A Country Doctor's Notebook (2003) - Plot & Excerpts
"I am a doctor, thrown straight from the university bench into a far away village, in the beginning of the revolution."¹¹ EXTRA! EXTRA! Now to be translated to a small screen featuring Daniel Radcliffe. And it will be "a new black comedy". I kid you not. I'm still trying to decide how I feel about it.Mikhail Bulgakov, the amazing Russian writer of The Master and Margarita fame, was a medical doctor by training. Just like the young protagonist of his semi-autobiographical collection of short stories The Notes of a Young Doctor (translated as A Country Doctor's Notebook), he has spent the time of his internship in a country hospital in the middle of nowhere, having to deal with insane patient volume, confusing diagnoses, and plain human stubbornness and stupidity that can make any medical professional's life a living hell. And what amazed me is that so many of these things are still present even in our sophisticated modern-day medicine. Some things never change, do they?" We are cut off from people. The first gas lights are nine miles away at the railroad station [...] A train to Moscow would rush by with a whistle without stopping - it does not need a God-forsaken station lost in the blizzard [...] We are alone here."A Country Doctor's Notebook describes the 'highlights' of the internship time of a brand-new young medical graduate Dr. Bomgard, sent straight from the medical university in Russia in the winter of 1917 to be the only doctor in a provincial hospital (the staff there consisting of a couple of nurses and a pharmacist) without any supervision or backup - save for quite a few medical textbooks and brand-new medical knowledge that he brought with him. This gives quite a new meaning to the whole 'thrown in at the deep end' phrase, doesn't it?"Well, and what if they bring in a woman in a complicated labor? Or, let's say, a patient with a strangulated hernia? What am I supposed to do then? Please, kindly tell me. Forty-eight days ago I graduated with high distinction, but distinction is one thing and hernia is another. Once I saw my professor operate on the strangulated hernia. He was doing it, and I was sitting in the audience, watching him. And that's it. I felt cold sweat running along my spinal column when I thought about hernias. Every night I sat in the same pose, having drank tea: on my left side, I had all the manuals on operative gynecology, with Dodelein's atlas on top. And on my right - ten different illustrated surgical manuals."Some of the situations seem almost surreal in their severity and grave danger. Picture a young doctor having to perform a maneuver to turn a malpositioned fetus in the mother's womb to save two lives - and never having done this procedure before, flipping through the pages of the textbook minutes before the surgery to figure out what the hell he is supposed to do. Imagine him performing a tracheostomy (surgically opening a throat to enable breathing) on a small dying child with diphtheria while her frantic mother is waiting outside. Think about discovering that your seemingly intelligent patient has taken his entire course of medications all at once (to speed up the healing process, apparently) and now is almost dying in front of your eyes. Imagine the entire villages infected with syphilis without having any idea about the disease or its severity, and abandoning life-saving treatment halfway through at the earliest signs of improvement. Think about realizing that your colleague has fallen prey to the deadly morphine addiction, painstakingly documenting the horrific mental and physical destruction (by the way, probably one of the earliest realistic portrayals of narcotic addiction in fiction, and based on personal experience with the drug, no less)."I felt defeated, broken, flattened by the cruel fate. Fate threw me into this wilderness and made me fight my battles alone, without any support or instruction. What unbelievable difficulties I have to suffer through. They can bring in any strange or difficult case, most often a surgical case, and I have to face it, with my unshaven face, and win. And if you don't win, then you have to suffer and torture yourself - like now, riding along a bumpy country road, leaving behind an infant's little corpse and his mother."The young doctor's patients are poor peasants - illiterate, superstitious, ignorant of their diseases, frustratingly suspicious of surgeries and other "out there" treatments. After building up a favorable reputation after a miraculous life-saving amputation on day one, the doctor ends up seeing over a hundred patients daily (that's in addition to the hospitalized patients), often having almost no time to sleep, and often still having to make a house call to a woman dying in labor or a patient too sick to be transported to the hospital, often riding miles in miles in the middle of Russian winter blizzard."After that, I started seeing about a hundred peasants a day. I stopped eating dinners. Mathematics is a cruel science. Let's imagine that I was spending only five minutes - five! - with every one of my hundred patients. Five hundred minutes - eight hours and twenty minutes. All in a row, please note that. And besides that I had a hospital ward for thirty patients. And in addition to that, I was still performing surgeries." The young doctor/ Bulgakov's alter ego laments the ignorance of his patients that endangers their lives and the lives of their loved ones, facilitates the spread of diseases, and causes harm and grief. And yet, so unlike the doctor stereotype of that long-gone era he exhibits astounding patience and perseverance, fighting the uphill battle and actually succeeding with every life saved, every disaster averted. These stories are often sad but at the same time life-affirming. And I happily give this book about my colleague almost a hundred years ago, facing similar problems that we encounter even in modern medicine, five well-earned stars."In a bout of inspiration, I opened a clinic patient roster and began counting. I counted for an hour. In a year I have seen 15,613 patients, I had 200 hospitalized patients, and only six died."
مجموعة قصصية تحكي تفاصيل سنة كاملة من حياة الطبيب الروسي الشاب ميخائيل بولغاكوف،، بدأت بعد تخرجه من جامعة كييف بتقدير امتياز وتعيينه كطبيب في مشفى في قرية نائية في أقصى الشمال في اوكرانيا ...تحكي القصص معاناة هذا الطبيب الذي بدأ العمل وحيداً دون أي خبرة عملية تذكر،، ليعمل كطبيب عام يقوم بكل شيء بدءاً من خلع الأسنان الى علاج الأمراض الصدرية ثم حالات الولادة المستعصية حتى العمليات الجراحية!! فضلاً عن ذلك فقد واجه هذا الطبيب القادم من المدينة صعوبات الحياة والفقر والجهل والتخلّف والأمراض السارية في تلك القرية النائية..أحببتها لأنها وصفت لي ما أبحث عنه كطالبة طب لا زالت على مقاعد الدراسة وتتساءل كيف يمكن لها في يوم من الأيام أن تتعامل مع مرضى حقيقيين لا مجرد أسئلة وأمراض مكتوبة في الكتب والمراجع !!لم يعجبني غرور الكاتب الواضح ورفضه لأن يعترف بأنه لا يعرف أو أنه مبتدىء وقد يخطىء، و انسحابه أو بالأحرى "هروبه" أكثر من مرّة بعد أن يموت المريض حتى لا يشعر بالذنب،، وقد اعترف بهذا في آخر سطر عندما قال " هذا يعني أنني يجب أن أتعلم دون غرور". ولكني أحببت الكتاب بشكل عام وأحببت جدّاً طريقته في وصف المرضى و الصعوبات التي كانت تواجهه.. أعجبتني قصتا "الحنجرة الحديدية" و "المنشفة ذات الديك" أكثر من الأخريات :)
What do You think about A Country Doctor's Notebook (2003)?
I love "The Russians" and so I picked up this book at a remainder table. Also, I liked Bulgakov's "voice" in "The Master and Margarita" --- a book that I've read at least twice without ever really understanding it.The stories in this book are a series of medical case histories. The background to them is the author's experience as a doctor performing some type of mandatory service in tsarist Russia at a remote country clinic. The case histories are quite interesting, but also the doctor's nail-biting anxieties about his abilities, his fears for his self-esteem and of public shame, and his eventual coolness in the face of the actual, as opposed to the imagined, disasters, all rang a bell with me --- as I think they might with anyone with a good education who must suddenly exercise his profession in the real world outside the classroom.There are no politics in this book although it was written in the 20's (?) and is set in the period 1916-18. The sense of the remoteness of the location and the enormous mental distance between the doctor and his patients prevails. I also wonder, from this book, whether tsarist Russia was really as bad as history says it was. It was intelligent enough to require local councils to set up and fund public clinics.The book begins with a story which describes a procedure, sets the tone and location, and ends a little bit sentimentally. It goes on to more complicated stories that involve, for example, morphine addiction and the question whether a doctor might ever be under a moral imperative to kill.
—Lawrence
میخاییل بولگاکف رو در ایران همه با کتاب مرشد و مارگاریتا می شناسن!بولگاکف ، نویسنده ی بزرگ روس ، پزشک بود و این کتاب یه جورایی اتوبیوگرافی یه برهه ای از زندگیش هستش که به قول خودش(اونجور که در این کتاب نوشته) مستقیم از روی نیمکت دانشگاه به روستای دورافتاده ای پرتاب شده بود! خوندن این خاطراتش برای من دانشجوی پزشکی بسیار جذاب بود ولی نمی دونم که آیا برای خوانندگان غیر پزشک هم می تونه همینقدر جذاب باشه یا خیر! ولی قطعا خواندن این کتاب برای خوانندگان غیر پزشک هم خالی از لطف نخواهد بود به خصوص پنجاه ، شست صفحه ی آخرش که به توصیف اعتیادش می پردازه که البته این قسمت رو به عنوان داستان زندگی دوست و همکارش تعریف می کنه اما اونجور که در مقدمه ی کتاب توسط مترجم گفته شده شرحی ست از زندگی ه خودش! و در این صفحات اعتیاد یک پزشک به یک ماده ی مخدر رو به شکل تکان دهنده ای به تصویر کشیده!بولگاکف در سال اول کاریش حدود پانزده هزار مریض رو مداوا می کنه و وقتی در اولین سالگرد کاریش به خاطرات سال گذشته اش فک می کنه به این نتیجه میرسه که الان دیگه خیلی تو کارش تسلط داره و هر مریضی رو ببینه می تونه درمان کنه و اضطراب روزهای اول کاریش براش خنده دار به نظر میاد اما طولی نمی کشه که در چند روز بعد می فهمه که هیچ وقت نباید به خودش مغرور بشه! که این بخش از کتاب رو اینجا عینا می نویسم:"نه ، دیگر هرگز ، حتی موقع خواب ، مفرورانه به خودم نمی نازم که هیچ چیزی باعث حیرت من نمی شود. نه. یک یک سال گذشت ، سال دوم هم می گذرد و به همان اندازه ی سال اول برای من غافلگیری در چنته خواهد داشت... یعنی همچنان باید سر به زیر بود و یاد گرفت."
—Molood Moosavi
If you watched A Young Doctor's Notebook with Daniel Radcliffe and decided to read the original stories (like me), and were expecting a rather comical representation of a Russian hospital tucked away deep in the countryside (like me), a bit of a surprise awaits you. That is, while the adaption was very enjoyable, Bulgakov's stories are even better (not that hard to believe, though). They are not particularly funny (which one would expect based on the mini-series), but there is a strong element of tragicomedy which managed to squeeze a laugh out of me at times. The stories can get rather nasty and disgusting (reading about pus and syphilis is no rainbows and butterflies), and the stubbornness and stupidity of people can be baffling (but that hasn't changed now, has it), and the overall picture is not very, ehm, promising, but it's a great read in a thank-god-i-wasnt-there way.All this symphony ends on a powerful note. Morphine...wow. It puts all the other feeble attempts to describe drug addiction to shame. Impressive and rather disturbing. I just wish my Russian skills wouldn't the same as a two-year-old's, so that I could enjoy this in the original.
—Guna
