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 is torture, but what can he do? In the receiving room he is met by his assistant, Sergei Sergeich, a small, fat man with a clean-shaven, well-scrubbed, plump face, with soft, smooth manners, wearing a roomy new suit and looking more like a senator than an assistant doctor. He has an enormous practice in town, wears a white tie, and considers himself more knowledgeable than the doctor, who has no practice at all. In the corner of the receiving room stands a big icon in a case, with a heavy icon lamp, beside it a candle stand under a white cover; on the walls hang portraits of bishops, a view of the Svyatogorsk monastery, and wreaths of dried cornflowers. Sergei Sergeich is religious and a lover of the beauteous. The icon was installed at his expense; on Sundays one of the patients, on his orders, reads an akathist5 aloud in the receiving room, and after the reading Sergei Sergeich himself makes the rounds of all the wards carrying a censer and censing everybody.
The patients are many, but time is short, and so the business is confined to a brief questioning and the dispensing of some sort of medicine like camphor ointment or castor oil. Andrei Yefimych sits with his cheek propped on his fist, deep in thought, and asks questions mechanically. Sergei Sergeich also sits rubbing his little hands and occasionally mixes in.
“We get sick and suffer want,” he says, “because we don’t pray properly to the merciful Lord. Yes!”
Andrei Yefimych does not do any surgery during receiving hours; he got out of the habit long ago, and the sight of blood upsets him unpleasantly. When he has to open a child’s