Reading Chekhov

Note the many negatives: Chekhov's acknowledgment of the "broadened scope" and "enrichment" the study of medicine has given him is perfunctory, compared to his gratitude for what it has helped him to avoid. As in his letter to Shche-glov about the limits of psychological understanding ("Nothing is clear in this world. Only fools and charlatans know and understand everything"), Chekhov is at pains to dissociate himself from any position of authority. When writing of the horrendous treatment of the Jew with liver cancer, he does not offer an alternative cure. Chekhov spoke of medicine as his wife and writing as his mistress (he later recycled the quip to say that fiction was his wife and the theater his mistress), but he never practiced medicine full-time, nor attained any particular distinction as a physician. Medicine in Chekhov's day did not have the power to cure that it has only recently begun to wield. Doctors understood diseases they were helpless to cure. An honest doctor would have found his work largely depressing. Simmons speculates that Chekhov's study of medicine originated in an incident of serious illness when he was fifteen-an attack of peritonitis-which led to friendship with the doctor who attended him. Simmons also notes that Chekhov "always attributed to this attack the hemorrhoidal condition which never ceased to trouble him for the remainder of his life." We hear a lot about these hemorrhoids in Chekhov's letters. They evidently bothered him a good deal more than the symptoms of tuberculosis, which appeared as early as 1884, but which he was not to acknowledge as such for thirteen years. "Over the last three days blood has been coming from my throat," he wrote to Leikin in December 1884. "No doubt the cause is some broken blood vessel." And then, two years later, "I am ill. Spitting of blood and weakness. I am not writing anything… I ought to go to the South but I have no money… I am afraid to submit myself to be sounded by my colleagues." It wasn't until March 1897, after a severe hemorrhage at the Hermitage restaurant in Moscow, that he allowed himself to be sounded and diagnosed. Chekhov's knowing-not knowing that he had the disease that killed him was, of course, an expression of denial, but it was also a product of the cruel-kind nature of tuberculosis itself, whose course is not predictable (consumptives have been known to live to old age) and which (as Rene and Jean Dubos point out in The White Plague: Tuberculosis, Man and Society) "waxes and wanes with long periods of apparent remission followed by periods of exacerbation." It was also of a piece with (and may have been implicated in the formation of) Chekhov's stance of insistent uncertainty. If nothing is clear in this world, then everything is possible-even the prospect of health.

The hemorrhage at the Hermitage occurred just as Chekhov and Alexei Suvorin were sitting down to dinner. Blood began pouring from Chekhov's mouth and the flow could not be stemmed. Suvorin took Chekhov to his suite at the Slaviansky Bazaar (where Chekhov was to book Anna Sergeyevna a few years later) and summoned Chekhov's colleague Dr. Nikolai Obolonsky, who could not persuade Chekhov to go to the hospital. The hemorrhage did not abate until morning, when Chekhov insisted on returning to his own hotel, the Moscow Grand (he was now living at Melikhovo and no longer kept a Moscow residence), and on behaving as if nothing had happened. On March 25, after further hemorrhages, he finally entered the clinic of a Dr. Ostroumov, where advanced tuberculosis was diagnosed. The clinic was located near the Novodevichie Cloister, in whose cemetery, seven years later-after writing Three Sisters, The Cherry Orchard, "The Lady with the Dog," "The Bishop," "In the Ravine," "Gooseberries," and "Ionitch," among other masterpieces-Chekhov would be buried.

While at the Oustromov clinic, with his characteristic inability to refuse almost any request, Chekhov read the manuscripts of two stories sent him by a stranger, a high-school girl named Rimma Vashchuk, who wanted to know whether she had "a spark of talent." He promptly wrote back to say he liked one of the stories, but that the other, entitled "A Fairy Tale," was "not a fairy tale, but a collection of words like 'gnome,' 'fairy,' 'dew,' 'knights'-all that is paste, at least on our Russian soil, on which neither gnomes or knights ever roamed and where you would hardly find a person who could imagine a fairy dining on dew and sunbeams. Chuck it… write only about that which is or that which, in your opinion, ought to be." Stung by Chekhov's criticism, the girl sent him an angry letter, and he, incredibly, wrote to her again from his hospital bed, to patiently explain his criticism. "Instead of being angry, you had better read my letter more carefully," he began. She returned an apology.