A Country Doctor's Notebook: Stumbling Through Snow & Surgery

Russia has a fine tradition of writers but they tend more toward tragic epic novels than humorous autobiographical essays. Thankfully in the 1920s, Mikhail Bulgakov, a Russian doctor-turned-writer, published a series of short stories based on his time in a remote village, just six months after graduating from medical school in 1917 revolutionary Russia. These stories were later compiled in the collection entitled, A Country Doctor's Notebook.

I first heard of these stories through the Sky Arts miniseries, A Young Doctor's Notebook that aired in the UK in December and starred Daniel Radcliffe and Jon Hamm. It's a darkly funny series and after enjoying its four-episode run, I proceeded to read the book. Bulgakov self-deprecatingly captures all the insecurities of a young doctor who has passed his exams with flying colors but has mostly just observed the practice of medicine. The Russians had a decent rural medical service, and the young doctor is thrown into a medical apprenticeship in the remote Muryovo Hospital, where he is the only doctor, in the middle of nowhere. There's no access to modern facilities, he travels by carriages and sleighs, the nearest electric light is thirty-two miles away, and there seems to be a perpetual blizzard raging around him.

Under these circumstances, our young hero attempts to treat stubborn villagers who seem to get into terrifying situations with unerring frequency. One of his first cases is a young girl who is caught in some farm equipment and is bleeding into oblivion by the time her father carries her over to the hospital. Assisted by a feldsher (medical assistant) and two midwives, the doctor spends some time fretting about why this girl won't just die already and finally decides to amputate her leg, an operation he has never personally performed. Somehow, all goes well, and although he thinks the girl will die at any minute, she survives against all odds. His assistants are impressed by his technique and ask how many amputations he has performed before. He lies and says two.

Of course, there are plenty of women giving birth and some of the stories are concerned with his foray into obstetrics, a subject he aced in university without ever actually delivering a baby. Thankfully, he has his trusty midwives to dispense practical advice that he would be lucky to find in textbooks and he acquits himself admirably. He also muses on his physical appearance a great deal, concerned that his baby face makes him look like a student and not a respectable doctor. So he grows a beard in the hopes of being taken seriously by the hard-to-impress villagers. After all, no one trusts a clean-shaven doctor.

A Country Doctor's Notebook is a revealing look at turn-of-the-century rural Russian life and the travails of the medical profession at a time when surgery was the answer to almost everything with occasional prescriptions of mouthwash and ointment. Some of the stories are incredibly funny, others are dark and full of the dangers that this isolation and hopeless atmosphere can produce. Bulgakov survives this trial by fire (or perhaps trial by blizzard would be more apt), but some of his colleagues are not so lucky. It is both a fun and sobering read, but well worth it for the novelty of reading some harrowing and hilarious anecdotes from a humorous Russian.