Михаил Булгаков - A Country Doctor's Notebook

When I was sitting the forensic medicine paper of my finals, I remember the professor saying:

‘Describe gunshot wounds inflicted at point-blank range.’

I launched into a long and woolly description, during which a page of a very thick textbook floated in my visual memory. At last I ran out of steam, the professor gave me a look of disgust and said in a grating voice:

‘Nothing resembling what you have described is to be found in point-blank wounds. How many “fives” [2] Russian examinations, which are generally oral, are marked on a scale of 1 to 5. ‘5’ indicates ‘distinction’, ‘4’ is ‘good’, ‘3’ is usually a bare pass. have you been given so far?’

‘Fifteen,’ I replied.

He put a ‘three’ against my name and I went out of the room covered in disgrace.

On qualifying, I was soon posted to Muryovo and now I am alone here. The devil alone knows what the characteristics of point-blank wounds are supposed to be, but when I was faced with a man lying on my operating table with a bubbly foam, pink with blood, oozing over his lips, did I lose my head? I did not, even though his chest had been peppered with buckshot at point-blank range, one lung was visible and the flesh of his chest hung in shreds. Six weeks later he left my hospital alive. At university I was not once permitted to hold a pair of obstetrical forceps, yet here—trembling, I admit—I applied them in a moment. I must confess that one baby I delivered looked rather odd: half of its head was swollen, bluish-purple and without an eye. I turned cold, dimly hearing Pelagea Ivanovna as she said consolingly:

‘It’s all right, doctor, you’ve just put one half of the forceps over his eye.’

I shivered with anxiety for two days, but after that the head returned to normal.

And the wounds I have stitched—the cases of suppurating pleurisy when I have had to prise the ribs apart; the cases of pneumonia, typhus, cancer, syphilis, hernia (successfully treated), haemorrhoids, sarcoma.

In a moment of inspiration I opened the out-patients’ register and spent an hour analysing and totalling. In a year, up to the very hour of that evening, I had seen 15,613 patients; 200 inpatients had been admitted, of whom only six died.

I closed the book and tottered to bed. At twenty-five years old and celebrating my first professional anniversary, I lay in bed and thought as I fell asleep that I was now vastly experienced. What had I to fear? Nothing. I had extracted peas lodged in little boys’ ears, I had wielded the knife countless times … My hand had acquired courage and did not shake. I spotted all tricky complications and had acquired a unique ability to understand the things that peasant women say. I was able to interpret them like Sherlock Holmes deciphering mysterious documents. Sleep is creeping up on me.

‘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.