Trees stand their ground whatever the weather. Overladen with snow. Chilled to the sap, the pith frozen and aching, trees do not withdraw their roots, fold them and then move to a different clime. They stand. Is this what duty is to trees? Pumping out oxygen so that we breathe it in and live. Doing their duty.
And is this a suitable model for doctors? To do their duty come what may. Chekhov (1860-1904) who was himself a doctor and who also makes clear that medicine, doctoring, was fundamental to his poetics, asks this question about a doctor’s duty in a number of his short stories. To emphasise how important medicine was to Chekhov’s poetics, he says
I have no doubt that the study of medicine has had an important influence on my literary work; it has considerably enlarged the sphere of my observation, has enriched me with knowledge the true value of which for me as a writer can only be understood by one who is himself a doctor
Chekhov goes on to say that the role of a writer is raise questions and not necessarily to answer these questions
It seems to me it is not for writers of fiction to solve such problems as that of God, of pessimism, etc. The writer’s business is simply to describe who has been speaking about God or about pessimism, how, and in what circumstances. The artist must not be the judge of his characters and of their conversations, but merely an impartial witness
And finally Chekhov says
An artist observes, selects, guesses, combines – and this in itself presupposes a problem: unless he had set himself a problem from the very first there would be nothing to conjecture and nothing to select
In a story ‘A doctor’s Visit’, the professor receives a telegram asking him to attend a patient outside Moscow and sends his assistant Korolyov instead. This is a journey two stations from Moscow and 3 hours by a 3-horse carriage from the station. It was a case of anxiety disorder
palpitations of the heart…so awful all night…I almost died of fright.
Korolyov gave advice and wanted to return to Moscow
He wanted to tell her that he had a great deal of work in Moscow, that his family were expecting him home; it was disagreeable to him to spend the evening and the whole night in a strange house quite needlessly; but he looked at her face, heaved a sigh, and began taking off his gloves without a word
In this story the young doctor stayed the night. He did his duty as he saw it. He sacrificed his own needs and preferences to the task at hand.
In another story, ‘On Official Duty’, the examining magistrate and the district doctor went to to the village of Syrnya to an inquest into a case of suicide. They were overtaken by a snowstorm and had to put up in a Zemstvo hut. This was also the hut in which the corpse was lying. They had to stay the night and
They had before them a long evening, a dark night, boredom, uncomfortable beds, beetles, and cold in the morning; and listening to the blizzard that howled in the chimney and in the loft, they both thought how unlike all this was the life they could have chosen for themselves and of which they had once dreamed, and how far away they both were from their contemporaries, who were at the moment walking along about the lighted streets in town without noticing the weather, or were getting ready for the theatre, or sitting in their studies over a book. Oh, how much they would have given now only to stroll along the Nevsky Prospect, or along Petrovka in Moscow, to listen to decent singing, to sit for an hour or so in a restaurant
This story, very clearly has the term ‘duty’ in the title. Again, Chekhov examines the choice of whether to stand, like trees do, whatever the climate or to abdicate one’s responsibility, to join with the others who enjoy themselves at the expense of duty.
It is ironic given Chekhov’s belief that it is not a writer’s task to answer ethical question but merely to raise them that in none of these stories does he write about doctors who choose not to do their duty.
In ‘Enemies’, which is the most developed of the stories dealing with this question of what is a doctor’s duty, Chekhov writes about a doctor who has just lost his young son to diphtheria. The story starts
Just as the doctor’s wife sank on her knees by the dead child’s bedside and was overwhelmed by the first rush of despair there came a sharp ring at the bell in the entry
The doctor was being summoned to the home of a land owner whose wife had taken ‘dangerously ill’. The dilemma was stark: ought the doctor leave his distressed wife, ignore his own grief and follow the land owner to perhaps save the wife’s life? This is a story demonstrating the inner conflict, the battle between the desire to follow conscience and one’s own personal needs. The land owner argues
Doctor, I am not a stone, I fully understand your position…I feel for you…But I am not asking you for myself. My wife is dying. If you had heard that cry, if you had seen her face, you would understand my pertinacity. My God, I thought you had gone to get ready! Doctor, time is precious. Let us go, I entreat you
He goes on
I’m not asking you to a case of toothache, or to a consultation, but to save a human life!
In the end, the doctor agrees to go. Chekhov’s approach is to depict doctors who do their duty sometimes in situations where the tension and conflict are immense and extraordinary.
The trees stand whatever their burden. In a sense one could argue that trees have no choice in the matter, that trees are rooted to the spot. But, of course Kant would have said that human beings have no choice either. That duty is compelling and inescapable.
Photos by Jan Oyebode