Tolstoy on unique illnesses and self-serving caregivers

Amid the tumbling flood of gossip, duels, dinner parties, battles, clothing choices, serf-floggings and broken engagements that comprises most of Leo Tolstoy’s War and Peace sit quiet islands of wisdom about how humans’ needs knit together to form social instruments and institutions. Resting on the bedrock of human nature, these islands are as ageless as the rest of Tolstoy’s torrent is ephemeral.

One of these islands, tucked into Volume III Part 1, Section XVI, describes both the incommensurable uniqueness of many human illnesses and the self-serving psychology of care giving.

Here’s how Tolstoy describes the illness and treatment of one Natasha Rostov:

Doctors visited Natasha both singly, and in consultation, spoke a good deal of French, German, and Latin, denounced one another, prescribed the most varied medications for all the illnesses known to them; but the single thought never occurred to any of them that they could not know the illness Natasha was suffering from, as no illness that afflicts a human being can be known; for each human being has his peculiarities, and always has its own peculiar, complex illness, unknown to medical science, not an illness of the lungs, the liver, the skin, the heart, the nerves, and so on, recorded in medicine, but an illness consisting in one of the countless combinations of afflictions of these organs. This simple thought did not occur to the doctors (just as it cannot occur to a sorcerer that he cannot do sorcery), because their life activity consisted in treating patients, because that was what they were paid for, and because they had spent the best days of their lives doing it. But above all else, that thought could not occur to the doctors, because they saw that they were unquestionably useful, and indeed they were useful to all the Rostov household. They were useful not because they made the patient swallow what were for the most part harmful substances (the harm little felt, because the harmful substances were given in small quantities), but they were useful, necessary and inevitable (for the same reason that they are and always will be and that there will always be imaginary healers, fortune tellers, homeopaths, and allopaths) because they satisfied the moral need of the sick girl and the people who loved her. They satisfied that eternal human need for the hope of relief, the need for compassion and action, which a human being experiences in time of suffering. They satisfy that eternal human need—noticeable in a child in its most primitive form—to rub place that hurts.

What would Sonia, the count and countess have done, how could they have looked at the weak, wasting Natasha, without undertaking anything, if it had not been for this taking pills at specific time, warm drinks, chicken cutlets, and all the details of life prescribed by the doctors, the observance of which constituted the occupation and comfort of everyone around her? The more strict and complicated the rules, the more comforting it was for everyone. How could the count have borne the illness of his beloved daughter, if he had not known that Natasha’s illness was costing him thousands of rubles and he would not spare thousands more to be of use to her; if he had not known that if she could not get better, he would spend thousands more and take her abroad and hold consultation there; if he had no occasion to talk in detail about how Metivier and Feller had not understood the illness, but Frieze had, and Mudrov had diagnosed it still better? What would the Countess have done if she had not been able to quarrel occasionally with a sick Natasha for not fully observing the doctor’s prescriptions?

Time passes. Finally, “despite the large quantity of pills, drops, and powders she had swallowed,” Tolstoy concludes that “youth had its way,” and Natasha started to recover.

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