A Country Doctor's Notebook (17 page)

My previous notes must sound somewhat hysterical. In fact there is nothing particularly unusual or alarming about my condition. It does not in the least affect my capacity to work. On the contrary, I live through the day
on the previous night's injection. I cope splendidly with operations, I am irreproachably careful when prescribing, and I give my professional oath that my addiction causes no harm to my patients. I pray that it never will. But something else does worry me: I keep thinking that other people may find out about my vice. During consultation hours I am disturbed by the thought of my assistant's grim, searching look behind my back.

Nonsense! He'll never guess. There's nothing to give me away. The pupils of my eyes can only betray me in the evening, and I never see him in the evening.

To make up for the terrible drain on the stock of morphine in our dispensary, I drove into the local town. There, too, I went through a nasty few minutes. I had taken care to fill out my order with all kinds of stuff such as caffeine (of which we had plenty), but as the storekeeper took it he said dubiously:

‘Forty grammes of morphine?'

I did not know where to look, and felt myself blushing like a guilty schoolboy. He said:

‘We haven't got that much. I can give you ten grammes.'

He really did not have that quantity, but I had the impression that he had discovered my secret; his probing eyes were boring into me and this made me nervous and jumpy.

My pupils, I have decided, are the only danger signs, and for that reason I shall make it a rule not to see anyone in the evening. For this, incidentally, there could be no more convenient place than my isolated practice; it is six months since I have seen anyone except my patients, and they have not the slightest interest in me.

18th May
A sultry night. A thunderstorm is brewing, black storm clouds building up beyond the forest. A moment ago there came a pale warning flash of lightning. The storm has begun.

A book is open in front of me and this is what it has to say about the symptoms of morphine withdrawal:

I have not experienced any hallucinations, but I can only say that the rest of this description is dull, pedestrian and totally inadequate. ‘Depressed condition' indeed! Having suffered from this appalling malady, I hereby enjoin all doctors to be more compassionate toward their patients. What overtakes the addict deprived of morphine for a mere hour or two is not a ‘depressed condition': it is slow death. Air is insubstantial, gulping it down is useless … there is not a cell in one's body that does not crave … but crave what? This is something which defies analysis and explanation. In short, the individual ceases to exist: he is eliminated. The body which moves, agonises and suffers is a corpse. It wants nothing, can think of nothing but morphine. To die of thirst is a heavenly, blissful death compared with the craving for morphine. The feeling must be something like that of a man buried alive, clawing at the skin on his chest in the effort to catch the last tiny bubbles of air in his coffin, or of a heretic at the stake, groaning and writhing as the first tongues of flame lick at his feet.

Death. A dry, slow death. That is what lurks behind that clinical, academic phrase ‘a depressed condition'.

I can't hold out. I have just had to inject myself. A deep breath. And another.

Feeling better. Ah … there it is … a stab of cold in the pit of my stomach, a taste of peppermint …

Three syringes of a 3% solution. That will last me until midnight.

Nonsense. That last entry was nonsense. It's not as bad as that. Sooner or later I'll give it up … but now I need sleep, sleep.

This idiotic, agonising battle against morphine is wearing me out.

(
The next couple of dozen or so pages are torn out
.)

…ing.

 … gain vomited at 4.30 a.m.

When I feel better I shall record this appalling experience.

14th November 1917
So having run away from Doctor …'s (
the name has been carefully crossed out
) clinic in Moscow, I am home again. The rain is streaming down and shrouding the outside world from my sight. Long may it do so. I don't need the world any more, and no one in the world needs me. I was in the clinic while the shooting and the coup d'etat took place, but the idea of abandoning the cure had begun insidiously to grow in my mind even before the fighting
started in the streets of Moscow. I have the morphine to thank for making me brave. I'm not afraid of rifle fire now. After all, what can possibly frighten a man obsessed by one thing only—the divine, wonder-working crystals? The nurse, utterly terrified by the crash of gunfire …

(
page torn out
)

 … pped out that page so that no one should read the disgraceful account of how a professional man ran away like a cowardly thief and stole his own suit.

And not only my suit; I was so desperate that I also took a hospital shirt. Next day, having given myself an injection, I pulled myself together and returned to Doctor N. His attitude was one of pity, but even so I sensed contempt behind his pity, which was wrong of him: he is after all a psychiatrist and ought to realise that I am not always in control of myself. I am a sick man. He should not despise me. I gave back the hospital shirt.

‘Thank you,' he said. ‘And what do you propose to do now?'

Being then in a state of euphoria, I said cheerfully: ‘I have decided to go back to my practice; my leave is over, anyway. I am very grateful to you for your help and I feel decidedly better. I shall continue the treatment at home.'

To this he replied: ‘You are not in the least better. I find it ludicrous that you should say this to me. One look at your pupils is enough. Who do you think you're talking to?'

‘I can't throw off the addiction all at once, professor … especially now, with all that's going on around us … the gunfire has made me a nervous wreck.'

‘It's over now. We have a new government. Go back to bed.'

As he said this I remembered it all: the chilly corridors, the blank, shiny oil-painted walls … and myself limping past them like a lame dog, waiting for something … For what? For a hot bath? No, for a wretchedly small injection of 5 milligrammes of morphine. I can stay alive on a dose of that size, but only just. And the anguish remains, weighing me down like lead, just as it did before. Sleepless nights, the shirt which I tore to shreds as I begged them to let me go.

No. They have invented morphine, extracting it from the dried, rattling seed-heads of that divine plant, so let them damn well find a painless cure for it! I shook my head obstinately. At that the professor stood up and I suddenly rushed for the door in terror. I thought he meant to lock me in and keep me in the clinic by force.

The professor turned red in the face. ‘I am not a warder,' he said with some irritation, ‘and this isn't the Butyrki Prison. Sit down and relax. Two weeks ago you claimed you were completely normal. Yet now …' Expressively, he imitated my gesture of fear. ‘I'm not keeping you here.'

‘Professor, give me back my committal certificate. I beg you.' my voice quavered pitifully.

‘By all means.'

With a jingle of keys he opened a drawer in his desk and handed me the certificate, on which I had voluntarily committed myself to taking the full two-month cure and had agreed that they should restrain me from leaving the clinic—the usual wording.

As I took the certificate with a trembling hand and stuffed it into my pocket I mumbled:

‘Thank you.'

Then I got up to go and started to leave.

‘Doctor Polyakov!' His voice rang out behind me. I turned round, my hand on the doorknob. ‘Listen,' he said, ‘think it over. You must realise that you will inevitably land up in a psychiatric hospital at a slightly, er … later stage. And when you do, you will be in a far worse condition. So far I have at least been able to deal with you as a doctor. But later you will be in a state of total mental collapse. Strictly speaking, my dear fellow, you are not fit to practise and I shall be breaking the law if I do not notify your local medical authority to that effect.'

I shuddered and plainly felt the colour drain from my face (although I was pale enough already).

‘I beg you, professor,' I said dully, ‘not to tell them anything … I'd be struck off with ignominy for being an addict … Surely you wouldn't do that to me?'

‘Oh, very well then, go,' he shouted irritably. ‘I won't say anything. All the same, you'll be back.'

I went, and I swear that I was racked with pain and shame all the way home. Why?

The answer's simple. Ah, my diary, my faithful friend—you at least won't give me away, will you? It was not because of the suit, but because I also stole some morphine from the hospital. Three cubes in crystal form and ten grammes of 1% solution.

But this in itself is not the only thing which interests me. The key was in the lock of the hospital's drug cabinet. Supposing it had not been. Would I have smashed open the cupboard? Would I? In all honesty?

Yes, I would.

So Doctor Polyakov is a thief. I must remember to tear that page out.

Still, he was exaggerating when he said I was unfit to practise. It is absolutely true that I am degenerating; the break-up of my moral personality has set in. But I can still work, and I am incapable of inflicting harm or wrong on a single one of my patients.

Why did I steal? It's very simple. During the fighting and unrest connected with the coup d'etat, I thought I might not be able to get any more supplies of morphine. But when the disturbances died down, I managed to find some in a suburban pharmacy—15 grammes of 1% solution, which to me was almost worse than useless, as one dose would have required nine injections. What was more, I had to put up with being humiliated: the pharmacist demanded a rubber stamp on my prescription and glowered at me suspiciously. Next day, however, all was well again when I was given 20 grammes in crystal form without the slightest delay, having written out a prescription for the hospital (adding, of course, an order for caffeine and aspirin as well). But why, after all, should I have to hide and feel afraid? I'm behaving as if the words ‘drug addict' were branded on my forehead. Whose business is it besides mine, for heaven's sake?

In any case, have I really gone so far downhill? I cite this diary as evidence. The entries are fragmentary, but then I'm not a writer by profession. Do they sound unbalanced? I would say that my reasoning is entirely sane.

For an addict there is one pleasure of which no one can deprive him—his ability to spend his time in absolute solitude. And solitude means deep, significant thought; it means, calm, contemplation—and wisdom.

The night flows on, black and silent. Somewhere out there is the bare leafless forest, beyond it the river, the chill air of autumn. Far away lies the strife-torn, restless city of Moscow. Nothing concerns me, I need nothing and there is nowhere for me to go.

The flame in my lamp burns softly; I want to rest after my adventures in Moscow and forget them.

And I have forgotten them.

18th November
Frost. The ground dry and hard. I went out for a walk along the path by the river, because I hardly ever get any fresh air.

I may be in a state of moral decay, but I am nevertheless making an effort to arrest it. This morning, for instance, I did not have an injection (I am now injecting myself with three syringes of 4% solution three times daily). Awkward. I feel sorry for Anna. Each extra per cent causes her agony, which saddens me. She is such a wonderful person.

So when the pains began I decided to suffer awhile (how Professor N. would approve if only he could see me!)
by delaying my injection, and set off for a walk by the river.

It was completely deserted. Not a sound, not so much as a rustle. Dusk had not yet fallen, but it was in the air, lurking in the marshland, creeping between the tussocks and tree-stumps … slowly closing in on Levkovo hospital, while I shuffled along leaning on my stick (to tell the truth, I have grown somewhat weaker recently).

Then I noticed a little old woman with yellow hair coming quickly towards me up the slope from the river, moving so fast that I could not see her feet under her colourful, bell-shaped skirts. At first sight I paid no attention to her and felt no alarm; she was after all just an old peasant woman. Then it struck me as odd that she was bareheaded and wearing only a blouse, because it was so cold. A moment later I began to wonder—where was she from? Who was she? When consulting hours at Levkovo are over, the peasant sleighs all drive away and there is no one to be seen for miles around—nothing but mist, marshland and woods. Suddenly I felt a cold sweat break out up and down my spine and I realised: the old woman was not running but actually flying, without touching the ground. This was bad enough; but what made me scream aloud was the fact that she was holding a pitchfork in both hands. Why was I so frightened? I fell on to one knee, holding out my hands to shield myself from the sight, then I turned and ran, stumbling, for home and safety, praying that my heart would not give out before I could reach my warm room, see my flesh-and-blood Anna … and take some morphine …

And I came home at a run.

What nonsense. A meaningless, chance hallucination.

19th November
Vomiting. A bad sign.

My conversation with Anna on the night of the 21st:

Anna:
The
feldsher
knows.

Myself:
Does he? So what? I don't care.

Anna:
If you don't leave this place and go into town, I shall kill myself. D'you hear? Look at your hands.

Myself:
They're trembling slightly. That doesn't stop me working, though.