This collection of essays is a profound study of illness, medicine, ethics, and poetics in a broad selection of Anton Chekhov’s stories. Leonard Polakiewicz’s overarching argument is that medical issues in Chekhov’s prose are not simply manifestations of life events, but are, more importantly, events through which the author realizes a fuller portrayal of his characters. His meticulous analysis of poetic structures brings deeper understanding to Chekhov’s view of the world as both a physician and an artist.

The first five chapters identify thematic and poetic paradigms in the early stories. The subjects of medical ethics and responsibility are presented in the context of the charlatanism of dishonest physicians and feldʹshers (poorly trained medical assistants) in the stories “Unpleasantness,” “Ward Six,” “Surgery,” and “Thieves.” Polakiewicz’s presentation of illness and literary poetics in stories dealing with typhus—from the early story “Typhus” to the later stories “Gusev,” “The Black Monk,” “Rothschild’s Fiddle,” “The Bishop,” and “The Betrothed”—demonstrates how Chekhov’s knowledge of medicine together with his artistic talent gives him unique insight into the human condition. The essay on “Typhus” provides a brilliant analysis of the musicality of sensations that traces the emotional trajectory of the hero’s psychological state throughout his illness. The rhythmic crescendo of sounds and temporal distortion of time, Polakiewicz suggests, links Chekhov’s poetics to a modernist, syncretistic aesthetic, at times bordering on synesthesia. An impressive analysis of the blending of poetic and thematic structures appears in the chapter on “Late Blooming Flowers,” where Polakiewicz provides a valuable template for reading Chekhov’s prose. He demonstrates how poetic features such as rhythmic prose, repeated details, diminutives, syncretism, ellipses, and nature imagery evoke Chekhovian themes of futliarʹnost, inauthenticity, communication lapses, and the potential for “awakening” and change.

Situated at the center of the book, as if at some mystical point of balance, is a remarkable chapter on “The Steppe.” Medicine as a theme recedes, as Polakiewicz focuses on the syncretistic interconnectedness of human life and the natural world, which shapes both the poetic fabric of the story and the personalities of the characters. Especially noteworthy is his detailed study of the relationship between the senses, the poetic word, and pictures. The view of Chekhov as a “masterful colorist” (182) and painter of “word pictures” (169) is vividly illustrated in an analysis of color codes, in which nearly every color of the spectrum reflects the mysterious beauty of the steppe and its inhabitants. Polakiewicz rightfully claims that the rhythmic musicality, along with the synesthesia of smells, taste and touch, places this story, along with others, in the modernist camp.

Chekhov’s approach to themes of fate, freedom, responsibility, death, and dying is the focus of the final third of the book. Two groups of stories are discussed: one where fate is intractable, the other where a character has the potential to change his course, whether he chooses to act on it or not. The latter group includes the stories “In Exile,” “Enemies,” “Verochka,” “Ward 6,” “Easter Eve,” “Rothschild’s Fiddle,” “The Lady with a Lapdog,” and “The Bishop.” Critical for Chekhov was that a person use his agency to act responsibly in the face of grave illness. Polakiewicz concludes his discussion of fate and responsibility with an affirmation of the role of creative potential in this paradox, offering “Lady with the Lapdog” as an example of individuals who overcome their fatalistic resignation and create a new future together. In Chekhov’s view, Gurov and Anna are the right kind of protesters because their protest is in the spirit of truth and leads to a meaningful life.

In the final chapters about death and dying Polakiewicz reminds us, in the words of Eudora Welty, that life, not death, is Chekhov’s pattern (302). A discussion of the religious dimension of death focuses on such works as “The Bishop,” “Easter Eve,” and “Rothschild’s Fiddle,” in which characters experience a new awareness and positive change in the presence of the divine. The book ends with a discussion of The Island of Sakhalin and pays tribute to Chekhov as a scientist, an empathic public servant, and an activist for prison reform and justice. It is an appropriate finale for Polakiewicz’s valuable and substantial contribution to Chekhov scholarship, as it suggests that answers to the questions posed earlier in the book can be found in Chekhov’s own refusal to resign himself to fate and, instead, to live in affirmation of life, despite his terminal illness.