A TMS/PPD short story by physician Anton Chekhov

[Forest]

I am not a literary maven, but I have to say that I love Anton Chekhov's short stories. Chekhov was an old-fashioned physician and a brilliant observer of human nature. I discovered him through a radio interview about a book where the author interviewed 125 of the best authors of our time and asked which books and authors spoke most powerfully to them. In this important list, Chekhov came out as the 8th most popular author of all time, and his book of short stories came out as the 9th most beloved book of all time. I love a good short story before bed, so I bought the book and have been amazed at how much insight the man could pack into an incredibly short story.

A bio of Chekhov, is provided by the author of the book I described above:

Anton Chekhov (1860–1904)

The son of a freed Russian serf, Anton Chekhov became a doctor who, between the patients he often treated without charge, invented the modern short story. The form had been over-decorated with trick endings and swags of atmosphere. Chekhov freed it to reflect the earnest urgencies of ordinary lives in crises through prose that blended a deeply compassionate imagination with precise description. “He remains a great teacher-healer-sage,” Allan Gurganus observed of Chekhov’s stories, which “continue to haunt, inspire, and baffle.”

Recently, I was reminded of the following story when it was forwarded to me by a TMS therapist. I think that Dr. Chekhov drew on his intuition and experience as a doctor when he wrote it. It shows how incredibly powerful our intuition can be when it comes to recognizing mind-body illness and how much good an old-fashioned doctor with good bedside manner can do when it comes to recognizing PPD/TMS, especially when they don't have spurious MRIs to distract them. This also came up in the recent thread about the cases of mass hysteria in Le Roy NY.

I think of TMS has having three tightly interwoven sources: childhood stress/trauma, current stress, and personality traits. What I like about this story is that not only does Chekhov get the mind-body connection, but he also begins to form a portrait of the TMS personality and how that personality can interact with the world to create stress and pain.

The Death Of A Government Clerk




ONE fine evening, a no less fine government clerk called Ivan Dmitritch Tchervyakov was sitting in the second row of the stalls, gazing through an opera glass at the Cloches de Corneville. He gazed and felt at the acme of bliss. But suddenly. . . . In stories one so often meets with this "But suddenly." The authors are right: life is so full of surprises! But suddenly his face puckered up, his eyes disappeared, his breathing was arrested . . . he took the opera glass from his eyes, bent over and . . . "Aptchee!!" he sneezed as you perceive. It is not reprehensible for anyone to sneeze anywhere. Peasants sneeze and so do police superintendents, and sometimes even privy councillors. All men sneeze. Tchervyakov was not in the least confused, he wiped his face with his handkerchief, and like a polite man, looked round to see whether he had disturbed any one by his sneezing. But then he was overcome with confusion. He saw that an old gentleman sitting in front of him in the first row of the stalls was carefully wiping his bald head and his neck with his glove and muttering something to himself. In the old gentleman, Tchervyakov recognised Brizzhalov, a civilian general serving in the Department of Transport.

"I have spattered him," thought Tchervyakov, "he is not the head of my department, but still it is awkward. I must apologise."

Tchervyakov gave a cough, bent his whole person forward, and whispered in the general's ear.

"Pardon, your Excellency, I spattered you accidentally. . . ."

"Never mind, never mind."

"For goodness sake excuse me, I . . . I did not mean to."

"Oh, please, sit down! let me listen!"

Tchervyakov was embarrassed, he smiled stupidly and fell to gazing at the stage. He gazed at it but was no longer feeling bliss. He began to be troubled by uneasiness. In the interval, he went up to Brizzhalov, walked beside him, and overcoming his shyness, muttered:

"I spattered you, your Excellency, forgive me . . . you see . . . I didn't do it to . . . ."

"Oh, that's enough . . . I'd forgotten it, and you keep on about it!" said the general, moving his lower lip impatiently.

"He has forgotten, but there is a fiendish light in his eye," thought Tchervyakov, looking suspiciously at the general. "And he doesn't want to talk. I ought to explain to him . . . that I really didn't intend . . . that it is the law of nature or else he will think I meant to spit on him. He doesn't think so now, but he will think so later!"

On getting home, Tchervyakov told his wife of his breach of good manners. It struck him that his wife took too frivolous a view of the incident; she was a little frightened, but when she learned that Brizzhalov was in a different department, she was reassured.

"Still, you had better go and apologise," she said, "or he will think you don't know how to behave in public."

"That's just it! I did apologise, but he took it somehow queerly . . . he didn't say a word of sense. There wasn't time to talk properly."

Next day Tchervyakov put on a new uniform, had his hair cut and went to Brizzhalov's to explain; going into the general's reception room he saw there a number of petitioners and among them the general himself, who was beginning to interview them. After questioning several petitioners the general raised his eyes and looked at Tchervyakov.

"Yesterday at the Arcadia, if you recollect, your Excellency," the latter began, "I sneezed and . . . accidentally spattered . . . Exc. . . ."

"What nonsense. . . . It's beyond anything! What can I do for you," said the general addressing the next petitioner.

"He won't speak," thought Tchervyakov, turning pale; "that means that he is angry. . . . No, it can't be left like this. . . . I will explain to him."

When the general had finished his conversation with the last of the petitioners and was turning towards his inner apartments, Tchervyakov took a step towards him and muttered:

"Your Excellency! If I venture to trouble your Excellency, it is simply from a feeling I may say of regret! . . . It was not intentional if you will graciously believe me."

The general made a lachrymose face, and waved his hand.

"Why, you are simply making fun of me, sir," he said as he closed the door behind him.

"Where's the making fun in it?" thought Tchervyakov, "there is nothing of the sort! He is a general, but he can't understand. If that is how it is I am not going to apologise to that fanfaron any more! The devil take him. I'll write a letter to him, but I won't go. By Jove, I won't."

So thought Tchervyakov as he walked home; he did not write a letter to the general, he pondered and pondered and could not make up that letter. He had to go next day to explain in person.

"I ventured to disturb your Excellency yesterday," he muttered, when the general lifted enquiring eyes upon him, "not to make fun as you were pleased to say. I was apologising for having spattered you in sneezing. . . . And I did not dream of making fun of you. Should I dare to make fun of you, if we should take to making fun, then there would be no respect for persons, there would be. . . ."

"Be off!" yelled the general, turning suddenly purple, and shaking all over.

"What?" asked Tchervyakov, in a whisper turning numb with horror.

"Be off!" repeated the general, stamping.

Something seemed to give way in Tchervyakov's stomach. Seeing nothing and hearing nothing he reeled to the door, went out into the street, and went staggering along. . . . Reaching home mechanically, without taking off his uniform, he lay down on the sofa and died.

I mentioned, above, how I see this story as a portrait of at least one type of TMS personality and how that personality can create internal tension. Do you see some of the same personality traits reflected in your own personal tension and pain? Or do you see the clerk's tension as arising more from his situation (current stress) rather than his personality? And, because this forum is about recovery, do you think that the clerk could have done anything to keep everything in perspective? Clearly, by finding a way to relate better to his fears and emotions, he could have saved his life. That's definitely a skill worth learning, for any of us!

 

[sewmuch]

What a story - and great point of discussion. I was chuckling as it snowballed but also recognizing that sometimes we want so badly to fix situations and continue to perceive they are not fixed, even when we have done what we can, that we keep on fixating. (The general probably thought the man was stalking him!) I think it is a combination of personality traits and perceived stress and fear.

A long time ago, I read a quote that said something like "Muddy water is best cleared by leaving it alone." To relate to this story, I think you have to try to right a situation, apologize, make amends, do your best, etc, but you also have to then let go. It is essential to forgive yourself, accept you are human and not perfect, and learn and go forward. Holding tension, regret etc from past events, reliving them over and over does not change them. The key is to recognize where that point of release is.

I am reminded of The Four Agreements by don Miguel Ruiz, a wonderful short and powerful book. In summary:

1. Be Impeccable with your Word: Speak with integrity. Say only what you mean. Avoid using the Word to speak against yourself or to gossip about others. Use the power of your Word in the direction of truth and love.
2. Don’t Take Anything Personally
Nothing others do is because of you. What others say and do is a projection of their own reality, their own dream. When you are immune to the opinions and actions of others, you won’t be the victim of needless suffering.
3. Don’t Make Assumptions
Find the courage to ask questions and to express what you really want. Communicate with others as clearly as you can to avoid misunderstandings, sadness and drama. With just this one agreement, you can completely transform your life.
4. Always Do Your Best
Your best is going to change from moment to moment; it will be different when you are healthy as opposed to sick. Under any circumstance, simply do your best, and you will avoid self-judgment, self-abuse, and regret.

I am also reminded of one of my favorite Zen stories:

Two traveling monks reached a river where they met a young woman. Wary of the current, she asked if they could carry her across. One of the monks hesitated, but the other quickly picked her up onto his shoulders, transported her across the water, and put her down on the other bank. She thanked him and departed.

As the monks continued on their way, the one was brooding and preoccupied. Unable to hold his silence, he spoke out. "Brother, our spiritual training teaches us to avoid any contact with women, but you picked that one up on your shoulders and carried her!"

"Brother," the second monk replied, "I set her down on the other side, while you are still carrying her."

We often continue to carry things with us long after the event has passed.

Thanks for posting Forest. It is always good to read stories and parables that can help us recover and grow. If you find any about worry about the future....now those are the ones I need most!!!