Reading Mikhail Bulgakov’s “A Young Doctor’s Notebook” is like stepping into a time machine that transports you straight back to the daunting early days of medical practice. As a seasoned professional, revisiting Bulgakov’s stark and often darkly humorous tales immediately resonated with my own memories of those first years navigating the immense responsibilities with, what often felt like, woefully inadequate preparation.
My own entry into medicine was in a vastly different setting – a houseman in a busy London hospital “firm,” a structure now almost archaic. Bulgakov, in stark contrast, found himself thrust into the deep end as the sole doctor in a remote rural Russian hospital just before the revolution. His duties were all-encompassing and overwhelming: medical emergencies, obstetrics, pediatrics, surgery, orthopedics, not to mention managing ward patients, all with the support of just a couple of feldshers and two midwives. The sheer volume of patients he faced daily – around 100 new cases – is almost unimaginable by today’s standards.
It brought back to me what it felt like to be a newly qualified doctor with scary responsibilities.
Bulgakov masterfully captures the heart-stopping moments and near misses that are, in truth, part and parcel of every doctor’s journey. He vividly recounts nerve-wracking emergency tracheostomies, the grim necessity of limb amputations, and the delicate tension of complicated deliveries. What truly shines through is his raw portrayal of the internal conflict between a terrified inner self and the meticulously constructed façade of confident professionalism that is essential for patient trust. His moments of private despair echo Bill Styles’ poignant concept of the “mask of professional brilliance” – a necessary shield for those in the medical field.
Bulgakov’s writing style naturally draws comparisons to Chekhov, sharing a similar vein of poignant realism, yet remains distinctly original. These stories, initially published in Russian “medical journals,” remind one of the insightful narratives found in publications like the sadly missed World Medicine, or the concise, impactful stories in contemporary medical magazines.
He is at his storytelling peak when recounting his own experiences, unburdened by modern patient confidentiality constraints, offering an unfiltered glimpse into the realities of early 20th-century medical practice. Perhaps the only deviation from this compelling form is the longer narrative of a colleague’s morphine addiction, which, while powerful, feels somewhat less integrated with the otherwise autobiographical collection.
Bulgakov’s depiction of early 20th-century, surgery-centric, low-tech medicine serves as a stark reminder of the almost miraculous advancements of modern medicine. However, his work also underscores a timeless truth: medical practice inherently exists on the edge of uncertainty. For doctors, the human beings at the heart of this endeavor, the weight of responsibility is profoundly personal. It transcends being merely a job; it’s a deeply felt commitment.
Set in a remote, peasant community where patients held both hopeful expectations of miracles and deep-seated suspicion of modern science, Bulgakov’s stories surprisingly mirror contemporary challenges. The parallels to navigating the complexities of Covid treatment and numerous other modern healthcare dilemmas are strikingly clear.
This Notebook Of A Young Doctor transcends its historical setting, revealing the enduring common threads in the experience of being a doctor across eras. Whether in the early 20th or 21st century, or indeed any period, the core feelings of responsibility, fear, and the drive to care remain constant. Bulgakov’s tales, infused with a unique blend of black humor and pragmatic cynicism, resonate deeply because they are the very stories we, as members of a resilient medical tribe, still share and understand – a shared language often incomprehensible to those outside our world.
Featured Book:
A Young Doctor’s Notebook. Mikhail Bulgakov. First published in Russian as short stories, 1925 – 27. Republished: Alma Classics 2012, ISBN-13: 978-1847492869
Featured Photo: by Joanna Kosinska on Unsplash
