Reading Chekhov VII: “A Medical Case”


We’re reading Chekhov in my living room again, with actors and friends, sipping wine, nibbling on cheese and olives. Chekhov is the world standard of short story writing, the best model there is of the doctor-writer, a tradition that goes back a long way to the gospel writer, Luke, who is supposed to have been a doctor, and of course it includes Walker Percy and William Carlos Williams. I met an Egyptian writer, Alaa Al Aswany, author of an important book , The Yacoubian Building, and as I was sitting in his dentist chair,  I asked him about doctors writing novels. He said, “it’s one profession, novelists and doctors. They’re both interested in understanding human pain.” In this story,”A Medical Case,” imagine young Dr. Chekhov visiting an industrial town toward the end of the 19th Century. Might it not have have been one of the seats of the industrial revolution in America — in one of the famous textiles towns like Lowell and Lawrence in our home state of Massachusetts?

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  • Potter

    Another very 
beautifully crafted story. Chekhov is extraordinary, very sensitive. This reminded me of “The Student” where
 a rookie
 seminary student, as he starts out in his career, has an awakening.
 protagonist in this one, young doctor Korolyov, is sent to the countryside 

to deal with a case that local doctors found baffling. This case is so 

interesting because the young woman’s affliction does not seem to have a 

physical cause yet she is very sick,has been so since childhood, now is immobile, bed-ridden, has 
palpitations, is not getting better. 

Doctoring is 
very much an art, not only a science, and it was much less of a
 science then. Diagnosis is an art, if not always and only 

This story shows what doctoring was and is still about.
 But it was probably even 
more-so at the time: an art, an art that starts with 
listening, noticing and compassion. 

This story reminded me in a way of the neurasthenia of Anna 
in “About 
Love”. In the end we realize she had disease of the spirit
 brought on by 
feeling trapped between her needs and her desires (again this 
feeling of being trapped), unable to absorb and accept an inner conflict.
I think Chekhov is dealing with mental illness, and, in so doing, the mind-body 
connection. Today he would be a psychiatrist (too). Today we might 
call Liza’s illness general anxiety disorder (which has physical symptoms)
where everything seems a threat or cause for worry panic and fear. Today a 
doctor would prescribe xanax or prozac, and follow through with 
mindfulness based stress reduction
(MBSR)/or meditation practice and/or some
 group therapy, one on one therapy, or all of the above. 

In that way the 
future is really so much better, as the young doctor imagines.

  • Potter

    I am realizing that Chekhov was comparable to, say, Shakespeare. Yes! Am I going off the deep end?

    More thoughts before I listen: The young doctor is from the big city Moscow. The doctors in Moscow were the BIG DOCTORS. Today, the doctors in Boston are the BIG DOCTORS. The doctors in the rural areas suffer by comparison though they may be just as good at times. I sense there is a tinge of resentment here and we do run to Boston. Remember the Downton Abbey episode last year when the country doctor had better advice than the big doctor from the city?

    In regard to the painting you showed by Levitan. It was impressionist. I think that Chekhov’s writing is also impressionist- and it brings to mind the music of Debussy and even Ravel.

    For me, more than the psychology, which is very interesting, it’s the impressionism of the words, the writing. That makes me want to know Russian. But reading it in Russian would not be enough; one has to be immersed in the culture as well.