Open Culture points us to Koji Yamamura‘s powerful animation of Kafka’s nightmare short story “A Country Doctor”.
I was in great difficulty
So says the doctor as he tells us of how he was called in the middle of a nighttime blizzard to attend a dying boy, a house call that will ultimately force him to face his own shameful and tormented soul.
His own horse dead from overexertion in the severe winter, the doctor is forced against his will to leave his maid in the arms of a mysterious groomsman, the only person who will lend him a horse on this terrible night.
Arriving at the sick house, the doctor at first dismisses the boy’s illness as a short-term coffee overdose, ranting on about patients who torment his unnecessary emergency calls, his low pay from the district and the uselessness of his calling. Despite this, he gives the family a prescription for the boy because
it is easy to write prescriptions, but difficult to come to an understanding with people.
When it appears this is not enough to satisfy them, the doctor heads back to the sick bed only to discover that the boy is actually dying from a maggot infested wound that will become a flower, and for which there is no cure. At that point, he is surrounded by the villagers and his employers, exposed, literally, as the useless failure that he is, stripped of his clothes and laid in the bed with the dying boy.
Take off his clothes and he will heal.
And if he doesn’t cure, then kill him.
It’s only a doctor, only a doctor.
After convincing the boy that his wounds are actually not as bad as those of many others, which actually comforts him, the doctor escapes, naked on horseback through the storm, past the villagers and back into his home, accompanied by the chanting of children, who sing –
Enjoy yourselves, you patients. The doctor has lain in bed with you.
Wow.
In this short tale written almost a century ago in 1916, Kafka has embodied the inherent conflict between the humanly imperfect doctor and the society which both respects and ultimately despises him for his inability to save them all from death – for in modern society, the doctor has replaced the priest as the road to salvation.
Always demanding the impossible from the doctor. They have lost the old faith. The priest sits at home and tears his religious robes to pieces, one after the other. But the doctor is supposed to achieve everything with his delicate surgeon’s hand.
He also shows us the toll this conflict can take on the individual doctor, who has clearly become burnt out and as a result, useless to his patients.
I’ll never come home at this rate. My flourishing practice is lost. A successor is robbing me, but to no avail, for he cannot replace me. … Betrayed! Betrayed! Once one responds to a false alarm on the night bell, there’s no making it good again—not ever.
In some ways, the story portends the decline, not just of an individual doctor, but of the medical profession itself.
Called to society’s side, we fail to see the real problems in front of us, and even when we do, we are ill-equipped to cure them. But with the rise of the internet, we are being stripped bare of our robes of power, and sent on our way, while others who represent the gods of technology step into our place as the beacons of hope and immortality. If Kafka’s truths are indeed as timeless as they seem, these new gods will ultimately fail as well.
Then again, I may just be having a bad day.
Bad day. This story is, at core, about confronting demons; and perhaps also about humility. And humanity, but the dark side.
One striking detail is that the doctor of the story was ready to diagnose (excess caffiene) and prescribe (who knows what?), having never seen the patient. And when he did see the patient, the actual illness was something the profession had no tools to treat — antibiotics were not really available then. His superior sense of self made him rant about patients making him go out in the storm; but his training made him recognize, when he actually saw the patient, the gravity of the situation — even if he had no remedy in those times. And the doctor also saw that he was ill-prepared to deal with the suffering of all those around the patient.
I’d say things have come a long way. Doctors have more at their disposal; patients + families do, also, even if some of those sources are unworthy.
The impossible medical problems have driven research forward in ways that could not have been predicted. Research and experience have also been behind better interactions with patients — at least in some specialties, but I suspect there is improvement in all.
Tech and the internet generally is maybe a double-edged sword. I do not see it replacing a good physician, but rather supplementing what is available to the doctor. From the patient’s point of view, Dr. Google is nothing like a real doctor — it may give some information (perhaps too much and yet not enough, at the same time), but also be way off the mark in a particular situation.
Also — not everything can be solved. Even now. Neither physicians nor algorithms have a magic wand. As a patient, I use the internet; but I know it can be a bad and stupid place. That is why I am grateful to find good doctors, who will listen, answer questions, think about things that might seem off-topic but might not be; doctors who have a far better ability to look at the whole person and the whole problem than any program could.