A Country Doctor's Notebook

  Dazed, my vision blurred by a film of sweat, I saw the happy faces of the midwives and one of them said to me:

  ‘You did the operation brilliantly, doctor.’

  I thought she was making fun of me and glowered at her. Then the doors were opened and a gust of fresh air blew in. Lidka was carried out wrapped in a sheet and at once the mother appeared in the doorway. Her eyes had the look of a wild beast. She asked me:

  ‘Well?’

  When I heard the sound of her voice, I felt a cold sweat run down my back as I realised what it would have been like if Lidka had died on the table. But I answered her in a very calm voice:

  ‘Don’t worry, she’s alive. And she’ll stay alive, I hope. Only she won’t be able to talk until we take the pipe out, so don’t let that upset you.’

  Just then the grandmother seemed to materialise from nowhere and crossed herself, bowing to the doorhandle, to me, and to the ceiling. This time I did not lose my temper with her, I turned away and ordered Lidka to be given a camphor injection and for the staff to take turns at watching her. Then I went across the yard to my quarters. I remember the green lamp burning in my study, Döderlein lying there and books scattered everywhere. I walked over to the couch fully dressed, lay down and was immediately lost to the world in a dreamless sleep.

  A month passed, then another. I grew more experienced and some of the things I saw were rather more frightening than Lidka’s throat, which passed out of my mind. Snow lay all around, and the size of my practice grew daily. Early in the new year, a woman came to my surgery holding by the hand a little girl wrapped in so many layers that she looked as round as a little barrel. The woman’s eyes were shining. I took a good look and recognised them.

  ‘Ah, Lidka! How are things?’

  ‘Everything’s fine.’

  The mother unwound the scarves from Lidka’s neck. Though she was shy and resisted I managed to raise her chin and took a look. Her pink neck was marked with a brown vertical scar crossed by two fine stitch marks.

  ‘All’s well,’ I said. ‘You needn’t come any more.’

  ‘Thank you, doctor, thank you,’ the mother said, and turned to Lidka: ‘Say thank you to the gentleman!’

  But Lidka had no wish to speak to me.

  I never saw her again. Gradually I forgot about her. Meanwhile my practice still grew. The day came when I had a hundred and ten patients. We began at nine in the morning and finished at eight in the evening. Reeling with fatigue, I was taking off my overall when the senior midwife said to me:

  ‘It’s the tracheotomy that has brought you all these patients. Do you know what they’re saying in the villages? The story goes that when Lidka was ill a steel throat was put into her instead of her own and then sewn up. People go to her village especially to look at her. There’s fame for you, doctor. Congratulations.’

  ‘So they think she’s living with a steel one now, do they?’ I enquired.

  ‘That’s right. But you were wonderful, doctor. You did it so coolly, it was marvellous to watch.’

  ‘Hm, well, I never allow myself to worry, you know,’ I said, not knowing why. I was too tired even to feel ashamed, so I just looked away. I said goodnight and went home. Snow was falling in large flakes, covering everything, the lantern was lit and my house looked silent, solitary and imposing. As I walked I had only one desire—sleep.

  BLACK AS EGYPT’S NIGHT

  WHERE HAS THE WORLD DISAPPEARED TO TODAY, my birthday? Where, oh where are the electric lights of Moscow? Where are the people, where is the sky? I look out of my windows at nothing but darkness …

  We are cut off; the nearest kerosene lanterns are seven miles away at the railway station, and even their flickering light has probably been blown out by the snowstorm. The midnight express to Moscow rushes moaning past and does not even stop; it has no need of this forlorn little halt, buried in snow—except perhaps when the line is blocked by drifts.

  The nearest street lamps are thirty-two miles away in the district town. Life there is sweet: it has a cinema, shops. While the snow is whirling and howling out here in the open country, there on the screen, no doubt, the cane-brake is bending to the breeze and palm trees sway as a tropical island comes into view …

  Meanwhile we are alone.

  ‘Black as Egypt’s night,’ observed Demyan Lukich, as he raised the blind.

  His remarks are somewhat solemn but apt. Egyptian is the word for it.

  ‘Have another glass,’ I invited him. (Don’t be too hard on us; after all, we—a doctor, a feldsher and two midwives—are human too. For months on end we see no one apart from hundreds of sick peasants. We work away, entombed in snow. Surely we may be allowed to drink a couple of glasses of suitably diluted spirit and relish a few of the local sprats on the doctor’s birthday?)

  ‘Your health, doctor!’ said Demyan Lukich with heartfelt sincerity.

  ‘Here’s hoping you survive your stay with us!’ said Anna Nikolaevna as she clinked her glass and smoothed her flowered party dress.

  Raising her glass, Pelagea Ivanovna took a sip and then squatted down on her haunches to poke the stove. The hot gleam lit up our faces and the vodka generated a warm inner glow.

  ‘I simply cannot imagine,’ I said indignantly as I watched the shower of sparks raised by the poker, ‘what that woman did with so much belladonna. The whole story sounds insane!’

  Feldsher and midwives smiled as they remembered what had happened. At morning surgery that day a red-faced peasant woman of about thirty had elbowed her way into my consulting room. She had bowed to the gynaecological chair which stood behind me, then produced from the front of her dress a wide-necked medicine bottle and crooned ingratiatingly:

  ‘Thanks very much for the medicine, doctor. It did me so much good. Please may I have another bottle?’

  I took the bottle from her, and as I glanced at the label a green film passed across my vision. On the label was written in Demyan Lukich’s sprawling hand: ‘Tinct. Belladonnae … etc. 16th December 1916’.

  In other words, yesterday I had prescribed for this woman a hefty measure of belladonna and today, my birthday, 17 December, the woman had come back with an empty bottle and a request for more.

  ‘You … you … you mean to say you drank all this yesterday?’ I asked, appalled.

  ‘All of it, sir, all of it,’ said the woman in her comfortable, sing-song voice. ‘And God bless you for it … half the bottle when I got home and the other half when I went to bed. The pain just vanished …’

  I steadied myself against the gynaecological chair.

  ‘What dose did I tell you?’ I croaked. ‘I told you five drops at a time … What have you done, woman? You’ve … you’ve …’

  ‘I took it, I swear I did!’ the woman insisted, thinking I did not believe she had taken my belladonna.

  I seized both her ruddy cheeks and stared at her pupils. There as nothing wrong with them. They were rather beautiful and completely normal. Her pulse, too, was excellent. The woman exhibited no signs whatsoever of belladonna poisoning.

  ‘It’s impossible!’ I said, then shouted: ‘Demyan Lukich!’

  Demyan Lukich in his white overall appeared from the passage leading to the dispensary.

  ‘Just look what this beauty has done, Demyan Lukich! I don’t understand it.’

  The peasant woman looked round anxiously, realising that she had done something wrong. Demyan Lukich took the bottle, sniffed it, turned it round in his hands and said sternly:

  ‘You, my dear, are lying. You didn’t take this medicine!’

  ‘I swear …’ she began.

  ‘Don’t try and fool us, woman,’ Demyan Lukich scolded, pursing his lips. ‘We can see through all your little tricks. Own up now—who did you give this medicine to?’

  The woman raised her thoroughly normal pupils towards the immaculately whitewashed ceiling and crossed herself.

  ‘May I be …’

  ‘Stop it,’ growled Demyan Lukich and turned to me
: ‘This is what they do, doctor. A clever actress like this one here goes to the clinic, we prescribe her some medicine and she goes back home and shares it out among all the women in the village.’

  ‘Oh, sir, how could you …’

  ‘Shut up!’ the feldsher cut her off. ‘I’ve been here eight years and I know. Of course she’s been going round every farm and emptying the bottle a few drops at a time,’ he went on.

  ‘Give me some more of those drops,’ the woman begged in a wheedling tone.

  ‘No, we won’t,’ I replied as I wiped the sweat from my brow. ‘I’m not letting you have any more of this medicine. Is your stomach-ache better?’

  ‘Like I said—just vanished!’

  ‘Well, that’s good, anyway. I shall give you something else, which will also do you good.’ I prescribed the woman some valerian and she left, much disappointed.

  This was the incident we discussed sitting in the doctor’s quarters on my birthday, while outside the windows were draped with the black curtain of the snowstorm.

  ‘Ah, yes,’ said Demyan Lukich, elegantly munching a sardine, ‘ah, yes: we’re used to that sort of thing here. And you, dear doctor, after all the time you’ve spent at university and in Moscow, are going to have to get used to a lot of things. We’re living at the back of beyond.’

  ‘Yes, the back of beyond,’ came the response like an echo from Anna Nikolaevna.

  The snowstorm roared in the chimneys and brushed past the walls. The dark cast-iron of the stove gave off a purple glow. A blessing on the fire which warms medical folk stranded in the depths of the countryside!

  ‘Have you heard about your predecessor Leopold Leopoldovich?’ enquired the feldsher, as he lit a cigarette, having first politely offered one to Anna Nikolaevna.

  ‘He was a marvellous doctor!’ said Pelagea Ivanovna enthusiastically, her eyes gleaming as she stared into the life-giving fire. The imitation brilliants of her Sunday-best comb glinted in her black hair.

  ‘Yes, he was a remarkable personality,’ the feldsher agreed. ‘The peasants literally worshipped him. He had the right approach to them. They were always ready to lie down and be operated on by Liponty. They called him “Liponty Lipontyevich” instead of Leopold Leopoldovich. They had faith in him. And he knew how to talk to them. For instance, his friend Fyodor Kosoi from Dultsevo might come to his surgery. It’s like this Liponty Lipontych, he would say, my chest’s blocked up so it’s hard to draw breath. And besides that, there’s a sort of rasping in my throat …’

  ‘Laryngitis,’ I muttered automatically, having fallen into the habit of lightning diagnosis.

  ‘Quite right. “Well,” Liponty would say, “I’ll give you something for it which will put you right in a couple of days. There are some French mustard-plasters. Put one on your back between your shoulder-blades, the other on your chest. Keep them on for ten minutes, then take them off. Off you go and do as you’re told!” ’

  ‘So the man took his mustard-plasters and went. Two days later he was back at the surgery again.

  ‘ “Well, what’s the matter now?” Liponty asked.

  ‘Kosoi said: “Well, you see, Liponty Lipontyevich, those mustard-plasters didn’t do any good.”

  ‘ “Nonsense!” Liponty replied. “A French mustard-plaster must have done you some good. I suppose you never put it on, is that it?”

  ‘ “What do you mean—never put it on? It’s on still …”

  ‘With that he turned round and there was the mustard-plaster sticking to the back of his sheepskin jerkin!’

  I burst into laughter, while Pelagea Ivanovna giggled and poked furiously at a log.

  ‘If you’ll forgive me,’ I said, ‘I think you made that one up! It couldn’t have really happened!’

  ‘Made it up? Made it up?’ the midwives shouted in chorus.

  ‘I most certainly did not!’ the feldsher exclaimed bitterly. ‘Our life, in fact, is one long string of incidents like that … Why, things happen here which …’

  ‘What about the sugar?’ Anna Nikolaevna exclaimed. ‘Tell him about the sugar, Pelagea Ivanovna!’

  Closing the stove door and lowering her eyes, Pelagea Ivanovna began:

  ‘One day I went to a confinement at Dultsevo …’

  ‘That place Dultsevo is notorious!’ the feldsher burst out, then apologised: ‘Sorry! Do go on, my dear.’

  ‘Well, naturally I examined her,’ Pelagea Ivanovna went on, ‘and in the birth canal I felt something extraordinary … There were some kind of grains or small lumps … It turned out to be granulated sugar!’

  ‘How’s that for a story!’ said Demyan Lukich triumphantly.

  ‘Excuse me, but … I don’t understand …’

  ‘That’s peasant women for you!’ answered Pelagea Ivanovna. ‘She’d been taught by the local wise-woman. She was having a difficult birth, she said, which meant that the baby didn’t want to come out into the light of day. She would have to entice it out, so the way to do it was to lure it out with something sweet!’

  ‘Horrors!’ I exclaimed.

  ‘When a woman’s in labour they give her hair to chew,’ said Anna Nikolaevna.

  ‘What on earth for?’

  ‘God alone knows. I’ve had three confinements where the wretched woman was lying there and spitting something out. Her mouth was full of hair or bristles. Apparently they believe it makes for an easier birth …’

  The midwives’ eyes sparkled as they recounted their experiences. We sat for long by the fire drinking tea, and I listened entranced. Pelagea Ivanovna described how whenever she had to bring an expectant mother from her village to the hospital, she always let her own sleigh travel behind the peasants’ sleigh, to prevent them from changing their minds on the way and taking the woman back to her mother; how one day, when a woman had a breech presentation, they had hung her upside down from the ceiling to make the baby turn round; how a woman from Korobovo, hearing that it was the practice for doctors to rupture the birth-sac, had cut her baby’s head with a table knife so badly that even a man so renowned for his skill as Liponty was unable to save the child and only just managed to save the mother; how …

  The stove door was long since closed; my guests had departed to their quarters. I noticed that the light shone dully for a while in Anna Nikolaevna’s window, then went out. Everything vanished. To the snowstorm was added the impenetrable dark of a December evening, and a black veil shut me off from earth and sky.

  I paced up and down my study and the floor creaked under my feet; the room was warmed by a Dutch stove and I could hear a mouse gnawing busily away.

  ‘No,’ I reflected, ‘I will fight against this Egyptian darkness for as long as fate keeps me here in the wilderness. Granulated sugar … ye gods!’

  In my reverie by the light of the green-shaded lamp there arose before my mind’s eye a great university city, in it a teaching hospital, in the hospital a vast chamber with tiled floor, gleaming taps, sterile white sheets, and a lecturer with a sharp-pointed, greying, very wise-looking beard …

  A knock heard at such a moment can be alarming, terrifying. I started.

  ‘Who’s there, Aksinya?’ I asked, leaning over the banisters of the staircase (the doctor’s quarters were on two floors: upstairs my study and bedroom, downstairs the dining-room, another room of unknown function and the kitchen, the abode of Aksinya and her husband, the invaluable hospital watchman).

  The heavy bolt rumbled, a lighted lamp appeared and bobbed down below, a cold draught blew. Then Aksinya announced:

  ‘It’s a patient, a man.’

  I was, to tell the truth, delighted. I was not yet ready for sleep and was feeling a little lonely and depressed from the gnawing of the mouse and my own memories. And since it was a man it could not be the worst of all—childbirth.

  ‘Is he walking?’

  ‘Yes,’ Aksinya answered, yawning.

  ‘All right, send him into my study.’

  The staircase creaked for a long time. The perso
n coming up was a large, heavily-built man. Meanwhile I sat down at my desk trying hard to ensure that my eager twenty-four years did not peep too obviously from behind my professional Aesculapian persona. My right hand lay ready on a stethoscope, as though on a revolver.

  Through the door sidled a figure, cap in hand, wearing a sheepskin coat and felt boots.

  ‘Why have you come so late in the day?’ I asked weightily, to appease my conscience.

  ‘Sorry, doctor,’ replied the figure in a gentle, pleasant bass voice. ‘The snowstorm’s a terror. Held me up, I’m afraid. Couldn’t help it, begging your pardon, sir.’

  ‘A polite man,’ I thought to myself with pleasure. I liked the figure very much, and even his thick red beard made a favourable impression on me. His beard was clearly the object of considerable care and attention. Its possessor not only combed it but even anointed it with a substance which a doctor, even after such a short spell in the country, could identify without difficulty as clarified butter.

  ‘What’s the trouble? Take off your coat. Where are you from?’

  The sheepskin coat fell in a mountainous heap on to a chair.

  ‘I’ve been suffering from a terrible fever,’ the patient replied with a doleful look.

  ‘Fever? Aha! Are you from Dultsevo?’

  ‘Yes, sir. I’m the miller.’

  ‘Tell me how it troubles you.’

  ‘Every day at twelve o’clock my head starts to ache, then I seem to get hot all over … It makes me shiver for a couple of hours or so and then it goes.’

  ‘Diagnosed already!’ rang out triumphantly in my head.

  ‘And the rest of the time you don’t feel anything?’

  ‘My legs are a bit weak.’

  ‘Aha. Undo your shirt, please. Hm … yes …’

  When I had finished examining the patient I was delighted by him. After all the incoherent women and frightened adolescents who twitched with horror at the touch of a metal spatula, after that morning’s affair of the belladonna, the miller was a sight for my sore, university-trained eyes.