According to actor and dramaturg Anne Gridley’s neurologist, humans can only consciously attend to walking for about eight seconds before the act slips into muscle memory. Yet Watch Me Walk, written by Gridley, challenges us to spend nearly two hours thinking about walking. 

The autobiographical play begins with the veteran experimental performer pacing the stage in rose-adorned combat boots—more useful, she later notes, than $7,000 custom orthotics—and near silence. The sense that something might happen eventually ebbs into boredom. Why turn foot drop, the dragging of the front foot, into a spectacle? 

Before long, Gridley deliberately falls and then asks the audience to offer help—and to accept her refusal. Later, she presents a slideshow on her 20 colorful walking sticks; some of their names are Dorothy Parker, Tonya Harding, and Gabagool. At one point, wearing a ballgown made of caution tape reading “fall risk,” she ascends a ladder. She sings, “I’m climbing on a ladder, and it’s making you feel nervous—and yes, that is the point.”  

Directed by Eric Ting, Watch Me Walk educates non-disabled viewers and invites them to confront their discomfort. “Maybe don’t say ‘spaz’ anymore; that word describes the way I walk,” Gridley told Culturebot. “So every time you just casually say, ‘I was spazzing out,’ I want you to think of me walking back and forth stiffly across the stage.” 

Gridley is having fun, too, even as she, at other times, fights back tears. Full of tonal turns, the production is at once cringey, candid, wacky, and whimsical. Through a series of loosely connected but ultimately moving vignettes, Gridley chronicles her life with hereditary spastic paraplegia (HSP), probing tragic family narratives, ableist encounters (“It was a woman, so I didn’t punch her in the face”), and health insurance struggles (“Viva Luigi!”). 

She dramatizes her neurodegenerative condition—shared by her mother and grandmother—by dressing as a gigantic purple nerve cell and as Little Orphan Annie, wryly highlighting the chronic disregard for so-called “orphan diseases,” whose rarity limits research and pharmaceutical attention. 

Observed annually on the last day of February, Rare Disease Day is an international effort to expand access to healthcare, diagnosis, and therapies for people with rare diseases. Although Watch Me Walk closed its in-person run on February 15, a recording of the play will stream for one week starting on February 28. The same day at 3:00 p.m. EST, the Spastic Paraplegia Foundation (SPF) will host a Rare Disease Day online forum on HSP and Primary Lateral Sclerosis, featuring patients, families, researchers, and advocates. 

Soho Rep, where Watch Me Walk was staged, hopes that streaming the play alongside SPF’s virtual event “will create a coordinated awareness moment,” showing how “storytelling, dialogue, and science together help humanize rare neurological diseases while advancing the pursuit of effective treatments and a cure.” 

Photos by Maria Baranova

WNYC: Under The Radar’s “Watch Me Walk”

In advance of the event, Guy Glass has had the opportunity to speak with Margo Weishar about her play: 

Guy: 
Hello Margo. It is such a pleasure to speak with you. For anyone who may be deciding if they want to come to the reading, can you tell us a bit about the play and the subject matter? And about how you became interested in writing about Elizabeth Blackwell. 

Margo: 
What really interests me is people who break out of the norm. 
People who do things that are completely extraordinary, and what motivates them to do that, and what is their personal cost in doing that. 
Elizabeth Blackwell became the first woman to graduate from medical school in the United States, and then she had a career in promoting women in medicine. But I also wanted to show her as a human being. The only pictures we have are of an old woman, but she was a vital, curious, intelligent, daring, brave person who fought against incredible odds to get where she was. And so that’s who I really wanted to investigate. You know, we all rely on these pioneers to break barriers down so that people like me can walk through them. But what does it take from them to do that? What are the choices they had to make in your own lives to make that possible? So that was the question that really ended up fascinating me. 
 

I got a theater degree because it was something I’ve always done in my life, and I decided I really wanted to formally go and learn. And when I started working with playwright Michael Hollinger, I took a class on solo performance. 
I always loved historical fiction, and I liked plays that were based on historical women. And so, I thought I’ll look at Elizabeth Blackwell as a subject for this solo performance. I started researching and found there was a wealth of primary source information. Not only she, but also her sister Emily became a doctor, and then a lot of her other family members were prominent. There are letters between the nine brothers and sisters in collections at Harvard and at Oxford which I could read online. The more I read and the more material I looked at, the more I felt, wow…this woman had an amazing life! After I did the solo performance, I started developing it as a play. And I really liked where it was going and refined it to the point where I had a public reading at Villanova in May of 2024. 

Guy: 
As you know, I am also a physician-playwright. There are not all that many of us! Can you say something about what it was like as a doctor transitioning to becoming a playwright? Do you feel like you have a special perspective because of being a doctor?  

Margo: 
I feel like my life has had two parallel tracks because I grew up around theater and performing. My father was a scenic designer who was a graduate of Yale Drama School. I am the first and only doctor in my family. I was always that kid who was good at science, but also the lead in the play. I produced and directed the first musical production at Penn med school ever: Sondheim’s Company with a full orchestra, which we put on with all the med students. So, it was always part of my life even during my medical training, although there was a time when I had to kind of put it on the back shelf. 

As far as playwriting, I feel very passionate about telling certain stories that haven’t been told. And now as a woman who has lived a life, had a career, raised three children, and now has a grandchild, I have a lot of life experience. I felt like that kind of voice is somewhat rare in the playwriting world, especially telling stories about women. And especially about women in science. I’ve had the opportunity to play on stage Ada Lovelace, the daughter of Lord Byron, who is credited with developing the first computer and the first computer language. 
I’ve played Maria Sibylla Merian, an artist and biologist in the 1700’s, who drew beautiful studies of insects and plants.
I directed a play about Henrietta Swan Leavitt, a Harvard astronomer in the early 1900’s. I’ve always been fascinated by these incredibly accomplished women who history has ignored. I really felt like that was my impetus for trying my hand at it. I didn’t know if I’d be any good at it. But having my work read by others I could see it was starting to reverberate with people. People were liking it and I was liking what I was hearing. The whole skill was very new to me and quite surprising. 

Guy: 
One of the things I don’t think people who are outside the theater world realize is just how long the development process of a play can take. In what way do you hope the reading at the College of Physicians will help you, and what do you expect will happen next? 

Margo: 
I have another amazing mentor, Ed Sobel, a professor at Villanova and a professional dramaturg. Ed has been working with me on focusing and refining the play. And it is just an amazing thing for me to work with somebody who is so great at what he does. Because he’s asking me questions and really trying to focus on what the essential story is that I want to tell. Having good actors is another good thing. The way people say things will help me to streamline.  

And of course, the last and most important element is how it plays to an audience, somebody who’s seeing it and hearing it for the very first time, what they will come away with and whether I can achieve the emotional impact of what I’m trying to say. As you know, things can be back to the drawing board after that experience. I might hear certain things that really hit perfectly or other things I never even considered. It’s not like a novel, where you finish it, you publish it, and it goes out in the public. You can have multiple full productions before you publish a script because sometimes something doesn’t work in a production. Maybe it’s just the wrong actors. And then you go see it somewhere else and you think, no, that scene was great. You have to see it. It’s a collaborative art, and we need all those people, designers and directors, to interpret what we wrote before we can say, yes, this is the final version. 

It’s interesting. I was in London last week and I got to see a Tom Stoppard play called Indian Ink. This play had been produced 30 years ago. 
And when Stoppard went back to it, he changed the ending. 30 years later! So even Tom Stopford can say yes, I think I can do it better now. 

Guy:  
Thanks for talking to me today, Margo. And best of luck on the reading. 

Margo:  
Thank you! 

4:48 Psychosis raises the question of what constitutes theater. Is this a case study in psychotic depression, a work of art, or both? Can one call language without boundaries a play? What direction remains for contemporary theater to take following total fragmentation?  
 

These concerns have not stood in the way of 4:48 Psychosis being produced - if anything, it seems to be gaining in popularity. What could be stumbling blocks are seen by directors as a challenge to be met creatively. The play’s initial production, at London’s Royal Court (2000) divided the words among three performers. All three initially learned the whole text, and although most lines were eventually allocated, others were voiced spontaneously by different actors from performance to performance. The “action” appeared to take place within the mind of the protagonist. Projections onto a mirror helped create a Rorschach-like effect. As evidence that the play encourages a wide variety of interpretations, in the celebrated TR Warszawa production, six actors embodied discrete characters, creating encounters between a central character and her doctor, family members, or friends. This production, brought to New York in 2014, employed a Polish translation with English surtitles.  Another production, by Theatre du Pif of Hong Kong in 2016, purported to bring “an Asian sensibility” to the play, using a Korean designer and Hong Kong musicians.”  

In conclusion, 4:48 Psychosis is clearly not everyone’s idea of entertainment (one critic likened watching it to being locked in a freezer). However, it provides a beautiful, albeit brutal, window into the depressed, suicidal mind.  

A previous version of this review was published in the NYU Literature, Arts, and Medicine Database.  

Primary Source Sarah Kane: Complete Plays 
Publisher Bloomsbury Methuen Drama 
Place Published New York 
Page Count 43 
Web Art: File:4.48 psychose.JPG – Wikimedia Commons 

Attending plays is not always just a passive experience. Through various means playwrights, producers, composers, choreographers, set designers, and others have available to them, they can make plays immersive and interactive for audiences. A good example, among many, is Florian Zeller’s play, The Father. 

The Father is the story of an older man with Alzheimer’s disease (André) and his progression through first living on his own, then living with his daughter (Anne), and finally living in a nursing home. Or, is it? It’s hard to tell, and that is the intention of the playwright, Florian Zeller, who in a 2021 interview with Forbes Magazine,* said his aim was, 

to tell the story from the inside and put the audience in a unique position as though they were going through a labyrinth—questioning everything they’re seeing. It also was a way for me to play with the idea of disorientation because I not only wanted The Father to be a story but also an experience. The experience being what it’s like to lose everything, including your own bearings as a viewer and to be uncertain of what is and isn’t real. It was a way for the audience to experience a slice of dementia.

The director, Doug Hughes, creates the audience experience through an interplay among set designs, lighting effects, repeated scene sequences, and time loops as circumstances for various behaviors like memory loss, paranoia, anger, and lasciviousness. All the scenes take place in one room that serves at different times as André’s flat, Anne’s flat, and André’s nursing home room. The furnishings of the room change based on the supposed setting, but the walls are exactly the same for all of them. In different scenes, André is not always sure where he is, and neither is the audience.  

Early in the play, André hears Anne tell him she’s relocating from Paris to London with her lover, but she is present to him in most of the scenes thereafter and until the end of the play when he’s told by a nurse that Anne had moved to London some time ago. Had she really left Paris and was never actually there in all those other scenes? He wonders and so does the audience. In other scenes, the way characters from the past and present enter and exit distorts time for André, and so while audience members know the linear trajectory of the disease course, they can’t be sure of where they are in that course during a given scene. With the last scene taking place in André’s nursing home room with the same walls seen in his flat and Anne’s flat, the audience can’t be faulted for wondering whether all that came before was just one of André’s hallucinations. 

The Disorienting Is Clarifying

If the play had been staged as the customary audience view of outside looking in, the audience would have merely witnessed the familiar manifestations of Alzheimer’s disease and a familiar progression of events. This view would have afforded a new appreciation for the trauma it causes to those who are not closely acquainted with the symptoms of Alzheimer’s, while those who are familiar with them could possibly achieve a measure of catharsis. Zeller endeavors to do much more by offering a view of Alzheimer’s from the inside looking out and a means to grasp the actual experience of it. He is successful when audience members find themselves working as hard as André is to discern fact from fiction, past from present, and here from there.   

This can be no easy feat for the stage, and no wonder then that the Broadway production team enlisted an “illusion consultant” (Jim Steinmeyer) and a medical advisor (Dr. Randi Diamond). The intimate experiences the actor playing André (Frank Langella) and the director (Doug Hughes) have had with Alzheimer’s disease through family members no doubt contributed to the production’s authenticity as well.  

Zeller doesn’t leave the audience members defenseless in their efforts to orient themselves. He associates André’s grasp of his own situation with the whereabouts of his watch: “I need to know exactly where I am during the day. I’ve always had this watch, you know. If I were to lose it, I’d never recover.” As André’s dementia progresses and his powers of perception weaken, we see fewer objects in Anne’s flat. In the end, Zeller is hoping that confusing and disorienting the audience members will clarify the dementia experience for them.

Notes:
*Dawson A. Florian Zeller takes viewers into the labyrinth of dementia with The Father. Forbes. March 30, 2021.
This essay is based on a live performance of The Father presented by the Manhattan Theater Club at the Samuel J. Friedman Theater in New York City that ran between April and June of 2016. 
Translated from French by Christopher Hampton.
Brain photo:  Processing language, left brain hemisphere (sagittal view). Stephanie Forkel, NatBrainLab. Source: Wellcome Collection
License: Attribution 4.0 International (CC BY 4.0)
Watch photo from Wikicommons images and licensed under the Creative Commons Attribution-Share Alike 3.0 Unported license.

Carrie Coon, Letts’ wife, plays Agnes White, a lonely server living in an Oklahoma motel who falls in love with Peter Evans (Namir Smallwood), an AWOL Gulf veteran. Peter becomes increasingly convinced that he is the subject of clandestine experiments, and that he is infested with government-planted bugs. These bugs are, of course, invisible, yet he drags Agnes with him into a seeming folie à deux—a bedlam of flypaper, aluminum foil, and bug zappers.  

Peter’s delusions (and, in turn, Agnes’s) eventually cross a line into a realm in which logic no longer applies. By spilling so far into excess, even occasionally veering into bizarre spoofiness, Bug risks trivializing Peter’s paranoia—a risk especially fraught now that the part is played for the first time by a Black actor.  

Initially, Peter cites a real case of government experimentation: the Tuskegee Syphilis Study, in which poor Black sharecroppers were never told they had syphilis. The experiment ran from 1932 until 1972—long after penicillin became the standard treatment in the mid-1940s. To observe how the disease naturally progressed, researchers deliberately withheld the antibiotic, ending the study only after a press leak. 

This gross violation of ethics is widely believed to have damaged Black Americans’ trust in the medical establishment. But according to medical ethicist Harriet A. Washington [1], “that narrative is flawed and untrue.” While Tuskegee certainly contributes to that distrust, the larger impetus is “four centuries of abuse in the medical arena,” which Washington chronicles in her 2007 book Medical Apartheid: The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present. “In fact, one study indicated that African Americans who had never heard of Tuskegee were more likely to fear vaccine administration and medication design.” 

What if Bug had dialed down Peter’s paranoia and explored it within this broader historical context instead of reinforcing the singularity of Tuskegee? Overemphasizing Tuskegee because of its infamy (or because of one’s ignorance) serves to obscure other historical ethics violations as well as systemic racial inequities that persist today. For instance, what if Peter struggled to access mental healthcare because of structural barriers? 

In her 2021 book Carte Blanche: The Erosion of Medical Consent, Washington mentions an experimental anthrax vaccine that soldiers were required to receive beginning in 1998. “Soldiers of all races were affected,” she writes, “but Blacks were overrepresented because they constituted 12.3 percent of Americans, but were 24.5 percent of the 1.7 million ground troops deployed to the Gulf in 1990 and 26.2 percent of Army reservists in 2001—twice their representation in the population at large, and so at twice the risk of being forced into military research.” 

Many service members reported autoimmune conditions after getting the jab, but the Pentagon attributed their symptoms to “emotional issues,” Washington continues. “The military subsumed vaccine-related illnesses under the nebulous symptomatology of ‘Gulf War Syndrome.’” What if Bug had dramatized that ‘nebulous symptomatology’? 

Peter also references another example of government research: the Edgewood Arsenal experiments. After World War II, the U.S. Army Chemical Corps tested chemical weapons on American soldiers at a secluded research facility on the Chesapeake Bay, exposing volunteers to more than 250 different chemicals, including LSD, mustard gas, and sarin. The studies ended after researchers were accused of ethical transgressions, including issues with informed consent and recruitment. Archival footage, unearthed in a 2022 documentary, shows men “going temporarily blind, reduced to babbling or completely dysfunctional logs, or worse, ready to commit violence upon themselves.” [2] 

Washington argues in Carte Blanche that “the medical crimes that were denounced and punished at Nuremberg have American analogues.” 

“Although not perfect parallels,” she notes, “they share a violent, nonconsensual, and largely racial disparate nature, as well as the frequent invocation of military expedience.” 

In this light, Peter’s condemnation of his doctors as neo-Nazis feels less outlandish than the play permits. Letts may hint that Peter is not entirely psychotic—that his madness holds some truth. But that seed never grows.  

The play ultimately bubbles over (spoiler alert: self-harm, violence, and fire). A future iteration of the three-decades-old play, if there is one, might benefit from taking Peter’s delusions more seriously—and leaving open the possibility that they are, in fact, real. 

Bug will get under your skin, but to what end? 

Bug, through March 8th at the Samuel J. Friedman Theatre in New York; manhattantheatreclub.com/shows/2025-26-season/bug/.  

[1] “Harriet A. Washington on the Narrative Around Vaccine Hesitancy in the African American Community: In Conversation with Andrew Keen.” Keen On from Literary Hub, 19 Mar. 2021, lithub.com/harriet-a-washington-on-the-narrative-around-vaccine-hesitancy-in-the-african-american-community/. 
[2] Simonpillai, Radheyan. “‘It Affected a Great Number of People’: Inside the World of Shocking Military Drug Experiments.” The Guardian, 9 June 2022, theguardian.com/tv-and-radio/2022/jun/09/dr-delirium-and-the-edgewood-experiments-documentary. 

Web image by Matthew Murphy.

Agnes recognizes William’s unique potential and supports his choice to leave his family and head off to London to make his name in the theater world. Shakespeare rarely returns home to Stratford, and we only learn of his growing success indirectly. Agnes is forced to raise her children as a single parent and has to deal with her overwhelming grief when Hamnet dies. As she mourns the loss of her son, she is overcome with doubt about the fidelity of her absent husband, and her faith in their marriage is threatened. Ultimately, Agnes is given a playbill featuring the production of a new play written by her husband and she sets off on a trip to London to confront him on his own turf. She arrives uninvited at the Globe Theater in time to witness a performance of the play in which her husband has been able to channel his own grief at the loss of his son into one of the enduring literary works in the Western canon.  

I first became aware of this book in a New York Times article that appeared in the early stages of the COVID 19 pandemic shutdown. It was recommended as a worthwhile book to read in quarantine. I had never heard of Maggie O’Farrell but the two-sentence summary captured the book and author perfectly. I do not think O’Farrell is a prophetess, but she was nothing if not attuned to our times and circumstances. Assuming she was writing this novel well before coronavirus escaped the food market in Wuhan, the way she frames Hamnet’s death in the setting of the bubonic plague in Stratford is inspired. Her story captures the explosive fear that envelops the town as the plague spreads — you can feel the wind in your face as the townspeople slam the door shut in the face of anyone suspected or proven to be infected. The story is written in the present tense which heightens the sense of immediacy of events as they unfold for William and his parents, Agnes and her family, and the people living in Stratford. O’Farrell’s prose feels Elizabethan – in the description of glove making, removing honey from a beehive, preparing shrouds for the dead child. As I read, I found myself looking up many more words than usual; the language itself has the power to transport you back in time.  

But, while the choice of bubonic plague as the cause of death may have been fortuitous for book clubs and book sales in the world we lived in during the pandemic, I do not think it is the driving force in this book. The dominant theme is how we deal with grief from any cause. O’Farrell is not the first author to use the death of a child as a vehicle to explore the myriad consequences triggered by the loss of a loved one, especially for parents who lose a young son or daughter. The steady movement of the plot to the climactic scene in London makes Shakespeare’s response seem the more substantive. His literary genius has enabled him to channel his sadness at the loss of the son he adored into the creation of an authentic character into whom he could project all the hopes and dreams that he had for Hamnet.  

Interestingly, O’Farrell never names Shakespeare throughout the novel, referring to Shakespeare always as “he” or “him” I can only speculate what O’Farrell means to convey with this literary device. I think she is acknowledging that it is the truly rare individual who can accomplish what Shakespeare was able to do in redirecting his grief from personal sadness into a timeless literary masterpiece. We are thus like Agnes who must go through our day-to-day routine, try to find meaning in tragedy and the courage and strength to stay on our feet and continue to move forward. That is Agnes’ accomplishment — that she can summon the will to travel to London to confront William, and by her action have the goodness of heart to realize that her husband shares her loss. She is able to appreciate the gift he has been given to transform his personal grief into a meaningful expression that the world can share. With this newfound knowledge, her marriage will be reinvigorated, and their mutual love will be reinforced. Agnes is thus the named character who occupies center stage as the story unfolds.  

O’Farrell has written a truly beautiful book that brings to life the pain of loss and the capacity of men and women to endure. As we coped with the COVID-19 pandemic as individuals and communities, many were forced to deal with unexpected pain, suffering and death. Hamnet is a book for our time. Physicians and all other health professionals do their best to support families and communities as they deal with untimely loss of loved ones. I only hope that it will not set the bar too high on expectations of how to transform grief into meaning. We are not all going to be Shakespeares but we can hope to be Agneses, who can still find joy and meaning in our lived lives in the aftermath of devastating loss.   

Hamnet
Maggie O’Farrell 
Alfred Knopf, 2020: 384 pages 

A previous version of this review was published in the NYU Literature, Arts, and Medicine Database 
Web image by Medhum.org

Before embarking on my project, I reviewed the literature pertaining to the use of plays in medical settings.  Friedrich Schiller, the German playwright (who was, incidentally, a physician), laid the groundwork for the use of theater as an educational tool in his 1784 essay “The Stage as a Moral Institution” calling it “a great school of practical wisdom, a guide for civil life, and a key to the mind” (Schiller, page 252).  In his view, the theatricalization of the “vices and virtues of men” and of “human woe” not only makes them more palatable, but it also actually teaches the audience to be more empathic. 

I found a wide range of milieus in which plays have been used.  In 1938, The Federal Theatre Project, a program sponsored by the WPA, produced a play entitled Spirochete with the goal of reducing the spread of syphilis (Flanagan, page 144).  More recently, dramatic narratives were used by scientists to provide a forum for learning about human genetics; these have been collected in a volume entitled The Drama of DNA.  

A pioneering program that proved inspirational to me is Medical Readers’ Theater, developed in the 1980s at East Carolina University’s Brody School of Medicine. Stories by William Carlos Williams and other doctor writers have been turned into scripts used to encourage dialogue among medical staff, students and the public about a variety of medical issues. These plays are available in anthologies accompanied by discussion questions.   

There are also numerous popular plays which are natural fits for teaching because they illustrate points of ethics, diagnosis, doctor-patient relationship, etc. at the same time as just being entertaining.  Some of the ones I have used include Wit, A Streetcar Named Desire, and Next to Normal.    

While deciding what to do for my thesis project, I was becoming quite taken with Anton Chekhov’s writing through working with Jack Coulehan at Stony Brook.  Previously, although I knew of course that Chekhov had a reputation for being one of the great playwrights, I had had the impression that his plays were a bit boring because nothing much happens in them.  What can I say?  I must just not have seen the right productions.   

I researched Chekhov’s life, read his short stories, and even plowed through Sakhalin Island, the epidemiological survey he wrote about health conditions in a penal colony. As a result, I became an admirer and gained insight into his method.  It does not matter whether there appears to be anything happening or not.  The author’s job is to record what he observes. It is not by chance that this is also the job of a physician.  One can understand why Chekhov might have wanted to continue to practice medicine even after becoming one of Russia’s most celebrated writers.  Chekhov soon became my personal role model as a doctor writer, and it felt like an honor to dedicate my time and energy to his work, and in my own extremely modest way, to add to his dramatic corpus.   

Chekhov wrote over 500 short stories, and doctors play a significant role in about 25 of them.  I chose “A Nervous Breakdown” (1889) and “A Doctor’s Visit” (1898) “for adaptation.  As “A Doctor’s Visit” has fewer characters and is the shorter of the two that is the one I use to teach.  Some students may even have read the original story already because it is so well known.   

The plot may be summarized as follows:  A doctor has been summoned away from the city to see the daughter of a factory owner, but for some reason he sends his assistant instead.  (Perhaps he just did not want to go out to the boondocks.) The assistant doctor arrives at the house and examines the young lady.  After not finding anything wrong, he concludes that he’s been called for nothing. The patient’s mother, who is depressed and overwhelmed, implores him to spend the night instead of going home to his family.  The doctor is not in a position to refuse, but he feels as if his time is being wasted and he is annoyed.  

However, in the short time he is in the factory town, the doctor gets a sense of what it is like in live in such a place. He sees how unhealthy the environment is for the workers. He sees how, despite having lavished a fortune on expensive furnishings, the inhabitants of the house are miserable. Adding insult to injury, a servant repeatedly contradicts him and gets on his nerves.  

In spite of the prejudices he has brought with him from the city, the totality of his experience makes an impression on this doctor. The next morning, he meets with the patient again. This time, he recognizes that she is a sensitive and intelligent young lady, and he now has empathy for what she must be going through. There is a moment of understanding between them. Although it does not perhaps appear as if the doctor has applied any treatment, the patient responds and shows a sense of hope.  The doctor has also changed as a result of this experience. He leaves the house and heads home in a good mood.   

Like general practitioners today, general practitioners in 19^th-century Russia undoubtedly ended up doing a good bit of psychiatry.  Although Chekhov and Freud were contemporaries, there seems to be no evidence that Chekhov was aware of Freud’s “talking cure. “  But even if not, and even if the doctor in “A Doctor’s Visit” does not think he has done anything, the doctor has in fact unwittingly administered a brief psychotherapy session.  The powerful results he obtains with such simple means remind me of some of my own experiences as a psychiatrist.  Sometimes when one uses one’s psychoanalytic theories to make what one thinks are brilliant interpretations, they fall on deaf ears.  Just being present and listening often produces the best outcomes.   

The greatest technical challenge this playwright confronted in dramatizing “A Doctor’s Visit” was figuring what to do about the doctor’s internal thoughts.  There is plenty of spoken dialogue in Chekhov’s story, and I used much of it practically verbatim.   But how to dramatize one’s inner dialogue?  It would be cumbersome to have a narrator describe it, and unnatural to have the doctor verbalize it.  My solution was to create a brand-new character, a young apprentice, someone the doctor uses to bounce ideas off.   I hope audiences and readers feel this was a reasonable compromise on my part.   

My adaptations of Chekhov’s two stories made their debut in 2015.  Since then, “A Doctor’s Visit” has been used to teach students at several medical schools:  Stony Brook, Drexel, New York University, Boston University, Cleveland Clinic, and the University of Pennsylvania.   At all but one of these I introduced the play in person, read the stage directions aloud, and led the discussion.  The text of the play is included in an appendix to this article in the hope that other schools will take it up.  And I am still available to read stage directions! 

References: 
Chekhov, Anton: “A Doctor’s Visit.”  Translated by Constance Garnett.  https://www.ibiblio.org/eldritch/ac/jr/193.h
Coulehan, Jack.  “Cold Eye, Warm Heart: Medicine and Anton Chekhov.” MedHum, October 2, 2025 Flanagan, Hallie. 1940, reprinted 1985. Arena: The Story of the Federal Theatre. New York: Limelight Editions 
Rothenberg, Karen H. and Bush, Lynn Wein. 2014. The Drama of DNA. New York: Oxford University Press 
Savitt, Todd L. (ed.) 2002.  Medical Readers’ Theater:  A Guide and Scripts.  Iowa City: University of Iowa Press 
Schiller, Friedrich. 1784. “The Stage as a Moral Institution.” In Theatre/Theory/Theatre, 250-254.  New York:  Applause 

Web image created based on this vintage illustration from WikiCommons

A Doctor’s Visit:  An Adaptation of a Short Story by Chekhov

by Guy Fredrick Glass

Downloads of this play may be distributed and performed for educational purposes only, with permission of the author.  Dr Glass may be contacted at gf***@*ol.com 

[embedpress_pdf]https://medhum.org/wp-content/uploads/2025/12/A-Doctors-Visit-2017-version-copy.pdf[/embedpress_pdf]

Directed by Anne Kauffman, the play features “Primes,” or holographic simulations of the dead intended for therapeutic use by the living. June Squibb—who, at 96, is making history as the oldest performer to open a Broadway show—astonishes as Marjorie, an impish 85-year-old with dementia using a much younger version of her husband Walter (an uncanny yet tender Christopher Lowell) to regain and retain her memory. Marjorie’s daughter Tess (the incredible Cynthia Nixon) is skeptical and fearful of the technology, whereas Tess’s husband Jon, played by a standout Danny Burstein, is a fan—until an on-the-nose change of heart in the penultimate scene. 

Marjorie Prime’s central flaw is that it favors concepts over dramatic depth. The characters are well-acted but underdeveloped, and almost all they do is talk; the biggest event may be Marjorie urinating herself. Yet, despite its slow pace and formulaic structure, Marjorie Prime is intelligent and poignant. 

Marjorie’s memories are embellished and sanitized for her comfort and convenience. The fallibility of memory is hardly a novel concept, but the Primes enable this reconstructive process and also become a stand-in for genuine connection in the wake of grief, preventing the family from confronting painful realities and repairing their relationships.  

By the time the truth fully surfaces in the unsettling final scene, which makes adroit use of a stage turntable (props to scenic designer Lee Jellinek), there are no humans left to heal. When storytelling is delegated to AI, truth becomes archival rather than relational; however, truth must be witnessed between living people in order to be ethically and therapeutically meaningful.  

Playwright Jordan Harrison’s Primes, like flesh-and-blood clinicians, absorb and co-construct patients’ accounts of self, yet they are disembodied, unfeeling, and ultimately unable to act with compassion, turning dynamic stories into datasets.   

Marjorie Prime, through Feb. 15 at the Helen Hayes Theater in New York; 2st.com/shows/marjorie-prime.  

“Much of healthcare happens in interpersonal moments,” write Maura Spiegel and Danielle Spencer in the first chapter of The Principles and Practice of Narrative Medicine—and machines are good at many things, but participating in a truly interpersonal moment is likely not one of them. Several studies have suggested that models perform worse for underrepresented groups because they are trained on datasets that lack racial, cultural, and linguistic diversity. Additionally, AI may miss subtle emotional cues and fail to interpret tone, context, and metaphors, which, one bioethicist [1] predicts, could “fundamentally alter” how trust is practiced in healthcare. Others [2] have underscored that “AI should be viewed not as a replacement for the physician, but as a partner in delivering empathetic, patient-centered care.” 

However, AI is not wholly bad. For example, a recent systematic review [3] found that applying natural language processing (NLP) to unstructured text in electronic health records (EHRs) can detect signs of cognitive impairment. Some [4] have found solace in text-based simulations with lost loved ones. And perhaps technology should be viewed as a vehicle for strengthening partnerships between clinicians and patients. Designed by Gabriela Gomes, the video game Healing Spaces aims to help those with neurodegenerative diseases connect with their caregivers. It is a multisensory experience: an app with beach and forest scenes, and a box with aromatherapy that smells like pine trees. Healing Spaces may evoke memories or even create new ones between caregiver and patient, unlike the Primes’ hollow curation. 

Healing Spaces also includes sunscreen-scented lotion that caregivers can use to massage the hands of those in their care. Needless to say, holograms and lotion don’t pair well. “You can’t touch a hologram. So there’s something about them looking so much like your loved ones, but not being able to quite achieve intimacy with them,” said Harrison during Marjorie Prime’s Off-Broadway run about a decade ago. “The loneliness can never be quite extinguished, never satisfied, because they’re just pixels.”  

[1] Kerasidou, Angeliki. “Artificial Intelligence and the Ongoing Need for Empathy,  Compassion and Trust in Healthcare.” Bulletin of the World Health Organization, vol. 98, no. 4, 2020, pp. 245-250. pmc.ncbi.nlm.nih.gov/articles/PMC7133472/. 

[2] Ghenimi, Nadirah, et al. “Integrating AI with Narrative-Based Medicine: Enhancing Patient-Centered Care in Primary Practice.” Perspectives in Primary Care, 5 Dec. 2024, info.primarycare.hms.harvard.edu/perspectives/articles/integrating-ai-with-narrative-based-medicine.  

[3] Shankar, Ravi et al. “Natural Language Processing of Electronic Health Records for Early Detection of Cognitive Decline: A Systematic Review.”npj Digital Medicine, vol. 8, no. 1, 2025, p. 133. pubmed.ncbi.nlm.nih.gov/40025194/. 

[4] Fagone, Jason. “The Jessica Simulation: Love and Loss in the Age of A.I.” The San Francisco Chronicle, 23 July 2021, sfchronicle.com/projects/2021/jessica-simulation-artificial-intelligence/. 

Web image from 2nd Street Theater.

On September 9, 1982, on her 25th birthday, Julie Ridge became the 242nd person to swim from England to France. On April 11, 1991, Ridge was hospitalized for 21 days and unceremoniously received a diagnosis of bipolar disorder I. Julie’s one-woman show Bipolar & The English Channel tells the story of how a casual mile-a-day pool swimmer became an English Channel swimmer in nine short months and her 17-hour, 55-minute zig-zag journey across those grey murky seas. It also tells the less glamorous story of a world-record holding endurance athlete who wakes up one not-so-fine day floridly manic, locked down on an unforgiving New York City psychiatric ward – and her arduous journey back to sanity and a fulfilling life.  

On March 26, The College of Physicians of Philadelphia presented a performance of Julie Ridge’s one-woman show: https://collegeofphysicians.org/events/bipolar-english-channel-one-woman-show In advance of the event, Guy Glass has had the pleasure of speaking with writer and performer Julie Ridge about her work. 

Guy: Julie, I had the privilege of seeing your show Bipolar and the English Channel a couple of years ago in New York. It was informative, entertaining, and inspirational. As you know, I help arrange programming for the College of Physicians of Philadelphia. As a psychiatrist and playwright, theatrical representations of mental health issues are right up my alley. I am so glad it is working out to have you bring it to the College! 

The very striking title of your piece brings together two images that seem completely unrelated, but you fuse them together so convincingly. Can you say something about your background that sheds some light on the title, about your life as a swimmer, and then your discovery of your diagnosis? 

Julie: With the title, I’ve tried to conjure the image of how my life with bipolar disorder and my unlikely swim across the English Channel run parallel to each other and are symbiotically intertwined. My decision to the swim the English Channel came on as spontaneously as a manic episode. I tell the full story in the show, but the germ was planted when a friend who swam two miles-a-day broke his wrist, and I doubled my casual one mile a day in empathy for his mandatory pool abstinence. At the time, I was an actress performing in my first Broadway show and swam for peace of mind and to stay in shape. The story of learning I had bipolar disorder is the subject of the second act of the show – so, I ask your readers to come see it to hear the tale. 

Guy: Can you tell us how and why you decided to turn your story into a show? What is it like for you to perform? What has the reaction to the show been like, especially from the mental health community? 

Julie: After my diagnosis in 1991, I went back to school to get my master’s degree and became a psychiatric social worker. Over time, I’d developed a seminar that told the story of my English Channel swim and bipolar diagnosis. The decision to turn the informal seminar into a show first arose when I discovered I was a single hour shy of collecting my Actor’s Equity pension. I asked all my friends who were still in the theater if they could write me into a contract show, maybe as a person lying behind a couch or something, even just for the first act of one show, and I’d refund them my salary – I just needed that single hour to collect a lifetime pension. A couple of years went by, no offers were made, I was getting closer and closer to 65, so I decided to do it myself. I wasn’t going to lose my pension over one measly hour.  

On the 5th Anniversary of the non-profit organization I founded in memory of my dad, I pulled together the least expensive Actor’s Equity contract possible that would get me that hour. That contract was four staged readings at the Studio Theater on Theater Row off Broadway in New York City. It was the first time I’d disclosed my bipolar disorder publicly and, frankly, I was terrified. But community members, family, buddies from high school and college, and colleagues were incredibly warm and receptive.  

That four-day run led to performances in the United Solo Festival off Broadway for two consecutive years. A performance at my sister’s temple outside of Boston was seen by a friend with connections to the Sedona Festival, which led to another gig at the JCC in Hartford Ct and so on. It’s my hope that I will be able to perform the show each year in venues across the country.  

As for how it is to perform it – I actually have acute social phobia and get terribly anxious every time I perform the show. It’s odd, because performing when I was an actress was easy and highly enjoyable. But those shows were written by other people and not about my life. Doing something so intimate and personal is quite different. I never know how it’s going to land and be received.  

Guy: I see that in addition to Bipolar & The English Channel, there is a documentary film about you. Can you say something about how this came about?  

Julie: Seems there’s a story behind everything! Zac Norrington, a film student at the New School in New York City needed a subject for his Capstone project senior year. Long distance swimming and cold-water swimming was something of personal interest to him because of a near-death experience his grandfather had. Zac brilliantly thought to contact Ned Dennison, the Director of the International Marathon Swimming Hall of Fame (IMSHOF) for recommendations on swimmers he might interview in New York. Turns out that swims I’d done in 1983 and 1985 put me in the record books. My athletic resume in the 1980s was out of the ordinary, and to my amazement, I was inducted into IMSHOF in 1985.  

Ned recommended me and a couple of other swimmers. Zac interviewed a few of us, showed his preliminary work to his class and professor and they all said “forget about the other swimmers. Focus on Julie’s story.” He did. His short documentary BREATHE, is about the intersection of my double swim around Manhattan Island and my bipolar disorder. He submitted the doc to several festivals, we got showings at many of them, including the prestigious ReelAbilities Film Festival. At our last festival, The Greenwich Village Film Festival, we won Best Short Documentary. Zac was a wonderful director, cameraman, editor and producer. He completed the entire movie during the pandemic. I’m very impressed with the work he did culling together our interviews, still photos and archival footage. It’s been an honor attending talk backs to represent the film. 

Guy: Can you tell us about the organization you founded, the Frank Ridge Foundation? What its mission is, why you decided to start it, and about some the foundation’s projects?  

Julie: Ah, the subject nearest and dearest to my heart. Thanks for asking. Frank Ridge is my dad – one of the kindest and most loving dads a girl can be fortunate enough to have. Dad died in 2013 after 90 full years, rich with adventure, and community involvement. Pops supported everything I ever did, unquestioningly and unconditionally. He was by my side stroke after boring stoke for all of my swims, was in Hawaii melting in the heat with me when I completed the Ironman Triathlon and rode side-by-side with me as we biked 3,700+ miles across America. Dad was also a pretty smart businessman, and he left me and my sisters some money. I’ve never had much money – I chose lucrative fields like acting, writing and social work – so what he left felt like a fortune. I took almost half of my inheritance and founded a non-profit in his honor, the Frank Ridge Memorial Foundation, Inc. (frankridgememorialfoundation.org), dedicated to living well with mental health conditions through awareness and understanding. Our primary work is:  

• Creating and facilitating resource-rich topical seminars, using accurate compassionate movies as the springboard for conversation, for community members and mental health practitioners required NY continuing education.  

• Maintaining our resource-rich website. 

• Providing meaningful part-time employment for individuals living well with mental health conditions.  

• And performing Bipolar & The English Channel whenever the opportunity arises. 

I’ve loved working for myself running this organization for the past 12 years and hope to keep on for as long as I am able! 

BREATHE TRAILER: 

VIEW THE FILM HERE: 

https://www.docnyc.net/film/doc-nyc-u-life-in-the-big-apple/breathe/

The artist depicts Chekhov as he was in the early 1890’s, soon after he had purchased a small, dilapidated estate and moved there from Moscow with his family. In addition to serving as country doctor and public health official in Melikhovo, Chekhov at that time was composing many of the stories and plays that made him one of Russia’s most well-loved writers and a major influence on 20^th century literature. How was he able to pursue two such different and demanding careers? Several years earlier, at the height of Chekhov’s early literary success, his friend Alexi Suvorin had urged the young writer to give up medicine. Don’t spread yourself too thin, he said. You’ll never reach your potential unless you concentrate on writing. In response, Chekhov wrote, “You advise me not to chase after two hares at once and to forget about practicing medicine. Well, I don’t see what’s so impossible about chasing two hares at once… Medicine is my lawful wedded wife and literature my mistress. When one gets on my nerves, I spend the night with the other. This may be somewhat disorganized, but then again, it’s not boring, and anyway, neither loses anything by my duplicity.” (1) In this famous passage, the 28-year-old writer dances lightly over a fundamental truth of his life and identity. In fact, Chekhov’s career was not so much a matter of jumping from one bedroom to another, as was the case perhaps with the poets Wallace Stevens and T. S. Eliot, or the composer Charles Ives. Rather, Chekhov thrived on the effective, if not always seamless, integration of the arts of medicine and writing, which reinforced one another throughout his creative life. This essay explores that integration, and the manner in which Chekhov’s cold eye (objectivity) and warm heart (compassion) reveal themselves in his medical and literary lives. 

DOCTOR CHEKHOV  

“Medicine Is My Lawful Wife” 

When he graduated from the Moscow State University School of Medicine in June 1884, Chekhov was already earning his living as a professional writer. The grandson of serfs, Anton was the third of six children in a poor merchant family from Taganrog, a southern provincial town on the shore of Sea of Azov. His father had moved the family to Moscow after going bankrupt in 1877. By the time Anton entered medical school on a scholarship in 1879, the Chekhovs were living in squalor. His father had a dead-end job. His older brothers were alcoholics and generally unemployed. Anton soon discovered that he could ameliorate the situation by selling comic sketches to local magazines for eight kopecks per line. This was a type of moonlighting he loved. He wrote obsessively, often knocking off a story or two each night, after spending the day listening to lectures or working in the hospital. Chekhov ultimately published more than 200 pieces while a medical student, most of them under his preferred pseudonym, Antosha Chekhonte. 

Chekhov was a natural storyteller. Thus, it wasn’t surprising that the newly minted Doctor Chekhov continued to write, even after he opened his office and patients began to arrive. “Continued to write” is an understatement. Chekhov published 54 stories in 1885, 76 in 1886, and 57 in 1887. His work evolved from humorous sketches to longer, more serious stories for leading literary journals. In 1888 Chekhov won the prestigious Pushkin Prize and published “The Steppe,” his longest and most innovative story to date. Ivanov, his first full-length play, had a successful premiere in St. Petersburg in January 1889. By that time the young doctor had become one of the best known writers in Russia. 

Yet Chekhov always saw himself as a physician, even though in 1889 he did, in fact, retire from a normal paying practice; after that, he offered his medical services at no charge, even though the generous Chekhov often found himself financially strapped. He took care of the peasants near Melikhovo (as depicted in the painting), donated his services to the government as a district physician, and engaged regularly in public health initiatives. In less than five months in 1891, Chekhov reported seeing 453 patients at a district health center and making 576 house calls, in addition to his home practice. (2) Throughout his life, Chekhov also was heavily involved in grass roots activism, building schools for peasants, raising funds to help famine victims, and, later, near the end of his life, supporting the establishment of a sanitarium for tuberculosis victims at Yalta.  

“My Debt To Medicine” 

One of the best known of these public health efforts was his 1890 epidemiological survey of health and social conditions in the prison colonies on Sakhalin Island. Traveling by himself, Chekhov journeyed six weeks by train, steamboat, and horse-drawn carriage across Siberia to reach the 1000-km long Pacific island on which the Czarist government had recently established a notorious gulag. There, he embarked on a one-man, three-month survey of the population, tenaciously picking his way from settlement to settlement and from house to house, often by foot.  

Biographers have long tried to pinpoint his motivation for this perilous journey. During the year prior to the trip, Chekhov had undergone a crisis of confidence. In a letter to Suvorin, he opined, “I don’t love money enough for medicine, and I lack the necessary passion—and therefore talent—for literature. The fire in me burns with an even, lethargic flame; it never flares up or roars… I have very little passion. Add to that the following psychopathic trait: for two years now, seeing my works in print has for some reason given me no pleasure.” (3) He reported symptoms suggestive of clinical depression, perhaps precipitated by grief over the death of his brother Nicholas from tuberculosis. There was also a literary issue. The master of the short story had promised himself that he would create a Tolstoy-like novel that would confirm his status as a serious writer. But he was unable to do so.  

Undoubtedly a major factor for choosing Sakhalin was Chekhov’s desire to pay his debt to medicine. He had recently developed a scientific interest in penology and had read about the dismal conditions in the Siberian gulag. He saw an opportunity to influence this situation by obtaining accurate data on the health status of Sakhalin convicts. He had never completed the research thesis (the equivalent of a Ph.D.) that would make him eligible to be a medical specialist or professor. Hence, his notion of “my debt to medicine”—he would perform a survey, write his thesis, and become a teacher. 

Ultimately, Chekhov claimed to visit every settlement and survey every household on Sakhalin Island, using a 12-item data collection form. He said he completed over 10,000 of these forms in three months, a feat that (if true) qualifies Chekhov as the speediest shoe-leather epidemiologist of all time. After his return to European Russia, the author found it difficult to organize his data into a coherent study. While he had planned to write a strictly scientific monograph, his creative spirit struggled with the limitations of science. What about his personal experience? What about the interesting stories? After struggling for years, in 1895 Chekhov published The Island of Sakhalin, a curious (but engrossing) mixture of journal, geography, history, medicine, statistics, and travelogue. (4) Unfortunately, the faculty of the University of Moscow was unimpressed.  

“As I Grow Older, the Pulse of Life in Me Beats Faster” 

Picture the mature Chekhov—a middle-aged bachelor, longish face, rather neatly trimmed beard, a prince-nez clipped to the bridge of his nose. His household included his aging parents and his sister Masha, an unmarried schoolteacher who had become his confidant and secretary. His three surviving brothers looked to him for guidance and financial help. Anton was popular, witty, and generous. Among the guests at Melikhovo, there were frequently female admirers. Chekhov’s encounters with women were flirtatious and obviously enjoyable. He had teasing, sexually charged relationships with several women, but whether any of these liaisons are actually “affairs” is uncertain.  

The doctor in the painting already suffered from the tuberculosis from which he would die at the age of 44 years. In fact, he first coughed blood as a medical student. Yet, Chekhov dismissed that episode and each subsequent episode that occurred with disheartening regularity as “influenza” or “bronchitis,” steadfastly refusing to label himself consumptive. As a physician Chekhov must surely have understood the meaning of his symptoms. Was his denial simply a face to show others? Or was his denial so great that it made him unaware? The cat finally came out of the bag in early 1897. While dining at a restaurant in Moscow, Chekhov had a violent spell of hemoptysis that left him critically ill. For the first time, he sought medical treatment and entered the clinic run by Dr. Ostropov, one of his medical school professors. Chekhov’s chronic illness progressively worsened. At the insistence of his doctors, Chekhov left his beloved Melikhovo after 1898 and lived mostly at a new home in the sunny Black Sea resort of Yalta. 

It was also during these last years that the bachelor writer courted and married Olga Knipper, an actress with the Moscow Theater Arts Company. Even after their marriage in 1901, Olga remained at work in Moscow during much of the year, while the invalid Chekhov lived in Yalta, theirs being perhaps one of the earliest examples of the modern two-career commuter marriage. Chekhov found himself able to devote less and less of his waning energy to writing, especially since he refused to give up his social and philanthropic activities. Nonetheless, between 1898 and his death in 1904 Chekhov completed some of his greatest work, including several stories, two novellas (“Peasants” and “In the Ravine”), and his last plays, The Three Sisters (1900) and The Cherry Orchard (1903).  

COLD EYE, WARM HEART 

Chekhov’s Doctors 

Several characteristics of Chekhov’s work reveal the influence of medical training and practice. He used clinical knowledge to lend accuracy to his descriptions of disease and medical situations. This characteristic is perhaps most clearly seen in the characterization of mental disorders. For example, the title character in Ivanov is a subtle portrait of a man suffering from clinical depression, who eventually commits suicide. The young heiress in “A Doctor’s Visit” presents symptoms we would now label as generalized anxiety or panic disorder. The title character in Uncle Vanya appears to have a neurotic depression, a condition that meets today’s DSM 5 criteria for Persistent Depressive Disorder. In the peculiar story called “The Black Monk,” Chekhov describes a psychotic condition, presumably schizophrenia.  

Chekhov also drew from his medical experience in creating a multitude of physician characters. Doctors play significant roles in nearly 30 stories and in all of his major plays, except The Cherry Orchard. The author’s sensibility as a medical insider gives insight and poignancy to these characters, who range from committed altruists to lazy bureaucrats to burned out cases. Chekhov knew too much about the contemporary state of medical science to portray his doctors as curing many people. Thus, they often appear impotent. Yet, at their best Chekhov’s doctors convey the seamless fabric of tenderness (compassion) and steadiness (detachment) that lies at the heart of good medical practice. They also demonstrate courage, altruism, and self-effacement. For example, in “The Grasshopper” (1892) Dr. Dymov dies as a result of contracting diphtheria from a patient. Dr. Kirilov in “Enemies” (1887) demonstrates extraordinary devotion to duty by leaving his distraught wife and dead son in order to make an emergency house call.  

Perhaps Chekhov’s most textured portrait of a good physician appears in “A Doctor’s Visit” (1898). The protagonist, Korolyov, is a young doctor substituting for his boss, the professor of medicine. During the course of the story he moves from being a careful observer (detached concern) who ascertains that his young patient has nothing wrong but a “case of nerves,” to making an imaginative leap by which he connects more deeply with her. This empathic connection allows him to relieve some of her suffering by re-framing her illness. While he cannot solve her existential problems, his demonstration of solidarity leads her to trust him and to gain insight. Korolyov is like Chekhov himself. Dr. Pavel Archangelsky, who supervised Chekhov’s first job as a physician, captured the author’s ability to listen carefully when he later commented: “… he did everything with attention and a manifest love of what he was doing, especially toward the patients who passed through his hands. He listened quietly to them, never raising his voice, however tired he was and even if the patient was talking about things quite irrelevant to his illness.” (5)  

At the other end of the spectrum, some of Chekhov’s doctors are insensitive, incompetent, or impaired. Mayer, the callous medical student in “A Nervous Breakdown” (1889) is a disaster. Mayer can rattle off statistics on the number of whores in London and Moscow, but he is unable to “see” (empathize with) the suffering of the living-and-breathing whores he encounters. Shelestov in “Intrigues” (1883) and the public health doctor in “Darkness” (1887) are examples of self-centered physicians a little further along in their professional lives. The former is superficial and pompous; the latter is narrow-minded and detached.  

Chekhov’s most complete insensitive and acquisitive social climber is found in “Ionych” (1898). Dr. Startsev, when the reader first meets him, is a young physician setting up practice in a provincial town. After surviving an unrequited infatuation with the daughter of a wealthy townsman, Startsev devotes himself entirely to work. His practice prospers and he branches out into real estate. As he grows corpulent and wealthy, Startsev loses touch with his patients (and his own humanity): 

“Probably because his throat is covered with rolls of fat, his voice has changed; it has become thin and sharp. His temper has changed, too; he has become ill humored and irritable. When he sees his patients, he is usually out of temper; he impatiently taps the floor with his stick, and shouts in his disagreeable voice: ‘Be so good as to confine yourself to answering my questions! Don’t talk so much!’” (6) 

“Ionych” traces the progressive destruction of a medical practitioner who finds that medical affluence is more to his liking than the emotionally and physically difficult path of medical virtue.  

Some of Chekhov’s most interesting doctors are tortured by existential or spiritual conflict. Chekhov accurately depicted professional burnout, a syndrome characterized by depletion, detachment, depersonalization, denial, and depression. (7) Dr. Kirilov, who chooses to “go to the office” instead of mourning with his wife, may illustrate the relatively early phase of emotional detachment. Dr. Ovchinnikov in “An Awkward Business” (1888) demonstrates the more advanced symptom of depersonalization when he slugs his assistant in response to the man’s incompetence. The overworked Ovchinnikov reacts to his personal depletion by objectifying and dehumanizing his assistant, a response that compromises the medical care he is trying to protect. Chebutykin in The Three Sisters (1900) illustrates the extreme of alcoholism. Though still employed as a military physician, Chebutykin convincingly asserts that he has forgotten all the medicine he ever learned.   

Ragin in “Ward #6” (1892) and Nikolai Stepanovich in “A Dreary Story” (1889) are complex characters in whom depression and burnout are superimposed on a deep sense of existential failure. Like many of Chekhov’s characters, these physicians suffer from a lack of self-knowledge; they move through life relying on one form of self-deception or another. When they were younger, they committed themselves to noble ideals—Stepanovich to teaching and Ragin to practice in a provincial hospital. But in the long run they never “found” themselves. Professor Stepanovich yearns for a unifying moral principle that would knit together the fragments of his life. Dr. Ragin experiences his failure as emotional numbness. He yearns to suffer, assuming that if he experienced pain, he would be freed from his inability to feel. Thus, the academic physician pines for salvation in the cognitive sphere; the practitioner yearns for emotional redemption. In each case the focus remains inward, rather than turning outward to others, in whom salvation might actually be found.  

Medical Sensibility 

Medical attitudes and methodology play a larger role in Chekhov’s work than does medical knowledge. He believed that his duty as a writer was to present his observations clearly and accurately; in other words, to lay out the data in an objective fashion and allow readers to reach their own conclusions, rather than providing an author’s interpretation. He wrote, “The artist should not be a judge of his characters and what they say, but only an objective observer.” (8) 

This objective attitude put him in conflict with most other Russian writers of the time. It was a major source of conflict with Tolstoy, who was widely revered at the time as a living saint. The two men enjoyed a close personal bond but approached writing with radically different philosophies. After his mid-life religious conversion, Tolstoy viewed literature as a way to communicate his moral vision. He preached the gospel of a radical Christianity, in which all men work together to achieve economic and social equality. However, he rejected the concept of material progress and was particularly skeptical of medicine and doctors. Chekhov, on the other hand, strove to be objective, to present people as they are and the world as it is. His medical training taught him to be a careful observer; his medical attitude made him leery of judging others.  

Other Russian writers and intellectuals spoke out against the czarist government’s repressive social institutions. While this protest was disguised in various ways in order to satisfy the state censors, late 19^th century Russians (like their 20^th century counterparts) learned to speak and understand a subtle code of insurrection. The intellectuals addressed “big issues”—democracy, education, social revolution. They wrote articles, organized meetings, and gave speeches. Here again, Chekhov found himself on a different wavelength. He rarely engaged in theoretical discussion and did not advocate radical social change. Rather, he preferred a pragmatic, case-based approach. His goals were relatively limited, but achievable. Treat the sick patient. Document and publicize the abysmal condition of prisoners. Contain the cholera epidemic. Provide financial assistance to keep farmers afloat during the famine. Raise money for a new school. On and on, but always specific and personal.  

In “About Love” (1898), the narrator speculates on the essence of love. Are there universal characteristics that identify love wherever it occurs? “What seems to fit one instance doesn’t fit a dozen others,” the narrator concludes. “It’s best to interpret each instance separately in my view, without trying to generalize. We must isolate each individual case, as doctors say.” (9) Indeed, Chekhov’s stories and plays rigorously follow this dictum. While many of his Russian contemporaries used fiction to advance moral or social theories, Dr. Chekhov focused on the complexities of human interaction. In Chekhov’s world, biology and circumstance constrain freedom. People often do not listen. Acts performed with good intentions frequently result in hurtful outcomes. And yet occasionally and in unexpected places, one finds a glimmer of love, courage, spirituality, or healing. “Never generalize,” Chekhov tells his readers. “Never theorize. Pay attention to the particulars. Focus on the concrete.” In this respect, the 19^th century physician-storyteller presages the 20^th century physician-poet, William Carlos Williams, who coined the aphorism, “No ideas but in things.”  

In the long run, Chekhov’s objectivity and aversion to theory played a major role in the development of modern literature, as 20^th century writers followed Chekhov in attempting to describe the world of human character and relationship objectively, and allowing that world to speak for itself. To the extent that Chekhov’s “lawful wedded wife” contributed to his sensitivity, skills, and attitudes, perhaps medical education and practice played an unanticipated role in the history of literature, his delightful “mistress.” 

Adapted in part from Coulehan J. (Ed.) Chekhov’s Doctors, Kent State University Press,  2003

Sir Luke Fildes’ “The Doctor,” is in the Tate: File:The Doctor Luke Fildes crop.jpg – Wikimedia Commons 

Portrait of Chekhov: File: Chekhov 1898 by Osip Braz.jpg – Wikimedia Commons 

REFERENCES 
1, Chekhov A. The Selected Letters of Anton Chekhov, translated by Sidonie Lederer, New York, The Ecco Press, 1984, p.  
2, Coope J. Doctor Chekhov. A Study in Literature and Medicine, Chale, Isle of Wight, Cross Publishing, 1997, p.  
3, Chekhov A. The Selected Letters of Anton Chekhov, translated by Sidonie Lederer, New York, The Ecco Press, 1984, p. 81. 
4, Chekhov A. A Journey to Sakhalin, translated by Brian Reeve, Cambridge, Ian Faulkner Publishing, 1993.  
5, Coope J. Doctor Chekhov. A Study in Literature and Medicine, Chale, Isle of Wight, Cross Publishing, 1997, p. 27. 
6, Chekhov A. Ionych. In: The Tales of Chekhov. Volume 3, translated by Constance Garnett, New York, The Ecco Press, 1972, p. 91. 
7, Coulehan JL. Being a Physician. In: Mengel MB, Holleman WL (Eds.) Fundamentals of Clinical Practice. A Textbook on the Patient, Doctor, and Society, New York, Plenum Medical Books Company, 1997, pp. 73-101. 
8, Chekhov A. The Selected Letters of Anton Chekhov, translated by Sidonie Lederer, New York, The Ecco Press, 1984, p. 54. 
9, Chekhov A. About love. In: The Tales of Chekhov. Volume 5, translated by Constance Garnett, New York, The Ecco Press, 1972, p. 290.

Reviews of Chekhov’s Stories

Cold Eye, Warm Heart: Medicine and Anton Chekhov  

Aug 6, 2025 6286

An Awkward Business by Anton Chekhov 

Jun 11, 2025 1431

The Grasshopper by Anton Chekhov

May 11, 2025 1252

Ionych by Anton Chekhov 

Mar 11, 2025 2065

A Doctor’s Visit  by Anton Chekhov 

Mar 11, 2025 1730

Ward No. 6 by Anton Chekhov

Mar 11, 2025 3245

A Nervous Breakdown by Anton Chekhov 

Feb 11, 2025 1477

Enemies by Anton Chekhov

Jan 11, 2025 1566

Painting an Ideal: Luke Fildes’ The Doctor with Hannah Darvin

Dec 28, 2024 1228