Ward No. 6 (Chekhov)
Short summary
A small provincial Russian town, late 19th century. Dr. Andrey Yefimitch Ragin ran a dilapidated hospital with deplorable conditions. Initially conscientious, he gradually became indifferent to his duties, preferring to read philosophy and drink vodka with his only friend, the postmaster Mihail Averyanitch.
Andrey Yefimitch became interested in Ward No. 6, where mental patients were kept in squalid conditions and guarded by a brutal attendant named Nikita. He was particularly drawn to a patient named Ivan Dmitritch Gromov, an educated man suffering from persecution mania. They engaged in philosophical discussions about suffering and happiness.
The doctor's frequent visits to the ward aroused suspicion among his colleagues. Dr. Hobotov, a young doctor who coveted Andrey Yefimitch's position, arranged for a medical commission to examine his mental state. Finding him eccentric, they conspired to remove him from his post. Mihail Averyanitch suggested a trip to distract his friend, but the journey only exhausted Andrey Yefimitch, who longed for solitude.
Upon returning, Andrey Yefimitch found himself homeless and penniless. Hobotov and Mihail Averyanitch tricked him into visiting the hospital, where he was committed to Ward No. 6 as a patient. When he realized the deception and tried to leave, he was confronted by Nikita.
"What right has he not to let you out? How dare they keep us here? I believe it is clearly laid down in the law that no one can be deprived of freedom without trial! It's an outrage! It's tyranny!"... "Open the door," cried Andrey Yefimitch, trembling all over; "I insist!"
When Andrey Yefimitch persisted in trying to leave, Nikita beat him severely. The next day, the doctor lay motionless, refusing food and drink. By evening, he died of an apoplectic stroke, his final thoughts a confused mix of images and philosophical musings about immortality.
Detailed summary by chapters
Chapter titles are editorial.
Chapter 1. Introduction to Ward No. 6 and its inhabitants
In a small provincial town stood a hospital with a special annex known as Ward No. 6. This small lodge was surrounded by weeds and had a dilapidated appearance with a rusty roof and crumbling chimney. The building had a desolate, Godforsaken look typical of institutional structures meant to house society's unwanted.
In the hospital yard there stands a small lodge surrounded by a perfect forest of burdocks, nettles, and wild hemp. Its roof is rusty, the chimney is tumbling down... These nails, with their points upwards, and the fence, and the lodge itself, have that peculiar, desolate, Godforsaken look which is only found in our hospital and prison buildings.
Inside the lodge, the conditions were squalid. The floor was splintered, the walls dirty blue, and the air reeked of various unpleasant odors. The ward housed five mental patients, each with their own peculiarities. The porter, Nikita, an old soldier with a grim face, maintained order through physical discipline and violence.
Among the patients was a consumptive workman who spent his days grieving silently, a lively old Jewish man named Moiseika who whistled and sang constantly, and a former postal sorter who believed he had received special medals and orders. The most notable patient was Ivan Dmitritch Gromov, a well-educated man suffering from persecution mania.
Chapter 2. Ivan Dmitritchs backstory and mental decline
Ivan Dmitritch came from a respectable family. His father, a government official, died in prison after being charged with fraud. Following this tragedy, the family's property was sold at auction, leaving Ivan and his mother destitute. Ivan abandoned his university studies in Petersburg and returned home to support his mother.
He worked briefly as a teacher but was unsuccessful in this role. After his mother's death, he became a court usher. Despite his difficult circumstances, Ivan was known for his intelligence, education, and passionate nature. He spoke eloquently about social issues and criticized the provincial town's lack of culture and progress.
Ivan was an avid reader who devoured books and magazines with great intensity. He was particularly drawn to discussions about society's failings and the need for intellectual advancement. His nervous temperament and tendency toward harsh judgments made him a distinctive figure in the otherwise dull provincial setting.
Chapter 3. Ivans paranoia and deterioration
One autumn morning, Ivan Dmitritch encountered a group of convicts being escorted by soldiers. This chance meeting triggered something in his mind, and he began to experience intense anxiety about the possibility of being wrongfully imprisoned. He became convinced that he might be arrested at any moment, despite having committed no crime.
His paranoia grew rapidly. Every police officer he saw seemed suspicious, and ordinary events took on ominous significance. He began avoiding people and seeking solitude. His work became unbearable as he feared being framed for fraud or theft. When two decomposed bodies were found near the cemetery, Ivan worried people would suspect him of murder.
Eventually, his mental state deteriorated completely. He hid in his landlady's cellar, then ran through the streets without his coat. After being brought home, he was sent to the hospital and eventually transferred to Ward No. 6, where he remained, forgotten by the town, his books taken apart by children.
Chapter 4. The other patients of Ward No. 6
Besides Ivan Dmitritch, Ward No. 6 housed several other patients. To Ivan's left was Moiseika, the elderly Jewish man who had gone mad twenty years earlier when his hat factory burned down. Though simple-minded, he was allowed to leave the ward and beg in town, where people would give him food and small coins that Nikita would later confiscate.
To Ivan's right was an obese peasant who had lost all capacity for thought or feeling. He was completely unresponsive, even when Nikita beat him severely. Another patient was a former postal sorter who kept imaginary medals under his pillow and mattress, constantly speaking of awards he believed he had received.
Life in the ward was monotonous. The patients washed in the morning, drank tea from tin mugs, ate simple meals of cabbage soup and boiled grain, and spent the rest of their time lying down, sleeping, or pacing. They rarely saw anyone from outside except the barber who came every two months.
Chapter 5. Dr. Ragins background and philosophy
Dr. Andrey Yefimitch Ragin, the hospital's head physician, was a peculiar man. Though he had once been religious and considered entering the priesthood, he followed his father's wishes and became a doctor instead. He was physically imposing with a coarse appearance, resembling an innkeeper with his flat hair, broad shoulders, and red nose, yet his manner was gentle and hesitant.
When Andrey Yefimitch first took charge of the hospital, he found it in a deplorable state. Patients slept alongside staff in filthy wards, medical supplies were inadequate, and corruption was rampant. Though initially zealous about improvements, he soon became disillusioned with the futility of his efforts.
The doctor developed a philosophical outlook that justified his inaction. He reasoned that suffering was inevitable and that death was the natural end for everyone. He questioned the purpose of medicine, wondering why one should prolong life when it would ultimately end in death anyway. This rationalization allowed him to withdraw from active involvement in the hospital's affairs.
Chapter 6. Dr. Ragins daily routine and friendship with Mikhail Averyanitch
Andrey Yefimitch settled into a predictable routine. He rose at eight, drank tea, and then went to the hospital where he perfunctorily examined outpatients alongside his assistant, Sergey Sergeyitch, a religious man who considered himself more competent than the doctor. After seeing a few patients, Andrey Yefimitch would leave the rest to his assistant and return home to read.
Reading was his greatest pleasure. He spent hours with his books, frequently pausing to drink vodka and nibble on pickles. His elderly cook, Daryushka, would timidly inquire about meals, to which he would respond distractedly. In the evenings, his only friend, the postmaster Mihail Averyanitch, would visit.
Mihail Averyanitch, a former cavalry officer who had fallen on hard times, was the only person whose company Andrey Yefimitch enjoyed. Their conversations typically followed the same pattern: the postmaster would recount adventures from his military days, while the doctor would philosophize about intellectual matters and the lack of intelligent society in their provincial town.
Chapter 7. Dr. Ragins reflections on mortality and intelligence
After his friend departed each evening, Andrey Yefimitch would continue reading late into the night. During these solitary hours, he contemplated profound questions about human existence. He pondered the transience of life and the ultimate meaninglessness of human endeavors when viewed against the backdrop of eternity.
"A man's peace and contentment do not lie outside a man, but in himself... The ordinary man looks for good and evil in external things—that is, in carriages, in studies—but a thinking man looks for it in himself."
The doctor was troubled by the contradiction between his philosophical ideals and the reality of his life. He recognized that while he preached about the insignificance of material comfort, he continued to benefit from his position at the hospital. He knew that patients suffered under the current system, yet he did nothing to change it, justifying his inaction by claiming that one person could not make a difference.
Despite his awareness of medical advancements happening elsewhere, Andrey Yefimitch remained passive. He understood that his hospital was outdated and harmful to patients, yet he continued to receive his salary and maintain the status quo, rationalizing that this was simply the way of the world.
Chapter 8. Introduction of Dr. Hobotov
Two years before the main events of the story, the local Zemstvo hired a young doctor named Yevgeny Fyodoritch Hobotov to assist Andrey Yefimitch. Hobotov was under thirty, tall and dark with broad cheekbones and small eyes. He arrived in town with few possessions and a woman he called his cook, who had a baby at the breast.
Hobotov was unimpressed by the hospital's outdated practices but refrained from making changes out of respect for his senior colleague. Privately, he considered Andrey Yefimitch to be a crafty old man with substantial savings and secretly envied his position, hoping to eventually replace him.
Chapter 9. Dr. Ragins first visit to Ward No. 6 and conversation with Ivan
One day, a strange rumor circulated through the hospital: Dr. Ragin had begun visiting Ward No. 6. This was unprecedented, as the doctor had previously shown no interest in the mental patients. The rumor proved true when Andrey Yefimitch, after giving Moiseika a coin, entered the ward and engaged Ivan Dmitritch in conversation.
Ivan was initially hostile, calling the doctor a "reptile" and accusing him of keeping patients imprisoned unjustly. Andrey Yefimitch responded calmly, explaining that he had no power to release anyone and that society would simply return Ivan to the ward if he were let out.
"You ask me what to do. The very best thing in your position would be to run away. But, unhappily, that is useless. You would be taken up. When society protects itself from the criminal, mentally deranged, or otherwise inconvenient people, it is invincible."
Despite this tense beginning, the two men found common ground in their intellectual interests. Ivan spoke passionately about justice and truth eventually triumphing, while the doctor was impressed by Ivan's intelligence and articulate speech. Their conversation touched on prisons, madhouses, and the nature of suffering, revealing that despite their different circumstances, they shared similar concerns about society and human existence.
Chapter 10. Ivans criticism of Dr. Ragins philosophy
The next day, Andrey Yefimitch returned to Ward No. 6, eager to continue his conversation with Ivan Dmitritch. However, Ivan was suspicious and hostile, accusing the doctor of being a spy sent to test him. Gradually, Andrey Yefimitch managed to calm him, and they resumed their philosophical discussion.
The doctor expounded his Stoic philosophy, arguing that peace and contentment come from within rather than from external circumstances. He suggested that a wise man should be indifferent to suffering and satisfied with intellectual pursuits regardless of his physical surroundings. To illustrate his point, he cited Marcus Aurelius and claimed there was no real difference between a comfortable study and the squalid ward.
Ivan vehemently disagreed, arguing that such philosophy was merely a justification for inaction and privilege. He pointed out that the doctor had never truly suffered and had arranged his life to avoid discomfort. Ivan insisted that human beings naturally respond to pain and injustice with emotion, and that to be indifferent to suffering was to cease being fully human.
"To despise suffering, to be always contented, and to be surprised at nothing, one must reach this condition... or to harden oneself by suffering to such a point that one loses all sensibility to it—that is, in other words, to cease to live."
Ivan challenged the doctor's detachment by suggesting that if Andrey Yefimitch were to experience real suffering or humiliation, his philosophical stance would quickly crumble. This criticism struck a nerve, as it exposed the contradiction between the doctor's theories and his comfortable, sheltered existence.
Chapter 11. Dr. Ragins regular visits to Ward No. 6
Despite their disagreements, Andrey Yefimitch found his conversations with Ivan Dmitritch intellectually stimulating and began visiting Ward No. 6 regularly. Initially suspicious, Ivan gradually became accustomed to the doctor's presence, and their relationship evolved into one of mutual respect, though Ivan maintained a tone of condescending irony.
"You have never known suffering, but have only like a leech fed beside the sufferings of others, while I have been in continual suffering from the day of my birth till today. For that reason, I tell you frankly, I consider myself superior to you and more competent in every respect."
These visits represented a significant change in the doctor's routine. He now spent hours in the ward, engaged in philosophical debates that challenged his long-held beliefs. For the first time in years, Andrey Yefimitch found someone who could match his intellectual capacity and provide meaningful conversation in the otherwise intellectually barren town.
Chapter 12. The towns reaction to Dr. Ragins behavior
The doctor's frequent visits to Ward No. 6 did not go unnoticed. Hospital staff, including Nikita and Sergey Sergeyitch, observed his lengthy conversations with Ivan Dmitritch and began whispering among themselves. Dr. Hobotov and his assistant even spied on these interactions, exchanging meaningful glances and concluding that the old doctor had "gone off his chump."
Andrey Yefimitch began to notice a change in how people treated him. His friend Mihail Averyanitch became overly solicitous, suggesting that the doctor give up alcohol. The hospital superintendent, housekeeper, and even young Masha, the superintendent's daughter, behaved strangely around him. There was a sense that people were watching him with concern or suspicion.
The situation came to a head when Andrey Yefimitch was summoned to the town hall for what appeared to be a routine meeting about hospital renovations. However, he gradually realized that the gathering, which included Hobotov and a visiting doctor, was actually an informal assessment of his mental state. They asked him simple questions about the date and calendar, treating him as though he were mentally impaired.
Chapter 13. Dr. Ragins forced vacation with Mikhail Averyanitch
Following the humiliating examination, Andrey Yefimitch was deeply disturbed. Mihail Averyanitch, sensing his friend's distress, proposed they take a vacation together. Despite his initial reluctance to disrupt his routine, the doctor agreed, partly to escape the increasingly uncomfortable atmosphere in town.
The two men set off by carriage to the nearest railway station and then traveled by train to various cities. Throughout the journey, Mihail Averyanitch talked incessantly, pointing out sights and sharing stories, while Andrey Yefimitch found himself increasingly irritated by his friend's constant chatter and inability to allow him any peace or solitude.
In Moscow, they visited churches and museums. In Warsaw, Mihail Averyanitch disappeared for a night of gambling and returned asking to borrow money, which Andrey Yefimitch provided without comment. The doctor grew increasingly weary of travel and longed to return to his quiet routine of reading and contemplation.
Chapter 14. Dr. Ragins growing weariness with his friend
As their journey continued, Andrey Yefimitch found Mihail Averyanitch's company increasingly unbearable. The postmaster's constant need for conversation and activity prevented the doctor from enjoying any moment of peace. In hotels, Andrey Yefimitch began feigning illness to avoid sightseeing with his friend.
He spent days lying on the sofa with his face to the wall, tormented by his companion's intrusions and unable to concentrate on his thoughts. The doctor reflected that true happiness was impossible without solitude, and that even a fallen angel had likely betrayed God because he longed for privacy that angels never experienced.
What had begun as a pleasant diversion had become a form of torture for Andrey Yefimitch. He was vexed with himself for having agreed to the trip and with Mihail Averyanitch for his well-intentioned but suffocating supervision. The doctor longed for the familiar comfort of his books and his quiet rooms at home.
Chapter 15. Dr. Ragins return and forced retirement
When Andrey Yefimitch and Mihail Averyanitch finally returned to their town, they discovered significant changes had occurred. Dr. Hobotov had taken over Andrey Yefimitch's position at the hospital, and the doctor's hospital apartment was now occupied. He was forced to look for new lodgings in town.
The doctor rented three rooms in a small house. His elderly cook, Daryushka, continued to serve him, but his circumstances were greatly reduced. When Mihail Averyanitch inquired about his finances, Andrey Yefimitch revealed that he had only eighty-six roubles to his name, having never accumulated savings despite his years of service.
Life in the new lodgings was difficult. Andrey Yefimitch had no money for new books and spent his time cataloging his old ones. He attended church on weekends and twice attempted to visit Ivan Dmitritch, but the patient was agitated and unwelcoming. The doctor's health began to deteriorate, and he spent increasing amounts of time lying on his sofa, lost in trivial thoughts.
Chapter 16. Dr. Ragin confronts Hobotov and Mikhail Averyanitch
Dr. Hobotov occasionally visited Andrey Yefimitch, ostensibly out of professional courtesy, bringing medicines that the older doctor never took. Mihail Averyanitch also continued his visits, though he had not yet repaid the money borrowed in Warsaw. These visits became increasingly irritating to Andrey Yefimitch, who found it difficult to maintain his philosophical detachment.
One day, both Hobotov and Mihail Averyanitch visited simultaneously. They spoke condescendingly to Andrey Yefimitch, suggesting he needed to recover from an illness he didn't believe he had. Mihail Averyanitch even hinted at finding the doctor a wife, treating him like a child rather than a respected colleague.
Suddenly, years of suppressed emotion erupted. Andrey Yefimitch shouted at his visitors, calling them stupid and demanding they leave. This outburst shocked everyone, including the doctor himself, who had never lost his composure so completely. Afterward, he was deeply ashamed and went to the post office the next day to apologize to Mihail Averyanitch.
Chapter 17. Dr. Ragin is tricked and committed to Ward No. 6
After accepting Andrey Yefimitch's apology, Mihail Averyanitch and Dr. Hobotov continued their campaign to "help" him. They insisted that he needed treatment and should enter the hospital. The postmaster extracted a promise from Andrey Yefimitch that he would follow Hobotov's instructions, appealing to their friendship.
Later, Hobotov invited Andrey Yefimitch to the hospital for a consultation. Believing he was going to see a patient, the doctor accompanied his younger colleague. Instead, Hobotov led him to Ward No. 6 and then disappeared, claiming he needed to fetch a stethoscope.
Andrey Yefimitch waited in the ward, conversing briefly with the patients. After half an hour, Nikita appeared with hospital clothes and informed the doctor that this would be his bed. The horrifying truth dawned on Andrey Yefimitch: he had been tricked and was now being committed as a patient in Ward No. 6.
"I have got into an enchanted circle which there is no getting out of. I don't care; I am ready for anything... So long as prisons and madhouses exist someone must be shut up in them. If not you, I. If not I, some third person."
Too stunned to resist, Andrey Yefimitch changed into the hospital clothes. He felt deeply humiliated, especially when he realized that his watch and other personal belongings had been taken away. He was now a prisoner in the very ward he had administered for so many years.
Chapter 18. Dr. Ragins first night in Ward No. 6
Ivan Dmitritch, who had been lying with his face to the pillow, recognized Andrey Yefimitch and reacted with bitter satisfaction at seeing the doctor reduced to a patient. He taunted the doctor, suggesting that those who exploit others will eventually be exploited themselves. Andrey Yefimitch tried to explain that there had been a misunderstanding, but Ivan refused to engage further.
"It's some misunderstanding... You can go and spy and probe somewhere else, it's no use your doing it here. I knew yesterday what you had come for... A spy or a doctor who has been charged to test me—it's all the same."
As evening approached, Andrey Yefimitch grew increasingly distressed. He looked out the window at the prison in the distance and felt a growing sense of terror. When he tried to leave the ward to get some air, Nikita blocked his way, explaining that patients were not allowed out after bedtime.
Both Andrey Yefimitch and Ivan Dmitritch protested this restriction, demanding that the door be opened. Nikita responded by physically assaulting them. He punched the doctor in the face and beat him on the back. Ivan Dmitritch screamed, presumably receiving similar treatment. Afterward, silence fell over the ward, broken only by the moonlight casting net-like shadows through the barred windows.
Lying in pain, Andrey Yefimitch had a terrible realization: for twenty years, he had allowed this brutality to continue under his supervision. The patients he had philosophically dismissed as inevitable sufferers were real people enduring real pain day after day, year after year. This recognition of his moral failure overwhelmed him, and he collapsed unconscious onto the bed.
Chapter 19. Dr. Ragins death
The next morning, Andrey Yefimitch awoke with a headache and a profound sense of apathy. He refused food and drink and lay motionless on his bed, responding to questions with, "It is all the same to me." His former friend Mihail Averyanitch visited, bringing tea and pastilles, as did Dr. Hobotov, who prescribed bromide.
That evening, Andrey Yefimitch suffered an apoplectic stroke. He experienced violent shivering and nausea, followed by a greenish haze before his eyes. As death approached, he briefly contemplated the possibility of immortality, which many people, including Ivan Dmitritch and Mihail Averyanitch, believed in.
Andrey Yefimitch understood that it was all over, and remembered that Ivan Dmitritch, Mihail Averyanitch, and millions of people believed in immortality. And what if it really existed? But he did not want immortality—and he thought of it only for one instant.
In his final moments, Andrey Yefimitch experienced a series of disconnected visions: a herd of deer running past him, a peasant woman with a registered letter, and Mihail Averyanitch saying something indistinct. Then everything vanished, and he "sank into oblivion forever."
The hospital porters carried his body to the chapel, where it lay with open eyes under the moonlight. The next morning, Sergey Sergeyitch came to pray before the crucifix and closed the eyes of his former superior. Andrey Yefimitch was buried the following day, with only Mihail Averyanitch and Daryushka attending the funeral.