A Young Doctor’s Notebook. To A Healthy Fear.

“No. Never, not even when falling asleep, will I ever proudly mutter about nothing being able to surprise me. No. As one year has passed, so will another, and it will be just as rich in surprises as the first one… And so I have to go on dutifully learning.”

Mikhail Bulgakov

When you chance upon something precious in a bookstore, you must buy it immediately. Or else, it will disappear. Bookstore budgets are so tight these days if a book doesn’t sell at all, it may never come back into stock, which is a terrible fate for a new release, but even more terrible for strong backlist title – out of sight, out of mind, out of print*.

A Doctor’s Notebook was one such find. It contains a series of semi-autobiographical stories of a green, graduate doctor working alone in the deepest, darkest depths of Soviet Russia. The doctor in question just happens to be Mikhail Bulgakov who is better known as the author of The Master and Margarita. In other words, the prospect was doubly attractive.

If I needed any further encouragement, the first page was enough.

“…at five past two on the 17th September of that same unforgettable year of 1917 I was standing on the trampled, dying grass, grown soft in the light September rain, of the Muryino Hospital yard. I stood there looking like this: my legs were ossified, and to such a degree that right there in the yard I was mentally leafing through the pages of textbooks, obtusely trying to remember whether there really did exist…an illness in which a man’s muscles become ossified. What was the damn thing called in Latin?…I confess that in a surge of faint-heartedness I whispered a curse on medicine and the application I had submitted to the university five years before…My  fingers were unable to catch hold of anything, and being stuffed with all sorts of knowledge from interesting medical books, I again recalled an illness – palsy.”

As I approach graduation, I am becoming familiar with an experience of abject terror that comes with the responsibility for a living person’s health. We all hope that it will cede to confidence in a moment or two and to that end, we study. We work desperately to glean experience from knowledge which is, by definition, impossible. That is the sentiment so brilliantly captured in this collection of stories. Technology may have come a long way in the last 100 years of medicine, but the space between the doctors’ ears remains unchanged.

Bulgakov relates a series of baptisms by fire which are salted with honest fear and peppered with comic neuroticism. In addition to the challenges of performing amputations, tracheostomies and complex obstetric procedures for the first time, unsupervised, unaided and without access to the internet, the good doctor has to battle with isolation, insularity and ignorance. His only assistants are a pharmacist and two midwives who are fiercely loyal to his predecessor, Leopold Leopoldovich: “On her lips, the word ‘Leopold’ invariably came out like ‘Doyen'”. The surrounding villages seem to sequester patients with formidable conditions, like syphilis or diptheritic croup, who present in extremis and then doubt the necessity of the doctor’s orders. Others take the orders too literally, applying plasters and salves to their clothing instead of their skin, or are more inclined to trust the local ‘wise’ women, putting sugar in the birth canal to lure out a stubborn, obstructed baby. I’d like to tell you stories like these are a thing of the past, but I cannot.

If you are not at all medically-minded, Bulgakov does for medicine what P.G Wodehouse does for early 20th century aristocracy. If you are a doctor, paramedic or doctor-to-be with a touch of the old anxiety, one read of these tales will cheer you right up. These  light-hearted, satirical sketches  are well worth the time if you can find yourself a copy.

• What is your favourite satire?

 *I would love an economist to validate my feelings about books as luxury goods – goods that don’t conform to the laws of supply and demand, that are price inelastic and are not perfect substitutes for one another. I know it to be true. You know it is true. When did books become widgets? Does that encourage great writing? Or suppress it? Are we hurtling at great speed toward a resurgence of pulp fiction?