Features of the series “Notes of a Young Doctor”
At the very beginning of M. Bulgakov’s literary career, as M. O. Chudakova noted in her work Chudakova, M.O. Decree. op. - With. 262
Characteristic is a story from the perspective of a narrator, “close to the author, about his own misadventures, with an emphasized freedom from fictional “fiction”, relying on autobiography in the genre of a diary or notes.” Several works have this very word in the title: “Notes of a Young Doctor”, “Notes on Cuffs”, “Notes of a Dead Man”. This is always a chronologically sequential, organized first-person narrative, with a series of time milestones - years, seasons, months, days.
The “Notes of a Young Doctor,” known to us only in the printed edition of 1925-1927 (the 1916-1918 edition entitled “Sketches of a Zemstvo Doctor” has not survived), is based on material from the author’s first post-university years: service as a zemstvo doctor (1916-1917 ) in the Smolensk province. “Notes of a Young Doctor” began in 1916-1917 in Nikolskoye and Vyazma, work on them continued in Kyiv (1918-1919).
In 1963, stories collected by E.S. Bulgakova, published as a separate publication. However, the book did not include the story “Star Rash” (1926); it was published in Russian only in 1981 by L. Yanovskaya. The second time the series “Notes of a Young Doctor” was published as part of a one-volume book; the story “Morphine” (1927) was not included in the collection.
In “Notes of a Young Doctor,” Bulgakov recalls his medical practice in the rural wilderness. Before us unfold pictures of the peaceful activities of a doctor, the struggle for human life not only against diseases, but also against the inertia and ignorance of the village.
“Notes of a Young Doctor” is not an autobiography, but literature using medical observations and personal experience. Here you can already feel the attentive and completely professional view of the author from the outside on the characters and events.
All seven stories in “Notes of a Young Doctor” are characterized by a local plot and the short duration of the event described (the action most often takes place within one day). Bulgakov conveys only episodes from the doctor’s work, but from them a general idea of his activities can easily be formed. Each case is told with such detail, with such intensity of the author's gaze, that the reader feels like an eyewitness to what is happening.
The seven stories of the cycle are united not only by the personality of the narrator, but by the time and place of action. As for the location of the action, only in one of the stories (“Steel Throat”) the hospital where Bulgakov’s largely autobiographical hero works as a zemstvo doctor is called Nikolskaya, as it actually was in the writer’s real biography, and in others (“Blizzard ", "Baptism by turning") - N-koy. By reporting about the time of the hero’s service, Bulgakov deprives the stories of the signs of this time. The year 1918, which passed through the country with fire and blood, embodied in “The White Guard,” is quiet and ordinary in “Notes of a Young Doctor.” Only in one episode does a soldier appear, returning “from the collapsed front after the revolution,” and patients, turning to the doctor, call him either in the old fashioned way, “Mr. Doctor,” or in a new way, “Comrade Doctor.”
According to "Towel with a Cock" and "Steel Throat", the hero-narrator first arrives at his place of duty on September 17, 1917, at 23 years old, having just been released from the university by a doctor less than two months ago. And in the story “Egyptian Darkness” he celebrates, already in December, his 24th birthday. In fact, Bulgakov had already worked, by the time he arrived in the Smolensk province, throughout 1916 in front-line hospitals, finding himself in Vyazma being both older and more experienced; in May 1916 he turned 25 years old. Why does the author need these transformations? “We can assume - for the sake of simplicity and “truth of art” - otherwise, in all its complexity, life is difficult to perceive from the text: there are too many distracting, atypical circumstances in it, explanations, reservations and connections that we need.” Mikheev M. Repeating the motif in Bulgakov’s “Notes of a Young Doctor” // Literary text as a dynamic system. - M., 2006, - p. 239.
The series of stories “Notes of a Young Doctor” are truly fascinating, artistically vivid stories about the development of the personality of a young doctor, a gifted person who is constantly fighting to defend human life.
At the center of “Notes” is a hero with an obvious past (he graduated from university, receiving a doctor’s degree), present and future. The future is present in the dream stories of the “young doctor” and in the retrospective view of the narrator, looking at his life from a different time. He is an intellectual who is quite clearly aware of his role in society.
The contents of the book are several cases from the medical practice of yesterday's university graduate, faced with the need to be the only, “universal” doctor in a small hospital. Fear of complex operations, loneliness, and awareness of the limitations of one’s knowledge (“unsuitable university burden”) keep the young doctor in constant tension and create an anxious mood. His fears come true - a dying, crippled girl is brought from the village, and the doctor performs an amputation; then comes the day of the first difficult childbirth in his medical practice; finally, the most difficult thing is a case when it is impossible to help, a fatal outcome.
And, surprisingly, with such a seemingly gloomy plot, the stories are optimistic, imbued with a love of life. The secret of this cheerfulness is in the character of the hero-storyteller, who has an inexhaustible sense of humor and subtle irony, most often directed at himself, which expresses the originality of the hero’s personality.
This is the smile of a person who, literally with sweat and blood, overcomes enormous difficulties, who acutely feels the full responsibility of medical duty and at the same time retains the ability to notice the funny. “The round figure of a silent grandmother crossing herself first on the doorframe, sometimes on the doctor” Bulgakov, M.A. Op. op. - With. 58; a hospital watchman rushing to give birth, and fury, with curses tearing the flying sole of a boot as he walked; the physiognomy of the doctor himself, “only half shaved and therefore reminiscent of the convicts of Sakhalin” Ibid. - With. 32 - all this is a necessary release after pages that keep the reader in suspense.
In these seemingly simple stories, Mikhail Bulgakov emerges as a master of subtle psychological writing. As noted by E.A. Yablokov, studying the work of M. Bulgakov: “the hero’s personality is often divided into two: one speaks, orders, acts; the other watches the actions of the first with fear and despair.” Yablokov, E.A. Text and subtext in the stories of M. Bulgakov (“Notes of a Young Doctor”) / E. A. Yablokov. - Tver: Tver. State Univ., 2002. - p. 11 - (Lectures in Tver). : “Inside myself I was thinking: “What am I doing? After all, I’ll kill the girl.” But he said something else: “Well, quickly, quickly agree!” Bulgakov, M.A. Op. op. - With. 31. In moments of danger to the patient’s life, the doctor became tough and stern. He looks around “angrily and gloomily”, speaks “sternly”, “not recognizing his voice”, “like a wolf leers” at a pile of tweezers. These are the features of the external portrait. But the hero’s state of mind at these same moments is characterized by common sense, inspiration and mercy.
The author seems to be saying: you cannot smile and be kind while doing a difficult, dangerous task. During an operation, when the issue of a person’s life is being decided, the faces of doctors, midwives, and paramedics become “angry” and their movements become “predatory.” This is a consequence of intense tension in the mind and body. And it is this tension that helps them win the fight with death.
For the main character in the story “Towel with a Rooster,” which shows the initial stage of a young doctor’s professional development, the most significant, according to I.Yu. Mahova Makhova, I. Yu. Competence in phenomenological research (based on the stories of M.A. Bulgakov “Notes of a Young Doctor”) // Psychology of competence: phenomenology, diagnostics and dynamics in the conditions of a Russian university. - Komsomolsk-on-Amur, 2006 - p. 59, “external signs of his conformity to the image of an experienced doctor. The patient’s condition, her health and life are secondary”:
“Heading to the Murya wilderness, I remember, back in Moscow, I promised myself to behave respectably. My youthful appearance poisoned my existence at first. Everyone had to introduce themselves:
Doctor so-and-so.
And everyone always raised their eyebrows and asked:
Really? I thought you were still a student.
No, I’m done,” I answered gloomily and thought: “I need to get glasses, that’s what.” Bulgakov, M.A. Op. op. - With. 9.
In the story “Baptism by Turning,” the extreme medical situation associated with the need for obstetric surgery with a transverse position of the fetus is perceived by the young doctor differently than in the story “Towel with a Rooster”: here, in the first place in importance are knowledge, skills, and not maintenance reputation as a qualified, serious doctor. When describing the situation, the emphasis is on the feeling of loneliness and the lack of a competent environment. In this case, a new significant object arises - the patient, but which has only “object” features for the young doctor:
“What is wrong with this woman with an unsuccessful birth? Hmm... incorrect positioning... narrow pelvis... Or maybe something even worse. Well, you'll have to use forceps. Should we send her straight to the city? Yes, this is unthinkable! Nice doctor, nothing to say, everyone will say! And I don’t have the right to do that. No, you have to do it yourself. So what to do? The devil knows. It will be a disaster if I get lost; shame in front of midwives... " Bulgakov, M.A. Op. op. - With. 20.
“... Here I am, alone, with a woman suffering under my arms; I am responsible for her. But I don’t know how to help her, because I saw childbirth up close only twice in my life in the clinic, and they were completely normal. Now I’m doing research, but this doesn’t make it any easier for me or the woman in labor; I still don’t understand anything and I can’t feel it inside. And it's time to decide on something.
Transverse position... since it’s a transverse position, that means you need to... need to do...
A turn on the leg,” Anna Nikolaevna could not resist and seemed to remark to herself. An old, experienced doctor would look askance at her for poking ahead with his conclusions... I’m not a touchy person...” Ibid. - With. 22.
The story “Steel Throat” continues the professional development of the doctor. On a blizzard November night they wake him up. They brought in a girl dying of diphtheria croup. The doctor has never performed a tracheotomy, but he understands that the child is doomed, surgery is the only chance of salvation. And he takes risks. The girl is saved. There is a rumor in the villages that Lidka was given a “steel throat” and she is living well with it. The doctor’s popularity is growing to “tragic” proportions: he sees more than a hundred people a day. A young doctor, yearning for the light of electric light bulbs, dreaming of the advice of experienced colleagues, not confident in his abilities, and, nevertheless, bravely going to the operation - this is how the main character appears before us. He understands what awaits him if he fails. No one will forgive him: neither his mother, nor his peasant patients. But the duty of a doctor is above all for him. The whiny grandmother, the culprit of an advanced illness, the personification of the darkness and ignorance of the village, is impressive in her own way; Lidka’s mother, with her “black rage” and “bad voice” before the operation and “shining eyes” after her daughter’s recovery, and, finally, the young paramedic, a very capable person, who fainted during the operation.
“I took the lifeless hand, put my fingers on it in a familiar gesture and shuddered. It began to tremble finely and frequently under my fingers, then it began to break, to be pulled into a thread. I felt the usual chill in the pit of my stomach, as always when I saw death point-blank. I hate her" Bulgakov, M.A. Op. op. - With. 41. These lines are from the story “Blizzard” (1926). A story about how we failed to defend a life that had just blossomed. The clerk, passionately in love with the young beauty - the forester's daughter, after the long-awaited engagement, took the bride sledding, and the trotter "from the moment he picked it up, the bride was thrown - and his forehead hit the doorframe."
The title of the story “Blizzard” immediately “twists” the main plot line. The blizzard turned out to be insidious and deceptive. In the morning it was a beneficial blizzard: it gave the narrator, a young doctor, the first almost free day in the entire winter. Only two patients came to his hospital for an appointment. And this gave him a happy opportunity to rest and wash himself, since he was already dying under the burden of his early glory. After an incredibly successful operation (“Steel Throat”), the first in his career, a hundred patients a day began to come to him. In addition, he had an inpatient department for thirty people. He performed surgeries and went to deliver babies, since he was the only doctor in the rural hospital.
And now, despite the blizzard, without having time to wash himself, somehow drying his head in front of the stove, he went to another village following a desperate note from his colleague, also, as it turned out, a young doctor. Having arrived at the place, he realized that he would definitely get sick now, and it was even more offensive for him when he saw that he had come here in vain - the girl could not be saved. In dull despair after a meeting with death, he immediately, brushing aside entreaties to stay and wait out the blizzard, goes back. The driver lost his way, the travelers were being chased and were already overtaken by wolves. Whether the case was saved or shots fired from a Browning car, which luckily the doctor had with him, is unknown. Only the old, peeling hospital, lost in the snow, seemed to the young doctor more beautiful than the palace after his experience.
In this story, the affection for A.S. Pushkin, characteristic of all of M. Bulgakov’s work, also appeared. The story is preceded by an epigraph from the textbook poem “Winter Evening” (1825):
Then, like a beast, she will howl,
She will cry like a child.
It is unlikely that the epigraph was needed only to remind everyone of the familiar lines. No, what was needed was a memory of the whole atmosphere of his poetry. Perhaps it’s also because Pushkin’s sadness always conceals light within itself.
The hero of the stories is not distinguished by either a titanic will or an iron character. But he is constantly fighting hard. First of all, with the disease: “... I looked into the pupils, tapped on the ribs, listened to how my heart was beating mysteriously in the depths, and carried within me one thought - how to save it? And this is to be saved. And this! Everyone!” Bulgakov, M.A. Op. op. - With. 37. But not only is there a struggle with the disease, the doctor also has to overcome his own cowardice and ignorance. And his ineradicable love for people helps him in this. After what the doctor thought was a hopeless amputation, he asked: “When he dies, be sure to send for me.” And here is the doctor alone. “Now they’ll knock... they’ll say: “She’s dead...” Yes, I’ll go and take a last look.” Ibid. - p. 18. This is how people think about their relatives, but Bulgakov’s doctor thinks this way. But then there’s an unexpected turn in the story, and a stone falls from the reader’s soul. There is indeed a knock on the doctor's door, but a lot of time has passed - a recovered girl is at the door.
The thought of the need to “obediently learn” never leaves a young doctor. The writer’s conviction that educational institutions are not able to produce people fully prepared for independent work will take shape later in “The Life of M. de Moliere”: “I believe that it is impossible to become an educated person in any educational institution. But in any well-run educational institution, you can become a disciplined person and acquire a skill that will be useful in the future, when a person begins to educate himself outside the walls of the educational institution.” Bulgakov, M.A. Selected works: In 3 volumes. Volume 2: The Life of Monsieur de Moliere; Notes of a deceased person; Master and Margarita. - M.: TERRA, 1997. - p. 122.
Among the works of M. Bulgakov, published in the 1920s in the magazine “Medical Worker,” there is also the story “Star Rash.” “These lines, in fact, have no analogues in world literature. With the greatest chastity and humanity, Bulgakov described in his story patients with syphilis and the details of their medical examination, while simultaneously giving a deep scientific analysis of the spread of this terrible disease and outlining measures to combat it. This medical program can still serve today as an example of medical fearlessness and scientific consistency.” Vilensky, Yu.G."Doctor Bulgakov", Kyiv, 1991, p. 47. The story mentions a university and a professor with a gray beard. This is Sergei Petrovich Tomashevsky, an outstanding Russian syphilidologist, public figure, “advocate of women’s medical education” Ibid. - With. 49. His report, for example, states that the clinic treated patients with all forms of syphilis, about a sixth of which were tertiary lyues, and three-quarters of the patients were found to have condylomas. Clinic S.P. Tomashevsky had a rich library; the newest methods of treatment were used here. “Sufficient diagnostic experience, radicalism in the use of salvarsan, an epidemiological approach to syphilis - Mikhail Bulgakov undoubtedly acquired all this within these walls.” Ibid.. Not much time will pass, and the young doctor, abandoned in the provincial wilderness, will face one on one tragic epidemic of the region: “Now, when many years have passed, far from the forgotten peeling white hospital, I remember the starry rash on his chest. Where is he? Ah, I know, I know. If he's alive, he and his wife make occasional trips to the ramshackle hospital. They complain of ulcers on their legs. I can clearly imagine him unwinding his foot wraps, looking for sympathy. And a young doctor, man or woman, in a white darned robe, bends down at his feet, presses his finger on the bone above the ulcer, looking for the cause. Finds and writes in the book: “Lues III” Bulgakov, M.A. Op. op. - With. 78. It is this difficult and dangerous branch of medicine that will become in 1918 - 1919. the main specialty of Dr. M.A. Bulgakov.
It is not at all accidental that this story fell out of the cycle, and for a long time. It is in it that it is clearly stated that the young doctor’s communication with local peasants went exactly the same way as in A.P. Chekhov’s story “New Dacha”. The simple-minded intellectual enthusiast constantly runs into a wall of heavy mistrust; his relations with the peasants were not idyllic. The year “spent in close communication with them gave Bulgakov a lot to form a living, not speculative, idea of his people” Shteiman, M.S. Op. op. - With. 290.
“The Young Doctor's Stories,” as the author himself called them, were indeed written by a young man; they are bright, smiling, and well convey the excitement and joy of a medical graduate starting a rural practice, who bears little resemblance to the author. Conflicts and difficult situations are resolved easily and successfully.
While working on his first works, the young writer gradually learns the lesson of Russian classical prose: there must be a certain distance between the author and the characters, even dear and close to him. That is, the writer should look at what happened to him and other people as his own and someone else’s past. Of course, such maturity and height of a writer’s vision could not come immediately.
Bulgakov is looking not only for a new point of view on current events and their participants, but also his own style. I.A. Bunin in “Cursed Days” spoke with bitterness about the decay and disease of the language, about its breakdown and contamination even among the people. The satirist Bulgakov sees this disease, and hence all his ridicule of abbreviations, clerical cliches, pseudo-revolutionary jargon, and the self-confident illiteracy of newspapermen. “But Bulgakov also laughs at the previous “sleekness of smooth phrases” of decadent writers and literary figures of the beginning of the century. He himself did not fence himself off from the new “swirly” language of the turning point, where “incorrect” living speech, church high style and biblical images, bookish intellectual conversation, rhetoric of rallies and clumsy typewritten phrases of the office were intricately combined. On the contrary, the language of Bulgakov's satire lives by this irregularity and decay, skillfully using all the cliches and absurdities, colliding incompatible dialects and jargons. Hence his unique comedy” 40 Ibid. - With. 294. A novice prose writer already knows how, following Chekhov, to show the character of a character through his speech.
Baptism by turning
The days flew by in the N hospital, and I began to gradually get used to the new life.
In the villages, flax was still crushed, the roads remained impassable, and at my receptions there were no more than five people. The evenings were completely free, and I devoted them to sorting through the library, reading textbooks on surgery and long, lonely tea parties at the quietly singing samovar.
It rained all day and night, and the drops incessantly knocked on the roof, and water gushed under the window, flowing down the gutter into the tub. There was slush, fog, and black darkness in the yard, in which the windows of the paramedic’s house and the kerosene lantern at the gate glowed like dim, blurry spots.
One of these evenings I was sitting in my office reading an atlas on topographic anatomy. There was complete silence all around, and only occasionally the gnawing of mice in the dining room at the buffet broke it.
I read until my heavy eyelids began to droop. Finally he yawned, put the atlas aside and decided to go to bed. Stretching and anticipating a peaceful sleep to the sound and patter of rain, he went into the bedroom, undressed and lay down.
Before I had time to touch the pillow, the face of Anna Prokhorova, seventeen years old, from the village of Toropovo, appeared in front of me in the sleepy haze. Anna Prokhorova needed to have a tooth pulled. Paramedic Demyan Lukich floated silently by with shiny tongs in his hands. I remembered how he says “such” instead of “such” - out of love for high style, I grinned and fell asleep.
However, no later than half an hour later I suddenly woke up, as if someone had pulled me, sat up and, fearfully peering into the darkness, began to listen.
Someone was persistently and loudly drumming on the outer door, and these blows immediately seemed ominous to me.
There was a knock on the apartment.
Who's there?
“It’s me,” a respectful whisper answered me, “I, Aksinya, the nurse.”
What's the matter?
Anna Nikolaevna has sent for you, they tell you to go to the hospital as quickly as possible.
And what happened? - I asked and felt my heart skip a beat.
Yes, the woman was brought there from Dultsev. Her birth was unsuccessful.
"Here it is. Began! - flashed through my head, and I couldn’t get my feet into my shoes. - Oh, damn it! Matches don't light. Well, sooner or later it had to happen. You can’t spend your entire life with laryngitis and stomach catarrhs.”
Fine. Go tell me I'll be right there! - I shouted and got out of bed. Aksinya’s steps padded outside the door, and the bolt rattled again. The dream disappeared instantly. Hastily, with trembling fingers, I lit the lamp and began to get dressed. Half past twelve... What's going on with this woman with an unsuccessful birth? Hm... Incorrect position... narrow pelvis. Or maybe something even worse. Well, you'll have to use forceps. Should we send her straight to the city? Yes, this is unthinkable! Nice doctor, nothing to say, everyone will say! And I don’t have the right to do that. No, you have to do it yourself. So what to do? The devil knows. It will be a disaster if I get lost; It's a shame to see midwives. However, you need to look first, don’t worry too soon...
I got dressed, threw on my coat and, mentally hoping that everything would turn out well, in the rain, I ran along the flapping boards to the hospital. In the semi-darkness, a cart could be seen at the entrance; the horse hit the rotten boards with its hoof.
Have you brought a woman in labor? - for some reason I asked the figure moving near the horse.
“We... well, we, father,” the woman’s voice answered plaintively.
In the hospital, despite the dead hour, there was activity and bustle. In the waiting room, a lightning lamp was blinking. In the corridor leading to the maternity ward, Aksinya rushed past me with a basin. A faint groan suddenly came from behind the door and froze. I opened the door and entered the birthing room. The whitewashed small room was brightly lit by an overhead lamp. A young woman was lying on the bed next to the operating table, covered with a blanket up to her chin. Her face was distorted into a painful grimace, and wet strands of hair stuck to her forehead. Anna Nikolaevna, with a thermometer in her hands, was preparing a solution in an Esmarch mug, and the second midwife, Pelageya Ivanovna, was taking clean sheets from the cabinet. The paramedic, leaning against the wall, stood in Napoleon's pose. When they saw me, everyone perked up. The woman in labor opened her eyes, wrung her hands and again moaned pitifully and heavily.
Well, what is it? - I asked and was surprised at my tone, he was so confident and calm.
Transverse position,” Anna Nikolaevna quickly answered, continuing to add water to the solution.
So-so,” I drawled, frowning, “well, let’s see...
The doctor should wash his hands! Aksinya! - Anna Nikolaevna immediately shouted. Her face was solemn and serious.
While the water was flowing, washing away the foam from my hands, red from the brush, I asked Anna Nikolaevna minor questions, such as how long ago the woman in labor was brought in, where she was from... Pelageya Ivanovna’s hand threw back the blanket, and I, sitting down on the edge of the bed, quietly touching, began to feel the swollen stomach. The woman moaned, stretched out, dug her fingers in, crumpled the sheet.
Quietly, quietly... be patient,” I said, carefully placing my hands on the stretched, hot and dry skin.
As a matter of fact, after the experienced Anna Nikolaevna told me what was going on, this research was unnecessary. No matter how much I researched, I still wouldn’t know more than Anna Nikolaevna. Her diagnosis, of course, was correct. Transverse position. The diagnosis is obvious. Well, what next?..
Frowning, I continued to feel my stomach from all sides and glanced sideways at the faces of the midwives. Both of them were intently serious, and in their eyes I read approval of my actions. Indeed, my movements were confident and correct, but I tried to hide my anxiety as deeply as possible and not show it in any way.
“Okay,” I said, sighing, and got up from the bed, since there was nothing more to see from the outside, let’s explore from the inside.
Approval flashed again in Anna Nikolaevna's eyes.
Aksinya!
The water started pouring out again.
“Eh, I wish I could read Doderlein now!” - I thought sadly, soaping my hands. Alas, it was impossible to do this now. And how would Doderlein help me at this moment? I washed off the thick foam and lubricated my fingers with iodine. The clean sheet rustled under Pelageya Ivanovna’s hands, and, bending over to the woman in labor, I began to carefully and timidly carry out an internal examination. A picture of an operating room in an obstetric clinic involuntarily came to mind. Brightly burning electric lamps in frosted balls, shiny tile floors, sparkling taps and appliances everywhere. An assistant in a snow-white robe manipulates a woman in labor, and around him are three resident assistants, trainee doctors, and a crowd of student curators. Nice, bright and safe.
Here I am, alone, with a tormented woman under my arms; I am responsible for her. But I don’t know how to help her, because I saw childbirth up close only twice in my life in the clinic, and those were completely normal. Now I’m doing research, but this doesn’t make it any easier for me or the woman in labor; I don’t understand anything at all and I can’t feel it inside her.
And it's time to decide on something.
Transverse position... since it’s a transverse position, that means you need to... need to do...
A turn on the leg,” Anna Nikolaevna could not resist and seemed to remark to herself.
An old, experienced doctor would look askance at her for poking around with her conclusions... I’m not a touchy person.....
Yes,” I confirmed meaningfully, “a turn on the leg.”
And Doderlein’s pages flashed before my eyes. Direct turn... combined turn... indirect turn...
Pages, pages... and on them there are drawings. Pelvis, twisted, squashed babies with huge heads... a dangling arm with a noose on it.
And I just read it recently. And he emphasized, carefully thinking about every word, mentally imagining the relationship of parts and all the techniques. And while reading, it seemed that the entire text was imprinted forever in the brain.
And now only one phrase emerges from everything I read:
“The transverse position is an absolutely unfavorable position.”
What's true is true. Absolutely unfavorable for both the woman herself and the doctor who graduated from university six months ago.
Well... we’ll do it,” I said, getting up.
Anna Nikolaevna's face perked up.
Demyan Lukich,” she turned to the paramedic, “prepare chloroform.”
It’s great that she said that, otherwise I wasn’t sure yet whether the operation was being done under anesthesia! Yes, of course, under anesthesia - how could it be otherwise!
But still, Doderlein needs to be watched...
And I, having washed my hands, said:
Well, okay... you prepare for anesthesia, put her to bed, and I’ll come now, I’ll just take some cigarettes from home.
“Okay, doctor, we’ll have time,” answered Anna Nikolaevna.
I dried my hands, the nurse threw my coat over my shoulders, and without putting it on my sleeves, I ran home.
At home in my study, I lit a lamp and, forgetting to take off my hat, rushed to the bookcase.
Here he is - Doderlein. "Operative obstetrics." I hastily began to rustle the glossy pages.
"... turning is always a dangerous operation for the mother..."
A chill crept down my back, along my spine.
"... The main danger is the possibility of spontaneous uterine rupture."
Self-pro-from-freely...
“... If the obstetrician, when inserting his hand into the uterus, due to lack of space or under the influence of contraction of the walls of the uterus, encounters difficulties in penetrating the leg, then he should abandon further attempts to perform the rotation...”
Fine. If I manage, even by some miracle, to identify these “difficulties” and give up “further attempts,” what, one wonders, will I do with the chloroformed woman from the village of Dultsevo?
"...An attempt to penetrate to the legs along the back of the fetus is absolutely prohibited..."
Let's take note.
"Sad consequences." A little vague, but what impressive words! What if the husband of the Dultsev woman remains a widower? I wiped the sweat on my forehead, gathered my strength and, bypassing all these terrible places, tried to remember only the most essential: what, in fact, I should do, how and where to insert my hand. But, running through the black lines, I kept coming across new terrible things. They hit my eyes.
"... due to the enormous danger of rupture...... internal and combined turns represent operations that should be classified as the most dangerous obstetric operations for the mother..."
And as a final chord:
"...With every hour of delay the danger increases..."
Enough! Reading bore fruit: everything was completely confused in my head, and I was instantly convinced that I did not understand anything, and above all, what kind of turn I would actually make: combined, non-combined, direct, indirect!..
I abandoned Doderlein and sank into a chair, trying to put my scattered thoughts in order... Then I looked at my watch. Crap! It turns out that I’ve been home for twelve minutes already. And there they are waiting.
"...With every hour of delay..."
Hours are made up of minutes, and the minutes fly by like crazy in such cases. I threw Doderlein and ran back to the hospital.
Everything was already ready there. The paramedic stood at the table, preparing a mask and a bottle of chloroform on it. The woman in labor was already lying on the operating table. A continuous groan echoed throughout the hospital.
Be patient, be patient,” Pelageya Ivanovna muttered affectionately, leaning towards the woman, “the doctor will help you now...
Ooh! My little cheeks... No... My little pussy is gone!.. I can’t stand it!
I suppose... I suppose... - muttered the midwife, - you’ll endure it! Now we’ll give you a sniff... You won’t hear anything.
Water began to flow noisily from the taps, and Anna Nikolaevna and I began to clean and wash our arms, bare to the elbows. Anna Nikolaevna, amid groans and screams, told me how my predecessor, an experienced surgeon, made turns. I listened to her eagerly, trying not to utter a word. And these ten minutes gave me more than everything I read on obstetrics for the state exams, in which I received a “very” in obstetrics. From fragmentary words, unfinished phrases, and casually thrown hints, I learned the most necessary things that do not happen in any books. And by the time I began to wipe my hands perfectly white and clean with sterile gauze, determination took possession of me and I had a completely definite and firm plan in my head. Whether it’s combined or not, I don’t even need to think about it now.
All these learned words are useless at this moment. One thing is important: I must insert one hand inside, help turn with the other hand from the outside and, relying not on books, but on a sense of proportion, without which a doctor is no good, carefully but persistently lower one leg and remove the baby by it.
I must be calm and careful and at the same time infinitely decisive and not cowardly.
“Come on,” I ordered the paramedic and began to lubricate my fingers with iodine.
Pelageya Ivanovna immediately folded the hands of the woman in labor, and the paramedic covered her exhausted face with a mask. Chloroform slowly began to drip from the dark yellow bottle. A sweet and sickening smell began to fill the room. The faces of the paramedic and midwives became stern, as if inspired...
Gah! A!!! - the woman suddenly shouted. For several seconds she struggled convulsively, trying to throw off the mask.
Hold it!
Pelageya Ivanovna grabbed her hands, laid her down and pressed her to her chest. The woman shouted several more times, turning her face away from the mask. But less often... less often... she pressed dully to her chest. The woman shouted several more times, turning her face away from the mask. But less often... less often... she muttered dully:
Haa... let me go! A!..
Then it got weaker and weaker. There was silence in the white room. Transparent drops kept falling and falling onto the white gauze.
Pelageya Ivanovna, pulse?
Pelageya Ivanovna raised the woman’s hand and released it; she flopped lifelessly on the sheets like a whip.
The paramedic pulled back his mask and looked at the pupil.
A pool of blood. My hands are up to my elbows in blood. Blood stains on the sheets. Red clots and lumps of gauze. And Pelageya Ivanovna is already shaking the baby and patting him. Aksinya rattles buckets, pouring water into basins. The baby is immersed either in cold or hot water. He is silent, and his head lifelessly, as if on a thread, dangles from side to side. But then suddenly it was either a creak or a sigh, followed by a weak, hoarse first cry.
Alive...alive - Pelageya Ivanovna mutters and lays the baby on the pillow.
And the mother is alive. Luckily, nothing bad happened. Here I feel the pulse myself. Yes, it is smooth and clear, and the paramedic quietly shakes the woman by the shoulder and says:
Well, auntie, auntie, wake up.
They throw aside the bloody sheets and hastily cover the mother with a clean one, and the paramedic and Aksinya take her into the room. The swaddled baby rides off on a pillow. A wrinkled brown face looks out from the white rim, and a thin, whiny squeak is not interrupted.
Water flows from the washbasin taps. Anna Nikolaevna greedily takes a drag on her cigarette, squints against the smoke, and coughs.
And you, doctor, made a good turn, so confidently.
I diligently rub my hands with the brush, looking sideways at her: isn’t she laughing? But she has a sincere expression of proud pleasure on her face. My heart is full of joy. I look at the bloody and white mess all around, at the red water in the basin and feel like a winner. But somewhere deep down, a worm of doubt is stirring.
Anna Nikolaevna looks up at me in surprise.
Well maybe? All is well.
I vaguely mutter something in response. Actually, I want to say this: is everything intact with my mother, did I harm her during the operation... This is something that vaguely torments my heart. But my knowledge of obstetrics is so unclear, so bookishly fragmentary! Breakup? What should it be expressed in? And when will he make himself known - now or, perhaps, later?.. No, it’s better not to talk about this topic.
“Well, you never know,” I say, “the possibility of infection cannot be ruled out,” I repeat the first phrase I come across from some textbook.
Ah, th-this! - Anna Nikolaevna drawls calmly - well, God willing, nothing will happen. And from where? Everything is sterile and clean.
It was just after two when I returned to my room. On the table in the office, in the spot of light from the lamp, Doderlein lay peacefully open on the page of “Dangers of Turning”. For another hour, swallowing cold tea, I sat over it, turning over the pages. And then an interesting thing happened: all the former dark places became completely understandable, as if filled with light, and here, by the light of a lamp, at night, in the wilderness, I understood what real knowledge means.
“You can gain a lot of experience in the village,” I thought, falling asleep, “but you just need to read, read, more... read...”
One of the earliest works written by Mikhail Afanasyevich Bulgakov is “Notes of a Young Doctor.” It clearly shows the worldview and beliefs of the future great writer, which are reflected in his later work. Among the main features one can note light and kind humor, perhaps even some naivety. Treats his heroes condescendingly
“Notes of a Young Doctor” tells us about a young man who decided to devote himself to medicine. At first he looks timid and indecisive, but over time he gains the necessary experience and self-confidence arises. But the most important thing that the main character acquires is a huge responsibility to the people and patients of representatives of this profession. He always rushes to the suffering and needy, no matter what the weather is outside. Bomgaard puts a lot of love, care and warmth into her work, which helps patients recover.
The main character of "Notes of a Young Doctor" is haunted not only by luck and success. From time to time, difficulties arise along his path that he is unable to overcome. Thus, his colleague and friend Doctor Polyakov dies in the chapter “Morphine”. In the story "Blizzard", the beloved of one of the heroes also cannot be helped. However, the doctor does not run away from insoluble problems, does not despair, but continues his difficult mission - saving a person’s life. Only one thing frightens the main character of the work - his powerlessness in the face of the disease that has gripped the patient. He is constantly trying to improve himself, develop, gain new skills and knowledge. In a word, this doctor works a lot on himself.
This story brought its creator, Mikhail Afanasyevich Bulgakov, great fame.
The plots of the stories from the cycle that Bulgakov wrote, “Notes of a Young Doctor,” are quite simple, but they give a panorama of the life of one village located in and at the same time reveal the character of the author.
"Towel with a rooster"
Bomgard, as soon as he arrived at the new place, was immediately faced with the need to carry out an amputation. Fortunately, the operation ends successfully; the old paramedic praises him and adds that, apparently, the doctor has a lot of experience in this area. Bomgard answers with a trembling that he has already done two, and reproaches himself for lying.
"Snowstorm"
A doctor goes to a remote village on an emergency call and gets caught in a snowstorm. The author's idea in the story is simple: medical ethics does not allow him to refuse a patient, despite any obstacles standing in the way, and no matter what the cost.
"Neck of Steel"
A girl in the last stages of diphtheria goes to see a doctor. Bomgard, enraged by the ignorance of the child's grandmother and mother, performs a tracheotomy and temporarily inserts a steel tube into the throat so that the patient does not die from suffocation. This story ends with an anecdote: peasants from all the surrounding villages come to see the rescued girl, confident that the doctor sewed a steel pipe down her throat.
"Darkness of Egypt"
Continues with the following story, which anecdotally describes the ignorance of ordinary peasants. It is about a miller suffering from malaria. He decides to take the course of quinine prescribed to him for a week at a time, because he does not want to wait long for his recovery. This is what Bulgakov told us about in this story.
"Morphine"
“Notes of a Young Doctor” continues with a story - the darkest of all included in the collection. It is actually a monologue of a morphine addict who committed suicide as a colleague of Dr. Bomgard. Bulgakov was very familiar with this topic, since he himself went through the torments of addiction to this substance, but found the strength to overcome the disease, unlike Polyakov, that unfortunate doctor. Several pages of the poignant story created by Mikhail Bulgakov ("Notes of a Young Doctor") show the horror of drug addiction and its inevitable ending - moral degradation, loss of friends and loved ones, personality disintegration.
"Baptism by turning"
Here Bomgrad is forced to undergo a difficult birth. Having no experience in this, he feverishly reads the manual before the operation, but in the end the doctor has to rely only on his professional intuition. Having completed the operation safely, he reads the book again and notices that all the previously unclear places are now completely clear to him. Book experience was confirmed by practical experience, notes Bulgakov. The book "Notes of a Young Doctor" continues with the following story.
"The Missing Eye"
In this work, Bomgard sums up the results of the first year of practice at the Muryevskaya hospital, notices without surprise that he has changed a lot both externally and internally, and recalls various funny incidents. Now, thanks to experience, he looks at a new case without fear, but the doctor is saved from excessive pride by those in which excessive education prevents him from seeing the obvious and simple (for example, the case with the “missing” eye). The young 23-year-old doctor notes: every year will bring similar surprises, and learning will never stop.
"Star Rash"
In this story, a doctor encounters a hotbed of syphilis and clearly understands that this terrible disease has a social nature, which makes it more difficult to cope with than any other illness. Bomgard begins a persistent and long struggle against syphilis, but in the end he must admit that successful treatment requires a system that would be able to overcome the fear of this disease among the peasants.
"I killed"
The cycle “I Killed” ends the cycle created by M. Bulgakov (“Notes of a Young Doctor”). Bomgard told the story of Yashvin, his colleague, who introduced himself as the only surgeon with a pistol, and not a scalpel. Yashvin's story takes place in Kyiv in 1919. The doctor is forcibly taken away by the Petliurists and arranged as a regimental doctor subordinate to Colonel Leshchenko. Observing torture, murder, reprisals and brutal morals during the Civil War, Yashvin ultimately does his hard work and puts himself above professional medical ethics. This is a difficult conflict, considering also the fact that it arises before a representative of such a humane profession.
The collection of stories tells about the events of 1916-1917. and the beginning of 1918, when Mikhail Afanasyevich himself, being a young specialist, was sent to Nikolskoye. The plot is as follows: Bulgakov describes a young doctor, who recently graduated from university, who arrives in a remote Russian village and for the first time is faced with the need to single-handedly identify diseases, prescribe the right treatment and carry out complex operations that he often has not even seen in person. The main events of the book are taken from the life of the author. We described them in detail in a brief retelling.
On September 17, 1917, the hero arrives at the Murinsky hospital, almost numb on the road. The watchman Yegorych meets him. Many people are surprised how young the new doctor is.
Warming up in the kitchen, the hero meets the staff - paramedic Demyan Lukich, midwives Pelageya Ivanovna and Anna Nikolaevna. In the hospital, he sees a huge library and instruments left over from his predecessor Leopold Leopoldovich. In the evening, the hero alone thinks about what to do if he has to treat something he doesn’t know. Afraid of almost everything. At night they bring in a girl who was caught in a flax thresher. She dies, but the doctor amputates her leg anyway. Two and a half months later, the patient and her father come to him and gratefully give him a towel with an embroidered rooster.
Steel throat
November. The hero is again afraid of childbirth or hernia. At this moment, a three-year-old girl with advanced diphtheria croup is brought in. Her mother and grandmother did not want to treat her and asked for drops. The case is hopeless, but the doctor persuades the mother to have an operation, although he himself does not understand why and is afraid of her consent.
In the end they leave, but after a while the mother agrees. During the operation, the paramedic faints, but everything goes well. Months later, Lidka only had scars on her throat, and in the villages they only say that the new doctor gave her a throat of steel.
Baptism by turning
The hero reads an anatomical atlas and falls asleep. Aksinya, the nurse, wakes him up. A woman has an unsuccessful birth - transverse position. The doctor conducts an external and internal examination and decides to perform a pedicle rotation.
Having said that he is going to get cigarettes, he runs home and looks at a reference book on obstetrics. How he performs an operation in a dream, and when he returns home, he understands everything better than what is described in the book.
Snowstorm
During a blizzard, the hero rests and takes a bath. But they sent for him, because after the engagement in the village, the groom was giving his bride a ride, and the sleigh skidded, hitting her on the doorframe.
Upon arrival, he finds the girl dead and goes back. On the way, they get lost in a snowstorm and wander for four hours. As a result, they go to the hospital, barely fighting off the wolves.
star dust
The hero identifies a man with syphilis, but he only complains about his throat and does not listen to recommendations that he needs treatment. After receiving treatment, he disappears. At the same time, he could infect a woman who, having learned all this, is terrified of getting sick.
But after going through all the preventive measures, she becomes healthy. Everyone else does not consider syphilis a disease and is treated only in the later stages. As a result, the doctor seeks to open a department for syphilitics.
Egyptian darkness
Hero's birthday. The entire staff notes and tells funny cases of how villagers, having misunderstood the treatment, find themselves in anecdotal situations.
Then the miller comes, striking the doctor with his lack of understanding. As a result, he is admitted to the department and is prescribed to drink ten powders, which he eats all at once. The doctor decides to fight this illiteracy in the future.
Missing Eye
The morning after the hero's birthday. He is confident that he has been through everything and can heal everything by remembering the past.
But then a woman comes to him with a child whose eye has disappeared and is all yellow. The doctor does not know what it is and suggests cutting it, since there is no eye. The mother says that the eye was there and goes away. A week later he sees a healthy child and realizes that it was just a huge abscess. The doctor says no more.
Interesting? Save it on your wall!Brief summary of the episodes of the series "Notes of a Young Doctor":
1 season:
Episode 1
Moscow, 1934. Recalling the beginning of his career, the Russian doctor mentally travels back 17 years, when he, having just completed his studies at the university, arrived in a distant village to replace the late doctor and head the local hospital. There he meets a persistent paramedic and midwives Anna and Pelageya, and soon becomes convinced that even excellent grades and knowledge of the subject are worth nothing without practical experience.
Episode 2
Day after day, the dreams and hopes of the young doctor for the successful cure of all patients in the area are fading away more and more - after all, his desire to make medical discoveries, as well as attempts to cure syphilis among the peasants, are broken by their lack of education and desire to take advantage of the inexperience of the new doctor for their own purposes. The last straw is a brutal operation to amputate the legs of a small child, which opens the doctor’s eyes to his future in this outback.
Episode 3
Despite his success in the operating room, life in a snowy hospital isolated from society begins to have a depressing effect on the young doctor. When all efforts and tricks to combat boredom do not bring results, and the emerging abdominal pain begins to drive him crazy, the doctor turns his attention to the contents of the first aid kit, one drug from which can solve his problems.
Episode 4
Reaping the benefits of his unexpectedly successful operation, after some time the young doctor loses control of his progressive addiction, which leads to a shameful incident. Having decided to start fighting the addiction, the doctor undergoes a serious test during a trip to a neighboring village, where a patient with a broken skull is waiting for him. Meanwhile, in 1934, a doctor under investigation comes to his senses in a very unpleasant place.
Season 2:
Episode 1
Soon the young doctor starts a relationship with Pelageya, thus satisfying two of his needs at once, however, when the time for the scheduled visit of the inspection approaches, it becomes clear that it will be very problematic to hide a large shortage of morphine. The only solution that came to mind turns into a tragedy when a detachment of wounded soldiers arrives along with the inspection. In 1935, the cured doctor is released and goes on a journey.
Episode 2
In the absence of morphine, the young doctor tries to replace it with cocaine, but the result is only a quarrel with Pelageya. The next day, the White Guards appear at the hospital, along with the lovely Natasha, who immediately captivates the doctor, but after a night full of dramatic events, it turns out that the beauty’s heart is already occupied. In 1935, the doctor meets a fellow traveler who very clearly expresses his attitude towards drug addicts.
Episode 3
1935 The doctor, continuing his journey, decides to write an opera, which does not find understanding from his companion. Meanwhile, the young doctor ignores Pelageya’s rapidly progressing illness, attributing it to the suffering of her broken heart, at the same time, he does not disdain anything for the sake of the favor of the inaccessible beauty who lingered within the walls of his hospital. Indifference to a dying assistant for the sake of consoling a woman grieving because of his fault makes a shocking impression on a man who remembers this many years later.
Episode 4
Using Pelageya's funeral as an opportunity to demonstrate his compassion to Natasha, the young doctor continues to try to get her to reciprocate, however, when a Bolshevik raid forces the aristocrat and the others to leave the hospital, the doctor, in despair, confesses to the woman his lies. Soon the young doctor is given the opportunity to save his beloved from the Bolsheviks and win her favor, but suddenly the man finds himself faced with a difficult choice that later determines his future.