Medicine in the cards
Convicts and Anton Pavlovich Chekhov’s medical travels – by Jonathan Cole, Andrew Dawson, Marius Turda
It is not widely known that Anton Pavlovich Chekhov was not simply one of the best short story writers in the world but also a respected physician. As he wrote: “Medicine is my lawful wife and literature is my mistress.” He was also fascinated by new medical encounters on his travels and this is why his single largest work is not a play or a collection of short stories, but an account of a penal colony and the medical profile of its convict patients.
In 1890 – aged 30 and already a famous writer – Chekhov travelled for three months, on coaches, sledges and boats, under appalling conditions, on a journey he thought might kill him, across Russia and beyond Siberia to the island of Sakhalin, just north of Japan. As the editor of Chekhov’s letters, Simon Karlinksy, notes: “No other event in Chekhov’s life is more surrounded by myths, more misunderstood and more frequently misinterpreted than his Sakhalin journey.”
At the end of the 19th century, Sakhalin was a penal colony: a place where hard-labour convicts and their dependents would – once their sentence was served – live as ‘felons’ in local villages for a probationary period before being allowed to leave the island, but only to then take up residency in Siberia. They were never allowed back into Russia beyond that.
It is not clear what made Chekhov go to Sakhalin. Some had chided him for not being radical enough; maybe he was trying to prove them wrong. Others thought his literary genius had dried up, and that he was looking for new ideas for the ‘Great Russian Novel’ he never wrote. Some have pointed to family ill-health as a motivation for travel: his brother had recently died in his arms from tuberculosis, a disease Chekhov also had, and which eventually would kill him in 1904, aged 44. Chekhov certainly wanted to experience travelling to faraway places, enjoying the ‘Boy’s Own’ stories of Nikolai M Przhevalsky’s explorations of Tibet. His publisher and great supporter Aleksey Suvorin thought he was mad. But Chekhov assuaged him, providing the following explanation:
You write that Sakhalin is of no use? Sakhalin is the only place where criminal colonisation can be studied, a place of the most unendurable sufferings… we have rotted alive millions of people, herded people tens of thousands of miles, infected them with syphilis, debauched them and bred criminals. All of us are guilty.
Central to Chekhov’s investigation was a census he compiled of those he met, containing information about their name, religion, age, family status, occupation and so on. In some cases, he also included the individual’s medical condition in the personal record. “I used small cards produced for me in the printing shop of the police department,” he said. In three months, and working up to 17 hours a day, he collected data from 10 000 prisoners, guards and settlers. He visited each settlement and most of the 5000 dwellings.
Many inmates suffered from tuberculosis and syphilis. Some were blind. Some were alone, while others were accompanied by their families. Chekhov’s medical cards explore their personal experiences without sentiment, his literary skills informing his medical observations.
He used the travel experience and the information accumulated in Sakhalin to write a doctoral dissertation. It was, however, deemed insufficient, and the doctoral committee rejected it. Undeterred, he published the text as a book, poetic in its description of the island, frequently humorous and acerbic, and yet forensic and dispassionate in describing conditions on the colony and the dehumanising effects of its brutality, cruelty and deprivation. Chekhov knew that his artistic, descriptive power would not suffice to change attitudes, so he augmented his insight with the medical data he had obtained. The work was no polemic.
In it, he produced one of the first fusions between the medical and artistic worlds, long before medicine–art projects existed – a theme which has so far not been fully explored by historians of medicine.
To remedy this, the 7746 Sakhalin medical cards (now split between the Chekhov Museum in Yuzhno- Sakhalinsk and the Russian State Library in Moscow) are the subject of a collaborative research project made possible by a Wellcome Trust Small Arts Award. The project brings together scholars from across the medical humanities. Initiated and led by Andrew Dawson, a theatre artist, and Jonathan Cole, a clinician, neuroscientist and author, it also benefits from the contribution of Donald Rayfield, Chekhov’s biographer, and Marius Turda, a medical historian at Oxford Brookes University.
The project took the link between medicine and literature that Chekhov embodied, and added theatre to create an innovative public engagement event. Chekhov’s narrative was invested with a dramatic form in order to reveal the medical aspects of his comments and reflections. While telling a fascinating story of human endurance, the team also aimed to reassess Chekhov’s life and work, and its wider contribution to the history of medicine. Andrew focused on the visual and movement aspects of the project; Donald provided the literary expertise on Chekhov; Jonathan and Marius engaged with the late-19th-century history of medicine and new thinking on the ways in which medical knowledge informed broader developments in European society.
In September 2012, Andrew and Jonathan visited Sakhalin, to see first- hand the places Chekhov referred to in his book. It was long journey and a thrilling experience. They spent six nights on Sakhalin, staying in Yuzhno- Sakhalinsk and Aleksandrovsk. They looked down from a large cliff where Chekhov had also stood onto three coral rocks standing off shore called ‘The Three Brothers’. Visiting the site of such a notorious prison, it became clear what Chekhov meant by calling this place ‘The Chasm of Sorrow’. A film was produced as a result – you can watch it and read more about the research online – which showed not only the physical beauty of the island but also the life of the curators of the two museums in Sakhalin, who, in keeping his flame alive on this distant island, are themselves worthy of a Chekhov play.
Dr Jonathan Cole is Honorary Senior Lecturer in Clinical Neurosciences, University of Southampton, and Professor at the University of Bournemouth (email@example.com). Andrew Dawson is an artist, director and choreographer, based in London (firstname.lastname@example.org). Dr Marius Turda is Reader in Central and Eastern European Biomedicine, Oxford Brookes University (email@example.com). They welcome enquiries from anyone who would like to contribute to their research on Chekhov.