Literature, Arts, and Medicine Database

Bulgakov, Mikhail
The Steel Windpipe

A little girl is brought to the rural hospital by her mother, who throws himself at the feet of the young doctor, “Please do something to save my daughter!” It seems that she has been suffering from a sore throat and is now having difficulty breathing. The doctor looks into her throat; diphtheria is evident.

At first he scolds the mother for not having brought the girl earlier. Then he suggests surgery: a tracheotomy. The doctor knows this is the only way he might save the child, but he is consumed by anxiety because he has never performed the procedure. At first the mother objects to surgery, but then relents. The tracheotomy is successful and the child survives.

Bulgakov was sent to a country hospital like the one in this story (without having done an internship) after graduating in medicine from Kiev University in 1916. He spent 18 months in this difficult, isolated practice, before returning to Kiev to specialize in venereal diseases. This tale, like his other “doctor stories,” was written in the mid-1920’s, after Bulgakov gave up medical practice for a career in writing. It presents a gripping portrait of a young doctor being initiated into the rigors and responsibilities of his profession. The clinical situation in this tale is reminiscent of that in William Carlos Williams’s  The Use of Force (annotated by Felice Aull and also by Jack Coulehan with Pamela Moore, The Use of Force).