Chekhov published his first short story as a 20 year old medical student. Over the next 24 years, he published nearly 600 more, along with a string of plays including The Seagull, Uncle Vanya, Three Sisters, and The Cherry Orchard. He worked as a doctor until  he could support himself from his writing, finally abandoning his “wife” (medicine) for his “mistress” (literature).

Unsurprisingly, doctors turn up throughout his short stories and plays. My favourite is Astrov, from Uncle Vanya. I’ve already quoted him in the BMJ, introducing a series on health and the environment:

“Man has been endowed with reason, with the power to create, so that he can add to what he’s been given. But up to now he hasn’t been a creator, only a destroyer. Forests keep disappearing, rivers dry up, wild life’s become extinct, the climate’s ruined and the land grows poorer and uglier every day.”

Astrov is a utopian, but burnt out. Like many of Chekhov’s characters, his life hasn’t turned out the way he wanted it to. Read his big speeches at the beginning of Uncle Vanya to see whether he’s for you.

Astrov turned up recently in a week long “Jubilee for Anton Chekhov” at the Hampstead Theatre, London. From the two programmes I attended, I learnt a lot about Chekhov, and Russian medicine.

Medicine was a good choice for a poor grammar school boy, said  Rosamund Bartlett, doyenne of Chekhov scholars. Since the emancipation of the serfs the status of doctors had been steadily increasing. While a student, Chekhov found that short story writing was lucrative enough to support his family after his father’s grocery business  had gone bust. For his short stories, he used the pseudonym, Antosha Chekhonte, saving his real name for all the scientific papers he said he was going to write, said Bartlett.

Novelist William Boyd read out his A-Z of Chekhov, which didn’t include much about medicine, other than the fact that Chekhov named his daschunds Quinine and Bromine. Boyd ascribed great importance to Chekhov’s first serious haemoptysis: from then on he knew the clock was ticking, said Boyd.

But I wonder. Did a lung haemorrhage always presage galloping consumption  and premature death? Did Chekhov, who must have treated dozens of such patients, believe that? He’d watched a brother die of TB, so maybe he did. (There’s a parallel here with John Keats and his brother, Tom, who died before him, from TB.) Knowing that he was under sentence of death may have explained Chekhov’s generosity and sympathy, thought Boyd. But I’m not sure I buy that either – many doctors manage enormous empathy without themselves suffering from a terminal disease.

Did being a doctor affect Chekhov’s  writing? Boyd quoted Chekhov as saying that the writer should have “the objectivity of a chemist.” And certainly, Chekhov seemed very clear eyed about the world, even if his doctor characters weren’t always. Three of Chekhov’s last four plays all have doctors (the exception being The Cherry Orchard). Actor Michael Pennington detected a sort of running doctor joke throughout the other three: in these plays doctors range from the merely complex to the “almost criminally detached.”

Actress Eileen Atkins read Ionych, a short story newly translated by Bartlett. It tells of  a country doctor who loses his heart very briefly to the only child of well off family, only to quickly recover his composure and go on to grow very fat and rich from his private patients. Ionych had begun his practice as a zemsky doctor. As Boleslav Lichterman  explains in his article on Ionych, “Zemskaya” medicine emerged after the abolition of serfdom and was based on the principles of free and accessible care and prevention – a sort of proto-NHS. Chekhov was always very supportive of the zemsky doctors, arranging for a production of Uncle Vanya at one of their conferences.

In 1899, by then Russia’s greatest living writer, Chekhov built a house overlooking the Black Sea, at Yalta. His failing lungs could no longer survive a Russian winter. He died in 1904.

All the important buildings associated with Chekhov in Russia have been well preserved. Not so his “White Dacha” in Yalta. It survived the Russian Revolution, civil war, and Nazi occupation, but Ukrainian independence has proved the toughest challenge, said Bartlett. The Ukrainian government refuses to support it on the grounds of Chekhov’s Russian nationality; Russia isn’t interested because the museum is in the Ukraine. Meanwhile, it’s threatened by subsidence, damp, and general decay. It sounds like a play, but too political to be by Chekhov.

The week long Chekhov jubilee was to raise funds for its preservation. www.yaltachekhov.org

Tony Delamothe is a deputy editor of the BMJ.