Fear and Loathing in Ward No 6

“In the hospital yard there stands a small lodge surrounded by a perfect forest of burdocks, nettles, and wild hemp. Its roof is rusty, the chimney is tumbling down, the steps at the front-door are rotting away and overgrown with grass, and there are only traces left of the stucco. The front of the lodge faces the hospital; at the back it looks out into the open country, from which it is separated by the grey hospital fence with nails on it. These nails, with their points upwards, and the fence, and the lodge itself, have that peculiar, desolate, God-forsaken look which is only found in our hospital and prison buildings.”

Ward No. 6., a story by Anton Chekov, opens with this description of an outpost hospital 150 miles from a train station. This provincial hospital with a lunatic asylum annex, worlds apart from “sane” society, is the setting for the reader to examine the disturbing dehumanization taking place in Russia and, perhaps, everywhere else.

Chekhov wrote the story with reformist concerns after he visited a far east penal colony of the Russian Empire – Sakhalin Island.[1] Chekhov’s aim was to survey the prisoners and publicize their conditions. His compiled notes became the book Sakhalin Island.

Chekov, as guide, invites us onto the premises of the provincial hospital and into its mental ward. He would have us understand suffering in the presence of it and not in the abstract. So, he has us listen in on conversations between Dr. Andrei Yefimich Ragin, who is in charge of the hospital and asylum, and inmate Ivan Dmitrich Gromov.

With a phrase similar to Dante’s opening of the Divine Comedy – “abandon all hope, ye who enter here” – Chekhov forewarns us about our entry into Ward No. 6: “If you are not afraid of being stung by nettles, let us go along the narrow path.”

As we follow our tour guide, he shows us the hospital’s neglected and unsanitary conditions and then introduces us to the brutish Nikita, who I consider one of the “nettles”.

“The porter, Nikita, an old soldier wearing rusty good-conduct stripes, is always lying on the litter with a pipe between his teeth. He has a grim, surly, battered-looking face, overhanging eyebrows which give him the expression of a sheep-dog of the steppes, and a red nose; he is short and looks thin and scraggy, but he is of imposing deportment and his fists are vigorous. He belongs to the class of simple-hearted, practical, and dull-witted people, prompt in carrying out orders, who like discipline better than anything in the world, and so are convinced that it is their duty to beat people. He showers blows on the face, on the chest, on the back, on whatever comes first, and is convinced that there would be no order in the place if he did not.”

After walking past the cluttered pitiful state of the entry-way conditions and the fearful porter, we enter the annex.

Here, the “walls are painted dirty blue, the ceiling is as sooty as in a hut without out a chimney . . .The wooden floor is gray and full of splinters.  There is a stench of sour cabbage, smoldering wicks, bugs, and ammonia, and for the first minute this stench gives you the impression of having walked into a menagerie.

“The beds in the room are bolted to the floor. Sitting and lying on them are men in blue hospital dressing gowns, wearing nightcaps in the old style. These are the lunatics.

There are five of them in all.”

Chekhov describes the inmates and then begins to focus on the two protagonists, inmate Ivan Dmitrich Gromov and doctor Andrei Yefimich Ragin. We learn about both from their dialog. As we listen in, we soon begin to wonder who the patient is and who is the doctor.

Early in life Ivan Dmitrich Gromov was severely flogged by his father. His mental state became more unstable with personal misfortunes. Later in life he sees convicts being led away by armed guards. This was not an uncommon sight for Gromov to witness. But this time he reacts with pity and unease and transference. He begins to conceptualize that like the convicts, it is also his lot in life to be clamped in chains and punished for some crime. This inordinate thinking, a persecution complex that becomes a paralyzing fear of some random moment someone will come down on him for something, lands Gromov in Ward No. 6. He tells Dr. Ragin that he has “persecution mania.”

Though he’s an inmate because he’s out of touch with reality, Gromov is very much in touch with the mental anguish caused by his fixation and the physical pain delivered by the blows of Nikita. Ward No. 6 reinforces Gromov’s cycle of fear and pity.

Dr. Andrei Yefimich Ragin, on the other hand, is not in touch with the human condition. Passive and cynical, he is unable to bring reforms to the hospital.

In conversations with Gromov, Ragin justifies his indifference to others’ plight by suggesting that everything is subject to chance. For instance, he posits that there is no difference between wearing a doctor’s smock and an inmate’s smock.

To further justify his coolness to the human condition he references Ecclesiastes – “it is all futile, senseless” – and quotes Marcus Aurelius: “Pain is just the idea of pain: make an effort of will to change that idea, reject it, cease to complain, and the pain will disappear.” The inner self should dictate one’s experience according to Ragin.[2]

The doctor’s inner self has him ignoring the unsanitary and detrimental conditions of Ward No. 6 and the plight of his patients. Dr. Ragin “knows such surroundings are torture to feverish, consumptive, and impressionable patients, but what can be done?” His stoic outlook of mind over matter is, in practice, one of heartless neglect toward others.

He increases suffering, instead of relieving it, by remaining aloof and disconnected from it. He has intellectualized reality to justify his inaction and seeks further intellectualization to relieve him of his post’s boredom and purposelessness.

Adding to the doctor’s disinterest is what our guide tells us: “probably in no other place is life so monotonous as in this annex.” As one day is no different than another in this outpost hospital, Dr. Ragin becomes disenchanted with his doctor routine.

When he first came to the hospital, Dr. Ragin “worked very diligently. He saw patients every morning till dinnertime, performed operations, and even practiced obstetrics. . ..  But in the course of time the work unmistakably wearied him by its monotony and obvious uselessness.”

The doctor extrapolates from his daily routine and reasons “why interfere with people dying if death is the normal and prescribed end for everyone?” and “If the aim of medicine is to utilize drugs to alleviate suffering, the question necessarily arises: why alleviate it?” With similar thoughts, he reasons away the need for himself to be involved in the lives of suffering people. Why should anyone be spared pain when “their lives have nothing of importance in them and would be entirely empty, like the life of an amoeba, were it not for suffering?

“Oppressed by such reflections, Andrey Yefimich let things go and gave up going to the hospital every day.”

To avoid the messy, tedious, and nonsensical reality around him, Dr. Ragin leaves work early and goes home to his books and beer. He withdraws from the physical world to seek mental stimulation. As he reads he is wowed by recent medical discoveries and yet makes not one application to his own hospital. He blames society for the mess he has to deal with.

Evenings consist of conversations with his postmaster friend Mikhail, the only one in town who doesn’t bore the doctor. (Is Ragin more Epicurean in practice than Stoic?)

This routine changes when one day Dr. Ragin follows an inmate, the Jew Moiseika, returning to the annex from his daily wandering in the town. The doctor notices that Moiseika is walking around with bare feet in the winter. Inside, he tells Nikita to give Moiseika some boots for the cold weather. Dr. Ragin, we learn, is not unaware of what’s around him.

From his bed Gromov hears the doctor’s voice, jumps up and reacts with loud vitriol at his presence. The doctor goes in to see who is making the fuss about him. After Gromov calms down, the two begin a dialog that Dr. Ragin finds pleasurable: “What an agreeable young man!” The doctor, breaking with routine, visits Gromov again the next day.

The doctor encounters Gromov lying in bed holding his head in terrible pain. Gromov is suffering with a splitting headache. He reasoned over and over again since the day before that Dr. Ragin was a “spy or doctor who has been charged to test me – it’s all the same -.” Gromov’s persecution mania was triggered.

Dr. Ragin responds, reasoning that if true and Gromov is arrested and sent to prison then he is no worse off being right where he is. This response frees Gromov up a bit and the two have a bit of relaxed conversation. Gromov wishes to be in a better place – outside in “the country somewhere” and “to have a decent doctor to cure one’s headache.”

“It’s so long since I have lived like a human being. It’s vile here. Insufferably vile!”

The doctor responds, not with an antidote for Ivan’s headache, not with a ride in the country, but with a philosophical take on how to think about things – with simple equivalency.

“There’s no difference between a warm and comfortable study and this ward” and “Peace and contentment do not lie outside a man, but within him.”

Gromov questions this. The doctor continues.

“The ordinary man expects the good and the bad from external things – from an open carriage and a study – but a thinking man derives them from within himself.”

Gromov rejects the doctor’s philosophical reasoning. The doctor responds, telling Gromov that “One must strive for the comprehension of life, and therein lies true happiness.”

Gromov understands nothing of what the doctor has been saying and inferring: Comprehension? External, internal? Life is just a mental exercise, a thought experiment, detached from the tragic dimension of human existence? Gromov gets up, looks angrily at the doctor and speaks:

“I only know that God has created me of warm blood and nerves, yes, indeed! If organic tissue is capable of life it must react to every irritant. And I do react! I respond to pain with tears and outcries, to baseness with indignation, to filth with loathing. To my mind, that is precisely what is called life.  . . . How is it that you don’t know that?”

Gromov continues, commenting perceptively about the Stoics. He then asks why Dr. Ragin why he preaches Stoicism. “Are you a sage? A philosopher?” The doctor responds “No …. but everyone ought to preach it because it is reasonable.”

Gromov, the inmate, then wants to know how the doctor considers himself to be “competent to judge comprehension and contempt for suffering”.

“Have you ever suffered? Have you any idea of what suffering is? Allow me to ask you, were you ever thrashed as a child?”

“No, responds the doctor, “my parents had an aversion to corporal punishment?”

Gromov tells the doctor that his own father, “a harsh, hemorrhoidal government clerk with along nose and a yellow neck” flogged him cruelly. Sizing the doctor up, Gromov then proceeds with his analysis of the doctor, excoriating his competency to understand anything about Gromov’s life or life itself.

“No one has laid a finger on you all your life, no one has terrorized you nor beaten you; you are as strong as an ox. . .. You are by nature a lazy, flaccid man, and so you have tried to arrange your life in such a way that nothing should disturb you or force you to budge.”

I’ll stop here and leave you with Gromov’s cri de coeur and Dr. Ragin’s inability to come to terms with suffering. Even when the doctor does act to relieve suffering, he thinks that he will be paid back for his trouble. He lends his postmaster friend money after his friend suffers gambling loses. But the doctor is never repaid and soon becomes destitute. It appears from all that happens to the doctor as the story unfolds, that the doctor’s friends and associates also hold to “It’s all the same” thinking.

This story is rich with insight and worth a read. And though one may not be interested in reading a story in a Russian setting, consider that cultures change but human nature doesn’t change much from place to place or age to age.

“It’s all the same!”, first spoken by Gromov when he encounters Dr. Ragin (“a spy or a doctor”) is oft repeated and inferred by Dr. Ragin as he explains his philosophy to Gromov. You’ll have to read the story to see how the doctor’s “It’s all the same” philosophy works out. He holds on to it to the end of the story.

““Ward Six” is affective and effective largely because Chekhov makes proper, judicious, and artistic use of the very faculty that is impaired in his two heroes, Gromov and Ragin, the faculty for contemplating similarities. Their respective disorders, which are two extremes of the same continuum, prevent them from experiencing fear and pity in a healthy, moderate, cathartic fashion.”[3]

As you read Ward No. 6, ask yourself these questions:

Is “society” at fault and therefore responsible for the ills and disorder of society or are individuals responsible?

If one assigns “society” as the cause for “systemic” failures, is the individual therefore absolved of any personal responsibility?

Is detachment from reality a sign of mental illness?

Do you spend your time in the laboratory of thought and have never played baseball or wrestled with another human being?

Does lying to oneself promote mental health?

Is it healthy to be being disconnected from physical reality via drugs or the TV and the internet – supposed mental stimulants that will lessen our boredom?

“It’s all the same!”:  Is that a motto for your life? How has that worked out for you?

If we say chance or fate determines things, do we give up believing we can make a difference?

Do false equivalencies, such as occur in Ward No. 6 and that also operate in our culture, lead to mental illness?

A momentary transposition of one’s reality into another through imagination is healthy.  Day dreaming is healthy. But what about the permeant transpositions into unreality that is occurring around us today?

Have you ever asked God to heal your imagination?

(As mentioned before, Chekhov is my favorite writer. His stories (and plays) show rather than tell. Chekhov doesn’t moralize or preach. As with Ward No. 6, he lets readers see and hear for themselves and make their own judgements. I appreciate this way of writing. For one thing, I am not a fan of preaching. I had my fill growing up. I attended churches where preaching, and not the Eucharist, is the pinnacle of the service. I’ve moved on to an Anglican church.)

[1] Chekhov spent three months at Sakhalin Island interviewing thousands of convicts and settlers under the ruse of taking a census. For more details of his trip see Anton Chekhov and the Sakhalin Penal Colony – Hektoen International (hekint.org).

[2] When Chekhov wrote Ward No. 6, he was reading Marcus Aurelius’ Meditations. A couple of quotes from that journal apply to Dr. Ragin’s disposition: “Our life is what our thoughts make it.”; “You have power over your mind – not outside events. Realize this, and you will find strength.”

[3] Liza Knapp, “The Suffering of Others: Fear and Pity in “Ward Six,” in Anton Chekhov’s Selected Stories, ed. Cathy Popkin (W.W. Norton & Company, Inc., 2014), 629

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Audio: Ward No. 6 : Anton Chekhov : Free Download, Borrow, and Streaming : Internet Archive

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“We need everyone who suffers to be a victim because only thus can we maintain our pretense to universal understanding and experience the warm glow of our own compassion, so akin to the warmth that a strong, stiff drink imparts in the cold.”

“Psychology is not a key to self-understanding, but a cultural barrier to such understanding as we can achieve…” from the Preface of Admirable Evasions, How Psychology Undermines Morality by Theodore Dalrymple, 2015.

Theodore Dalyrymple is a pen name used by retired prison psychiatrist Dr. Anthony Daniels.

Admirable Evasions: How Psychology Undermines Morality by Theodore Dalrymple | Goodreads

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Dr. Ragin – “superfluous man”

“The name ‘superfluous man’ refers to an important and recurrent character type in 19th c. Russian literature. It denotes an idealistic but inactive hero who is aware of and sensitive to moral and social problems but who does not take action; in part because of personal weakness and lassitude, in part because of social and political restraints to freedom of action.”

A short note on the term ‘superfluous man’ and its examples – Literary Ocean

– “usually an aristocrat, intelligent, well-educated, and informed by idealism and goodwill but incapable, for reasons as complex as Hamlet’s, of engaging in effective action. Although he is aware of the stupidity and injustice surrounding him, he remains a bystander.”

Superfluous man | literature | Britannica

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World Economic Forum’s Ward No. 6:

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Informed Dissent:

God help us . . .

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Call to Action>>>>

Sign The Petition To Investigate The CDC! (standforhealthfreedom.com)

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