The Wisdom of Pain in Chekhov's "Ward Number Six"

A The Wisdom of Pain in Chekhov's "Ward Number Six" Sally Wolff In "Ward Number Six," Anton Chekhov, trained as a physidan, yet distanced from medicine from time to time by his writing career, analyzes the medical profession and the status of the nineteenth-century Russian physidan, asking penetrating questions about the nature of suffering, disease, and death. Set against the backdrop of decaying Czarist Russia, Chekhov's tale is darkly meditative and philosophical, ruminating upon the inadequades of medidne in relieving human suffering, the necessity of humane diagnosis and treatment of the mentally ill, the inequities of the medical profession in supporting the physidan, and in a larger and more universal sense, the role of any sodety in nurturing the physical, spiritual, and intellectual life of its members. Chekhov condemns the concept of a mental hospital as a place for incarceration and punishment, and his story is in part a plea for effective and humane psychiatric care. In the demise of Dr. Andrew Yefimovich Ragin, Chekhov underscores the ineffectuality and failure of one dodor—and of medidne in general—in mediating against pain and death amid the sodal degeneration of his own culture. The poignance of the lesson in "Ward Number Six" retains resonance even today, although the particular triumphs and failures of medicine have changed. The setting for the story immediately links the environs of the hospital called Ward Number Six with decay and melancholy, an appropriate assodation for this sad tale. The roof is rusty, the chimney half collapsed. The porch steps have rotted and are overgrown with grass. . . . Those nails with spikes uppermost, the fence, the hut itself ... all have the melancholy, doomed air peculiar to hospital and prison buildings.1 Literature and Medicine 9 (1990) 134-41 © 1990 by The Johns Hopkins University Press Sally Wolff 135 The opening descriptions of the mental patients in Ward Number Six show them to be ironic representations of sodety in a larger context. The first patienf s pose suggests the sardonic tone of this tragic story: "He grieves all day and night, shaking his head, sighing, smiling a bitter smile" (p. 24). In part, "Ward Number Six" is a self-portrait of a physidan struggling against the call of a rival profession. Like Chekhov, who began his writing career before he began his medical one, Andrew Ragin starts another profession before he enters medidne. Ragin prepares for a theology degree until his father, a doctor of medidne, raises objections. "Ragin himself has often confessed that he never had any vocation for medidne or for sdence in general" (p. 31). Despite these questionable motivations, Ragin eventually trains for the profession of medidne. Chekhov reveals this semiautobiographical charader with both the inside perspective of one trained in medidne, and the critical distance of one removed from it. Through Ragin, Chekhov expresses his own self-critirism at his divided professional interests and his suspidon about the efficacy of medidne in curing human ills. Ragin's failure as a physidan may stem partly from his initial lack of commitment to the profession, but it crystallizes with his growing disillusionment about medical ineffidency at Ward Number Six. Donald Rayfield has seen Ragin's flaws as a matter of hubris and an easy-going nature.2 But Ragin suffers, too, from fatigue and a sense of futility. He soon adopts the attitude of "apparent indifference to the irregularities" that he sees around him (p. 33). W. H. Bruford sees this indifference as evidence of Chekhov's skeptidsm of the stoic ideal, since "to cultivate indifference to suffering is to aim at a living death, for to feel is to live."3 The burden of Ragin's medical practice soon crushes his spirit. He feels the routine and "palpable futility of his job" (p. 33) and becomes unable to cope with the hordes of patients—"thirty patients today, and tomorrow, like as not, thirty-five . . . then forty on the next day—so on, day in day out, year in year ouf ' (p. 33). Allowing his duties as a dodor to slide, Ragin stops attending the hospital every day, weary with asking "his own questions which he has been asking for over twenty years without...