonja’s the more complex character, a Russian who stayed in Chechnya after the wars begin, in part because of guilt. Her family lived in Chechnya—part of the Russian elite. She did some of her training in London. Marra describes her as plain, much less attractive than her sister, Natasha, who for a time also worked in the hospital as a self-trained midwife (also from a sense of atonement). After the wars began, Natasha tried to flee to London to be with her sister but her only means of escape was by sex traffickers. In her months of misery, she became a heroine addict. One of the major quests of this chilling novel is the two sisters’ attempts to be reunited with one another, complicated by their ambiguous relationship as children.
The war in ubiquitous. When the story begins, Akhmed’s neighbor, Dokka, has been carted off in the middle of the night by the Feds. Dokka’s eight-year-old daughter, Havaa, managed to escape; and once Akhmed realizes that he must protect her, he decides to take her to the hospital in Volchansk, eleven kilometers away, and that brings him in contact with Sonja. She’s not very happy about taking care of a child; she’s totally overwhelmed by the needs of the hospital’s patients, particularly the endless numbers who need amputations. In order to avoid the roadblocks, Akhmed has to trek through fields and back roads—dangerous because of the trigger-happy soldiers at the check points and the landmines almost everywhere else. When Sonja learns that Akhmed is a trained doctor, she says that the only way she will harbor Havaa is if Akhmed will help her in the hospital. It’s at that stage when she learns how unskilled he is. Akhmed also has to return home each night to his bedridden wife and attend to her needs, and that means continual days and nights of skirting the soldiers and watching where he walks.
The closely-knit community that Akhmed resides in before he became embroiled in taking care of Havaa includes his neighbor Klassan, who is diabetic and needs insulin (no easy item to acquire in the midst of continued turmoil), and Klassan’s son, Ramzan. Daily life has become almost impossible, whether it’s scrounging for food or medicine, as well as the uncertainties of neighbors whose loyalties are such that no one knows whom to trust. For a variety of reasons—namely, his own survival, and the procurement of insulin for his father—Ramzan has become an informer, turning in his neighbors (including Havaa’s father) to the Feds. Marra remarks of his characters, “Whether eating scavaged food or selling an old friend, they had all shamed themselves to survive.” And the title of this superb first novel—beautifully written, carefully orchestrated with numerous flashbacks into his main characters’ lives, and replete with dark humor in the midst of such carnage and uncertainty—“a constellation of vital phenomena” becomes the novel’s moral center. The words first appear mid-way through the narrative when Sonja opens her copy of The Medical Dictionary of the Union of Soviet Physicians: “Life: a constellation of vital phenomena—organization, irritability, movement, growth, reproduction, adaptation.” That’s pretty good, especially the last word. And much later, when she thinks of what Akhmed has taught her (not what she had taught him), she looks at the passage again—this time her epiphany, connecting everything, instead of looking at life as exclusion, yet bearing witness to what little we can control or understand.
Anthony Marra: A Constellation of Vital Phenomena
Hogarth, 384 pp., $26
Charles R. Larson is Emeritus Professor of Literature at American University in Washington, D.C. Email: firstname.lastname@example.org.