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ART AND MEDICINE |
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Year : 2004 | Volume
: 5
| Issue : 3 | Page : 66-68 |
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Anton Chekhov: A Life in Medicine and Literature
Rachel Hajar
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Date of Web Publication | 22-Jun-2010 |
Correspondence Address: Rachel Hajar ,
 Source of Support: None, Conflict of Interest: None  | Check |

How to cite this article: Hajar R. Anton Chekhov: A Life in Medicine and Literature. Heart Views 2004;5:66-8 |
'Art Tells the Truth' | |  |
"Medicine is my lawful wife and literature my mistress; when I get tired of one, I spend the night with the other" is a well-known quote by Anton Chekhov, the Russian physician and writer. Founder of both the modern short story and modern prose drama, he is considered one of the greatest short story writers of all time. He was awarded the prestigious Pushkin Prize in 1888. He was Russia's - and perhaps the world's - foremost story writer. He began writing shortstories during his days as a medical student at the University of Moscow. He sandwiched his writing between professional duties. He wrote to a friend:
I started a story this morning. The idea I had for it was not bad but the pity of it was it had to be written in the gaps between other duties. After the first page Mrs. Dmitriev came in asking for a medical certificate. After the second page I received a telegram from Shekhtel saying he was ill so I had to go and see him. After the third page it was lunchtime and so on. And so I am writing in fits and starts, like an irregular pulse.
His stories are remarkable for the paucity of external plot, events, and excitements. His focus was the internal drama - fears, anxieties, yearnings, desperation, loneliness, and hope within a given character. His characters are incredibly passive, filled with hopelessness and the fruitlessness of all efforts. "What difference does it make?" says Chebutykin in Three Sisters.
Chekhov revolutionized story-writing by revealing the inner life of his characters through ordinary conversations, pauses, non-communication, non-happening, and incomplete thoughts to expose the truth behind trivial words and daily life. He portrayed life in the small towns of Russia and his characters belong often to the provincial middle class, petty aristocracy, or landowners of pre-revolutionary Russia. They are ordinary people leading dull and tedious lives - unsatisfactory lives. His younger characters are portrayed as victims of illusion and the older ones, victims of disillusionment. The passage of time is a constant preoccupation, as are the trivialities of life and the halfhearted and unsuccessful search for its meaning. He emphasizes character and mood, the misery of lonely people, and the misunderstandings that build up from self-absorption and desperation.
Disease features prominently in Chekhov's stories, and his characters often suffer tragic and untimely deaths. Chekhov suffered from tuberculosis and died of the disease at the age of forty-four, hence it is not surprising that he was haunted by the notion of infirmity.
Disease and death are recurring themes and underlines Chekhov's recognition that human beings are subject to forces beyond their control.
Chekhov's stories examine many kinds of disappointment and failed ideals. Often his characters are disillusioned by events that force them to reevaluate their personal philosophies and understanding of the world. They tackle frustrated dreams, loneliness, and the breakdown of romantic ties, but they never fundamentally alter their worldview. Consequently, Chekhov's tales conclude with either a moment of revelation or anti-climax. His characters are either crushed by their sense of disillusionment with the world, or they hold out hope in a better future.
Chekhov often described his stories and plays as comic satires. "When a woman isn't beautiful, people always say, 'You have lovely eyes, you have lovely hair'." (from Uncle Vanya). He often depicted silly social situations, marital problems, and farcical encounters between husbands, wives, mistresses, lovers, and whims of young women.
Chekhov's stories concern human folly, the tragedy of trivialities, and the cruel irony of ordinariness. Chekhov weaves humor with pathos to magnify the inconsequential details of people's lives. By highlighting the trivialities of daily life, his characters, though frequently absurd, are transformed into sad and touching figures but the tragedy is that they never transcend their mundane lives. They are trapped in the "toils of fate."
In crafting his stories, Chekhov applied the objectivity of a scientist and a physician combined with the sensitivity and psychological understanding of an artist. In a tribute to Chekhov, a writer described that when reading Chekhov, "one gets the impression of holding life itself, like a fluttering bird, in one's cupped hands". There is no doubt that the acute observations of the human condition that permeates his stories are due to his medical training. That his characters are drawn with compassion and humor in a clear and simple style is a testament to his artistic genius. A friend and fellow student, Rossolimo, who became a well-known professor of neuropathology at Moscow says:
Chekhov did not go to work as an average medical student. He collected the elements of the case history together with surprising ease and accuracy . . . but it was where one had to touch on the ordinary life of the patient, uncovering its intimate details, about how the illness developed into its present state that Chekhov seemed to bowl along effortlessly without forcing himself, in contrast to many students and even doctors who find it difficult to relate to the vivid statements emerging from the unique circumstances of patients' lives".
Like many of his characters, Chekhov's own life was touched by tragedy. In his exemplary biography Anton Chekhov: A life, Donald Rayfield says Chekhov "mourned in fiction" for his gifted brother Nikolai's untimely death, his broken family, and the suicides of many of his friends. These tragic events and glimpses into the state of affairs of his patients' private lives fostered an understanding of suffering.
Among the finest works of Chekhov's later years are his hundreds of letters to notable contemporaries. Chekhov was often distressed at the sufferings of the sick. He wrote to Suvorin, his publisher:
A doctor has terrible days and hours. I would not wish them on anyone. Among doctors, it is true that there are ignorant and rude people, as also among writers, engineers and people in general. But these terrible hours and days that I am speaking of only happen to doctors. And for that I say much will be forgiven them. A country wife was carting rye, and tumbled head first off the cart. Smashed herself dreadfully. Concussion of the brain, strain of the neck muscles, vomiting and great pain and so on. They brought her to me. Moans and ohs and ahs. She implores God for death. Yet her eyes are fixed on the peasant who brought her in and she mumbles" "Have done with the lentils, Krylla, thresh them later but get threshing the oats now." I tell her that talk about oats could be put off for really there's something of a more serious nature to talk about, but she tells me "He's got very good oats." A bustling greedy country wife. Such people find it easy to die.
Chekhov died of pulmonary tuberculosis in 1904. There was a history of tuberculosis in the family - a niece died of tuberculosis the age of 26. His letters indicate that Chekhov refused to put a name to what he must have long suspected but subconsciously denied. In 1886, he wrote to a friend:
I am afraid of being auscultated by my colleagues. What if they find prolonged expiratory sounds, bronchial breathing. It seems not to be the lungs that are at fault but the throat.
In 1888, he wrote to Suvorin:
I noticed a couple of times that I was bringing up blood, sometimes in large quantities so that I could taste it the whole time and sometimes more slightly. Each winter, autumn, spring and especially when the weather is humid I cough. But all this only frightens me when I see blood. There is something very ominous in the slow trickle of blood from the mouth, seen in the glow from the fire. But when there is no blood I am not worried and do not threaten literature with "yet one more loss." In fact consumption or any other lung disease can be recognized only through an aggregation of symptoms, and in my case there is not an aggregate. Expectoration in itself is not serious. Sometimes a lung hemorrhage can go on for a whole day . . . but the result is the patient goes on living, and this happens in the majority of patients. If the hemorrhage I had in the district court had been the beginning of consumption I should have been in the other world a long time ago. This is my kind of logic.
Tuberculosis was known as consumption from the Greek word "phthisis", which means "chronic wasting away." Before the discovery of streptomycin, it was always fatal. It was only in 1882 that Robert Koch announced his discovery of the tubercle bacilli responsible for causing tuberculosis and the definitive diagnosis was the isolation of the tubercle bacillus in the sputum. Tuberculosis can mimic many forms of disease and the clinical diagnosis was much more difficult before the discovery of x-ray by Wilhem Wilhem Conrad Roentgen in 1895.
Chekhov watched his brother die from tuberculosis. Chekhov's refusal to be examined by his colleagues is understandable since tuberculosis was always fatal during his time. His symptoms that he described above would have been immediately recognized as consumption by another physician. Chekhov must have known he had consumption but he preferred not to know. Knowing that he had an incurable and fatal disease would have been equivalent to a death sentence. Such knowledge would have tormented him. He chose to pretend he only had bouts of "flu" until "the followers of Aesculapius" - the phrase he used to refer to his doctors - "enlightened my blissful ignorance and found some infected sputum in the apex of each lung" he wrote to his brother, Michael, from his hospital bed. Tubercle bacilli were discovered in his sputum.
When Chekhov's doctors proved what he probably knew all along, he seemed to have been in a lighter mood, for when Suvorin, his publisher, visited him, he found Chekhov sitting in bed laughing and joking as usual with a large glass of blood stained sputum by his side. He said to Suvorin:
We say when they [patients] have a cough it is gastric and when they have a hemorrhage it is a burst vein. But gastric coughs do not exist and coughed up blood definitely comes from the lungs. Blood is coming from my right lung as it did in the case of my brother, and another of my tuberculous relatives. The doctors try and tell me, as a doctor, that it is gastric hemorrhage. I listen to them but don't take notice; I know I have TB.
He spent the remaining years of his life in exile from Moscow, traveling to warmer climates and settling in Yalta, south Russia but he continued to write. Some of his best stories and plays were written during this time. In addition, he continued his humanitarian efforts to help those in need and relieve their suffering. He remained optimistic throughout his illness. His last letter was written on the same day to his old friend Rossolino:
I have had a high temperature every day . . . my breathing is labored enough to make you want to scream and there are even moments when I quite lose heart.
He died in a German health resort in 1904. Chekhov would have smiled ruefully at the refrigerated railway car that brought his body back to Russia. It bore the inscription "for oysters".[1]
References | |  |
1. | John Coope. Doctor Chekhov, Cross Publishing, Chale, Isle of Wight, 1997 |
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