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       A Country Doctor's Notebook, p.1
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           Mikhail Bulgakov
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A Country Doctor's Notebook



  “This book has a freshness and liveliness … an epic quality because of the background of Russia’s vastness, the great distances, the weight of the ignorance, the need.”


  “These straightforward yet extraordinary sketches gain their strength from also being the account of a young man’s growth. One begins to see that he became a novelist not because he had material but because he was storing up passion and temperament.”


  “Stories as keen and bright as a scalpel … Courage shines from every angle of this profoundly human collection by the greatest of modern Russian writers.”


  “Bulgakov casts a wonderfully wry, self-deprecating humour. His compassion for human folly is unfailing … These stories stand testament both to human resilience and a remarkable literary talent.”



  MIKHAIL BULGAKOV (1891–1940) was born in Kiev, one of seven children born to a university lecturer and a teacher. Although he showed an early interest in theater and literature, he went on to study medicine at Kiev University, and in the early part of the First World War served as a doctor on the front lines. Twice wounded, he left the service and after recovering—and getting over his subsequent morphine addiction—was appointed provincial physician to Smolensk province in 1916. He detailed this experience in A Country Doctor’s Notebook, but the book went unpublished until years after his death. During the Russian Civil War he served briefly as a physician for the Ukrainian People’s Army, while most of his family emigrated to France and Germany. Bulgakov, however, was refused permission to leave. In 1919 he left medicine to write full-time, settling in Moscow and publishing works such as Heart of a Dog (1925) and The White Guard (1926). Though his work was often censored, Stalin showed his personal favor by protecting him from imprisonment and found work for him at Moscow’s Art Theater. During much of the 1930s Bulgakov worked there as a stage director, while laboring at home on his masterpiece, The Master and Margarita. He finished the book in 1939 but died of a kidney disorder the following year, leaving The Master and Margarita unpublished until twenty-six years after his death.

  MICHAEL GLENNY (1927–1990) was one of the world’s leading translators of Russian literature, and famous for bringing dissident writers to the fore, including Aleksandr Solzhenitsyn and Georgi Vladimov. He was the first person to translate Mikhail Bulgakov into English, and his translations remain the definitive editions.


  I was by no means the only reader of books on board the Neversink. Several other sailors were diligent readers, though their studies did not lie in the way of belles-lettres. Their favourite authors were such as you may find at the book-stalls around Fulton Market; they were slightly physiological in their nature. My book experiences on board of the frigate proved an example of a fact which every book-lover must have experienced before me, namely, that though public libraries have an imposing air, and doubtless contain invaluable volumes, yet, somehow, the books that prove most agreeable, grateful, and companionable, are those we pick up by chance here and there; those which seem put into our hands by Providence; those which pretend to little, but abound in much. —HERMAN MELVILLE, WHITE JACKET



  First published posthumously in 1975 by Collins & Harvill, London

  © 2013 Melville House Publishing

  Translation and translator’s introduction © 1975, 2013, the estate of Michael Glenny

  Design by Christopher King

  First Melville House printing: December 2012

  Melville House Publishing

  145 Plymouth Street

  Brooklyn, NY 11201


  The Library of Congress has cataloged the paperback edition of this book as follows:

  Bulgakov, Mikhail, 1891-1940.

  [Zapiski iunogo vracha. English. 2013]

  A country doctor’s notebook / Mikhail Bulgakov; [translated by Michael Glenny].

  pages; cm

  eISBN: 978-1-61219-191-1

  I. Glenny, Michael, translator. II. Title.

  PG3476.B78A2 2013






  About the Author


  Title Page



  by Michael Glenny


  The Embroidered Towel

  The Steel Windpipe

  Black as Egypt’s Night

  Baptism by Rotation

  The Speckled Rash

  The Blizzard

  The Vanishing Eye


  The Murderer



  There have been several doctor-writers, Russian and English, in recent times—Chekhov, Somerset Maugham and A. J. Cronin are perhaps three of the best known—and with this collection of stories Mikhail Bulgakov is revealed as another writer who gained his earliest and perhaps his deepest insights into human nature through the practice of medicine.

  Born in 1891, Mikhail Bulgakov was the eldest of the six children of a professor at Kiev Theological Academy. He studied at Kiev University and qualified in medicine in 1916. After eighteen strenuous months in general practice (the subject-matter of most of this book) he decided to specialise, and set up in Kiev as a venereologist. Another eighteen months or so later, the upheavals of the Civil War caused Bulgakov to move to the Caucasus, where he resolved to give up medicine in favour of writing. One of his brothers, Nikolai Bulgakov, was also a doctor, but whereas Mikhail practised only for a few years, stayed in Russia and died there, Nikolai emigrated to France after the revolution and made a distinguished career in Paris as a cardiologist.

  By 1916, despite heavy losses from two years of fighting, the Russian army was only capable of absorbing a marginal increase in manpower. This factor, together with the strain placed on civilian medical resources by mobilisation, meant that Bulgakov and many of his fellow graduates of that year were not conscripted as army doctors. Without doing the normal hospital internship on qualifying, they were instead drafted to local government clinics and country hospitals all over Russia. It is perhaps not generally realised that pre-revolutionary Russia possessed a very creditable rural medical service, financed and managed by the provincial government authorities or Zemstvos. These were elective bodies, of which the nearest British equivalents are perhaps the County Councils, and they were responsible for such matters as education, roads and public health.

  Since there were too few incentives or facilities for general practitioners to function outside the larger towns, the medical care of the peasantry in the outlying countryside was chiefly undertaken by the Zemstvo, through a network of polyclinics or small one-doctor hospitals of about forty beds. The standard of this service varied from province to province according to the relative wealth, zeal and efficiency of the different Zemstvos. Bulgakov served his medical apprenticeship near the village of Nikolskoye in the province or guberniya of Smolensk, one of the northwestern regions of European Russia, and to judge by his description of the facilities and equipment available to him, the medical services of this Zemstvo were among the best.

  Even so, it is very clear from these stories that as a means of initiation into medicine, Bulgakov’s assignment to this remote country practice was much like learning to swim by being thrown into the deep end
of the pool. Nowadays it can only be in some of the remoter parts of the ‘third world’ that totally inexperienced young doctors find themselves ‘thirty-two miles from the nearest electric light’, entirely cut off from the outside world for long spells, or obliged to keep a pack of wolves at bay with a pistol while driving back from a night call. Perhaps most demoralising for a nervous beginner were the primitive communications: carts or sleighs the only transport, roads that were poor at the best of times and often impassable in the springtime thaw or the winter blizzards, erratic mails or none for weeks on end and above all—no telephone. The effects of this isolation and confinement on anyone of less than robust and balanced temperament is grimly illustrated in the story called ‘Morphine.’

  For Bulgakov, however, the greatest underlying source of unease, amounting at times to despair, was something less tangible though very real to him, since it occurs as an ever-present refrain throughout these stories. This was the sense of being a lone soldier of reason and enlightenment pitted against the vast, dark, ocean-like mass of peasant ignorance and superstition. Again and again Bulgakov stresses what it meant to experience in physical reality the moral anomaly which for a century and more before the revolution had caused such agony to the liberal, educated elite of Russia: that intolerable discrepancy between the advanced civilisation and culture enjoyed by a small minority and the fearsome, pre-literate, mediaeval world of the peasantry. Although his patients are his contemporaries and fellow citizens of what purports to be a modern state, Bulgakov is constantly haunted by an awareness that in dealing with them he is actually at the point of contact between two cultures which are about five hundred years apart in time. It is books like this which make one appreciate the tremendous achievements of the Soviet education programme since 1917.

  It will not escape the reader’s notice that much of Bulgakov’s narrative dwells on night, winter, blizzards and gales. This is not just a literary device to heighten the sense of drama, urgency and danger: it expresses the author’s profound feeling that in the rural Russia of his early career, a doctor was literally someone fighting an elemental force. The dominant, recurrent image in his stories is that of light and dark: the light over the gateway to his little hospital, the welcoming green-shaded lamp in his study, the single light burning in an otherwise darkened, storm-swept building. These brave pinpoints of light—the light of reason—are always contrasted with the vast, malevolent, surrounding darkness which threatens to engulf them yet never succeeds in putting them out.

  Despite this background intimation of an almost mythic conflict between enlightenment and unreason, Bulgakov’s writing in A Country Doctor’s Notebook is thoroughly down-to-earth, realistic, and far removed from the grotesque fantasy that was the distinctive style of much of his other work in the mid-twenties. This contrast is so marked that it is hard to credit ‘Dr Bulgakov’ as being also the author of such fierce, surrealistic satire as The Heart of a Dog and the diablerie of The Master and Margarita. These date from Bulgakov’s richly productive period of 1924–1927, when the publication of his first novel, The White Guard, and the overnight success of its subsequent stage version, The Days of the Turbins, were making it possible for him to give up hack journalism for a living and turn to full-time writing for the theatre. Yet at the same time Bulgakov would, as it were, regularly lay aside the sardonic persona of the satirist and put on again the white coat he had finally doffed some five or six years earlier and would recreate, with keen, fresh observation and gentle self-deprecating humour, the agonies and triumphs of a medical novice pitched into a job of terrifying responsibility.

  The result was a collection of partly-fictional, partly-autobiographical stories; between 1925 and 1927 they were published serially in two monthlies, Krasnaya panorama and Meditsinsky rabotnik, the former being a magazine with a general readership, the latter meant particularly for the medical profession. When the series was finished, Bulgakov intended to collate and edit its parts for publication as a separate book to be entitled The Notes of a Young Doctor (Zapiski yunovo vracha). But this plan was never realised, and the stories passed into oblivion along with the magazines in which they had appeared. Almost forty years later and long after Bulgakov’s death (he died in 1940), they were unearthed and some of them published in the magazine Ogonyok. This was followed in 1966 by the appearance of six of these stories in an edition of Bulgakov’s Collected Prose. It is this book which has provided the text of two-thirds of the present collection; the remaining three stories—‘The Murderer’, ‘Morphine’ and ‘The Speckled Rash’—were translated from photostats of copies of Meditsinsky rabotnik found in Moscow archives. For kindly making the latter available to me I am greatly indebted to Mr Peter Doyle of the University of Manchester. My gratitude for her assistance with the texts is due to Miss K. Costello. I also wish to express particular thanks to the two medical men, Dr Hope St John Brooks and Dr Robert Salo, who have so kindly cast their keen professional eyes over the translation and corrected the terminology of a mere layman.



  IF YOU HAVE NEVER DRIVEN OVER COUNTRY roads it is useless for me to tell you about it; you wouldn’t understand anyway. But if you have, I would rather not remind you of it.

  To cut a long story short, my driver and I spent exactly twenty-four hours covering the thirty-two miles which separate the district town of Grachyovka from Muryovo hospital. Indeed so nearly exactly twenty-four hours that it was uncanny: at 2 p.m. on 16 September 1916 we were at the last corn-chandler’s store on the outskirts of the remarkable town of Grachyovka, and at five past two on 17 September of that same unforgettable year 1916, I was in the Muryovo hospital yard, standing on trampled, withered grass, flattened by the September rain. My legs were ossified with cold, so much so that as I stood there bemused, I mentally leafed through the textbook pages in an inane attempt to remember whether there was such a complaint as ossification of the muscles or whether it was an illness I had dreamed up while asleep the night before in the village of Grabilovka. What the devil was it in Latin? Every single muscle ached unbearably, like toothache. There is nothing I can say about my toes—they lay immobile in my boots, as rigid as wooden stumps. I confess that in a burst of cowardice I pronounced a whispered curse on the medical profession and on the application form I had handed in five years earlier to the rector of the university. All the time a fine rain was drizzling down as through a sieve. My coat had swelled like a sponge. I vainly tried to grasp my suitcase with the fingers of my right hand, but in the end spat on the wet grass in disgust. My fingers were incapable of gripping anything. It was then, stuffed as I was with all sorts of knowledge from fascinating medical books, that I suddenly remembered the name of the illness—palsy. ‘Paralysis’, I said to myself in despair, God knows why.

  ‘Your roads take some getting used to,’ I muttered through stony, blue lips, staring resentfully at the driver, although the state of the road was hardly his fault.

  ‘Ah, comrade doctor,’ he answered, with lips equally stiff under their fair moustache, ‘I’ve been driving fifteen years and I still can’t get used to them.’

  I shuddered and glanced round miserably at the peeling, white, two-storey hospital building, at the bare log walls of my assistant’s house, and at my own future residence, a neat, two-storey house with mysterious windows blank as gravestones. I gave a long sigh. Suddenly instead of Latin words a faraway memory flashed through my head, a sweet phrase which a lusty tenor in blue stockings sang in my numbed and shaken head: Salut, demeure chaste et pure … Farewell, farewell, it will be a long time before I see you again, oh golden-red Bolshoi Theatre, Moscow, shop windows … ah, farewell.

  ‘Next time, I’ll wear a sheepskin coat,’ I said to myself in angry desperation, tugging at the suitcase by its straps with my inflexible hands. ‘I’ll … though next time it’ll be mid-October, I’ll have to wear two sheepskin coats. I certainly shan’t be going to Grachyovka for a month ye
t. Just think … I actually had to put up for the night en route! When we had only driven fifteen miles and it was as black as the tomb … it was night … we had to stop in Grabilovka, a school teacher put us up. This morning we set off at seven in the morning, and here we are … God, it’s been slower driving here than if we’d come on foot. One wheel got stuck in a ditch, the other swung up into the air, my case fell on to my feet with a crash, we slithered from side to side, lurching forward one moment, backward the next. And all the time a fine rain drizzling down and my bones turning to ice. Who’d believe you can freeze as easily in the middle of a grey, miserable September as in the depth of winter? Ah well, it seems you can. And as you die a slow death there’s nothing to look at except the same endless monotony. On the right the bare, undulating fields and on the left a stunted copse, flanked by five or six grey, dilapidated shacks. Not a living soul in them, it seems, and not a sound to be heard.’

  In the end the suitcase yielded. The driver lay on his stomach and shoved it down on top of me. I tried to catch it by the strap but my hand refused to perform and the beastly thing, crammed with books and all sorts of rubbish, flopped down on to the grass, crashing against my legs.

  ‘Oh Lor …’ the driver began fearfully, but I did not complain. My legs were no more sensitive than two sticks of wood.

  ‘Hey, anybody at home? Hey!’ the driver cried out and flapped his arms like a rooster flapping its wings. ‘Hey, I’ve brought the doctor!’

  At once faces appeared, pressed against the dark windows of the assistant’s house. A door banged and I saw a man hobbling towards me in a ragged coat and worn old boots. He hurriedly and respectfully doffed his cap, ran up and stopped two paces short of me, then smiling somewhat bashfully he welcomed me in a hoarse voice:

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