Showing 1 - 10 of 11 annotations associated with Bulgakov, Mikhail
A little girl is brought to the rural hospital by her mother, who throws himself at the feet of the young doctor, “Please do something to save my daughter!” It seems that she has been suffering from a sore throat and is now having difficulty breathing. The doctor looks into her throat; diphtheria is evident.
At first he scolds the mother for not having brought the girl earlier. Then he suggests surgery: a tracheotomy. The doctor knows this is the only way he might save the child, but he is consumed by anxiety because he has never performed the procedure. At first the mother objects to surgery, but then relents. The tracheotomy is successful and the child survives.
Bomgard, a young doctor recently transferred from a rural area to a small town hospital, receives an urgent message from Polyakov, the doctor who replaced him. Polyakov has become ill; he needs medical help. Before Bomgard can respond, however, Polyakov arrives at the hospital, dying of a self-inflicted wound. In his last moments, he gives Bomgard a notebook, on which is recorded the story of Polyakov's addiction to morphine.
Polyakov first took morphine to relieve an abdominal pain. He found that it also relieved his despair over the loss of his lover, an opera singer in Moscow. Morphine relieved his loneliness and improved his work. He gradually increased the dose until he became hopelessly dependent on the substance. He failed in his attempts to break the habit at a clinic in Moscow. Eventually there is nothing in life but the drug and Polyakov suicides.
Doctor Yashvin sits with his colleagues and admits, "I have killed a man." The story of his resistance activity during the Bolshevik revolution ensues. The young doctor was called to serve as the personal physician of an enemy colonel. In this command the doctor witnesses horrible atrocities against common people as well as resistance fighters, the last straw being the brutal beating of a woman who comes demanding to know why her husband has been shot. Called upon to attend to a knife wound sustained by the colonel and finding the latter in a vulnerable position, Yashvin takes advantage of the moment, shoots the colonel dead, and escapes.
The narrator of the story, a former district doctor in Russia, reminisces about his frequent encounters with patients suffering from secondary syphilis ("the speckled rash"). The first case he diagnoses is a 40-year-old man seeking treatment for a sore throat. The doctor recommends the application of a bagful of mercury ointment once a day and a follow-up visit after 6 days, but the man never returns. The physician advises him that his wife needs to be examined also, but she is never seen in the clinic.
The doctor remembers many other cases of secondary syphilis in the community. Except for one young woman, patients seem to have little fear of the disease. Children and even entire families are infected. The physician decides to tackle the widespread venereal disease and to confront the rampant patient apathy in the district.
His weapons include mercury ointment, potassium iodide, Salvarsan (an arsenic compound) injections, harsh words, and warnings about the horrible effects of the disease if left untreated. He opens an inpatient unit to treat patients with syphilis. Now long-removed from that remote medical outpost, the narrator still wonders about the people living there.
Looking back on his first year of medical practice in an out-of-the-way section of Russia, a 25 year old physician reflects on how much he has changed both personally and professionally. He lists the year's accomplishments: performing a tracheostomy, successful intubations, amputations, many obstetrical deliveries, and setting several fractures and dislocations. With pride, the doctor calculates he has seen 15,613 patients in his first twelve months of practice.
He recalls some poignant moments. A pregnant woman has a baby while lying in the grass near a stream. The doctor pulls a soldier's carious tooth but is horrified when a piece of bone is attached to it. During a delivery, he inadvertently fractures a baby's arm and the infant is born dead.
Basking in his year's worth of experience and newfound clinical confidence, the physician quickly comprehends the limits of his knowledge on the first day of his second year in practice when a mother brings her baby to the doctor. The infant's left eye appears to be missing. In its place sits an egg-like nodule. Unsure of the diagnosis and worried about the possibility of a tumor, the physician recommends cutting the nodule out. The mother refuses. One week later she returns with her child whose left eye is now normal in appearance. The doctor deduces that the boy had an abscess of the eyelid that had spontaneously ruptured.
The physician-narrator celebrates his 24th birthday in the company of two midwives and a feldsher (physician’s assistant). They toil in a remote area of Russia where conditions are harsh. The doctor tells the group about a peasant woman who requested a refill of belladonna (an atropine-like drug) that was prescribed for stomach pain the day before. Although the instructions were to take five drops as needed, the bottle was completely empty already. Since the woman had no signs of belladonna poisoning, the feldsher concludes she shared it or maybe even sold it to other villagers.
The group shares other stories about patient mistakes and misguided beliefs. That same night a man comes to the doctor’s house. He is a miller suffering from recurrent fevers. The physician diagnoses malaria and remarks how sensible and literate the patient is. Powdered quinine is prescribed to be taken once a day before the onset of fever. Soon the doctor receives word the miller is dying. The patient has defied the instructions and taken all 10 doses of quinine at one time to expedite his recovery. His stomach is pumped, and he survives the overdose.
The narrator is an inexperienced and overworked doctor in a remote region of Russia. Although accustomed to seeing as many as a hundred or more patients in a day, a blizzard brings him unexpected relief. Only two patients show up in the clinic. He welcomes the prospect of a leisurely day but soon receives a summons for help from a physician in a nearby district.
A bride-to-be has fallen out of a sleigh and is unconscious. The narrator travels more than 2 hours to lend his help, but she is already dying. He later realizes the young woman had a fracture at the base of the skull. Ignoring advice to stay the night, the doctor insists on returning home. Four hours after departing in a sleigh, the doctor and driver are lost and trapped in the snow. With great effort, the two men free the sleigh and horses from the drifts.
As their journey resumes, wolves chase the sleigh until the doctor fires his pistol. Finally, he sees the lights of his hospital in the distance. Once safe in his house, the doctor picks up a manual containing information about skull fractures but decides instead to go to sleep.
A bedraggled street dog is about to perish in the cold winter night, after having been scalded by boiling water earlier in the day. Suddenly, an elegant man feeds him and takes him home. The dog's savior is a famous and wealthy medical professor who rejuvenates people by hormonal manipulations.
As soon as the dog becomes accustomed to his new life of plenty, he finds himself the subject of a strange experiment--the professor and his assistant implant the testicles and pituitary gland of a dead criminal into the dog's body. After a rocky post-operative course, the dog gradually begins to change into an animal in human form and names himself Poligraph Poligraphovich Sharik. The half-beast-half-man, who gets along very well in the prevailing proletarian society, turns his creator's life into a nightmare--until the professor manages to reverse the procedure.
A young doctor, recently assigned to a country hospital, is fraught with anxiety, especially over his lack of experience with obstetrical problems. One night the midwives call him; a woman is having a difficult labor. The fetus is presenting in a transverse position. The doctor must reach internally and “turn it around by the foot,” as Anna Nikolaevna, the seasoned midwife, reminds him.
The doctor has never performed this procedure. He buys time by going back to his room to consult the textbook (under the pretext of going for cigarettes). Finally, he can't avoid it any longer. He performs the rotation. It works! Both mother and baby are saved.
This is a collection of partly fictional, partly autobiographical stories about a young Russian doctor sent to practice at a rural hospital immediately after graduating from medical school. Muryovo hospital serves the peasantry in a remote region lacking decent roads and amenities like electricity. The doctor works day and night, aided by a feldsher and two midwives. Sometimes he sees over 100 patients a day in his clinic while attending to another 40 in the hospital.
The stories reveal in a clear, engaging style the doctor's anxiety as daily he encounters new problems (his first amputation, his first breech presentation, his first dental extraction) and-- for the most part--overcomes them. They also reveal a constant tension between the peasants' ignorance and the doctor's instructions. Full of blizzards and isolation, the stories are also warm and companionable, with vignettes of friendship, gratitude, and nobility.