Михаил Булгаков - A Country Doctor's Notebook

In the surgery a dim figure in full skirts clung to me and a voice whined:

‘Oh, sir, how can you cut a little girl’s throat? How can you? She’s agreed to it because she’s stupid. But you haven’t got my permission—no you haven’t. I agree to giving her medicine, but I shan’t allow her throat to be cut.’

‘Get this woman out!’ I shouted, and added vehemently: ‘You’re the stupid one! Yes, you are. And she’s the clever one. Anyway, nobody asked you! Get her out of here!’

A midwife took a firm hold of the old woman and pushed her out of the room.

‘Ready!’ the feldsher said suddenly.

We went into the small operating theatre; the shiny instruments, blinding lamplight and oilcloth seemed to belong to another world … for the last time I went out to the mother, and the little girl could scarcely be torn from her arms. She just said in a hoarse voice: ‘My husband’s away in town. When he comes back and finds out what I’ve done, he’ll kill me!’

‘Yes, he’ll kill her,’ the old woman echoed, looking at me in horror.

‘Don’t let them into the operating theatre!’ I ordered.

So we were left in the operating theatre, my assistants, myself, and Lidka, the little girl. She sat naked and pathetic on the table and wept soundlessly. They laid her on the table, strapped her down, washed her throat and painted it with iodine. I picked up the scalpel, still wondering what on earth I was doing. It was very quiet. With the scalpel I made a vertical incision down the swollen white throat. Not one drop of blood emerged. Again I drew the knife along the white strip which protruded between the slit skin. Again not a trace of blood. Slowly, trying to remember the illustrations in my textbooks, I started to part the delicate tissues with the blunt probe. At once dark blood gushed out from the lower end of the wound, flooding it instantly and pouring down her neck. The feldsher started to staunch it with swabs but could not stop the flow. Calling to mind everything I had seen at university, I set about clamping the edges of the wound with forceps, but this did no good either.

I went cold and my forehead broke out in a sweat. I bitterly regretted having studied medicine and having landed myself in this wilderness. In angry desperation I jabbed the forceps haphazardly into the region of the wound, snapped them shut and the flow of blood stopped immediately. We swabbed the wound with pieces of gauze; now it faced me clean and absolutely incomprehensible. There was no windpipe anywhere to be seen. This wound of mine was quite unlike any illustration. I spent the next two or three minutes aimlessly poking about in the wound, first with the scalpel and then with the probe, searching for the windpipe. After two minutes of this, I despaired of finding it. ‘This is the end,’ I thought. ‘Why did I ever do this? I needn’t have offered to do the operation, and Lidka could have died quietly in the ward. As it is she will die with her throat slit open and I can never prove that she would have died anyway, that I couldn’t have made it any worse …’ The midwife wiped my brow in silence. ‘I ought to put down my scalpel and say: I don’t know what to do next.’ As I thought this I pictured the mother’s eyes. I picked up the knife again and made a deep, undirected slash into Lidka’s neck. The tissues parted and to my surprise the windpipe appeared before me.

‘Hooks!’ I croaked hoarsely.

The feldsher handed them to me. I pierced each side with a hook and handed one of them to him. Now I could see one thing only: the greyish ringlets of the windpipe. I thrust the sharp knife into it—and froze in horror. The windpipe was coming out of the incision and the feldsher appeared to have taken leave of his wits: he was tearing it out. Behind me the two midwives gasped. I looked up and saw what was the matter: the feldsher had fainted from the oppressive heat and, still holding the hook, was tearing at the windpipe. ‘It’s fate,’ I thought, ‘everything’s against me. We’ve certainly murdered Lidka now.’ And I added grimly to myself: ‘As soon as I get back to my room, I’ll shoot myself.’ Then the older midwife, who was evidently very experienced, pounced on the feldsher and tore the hook out of his hand, saying through her clenched teeth:

‘Go on, doctor …’

The feldsher collapsed to the floor with a crash but we did not turn to look at him. I plunged the scalpel into the trachea and then inserted a silver tube. It slid in easily but Lidka remained motionless. The air did not flow into her windpipe as it should have done. I sighed deeply and stopped: I had done all I could. I felt like begging someone’s forgiveness for having been so thoughtless as to study medicine. Silence reigned. I could see Lidka turning blue. I was just about to give up and weep, when the child suddenly gave a violent convulsion, expelled a fountain of disgusting clotted matter through the tube, and the air whistled into her windpipe. As she started to breathe, the little girl began to howl. That instant the feldsher got to his feet, pale and sweaty, looked at her throat in stupefied horror and helped me to sew it up.

Dazed, my vision blurred by a film of sweat, I saw the happy faces of the midwives and one of them said to me:

‘You did the operation brilliantly, doctor.’

I thought she was making fun of me and glowered at her. Then the doors were opened and a gust of fresh air blew in. Lidka was carried out wrapped in a sheet and at once the mother appeared in the doorway. Her eyes had the look of a wild beast. She asked me:

‘Well?’

When I heard the sound of her voice, I felt a cold sweat run down my back as I realised what it would have been like if Lidka had died on the table. But I answered her in a very calm voice:

‘Don’t worry, she’s alive. And she’ll stay alive, I hope. Only she won’t be able to talk until we take the pipe out, so don’t let that upset you.’

Just then the grandmother seemed to materialise from nowhere and crossed herself, bowing to the doorhandle, to me, and to the ceiling. This time I did not lose my temper with her, I turned away and ordered Lidka to be given a camphor injection and for the staff to take turns at watching her. Then I went across the yard to my quarters. I remember the green lamp burning in my study, Döderlein lying there and books scattered everywhere. I walked over to the couch fully dressed, lay down and was immediately lost to the world in a dreamless sleep.

A month passed, then another. I grew more experienced and some of the things I saw were rather more frightening than Lidka’s throat, which passed out of my mind. Snow lay all around, and the size of my practice grew daily. Early in the new year, a woman came to my surgery holding by the hand a little girl wrapped in so many layers that she looked as round as a little barrel. The woman’s eyes were shining. I took a good look and recognised them.

‘Ah, Lidka! How are things?’

‘Everything’s fine.’

The mother unwound the scarves from Lidka’s neck. Though she was shy and resisted I managed to raise her chin and took a look. Her pink neck was marked with a brown vertical scar crossed by two fine stitch marks.

‘All’s well,’ I said. ‘You needn’t come any more.’

‘Thank you, doctor, thank you,’ the mother said, and turned to Lidka: ‘Say thank you to the gentleman!’

But Lidka had no wish to speak to me.

I never saw her again. Gradually I forgot about her. Meanwhile my practice still grew. The day came when I had a hundred and ten patients. We began at nine in the morning and finished at eight in the evening. Reeling with fatigue, I was taking off my overall when the senior midwife said to me: