It significantly broadened the scope of my observations and enriched me with knowledge whose value for me as a writer only a doctor can appreciate. It also served as guiding influence; my intimacy with medicine probably helped me to avoid many mistakes. My familiarity with the natural sciences and the scientific method has always kept me on my guard; I have tried wherever possible to take scientific data into account, and where it has not been possible I have preferred not writing at all. . . . I am not one of those writers who negate the value of science, and I would not wish to be one of those who believe they can figure out everything for themselves.
Note the many negatives: Chekhov’s acknowledgment of the “broadened scope” and “enrichment” the study of medicine has given him is perfunctory, compared to his gratitude for what it has helped him to avoid. As in his letter to Shcheglov about the limits of psychological understanding (“Nothing is clear in this world. Only fools and charlatans know and understand everything”), Chekhov is at pains to dissociate himself from any position of authority. When writing of the horrendous treatment of the Jew with liver cancer, he does not offer an alternative cure. Chekhov spoke of medicine as his wife and writing as his mistress (he later recycled the quip to say that fiction was his wife and the theater his mistress), but he never practiced medicine full-time, nor attained any particular distinction as a physician. Medicine in Chekhov’s day did not have the power to cure that it has only recently begun to wield. Doctors understood diseases they were helpless to cure. An honest doctor would have found his work largely depressing. Simmons speculates that Chekhov’s study of medicine originated in an incident of serious illness when he was fifteen—an attack of peritonitis—which led to friendship with the doctor who attended him. Simmons also notes that Chekhov “always attributed to this attack the hemorrhoidal condition which never ceased to trouble him for the remainder of his life.” We hear a lot about these hemorrhoids in Chekhov’s letters. They evidently bothered him a good deal more than the symptoms of tuberculosis, which appeared as early as 1884, but which he was not to acknowledge as such for thirteen years. “Over the last three days blood has been coming from my throat,” he wrote to Leikin in December 1884. “No doubt the cause is some broken blood vessel.” And then, two years later, “I am ill. Spitting of blood and weakness. I am not writing anything. . . . I ought to go to the South but I have no money. . . . I am afraid to submit myself to be sounded by my colleagues.” It wasn’t until March 1897, after a severe hemorrhage at the Hermitage restaurant in Moscow, that he allowed himself to be sounded and diagnosed. Chekhov’s knowing–not knowing that he had the disease that killed him was, of course, an expression of denial, but it was also a product of the cruel-kind nature of tuberculosis itself, whose course is not predictable (consumptives have been known to live to old age) and which (as René and Jean Dubos point out in The White Plague: Tuberculosis, Man and Society) “waxes and wanes with long periods of apparent remission followed by periods of exacerbation.” It was also of a piece with (and may have been implicated in the formation of) Chekhov’s stance of insistent uncertainty. If nothing is clear in this world, then everything is possible—even the prospect of health.
The hemorrhage at the Hermitage occurred just as Chekhov and Alexei Suvorin were sitting down to dinner. Blood began pouring from Chekhov’s mouth and the flow could not be stemmed. Suvorin took Chekhov to his suite at the Slaviansky Bazaar (where Chekhov was to book Anna Sergeyevna a few years later) and summoned Chekhov’s colleague Dr. Nikolai Obolonsky, who could not persuade Chekhov to go to the hospital. The hemorrhage did not abate until morning, when Chekhov insisted on returning to his own hotel, the Moscow Grand (he was now living at Melikhovo and no longer kept a Moscow residence), and on behaving as if nothing had happened. On March 25, after further hemorrhages, he finally entered the clinic of a Dr. Ostroumov, where advanced tuberculosis was diagnosed. The clinic was located near the Novodevichie Cloister, in whose cemetery, seven years later—after writing Three Sisters, The Cherry Orchard, “The Lady with the Dog,” “The Bishop,” “In the Ravine,” “Gooseberries,” and “Ionitch,” among other masterpieces—Chekhov would be buried.
While at the Oustromov clinic, with his characteristic inability to refuse almost any request, Chekhov read the manuscripts of two stories sent him by a stranger, a high-school girl named Rimma Vashchuk, who wanted to know whether she had “a spark of talent.” He promptly wrote back to say he liked one of the stories, but that the other, entitled “A Fairy Tale,” was “not a fairy tale, but a collection of words like ‘gnome,’ ‘fairy,’ ‘dew,’ ‘knights’—all that is paste, at least on our Russian soil, on which neither gnomes or knights ever roamed and where you would hardly find a person who could imagine a fairy dining on dew and sunbeams. Chuck it . . . write only about that which is or that which, in your opinion, ought to be.” Stung by Chekhov’s criticism, the girl sent him an angry letter, and he, incredibly, wrote to her again from his hospital bed, to patiently explain his criticism. “Instead of being angry, you had better read my letter more carefully,” he began. She returned an apology.
During the amended “city tour,” on the way to the Novodevichie cemetery, Sonia pointed out a low, long, white building behind some trees as the former Ostroumov clinic, which is now a part of the Moscow University medical school—and, a few blocks later, identified a large red wooden house as Tolstoy’s Moscow house. I knew that Tolstoy had visited the debilitated Chekhov two days after his arrival at the clinic, but I hadn’t realized how close to the clinic he lived. “We had a most interesting conversation,” Chekhov wrote two weeks later to Mikhail Menshikov, of Tolstoy’s visit, “interesting mainly because I listened more than I talked. We discussed immortality. He recognizes immortality in its Kantian form, assuming that all of us (men and animals) will live on in some principle (such as reason or love), the essence of which is a mystery. But I can imagine such a principle or force only as a shapeless, gelatinous mass; my I—my individuality, my consciousness—would merge with this mass—and I feel no need for this kind of immortality, I do not understand it, and Lev Nikolayevich was astonished that I don’t.” Three years later, when Tolstoy was himself ill, and there was a great deal of speculation about the seriousness of his condition, Chekhov wrote again to Menshikov, to say that he had come to think that Tolstoy was not terminally ill, but he added:
His illness frightened me, and kept me on tenterhooks. I am afraid of Tolstoy’s death. If he were to die, there would be a big empty place in my life. To begin with, because I have never loved any man as much as him. I am not a believing man, but of all beliefs I consider his the nearest and most akin to me. Second, while Tolstoy is in literature it is easy and pleasant to be a literary man; even recognizing that one has done nothing and never will do anything is not so dreadful, since Tolstoy will do enough for all. His work is the justification of the enthusiasms and expectations built upon literature. Third, Tolstoy takes a firm stand, he has an immense authority, and so long as he is alive, bad taste in literature, vulgarity of every kind, insolent and lachrymose, all the bristling, exasperated vanities will be in the far background, in the shade. Nothing but his moral authority is capable of maintaining a certain elevation in the moods and tendencies of literature, so-called . . .
Chekhov had met Tolstoy only a few times, but “when he spoke about Tolstoy,” Gorky writes in his memoir of Chekhov, he “always had a particular, barely detectable, affectionate and bashful smile in his eyes. He would lower his voice as if talking of something spectral, mysterious, something requiring mild and cautious words.” As for Tolstoy, “he loved Chekhov,” Gorky wrote, “and always when he looked at him his eyes, tender at that moment, seemed to caress Chekhov’s face.” However, Tolstoy did not love Chekhov’s plays. He is reported to have said to Chekhov, “You know, I cannot abide Shakespeare, but your plays are even worse.”