Recently, however, a rather strange rumor spread through the hospital.
The rumor went around that the doctor had started visiting Ward No. 6.
V
Strange rumor!
Dr. Andrei Yefimych Ragin is a remarkable man in his way. They say that he was very pious in his youth, was preparing for a clerical career, and that, on graduating from high school in 1863, he intended to enter a theological academy, but that his father, a doctor of medicine and a surgeon, supposedly mocked him venomously and said categorically that he would not consider him his son if he became a priest. How much truth there is to it I do not know, but Andrei Yefimych himself admitted more than once that he never felt any vocation for medicine or generally for any particular science.
However that may be, having completed his studies in the medical faculty, he did not become a priest. He showed no devoutness, and resembled a clergyman as little at the start of his medical career as he does now.
His appearance is heavy, coarse, peasant-like; with his face, his beard, his lank hair and sturdy, clumsy build, he resembles a highway innkeeper, overfed, intemperate, and tough. His face is stern, covered with little blue veins, his eyes are small, his nose red. Tall and broad-shouldered, he has enormous hands and feet; it looks like one whack of his fist would be lights out. But he walks softly, and his gait is cautious and furtive; meeting you in a narrow corridor, he always stops first to make way, and says, not in a bass but in a high, soft tenor: “Excuse me!” He has a small growth on his neck that prevents him from wearing stiff, starched collars, and therefore he always goes about in soft linen or cotton shirts. Generally, he does not dress in doctorly fashion. He goes about in the same suit for some ten years, and new clothes, which he usually buys in a Jewish shop, seem as worn and wrinkled on him as the old; he receives patients, eats dinner, and goes visiting in the same frock coat; but that is not from stinginess, but from a total disregard for his appearance.
When Andrei Yefimych came to take up his post in town, the “charitable institution” was in a terrible state. In the wards, the corridors, and the hospital yard, it was hard to breathe for the stench. The peasant caretakers, nurses, and their children slept in the wards along with the patients. People complained that there was no bearing with the cockroaches, bedbugs and mice. Erysipelas had installed itself permanently in the surgery section. There were only two scalpels and not a single thermometer in the entire hospital; the baths served for storing potatoes. The superintendent, the matron, and the doctor’s assistant robbed the patients, and of the old doctor, Andrei Yefimych’s predecessor, it was said that he had secretly traded in hospital alcohol and had started a real harem for himself among the nurses and female patients. The townspeople were well aware of these disorders and even exaggerated them, but they viewed them calmly; some justified them by saying that only tradesmen and peasants stayed in the hospital, who could not be displeased, since they lived much worse at home than in the hospital—no one was going to feed them on grouse! Others said in justification that the town alone, without the help of the zemstvo,4was unable to maintain a good hospital; thank God they at least had a bad one. And the young zemstvo would not open a clinic either in town or near it, explaining that the town already had its own hospital.
Having inspected the hospital, Andrei Yefimych came to the conclusion that it was an immoral institution and highly detrimental to the health of the citizens. In his opinion, the most intelligent thing that could be done would be to discharge the patients and close the place down. But for that he reckoned that his will alone was not enough and in any case it would be useless; when physical and moral uncleanness was driven out of one place, it went to another; one had to wait until it dispersed of itself. Besides, if people had opened the hospital and put up with it in their town, it meant they needed it; prejudice and all this everyday filth and muck are necessary, because in time they turn into something useful, as dung turns into black earth. There is nothing good in the world that does not have some filth in its origin.
On taking over the post, Andrei Yefimych treated these disorders with apparent indifference. He merely asked the peasant caretakers and nurses not to sleep in the wards, and installed two cabinets with instruments. The superintendent, the matron, the assistant doctor, and the surgical erysipelas stayed where they were.
Andrei Yefimych is extremely fond of intelligence and honesty, but he lacks character and faith in his right to organize an intelligent and honest life around him. He is positively incapable of ordering, prohibiting, or insisting. It looks as if he has taken a vow never to raise his voice or speak in the imperative. To say “give” or “bring” is hard for him; when he wants to eat, he coughs irresolutely and says to his cook: “How about some tea?” or “How about some dinner?” But to tell the superintendent to stop stealing, or to dismiss him, or to abolish the useless, parasitic post altogether—is completely beyond his strength. When Andrei Yefimych is deceived or flattered, or handed a false receipt to sign knowingly, he turns as red as a lobster and feels guilty, but all the same he signs the receipt; when the patients complain to him that they are hungry or that the nurses are rude, he gets embarrassed and mutters guiltily:
“All right, all right, I’ll look into it later … There’s probably some misunderstanding …”
At first Andrei Yefimych worked very assiduously. He received every day from morning till dinnertime, did surgery and even took up the practice of obstetrics. Ladies said of him that he was attentive and excellent at diagnosing illnesses, especially in children and women. But as time went on he became noticeably bored with the monotony and obvious uselessness of the work. Today you receive thirty patients, and tomorrow, lo and behold, thirty-five come pouring in, and the next day forty, and so it goes, day after day, year after year, and the town mortality rate does not go down, and the patients do not stop coming. To give serious aid to forty outpatients between morning and dinnertime was physically impossible, which meant, willy-nilly, that it was all a deceit. During the fiscal year twelve thousand outpatients were received, which meant, simply speaking, that twelve thousand people were deceived. To put the seriously ill in the hospital and care for them according to the rules of science was also impossible, because while there were rules, there was no science; and to abandon philosophy and follow the rules pedantically, as other doctors did, you first of all needed cleanliness and ventilation, not filth, and wholesome food, not soup made from stinking pickled cabbage, and good assistants, not thieves.
Then, too, why prevent people from dying, if death is the normal and natural end of every man? So what if some dealer or clerk lives for an extra five or ten years? If the purpose of medical science is seen as the alleviation of suffering by medication, then, willy-nilly, the question arises: why alleviate it? First, they say that suffering leads man to perfection, and, second, if mankind really learns to alleviate its suffering with pills and drops, it will completely abandon religion and philosophy, in which it has hitherto found not only a defense against all calamities, but even happiness. Pushkin suffered terribly before death, poor Heine lay paralyzed for many years: why should there be no illness for some Andrei Yefimych or Matryona Savishna, whose life is insipid and would be completely empty and similar to the life of an amoeba were it not for suffering?
Oppressed by such reasoning, Andrei Yefimych threw up his hands and stopped going to the hospital every day.
VI
His life goes like this. Ordinarily he gets up in the morning at around eight, dresses and has tea. Then he sits in his study and reads or goes to the hospital. There, in the hospital, in a dark, narrow corridor, the outpatients sit waiting to be received. Peasants and nurses rush past them, their boots stomping on the brick floor, skinny patients in robes pass by, dead bodies and pots of excrement are carried out, children cry, a drafty wind blows. Andrei Yefimych knows that for the feverish, the consumptive, and the impressionable sick in general, such an atmosphere
