Anton Chekhov

IV

Fresh faces are rarely seen in Ward No. 6. The doctor has not taken in any new mental cases for a long time, and the people who are fond of visiting lunatic asylums are few in this world. Once every two months Semyon Lazaritch, the barber, appears in the ward. How he cuts the patients' hair, and how Nikita helps him to do it, and what a trepidation the lunatics are always thrown into by the arrival of the drunken, smiling barber, we will not describe.

No one even looks into the ward except the barber. The patients are condemned to see day after day no one but Nikita.

A rather strange rumour has, however, been circulating in the hospital of late.

It is rumoured that the doctor has begun to visit Ward No. 6.

V

A strange rumour!

Dr. Andrey Yefimitch Ragin is a strange man in his way. They say that when he was young he was very religious, and prepared himself for a clerical career, and that when he had finished his studies at the high school in 1863 he intended to enter a theological academy, but that his father, a surgeon and doctor of medicine, jeered at him and declared point-blank that he would disown him if he became a priest. How far this is true I don't know, but Andrey Yefimitch himself has more than once confessed that he has never had a natural bent for medicine or science in general.

However that may have been, when he finished his studies in the medical faculty he did not enter the priesthood. He showed no special devoutness, and was no more like a priest at the beginning of his medical career than he is now.

His exterior is heavy — coarse like a peasant's, his face, his beard, his flat hair, and his coarse, clumsy figure, suggest an overfed, intemperate, and harsh innkeeper on the highroad. His face is surly-looking and covered with blue veins, his eyes are little and his nose is red. With his height and broad shoulders he has huge hands and feet; one would think that a blow from his fist would knock the life out of anyone, but his step is soft, and his walk is cautious and insinuating; when he meets anyone in a narrow passage he is always the first to stop and make way, and to say, not in a bass, as one would expect, but in a high, soft tenor: "I beg your pardon!" He has a little swelling on his neck which prevents him from wearing stiff starched collars, and so he always goes about in soft linen or cotton shirts. Altogether he does not dress like a doctor. He wears the same suit for ten years, and the new clothes, which he usually buys at a Jewish shop, look as shabby and crumpled on him as his old ones; he sees patients and dines and pays visits all in the same coat; but this is not due to niggardliness, but to complete carelessness about his appearance.

When Andrey Yefimitch came to the town to take up his duties the "institution founded to the glory of God" was in a terrible condition. One could hardly breathe for the stench in the wards, in the passages, and in the courtyards of the hospital. The hospital servants, the nurses, and their children slept in the wards together with the patients. They complained that there was no living for beetles, bugs, and mice. The surgical wards were never free from erysipelas. There were only two scalpels and not one thermometer in the whole hospital; potatoes were kept in the baths. The superintendent, the housekeeper, and the medical assistant robbed the patients, and of the old doctor, Andrey Yefimitch's predecessor, people declared that he secretly sold the hospital alcohol, and that he kept a regular harem consisting of nurses and female patients. These disorderly proceedings were perfectly well known in the town, and were even exaggerated, but people took them calmly; some justified them on the ground that there were only peasants and working men in the hospital, who could not be dissatisfied, since they were much worse off at home than in the hospital — they couldn't be fed on woodcocks! Others said in excuse that the town alone, without help from the Zemstvo, was not equal to maintaining a good hospital; thank God for having one at all, even a poor one. And the newly formed Zemstvo did not open infirmaries either in the town or the neighbourhood, relying on the fact that the town already had its hospital.

After looking over the hospital Andrey Yefimitch came to the conclusion that it was an immoral institution and extremely prejudicial to the health of the townspeople. In his opinion the most sensible thing that could be done was to let out the patients and close the hospital. But he reflected that his will alone was not enough to do this, and that it would be useless; if physical and moral impurity were driven out of one place, they would only move to another; one must wait for it to wither away of itself Besides, if people open a hospital and put up with having it, it must be because they need it; superstition and all the nastiness and abominations of daily life were necessary, since in process of time they worked out to something sensible, just as manure turns into black earth. There was nothing on earth so good that it had not something nasty about its first origin.

When Andrey Yefimitch undertook his duties he was apparently not greatly concerned about the irregularities at the hospital. He only asked the attendants and nurses not to sleep in the wards, and had two cupboards of instruments put up; the superintendent, the housekeeper, the medical assistant, and the erysipelas remained unchanged.

Andrey Yefimitch loved intelligence and honesty intensely, but he had no strength of will nor belief in his right to organize an intelligent and honest life about him. He was absolutely unable to give orders, to forbid things, and to insist. It seemed as though he had taken a vow never to raise his voice and never to make use of the imperative. It was difficult for him to say. "Fetch" or "Bring"; when he wanted his meals he would cough hesitatingly and say to the cook, "How about tea. . . ?" or "How about dinner . . .?" To dismiss the superintendent or to tell him to leave off stealing, or to abolish the unnecessary parasitic post altogether, was absolutely beyond his powers. When Andrey Yefimitch was deceived or flattered, or accounts he knew to be cooked were brought him to sign, he would turn as red as a crab and feel guilty, but yet he would sign the accounts. When the patients complained to him of being hungry or of the roughness of the nurses, he would be confused and mutter guiltily: "Very well, very well, I will go into it later. . . . Most likely there is some misunderstanding. . . ."

At first Andrey Yefimitch worked very zealously. He saw patients every day from morning till dinner-time, performed operations, and even attended confinements. The ladies said of him that he was attentive and clever at diagnosing diseases, especially those of women and children. But in process of time the work unmistakably wearied him by its monotony and obvious uselessness. To-day one sees thirty patients, and to-morrow they have increased to thirty-five, the next day forty, and so on from day to day, from year to year, while the mortality in the town did not decrease and the patients did not leave off coming. To be any real help to forty patients between morning and dinner was not physically possible, so it could but lead to deception. If twelve thousand patients were seen in a year it meant, if one looked at it simply, that twelve thousand men were deceived. To put those who were seriously ill into wards, and to treat them according to the principles of science, was impossible, too, because though there were principles there was no science; if he were to put aside philosophy and pedantically follow the rules as other doctors did, the things above all necessary were cleanliness and ventilation instead of dirt, wholesome nourishment instead of broth made of stinking, sour cabbage, and good assistants instead of thieves; and, indeed, why hinder people dying if death is the normal and legitimate end of everyone? What is gained if some shop-keeper or clerk lives an extra five or ten years? If the aim of medicine is by drugs to alleviate suffering, the question forces itself on one: why alleviate it? In the first place, they say that suffering leads man to perfection; and in the second, if mankind really learns to alleviate its sufferings with pills and drops, it will completely abandon religion and philosophy, in which it has hitherto found not merely protection from all sorts of trouble, but even happiness. Pushkin suffered terrible agonies before his death, poor Heine lay paralyzed for several years; why, then, should not some Andrey Yefimitch or Matryona Savishna be ill, since their lives had nothing of importance in them, and would have been entirely empty and like the life of an amoeba except for suffering?

Oppressed by such reflections, Andrey Yefimitch relaxed his efforts and gave up visiting the hospital every day.

VI

His life was passed like this. As a rule he got up at eight o'clock in the morning, dressed, and drank his tea. Then he sat down in his study to read, or went to the hospital. At the hospital the out-patients were sitting in the dark, narrow little corridor waiting to be seen by the doctor. The nurses and the attendants, tramping with their boots over the brick floors, ran by them; gaunt-looking patients in dressing-gowns passed; dead bodies and vessels full of filth were carried by; the children were crying, and there was a cold draught. Andrey Yefimitch knew that such surroundings were torture to feverish, consumptive, and impressionable patients; but what could be done? In the consulting-room he was met by his assistant, Sergey Sergeyitch — a fat little man with a plump, well-washed shaven face, with soft, smooth manners, wearing a new loosely cut suit, and looking more like a senator than a medical assistant. He had an immense practice in the town, wore a white tie, and considered himself more proficient than the doctor, who had no practice. In the corner of the consulting-room there stood a large ikon in a shrine with a heavy lamp in front of it, and near it a candle-stand with a white cover on it. On the walls hung portraits of bishops, a view of the Svyatogorsky Monastery, and wreaths of dried cornflowers. Sergey Sergeyitch was religious, and liked solemnity and decorum. The ikon had been put up at his expense; at his instructions some one of the patients read the hymns of praise in the consulting-room on Sundays, and after the reading Sergey Sergeyitch himself went through the wards with a censer and burned incense.

There were a great many patients, but the time was short, and so the work was confined to the asking of a few brief questions and the administration of some drugs, such as castor-oil or volatile ointment. Andrey Yefimitch would sit with his cheek resting in his hand, lost in thought and asking questions mechanically. Sergey Sergeyitch sat down too, rubbing his hands, and from time to time putting in his word.

"We suffer pain and poverty," he would say, "because we do not pray to the merciful God as we should. Yes!"

Andrey Yefimitch never performed any operation when he was seeing patients; he had long ago given up doing so, and the sight of blood upset him. When he had to open a child's mouth in order to look at its throat, and the child cried and tried to defend itself with its little hands, the noise in his ears made his head go round and brought tears to his eyes. He would make haste to prescribe a drug, and motion to the woman to take the child away.

He was soon wearied by the timidity of the patients and their incoherence, by the proximity of the pious Sergey Sergeyitch, by the portraits on the walls, and by his own questions which he had asked over and over again for twenty years. And he would go away after seeing five or six patients. The rest would be seen by his assistant in his absence.

With the agreeable thought that, thank God, he had no private practice now, and that no one would interrupt him, Andrey Yefimitch sat down to the table immediately on reaching home and took up a book. He read a great deal and always with enjoyment. Half his salary went on buying books, and of the six rooms that made up his abode three were heaped up with books and old magazines. He liked best of all works on history and philosophy; the only medical publication to which he subscribed was The Doctor, of which he always read the last pages first. He would always go on reading for several hours without a break and without being weary. He did not read as rapidly and impulsively as Ivan Dmitritch had done in the past, but slowly and with concentration, often pausing over a passage which he liked or did not find intelligible. Near the books there always stood a decanter of vodka, and a salted cucumber or a pickled apple lay beside it, not on a plate, but on the baize table-cloth. Every half-hour he would pour himself out a glass of vodka and drink it without taking his eyes off the book. Then without looking at it he would feel for the cucumber and bite off a bit.

At three o'clock he would go cautiously to the kitchen door; cough, and say, "Daryushka, what about dinner . . . ?"

After his dinner — a rather poor and untidily served one — Andrey Yefimitch would walk up and down his rooms with his arms folded, thinking. The clock would strike four, then five, and still he would be walking up and down thinking. Occasionally the kitchen door would creak, and the red and sleepy face of Daryushka would appear.

"Andrey Yefimitch, isn't it time for you to have your beer?" she would ask anxiously.

"No, it's not time yet . . ." he would answer. "I'll wait a little. . . . I'll wait a little. . . ."

Towards the evening the postmaster, Mihail Averyanitch, the only man in town whose society did not bore Andrey Yefimitch, would come in. Mihail Averyanitch had once been a very rich landowner, and had served in the calvary, but had come to ruin, and was forced by poverty to take a job in the post office late in life. He had a hale and hearty appearance, luxuriant grey whiskers, the manners of a well-bred man, and a loud, pleasant voice. He was good-natured and emotional, but hot-tempered. When anyone in the post office made a protest, expressed disagreement, or even began to argue, Mihail Averyanitch would turn crimson, shake all over, and shout in a voice of thunder, "Hold your tongue!" so that the post office had long enjoyed the reputation of an institution which it was terrible to visit. Mihail Averyanitch liked and respected Andrey Yefimitch for his culture and the loftiness of his soul; he treated the other inhabitants of the town superciliously, as though they were his subordinates.

"Here I am," he would say, going in to Andrey Yefimitch. "Good evening, my dear fellow! I'll be bound, you are getting sick of me, aren't you?"

"On the contrary, I am delighted," said the doctor. "I am always glad to see you."

The friends would sit on the sofa in the study and for some time would smoke in silence.

"Daryushka, what about the beer?" Andrey Yefimitch would say.

They would drink their first bottle still in silence, the doctor brooding and Mihail Averyanitch with a gay and animated face, like a man who has something very interesting to tell. The doctor was always the one to begin the conversation.

"What a pity," he would say quietly and slowly, not looking his friend in the face (he never looked anyone in the face) — "what a great pity it is that there are no people in our town who are capable of carrying on intelligent and interesting conversation, or care to do so. It is an immense privation for us. Even the educated class do not rise above vulgarity; the level of their development, I assure you, is not a bit higher than that of the lower orders."

"Perfectly true. I agree."

"You know, of course," the doctor went on quietly and deliberately, "that everything in this world is insignificant and uninteresting except the higher spiritual manifestations of the human mind. Intellect draws a sharp line between the animals and man, suggests the divinity of the latter, and to some extent even takes the place of the immortality which does not exist. Consequently the intellect is the only possible source of enjoyment. We see and hear of no trace of intellect about us, so we are deprived of enjoyment. We have books, it is true, but that is not at all the same as living talk and converse. If you will allow me to make a not quite apt comparison: books are the printed score, while talk is the singing."

"Perfectly true."

A silence would follow. Daryushka would come out of the kitchen and with an expression of blank dejection would stand in the doorway to listen, with her face propped on her fist.

"Eh!" Mihail Averyanitch would sigh. "To expect intelligence of this generation!"

And he would describe how wholesome, entertaining, and interesting life had been in the past. How intelligent the educated class in Russia used to be, and what lofty ideas it had of honour and friendship; how they used to lend money without an IOU, and it was thought a disgrace not to give a helping hand to a comrade in need; and what campaigns, what adventures, what skirmishes, what comrades, what women! And the Caucasus, what a marvellous country! The wife of a battalion commander, a queer woman, used to put on an officer's uniform and drive off into the mountains in the evening, alone, without a guide. It was said that she had a love affair with some princeling in the native village.

"Queen of Heaven, Holy Mother..." Daryushka would sigh.

"And how we drank! And how we ate! And what desperate liberals we were!"

Andrey Yefimitch would listen without hearing; he was musing as he sipped his beer.

"I often dream of intellectual people and conversation with them," he said suddenly, interrupting Mihail Averyanitch. "My father gave me an excellent education, but under the influence of the ideas of the sixties made me become a doctor. I believe if I had not obeyed him then, by now I should have been in the very centre of the intellectual movement. Most likely I should have become a member of some university. Of course, intellect, too, is transient and not eternal, but you know why I cherish a partiality for it. Life is a vexatious trap; when a thinking man reaches maturity and attains to full consciousness he cannot help feeling that he is in a trap from which there is no escape. Indeed, he is summoned without his choice by fortuitous circumstances from non-existence into life . . . what for? He tries to find out the meaning and object of his existence; he is told nothing, or he is told absurdities; he knocks and it is not opened to him; death comes to him — also without his choice. And so, just as in prison men held together by common misfortune feel more at ease when they are together, so one does not notice the trap in life when people with a bent for analysis and generalization meet together and pass their time in the interchange of proud and free ideas. In that sense the intellect is the source of an enjoyment nothing can replace."