I am sitting in the clinically clean-looking lobby of the hospital, where a tree of colorful balloons extending from a bucket fails to give cheer to the large, hollow space. The inside of my left arm throbs—the epicenter of the pangs, on the soft inside of my elbow, is where the needle punctured my skin first and then a vein. Part of me stayed behind in the little office tucked within the belly of the hospital. A vial of my blood—is it still my blood? It will share intimate details about me, soon, as it is processed in the laboratory. But it is no longer part of my system. It no longer helps my body function.

The first impression of the hospital is provided by the large, shiny row of windows that constitutes the front entrance. Transparency. The second impression, on a mild day like this, is created by the row of people sitting outside, in front of the windows—smoking, in comfortable clothes, with series of tubes going in and out of their bodies and patchworks of gauze on their heads. Let the sun warm their faces and soften their thoughts.

This is the place where people come when they are ill. If they get better, they go elsewhere. (Many who are ill, of course, do not come here—because they do not know that they are ill, or because they do not want to.)

The faces of the people around me are solemn, restrained. There is little joy, except in the bundles of children that occasionally swoop by. Too young to have internalized the idea of the hospital as a serious place, they play their games here like anywhere else, making their parents take on a weary look. Inside, though, these parents must be thankful for their children's energy.

A woman walks by with a hand on her protruding stomach and a contented smile spread across her face. She seems oblivious to everything outside of her. Here is another joy to be found at the hospital—for the potential, the what-is-to-come. It does not compensate for the sorrow of the what-has-been. It neither replaces nor gives anything back. Calculus does not apply within the hospital's bounds, within the lives of the people here right now. But, stepping back for a moment, this is one of the loci through which the human race comes and goes.

My arm aches, but I accept it; I offered it willingly, with purpose. I trusted the nurse. Mistakes happen everywhere, but I feel safe in this hospital. Sitting here, looking up at the massive ceiling, it seems strange to think that the hospital is only a relatively recent institution. It feels like it was always there—or should have been.

I am reminded of Mikhail Bulgakov's short story, The Blizzard, in that brilliant collection under the name of A Country Doctor's Notebook. Based on his experiences as a young doctor in rural Russia, for instance (most memorably) with the addiction to morphine that he developed at the time, those tales present a different dynamic to medicine.

(As a much too brief aside: there is an intimate connection between medicine and the act of writing—or, at least, some of the greatest writers have come out of medicine. Aside from Bulgakov, there is Anton Chekhov, the greatest ever storywriter, whose only misfortune—as far as popular imagination goes—is that he did not write a novel. Other examples include Arthur Schnitzler, François Rabelais, W. Somerset Maugham, and Friedrich Schiller.)

In The Blizzard, an overworked doctor is granted respite from his onerous duties by a blizzard—or so it seems. Rather than enjoy a little freedom from the endless stream of patients that he travels around the countryside to see, he receives a request for help from a fellow physician that he cannot ignore. His long trip turns out to be futile—the patient, a prospective bride who fell from a sleigh, is practically dead. Instead of spending the night at the fellow physician's, he decides to head back home; on his return, he is caught in a nasty blizzard, and his sleigh becomes lost in the snowstorm. With great effort, the sleigh is freed at last, and it is only after being chased by wolves that he finally manages to return to his home at the hospital.

His hospital was, of course, nothing like the one in which I am sitting now. It was more like a doctor's practice, with a storeroom for supplies. And a doctor's task today is no longer to make house calls. Instead, we patients visit the doctors. We do not even have to go much further back to reach a time when there were no doctors as such or an organized practice of medicine.

I look at the signpost in the distance with the many rows of numbered locations, organized by department and specialization. To a patient, this hospital may well resemble the Russian countryside in its unwieldiness. Perhaps there is nostalgia, in many, for the friendly family doctor who makes the village rounds. For me, despite everything, I am glad that this hospital is here.

Some people place their souls in church for safekeeping. In the end, I am prepared to place my body here for the same purpose, even if there is no certainty. Perhaps, as in the case of religion, we need to take in medicine what Kierkegaard referred to as a leap of faith. There are blizzards everywhere.

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You can find A Country Doctor’s Notebook, which includes The Blizzard and a number of other great stories, here.  

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