"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.
VI
His life passed thus. At eight in the morning he rose and took his breakfast. After that he either sat in his study and read, or visited the hospital. In the hospital in a narrow, dark corridor waited the out-patients. With heavy boots clattering on the brick floor, servants and nurses ran past them; emaciated patients in dressing-gowns staggered by; and vessels of filth, and corpses were carried out. And among them children cried and draughts blew. Andréi Yéfimitch knew well that to the fevered, the consumptive, and the impressionable such surroundings were torment; but what could he do? In the reception-room he was met by the feldscher, Sergéi Sergéyitch, a little fat man, with a beardless, well-washed, puffy face, and easy manners. Sergéi Sergéyitch always wore clothes which resembled a senator's more than a surgeon's; in the town he had a large practice, and believed that he knew more than the doctor, who had no practice at all. In the corner of the room hung a case of ikons with a heavy lamp in front; on the walls were portraits of bishops, a view of Sviatogorsk Monastery, and garlands of withered corn-flowers. Sergéi Sergéyitch was religious, and the images had been placed in the room at his expense; every Sunday by his command one of the patients read the acathistus, and when the reading was concluded, Sergéi Sergéyitch went around the wards with a censer and sprinkled them piously.
There were many patients and little time. The examination was therefore limited to a few short questions, and to the distribution of such simple remedies as castor-oil and ointments. Andréi Yéfimitch sat with his head resting on his hands, lost in thought, and asked questions mechanically; and Sérgei Sergéyitch sat beside him, and sometimes interjected a word.
"We become ill and suffer deprivation," he would sometimes say, "only because we pray too little to God."
In these hours Andréi Yéfimitch performed no operations; he had got out of practice, and the sight of blood affected him unpleasantly. When he had to open a child's mouth, to examine its throat for instance, if the child cried and defended itself with its hands, the doctor's head went round and tears came into his eyes. He made haste to prescribe a remedy, and motioned to the mother to take it away as quickly as possible.