How did Michail Bulgakov contribute to the Russian history of medicine?
The history of medicine in Russia has seen practical developments over the years. It shares conceptual traits, narratives and methodological conventions with the other eastern European countries (Bernstein et al 9). The significant contributions of Michail Bulgakov on the Russian history of medicine bridge the major revolutions over the centuries and the general impact on the medical history and profession. Prior to the aspect of the revolution, Russia was backward in terms of medical provision, especially for the majority of the people during World War I (Bernstein et al 13). Over the years, vast advance has been established with public health and sanitation becoming perfect through the contribution of professional medical personnel to the present day. With the establishment of new economic policy and the suppression of the Russian war communism, medicine improved significantly with hospitals and medical schools improving slowly (Bernstein et al 13). For many years now, the quality of medical care has advanced tremendously and medical information and awareness has heightened and is provided to the Russians in masses.
During the time when Bulgakov practiced medicine as a profession, Soviet Russia had one of the socialist health care models with an integrated, centralized and hierarchically organized system with the government health care to the citizens. Health personnel were mostly state employees, especially during the world war (Bernstein et al 26). The control of the communicable diseases was given priority over the non-communicable ones. The Soviet system had highly emphasized hospital and specialists care. Through the integrated model, significant success was achieved, particularly in dealing with contagious illnesses, such as, tuberculosis, typhus and typhoid fever. However, the model effectiveness deteriorated following the increased underinvestment. Health outcomes and medical care in the Soviet Union was, on balance with the western standards (Bernstein et al 29).
Despite the doubling number of doctors per capita, especially during the 1900s, lack of money going into health was one of the obvious cases. Russia experienced significant changes in medicine after the World War I (Bernstein et al 30). This includes the adoption of a blended model of health care inclusive of private provision and financing relating to the financing and provision of the state. The government had introduced policies confirming that the citizens had the right to health care and medical assistance. The continued efforts of the likes of Bulgakov contributed to the promotion of such Medicare assistance efficiency and patient choice. Government efforts provided for the systematic and professional extension of medical practitioners and treatment facilities to most of the provinces (Bernstein et al 32).
Russian history of medicine
Health policy subjected matters of health of the non-serf population to the hands of the province health commissions (Bernstein et al 7). Further slight changes over the years introduced manifested itself through numerical augmentation of the people charged with the responsibility in public health such as the appointment of Bulgakov as a provincial physician in Smolensk province and his later return to Kiev to open a private practice at Andreyevsky Descent. During the time, public health was also in the hands of bureaucratic institutions such as medical boards, committees of public health, departments of state properties and appendages, and medical counsel (Bernstein et al 17). Most of the officials heading such departments produced lots of documents without the prior knowledge about the needs of medicine.
Although the growing vital amount of medical faculties of the Soviet Union’s institutions, as well as the continued improvement of medical science, contributed significantly to both the quantity and quality of Russian physicians. Bulgakov is a primary example, as one of the professional personnel admitted in Kiev University at the Medical Faculty and later finished with a special commendation that secured him a significant position as one of the key physicians based at a Kiev Military Hospital. This hardly had an influence on the general situation of health care within the Russian Empire. The existing medical system in the Soviet Union before and after the First World War brought significant changes to the medical institution’s education and provision of health care (Bernstein et al 57).
During the early 1900s, the extant situation in the medical profession was that there were a significant number of physicians who were unable to secure job opportunities or faced difficulties while serving. Similar cases led to Bulgakov volunteering as a medical doctor with the Red Cross during the First World War. A very small number of the Soviet Union medical institutions, cases of non-existent conditions majorly for the private practice in larger cities and provinces led to an artificial surplus of physicians. Such situations facilitated the establishment of poor financial compensations which was a sensitive factor for most of the then young practitioners such as Bulgakov. Following an outbreak of World War I, there were an increased number of vacancies in medicine practice. This was even for most of the graduates who had enjoyed the support of the Soviet Union while still studying at the universities (Bernstein et al 69).
Although most of the Soviet Union state authorities, tried to facilitate changes to the situation through ordering the early retirement of physicians and giving some of them opportunities to practice private medicine after reaching the age of 60 years. This had relations with the positions most of them held. The successive Soviet Union governments managed to draft Bulgakov as a young and professional doctor into their service. It should be considered that the case of “surplus” of the physicians, which appeared prior to the world war period, saw one physician serving approximately 30,000 inhabitants (Bernstein et al 117). In the Voronezh province, the ratio had a significant variation with 1:38,000 while in the Samara province as 1:53,000. In the Orenburg province, the ratio was higher as much as 1:70,000.
History statistics indicate the number of medical facilities in the Soviet Union and western region generally which were at the disposal of the State before cases of reorganization. This is especially when its medical functions were passed to the Zemstvos system. It was especially during the time when the state Ministry constituted the main body charged with the responsibility for the provision of medical assistance to the non-serf population of the Russian Empire (Bernstein et al 119). According to state based statistics, one hospital was meant to serve 721,499 inhabitants, especially after the first world war. One medical practitioner such as a physician or feldsher was assigned to serve approximately 101,516 inhabitants while one smallpox vaccinator charged with the responsibility of serving 5,790 of the people (Bernstein et al 119).
Altogether, in the Soviet Union during the time of Michail Bulgakov as one of the key physicians at a Kiev Military Hospital, there were approximately 269 out-patient clinics, 170 physicians who were employed at the district and province levels and 1200 rural kits, 1278 feldshers, 51 veterinarians and 3,276 smallpox vaccinators hired through the Ministry (Bernstein et al 126). Therefore, it is conclusive through such statistics that a qualified medical assistance might have been ensured is available for the significant part of the Soviet Union population. It is also worth mentioning that, during that time, even the regular medical procedures rooted in Russia were relatively dangerous for the health of the people due to cases of rather bad performance (Bernstein et al 172). As a result of careful organization of smallpox vaccinations in the west, the morbidity of smallpox underwent a sharp decrease. However, in Russia, the cases of smallpox vaccinations inoculated syphilis situations and other diseases.
Naturally, most of the people had to run away from cases of ignorant vaccinations since they failed to keep elementary hygienic rules throughout such simple task. Therefore, on the one hand, the Russian Empire population, except for minor parts living in the metropolitan cities with the ability to secure the use of private practitioners, significantly suffered the lack of medical services. In addition, most of the physicians themselves and the newly graduated ones faced cases of serious difficulties, especially in securing places of employment due to the faulty organizations of the Soviet Union public health system (Bernstein et al 172). Such problems, including the rest, no less significant, had to be subjected to permanent solutions, at least through legislative means by the successive governments who managed to draft medical practitioners as young and professional doctors such as Michail Bulgakov into their service.
Mikhail Bulgakov was one of the Soviet most post-revolutionary Russia satirists and successful playwright and writer during the 20th century first half. Bulgakov was widely recognized for one of his best masterpieces, “The Master and Margarita” and has been considered a significant contribution of the 2oth century (Milne 134). Most of his fiction sketches and stories, including his other works present significant adjustments of the intellectual class based on Russian class to life in reflection to the communist rule. Through the influence of Nikolai Gogol, Michail Bulgakov combined realism, fantasy and satire in ridiculing the modern progressive society especially the Soviet medical system.
Bulgakov was born in Kiev in the Russian Empire on 15 May 1891 among seven children. He was the oldest among three brothers born to Afanasi Bulgakov, who was an assistant professor at Kiev Theological Academy and a former teacher, Varvara Mikhailovna. Both of Bulgakov grandfathers were member of the Russian Orthodox Church and also clergymen (Milne 134). Afanasi Bulgakov was born to a priest father in Bryansk Oblust in Russia and later moved to study at the Kiev academy while Varvara Mikhailovna in Karachev. Mutual love, friendship and respect are some of the significant elements that reigned in the large family of Bulgakov and happy home. Since childhood, Bulgakov had an interest in theater and managed to write comedies, of which his sisters and brother acted out (Milne 134).
During 1901, Bulgakov decided to become part of the Kiev Gymnasium from which he developed a passion for the European and Russian literature by favorite authors, including Dickens, Dostoyevsky, and Pushkin, Gogol and Saltykov-Shchedrin opera and theatre. The gymnasium teachers exerted pressure and significant influence, especially on the relative formation of Bulgakov literary taste. Following his father’s death in 1907, his mother who was extraordinarily diligent and well-educated person assumed the sole responsibility in ensuring that Bulgakov received his education. Upon graduation in 1909 from the gymnasium, Bulgakov was admitted in Kiev University at the Medical Faculty (Milne 134). He later finished with a special commendation and then took a significant position as one of the key physicians at a Kiev based Military Hospital.
Bulgakov was married in 1903 to Tatiana Lappa and following an outbreak of World War I; he volunteered as a medical doctor with the Red Cross (Milne 134). Bulgakov was later assigned to the front as a medical practitioner where he had a bad injury on two occasions. His suffering from the wounds he endured had deleterious effects which lasted for a very long time. In order to suppress the chronic pain he was experiencing in the abdomen, Bulgakov had a self injection with morphine and over the following years, he grew addicted to the medication. During 1918, Bulgakov abandoned the use of morphine and dreaded never to use it again. He later released a book, “Morphine” in 1926 giving an account of his prying moments (Milne 135).
Bulgakov graduated in 1916 from the Kiev University, Medical Department and served as a one of the surgeons at the Chemovtsy hospital (Milne 135). This later led to his appointment as a provincial physician in Smolensk province. “A Country Doctor’s Notebook” reflects Bulgakov’s life during such times (Milne 135). He was later in 1917 moved to a hospital in Vyanza and in February 1918, Bulgakov returned to Kiev to open a private practice at Andreyevsky Descent. Here, Bulgakov lived through the civil war and witness major coups (Milne 135). The successive governments managed to draft Bulgakov as a young and professional doctor into their service. Two of his brothers also served in the army, especially against the Bolsheviks.
In 1919 February, Bulgakov was mobilized by the Ukranian People’s Party as an army physician and was later referred to the Northern Caucasus. Bulgakov becomes ill while serving in the Northern Caucasus when he suffered Typhus but barely survived. While still at the Caucasus, he changed his mind about medicine as a profession and started working as a part time writer and journalist. He was later invited by the German and French governments to work as a doctor, but was denied the opportunity to leave Russia and honor the call as a result of the typhus (Milne 135). It was the last time Bulgakov saw his family since the Soviets up rise and the Civil war; the majority of his relatives had to migrate to Paris.
Following the illness that Bulgakov suffered, he was forced to leave his career as a professional doctor and major in writing. In his autobiography, Bulgakov recalled about his writing and where he started. He explained that, during 1919 when travelling by train one night, he managed to write a short story and later took it to a newspaper publisher upon alighting in the next town. The short story was published, though Bulgakov made his first fiction efforts while in Kiev. This is when he decided to pursue the love for literature in 1919. He produced his first book; “Future Perspectives” which was written and published in 1919 was a success. Bulgakov later moved to Vladikavkaz in December 1919. During this time, he was already a play writer and wrote his first two successful plays, “The Turbin Brothers” and “Self Defense” which were produced with great success in the city theatre (Milne 137).
After his travels through the Caucasus, he later headed for Moscow with the intentions of remaining there for a long time to practice his career as a writer. Bulgakov found it difficult to secure employment in the capital, but managed to secure an appointment as a secretary in Glavpolitprosyet literary section. This was a republic central committee for political education. Later on 1921 September, Bulgakov in the company of his wife settled in Partriach’s pond, Bolshaya Sadovaya Street close to Mayakovskaya. In order to survive, Bulgakov started as a feuilletons writer and correspondence for Krasnaia Panorama and Gudok newspapers which were based in Berlin (Milne 137). In 1924, he wrote “The Fatal Eggs” for Almanac Nedra and later in 1925, “Heart of a Dog.” his works combined bitter elements and satire of science fiction, which reflected on the misuse of most of his discoveries and fate of the rest of the scientists.
During the time, the primary features that Bulgakov involved in his satire including grotesque situations, the skillful blending of realistic and relevant elements and concerns reflecting on significant ethical issues were already in shape. Such features later underwent developments through the works of Bulgakov especially through his most successful novels. He successfully created various plays from 1922 to 1926. This includes “Zoyka’s Apartment.” none of the plays were produced. One of his masterpieces, “The Run” which treated horrors of the fratricidal was banned personally by Joseph Stalin. This follows the department of repertoire decision that the work glorified white generals and the aspect of emigration. Bulgakov divorced his wife in 1925 and later married Belozerskaya Lyubov (Milne 138).
Stalin personally came to the rescue of Bulgakov defending him when some of the directors of the Moscow theatre severely criticized his work. This was with the idea that most of the work he produced were of quality. Despite being highly favored under Joseph Stalin soviet regime, Bulgakov faced restrictions from visiting or immigrating to the west. He was never in support of the regime and at times mocked it through a significant number of ways, such as his works which were consigned to a desk drawer for many years (Milne 142). This is since such writings contained politically sensitive matters to publish. Bulgakov later wrote a letter requesting for permission from Stalin to migrate that saw him receiving a personal phone call to deny him the request.
Some of the works of Bulgakov, which were banned through the influence of Stalin include “Don Quixote,” “Last Days” and “Ivan Vasilievich.” another significant setback that he faced was during the premiere of “The Cabal of Hypocrites” which received disappointing reviews as a play in Pravda and was withdrawn immediately from the theatre. 1928 saw the staging of “The Purple Island” and “Zoyka’s Apartment” in Moscow as comedies. Both plays were accepted with enthusiasm by the public, but received bad reviews from critics (Bulgakov 34). The career of Bulgakov as a writer faced a standstill as the government censorship created barriers for the publication of most of his work including the staging of some of his plays.
The letter that Bulgakov wrote on July 1929 was through the effort to reach out to Joseph Stalin for the government to grant him the permission to move since he felt the Soviet Unions had no more need for him as one of the literature and play writers. He claimed in his autobiography that writing a letter to Stalin was out of mental anguish and desperation, but he never had the intentions of posting it (Bulgakov 34). Since he replied the direct phone call from Stalin that he never wished to live away from his homeland, Bulgakov was given the opportunity to continue with his work at the Art Theatre. He later rejoined the theatre on May 1930 as one of the stage director assistants. Bulgakov later adapted “Dead Souls” by Golgol for the stage.
Bulgakov’s third marriage was to Yelena Shilovskaya in 1932 . She was the inspiration for the Margarita characters in his most successful and famous novel. He continued with his work on the novel, “The Master and Margarita” during the last years of his life (Milne 142). He also wrote critical works, plays and stories and continued to produce several dramatizations and translations of novels. The majority of his works was never published by others given bad reviews by his critics. His work which involved ridiculing of the Soviet Union was never published for several decades. The authorities’ refusal to let him continue with his work in the theatre in order to fulfill his desire in seeing his family who lived abroad pushed him to use drastic measures. Despite his continued impressive work, most of the projects he started while at the theatre faced restrictions making him unhappy and strained (Milne 142).
Bulgakov was known during his life following a significant contribution in medicine as a government and private practitioner and in writing plays that he later contributed to the Moscow Art Theatre. One of his dramatizations, “The Cabal of Hypocrites” that entailed a Moliere’s life is still active in the Moscow art Theatre (Milne 182). Even following the banning of most of his plays from the theatres, he still managed to write grotesquely entertaining comedy in the 1930s. Bulgakov also produced several plays related to the life and young years of Stalin, which contributed significantly to saving of his life during the years of terror when most of the writers who were not supporting his leadership were purged.
Bulgakov managed to write prose during the early 1920s upon publishing an autobiographical works, including “The White Guard” and a collection of short stories named “Notes of a Country Doctor” based on his experience during the post-revolutionary Ukraine (Milne 182). During the mid-1920s, Bulgakov developed an admiration for H.G Wells work and managed to write several stories involving science fiction elements such as “The Fatal Eggs in 1924 and “The Heart of a Dog” in 1925.
“Heart of a Dog” and “Fatal Eggs”
These are some of the successful masterpiece of Bulgakov as a writer. “Fatal Eggs” is a short story that was inspired by the contributions of H.G Wells in writing, which focuses on the events of Professor Persikov, who carried out an experiment with eggs only to discover that there is a red ray that is able to increase the growth in living organisms (Milne 185). During the time, cases of illness passed through chicken in Moscow, causing the death of the majority. In remedying the situation, the government decided to recommend and utilize the ray in farms. However, the mix up in egg shipment results to the professor acquiring the chicken eggs.
The government runs the farm, on the other hand, receives the shipment containing the eggs of snakes, ostriches and crocodiles meant for the professor. In the case, the mistake is never discovered until the eggs hatch into giant monsters that wreak havoc, killing the majority of the workers in the farm in Moscow suburbs (Milne 185). The propaganda aspect turn onto the professor then distorts his nature in a similar way his tampering enabled the creation of the monsters. Bulgakov’s parody of an unprofessional bureaucracy earned him a significant reputation as one of the counter-revolutionary aspects.
“Heart of a Dog” is a story based on the features of Frankenstein, a professor, capable of implanting human pituitary glands and testicles into a dog. The dog proceeds to turn into human with time, but the brutish idea turns into a manner of chaos. The story is relatively critical satire reflecting on the new Soviet man, which was later turned into one of the comic operas referred to as “The Murder of Comrade Sharik” done in 1973 by William Bergsma (Milne 186).
The Master and Margarita
Bulgakov began writing this novel in 1928, and it emerged to be one of his best works . He destroyed the first version of the novel in March 1930 upon receiving news that “Cabal of Sanctimonious Hypocrites” was banned. The masterpiece was later published twenty-six years later in 1966 by his widow, which contributed to the international recognition and appreciation of Bulgakov’s work. He was forced to rewrite the book from memory upon burning the draft manuscript. The novel is majorly a significant critique of the Soviet society following its literary establishment (Milne 187). It is highly appreciated upon its philosophical undertones and a higher artistic level in reflection of the picturesque descriptions, style and lyrical fragments. The novel is also a frame narrative that involves two plot lines and time periods with significant characteristics, including the description of a contemporary Moscow and the retelling of the gospels.
The novel changed and omitted parts during its publication with an indication of the relatively modified places were later made for self-publication. During 1967, Frankfurt publisher printed a version of the novel produced through the aid of such modifications. The first ever complete version in Russia was prepared through the guide of Anna Saakyants and was published through Khudozhestvennaya Literatura later in 1973 (Milne 187). The publication was based on a later version of 1940 which was proofread by the publisher. Since then, the version remained one of the canonical editions until the year 1989 when the preparation of the last version by a literature expert Lydia Yanovskaya took place based on the available manuscripts (Milne 188).
Parts of the masterpiece have become the major target of Satanist groups based in Moscow since the early 1980s. This also includes the fans of Bulgakov, which also involves cases of graffiti in different types (Milne 188). With attempts to deter such groups, the residents residing in the building that housed his apartment where the first version of the novel manuscript have been trying to convert the flat into a museum of his work and life.
Mikhail Bulgakov semi-autobiographical heroes are one of the factors that affirm that he was a monarchist through conviction. Through his life as a medical practitioner and writer, much is reflected that relates to the health care system in Russia, which has changed significantly and has been following an administrative structure of the region, which is divided into regions, federal and municipal levels (Milne 207). The system has been improvised to exercise efficiency through implementations and reforms.
Michail Bulgakov museums
There are two museums in Moscow established to honor his memory and his masterpiece, “The Master and Margarita.” Such museums are based in his old apartment building which is located in Bolshaya Sadovaya street in which “The Master and Margarita” parts are set. The building has been a gathering spot since 1980s, especially for his fans and Moscow-based groups with various types of graffiti scrawling the walls (Milne 207). Numerous quips, paintings and drawings, faced a complete whitewash in 2003 with the best drawings kept upon repainting the walls. This is to enable several layers of colored paints seen around some of the best drawings. Currently, there has been a rivalry amid the two museums, which is maintained through the later establishment of an official Museum M.A Michail Bulgakov (Milne 207). It invariable presentably as the only Michail Bulgakov Memorial Museum based in Moscow.
“The Master and Margarita” has inspired most of the musicians and authors who credited it as a masterpiece. Bulgakov house is also an influential factor which was converted into a private initiative in 2004. The house has photos, personal belongings and several significant exhibitions which relate to the life and different works of Bulgakov (Milne 207). There have been literary events and various poetic events held in honoring his works, including the organization of excursions that involve animations of the novel, “The Master and Margarita” with living characters. In the same building housing his apartment, there is also another government initiative found on March 2007 on the fourth floor as a second museum to keep alive his memory (Milne 207).
During the late 1930s, Bulgakov became part of Bolshoi Theatre as one of the consultants and librettist. He later had to leave following a perception that most of his work would undergo production. The favor of Stalin protected his work and him especially from cases of arrests and sometimes execution. However, he could not manage to get most of the masterpiece he produced published. The novels and dramas he wrote were indefinitely banned. In addition, for the second time, his career as one of the most reliable playwright faced long-term ruins. When he wrote his last play, “Batum” in 1939, Bulgakov faced humiliation since the work was a complimentary portrayal of the early revolutionary days of Stalin. Bulgakov was banned before performing any rehearsals, but requested for permission to go to the west of which he was denied (Milne 157).
With his health deteriorating, Bulgakov devoted most of his time during the last moments to what he referred to as his “sunset” novel. He faced a stressful moment between 1937 and 1939 as he veered from an optimistic glimpse with the belief that there is the possibility for the successful publication of most of his masterpiece, sessions of depression, especially when he felt no hope. During June 1938, while on the verge of finishing the manuscript, Bulgakov managed to draft a letter to inform his wife about his last piece of work (Milne 157). In the letter, he indicated that he already had a manuscript of about 327 pages which equals approximately 22 chapters. He explained that the most significant remains of the work were editing, which was going to be challenging and would necessitate him to pay a close attention to the details. This could even lead to a case of rewriting some parts, but continued to question about the future, indicating that maybe, possibly the manuscript will end up in the drawers just like the rest of the rejected and criticized plays (Milne 157).
In the letter, he finalized with an expression that may be his wife also did not know the future and from that draws own judgment about the book. Bulgakov indicated that the manuscript deserved to be hidden away like the rest of his criticized and banned plays. He later in 1939 arranged for a private session for his work, “The Master and Margarita” mostly in a circle of close friends. Bulgakov succumbed on March 10, 1940 to nephrosclerosis, which is an inherited kidney disorder (Milne 157). His father had also died from a similar disease that led to Bulgakov’s guess of a potential future mortal diagnosis. His burial was in Moscow, Novodevichy Cemetery.
Bernstein, Frances L, Christopher Burton, and Dan Healey. Soviet Medicine: Culture, Practice, and Science. DeKalb: Northern Illinois University Press, 2010. Print.
Bulgakov, Mikhail. A Young Doctor’s Notebook. Richmond: Alma Classics, 2012. Print.
Milne, Lesley. Mikhail Bulgakov: A Critical Biography. Cambridge: Cambridge Univ. Press, 1990. Print.
Бернстайн, Фрэнсис Л, Кристофер Burton, и дан Хили. Советской медицины: культуры, практики и науки . -Декалб: Northern Illinois University Press, 2010 г. Печать.
Булгаков, Михаил. Молодой доктор для ноутбуков . Ричмонд: Альма-классики, 2012 год. Печать.
Милн, Лесли. Михаил Булгаков: критическая – Творческая биография – Изобразительное искусство России . Кембридж: Кембриджский университет, 1990 год. Печать.