In this blog post, focusing on Mikhail Bulgakov’s ‘A Young Doctor’s Notebook’ and ‘Morphine’, I examined how the profession of medicine and the portrayal of illness in these works reflect human life and the fate of the era.
Modern Literature and the Tradition of the “Doctor-Writer”
One of the most significant changes in modern literature was the emergence of the portrayal of illness and the rise of doctor protagonists. This is linked to the fact that, as medicine developed into a systematic science during the modern era, doctors became important figures in society. Modern medicine began to provide empirical explanations for the origins of life, the causes of disease, the process of aging, and the nature of death, and these changes significantly transformed people’s consciousness. The very way of viewing human life had changed.
With the advent of the modern era, symbols that had defined human spiritual and material life—such as myths and religion—gradually receded, and science and medicine began to take their place. People paid close attention to the dazzling advancements in empirical science and directly experienced how science was transforming their lives. As medicine advanced, they also came to realize that human illness and death were closely linked to the environment and hygiene. It was no longer necessary to rely on magic or religion to treat illness. The sight of a neatly dressed doctor visiting homes to care for a child suffering from a fever became a common scene of the new era.
Literature, too, did not overlook these historical changes. Among the new figures emerging on the stage of modernity, the one literature focused on was the doctor. The doctor was a scientist with rational thinking who was directly involved in human life, illness, and death. If the doctor was a figure deeply involved in human destiny, then disease was a matter of life and death that humans simply had to overcome. Without fighting against disease, it was difficult to expect increased productivity and social development in modern society. Securing a stable labor force necessary for industrial society also made disease a problem that had to be solved, and to this end, modern society demanded the dedication and sacrifice of doctors.
Therefore, the portrayal of doctors as protagonists and the theme of illness in literature go beyond merely depicting a profession or a medical condition. They can be seen as symbols of modern individuals living in a new era and the new challenges of that era that they must resolve.
The frequent appearance of the motif of illness and doctor protagonists in Russian literature also demonstrates that the social significance of medicine and doctors had grown accordingly. This trend is particularly prominent in the works of Gogol, Dali, Dostoevsky, Turgenev, Tolstoy, Chekhov, Bulgakov, and Veresaev. Among them, Dali, Chekhov, Bulgakov, and Veresaev were so-called “physician-writers” who practiced medicine while also working as authors. Above all, the medical tradition in Russian literature was carried on and developed through these writers.
Vladimir Ivanovich Dali was born in 1801. After graduating from the Maritime School in St. Petersburg, he worked as a sailor. However, dissatisfied with that life, he enrolled in the Medical School in Tarut in 1826. Dali recalled this period as the happiest time of his life. However, his studies were interrupted by the war between Russia and Turkey, and in 1829, after hastily completing his thesis, he went to the battlefield to care for the wounded as a military doctor. In the spring of 1831, he returned to the front lines with the army dispatched to suppress the uprising in Poland. According to the recollections of officers at the time, he demonstrated exceptional surgical skill and earned a high reputation as a surgeon; in recognition of his meritorious service, he was awarded the Order of St. Vladimir. Beginning in March 1832, he served as chief physician at the Army Hospital in St. Petersburg, where he gained a reputation as an outstanding surgeon and ophthalmologist. However, as conflicts with the hospital director intensified, he eventually resigned from his medical practice.
Dali’s experience as a physician is clearly reflected in his works from the 1840s, which exhibited naturalistic tendencies. At that time, a genre of prose that documented the physiology, social life, and customs of human society was in vogue in Russia, and this became an important foundation for Russian realist literature. Dali was one of the most outstanding reportage writers of his time. Drawing on various aspects of Russian life as his subject matter, he created numerous works—such as “The Private” and “The Russian Peasant”—through precise observation and a distinctive writing style.
Anton Pavlovich Chekhov can be considered the most successful physician-writer in Russian literature. Chekhov graduated from the Medical Faculty of Moscow University and practiced medicine in the Moscow suburbs. Contemporary critics recognized the traits of a natural scientist in the simplicity, clarity, and precision of the descriptions found in Chekhov’s works, and they assessed that his profession as a doctor left a unique character and a deep imprint on his entire body of work. Chekhov himself acknowledged that his medical work had a significant influence on his literary activities.
Chekhov appears to have possessed a thoroughly scientific worldview and sense of inquiry. In particular, he was deeply interested in how the environment affects humans from a medical perspective. This stemmed from the hygiene lectures he attended at medical school and his interest in Darwin. His studies at medical school had a decisive influence on his views regarding the role of the external environment in human life, and these ideas deepened further through his experiences during his trip to Sakhalin. The impact of the environment and climate on humans, as well as the relationship between the physical and the mental, became important motifs and themes in Chekhov’s later works.
The characteristics that define Chekhov’s works can also be viewed in connection with this medical imagination. His tendency to unfold stories within the context of the most ordinary daily life rather than through dramatic events, to focus on the diverse and contradictory human reactions to events rather than the events themselves, and to highlight the breakdown of communication between characters can be seen as a sharp capture of the absurdities of modern society. Traces of medicine can also be found in works such as “Ah, Nuta,” “Typhus,” “The Duel,” “Ward No. 6,” “A House Call,” “Uncle Vanya,” and “Three Sisters.”
With the dawn of the 20th century, Russian literature was swept up in a new maelstrom of revolution and counter-revolution, utopia and anti-utopia, and the destruction of old forms and experimentation with new ones. Yet even amid these changes, the medical tradition in Russian literature persisted. And the writer who most notably revitalized and developed this tradition was none other than Mikhail Bulgakov.
Bulgakov and ‘A Young Doctor’s Notebook’
Bulgakov enrolled in the medical school at Kiev University in 1909. After graduating, he practiced medicine in Smolensk and Kiev. He gave up his medical career because Russia had plunged into extreme chaos amid the storm of revolution. When the revolution broke out, he joined the White Army, which opposed it, and after the civil war ended, he moved to Moscow to pursue a career as a writer.
His early works—the serialized novel ‘The Memoirs of a Young Doctor’ and the novella ‘Morphine’—deeply reflect his experiences as a physician. In these works, he vividly depicts how a young doctor, fresh out of medical school and entering the clinical field for the first time, adapts to reality; the actual process of performing surgery; and the devastating psychological effects of drug addiction.
Bulgakov left a distinct mark not only as a novelist but also as a playwright. The play ‘Days of the Turbins’, an adaptation of his novel ‘The White Guard’, was staged at the Moscow Art Theater in 1926, and in 1936, his play ‘Molière’ premiered at the same theater. He also adapted and staged Gogol’s ‘The Government Inspector’ and ‘Dead Souls’. His plays sparked controversy at every premiere because they bitingly satirized totalitarian society through highly symbolic dialogue.
Bulgakov left behind “The Master and Margarita,” considered one of the greatest novels of 20th-century Russian literature, as his final work. In this novel, he satirically criticized the Stalinist regime, which had suppressed even the freedom of creative expression. His famous line, “Manuscripts don’t burn!” conveys the message that art will never disappear, even if creative freedom is suppressed. The work also explores themes such as good and evil, the individual and power, the relationship between the fantastical and the real, and the immortality of art.
‘A Young Doctor’s Notebook’ consists of a series of seven short stories. When each story was published in a magazine, it was revealed that they were part of a series titled ‘The Memoirs of a Young Doctor’. These works were not published as a book during Bulgakov’s lifetime; the collection titled ‘The Memoirs of a Young Doctor’ was first published in 1963, 23 years after his death. Although the Moscow-based “Pravda” publishing house released it as Volume 23 of the “Spark” paperback series, this collection omitted “The Star-Shaped Rash,” and “The Iron Neck” was included under the title “The Silver Neck.”
The “Diary of a Young Doctor” published in the 1963 collection is arranged differently from the order in which the stories were actually published. Although “Pitch-Black Darkness” was the first story in the series to be published and “The Lost Eye” was the last, “The Handkerchief Embroidered with a Rooster” appears first in the collection. This is because the stories were arranged based on the chronology of events—that is, the temporal sequence of the narrative—rather than the order in which they were published. “The Handkerchief Embroidered with a Rooster” was placed at the beginning because it features the scene where the protagonist first arrives at the rural hospital. This book also follows the order of the 1963 collection.
“The Handkerchief Embroidered with a Rooster” was published in the 1926 issues No. 33 and 34 of ‘Medical Professional’. This story is the first in the series ‘Memoirs of a Young Doctor’. The protagonist, a young doctor, arrives at the Murinsky Hospital, located 40 versts from the town of Grachevka in Smolensk Province, on September 17, 1917. The inclusion of such a specific date in the story suggests that it is based on Bulgakov’s own real-life experiences. After graduating from Kiev Medical University, Bulgakov served as a doctor in the village of Nikolskoye in Smolensk Province from September 1916 to September 1917, and in the city of Vyazma from September 1917 to January 1918. In effect, his real-life experiences are recreated in the work with only the place names changed.
September 17, 1917—the day the young doctor in the novel arrives at the rural hospital—is one year later than in reality. This is related to the Socialist Revolution that took place in October 1917. Bulgakov set the young doctor’s first assignment at the rural hospital in September, just before the October Revolution. It appears he intended to overlay the historical context of the time onto the everyday episodes through this setting.
In the novel, the father of a girl who has been in an accident comes to the doctor and cries out, “Just don’t let her die… Just don’t let her die… I don’t mind if she becomes disabled. “I’ll accept that!” These words take on even greater significance when read with the situation in Russia at the time in mind. Russia, plunged into chaos by the revolution, was facing a life-or-death crisis as it endured a civil war. The situation feels similar to that of a critically ill patient for whom every second counts. It seems that through the young doctor’s experiences at the rural hospital, Bulgakov was expressing his concern for Russia’s fate.
Nevertheless, Bulgakov does not seem to have taken a completely pessimistic view of Russia’s fate. In “The Handkerchief Embroidered with a Rooster,” the girl survives dramatically after undergoing a surgery that had seemed impossible. This can be interpreted to mean that, in the end, Russia, too, survived rather than perishing. So what does the “handkerchief embroidered with a rooster” that the girl gave the doctor signify? The red rooster and the red-threaded border embroidery on the cloth seem to subconsciously allude to the turbulent times. Since the girl returned to see the doctor two and a half months after the surgery, the timing would be early December 1917—a period when the Socialist Revolution had succeeded and Russia was plunging into civil war. This is why the girl’s gift appears to overlap with the historical circumstances of the time.
Interestingly, when the collection was published in 1963, Soviet censors even altered the story’s temporal setting. The year 1917 in the story was changed to 1916. It appears they sought to block the political significance the author had embedded in the work from the very beginning. However, even the censors could not change the symbol of the “Red Rooster” itself. There is an idiom in Russian meaning “to set fire to,” which is derived from “The Red Rooster.” Historical records from that period document how, when the revolution broke out, peasants repeatedly set fire to the homes of landowners. In this sense, “The Red Rooster” conveys the meaning intended by the author, transcending historical time.
“The Epiphany Fetal Rotation” was published in the 1925 issues No. 41 and 42 of ‘Medical Professional’. The most striking part of this work is the scene where a young, inexperienced doctor secretly consults a medical textbook while performing surgery. This scene lends the work an even greater sense of realism. While flipping through the textbook, the doctor eventually tosses it aside as the surgery draws near. At that moment, he realizes that all the technical terminology is useless. What matters is that he must insert one hand inside while using the other from the outside to assist in rotating the fetus, and that he must rely not on the book but on his own medical intuition to carefully and persistently pull out one leg and deliver the baby.
This scene can be interpreted as a symbolic representation of the situation in Russia at the time. The fetus lying transversely inside the mother’s womb can be seen as symbolizing the instability of a world being rebuilt through the revolution. The scene in which the doctor realizes that academic terminology alone is useless in an actual surgery implies that the revolution, too, is not something that proceeds schematically according to theory or dogma, but rather takes place within the realities of life. The revolution, like a surgery performed by a doctor, is a concrete, real-world problem.
Furthermore, while performing the surgery, the doctor in the story heeds the advice of those around him, and their words actually play a decisive role in the procedure. Those assisting the young doctor can be seen as embodiments of the common people, who possess vivid life experiences. This conveys the message that a revolution, too, can only succeed if it is grounded in the living experiences of the people. Ultimately, the young doctor successfully completes the difficult surgery based on their experiences.
A Young Doctor Facing Solitude and Failure
“The Iron Neck” was published in the 33rd issue of ‘Red Panorama’ in 1925. The events of the story are set after the October Revolution of 1917. Compared to other works in ‘The Young Doctor’s Notebook’, the protagonist’s solitude and loneliness are particularly prominent in this story. This atmosphere persists from the very first sentence to the very end.
The protagonist is left alone in the darkness of November as a blizzard rages. His house is buried in snow, and the wind howls through the chimney. Having lived in a big city for twenty-four years, he had thought that the idea of a blizzard howling was something that only happened in novels. But in reality, the blizzard was indeed howling. He wanted to flee to a provincial city with electricity and as many as four doctors, but that was out of the question. He also knew that he could be timid at times. And in moments like this, he finds himself asking why he studied medicine in the first place.
The solitude felt in this scene runs much deeper than mere loneliness. The young doctor at a rural hospital is responsible for his patients’ lives, yet when it comes to himself, there is almost no one he can turn to for help. In a situation where he must make every decision alone, the doctor is confronted with both his abilities and his limitations.
At the end of the story, the protagonist returns to his snow-covered, lonely, quiet, and solemn quarters. When he gets home, all that remains for him is the desire to sleep. This kind of solitude brings to mind the tragic doctor in ‘Morphine’ who ends his life by suicide. This is because, for a young doctor in a rural hospital, exhausted by solitude and loneliness, drug addiction was the easiest way to escape those feelings.
If there is any solace for a rural doctor, it lies solely in the respect shown by the villagers. The state of mind the protagonist experiences resonates with the situation Bulgakov himself faced at the time. In a letter sent to his younger sister on December 31, 1917, he described the lonely and depressing life at the rural hospital. He wrote that he was going through the most difficult period of his life in Vyazma, living in complete solitude, and that his only solace was losing himself in thought on the vast plains, working during the day, and reading books in the evening. In this regard, “The Iron Neck” feels like a work that provides important clues for understanding why Bulgakov fell into drug addiction.
“The Snowstorm” was published in the 1926 issues No. 2 and No. 3 of ‘The Physician’. The plot of this story is connected to “The Handkerchief Embroidered with a Rooster.” This is likely because the story of a doctor who saved the life of a girl who had suffered serious injuries after falling into a grinder is mentioned in the opening section of “The Snowstorm.” Through this, we can see that the protagonist appearing in “A Young Doctor’s Diary” is the same character.
In “The Snowstorm,” it is recounted that the young doctor treated one hundred patients a day. This is actually based on Bulgakov’s own personal experience. According to a certificate sent to Bulgakov by the Suichevsky Autonomous Council on September 18, 1917, he treated 15,613 outpatients and cared for 211 inpatients from September 29, 1916, to September 18, 1917. Calculated based on working days—excluding public holidays and vacation days—this amounts to treating approximately 44 patients per day. Given that, it would have been entirely possible for him to treat as many as 100 patients on days when the patient load was particularly heavy.
When the young doctor returned from the hospital at 8:00 p.m., he was so exhausted that he had no desire to eat, drink, or sleep. On five occasions over a two-week period, people had to carry him away on a sled in the middle of the night. This illustrates just how grueling the doctor’s life was.
“The Snowstorm” is the only story in ‘A Young Doctor’s Notebook’ that deals with the doctor’s failure. The young doctor sets out on a long journey to treat the daughter of a farm manager, who suffered a head injury in an unexpected accident on her engagement day, but ultimately fails to save her. Even though the protagonist did his best, the outcome is far from a happy ending. Consequently, this story has a darker tone than the others.
The title, “Blizzard,” is also closely linked to this atmosphere. The blizzard foreshadows the protagonist’s fate. The blizzard, in which one cannot see even an inch ahead, symbolically represents the doctor’s uncertain future. Amid the blizzard, the protagonist thinks that he will arrive home, that someone—a kind person—will take him somewhere else again, and that he will once more find himself racing through the blizzard.
Another point worth noting is that, unlike the protagonists in other works, the doctor in this story appears as a traveling physician. In other works, patients come to see the protagonist, the doctor, but in “The Blizzard,” the protagonist goes directly to the patient. This structure reveals the doctor’s role and loneliness even more directly.
“Pitch-Black Darkness” was published in the 1925 issues No. 26 and 27 of ‘Medical Professional’. The title of the work is taken from the Old Testament. The Book of Exodus tells the story of how, when Moses stretched out his arm toward the heavens, the land of Egypt was enveloped in thick darkness, turning it into a world of pitch-black darkness for three days.
In the story, this pitch-black darkness symbolizes the ignorance and superstition of the Russian people. The mill owner does not take the medicine as prescribed by the doctor but instead takes it according to his own judgment. A thirty-year-old woman with a ruddy complexion distributes the medicine prescribed by the doctor to the villagers. The protagonist, a young doctor, fights against this ignorance and superstition. What he seeks is a level of rational judgment grounded in common sense, which is synonymous with enlightenment.
However, reality is not that simple. At the end of the novel, the protagonist dreams of a holy war against the ignorance and superstition of the people. But as the saying goes, “A dream is a happy joke!”—a dream is not reality. The protagonist goes off to fight in pitch-black darkness, without a scalpel or a stethoscope. Yet he is not alone. Demyan Lukich, Anna Nikolaevna, and Pelageya Ivanovna, dressed in white coats, become his army and march forward with him. This scene can be read both as the doctor’s dream of fighting against the darkness and as a hope for enlightenment.
“The Lost Eye” was published in the 1926 issues No. 36 and 37 of ‘Medical Professional’. This work can be compared to “The Snowstorm” in many ways. Like in “The Snowstorm,” the protagonist reflects on how many patients he has examined. He believes he has gained tremendous experience at the rural hospital.
He opens the outpatient registry, examines it for an hour, and then does the math. As a result, he confirms that over the course of a year, he treated 15,613 patients, admitted approximately 200 inpatients, and only six of them lost their lives. These figures are also based on real-life experience.
However, in “The Lost Eye,” the doctor makes a mistake. The story deals with the theme of a doctor’s misdiagnosis, which also appears to stem from Bulgakov’s actual experience. Unlike in “The Snowstorm,” however, this story does not lead to a tragic ending. Fortunately, the young child’s eye returns to normal, and upon realizing this, the doctor finds himself in an awkward predicament.
This episode also seems to convey a psychological conflict surrounding the choice between pursuing a career as a doctor or as a writer. For a doctor, a misdiagnosis is an event that reveals the unbearable transience of existence. Because of this, a doctor may harbor deep doubts about his profession or fall into a state of despair severe enough to harm himself. It appears that Bulgakov, too, asked himself many times while writing this work whether he could succeed as a writer. The final line of the work—“I must study more deeply”—feels imbued with Bulgakov’s own anguish as he sought a new path not as a doctor, but as a writer.
Fate and Human Conscience as Depicted in ‘The Young Doctor’s Diary’
“The Star-Shaped Rash” was published in the 1926 issues No. 29 and 30 of ‘The Medical Professional’. This story is the final installment in the “Memoirs of a Young Doctor” series. The protagonist began practicing medicine at a rural hospital in October 1917, just before the Socialist Revolution broke out. The story takes the form of the narrator reflecting on the past “after turbulent years that felt like destiny had passed.” With this, the “Memoirs of a Young Doctor” series comes to a close.
The protagonist leaves the snow-covered annex ward, remarking that a year has passed and that fateful, turbulent times have come and gone. He wonders what has become of the place since his departure. He believes the building has been freshly painted and the bed sheets replaced with new ones. Electricity may not have been installed yet. And he imagines that even as he writes this, some young doctor is examining patients there. In that hospital, where the yellow glow of a kerosene lamp casts a sallow light on the patients’ skin.
At the end of the series, the protagonist believes that another young doctor will be holding down his old post. Like him, that young doctor will care for patients with syphilis and listen to their complaints. The patients might grumble that he’s just a greenhorn, complaining that even though their throats hurt, he only examines their chests and stomachs and tells them to just put ointment on their feet.
Yet that young doctor will fight syphilis, overcoming every obstacle. For he is the one who knows exactly how devastating syphilis is, and he is the only one who knows how to treat it. Those who know what the problem is and how to solve it are bound to be solitary and lonely. Even if wealth and fame do not follow, he must do this work. It makes no difference whether it is destiny or a professional duty.
In that sense, ‘The Young Doctor’s Diary’ feels like the candid and moving diary of such people. Doctors, while respected by the public, must constantly endure loneliness, failure, fear, and responsibility. The young doctor in this work not only depicts the medical landscape of an era but also portrays a human being who has no choice but to continue his work because he knows what must be done.
“The Red Coffin” was published in October 1922 in the literary supplement of the magazine ‘The Night Before’. Unusually, the work bears the Latin subtitle “Historia morbi,” meaning “History of the Disease.” “The Red Coffin” contains elements of Bulgakov’s autobiography.
The story vividly conveys the anxiety and terror of a family standing at the crossroads of life and death. The protagonist is a first-person narrator who suffered a horrific experience during the Russian Civil War and is now suffering from mental illness. The narrator’s younger brother appears as Kolya, which is the same name as Bulgakov’s actual younger brother. The events that form the backdrop of the story are the battles between revolutionary and counterrevolutionary forces that took place in Kyiv in late October 1917.
The death of Bulgakov’s mother on February 1, 1922, was also a direct motivation for writing this work. The scene in which the protagonist, in a dazed state, recalls his mother’s words—“You have to find Kolya. Aren’t you his older brother?”—feels like her dying wish, and this is connected to that event. The room the protagonist sees in his dream also resembles the house where Bulgakov lived. Bulgakov repeatedly depicted his own home in various works. The sight of a worker hanged from a streetlamp in Verzhansk was also a scene he actually witnessed in the fall of 1919 while traveling with his unit from Kyiv to the North Caucasus along the front lines.
The central motif of ‘The Red Coffin’ is human conscience. The protagonist encounters the apparitions of the victims in a state of dream or madness, suggesting that he is tormented by pangs of conscience. The motif of human conscience appears repeatedly in Bulgakov’s literature, and ‘The Red Coffin’ is the first work to explore this motif. This theme continues to develop in later works such as ‘The White Guard’, ‘The Master and Margarita’, and the play ‘The Run’.
In ‘The Red Coffin’, a wounded human conscience ultimately leads to madness. The protagonist is powerless to act when an unnamed laborer is hanged by a general. He is also unable to save his younger brother on the battlefield. He drives himself mad because of his own timidity. This suggests that Bulgakov viewed resistance to violence as the moral duty of the intellectual.
Confined to a mental hospital, the protagonist says at the end of the play that the man who was hanged might return, and if so, they will justly suffer the consequences. He also states that he sent Kolya to assist with the hanging, and that the other party carried out the execution based on a verbal order without even a document number. This passage seems to show that, as his conscience reached its limit, a split in his consciousness occurred.
The work’s tragic ending serves as a stern warning of just how heavy the burden of guilt is for those who have abandoned their conscience. The vision of the horseman wearing a red helmet tormenting the narrator can also be understood in this context. Here, the red helmet symbolizes the victims of war, bleeding from their heads. Once abandoned, one’s conscience haunts a person to the very end. The protagonist’s statement, “The sense of oppression never goes away,” clearly illustrates the weight of this guilt.
“Morphine” and the Human Desire to Escape Reality
“Morphine” was published in the 1927 issues No. 45–47 of ‘Medical Professional’. Although this work was published as part of ‘The Diary of a Young Doctor’, most scholars classify it as a separate work. This is because it was published one year later than ‘The Diary of a Young Doctor’ and differs significantly in both content and form. However, like ‘The Diary of a Young Doctor’, ‘Morphine’ is also based on Bulgakov’s own autobiographical experiences.
The work recounts his experiences as a rural doctor from September 1916 to January 1918.The story in “Morphine” vividly reflects Bulgakov’s own experience of contracting diphtheria, undergoing a tracheotomy, and becoming addicted to anesthetics. He fell into morphine addiction in March 1917. At that time, Russia was in the immediate aftermath of the failure of the February Revolution, led by the socialist faction. Rapa, Bulgakov’s first wife, recalled that he was in a very calm state at the time—completely different from being in a daze—and that he even tried to write while in that condition. Bulgakov’s move from the village of Nikolskoye to the city of Vyazma was also related to his morphine addiction. It is said that many people at the Nikolskoye Hospital at the time were aware that he had fallen into a serious drug addiction. Consequently, he had to leave there and relocate elsewhere. However, his morphine addiction continued even in Vyazma. Rafa had to go from pharmacy to pharmacy in the city to obtain morphine. This experience is directly reflected in his work. In the novel, Dr. Anna Kirillovna, the female doctor and lover of Dr. Polyakov, administers morphine injections to him, just as Rafa did. Thus, Anna in the novel can be seen as a transformed version of Bulgakov’s first wife. Bulgakov’s descent into morphine addiction was also partly due to his inability to endure the dreary life in the village of Nikolskoye. As a young doctor, he was accustomed to the life and entertainment of the big city. For someone like him, enduring a lonely rural existence must have been difficult. In this situation, drug addiction allowed him to forget his gloomy reality and provided a state of creative euphoria. Through morphine, he experienced the sweet illusion of escaping reality. Bulgakov later managed to break free from his morphine addiction. Rapa, realizing the seriousness of the situation, advised him to return to Kyiv. In February 1918, the couple left the remote mountain town and moved to the big city; it was only after returning to Kyiv and receiving help from those around him that Bulgakov was able to completely quit morphine. His experience with morphine addiction is vividly depicted in ‘Morphine’. As the morphine spreads through his body, a warm sensation spreads throughout his entire body, followed by a cool wave passing through the pit of his stomach; then his thoughts become crystal clear, and his ability to work increases explosively. He describes how, as all unpleasant sensations vanish, it feels as though human mental capacity has reached its highest point. Bulgakov also highly praises Tolstoy in ‘Morphine’ for his literary depiction of morphine addiction. He is referring to Petya Rostov, as portrayed by Tolstoy in ‘War and Peace’. This demonstrates that Bulgakov understood the dazed state induced by anesthetics as analogous to the state in which human inspiration reaches its peak. In fact, he addressed morphine addiction in other works as well. A prime example is ‘The Master and Margarita’. He used the state of morphine addiction as a literary device to create situations—much like those in dreams—that are difficult to experience in reality. ‘Morphine’ takes the form of a frame narrative. A frame narrative is a novel in which a separate, independent story is embedded within the main work. In this work, Polyakov’s diary serves this role. Generally, a frame narrative creates a dual plot structure. It consists of a story led by the protagonist-narrator, within which another, structurally independent story is embedded. What is important in a frame narrative is not the narrator’s story, but the independent story that transforms the narrator into the reader. Through the story within the frame, the narrator and the reader attain the same status. As a result, while reading the story within the frame, the reader is prone to the illusion of becoming the narrator. I believe it is precisely because of this literary device that we can vividly experience Dr. Bomgard’s heart-wrenching emotions upon learning of Polyakov’s death in “Morphine.”After reading “A Young Doctor’s Notebook” and “Morphine,” one is led to reflect on why Bulgakov chose to use his experiences as a doctor as such an important source of material for his literature. Doctors must constantly make judgments and take action to save lives, but in the process, they must also confront their own powerlessness, failures, and even loneliness. Illness is not merely something to be treated; it also serves as a symbol revealing the reality of human existence and the instability of the times. The young doctor in ‘A Young Doctor’s Notebook’ continues to do his duty while enduring surgeries, house calls, misdiagnoses, failures, and the ignorance and complaints of his patients. The massive historical upheavals of revolution and chaos also overlap with his daily medical practice. There are moments when saving a single life feels like gazing upon the fate of an entire era. The scene where the girl in “The Handkerchief Embroidered with a Rooster” survives, or the scene in “Blizzard” where the doctor is unable to save a patient, prompt us to reflect on the doctor’s capabilities and limitations, as well as the fate of humanity. In “The Red Coffin,” the doctor’s dilemma leads to the broader issue of human conscience. A person who was powerless to act in the face of violence cannot escape their own conscience. The victim’s apparitions and madness reveal just how deep that guilt runs. Ultimately, a conscience once betrayed does not disappear but haunts a person to the very end. In “Morphine,” we see how people seek to escape a reality that is unbearable. Amid the solitude of rural life and the pressures of being a doctor, morphine offers a sweet illusion that allows one to forget reality. However, that illusion ultimately leads to an addiction that destroys the individual. Since the story is based on Bulgakov’s own experiences, the depiction feels all the more vivid. Ultimately, what runs through these works is not merely the disease itself. While a doctor is someone who treats illness, he is also a human being who is not free from anxiety, loneliness, failure, and fear. And this human side is revealed even more clearly amid the massive upheavals of the era—the revolution and the civil war. ‘A Young Doctor’s Notebook’ felt like a diary that recorded the lives of such people with sincerity and emotion, while ‘Morphine’ struck me as a work in which Bulgakov—a doctor and writer—transformed his most painful experiences into literature.At the end of ‘A Young Doctor’s Notebook’, the protagonist imagines that another young doctor will take his place. That doctor, too, will listen to patients’ complaints, battle syphilis, and continue doing what must be done in solitude. Those who know what the problem is and how to solve it are bound to feel isolated and lonely. Yet they also know that this work must be done—whether it is a matter of fate or a professional duty.Therefore, after reading this work, I find myself thinking that the image of the young doctor depicted by Bulgakov transcends that of a mere doctor of a particular era. He is a human being who, while quietly carrying out the work he can do, is constantly torn between his abilities and limitations, reality and ideals, and responsibility and fear. It is precisely for this reason that ‘A Young Doctor’s Notebook’ and ‘Morphine’ transcend their status as works centered on medicine; they invite us to reflect on human life, the fate of an era, and the conflict between conscience and reality.
