A Country Doctor's Notebook (14 page)

‘I cannot,' I mumbled, growing sleepier, ‘honestly imagine being brought a case that would floor me … perhaps in Moscow they might accuse me of a “
feldsher
” attitude to medicine … well, let them … it's all right for them in their clinics and teaching hospitals, X-ray cabinets and so on … whereas here there's just me … peasants couldn't live without me … How I used to shudder whenever there was a knock at the door, how I winced with fear … Now, though …'

‘When did it happen?'

‘Last week, sir … It all swelled up.'

And the woman began to whimper.

It was a grey October morning, the first day of my second year. Yesterday evening I had been congratulating myself, and now this morning I was standing there in my white coat nonplussed.

She was holding a year-old baby in her arms like a log, and the infant had no left eye. In place of an eye there protruded between taught, overstretched eyelids a yellow-coloured ball the size of a small egg. The baby was struggling and crying in pain, the woman snivelling. And I was at a loss.

I looked at it from every possible angle. Demyan Lukich and the midwife were standing behind me in silence; they had never seen anything like it.

‘What on earth is it? Cerebral hernia?… Hmm … well, at least he's alive … Sarcoma? No, rather too soft … Some revolting, unknown kind of tumour. How could it have developed … from an empty eye socket? Perhaps there never was an eye … at any rate, there isn't now.'

‘Look here,' I said in a burst of inspiration, ‘we shall have to cut this thing out.'

I had a mental picture of how I would cut the lower lid, move it to one side and … and what? What then? Perhaps it really is part of the brain … Ugh, it's soft enough … feels like brain.

‘What, cut him open?' the peasant woman asked, turning pale. ‘Cut his eye? I won't consent.' Horrified, she began wrapping the infant in his rags.

‘He has no eye,' I replied categorically. ‘Just take a look
at where his eye ought to be. Your baby has a strange sort of swelling.'

‘Give him some drops, then,' said the woman fearfully. ‘You're joking! What sort of drops? No drops are going to do him any good!'

‘You wouldn't leave him without an eye, would you?'

‘But he
has
no eye, I tell you.'

‘He had one the day before yesterday!' the woman exclaimed in desperation. (God!)

‘Well, if you say so, then I suppose … hell … only he hasn't got one now, has he? In any case, my dear, you'd better take the child into town. Right away, so they can operate … Don't you agree, Demyan Lukich?'

‘M'yes,' the
feldsher
replied gravely, obviously not knowing what to say, ‘I've never seen the like of it.'

‘Take him to be cut open in town?' the woman cried in horror. ‘I won't let you.'

In the end the woman took her baby away without giving us permission to touch the eye. For two days I racked my brains. shrugged my shoulders and ferreted about in the library in search of illustrations showing babies with protuberant swellings in place of their eyes … hopeless.

Then I forgot about the child altogether.

A week passed.

‘Anna Zhukhova!' I shouted. In came a cheerful peasant woman carrying a baby.

‘What's the trouble?' I enquired mechanically.

‘All's well, he's not going to die,' the woman announced with a sarcastic grin. The sound of her voice made me sit up with a jerk.

‘Recognise him?' she asked mockingly.

‘Wait a moment … that's … wait a moment—is that the child who …?'

‘That's him. Remember you said he had no eye, doctor, and you'd have to cut him open to …'

I felt I was going off my head. The woman stared at me triumphantly, her eyes laughing. The baby lay in her arms gazing out at the world with brown eyes. Of the yellow tumour there was no sign.

‘This is witchcraft,' I thought weakly. When I had somewhat recovered my wits, I cautiously drew down the eyelid. The baby whimpered and tried to turn his head, but I was still able to see it: a tiny little scar on the mucous membrane … Aha!

‘As we were driving away from here, it burst.'

‘No need to tell me,' I said with embarrassment. ‘I see what it was now.'

‘And you said he had no eye. Well, it grew again, didn't it?' And the woman giggled, taunting me.

‘I see now, damn it … An enormous abscess developed under his lower lid, swelled and completely covered the eye … Then when it burst, the pus ran out and everything went back into place.'

No, even when I'm on the verge of sleep I shall never again boast that nothing can surprise me. Now that this year is past, the next year will be just as full of surprises as the first. One never stops learning.

CLEVER PEOPLE HAVE LONG BEEN AWARE THAT happiness is like good health: when you have it, you don't notice it. But as the years go by, oh, the memories, the memories of happiness past!

For myself I realise now that I was happy in that winter of 1917, that headlong, never-to-be-forgotten year of storm and blizzard.

The first blast of the snowstorm snatched me up like a scrap of torn newspaper and transported me from a practice in the depths of the countryside to the town. What, you may wonder, is so special about a country town? If like me you have ever spent the winters snowbound and the summers deep in a landscape of sparse, monotonous woodland, without a single day off in more than a year; if you have ever torn the wrapper off last week's newspaper with your heart beating as though you were a lover joyfully ripping open a pale blue envelope; if you have ever driven twelve miles in a tandem-harnessed sleigh to a woman in labour, then you may realise what the town meant to me.

Kerosene lamps may be very cosy, but I prefer electricity.

And there they were again at last, those seductive little
electric lights! The main street of the little town, the snow well flattened by the runners of peasants' sleighs, was hung with red flags and shop signs that entranced the eye: a boot; a golden pretzel; a picture of a young man with insolent, pig-like eyes and a wholly unnatural haircut, signifying that behind those glass doors was the local Figaro, who for thirty kopecks was prepared to shave you at any hour of the day—except on holidays, in which this land of ours abounds.

To this day I shudder when I recall that Figaro's towels, which reminded me forcibly of a page in my German textbook of skin diseases, illustrating with appalling clarity a growth of hard chancre on a man's chin.

But even those towels cannot spoil my happy memories!

At the crossroads stood a real, live policeman, in a dusty shop window one could just make out tin trays packed with rows of cakes topped with orange cream. The square was carpeted with fresh straw, people were driving, walking about and chatting; there was a kiosk selling yesterday's Moscow papers full of thrilling news, and from not far away came the sound of Moscow-bound trains hooting to one another. In short, this was civilisation, Babylon, the Nevsky Prospekt.

The hospital, I need hardly add, boasted separate surgical, medical, isolation and maternity departments. There was an operating theatre with a gleaming autoclave, plated taps and operating tables with ingeniously designed flaps, cogwheels and screws. It had a Medical Superintendent, three interns (beside myself), several
feldshers
, midwives, nurses, a dispensary and a laboratory. Just think—a laboratory, complete with a Zeiss microscope and a fine assortment of stains.

All this impressed me so much that I would shudder and turn cold. It took me several days to get used to it when, in the December twilight, the hospital's single-storey wards would blaze with electric light as though at a word of command.

I was dazzled. Water splashed and roared in the bathtubs, and worn wooden-cased thermometers plunged or floated in them. All day long the children's isolation ward reverberated with moans, thin plaintive weeping and hoarse gurgles. Nurses darted to and fro.

I had shed a heavy burden. I no longer bore the godlike responsibility for everything that happened in the world. It was not my fault if someone developed a strangulated hernia, and I did not shudder when a sleigh drove up bringing a woman with a transverse foetus, a case of epyema requiring operation was no longer my affair. For the first time I felt that there was a limit to my responsibilities. Childbirth? Over there, please, to that low building—the furthest window with the net curtains; there you'll find our obstetrician, a charming, fat, balding man with a ginger moustache. That's his business. The sleigh makes for the curtained window. A compound fracture? You want our chief surgeon. Inflammation of the lungs? Go and see Pavel Vladimirovich in the medical department.

Oh, what a splendid thing a large hospital is, with its smooth, well-oiled machinery! I fitted into the mechanism like a new screw dropping into its appointed slot and took over the children's department; from then on my days were wholly taken up with diphtheria and scarlet fever. But only my days. I started sleeping at night, undisturbed by that ominous nocturnal tapping downstairs, which meant that I was likely to be roused and dragged out into the darkness
to face danger or whatever fate had in store. I took to reading in the evenings (chiefly about diphtheria and scarlet fever, but I also developed an odd addiction to Fenimore Cooper). I appreciated to the full the electric light over my desk, the charred ash that dropped down on to the tray of my samovar, my cooling tea, and the chance to sleep after many sleepless months.

So I was happy in that winter of 1917, after my transfer to that town from a remote, snowswept country practice.

One month flew by, then another, and a third. 1917 receded and February 1918 began. I got used to my new life and gradually began to forget my far-off practice. The hissing, green-shaded kerosene lamp, the loneliness and the snowdrifts became just a blurred memory. Ungrateful as I am, I forgot about my front-line post, where alone and without the least support I had relied on my own resources to fight disease and extricate myself from the most hair-raising situations, like a Fenimore Cooper hero.

Now and again, I must admit, when I went to bed with the pleasant thought that I would shortly fall asleep, fragments of recollection would pass through my fading consciousness. A green flash, a flickering lantern, the creak of sleigh-runners … a moan and then darkness, the muffled howl of a snowstorm … then the memory would turn head over heels and vanish into oblivion.

‘I wonder who's in that job now? A young man like me, I suppose. Ah well, I did my stint, Muryovo and then Gorelovo hospital … February, March, April and, let's say,
May as well—and I will have finished my probationary period. So I shall leave this splendid town at the end of May and return to Moscow. And if the revolution calls me to its service, I may yet have some more travelling to do … but at all events I shall never see my country practice again … Never again … Moscow … a clinic … asphalt, the bright lights …'

Such were my thoughts.

‘Still, it's a good thing that I spent some time out there in the wilds. It taught me to be brave and nothing frightens me now … Is there anything I haven't treated—literally anything? I didn't have any psychiatric cases … or did I? No, that's right … there was the farm manager who was drinking himself to death. I made rather a mess of treating him, though … delirium … Surely that's a mental illness? I really ought to read up some psychiatry … still, what the hell … maybe later, in Moscow. Right now children's diseases are my main concern, and especially the wearisome business of prescribing for children. Hell, if a child's ten years old, for instance, how big a dose of aminopyrine can I give him? Is it 0.1 or 0.15 grammes? I've forgotten. And if he's three? There are quite enough hideous, unforeseen problems in paediatrics alone, so it's goodbye to my old general practice. But why does that place keep creeping back into my mind so insistently this evening? The green lamp … After all, I'm finished with it for the rest of my days … well, that's enough of that … time for sleep.'

‘Letter for you. Someone who happened to come into town brought it.'

‘Let's have it.'

The nurse was standing in my hallway. An overcoat with a moth-eaten collar was thrown over her white overall with its hospital badge. Snow was melting on the cheap blue envelope.

‘Are you on duty in Casualty Reception?' I asked, yawning.

‘Yes, I am.'

‘Anyone there?'

‘No, it's empty.'

‘If any cashesh come in …' (I was yawning so hard my pronunciation was sloppy) ‘come and let me know. I'm going to sleep …'

‘Yes, doctor. Can I go now?'

‘Yes, yes. Off you go.'

She went out. The door squeaked, and I shuffled into the bedroom in my slippers, clumsily tearing open the envelope as I went. It contained a crumpled oblong prescription form stamped with the address of my old country practice … that unforgettable letterhead.

I smiled.

‘That's interesting … I've been thinking about the place all evening and now this turns up … must have had a premonition …'

Beneath the letterhead a prescription was written in indelible pencil. Some of the Latin words were illegible, others crossed out.

‘What's this? Some prescription gone astray?' I muttered, then stared at the word ‘morphini'. ‘Well, what's so unusual about this prescription? Ah, yes … a four-percent solution! Who's been prescribing a four-per-cent solution of morphine? And what for?'