Doctors in the Serpukhov district were few and Chekhov quickly found himself very much in demand by peasants and workers within a radius of fifteen miles of Melikhovo. Hardly a day passed without peasants, usually women with children, arriving at his house for treatment. He went about the business methodically, registering the patients and keeping records. Soon the house took on the aspect of a dispensary. His reception hours were in the morning; at the very break of day a line of peasants would form in the yard. Emergency cases were not infrequent; Misha recalls a field worker being brought into the study with a pitchfork wound in his stomach. Calls at all hours of the day and night and in every kind of weather took him long distances from home. Yet he never refused aid. If he had just returned from a case, weary and ready for tea, only to be called out again, his mother would then protest. "Dysentery, Mother, will not waitl" he replied on one such occasion. In the summers his sister aided him, especially in maintain* ing the "apothecary shop" — for he prescribed drugs and medicines at his own expense. He rarely received fees from these poor people — occasionally a rouble or two, or a grateful peasant might turn over to him a suckling pig.
Chekhov's reputation as a doctor became so well established that the local County Council, when cholera threatened the area in July 1892, asked him to serve on the Serpukhov Sanitary Council to organize measures against the spread of the epidemic. He agreed, and without salary. Here was a need for social medicine. Chekhov went about the assignment energetically. He read up on cholera and the latest treatment, and on preventive measures in epidemics of this sort. His first task was to arrange for the building of barracks to serve as immunizing wards in the twenty-five villages, four factories, and a monastery that constituted his district. Since the County Council had almost no funds for this kind of activity and at first could not even afford him an assistant (later one was assigned to him), he had to set out himself to raise the money for the barracks. This was often a distasteful job, for some of the rich manufacturers and estate owners in the district treated him as a hired hand. Even the head of the monastery refused aid, and when Chekhov asked him what he would do with those who fell ill in his hostel, he piously replied that they were people of substance and would pay all charges themselves. Chekhov's neighbor, Count Orlov-Davydov, had given five hundred roubles to his doctor for the cholera campaign and then fled to Biarritz to escape the epidemic. To Suvorin, who was also abroad at this time, at St. Moritz, Chekhov wrote: "Before Count Orlov-Davydov's departure, I met his wife. Complete with enormous diamonds in her ears, a bustle, and not knowing how to comport herself properly. A millionairess. With such persons you experience a stupid schoolboy feeling of wanting to be rude." (August 16, 1892.) In the end, by virtue of his "beggar-like eloquence," he obtained the funds to provide two excellent barracks completely equipped, and five rather poor ones. And in addition, he begged "lime, vitriol, and assorted stinking junk from manufacturers" for all his twenty-five villages.
Chekhov's task, however, had hardly begun. For weeks he was continually on the go, in a horse and buggy, over roads that he did not know, visiting his villages, lecturing ignorant and mistrustful peasants on the epidemic, and collecting data for meetings of the Sanitary Council which he had to attend. As the cholera wave moved closer to the district, curiously enough many cases of typhus, diphtheria, and scarlet fever appeared in the villages. Chekhov was run off his feet attending the sick. In the short space of a few weeks he reckoned that he had treated about a thousand patients. "My soul is weary," he wrote in this same letter to Suvorin. "I'm bored. Not to belong to oneself, to think only of diarrhea, to start up at night from the dog's barking and a knock at the gate (haven't they come for me?), to drive jades along unknown roads, to read about and expect nothing but cholera, and at the same time to be entirely indifferent to this illness and the people you serve — that, my dear sir, is a mess that might do in anyone."
With the approach of cold weather the danger of the epidemic lessened. Actually, the nearest that cholera got to his district was a village twenty miles away where sixteen people were infected and four died. Chekhov asked to be relieved of his duties by the middle of October, and shortly thereafter he attended a dinner of the Serpukhov Sanitary Council, to whose executive committee he had been appointed, and official thanks were tended him for his efforts.
During the following summer, 1893, a milder cholera scare arose in the neighborhood, and once again Chekhov agreed to serve. Although no cases turned up, he fulfilled all his duties. But this time he felt particularly irked at being confined to the area when he very much wished to travel abroad. For the Sanitary Council he wrote two detailed reports, covering the years 1892-1893, on the temporary dispensary he had set up at Melikhovo to service cholera victims and other illnesses.
Although initially Chekhov had felt a certain elation over his participation in this program of social medicine, in the end he grew impatient and then finally revolted against the hard work. It was a temporary reaction which he had experienced several times before, probably because his complete preoccupation with his "legal wife" had utterly banished all thought of his "mistress" — writing had to be put aside entirely during the cholera epidemics. He felt harried by the demands on his time. No money was coming in. He threatened to throw up medicine entirely. "It is not good to be a physician," he concluded a letter to Suvorin on August 2. "It is terrible and dull and repulsive. ... A girl with worms in her ear; diarrhea; vomiting; syphilis — phui!! Sweet sounds of poesy, where are you?"
Nevertheless, Chekhov's activity as a country doctor at a time of epidemic not only intensified his aroused social sense, but for the first time in his life gave him the exhilarating feeling of belonging to a definite social entity typical of Russian existence at that time — the rural community dominated by the County Council. Though he had been instinctively opposed to organized effort for human betterment and had refused a salary as a County Council physician in order to preserve his freedom of action, he now enthusiastically praised the organized efforts of his rural colleagues to stem the tide of spreading disease. Tolstoy, with his scorn for doctors, Chekhov asserted, ought now to adopt a more respectful attitude toward medicine and the participation of educated people in welfare activities. In contrast to the ignorance and chaos that used to prevail in the past in the face of epidemics in the countryside, Chekhov declared, the intelligent endeavors of this rural educated class had performed wonders in holding down the mortality rate. It gave him a choked feeling, he told Suvorin, to observe how city critics like Burenin in New Times poured forth their venom on this class. And he wrathfully condemned a socialistically-minded writer1 charged with taking advantage of the epidemic to promote riots among the masses. "If our socialists actually exploit cholera for their own ends," he wrote, "then I shall despise them. Employing vile means to attain good ends makes the ends themselves vile. Let them ride on the backs of doctors and medical assistants, but why lie to the people? Why assure the people that they are right in their ignorance and that their crudc prejudices arc holy truth? Can any splendid future possibly justify this base lie? If I were a politician, I would never resolve to hold up the present to shame for the sake of the future, even though they promised me tons of bliss for a grain of foul lying." (August 1, 1892.)
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Suvorin's disdain for Melikhovo saddened Chekhov, who had fondly hoped he would be a frequent visitor and might even buy an estate in the neighborhood. He wrote his friend that the place had lost half of its value because of his unwillingness to visit. A slight eoldness developed in their relations. When Suvorin invited him abroad in the summer of 1892, there was more acrimony than envy in Chekhov's refusal; he seemed to resent his rich friend's swanking it in Europe while he was tied down to Melikhovo by the cholera epidemic. However, when Suvorin fell ill in October, Chekhov at oncc responded to his telegram and went to Petersburg to tend him. And he wrote Leontiev-Shcheglov of the illness, which turned out not to be serious: "I don't know what to tell you. . . . For me this would be such a loss that I think I would age by ten years." (October 30,1892.)