10 the Pharos/Summer 2012 Anton Chekhov in Medical School— and After

10 The Pharos/Summer 2012 Anton Chekhov in medical school— and after An artist’s flair is sometimes worth a scientist’s brains – Anton Chekhov Leon Morgenstern, MD The author (AΩA, New York University, 1943) is Emeritus it significantly enlarged the scope of my observations and Director of the Center for Health Care Ethics and Emeritus enriched me with knowledge whose true worth to a writer Director of Surgery at Cedars-Sinai Medical Center in Los can be evaluated only by somebody who is himself a doctor; Angeles, and Emeritus Professor of Surgery at the David it has also provided me with a sense of direction, and I am Geffen School of Medicine at UCLA. sure that my closeness to medicine has also enabled me to avoid many mistakes.1p425 t is often overlooked, and sometimes forgotten, that Anton Chekhov, the noted Russian writer of short stories and plays, Medical school was a pivotal juncture in the delicate balance Iwas also a doctor. He was one of the principal authors in between the two careers. It made him into the doctor he was. what has been called the Golden Age of Russian Literature It helped him reach the goal of becoming the writer he was in the mid- and late-nineteenth century, along with Fyodor to be. Dostoevsky, Leo Tolstoy, and Ivan Turgenev. Chekhov was born in Taganrog, a port town founded by In 1879 at the age of nineteen, Anton Chekhov enrolled in Peter the Great on the Sea of Azov in Southern Russia. His the medical school of Moscow University. He was destined family was only one generation removed from serfdom, hav- to become a famous author rather than a famous doctor. His ing had its freedom bought by an industrious grandfather, talent in writing eclipsed any ambition he might have had in the only one of his kin who could read and write. His father medicine, but his devotion to doctoring remained evident in had no formal education, was a stern disciplinarian and head his literary works as well as in his medical activities through- of the household, and had a penchant for failure in all of his out his lifetime. As he himself put it, bread-winning ventures. Anton was the third of six children born to this impecunious family. Theirs was a struggle to rise I have no doubt that my involvement in medical sci- above their legacy of the economic enslavement of serfdom ence has had a strong influence on my literary activities; to a life of independence and respectability. In that struggle it was Anton who eventually achieved that goal for his family.2,3 At age eight Anton entered the Taganrog gymnasium to Anton Chekhov. Portrait by Nikolai Chekhov. © Sovfoto. begin his elementary and high school education. He was a The Pharos/Summer 2012 11 Anton Chekhov in medical school—and after Chekhov with family and friends, 1890. Anton Chekhov at 28 years of age. All photos © Bettmann/CORBIS mediocre student, more interested in the usual pastimes of When Anton was still in high school at age sixteen his boyhood than in the quest for good grades. At age fifteen, father fled to Moscow to escape going to debtor’s prison. A he was stricken with a severe abdominal illness, described as short time later his mother left to join him there with the two “peritonitis.” The Taganrog school doctor who treated him, younger children. The older brothers had also already left to a Dr. Schlempfe, encouraged young Anton to strive for a ca- study in Moscow. Anton was left to fend for himself for the reer in medicine, preferably at his own alma mater in Zurich, next two years, attending high school, working at tutoring and Switzerland. While in high school, Anton did dream of Zurich other odd jobs, and longing for the company of his close-knit and its medical school but eventually resigned himself more family. realistically to settle for medical school in Moscow. He wrote If grades were then, as they are now, a meaningful pre- to his brother Misha, “I have only one secret illness which tor- requisite to medical school entry, Anton’s performance as a ments me . lack of money.” 4pp38–39 That same year his father student would never have earned him admission. In a crucial wrote, “Antosha! When you finish studying at the Taganrog examination at the gymnasium for university eligibility he gimnazia, you must join the [Moscow] Medical faculty, for failed in mathematics, did poorly in Latin, as well as in natu- which you have our blessing.” 5p62 The choice of medicine as ral science, all usual requirements for admission to medical a career goal reflected not only the early exhortation by Dr. school. Nevertheless, by a special vote, he was gratuitously Schlempfe in that direction but also the promise of a stable granted a matriculation certificate for the Moscow University source of income for his impoverished family. Curiously, many medical school in June 1879. He was also awarded a sorely years later, in a letter to a friend, he wrote, needed stipend of twenty-five silver roubles a month by the Taganrog City Council. In August of 1879, he was off to In 1879 I entered the Medical School of Moscow Moscow for the beginning of not one, but two careers. The University. At the time I had only a vague knowledge of the one in medicine was about to begin; the other, writing, was al- University’s various faculties, and I do not remember why I ready in progress. He had written humorous sketches, verses, chose medicine, but I have had no subsequent regrets.1p425 and even the outline for a drama (“Fatherlessness”) while still in high school. These have never been published. Medical 12 The Pharos/Summer 2012 Chekhov’s dacha. Chekhov’s with his wife Olga Knipper-Chechova. school would provide a new and more productive venue for for a busy household, hardly conducive to the quiet atmo- refining and developing his talents as a storyteller while he sphere more suited to the study requirements of a first-year studied to become a doctor. medical student. As Anton put it, in a letter to his brother There were nine medical schools in Russia at the time. All Alexander, were government schools tightly regulated and controlled by a rigid bureaucracy. Medical education was sponsored and Nikolka has gone to Voskresensk with Maria, it’s Mishka’s supported by the government, a system that allowed poor name day [birthday], Father is sleeping, Mother is praying, students such as Chekhov to attend. The affluent gentry gen- Auntie’s thinking about herbs, Anna is washing dishes and is erally stayed away. Curricula were patterned after and similar about to bring in the piss-pot, I am writing and wondering to Western schools. Among the great things happening in how many times tonight my whole body will be racked with medicine at the time were the innovations in microbiology pain for my presumption in daring to be a writer? I’m getting by Louis Pasteur in France and Robert Koch in Germany, in on with my medical studies.1p15 surgery by Theodor Billroth of Germany and Joseph Lister of England, and in immunobiology by Paul Ehrlich of Germany. In medical school, as a first-year student, Anton was soon None of these seemed to have had great impact on the studies immersed in chemistry, physics, zoology, and, of course, that Anton was ready to commence.5–10 anatomy. There was no shortage of bodies of the poor in When Anton rejoined his family in Moscow to begin his nineteenth-century Moscow. From these unfortunates, each medical studies he brought with him two students to board medical student had a corpse of his own for dissection. In his with the family and provide needed income. His father, Pavel, first examination in anatomy, Anton received a 3 (equivalent was still debt-ridden and all but destitute. Anton, though to a C). He also had a life outside of school, carousing with heavily involved with the stresses of his first-year classes, friends in popular student bars, paying an occasional visit to became the literal head of the household. His older brothers, a brothel, and pursuing other nonacademic ventures. Most Alexander and Nicolai, had moved elsewhere. His mother, significantly, however, he continued his attempts at writing. younger brothers Vania and Misha, and his sister Masha made In this he had his older brother Alexander, also an aspiring The Pharos/Summer 2012 13 Anton Chekhov in medical school—and after Chekhov with the cast of the Moscow Artist Theatre, during a reading of his play The Seagull. Chekhov circa 1900. writer, as a mentor and advisor on how to get published. In disease-ridden patients. The experience reinforced his choice a letter years later he wrote, “Oh, with what trash I began . of medicine as a calling. Little else is known of his academic my God, with what trash!” 11p8 The “trash” consisted of stories, achievements that year. Nor was there much doing in writing. sketches, and jokes submitted to the local weekly magazines That was about to change. in Moscow, most of which were rejected. But to earn money Anton’s third year began in September of 1881. Among his for a celebratory cake for his mother’s birthday, he finally had new subjects were obstetrics and gynecology, diagnostics, and a piece accepted for publication. It was a parody based on his skin diseases. Live patients replaced corpses in the curricu- impressions of his father and grandfather called, “Letter to a lum.

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