A Country Doctor's Notebook (18 page)

Anna:
Just look at them—they're absolutely transparent. Nothing but skin and bone. And take a look at your face. Listen, Sergei—go away, I implore you …

Myself:
What about you?

Anna:
Go away, go away. You're dying.

Myself:
Don't exaggerate. Still, I must admit I don't understand why I've suddenly weakened so quickly. After all, it's less than a year since this illness started. I suppose it's due to my constitution.

Anna
(sadly): What can bring you back to life? Perhaps your Amneris, that opera singer?

Myself:
Oh no, don't worry. I've got over her, thanks to the drug. I have morphine instead of her.

Anna:
Oh my God … what am I to do?

I thought that women like Anna only existed in novels. If ever I'm cured, I shall stay with her for the rest of my life. I only hope her husband never comes back from Germany.

27th December
I haven't touched my diary for a long time. I am wrapped up for the journey, the horses are waiting. Bomgard has left his practice at Gorelovo and I am being sent to replace him. A woman doctor is coming to take over my practice.

Anna is staying here. She will drive over to see me. Even though it is twenty miles away.

We have firmly decided that I will take a month's sick leave from 1st January and go back to the professor in Moscow. I shall sign a form again and suffer another month of inhuman torture in his clinic.

Farewell, Levkovo. Au revoir, Anna.

1918

January
I didn't go. I can't leave those life-giving crystals.

I would die if I took a cure now. I am becoming more and more convinced that I don't need a cure at all.

15th January
Vomiting in the morning.
Three syringes of 4% solution at dusk.
Three syringes of 4% solution late at night.

16th January
Operation day today, so I have to endure a long period of abstinence—from night time until 6 p.m.

At dusk—always my worst time—I clearly heard a
voice in my room, monotonous and threatening, repeating my name and patronymic:

‘Sergei Vasilievich. Sergei Vasilievich.'

It stopped as soon as I injected myself.

17th January
Blizzard today, so no consultation. During the hours of abstention I read a textbook of psychiatry and it appalled me. I am done for; there's no hope.

During abstinence I am terrified by the slightest sound and I find people detestable. I am afraid of them. In the euphoric phase I love everyone, although I prefer solitude.

I must be careful at Gorelovo—there is a
feldsher
here and two midwives. I must take the greatest possible care not to give myself away. I shall succeed, because by now I am very experienced. No one will find out, as long as I have a supply of morphine. I either prepare the solution myself or send a prescription to Anna in good time. Once she made a clumsy attempt to substitute a 2% for a 5% solution. She brought it herself from Levkovo in bitter cold and a raging snowstorm.

This caused a violent quarrel between us that night. I persuaded her not to do it again. I have told the staff here that I am ill, after racking my brains for a long time to decide what illness to invent. I said that I had rheumatism in my legs and severe neuralgia. They have been warned that I am going away in February for a month's sick leave to take a cure in Moscow. All is going smoothly. No trouble with my work. I avoid operating on the days when I am
overcome by uncontrollable vomiting and retching. Because of this, I've had to add gastric catarrh to my alleged ailments. Too many diseases for one person, I fear.

The staff here are very sympathetic and are themselves urging me to take sick leave.

Outward appearance: thin, pale with a waxen pallor.

I took a bath and afterwards weighed myself on the hospital scales. Last year I weighed 148 lbs (67 kgs); now I weigh 120 lbs (54 kgs). I had a fright as I watched the needle on the dial, but the shock soon passed.

My forearms and thighs are a mass of unhealed abscesses. I don't know how to prepare sterile solutions, besides which I have injected myself with an unsterilised syringe on about three occasions when I was in a great hurry to go out on my rounds.

This can't be allowed to go on.

18th January
I had the following hallucination:

I was sitting in front of a blank, dark window expecting some kind of pale figures to appear. The suspense was intolerable. Yet there was nothing there except the blind. I fetched some gauze from the hospital and draped it over the window. I was unable to think of a rational excuse for my action.

Hell, why
should
I have to find a pretext for every single thing I do? What I am living is not a normal existence, but torture.

Do I express my thoughts lucidly?
I think I do.
What is my life? An absurdity.

19th January
Today during the break in consulting hours, when we were relaxing and having a smoke in the dispensary, the
feldsher
started to tell a story as he wrapped powders in little screws of paper. Laughing for some reason, he described how a woman
feldsher
had become a morphine addict; unable to get the drug, she had swallowed half a tumbler full of an infusion of opium. I did not not know where to look during this painful story. Why on earth did he find it amusing? Why?

I slunk furtively out of the dispensary.

I wanted to say: ‘What's so funny about that affliction?' But I restrained myself.

In my position I cannot afford to be too rude to people.

That
feldsher
is as cruel as those psychiatrists who are so utterly, completely incapable of helping their patients.

Totally incapable.

I wrote the last entry during a period of abstinence and much of what I said was unfair.

A moonlit night. I am lying down, feeling weak after a fit of vomiting. I can hardly lift my hands, so am scribbling my thoughts in pencil. My mind is calm and serene. For a few hours I am happy. Soon I shall sleep. Overhead is the
moon, surrounded by a halo. Nothing upsets me after an injection.

1st February
Anna has arrived. She looks sallow and ill.

I have driven her to the end of her tether. This terrible wrong weighs on my conscience.

I have given her my oath that I will leave here in mid-February.

Will I do as I have promised?

Yes, I will.

Provided I am still alive.

3rd February
So now I am poised at the top of a slope. It is icy, slippery and as endlessly long as the hill down which Kaj's sledge ran in Hans Andersen's fairy tale. This is my last ride down this slope, and I know what is waiting for me at the bottom. Oh Anna, terrible grief will soon be your reward for having loved me …

11th February
I have decided to appeal to Bomgard. Why to him? Because he is not a psychiatrist; because he's young and we were friends at university. He is healthy and tough yet kind-hearted, if I have gauged his character right. Perhaps he will be reli … sympathetic. He will think of some solution. He can take me to Moscow if he wants to. I can't go to him. My sick leave has been approved.
I am not going to work in the hospital, but am lying in bed.

I swore at the
feldsher
. He just laughed … It doesn't matter. He had come to report to me, and offered to sound my respiration and heartbeat.

I refused to let him. Must I go on finding excuses for refusing? I am sick of inventing pretexts.

The note has been sent off to Bomgard.

People! Won't anyone help me?

I am lapsing into outbursts of self-pity. If anybody were to read this they would find it maudlin and insincere. But no one will read it.

Before writing to Bomgard, all my memories came back to me. I had a particular recollection of a Moscow railway station in November, when I was running away from the clinic. What an appalling evening that was. I had gone to a lavatory in the station to inject my stolen morphine. It was a nightmare. People were banging on the door, shouting and swearing at me for spending too long in there, my hands were shaking and the doorhandle was rattling so violently that I thought the door would burst open at any moment.

This was when I started to develop abscesses.

I wept the night that I remembered that incident.

12th Night
I wept again. Why does this disgusting weakness come over me at night?

13th February 1918. Dawn, Gorelovo
I can congratulate myself: I have not had an injection for fourteen hours! Fourteen! An unbelievable number. Murky yellowish light of dawn. Soon I shall be quite cured.

On mature reflection I don't need Bomgard, or anyone else for that matter. It would be shameful to prolong my life a minute more. Certainly not a life like mine. The remedy is right beside me. Why didn't I think of it before?

Well, let's get it over with. I owe nothing to anyone. I have destroyed only myself. And Anna. What else can I do?

Time will heal all, as Amneris sang. It's easy and simple enough for her.

This notebook is for Bomgard. That's all …

I read Sergei Polyakov's notes at dawn on the 14th February 1918 in that faraway little country town. They are reproduced here in full, without the slightest alteration. Not being a psychiatrist, I cannot say with certainty whether or not they are instructive or useful though I believe they are.

Now that ten years have passed, the pity and terror evoked by this diary have, of course, faded. This is natural, but on rereading the jottings, now, when Polyakov's body has long since decayed and the memory of him vanished for ever, I still find them interesting. Are they of value? I shall not presume to make a firm judgement on that point. Anna K. died of typhus in 1922 in the same country practice
where she had always worked. Amneris—Polyakov's first mistress—has gone abroad and will not return.

Should I publish the diary which was entrusted to me?

I should. Here it is.

Doctor Bomgard.

DOCTOR YASHVIN GAVE A CURIOUSLY WRY, ironic grin and asked: ‘May I tear the leaf off the calendar? It's exactly midnight, so now it's the second of the month.'

‘Go ahead, by all means,' I answered.

Yashvin took hold of a corner of the topmost leaf with his slender white fingers and carefully tore it off, revealing another cheap, nasty sheet of paper printed with the figure ‘2' and the word ‘Friday'. But something on that greyish page seemed to seize his interest. He narrowed his eyes as he looked at it, then raised his glance and gazed into the distance; he was evidently seeing some mysterious scene visible only to himself, somewhere beyond the wall of my room—or perhaps far beyond the Moscow night and the raw grip of a February frost.

‘What's on his mind?' I wondered, glancing at him. I had always been intrigued by Doctor Yashvin. Somehow his appearance did not match his profession. Strangers always took him for an actor. He had dark hair but a very white skin, and this made him both conspicuous and attractive. He was very smoothly shaven, he dressed impeccably, was extremely fond of the theatre and could discuss it with great taste and knowledge. But what really distinguished him from our interns and from my other guests that evening were his shoes. There were five of us in the room and four were wearing cheap box-calf boots with
clumsy, rounded toes, but Doctor Yashvin wore pointed patent leather shoes and yellow spats. I must add, though, that Yashvin's dandyish appearance was never exactly offensive and, to give him his due, he was a very good doctor. He was bold, successful, and most important, he found time to keep up his reading, in spite of regular visits to
The Valkyrie
and
The Barber of Seville
.

His shoes, however, were not the most interesting thing about him. What fascinated me was one remarkable characteristic: his gift, which he would occasionally display, of being a marvellous raconteur, even though he was usually a quiet and decidedly withdrawn man. He spoke very deliberately without striving for effect, without the average man's redundant verbiage and humming and hawing, and always on very interesting topics. The reserved, elegant doctor seemed to light up, his pale right hand making occasional short, smooth, economical gestures as if he were punctuating his account with little milestones in the air; he never smiled when telling something funny, and his similes were sometimes so apt and colourful that as I listened to him I was always disturbed by one thought:

‘You are a very good doctor, but you've chosen the wrong career. You should have been a writer.'

Now, too, this thought flashed through my head, even though Yashvin was not talking but screwing up his eyes at the figure ‘2' and at some imaginary object in the distance.

‘What is he looking at? Maybe there's a picture.' I looked over my shoulder and saw that the picture was totally uninteresting. It depicted an improbable-looking horse with an exaggerated chest and next to it an engine. The caption read: ‘Comparative size of horse (one horsepower) and engine (500 horsepower).'

‘This is all nonsense,' I said, continuing the conversation. ‘Banal prejudice. People are most unfair to doctors and to us surgeons in particular. Just think: a man does a hundred appendectomies and the hundred and first patient expires on the operating table. Is that murder?'

‘They're bound to say it is,' Doctor Gips replied.

‘And if the patient is a married woman, the husband will come to the surgery and throw a chair at you,' Doctor Plonsky affirmed confidently; he even smiled, and we all smiled, although there is nothing very funny about people hurling chairs around the surgery.

‘I can't bear it, because it rings so false, when someone says penitentially: “I have killed, ah me, I'm a murderer” ' I continued. ‘No doctor murders anyone, and if someone dies on you, then it's just bad luck. No, really, it's simply a joke! Murder is not part of our profession. How can it be? I call murder the premeditated killing of a person, or if you insist, the desire to kill him. A surgeon with a pistol in his hand—that, I'll admit, might be murder. But I've never met any such surgeon in my life, nor am I likely to.'