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Learning from ward number six.

The physician Anton Chekov (1860–1904) developed a passion for writing at an early age. Acutely aware of the social and health inequalities, his stories centre upon clinical encounters with poor and marginalised sectors of a society in turmoil. In Ward Number Six (1892), the setting is a destitute provincial hospital, the demise of which has gone unnoticed by the central authorities. The unwelcoming and rusting premises exude a ‘doomed air’. The story centres upon Andrej Ragin, the chief doctor, and his relationship with Ivan Gromov, a longterm psychiatric patient. Ragin is initially outraged by the filthy conditions and seeks to bring about change. However, the relentless flow of illness and death take their toll, and Ragin’s determination gives way to disillusionment and despair. A fatalistic attitude — ‘expel physical and moral filth from one place and it will only crop up elsewhere’ — eases his conscience and justifies his waning engagement with patients and dissipating sense of professional and moral duty. Ragin spends more and more of his time debating the purpose of life and death with Gromov. Ragin has lived a protected and comfortable life and believes that suffering and hardship are bestowed upon individuals at random and that these individuals must learn to ignore their effects. His philosophical stance is countered by