Medicine as a profession in the writer’s self-determination: the example of A.P. Chekhov (1860-1904) and J. Rizal (1891-1896)

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Abstract

The attitude of A.P. Chekhov, physician and writer, and of his contemporary Filipino colleague J. Rizal was compared, in order to find out how their artistic creativity is linked to their profession as doctors. Both writers demonstrate a high appreciation for progress in their works. Chekhov emphasizes the importance of hygiene and education, while Rizal believes that education is crucial. In his works, Chekhov often depicts the consequences of ignorance, negligence towards one’s health, and lack of hygiene. In particular, in the story “Peasants” he describes how poverty leads to drunkenness, filth, and ignorance. However, he is not willing to directly connect social and political statements with his art. Additionally, after his voyage to Skhalin, he firmly refuses to pass judgement on his characters, even if they are portrayed as dirty and ignorant. Nonetheless, in his social activism he cares for the sick, especially victims of epidemies, and establishes rural schools. Rizal became an ophthalmologist to cure his mother, who went blind after unjustly being imprisoned; similarly, he became a writer to heal the “social cancer” of his country - ignorance. Yet, he encounters the problem that Spanish authorities prohibit education for the people. So, even up to his exile and death, he has to confront the dilemma of which should take precedence, education or liberation. Therefore, for Chekhov, being a doctor, addressing social issues, and writing are separate spheres, while Rizal became a writer primarily to heal his country’s society. Nevertheless, both writers, in their short lives, combined medicine, creativity, and progressive social activism, thus embodying what Yu.M. Lotman calls “lifebuilding”.

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Introduction

This article is dedicated to the position Anton Chekhov (1860–1904) and his Filipino colleague, José Rizal (1861–1896) assume concerning progress. As our starting point we take the assumption that, for both of them, this position has to do with the fact that, by profession, they were physicians, because the contribution of medicine to progress, in the second half of the 19th century, was extraordinarily important. Contemporarily with Chekhov and Rizal there were such important physicians as I.F. Semmelweiss (1818–1865), H.L.F. Helmholtz (1821–1894), R. Virchow (1821–1902), and R. Koch (1843–1910).

As far as we know, Chekhov and Rizal were never compared directly. This may sound strange, if we keep in mind that both were born almost at the same time, both came from countries where education and progress were highly esteemed but not easily reached, that both describe to what it leads when education and progress are missing, both try to overcome these consequences. That is why our aim is, with the help of comparative literature studies, to show the meaning of their work as physicians for both writers’ fiction.

In doing so we use Yuri Lotman’s concept of “lifebuilding”. At the example of A.S. Pushkin, Lotman shows how a writer can bring all his experience together into a creative and biographical whole (Lotman, 1995, pp. 57–58, 65, 188).

Discussion

Anton Chekhov’s position

Chekhov actively engages with progress. According to him, “there is more love for human kind in electricity and in steam than in chastity and abstinence from meat” (Chekhov, 1974–1983, vol. 5, p. 278; Simmons, 1963, p. 319; all translations in this essay are ours. ‒ S.L.). However, Chekhov pays more attention to human progress than to technical one. For instance, in a letter to his publisher and friend A. S. Suvorin, in January 1889, he says that it is worth telling a young man’s story who “presses out of himself, drop by drop, the slave and, waking up on a wonderful morning, he feels that, in his veins, there is no longer a slave’s blood but true human blood” (Chekhov, 1974–1983, vol. 3, p. 130). Using doctor Astrov’s words from “Uncle Vanya” he expresses the viewpoint that “in man, everything should be excellent: face, clothes, soul, and thoughts” (Chekhov, 1974–1983, vol. 13, p. 85).

Accordingly, in his fictional and scenic works, Chekhov from time to time criticizes people’s “slavish” soul or thoughts, their “dirty” face or clothes. Not rarely he does this from a medical point of view. For example, in his short story “The Death of a Government Clerk” (1883) he shows how slavish thoughts lead to an “obsessive-compulsive disorder” and, consequently, to death caused by stress, most likely, by an anastomotic ulcer (Chekhov, 1974–1983, vol. 2, p. 165; Lipke, 2019, p. 22; Thiergen, 2011, p. 11).

In his tale “Ward No. 6” (1892) Chekhov tells the story of a head physician whose inability to improve his patients’ situation leads him to indifference, which is accompanied by alcoholism (Chekhov, 1974–1983, vol. 8, p. 85–86); accordingly, an atmosphere of dirt, smell and violence is perpetuated, in which psychiatry patients are kept, but not cured (Chekhov, 1974–1983, vol. 8, pp. 71–72).

In his novella “The Black Monk” (1894) Chekhov once more pays attention to questions of psychiatry and psychosomatics and describes how a psychiatric disease (most likely, bipolar disorder) leads to the main character’s death by tuberculosis (Chekhov, 1974–1983, vol. 8, pp. 247, 251).

In his tale “Peasants” (1897) Chekhov describes social injustice (Chekhov, 1974–1983, vol. 9, pp. 302, 309–310) and ignorance (Chekhov, 1974–1983, vol. 9, p. 309) as sources of dirt, alcoholism, and domestic violence (Chekhov, 1974–1983, vol. 9, pp. 281, 282, 306). This can be shown particularly by analyzing the first chapter of the tale. Here, the peasants are described as close to beasts. Even their village is called “Zhukovo” (“Beetleville”: Chekhov, 1974–1983, vol. 9, p. 281). In the Chikildeevs’ hut there are many flies (Chekhov, 1974–1983, vol. 9, p. 281). Even “across the bread and the plates creeped bugs” (Chekhov, 1974–1983, vol. 9, p. 284). The drunken Kiryak lives in the wood, like a beast (Chekhov, 1974–1983, vol. 9, p. 282; Freise, 1997, p. 174), he roars like one (Chekhov, 1974–1983, vol. 9, p. 284) and beats his wife, as the Chikildeevs beat their cat (Chekhov, 1974–1983, vol. 9, p. 282; Lipke, 2019, p. 147).

In other words, the poor human, in this case the peasant, is presented as “a sick beast” (Grossman, 1967, p. 34). Besides, Nikolay’s parents are described as “skinny, hunched, teethless” old people (Chekhov, 1974–1983, vol. 9, p. 282). All this shows that, due to their poverty, the peasants cannot care for hygiene or cleanliness, nor in any other form for their health. Their misery is equally closely linked to their lack of education. For example, they have nothing to talk about, their talking “was disgusting ‒ only on need and on sickness” (Chekhov, 1974–1983, vol. 9, p. 284).

Likewise, Kiryak’s cruelty is linked to the fact that he behaves like a beast (Chekhov, 1974–1983, vol. 9, p. 285). Even when noticing that his brother has arrived from Moscow, in front of whom he wants to look educated, Kiryak is hardly able to pronounce, “shaking, widely opening his drunken, red eyes”: “The brother with his family have arrived to their parents’ house… I mean, from Moscow. The first capital, I mean, city, Moscow, the mother of the cities… Sorry…” (Chekhov, 1974–1983, vol. 9, p. 285).

Likewise, the fact that his wife, Marya, becomes his victim, in her case is linked to ignorance as well. She does not know there can be a life beyond the one she is leading now, since “she had never been not only to Moscow, but even to the county seat; she was illiterate, she did not know any prayers, not even the ‘Our Father’” (Chekhov, 1974–1983, vol. 9, p. 286). Thus, in “The Peasants” Chekhov describes the combination of misery, dirt, drunkardness, and ignorance.

Yet, even if Chekhov knows in what sense the society should be criticized for making people suffer, in his art he cannot answer the question what to do, since he cannot combine writing fiction or dramas with “preaching”, that is, with proclaiming his social, political, or moral positions (Chekhov, 1974–1983, vol. 4, p. 54).

Nevertheless, this does not stop Chekhov from analyzing social and political life and from engaging with it. For example, in November 1888 he criticizes Suvorin for the fact that in his newspaper there are never any articles concerning prostitution, which Chekhov retains “a horrible evil” (Chekhov, 1974–1983, vol. 3, p. 67; Ermilov, 1949, p. 209).

Early in 1890, feeling his responsibility for his own life and for society and seeing that he has to understand both of them more deeply, Chekhov visits the island of Sakhalin, arriving via Siberia and going back via the Pacific and Indian Ocean. His desire to go to Sakhalin is due to the fact that Russia “exiles thousands of people in [Sakhalin] and ˂…˃ spends millions on it” (Chekhov, 1974–1983, vol. 4, p. 19; Novikova, 2012, p. 178). Accordingly, Chekhov presupposes that analyzing the situation in Sakhalin will help him to understand the state of the Russian society. In particular, Chekhov studies the medical and hygienical situation among the island’s prisoners and exiles (Geyzer, 1955, p. 142).

His Sakhalin impressions help Chekhov understand one of society’s main problems, namely, the tendency to judge and condemn other people. On this he writes in particular in his tale “The Duel” (1891): in V.B. Kataev’s words, condemning people does “not lead to the annihilation, but to the multiplication of evil” (Kataev, 1979, p. 123). In this case, the approach Chekhov has been taught by his professors of medicine, namely, paying attention rather to people (patients) with their individuality than to “cases” of diseases (Kataev, 1978, p. 88), helps him propose society at least partial therapy for its diseases: respecting people and their individuality and, thus, deporting less people to Sakhalin, and less schematically.

During his summer holiday near Kharkov at the end of the 1880s and, later on, in his farm near Moscow Chekhov spends a lot of time and energy on curing patients (Geyzer, 1955, pp. 142–143), on founding rural schools (Chekhov, 1974–1983, vol. 7, p. 329; Rayfield, 1999, pp. 118–119), and on helping those suffering from cholera (Chekhov, 1974–1983, vol. 5, pp. 99–107).

Thus, in his letters, A. P. Chekhov advocates progress, in particular, education and cleanliness. Accordingly, in many of his fictional and dramatic works he criticizes ignorance and dirt. Yet, in his art, he is not willing and not able to answer the question how to overcome these vices. Still, his expertise as a physician helps him, on the one hand, to describe social evils and, on the other hand, to acknowledge that a human being cannot be reduced to a diagnose and should instead be approached as an integral personality. As a doctor and the owner of a farm, Chekhov also concretely tries to improve people’s situation, thus realizing his own ideal of being an educated, free, and active human being.

José Rizal’s position

José Rizal grew up in a bourgeois family, in which the conviction was common sense that reason and knowledge can improve the world (San Juan Jr., 1971, p. 18; 1984, p. 30). Besides, his was an ethnically mixed family, with Filipino, Chinese, and Spanish roots, so that he found it difficult to determine his position in life (San Juan Jr., 1984, p. 60). Thus, being an “ilustrado” is what makes up young José’s identity (Schumacher, 1991, pp. 19–21).

Besides, he felt particularly close to his mother, whom he considered to be a profoundly educated and erudite woman, which made it even more painful for him that she was imprisoned, though innocent, and that her eyesight suffered from the conditions in the jail. It was precisely in order to help her that Rizal chose ophthalmology as his specialization and traveled as far as Germany in order to gain experience as an intern with some of the best ophthalmologists (Coates, 1968, p. 19; Rizal, 1930–1938, vol. I, p. 61; San Juan Jr., 1984, p. 26).

To this background, it is not surprising that Rizal calls his first novel, written in 1887 and published in Berlin, “Noli me tangere” (“Touch me not”). This is of course an allusion to the fact that friars are both powerful and shameless enough to “touch” women. The novel’s heading also recalls the encounter between the risen Christ and Mary Magdalene, to whom he says these words (Jn 20: 11–18; Lipke, 2020, pp. 50–51). But it is also an allusion to a certain type of cancer of the eye, which causes extreme pain every time the eye is touched (Albert et al., 2008, p. 3279). About this kind of cancer Rizal writes in the novel’s prologue, called “A mi Patria” (“To my Fatherland”): as there is a cancer of the body, there is “un cáncer social parecido” (“a similar kind of social cancer”: Rizal, 1983, p. 21). That is why Rizal declares, addressing his country, that, by writing this novel, he acts “deseando tu salud, que es la nuestra” (“desiring your health, which is ours”: Rizal, 1983, p. 21). Accordingly, the prologue shows: just as Rizal has become an ophthalmologist to cure his own mother, in the same way, in Madrid at the age of 26–27 years, he turns from a gifted hobby poet into a novelist in order to cure his country. Actually, for him, it is important not only to describe his country’s situation but also to improve it (San Juan Jr., 1971, p. v).

The novel shows: according to Rizal, the fundamental cure is overcoming ignorance by education. With its help all the other symptoms (like superstition, the Filipinos’ passivity, the Spaniards’ despotism) can also be overcome. Actually, the main character, Crisóstomo Ibarra, was sent to Europe for studies (Rizal, 1983, p. 87). That is why his main project, by which he wants to honor his deceased father, is founding schools (Rizal, 1983, pp. 128–133).

Rizal is faithful to his conviction that education is crucial also in his open letter which he sends from Europe in 1889 “Sa mga kababayang dalaga sa Malolos” (“To my compatriots, the young ladies of Malolos”: Rizal, 1961, p. 55). This letter was written on the occasion of some young ladies asking the general governor of the Philippine Islands to allow them to found an evening school so that they can study Spanish and, thus, become more educated (Rizal, 1961, p. 65). Rizal supports their initiative and expresses his opinion that Europe and America are currently stronger than Asia because “ang babayi sa Asia’y mangmang at alipin” (“the woman in Asia is ignorant and servile”: Rizal, 1961, p. 60; orthography of the Tagalog as in Rizal’s time).

Yet the novel “Noli me tangere” is tragic because Crisóstomo’s attempts at building an educated society fail. For instance, a village teacher tells Crisóstomo that he has tried to reform the way of teaching by no longer forcing the children and, instead, stimulating their curiosity; but this was harshly criticized by his employer, the parish priest, and by the children’s parents, so that he had to return to the old methods of education, which has led to almost 90% of the children dropping off from classes (Rizal, 1983, pp. 162–167). Likewise, Crisóstomo’s own attempt at founding a reformed school fails. Not by chance it is precisely during the solemn groundbreaking ceremony of the school building that a crane falls down and almost kills him (Rizal, 1983, pp. 315–316). Later on, Crisóstomo is excommunicated because he has beaten a priest who had condemned his deceased father for sending his son to Europe for studies (Rizal, 1983, pp. 333–335). After this, founding a school has definitely become impossible.

Likewise, in Rizal’s second novel “El filibusterismo” (1891) the catastrophe is linked to the fact that the authorities have forbidden the founding of a new school (Rizal, 1984, p. 259). That is why the question becomes inevitable which of the two should go first, overcoming ignorance so that future educated Filipinos can free their country from the yoke of colonialism, or freeing the country, since only after that it will be possible to implement education for all. Rizal does not have an answer to this question.

In his “A mi Patria”, recognizing he has not yet found out how to cure the country by overcoming ignorance, Rizal describes the aim of “Noli me tangere” as follows: he wants to act like the physicians in ancient Greece, who used to lay down their patients on the steps in front of the temples, so that those who come back from prayer can utter their ideas on how to cure them (Rizal, 1983, p. 21).

Thus, it is not surprising that José Rizal, being an “ilustrado”, chose medicine as his profession, a profession whose contribution to progress is beyond doubt, and that he chose ophthalmology as his specialization, since healthy eyes, according to him, are crucial because they give people the possibility to learn by reading. Then, during his stay in Paris, he decides to combine his desire for curing people from bodily blindness with his desire to cure his country from ignorance. Still, in sociopolitical life, unlike in medicine, he cannot find a clear answer to the question how to do this.

To the background that Rizal was not able to realize his ideas we should also pay attention to the fact that the Spanish colonial authorities considered him a revolutionary, exiled him to Mindanao in 1892 (Gibbs, 1960), and eventually condemned him to death and executed him in 1896 (Rodriguez, Russell, 1923, p. 308).

Conclusion

Thus, we have studied the examples of two writers, physicians and social activists of the second half of the 19th century, who have many things in common but differ in some. It is correct to call Anton Chekhov a physician and a writer, stressing that these, for him, are two different kinds of activities. As a physician he strives to improve life around himself. As a writer he is simply interested in art, though using two approaches he has learnt from medicine: accurate observing with the help of medical knowledge, on the one hand, and seeing in the patient rather a human person than just a case or a diagnose, on the other hand. And, maybe, his works in which he condemns ignorance and dirt but expresses compassion and understanding for people who are unable to overcome them, are actually his contribution to “healing” society.

Unlike Chekhov, José Rizal is a doctor and social activist who has turned a novelist in order to reform and to cure his country. Accordingly, his fictional prose shows his ability to describe society’s evils, and to criticize ignorance. But he does not yet know how to heal his country.

But both of them show how to “build one’s life”, according to Yuri Lotman’s intuition, by integrating their activities as physicians, writers and progressive activists into a whole.

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About the authors

Stephan Lipke

RUDN University

Author for correspondence.
Email: stephanlipkesj@gmail.com
ORCID iD: 0000-0001-9072-6945

Candidate of Philology, Associate Professor, Assistant Professor at the Department of History of Philosophy, Faculty of Humanities and Social Sciences

6 Miklukho-Maklaya St, Moscow, 117198, Russian Federation

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