29 Doctors and Illnesses
W
hen we first got to Voronezh, we stayed in the hotel. Those in charge of us evidently permitted this to exiles arriving at their destination, even when they had no papers. We were not actually given rooms, only beds in rooms (separate for men and women) shared by a number of people. We were put on different floors, and I had to keep running up the stairs because I was worried about M.'s condition. But every day it got harder to climb the stairs. After several days my temperature shot up, and I realized I must be falling ill with spotted typhus, which I had no doubt picked up on the journey. The first symptoms of spotted typhus are unmistakable and cannot be confused with anything else, certainly not with flu. But this meant many weeks in the hospital, in the isolation wing, and I kept picturing the scene of M. throwing himself out of the window. Hiding my temperature from him—it was still going up—I begged him to see a psychiatrist. "If that's what you want," he said, and we went together. M. described the whole course of his illness himself, and there was nothing for me to add. He was completely objective and lucid. He told the doctor that at moments of tiredness or distraction he still had hallucinations. Most of all this happened when he was falling asleep. He said he now understood the nature of the voices and had learned to stop them with an effort of the will, but that in the hotel there were many irritants that made it difficult for him to fight his illness—it was very noisy, and he couldn't rest during the day. But the most unpleasant thing was the constant closing of doors, even though he knew they closed from the inside, not the outside.
Prison was ever-present to our minds. Vasilisa Shklovski cannot stand closed doors—because of all the time she spent in prison as a young woman, when she learned at first hand what it means to be closed in. And even people who had no experience of prison cells were not always free of this kind of association. When Yakhontov stayed in the same hotel during his visit to Voronezh a year and a half later, he immediately noticed how the keys ground in the locks. "Oho," he said, as we closed the door on leaving his room. "It's a different sound," said M., reassuringly. They understood each other perfectly. This is why M. is so insistent in his verse on the right to "breathe and open doors"—it was a right he was terrified of losing.
The psychiatrist was careful about what he said to us. We all suspected each other of being police spies, and there were many among people who had suffered like M.—a man who had undergone a psychological trauma was often incapable of resistance. But without waiting for M. to finish, the psychiatrist said that such "complexes" were very often observed in "psychostenic types" who spent any length of time in prison.
I then told the doctor about my own illness (at this moment M. understood my purpose in bringing him here and became terribly alarmed) and asked whether it wouldn't be best for M. to go into a clinic while I was in the hospital. The doctor replied that it would be perfectly all right to leave M. where he was since there were scarcely any traces left of his traumatic psychosis. He added that he had often observed the same condition among people exiled to Voronezh. It was caused by a few weeks, or even days, of imprisonment, and always cleared up, leaving no trace. M. then asked him why it was that people got into this state after a few days in prison, whereas in the old days prisoners spent years in dungeons without being affected Eke this. The doctor only shrugged his shoulders.
But is it true that they were unaffected? Perhaps prison always causes mental trouble, if not psychological damage. Is this really a specific feature of our prisons? Or is it perhaps that before we go to prison our mental health is undermined by anxieties and brooding on "prison themes"? Nobody here is able to go into this question—and abroad the facts are not known, because we are only too good at keeping our secrets from the outside world.
I have heard that somebody abroad recently published his memoirs about life in a Soviet camp, and that the author was struck by the large number of mentally sick people he encountered among the prisoners. As a foreigner, he had lived in the Soviet Union in somewhat special conditions, and his knowledge of our life was very superficial. The conclusion he reaches is that certain psychotic conditions are just not treated in this country, and that people suffering from them get sent to camps for infringement of discipline and other offenses caused by their illness. The percentage of mentally unbalanced people in the country is indeed enormous, and among those sentenced for hooliganism and petty theft there are, I believe, many psychotics, not to mention psychopaths. They are given several years for breaking into a store and stealing a few bottles of vodka, and when they come out they immediately do the same thing again and are sent back to prison and the labor camps for a good ten years. Under Stalin much less attention was paid to them, and far fewer of them went to the camps than nowadays. But the question remains as to why so many intellectuals and nervous or sensitive people in general are so strongly affected by their arrest and often fall prey to this mysterious trauma which quickly passes after their release. The foreign author of the book about the camps does not say where the prisoners he saw had become mentally sick, in prison or "outside." Nor does he say who they were—youths who had stolen to buy drink, or peaceful citizens. And were they psychopaths or were they suffering from the prison trauma I have described? All these questions will remain open, both for foreigners and for ourselves, until we are able to speak up about our past, present and future.
After I came out of the hospital, M. again went to see a psychiatrist, an eminent specialist who had come from Moscow to inspect the local lunatic asylum. M. went on his own initiative to tell him the story of his illness and to ask whether it might not be the consequence of some organic trouble. He mentioned that he had earlier noted in himself a tendency toward obsessive ideas—for instance, at times when he was in conflict with the writers' organization he could think of nothing else. Moreover, he actually was very sensitive to external shocks. I had noticed the same thing, incidentally, in M.'s two brothers. Though they were both of a very different make-up, they also tended to become obsessional about any difficult event in their lives.
The Moscow psychiatrist did an unexpected thing: he asked M. and me to walk around the wards with him. Afterward he asked whether M. thought he had anything in common with the patients he had seen in the clinic, and if so, how he would describe it: senility? schizophrenia? hysteria? They parted friends.
Nevertheless, without telling M., I went back to see the doctor myself next morning. I was worried in case the fearful things he had shown us the day before might produce a new shock in M. The doctor reassured me, saying that he had deliberately shown his patients to M. because better knowledge of these things would help him to get over the painful memories of his own illness. As for M.'s nervous sensitivity and inability to withstand traumas, the psychiatrist saw nothing pathological about this: the traumas had been pretty severe, and one could only wish that there were fewer of them in our life.