The Dark Fields of Venus: From a Doctor’s Logbook
by Basile Yanovsky MD
Harcourt Brace Jovanovich, 240 pp., $7.95
In general, I disapprove of modern permissiveness in writing about sexual matters, but I realize that, even twenty years ago, this book could probably not have been published. Nobody could call it pleasant reading but, in my opinion, it should be required reading, especially for young people. A wall slogan in one clinic announces: “VD strikes one person every two minutes.” It is the duty of everyone to be as well informed about venereal disease as possible. At present, ignorance and misconceptions are all too common.
The book consists of 327 vignettes of daily life in a VD clinic. Dr. Yanovsky, in addition to being a medical man, is a distinguished novelist and a member of the Russian Orthodox Church. In consequence he is interested in his patients as human beings. In many cases, he found that personal questions were resented, but he discovered how to get round that.
…if I hold a pen in my hand and look at the chart, I can ask the most impertinent questions and always get a reply. That is considered objective, scientific, and of possible use in the treatment.
But before considering the patients, let us listen to what he tells us about the clinics themselves—staff, organization, shortcomings, etc. As one might expect, though there is plenty of money for medicines, there is very little for anything else. The toilets are usually filthy, the water fountains don’t work, the elevators are often out of order, and there is not enough space for the doctors to park their cars. But the most exasperating feature is the organizational setup.
The best pages of Kafka, Beckett, and Ionesco hardly equal the absurdity of NYC arrangements…. Out of the twelve or thirteen steps through which the poor VD customer is forced to move, one half of the total…require him to go back to the waiting-room, sit down, and wait again…. This danse macabre adds at least one hour to the patient’s waiting time, besides being absurd and humiliating….
If, furthermore, one keeps in mind that our clerks take about fifteen to twenty minutes to admit a patient, and that when they have finally written out his papers, they do not rush to bring them to the doctor but accumulate three or four charts at a time, since, as they put it, “they are not messengers,” then the absurdity of the patient-flow arrangement becomes obvious. Sometimes there are several doctors standing around, waiting for a chart to be filled out in order to do some work. The shortage is less of doctors than of intelligent, literate clerks.
Then there is one group of workers at the clinics about whom Dr. Yanovsky has serious misgivings, namely the VD “detectives,” of whom there are more than a hundred in New York City. Their job is to detect and follow up all syphilitics and their contacts and, lately, gonorrhea contacts as well.
This means that now
…all the sexual contacts of a man during the last two …