Waiting. This is how you spend a lot of time studying obstetrics and gynaecology, especially if you’re a bloke – waiting in a corridor, having been asked to leave during an intimate examination, or waiting at the midwives’ station on the labour ward for a mother-to-be who is slow to dilate. Don’t think I’m ungrateful. After a patient and her husband have agreed to let me deliver their baby, I walk out of the delivery suite to find some scrubs and think to myself, ‘Wow! Permission to have a go in one of the most important events of their lives!’
O&G, like most of medicine, is something you can’t learn from a book. My favourite Russian writer-doctor is not Anton Chekhov but Mikhail Bulgakov, who describes with aching clarity the slow and at times humiliating road to acquiring what London taxi-drivers call ‘the knowledge’. (Shortly before his death from renal disease in 1940, Bulgakov wrote of medics: ‘I won’t call doctors murderers, that would be too harsh, but I will call them casual untalented hacks.’)
Bulgakov received his medical degree at the age of 24 from the University of Kiev, just a year before the 1917 revolution. There was a shortage of doctors, since many had been called up to serve on the Eastern Front during the First World War. As a result, newly qualified medics were not given the usual hospital internships for further training but were instead sent out to fill gaps in rural clinics.
A Country Doctor’s Notebook is a lightly fictionalized account of Bulgakov’s eighteen months as the only medic in a remote village in the north-western province of Smolensk. The stories set in the village, ‘thirty-two miles from the nearest electric light’ and only accessible by sleigh during the dark Russian winter, crackle like the fire in the stove in his benighted hospital quarters. And Bulgakov’s gentle laughter at his younger self, a panic-stricken doctor fresh out of medical school who desperately tri
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