2023-11-12 03:01:10
Tolstoy’s critique called me to greater humility and honesty with my patients.
Born halfway between Moscow and the eastern border of Ukraine in 1828 to aristocratic parents, Tolstoy achieved immediate recognition with the first book he wrote; a semi-autobiographical account of his childhood, written following leaving university, where his tutors described him as “unable and unwilling to learn”. He was a master of realism and his incomparable gift for closely observing universal human experiences allowed his characters to transcend their historical trappings. His keen gaze focused on the end of life in the 60 pages that constitute “The death of Ivan Ilyich”one of his most famous stories.
The novel begins at the end, with a group of friends considering what they stand to gain from the protagonist’s death. The remainder of the first half of the book tells the relatively unremarkable life story of Ivan Ilyich; that of a well-to-do magistrate who diligently climbs the professional ladder before being derailed by a mysterious terminal illness when he was around 40 years old. Until the first abdominal twinge, Ilyich never stops questioning the rules of social convention, in part because he seems to be winning the superficial game they prescribe.
Tolstoy skillfully exposes the banality of a life dedicated to marriage, parties, an important job, and a large, well-equipped house. “with all the things that all people of a certain type acquire”. The satire of him, which challenges the thoughtless conformity with superficial social expectations, has gained weight today amid the constant pressure to demonstrate that we live perfect versions of our “better lives” on social networks. Between the lines, Tolstoy maintains that a life devoid of a purpose deeper (read: religious) is essentially meaningless.
Ilyich’s life story made me reflect on the extent to which I am satisfied with my own life.
And honestly, while my family, my friends, my work, my home, and my vacations are all sources of deep joy, I have often asked myself the question that Tolstoy poses to his readers here: Is there more to life than this? Over the years, this question has prompted me to explore faith and shape my work around global health and social justice. I was surprised to see my own struggle with purpose and fulfillment reflected in Ilyich’s reciprocal acceptance.
Despite the existential challenges, the first 20 pages are actually quite slow, with the exception of a wonderfully awkward visit to the recently bereaved; “[él] He entered, as always happens, with some perplexity regarding what he was going to do there…” and a painfully beautiful portrait of marital breakdown; “There were only rare periods of strange infatuation between the spouses, but they did not last long. They were islands in which They disembarked temporarily, but then they came out once more into the sea of a hidden enmity that was expressed in distancing.”
The novel begins to recover when the first symptoms appear: “a strange taste in the mouth and some discomfort on the left side of the stomach”. The discomfort evolves into “consciousness of constant heaviness” and finally, into enough pain and bad mood to cause his skeptical wife to arrange a consultation. “Everything went as expected; It was how it is always done. The waiting…the tapping, the listening, and the questions that asked for predetermined and obviously unnecessary answers, and the air of significance, which suggested that you simply submit to us and we will make it all right.”
Doesn’t that make you shudder? How regarding this; “On the way home he kept going over what the doctor had told him, trying to translate all those complicated and vague scientific terms into simple language and reading in them the answer to the question: bad, is it very bad for me or is it still bad? Alright?”. Ilych’s various doctors dismiss his questions as inappropriate and irrelevant, focusing instead on differential diagnoses, investigations, and the biomedical complexities of his purported condition. I was reminded of DH Lawrence, writing regarding the doctor’s desire to “unload their so-called science on me and reduce me to the level of a thing”.
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#Medicine #purpose #centered #patient #Arts #Culture
