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.


Nature is a menacing force in this story. Death is never far away and is suggested by the cold temperature. The narrator is reminded just how precarious life is when he responds to an emergency call in another doctor's district. Nothing can be done for the patient. Her death is imminent. The doctor has his own brush with death on the ride home. Fortunately for him, the contents of the doctor's black bag includes a Browning automatic pistol.

The young physician is so overworked that even his dreams are full of medical imagery and anxiety. He describes nightmares of unsuccessful surgeries and bloodied hands. At this point in his medical career, the physician seems consumed with one goal: Save each patient. The question that often haunts him is how to save them all. At times, his self-pity is evident. Given the extreme circumstances, it is hard to blame him. How much of one's life must a "good doctor" devote to his patients? What does it take for a doctor to survive?


Translated from the Russian by Michael Glenny.

Primary Source

A Country Doctor's Notebook


Collins & Harvill

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