Sergei G. Zhuravskii1,2, Vasilii V. Chikulin1
1Pavlov First Saint Petersburg State Medical University
2Federal Almazov North-West Medical Research Centre, Russian Federation
For eight years (1872‒1880), S.P. Botkin served as the private physician of Empress Maria Alexandrovna who suffered from pulmonary tuberculosis. The particular details of this clinical case were defined by its unique deontological aspects: the doctor, a famous professor, a recognized expert Europe-wide, was also a subject of the royal patient – his prescriptions were dependent on her wishes. Medical recommendations were often met with resistance, since due to her deep religiosity, the empress had no motivation to seek treatment. The long-term illness and the particular circumstances of the family background (the existence of the emperor’s second family) contributed to the fact that the relationship between the physician-in-ordinary and the empress was not confined to his official duties. Botkin sympathized with Maria Alexandrovna and understood that her spouse’s behavior was causing her distress; he was grateful for his participation in family affairs. The foundation of the empress’ attitude to Botkin lay in her Slavophile sentiment. It was significant that the authority of the court physician convinced society of the opinion that the royal couple’s separation was due to the state of the empress’ health. His professional enthusiasm, ability to influence the psyche and non-conformism – unusual for a royal household member – generated goodwill in the uncompliant patient, which largely ensured successful treatment. Botkin’s presence let the patient realize her need for care.
Keywords: history of medicine, court medicine, physician-in-ordinary S.P. Botkin, Empress Maria Alexandrovna, the health and illness of representatives of the Romanov dynasty, S.P. Botkin as a clinical psychologist