Hektoen International

A Journal of Medical Humanities

THEME

RUSSIAN LITERATURE
Published in October, 2020
H E K T O R A M A

 

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THE EDUCATION OF DOCTOR CHEKHOV

 

 

 

Chekhov was neither an academic star, nor a social standout. There were, however, two areas in which he excelled. The first was his ability to listen to patients and reconstruct their narratives. Dr. Pavel Archangelsky, Chekhov’s preceptor during summer externships at a rural clinic, reported that he “did everything with attention and a manifest love of what he was doing, especially towards patients who passed through his hands. He listened quietly to them, never raising his voice however tired he was and even if the patient was talking about things quite irrelevant to the illness. The mental state of the patient interested him particularly. As well as traditional medicines, he attached great significance to the effect the doctor had on the psyche of the patient, and on his way of life.”4

 

 

By Jack Coulehan

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THE GRASSHOPPER BY CHEKHOV: FOLLY AND REGRETS
 

 


 

The affair goes well for a while, but then the celebrity grows tired of his admiring liaison and wants to get rid of her…

When Olga enters the room and stares at the cold body of her lifeless husband she at last repents. She would explain it was all a mistake. Life could be beautiful again, and she would worship him and bow down in homage to him. But it is too late. Too late also for the good doctor who had taken medicine as his life-long jealous mistress and excluded the joys of humanities that add meaning and perspective to life. And in the next room they were preparing to wash the body and lay it out for the funeral.

 

By George Dunea READ ARTICLE

 


 

ANTON CHEKHOV AND THE SAKHALIN PENAL COLONY

 

From the beginning of black women’s professional involvement in medicine, public health marked a central component of the scope of their practice. Rebecca Cole, the second black woman physician in the United States, began her career as the “sanitary visitor” in the late 1860s for the New York Infirmary for Women and Children run by two of the first women physicians, famous sisters Elizabeth and Emily Blackwell. Elizabeth recalled that: “With tact and care,” Cole provided “simple, practical instruction to poor mothers on the management of infants and the preservation of the health of their families.”1 After spending much of the rest of the Reconstruction era practicing in South Carolina, Cole returned to her native Philadelphia and opened the Women’s Directory with white woman physician and fellow WMCP alumna, Charlotte Abby. In this work, Cole likely continued to hone an interest in public health while still treating individual patients, a balance that would become common among African American women physicians engaged in public health work.

By Michael Bloor

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CHEKHOV: WARD NO. 6 
Image of Anton Chekhov

 

Anton Chekhov wrote “Ward No. 6” in 1892, the same year he bought a country estate in Melikhovo with the money he had made from his literary pursuits. There he routinely made long journeys to treat sick peasants for free while himself ill with the tuberculosis he had contracted years earlier treating the Moscow poor. In the story he views the world from the eyes of both patient and physician.

 

By Stanley Guitontov READ ARTICLE
 

HEART ACHE AND COMPLICATED GRIEF
Image of a man's head on top of a heart with a succubus inside

 

The physician-writer Anton Chekhov wrote in the nineteenth century of the pain of loss, and in his masterpiece The Seagull, of something like complicated grief. This phenomenon, only recently named by Shear et al., provides a new framework for understanding people who do not adapt to a traumatic loss.(1) Complicated bereavement, officially, is still a diagnosis requiring further research in psychiatry, despite its critical importance.

 

By Laurie Elise Gordon 

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MIKHAEL BULGAKOV’S “THE STEEL WINDPIPE” IN A COUNTRY’S DOCTOR’S NOTEBOOK
Mikhael Bulgakov

 

 

Anton Chechov (1860–1904) is Russia’s most famous literary doctor, but another of Russia’s great twentieth century authors also practised medicine. Mikhael Bulgakov (1891–1940) was the banned author of The Master and Marguerita, first published twenty-six years after his death, a novel credited as a progenitor of magic realism and as the inspiration of both Salmon Rushdie’s Satanic Verses and Mick Jagger’s Sympathy for the Devil. Bulgakov qualified in 1916 and at age twenty-four found himself in sole charge of a country clinic 32 miles from the nearest town, the roads to which were frequently impassable. Czarist Russia, despite its ramshackle absolutist monarchy, had a rural medical service (provided by the local government “zemstvo” councils and financed from local taxation) that many countries would envy today. Bulgakov found himself treating the local peasants, in charge of a facility with beds, an operating theatre, a staff of two midwives, and a feldsher (physician’s assistant). In the collection of short stories he wrote about his early isolation in that country clinic (A Country Doctor’s Notebook), he dwelt often on the terrors induced by the combination of total clinical responsibility and utter inexperience.

By Michael Bloor

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PLACEBO EFFECT OR CARE EFFECT? FOUR EXAMPLES FROM THE LITERARY WORLD

 

All of these stories describe effects that are real and meaningful for the patients involved. Yet in today’s medical terminology these effects would easily be labeled placebo effects, suggesting that the patients did not receive real or specific treatment. They accordingly illustrate why the term is unhelpful and misleading in the context of clinical reality. Moreover, while the term placebo refers to inert drugs or treatments, no such inert substances or fake treatments were used in two of the four preceding stories. Dr. Koryolov, in A Case History, did not provide drugs, but only his words and his presence, and, in The Tongue Set Free, the key person provoking the healing effect was not a physician, but instead the little boy’s father. According to today’s standards, the powder and pills given to Natasha in a pretty box in War and Peace were probably more harmful than helpful as such, and the ink dissolved in wine in The Egyptian was by no means biologically inert, although Waltari hints that Senmut did not actually believe the solution as such would be helpful.

 

By Pekka Louhiala and Raimo Puustinen

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SUFFERING AND EMPATHY IN THE STORIES OF ANTON CHEKOV AND THEIR RELEVANCE TO HEALTHCARE TODAY
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Throughout his life, Anton Chekhov was often faced with the reality of suffering in human existence. His family’s bankruptcy and life of poverty in Moscow influenced young Anton’s thoughts about suffering and degradation in society, and his brief period of medical practice in Moscow provided him with enough experience to write over 150 short stories. These stories were heavily influenced by his perception of the effects of suffering on those he encountered. His journey to the Russian penal colony of Sakhalin influenced the short story Ward No. 6, which examines the idea that suffering is an inevitable part of human existence.

Chekhov repeatedly satirizes the belief that suffering is intrinsic to human existence and should be accepted as inevitable and ignored, portraying the stoical view of suffering as a means some people use to ignore or dismiss the suffering of others. In the story Misery,1 a sledge-driver who has recently lost his son tells a passenger of his loss and the simple response is: “We shall all die.”1 This story explores a belief that society when unchecked can drastically increase the suffering of those humans it is supposed to protect. When describing the hard life of the sledge-driver and his mare he suggests that the dumb animal is “probably lost in thought,”1 because anyone who faces the tumultuous degradation of life in the city would be “bound to think.”

 

By Peter McCann

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