Fresh faces are seldom seen in Ward No. 6. The doctor has long stopped admitting new patients and in this world there are few people who are fond of visiting lunatic asylums. Once every two months Semyon Lazarich, the barber, appears. I had better not describe how he shears the patients – with Nikita’s assistance – and the panic on the patients’ faces every time they see his drunken, grinning face.
Besides the barber no one ever looks into the ward. Day after day the patients are condemned to see only Nikita.
However, a rather strange rumour has recently been spreading through the hospital: that a doctor has started paying visits to Ward No. 6.
V
A strange rumour indeed!
Dr Andrey Yefimych Ragin is a remarkable person in his own way. As a young man he was said to be extremely pious and intended to go into the church. After leaving school in 1863 he prepared to enter a theological college, but his father – a surgeon and doctor of medicine – had apparently poured scorn over these plans and declared categorically that he would disown him if he became a priest. How much truth there was in this I do not know, but Andrey Yefimych admitted more than once that he had never felt any vocation for medicine or, come to that, for any specialized science.
Nevertheless, he took a degree in medicine and never became a priest: he showed no signs of godliness and at the start of his medical career bore as little resemblance to a priest as he does now.
He has a heavy, coarse, rough-hewn look. His face, flat hair and strong, clumsy build are reminiscent of some pot-bellied, intemperate, cantankerous highway innkeeper. His face is stern and a mass of blue veins, his eyes are small, his nose red. Tall and broad-shouldered, he has enormous hands and feet. With one grasp of a fist he could squeeze the life out of you. Yet his tread is slow and he walks cautiously, stealthily. If he meets someone in a narrow corridor he is always first to give way and say ‘Sorry’ – not in a bass voice as you might expect, but in a soft, reedy tenor. He has a small growth on his neck which prevents him from wearing starched collars and therefore he always wears soft linen or cotton shirts. In no way does he dress like a doctor. He’ll wear the same shirt for ten years and when he does put on new clothes – usually from a cheap Jewish shop – they look just as worn and crumpled as the old ones. He sees patients, dines and goes visiting in one and the same frock-coat. But this isn’t from meanness, but simply because he couldn’t care less about his appearance.
When Dr Ragin first came to the town to take up his appointment, the so-called ‘charitable institution’ was in a dire state. In the wards, corridors and hospital yard one could hardly breathe for the stench. The male orderlies, the nurses and their children slept in the wards with the patients. They complained that the cockroaches, bed-bugs and mice made their lives a misery. Erysipelas was rampant in the surgical department. There were only two scalpels and not one thermometer in the whole hospital, and the baths were used for storing potatoes. The superintendent, matron, the assistant doctor robbed the patients, and the previous doctor, Ragin’s predecessor, was said to have sold surgical spirits on the quiet and to have set up an entire harem recruited from nurses and female patients. These goings-on were all too well known in the town and even exaggerated, but the people were not concerned in the least. Some excused them on the ground that only lower-class people and peasants went into hospital – and they had no reason to complain since they were far worse off at home. Surely they didn’t expect to be fed on roast pheasant, did they? Others argued that the town on its own could not be expected to maintain a good hospital without the help of the district council. They should thank God that they had a hospital at all, however bad it was. But the newly elected council refused to open a clinic either in town or in the neighbourhood, on the grounds that the town already had its own hospital.
After inspecting the hospital Ragin concluded that it was an immoral institution, highly injurious to the health of its patients. In his opinion it would be best to discharge the patients and close the hospital. But, he reasoned, will-power alone was not sufficient to achieve this – and it would have been useless anyway. Banish physical and moral filth from one place and it will turn up somewhere else. Therefore one should wait until it disappeared of its own accord. Besides, if people opened a hospital and tolerated it, that could only mean they needed it. All these prejudices, abominations and foul living conditions were necessary, since in the course of time they would be converted into something useful, like manure into fertile soil. There was nothing good in this world that did not contain some abomination in its earliest beginnings.
After taking up his appointment Ragin adopted a rather indifferent attitude to all these abuses, it seemed. All he did was ask the orderlies and nurses not to sleep in the wards and installed two instrument cupboards. But the superintendent, matron, the doctor’s assistant and the surgical erysipelas stayed put.
Ragin has great admiration for intelligence and honesty but he has neither the character nor the confidence in his own authority to establish a decent and reasonable environment. To give orders, to prohibit or to insist is quite beyond him. It is as if he has solemnly vowed never to raise his voice or use the imperative mood. He even finds it difficult to say ‘Give’ or ‘Bring’. When he is hungry he coughs irresolutely and tells his cook: ‘I wouldn’t say no to some tea…’; or: ‘I rather fancy some lunch.’ But he hasn’t the gumption to tell the superintendent to stop pilfering, or to sack him, or to do away completely with his unnecessary, parasitical position there. When Ragin is tricked or flattered, when he is handed some patently falsified accounts for signature, he turns red as beetroot and feels guilty – but still he signs. When patients complain of hunger or about rude nurses he becomes flustered.
‘All right, all right’, he mutters guiltily. ‘I’ll see to it later. Probably some sort of misunderstanding…’
At first Ragin worked very diligently. He received patients from morning to night, performed operations and even did midwifery. The ladies said that he was very attentive and an excellent diagnostician, especially of children’s ailments. But as time passed he became visibly weary of the monotony and obvious futility of his work. One day he might see thirty patients, the next the number would rise to thirty-five, the day after that to forty, and so on, day in day out, year in year out. Yet the death-rate in the town didn’t drop, nor did the number of patients who came for treatment. To provide forty patients with any real help in the few hours between breakfast and lunch was physically impossible and the result was deception, whether he liked it or not. In the current year he had seen twelve thousand patients – in plain language twelve thousand people had been duped. But to put seriously ill patients in wards and treat them according to the rules of medical science was impossible, since the rules they followed were in no way scientific. However, if one were to give up theorizing and follow the rules slavishly, like the other doctors, then the most urgent need was for proper hygiene and ventilation instead of filth, wholesome food instead of soup made from sour, stinking cabbage, and honest assistants, not thieves.
And why stop people dying if death was the normal, rightful end of everyone? What does it matter if some huckster or bureaucrat lives an extra five or ten years? If one views the aim of medicine as the mitigation of suffering, the question naturally arises: why mitigate it? In the first place, we are told that suffering leads mankind to perfection; in the second place, if man could teach himself how to alleviate suffering with pills and drops he would completely jettison religion and philosophy in which, up to now, he has found not only a defence against all kinds of ills, but even happiness. On his deathbed Pushkin2 suffered terrible agonies. Heine,3 poor man, lay paralysed for years. So why prevent the illness of a mere Andrey Yefimych Ragin or Matryona Savishna, whose lives are empty and would be utterly vacuous and amoeba-like were it not for suffering?
Deflated by such arguments, Ragin lost heart and ended his daily visits to the hospital.
VI
This is his dail
y routine. Usually he rises at eight, dresses and has breakfast. Then he either sits in his study and reads or goes to the hospital where, in the narrow, dark little corridor, sit the out-patients, waiting for surgery to begin. Orderlies and nurses rush past, their boots clattering on the brick floor, emaciated patients pass through in their smocks, corpses and bedpans are carried out, children cry; there’s a terrible draught. Ragin knows what torment such an environment must be for the feverish and consumptive – and for all sensitive patients – but what can one do? In the surgery he is met by his assistant, Sergey Sergeich, a fat little man with a beardless, well-washed chubby face. With those gentle, relaxed manners and his new, loose-fitting suit he looks more like a senator than a doctor’s assistant. He has a huge private practice in town, wears a white tie4 and thinks he knows more than the doctor, who has no practice at all. In one corner of the surgery is a large icon in a case, with a large lamp, and next to it a candleholder in a white cover. On the walls are portraits of bishops, a view of Svyatogorsk Monastery5 and garlands of dried cornflowers. Sergey Sergeich is religious and loves magnificence. The icon was put there at his expense. On Sundays, at his command, a patient reads the Psalms aloud in the surgery and after the reading Sergey Sergeich goes in person around all the wards with his censer and burns incense in them.
There are many patients and little time, so the examinations are limited to a few questions and the distribution of remedies such as ammoniated liniment or castor oil. Dr Ragin sits there, his cheek resting on his fist, lost in thought and mechanically asking questions. Sergey Sergeich sits there too, rubbing his hands and putting in a word now and then.
‘We become ill and suffer hardship’, he says, ‘because we don’t pray enough to all-merciful God. Oh yes!’
During surgery hours Dr Ragin doesn’t perform any operations. He has long been out of practice and the sight of blood has an unpleasant effect on him. When he has to open a child’s mouth to examine its throat and the child cries and defends itself with its tiny hands, his head spins and his eyes fill with tears. He hastily writes out a prescription and gestures to the mother to take her child away as quickly as possible.
He soon tires of his patients’ timidity, of their silly talk and stupidity, of the proximity of the grandiose Sergey Sergeich, of the portraits on the walls and of his own questions that he has been asking over and over for more than twenty years. And he leaves after having seen five or six patients. The rest are seen by his assistant.
Buoyed by the pleasant thought that he has given up private practice long ago – thank God! – and that there is no one to disturb him, the moment he is home he sits at his study table and begins to read. He reads voraciously and always with great pleasure. Half his salary is spent on books and of the six rooms in his flat three are crammed with books and old magazines. Most of all he likes history and philosophy. The only medical journal he subscribes to is The Physician,6 which he always begins to read from the back. At each sitting he reads for several hours without break and this never tires him. He does not read as quickly and impulsively as Gromov used to do, but incisively, often pausing at passages that please him or which he does not understand. He always keeps a carafe of vodka on a table next to his books, with a gherkin or pickled apple lying on the table cloth, without a plate. Every half hour he pours himself a glass of vodka and drinks it without taking his eyes off his book. Then, again without looking up, he feels for the gherkin and takes a small bite.
At three o’clock he gingerly approaches the kitchen door and coughs. ‘Daryushka’, he says, ‘I wouldn’t mind some dinner.’ After a poor, badly served meal Dr Ragin wanders around his rooms, his arms crossed on his chest: he is thinking. Four o’clock strikes, then five, and still he is pacing and thinking. The kitchen door occasionally creaks and Daryushka’s sleepy red face appears.
‘Andrey Yefimych, isn’t it time for your beer?’7 she asks solicitously.
‘No, not yet’, he replies. ‘I’ll wait a bit…’
Towards evening Mikhail Averyanych, the postmaster, usually arrives. He is the one person in the entire town whose company doesn’t weary Ragin. Once Mikhail Averyanych had been a very wealthy landowner and cavalry officer, but he lost everything and straitened circumstances obliged him to take a job in late middle age at the post office. He has a lively, healthy look, magnificent grey sideburns, refined manners and a loud but pleasant voice. He is kind and sensitive, but hot-tempered. When a post office customer complains, voices dissent or simply starts arguing, Mikhail Averyanych turns purple, shakes all over and shouts thunderously: ‘Silence!’ Consequently the post office has long acquired the reputation of a fearsome place to be. Mikhail Averyanych likes and respects Ragin for his erudition and lofty principles, but he treats the other townspeople condescendingly, as if they were his subordinates.
‘Well, here I am!’ he says as he comes in. ‘How are you, my dear chap? I suppose you’re bored with me by now, eh?’
‘On the contrary, I’m delighted’, the doctor replies. ‘I’m always glad to see you!’
The friends sit on the study sofa and smoke for a while in silence.
‘Daryushka! I wonder if we might have a little beer?’ Ragin asks.
The first bottle is drunk – also in silence: the doctor is deep in thought and Mikhail Averyanych has the gay, animated expression of someone with fascinating things to relate. It is always the doctor who begins the conversation.
‘What a pity’, he slowly says, quietly shaking his head without looking at his friend (he never looks people in the eye). ‘What a great pity, my dear Mikhail Averyanych, there’s simply no one in this town who can or who would like to conduct an intelligent conversation. That’s a great drawback as far as we’re concerned. Even the educated classes don’t rise above mediocrity – the level of their development, I assure you, is in no way higher than that of the lower classes.’
‘Perfectly true! I do agree.’
‘And as you yourself know very well’, the doctor softly continues, with quiet deliberation, ‘in this world everything is insignificant and boring except the higher spiritual manifestations of the human intellect. The intellect draws a sharp distinction between animals and men, it indicates the divinity of man and to some extent even compensates him for the fact that he’s not immortal. Consequently, the mind is our only possible source of pleasure. But we don’t see or hear any evidence of intellect around us – that means we are deprived of genuine pleasure. True, we do have our books, but all that’s poles apart from living conversation and personal contact. If I may use a rather infelicitous simile, books are the accompaniment whilst conversation is the singing.’
‘Perfectly true!’
Silence follows. Daryushka emerges from the kitchen and with an expression of mute anguish and with her head propped on her fist she stops in the doorway to listen.
‘Oh dear!’ sighs Mikhail Averyanych. ‘It’s no good looking for intellect among the people of today!’
And he starts telling how healthy, cheerful and interesting life was in the old days, how enlightened the Russian intelligentsia was, how highly concepts of honour and friendship were valued. They would lend money without IOUs and to refuse a friend in need a helping hand was considered shameful. And what crusades there were, what adventures, skirmishes, what comrades-in-arms, what women! As for the Caucasus – such an amazing part of the world! There was that battalion commander’s wife, a really odd woman, who would dress as an officer and ride out at night into the mountains, alone, without any escort. She was said to be having an affair in a village up there with some petty prince.
‘Mother of God!’ sighs Daryushka.
‘And how we drank! And what fanatical liberals we were!’
Ragin listens but hears nothing: he is pondering something else as he sips his beer.
‘I often dream of clever people and having conversations with them’, he says unexpectedly, interrupting Mikhail Averyanych. ‘My father gave me an excellent education, but he w
as influenced by the ideas of the sixties and forced me to become a doctor. I think that had I disobeyed him I might now be at the very hub of current intellectual activity. Probably I’d be a member of some faculty. Of course, the intellect isn’t eternal either, it’s transitory, but you know very well the great liking I have for it. Life is a vicious trap. When a thinking person reaches manhood and his consciousness has matured, he cannot help thinking that he’s caught in a snare, as it were, from which there’s no escape. In fact he’s been called into life from non-existence against his will, by some sort of accident… Why? If he wants to know the meaning and purpose of his existence, either he meets with silence or is palmed off with some nonsense. He knocks, but the door isn’t opened. Death creeps up on him – also against his will. It’s the same with people in prison: united in common misfortune they find things easier if they all join together. And similarly in life – you don’t notice these pitfalls when men inclined towards analysis and generalization come together and spend their time exchanging proud, unfettered ideas. In this sense the intellect is an indispensable source of enjoyment.’
‘Perfectly true!’
With his eyes still averted from his friend, in a quiet voice and constantly pausing, Ragin continues to discuss clever people and conversations with them, while Mikhail Averyanych is all ears.
‘Perfectly true!’ he agrees.
‘So you don’t believe in the immortality of the soul?’ the postmaster suddenly asks.
‘No, my dear Mikhail Averyanych, I do not. Nor do I have any reason to believe.’
‘I must say, I have my doubts too. Even so, I still have the feeling that I shall never die. “Heavens!” I think to myself, “you old fogey! It’s time for you to die!” But deep down some little voice keeps telling me: “Don’t you believe it, you’ll never die!” ’
Ward No. 6 and Other Stories, 1892-1895 Page 8