“Enemies” in Our Times: Chekhov’s Lessons for Medicine and Society

Excerpt from Anton Chekhov’s “Enemies”

With tears in his eyes, trembling all over, Abogin sincerely poured out his soul before the doctor. He spoke fervently, pressing both hands to his heart, exposed his family secrets without any hesitation, and was even as if glad that these secrets had finally burst from his soul. If he had spoken like that for an hour, two hours, pouring out his soul, he would undoubtedly have felt better. Who knows, if the doctor had heard him out, shown friendly compassion, perhaps, as often happens, he would have been reconciled to his loss without protest, without any unnecessary foolishness…But something else happened. As Abogin spoke, the insulted doctor changed noticeably. The indifference and astonishment on his face gradually gave way to an expression of bitter offense, indignation, and wrath. The features of his face became still sharper, harder, and more unpleasant. When Abogin placed before his eyes the photograph of a young woman with a beautiful, but dry and expressionless face, like a nun’s, and asked whether it was possible, looking at that face, to allow that it was capable of expressing a lie, the doctor suddenly jumped up, flashed his eyes, and said, rudely rapping out each word:

“Why are you telling me all this? I have no wish to hear it! No wish!” he shouted and banged his fist on the table. “I don’t need to know your banal secrets, devil take them! Don’t you dare tell me these banalities! Do you think I haven’t been insulted enough already? That I’m a lackey who can be insulted endlessly? Eh?”

Abogin backed away from Kirilov and stared at him in astonishment.

“Why did you bring me here?” the doctor went on, his beard shaking. “You go crazy from your fat life and act out melodramas, but why bring me into it? What have I got to do with your love affairs? Leave me alone! Exercise your noble eccentricity, flaunt your humane ideas, play”—the doctor cast a sidelong glance at the cello case—“play your double basses and trombones, fatten up like capons, but don’t you dare jeer at a human being! If you can’t respect me, at least spare me your attention!”

“Excuse me, but what’s the meaning of all this?” Abogin asked, turning red.

“It means that it’s base and vile to play with people like that! I’m a doctor, and you consider doctors and workers in general, who don’t smell of perfume and prostitution, as your lackeys and in mauvais ton—well, go ahead, but no one gave you the right to turn a suffering man into a stage prop!”

“How dare you say that to me?” Abogin asked softly, and his face began to twitch again, this time clearly from wrath.

“No, knowing that I’m in grief, how could you dare bring me here to listen to banalities?” the doctor shouted, and again banged his fist on the table. “Who gave you the right to mock another man’s grief like this?”

“You’re out of your mind!” shouted Abogin. “That’s not magnanimous! I’m profoundly unhappy myself and…and…”

“Unhappy,” the doctor smirked contemptuously. “Don’t touch that word, it doesn’t concern you. A good-for-nothing who can’t pay off his debts also calls himself unhappy, a capon that suffocates from too much fat is also unhappy. Worthless people!”

“My dear sir, you are forgetting yourself!” shrieked Abogin. “Such words…call for a beating! Understand?”

Abogin hurriedly went to his side pocket, took out his wallet, and pulling two notes from it, flung them on the table.

“That’s for your visit!” he said, his nostrils twitching. “You’ve been paid!”

“Don’t you dare offer me money!” the doctor shouted and swept the notes from the table. “An insult isn’t paid for with money!”

Abogin and the doctor stood face to face and went on angrily hurling undeserved insults at each other. It seems that never in their lives, even in delirium, had they said so much that was unfair, cruel, and preposterous. In both men the egotism of the unhappy showed strongly. The unhappy are egotistic, spiteful, unfair, cruel, and less capable than the stupid of understanding each other. Unhappiness does not unite but divides people, and even where it seems that people should be united by the similarity of their grief, there is much more unfairness and cruelty done than in a comparatively contented milieu.¹

Commentary

“Enemies” by Anton Chekhov describes a heated encounter between two men, a physician and an aristocrat, who are both suffering from personal afflictions. Kirilov, the physician, has just lost his only child to diphtheria, while Abogin, the aristocrat, learns of his wife’s infidelity and abrupt departure. Initially under the impression that his wife is deathly ill, Abogin calls on Kirilov to tend to her. When Abogin discovers that she has betrayed him, both men enter into a bitter quarrel that prevents each from recognizing the other’s personal strife.

The story raises themes that are salient to the practice of medicine. When Abogin initially calls on Kirilov, the doctor attempts to appeal to his client’s understanding that he is in the midst of acute grief, but Abogin counters by invoking Kirilov’s sense of professional duty to save a life. Abogin eventually convinces Kirilov to attend to his wife, therein disrupting the boundary that Kirilov has attempted to establish with his client. This dialectic is a common tension experienced by those in medicine who are often asked to put aside their own suffering for the sake of another’s. In Kirilov’s case, the task is too burdensome, and he is unable to separate his anguish from what he perceives to be a lesser loss: he exhorts, “knowing that I’m in grief, how could you dare bring me here to listen to banalities?” If the boundary he had defined had been respected, it is possible that the antipathy between the two men might have been avoided; instead, Abogin’s incessant imposition, in part, catalyzes their subsequent discord.

The story also broaches the possibility of mutual healing through the telling and receiving of a personal account. As the narrator describes, “with tears in his eyes, trembling all over, Abogin sincerely poured out his soul before the doctor,” revealing that “if the doctor had heard him out…[Abogin] would have been reconciled to his loss without protest…but something else happened.” Instead of listening without judgment, the doctor is mired in his own grief and expresses “bitter offense, indignation, and wrath.” This exchange represents the complexities of serving and attending to others while simultaneously suffering from loss and demonstrates a failed opportunity to sublimate one’s own grief to better recognize that of another. Stripped of its potential for profound human connection and relief, the exchange between the physician and his client becomes transactional, and the suffering is economized rather than validated.

In turn, the story sheds light on the divisiveness that stems from grief. Not only do Kirilov and Abogin have different professions, but they also have different backgrounds, interests, and social classes. While Kirilov has a spartan lifestyle with meager means, Abogin lives a life of luxury marked by leisurely engagement in the arts and, in the doctor’s estimation, “noble eccentricity.” The selfishness of their respective griefs provokes them to view the other with disdain. The inequality of their social standings engenders contempt in the physician, who feels himself disrespected; he accuses Abogin of considering “doctors and workers in general…as [his] lackeys” and of “[turning] a suffering man into a stage prop.” Abogin, in turn, exclaims disrespectfully that “such words…call for a beating!”

Their individual differences can be magnified to reflect the collective divisions that permeate society. Grief propels the two men to uncharted enmity; as the narrator describes, “never in their lives, even in delirium, had they said so much that was unfair, cruel, and preposterous.” The narrator goes on to state that “in both men the egotism of the unhappy showed strongly…Unhappiness does not unite but divides people, and even where it seems that people should be united by the similarity of their grief, there is much more unfairness and cruelty done than in a comparatively contented milieu.” Although this story was written over a century ago, these words are still highly resonant in these polarized times, where discord among and within nations makes enemies of neighbors. We are hypervigilant to differences in race, religion, political affiliation, and other aspects of identity, and too myopic a focus on these dissimilarities along with a fabricated hierarchy of grief can impede an understanding of our shared humanity and our social suffering.

As Kirilov returns home in anger at the story’s conclusion and reflects on what he believes Abogin represents, “a firm conviction concerning those people took shape in his mind.” Kirilov mistakes the individual for the collective, and based on this single encounter of separate and unrecognized sufferings, his mind resolves into uncompromising hatred. This unfortunate turn bears lessons for individuals and societies tasked with recognizing and yet reconciling differences in service of a higher good. For if we do not heed these lessons in our personal and professional lives, we may find ourselves echoing the final lines of the story: “time will pass and…sorrow will pass, but that conviction, unjust and unworthy of the human heart, will not pass, but will remain in the… mind to the grave.”

Discussion Questions

• What are some challenges that clinicians face in setting personal and professional boundaries, and what are the ramifications of disrupting these boundaries?

• What are some ways that grief can bring people together and drive them apart? Can you think of specific examples within and outside of your practice?

• What role can compassionate listening play in the healing process for patients and physicians alike?

Funding

AS is supported by the Clifford Attkisson Clinical Services Research Training Program T32 MH018261 of the National Institute of Mental Health and the Leadership Training in Adolescent Health Program T71MC00003 of the Health Resources and Services Administration of the U.S. Department of Health and Human Services. RKT is a postdoctoral fellow in the National Clinician Scholars Program at University of California Los Angeles. Her fellowship is supported by the UCLA-UCSF ACEs Aware Family Resilience Network (UCAAN) 21–10317.

Declarations:

Conflict of Interest:

The authors declare that they do not have a conflict of interest.