V
It was indeed a strange rumour!
Doctor Andréi Yéfimitch Rágin was a remarkable man in his way. In early youth, so they said, he was very pious, and intended to make a career in the Church. But when in the year 1863 he finished his studies in the gymnasium and prepared to enter the Ecclesiastical Academy, his father, a surgeon and a doctor of medicine, poured ridicule on these intentions, and declared categorically that if Andréi became a priest he would disown him for ever. Whether this story is true or not it is impossible to say, but it is certain that Andréi Yéfimitch more than once admitted that he had never felt any vocation for medicine or, indeed, for specialised sciences at all.
Certain it is, also, that he never became a priest, but completed a course of study in the medical faculty of his university. He showed no particular trace of godliness, and at the beginning of his medical career was as little like a priest as at the end.
In appearance he was as heavy and rudely built as a peasant. His bearded face, his straight hair, and his strong, awkward build recalled some innkeeper on a main road—incontinent and stubborn. He was tall and broad-shouldered, and had enormous feet, and hands with which, it seemed, he could easily crush the life out of a man's body. Yet his walk was noiseless, cautious, and insinuating; and when he met anyone in a narrow passage he was always the first to step aside, and to say—not as might be expected in a bass voice—in a soft, piping tenor: "Excuse me!"
On his neck Andréi Yéfimitch had a small tumour which forbade his wearing starched collars; he always wore a soft linen or print shirt. Indeed, in no respect did he dress like a doctor; he wore the same suit for ten years, and when he did buy new clothing—at a Jew's store—it always looked as worn and crumpled as his old clothes. In one and the same frock-coat he received his patients, dined, and attended entertainments; and this not from penuriousness but from a genuine contempt for appearances.
When Andréi Yéfimitch first came to the town to take up his duties as physician to the hospital, that "charitable institution" was in a state of inconceivable disorder. In the wards, in the corridors, and even in the open air of the yard it was impossible to breathe owing to the stench. The male attendants, the nurses and their children, slept in the dormitories together with the patients. It was complained that the hospital was becoming uninhabitable owing to the invasion of beetles, bugs, and mice. In the surgical department there were only two scalpels, nowhere was there a thermometer, and the baths were used for storing potatoes in. The superintendent, the housekeeper, and the feldscher robbed the sick, and of the former doctor, Andréi Yéfimitch's predecessor, it was said that he sold the hospital spirits secretly, and kept up a whole harem recruited from among the nurses and female patients. In the town these scandals were well-known and even exaggerated; but the townspeople were indifferent, and even excused the abuses on the ground that the patients were all either petty tradespeople or peasants who lived at home among conditions so much worse that they had no right to complain; such gentry, they added, must not expect to be fed on grouse! Others argued that as no small town had sufficient resources to support a good hospital without subsidies from the Zemstvo, they might thank God they had a bad one; and the Zemstvo refused to open a hospital in the town on the ground that there was already one.
When he inspected the hospital for the first time Andréi Yéfimitch saw at once that the whole institution was hopelessly bad, and in the highest degree dangerous to the health of the inmates. He concluded that the best thing to do was to discharge the patients and to close the hospital. But he knew that to effect this his wish alone was not enough; and he reasoned that if the physical and moral uncleanliness were driven from one place it would merely be transplanted to another; it was necessary, in fact, to wait until it cleaned itself out. To these considerations he added that if people opened a hospital and tolerated its abuses they must have need of it; and, no doubt, such abominations were necessary, and in the course of time would evolve something useful, as good soil results from manuring. And, indeed, on this earth there is nothing good that has not had evil germs in its beginnings.
Having taken up his duties, therefore, Andréi Yéfimitch looked upon the abuses with apparent indifference. He merely asked the servants and nurses not to sleep in the wards, and bought two cases of instruments; but he allowed the superintendent, the housekeeper, and the feldscher to remain in their positions.
Andréi Yéfimitch was passionately enamoured of intellect and honesty, but he had neither the character nor the confidence in his own powers necessary to establish around himself an intelligent and honest life. To command, to prohibit, to insist, he had never learned; It seemed almost that he had sworn an oath never to raise his voice or to use the imperative mood. ... Even to use the words "give" or "bring" was difficult for him. When he felt hungry, he coughed irresolutely and said to his cook, "Suppose I were to have a cup of tea," or "I was thinking about dining." To tell the superintendent that he must cease his robberies, to dismiss him, or to abolish altogether his parasitical office he had not the strength. "When he was deceived or flattered, or handed accounts for signature which he knew to have been falsified, he would redden all over and feel guilty, yet sign the accounts; and when the patients complained that they were hungry or had been ill-treated by the nurses, he merely got confused, and stammered guiltily:
"Very well, very well, I will investigate the matter. ... No doubt there is some misunderstanding...."
At first Andréi Yéfimitch worked very zealously. He attended to patients from morning until dinner-time, performed operations, and even occupied himself with obstetrics. He gained a reputation for exceptional skill in the treatment of women and children. But he soon began visibly to weary of the monotony and uselessness of his work. One day he would receive thirty patients, the next day the number had grown to thirty-five, the next day to forty, and so on from day to day, from year to year. Yet the death-rate in the town did not decrease, and the number of patients never grew less. To give any real assistance to forty patients in the few hours between morning and dinner-time was physically impossible; in other words, he became an involuntary deceiver. The twelve thousand persons received every year, he reasoned, were therefore twelve thousand dupes. To place the serious cases in the wards and treat them according to the rules of medical science was impossible, because there were no rules and no science; whereas if he left philosophy and followed the regulations pedantically as other doctors did, he would still be in difficulty, for in the first place were needed cleanliness and fresh air, and not filth; wholesome food, and not shtchi made of stinking sour cabbage; and honest assistants, not thieves.
And, indeed, why hinder people dying, if death is the normal and lawful end of us all? What does it matter whether some tradesman or petty official lives, or does not live, an extra five years? We pretend to see the object of medical science in its mitigation of suffering, but we cannot but ask ourselves the question: Why should suffering be mitigated? In the first place, we are told that suffering leads men to perfection; and in the second, it is plain that if men were really able to alleviate their sufferings with pills and potions, they would abandon that religion and philosophy in which until now they had found not only consolation, but even happiness. Pushkin suffered agonising torment before his death; Heine lay for years in a state of paralysis. Why, then, interfere with the sufferings of some mere Andréi Yéfimitch or Matrena Savishin, whose lives are meaningless, and would be as vacuous as the life of the amoeba if it were not for suffering?
Defeated by such arguments, Andréi Yéfimitch dropped his hands upon his knees, and ceased his daily attendances at the hospital.