The Role of a Doctor as Explored by Solzhenitsyn in The Cancer Ward

Dr. Anthony Fauci has become a household name in the past year. Currently Chief Medical Advisor to the president, he’s served as the president of the National Institute of Allergy and Infectious Diseases since 1984. He has been among the leaders of governmental responses to several crises such as the ebola epidemic, SARS, HIV/AIDS, swine flu, and lately, COVD-19.

He’s come under fire from some conservatives for recommending strict measures to combat the coronavirus, such as mandated mask-wearing, social distancing, stay-at-home policies, school closures, and closing small businesses and restaurants. He’s drawn flak for changing his stance on some points (like mask wearing, the percentage of the population that must be vaccinated to reach herd immunity, and the date when the U.S. can abandon social distancing and mask wearing), and he’s drawn the ire of several million people by contradicting the former president’s statements about the virus.

Here’s the thing, though: on some level, I agree with Fauci. The things he says make sense. He comes across as a reasonable person, and generally explains himself well. He’s professional in his measured criticism of Trump, which can’t be easy given Trump’s treatment of him. I don’t buy the narrative that Fauci is an evil man who is trying to subvert the Founding Father’s principles by tyrannical overreach and abuse of power. I genuinely believe he’s a man who is trying to help the country battle a virus while taking as few casualties as possible. In order to illustrate my point, I’m going to quote a somewhat notorious interview with the New York Times. The author, Donald Mcniel, is referencing the percentage of the population that will have to be vaccinated to achieve herd immunity:

In the pandemic’s early days, Dr. Fauci tended to cite the same 60 to 70 percent estimate that most experts did. About a month ago, he began saying “70, 75 percent” in television interviews. And last week, in an interview with CNBC News, he said “75, 80, 85 percent” and “75 to 80-plus percent.”

Mcneil, Donald G. “How Much Herd Immunity Is Enough?” The New York Times, The New York Times, 24 Dec. 2020, http://www.nytimes.com/2020/12/24/world/how-much-herd-immunity-is-enough.html.

When asked in the same interview why he was moving the goalposts, Fauci responded:

“When polls said only about half of all Americans would take a vaccine, I was saying herd immunity would take 70 to 75 percent,” Dr. Fauci said. “Then, when newer surveys said 60 percent or more would take it, I thought, ‘I can nudge this up a bit,’ so I went to 80, 85.

Ibid.

What we have here is a white lie told to the American public. It’s a lie told, in Fauci’s eyes, for our own good: he only wants what is best for us, after all. We don’t want what he thinks we need, so he lies to make the cure more palatable. This raises an interesting question. Is it Fauci’s right to lie to us the public in order to enact a cure? Do we deserve the truth if we cannot be trusted to act correctly? It’s a prickly question– and one addressed in Aleksandr Solzhenitsyn’s 1968 novel The Cancer Ward.

Oleg Kostoglotov, the protagonist of the novel, is dying of cancer. Though permanently exiled and currently imprisoned at a labor camp, he is released to have his sickness treated. He stumbles into the cancer ward, is given a bed, and begins treatment. He is regularly given injections that he is told are “very important to [his] life.” Curious, he asks the doctor Vera Gangart, “What do the injections do for me?” She answers shortly, “They heal. They prevent metastases from arising. If I were to explain it more precisely you wouldn’t understand.” Later in the story, however, we are told what the injections are. A young nurse, Zoya, is taken with Oleg. They talk of getting married when Oleg gets better. As they kiss in a deserted, dark room, Zoya interrupts suddenly:

These injections… how can I explain it?… they’re called hormone therapy. They give you the opposite hormone: men get the female hormone, women the male hormone. It’s supposed to suppress the metastasis process. But mostly it suppresses […] sexual capacity. Even before secondary characteristics change. If a woman is given large doses, she might begin to grow a beard. Men can develop breasts.

Solzhenit︠syn, Aleksandr. The Cancer Ward. Dell Pub. Co., 1968. 282.

She continues to explain that not only is sexual capacity limited, but that desire itself fades. Oleg is understandably horrified beyond words. His maleness, his identity, his very being– all sacrificed to save his miserable life! In a moment of agony, he mourns his fate, denouncing those who exiled him from his country and the doctors. “First they deprived me of my own life. Now they are depriving me of the right… to continue myself. For whom will I live, and why? The worst of cripples!” A terrible fate, indeed. Oleg is faced with the same kind of question we find ourselves faced with today: at what point does the cost of physical preservation become too high? Our elderly are confined in their nursing homes; we are unable to visit them. Yes, their lives are saved… for now! At what point might it be appropriate to visit them, talk to them, look at them, touch them, enjoy their presence even if it means the possible transmission of the virus? At what point do their lives become not worth living?

Vera Gangart, the doctor who examines and cares for Oleg, is in love with him, and he with her. As he expresses his despair over his future while receiving a blood transfusion, she talks to him. They discuss a scientific materialistic book about love and simultaneously reject it. For Oleg, this is critical: having realized that she believes in spiritual love, a kind that transcends the physical, he agrees to continue his treatment. Why does he now make the sacrifice that was previously unthinkable? Because he now understands the purpose of the sacrifice: the doctor is healing not only his body, but his soul. Once cured, Oleg will love and be loved.

Solzhenitsyn develops his point later on in the book. A cancer ward doctor, a woman who is an x-ray specialist, has developed stomach cancer from excessive exposure to the x-rays. Fearing her colleagues, and unable to face the treatment she so often prescribes to her patients, she seeks out an old friend and mentor of hers: a doctor who runs a family practice; an old man with outdated views on medicine. He expounds on his view of what the doctor’s role is:

Girls of fourteen and boys of sixteen have to talk with a doctor. Not at their desks in a classroom of forty- that’s no way to talk- and not in the school medical office, with three minutes for each pupil. It has to be the same uncle they’ve been showing their throats to since childhood, the same doctor who has sat at tea with the family. Suppose this […] kind and stern doctor […] sits down with the boy or girl in his office and shuts the door and starts up a leisurely conversation that is both embarrasing and very interesting, and the doctor guesses, without any questions from the youngsters, what is on their minds, and himself provides the important and difficult answers.[…] He is not only forewarning them against missteps and wrong impulses, against harm to their bodies, but their whole picture of the world is cleansed and falls into place.

Ibid. 489

Thus are we introduced to the true role of the doctor: not one to administer injections, cut off tumors, and amputate limbs, but rather one tasked with making the body whole so that the person can fit into the world. This applies not only to bodily health, but to education, and cleansing of the patient’s world view. Though the doctor’s role might sometimes include amputations or unpleasant medicine, it is always with the end of rejoining the patient to the world, not isolating him or making him incapable of love. In order to truly heal his patient, then, a doctor must have an intimate knowledge of the patient as a “whole complex,” and not just a collection of parts with a broken gastro-intestinal tract, a brain tumor, or failing respiratory system. Thus, doctor Oreschchenkov concludes, a doctor “should have just as many patients as his memory and his personal knowledge permit.” This is why Oleg was truly healed: not because his cancer went into remission, but because he found a doctor who was willing to know him, to heal not only his body, but also to cleanse his world view so that he might love and be loved.

Perhaps this is what Fauci is missing. Though I hold he is well-intentioned and wants to cure us, he is operating far outside his scope. He does not know all the patients to whom he is prescribing the cure, and for many the cure is proving far worse than the ailment. For proof, I’ll direct you to this article. Instead of trying to show us why we must accept this treatment, as Vega did for Oleg, Fauci is taking her first approach; the approach she took when she did not care for Oleg as a man, but a conglomeration of broken parts. In the early stage of their relationship, Vega lied to and manipulated Oleg in order to ‘heal’ him. Likewise, Fauci is telling white lies to us so that we will be cured. We the American people, however, can intuit that Fauci does not and cannot care about us on an individual level. This is perhaps why people are rebelling against Fauci’s proposed cures, though they make sense from a specialist’s standpoint. Fauci is operating as a specialist, trying to preserve physical health by amputating the spiritual and social elements of our lives. This approach is not conducive to true health. It will not help us rejoin the world, to love others, and let ourselves be loved.

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