A doctor in Russia often enjoys the affection and respect of the people, and with reason, as far as I have been able to see. I know that my words would seem a paradox, above all when the mistrust of this same people for foreign drugs and foreign doctors is taken into account; in fact, they prefer, even when suffering from a serious illness, to address themselves year after year to a witch, or employ old women’s remedies (which, however, ought not to be despised), rather than consult a doctor, or go into the hospital. In truth, these prejudices may be above all attributed to causes which have nothing to do with medicine, namely, the mistrust of the people for anything which bears an official and administrative character; nor must it be forgotten that the common people are frightened and prejudiced in regard to the hospitals, by the stories, often absurd, of fantastic horrors said to take place within them. Perhaps, however, these stories have a basis of truth.
But what repels them above all, is the Germanism of the hospitals, the idea that during their illness they will be attended to by foreigners, the severity of the diet, the heartlessness of the surgeons and doctors, the dissection and autopsy of the bodies, etc. The common people reflect, moreover, that they will be attended by nobles—for in their view the doctors belong to the nobility. Once they have made acquaintance with them (there are exceptions, no doubt, but they are rare), their fears vanish. This success must be attributed to our doctors, especially the young ones, who, for the most part, know how to gain the respect and affection of the people.
I speak now of what I myself have seen and experienced in many cases and in different parts, and I think matters are the same everywhere. In some distant localities the doctors receive presents, make profit out of their hospitals, and neglect the patients; sometimes they forget even their art. This happens, no doubt; but I am speaking of the majority, inspired as it is by that spirit, that generous tendency which is regenerating the medical art. As for the apostates, the wolves in the sheep-fold, they may excuse themselves, and cast the blame on the circumstances amid which they live; but they are absurd, inexcusable, especially if they are no longer humane; it is precisely the humanity, affability, and brotherly compassion of the doctor which prove most efficacious remedies for the patients. It is time to stop these apathetic lamentations on the circumstances surrounding us. There may be truth in the lament, but a cunning rogue who knows how to take care of himself never fails to blame the circumstances around him when he wishes his faults to be forgiven—above all, if he writes or speaks with eloquence.
I have again departed from my subject; I wish only to say that the common people mistrust and dislike officialism and the Government doctors, rather than the doctors themselves; but on personal acquaintance many prejudices disappear.
Our doctor generally stopped before the bed of each patient, questioned him seriously and attentively, then prescribed the remedies, potions, etc. He sometimes noticed that the pretended invalid was not ill at all; he had come to take rest after his hard work, and to sleep on a mattress in a warm room, far preferable to the naked planks in a damp guard-house among a mass of pale, broken-down men, waiting for their trial. In Russia the prisoners in the House of Detention are almost always broken down, which shows that their moral and material condition is worse even than those of the convicts.
In cases of feigned sickness our doctor would describe the patient as suffering from febris catharalis, and sometimes allowed him to remain a week in the hospital. Every one laughed at this febris catharalis, for it was known to be a formula agreed upon between the doctor and the patient to indicate no malady at all. Often the robust invalid who abused the doctor’s compassion remained in the hospital until he was turned out by force. Our doctor was worth seeing then. Confused by the prisoner’s obstinacy, he did not like to tell him plainly that he was cured and offer him his leaving ticket, although he had the right to send him away without the least explanation on writing the words, sanat. est. First he would hint to him that it was time to go, and then would beg him to leave.
“You must go, you know you are cured now, and we have no place for you, we are very much cramped here, etc.”
At last, ashamed to remain any longer, the patient would consent to go. The physician-in-chief, although compassionate and just (the patients were much attached to him), was incomparably more severe and more decided than our ordinary physician. In certain cases he showed merciless severity which only gained for him the respect of the convicts. He always came into the room accompanied by all the doctors of the hospital, when his assistants visited all the beds and diagnosed on each particular case; he stopped longest at the beds of those who were seriously ill, and had an encouraging word for them. He never sent back the convicts who arrived with febris catharalis; but if one of them was determined to remain in the hospital, he certified that the man was cured. “Come,” he would say, “you have had your rest; now go, you must not take liberties.”
Those who insisted upon remaining, were, above all, the convicts who were worn out by field labour, performed during the great summer heat, or prisoners who had been sentenced to be whipped. I remember that they were obliged to be particularly severe, merely in order to get rid of one of them. He had come to be cured of some disease of the eyes, which were red all over; he complained of suffering a sharp pain in the eyelids. He was incurable; plasters, blisters, leeches, nothing did him any good; and the diseased organ remained in the same condition.
Then it occurred to the doctors that the illness was feigned, for the inflammation neither became worse nor better; and they soon understood that a comedy was being played, although the patient would not admit it. He was a fine young fellow, not ill-looking, though he produced a disagreeable impression upon all his companions; he was suspicious, sombre, full of dissimulation, and never looked any one straight in the face; he also kept himself apart as if he mistrusted us all. I remember that many persons were afraid that he would do some one harm.
When he was a soldier he had committed some small theft, he had been arrested and condemned to receive a thousand strokes, and afterwards to pass into a disciplinary company.
To put off the moment of punishment, the prisoners, as I have already said, will do incredible things. On the eve of the fatal day, they will stick a knife into one of their chiefs, or into a comrade, in order that they may be tried again for this new offence, which will delay their punishment for a month or two. It matters little to them that their punishment be doubled or tripled, if they can escape this time. What they desire is to put off temporarily the terrible minute at whatever cost, so utterly does their heart fail them.
Many of the patients thought the man with the sore eyes ought to be watched, lest in his despair he should assassinate some one during the night; but no precaution was taken, not even by those who slept next to him. It was remarked, however, that he rubbed his eyes with plaster from the wall, and with something else besides, in order that they might appear red when the doctor came round; at last the doctor-in-chief threatened to cure him by-means of a seton.
When the malady resists all ordinary treatment, the doctors determine to try some heroic, however painful, remedy. But the poor devil did not wish to get well, he was either too obstinate or too cowardly; for, however painful the proposed operation may be, it cannot be compared to the punishment of the rods.
The operation consists in seizing the patient by the nape of the neck, taking up the skin, drawing it back as much as possible, and making in it a double incision, through which is passed a skein of cotton about as thick as the finger. Every day at a fixed hour this skein is pulled backwards and forwards in order that the wound may continually suppurate and may not heal; the poor devil endured this torture which caused him horrible suffering, for several days.
At last he consented to quit the hospital. In less than a day his eyes became quite well; and, as soon as his neck was healed, he was sent to the guard-house which he left next
