Gulag_ A History - Anne Applebaum [228]
Even when a prisoner finally made it into the hospital, he often found that the quality of medical care varied widely. The larger camps had proper hospitals, with staff and medicines. The central Dalstroi hospital, in the city of Magadan, was known for having the latest equipment, as well as for being staffed by the best prisoner doctors, often Moscow specialists. While most of its patients were NKVD officers or camp employees, some of the more fortunate prisoners got treated by specialists as well, there and elsewhere: during his camp sentence, Leonid Finkelstein was even allowed to visit a dentist.88 Some of the invalid lagpunkts were also well-appointed, and seem to have been genuinely intended to nurse prisoners back to health. Tatyana Okunevskaya was sent to one, and marveled at the open spaces, the generous barracks, the trees: “I hadn’t seen them in so many years! And it was springtime!”89
In the smaller lagpunkt hospitals, the situation was far grimmer. Usually, lagpunkt doctors found it impossible to maintain even minimal standards of sterility and cleanliness.90 Hospitals were often no more than ordinary barracks in which the sick were simply dumped on ordinary beds—sometimes two to a bed—with only minimal supplies of medicine. An inspector reporting on one small camp complained that it had no designated hospital building, no sheets and underwear for patients, no medicine, and no qualified medical personnel. Death rates, as a result, were extremely high.91
Eyewitnesses concur. In one small hospital, in a lagpunkt of Sevurallag, “treatment and documentation were poor,” according to Isaac Vogelfanger, once the camp’s chief surgeon. Worse, food rations were remarkably inadequate and very few drugs were available. Surgical cases such as fractures and major injuries to soft tissues were badly handled and neglected. Seldom, as I later discovered, were patients discharged to return to work. Having been admitted with advanced signs of malnutrition, the majority would die in the hospital.92
A Polish prisoner, Jerzy Gliksman, remembered that in one lagpunkt prisoners actually lay “in a clutter” on the floor: “All passages were crowded with lying bodies. Filth and wretchedness were everywhere. Many of the patients raved and shouted incoherently, while others lay motionless and pale.”93
Worse were the barracks, or rather mortuaries, for terminally ill patients. In one such barrack, set up for prisoners with dysentery, “patients lay in bed for weeks. If they were lucky they recovered. More often they died. There was no treatment, no medicines . . . patients usually tried to conceal a death for three or four days in order to get the dead man’s rations for themselves.”94
Conditions were worsened by Gulag bureaucracy. In 1940, a camp inspector complained that one camp simply did not have enough hospital beds for sick prisoners. Since a prisoner who was not actually lying down inside a hospital was not allowed to receive a hospital ration, this meant that ill prisoners outside the hospital were simply receiving the reduced “shirkers” ration.95
Nor, although many camp doctors can be said to have saved the lives of many people, were they all necessarily inclined to be helpful. Some, from their privileged perspective, had come to sympathize more with the bosses than with the “enemies” whom they were required to treat. Elinor Lipper described one doctor, the head of a hospital for 500 patients: “She behaved