Isolated and embittered, Pavlov entered the Medical-Surgical Academy in fall 1875 and searched for a lab in which to continue his scientific investigations. Medical school was an unappetizing prospect—all the more so because he was surrounded there by students and faculty whom he blamed for Tsion’s downfall. Yet the Academy remained the most plausible venue for pursuit of his goal: not to become a practitioner of what he derisively called “the Latin kitchen,” but to position himself for one of Russia’s rare positions in physiology.
Russia’s leading medical school and center of scientific medicine, the Academy had risen from the camps of Peter the Great’s Cossack regiments on the Vyborg Side of the city, on the banks of the Neva and Bol’shaia Nevka rivers. In 1715, Peter ordered the construction of a hospital complex for soldiers and sailors with two anatomical theaters, a library, and a church. The main buildings were completed in the 1720s, and, as in Western Europe, hospital instruction gave rise to increasingly formalized programs for the training of physicians, surgeons, and auxiliary medical personnel. These programs were formally united by century’s end, and in 1798 Tsar Paul I ordered the construction of dormitories and teaching auditoriums. That year became the official founding date of the Medical-Surgical Academy.
In both Russia and Western Europe, the military’s need to mend soldiers and return them to the front made the military hospital a leader in putting therapeutics, rather than traditional religious duties, at the forefront of the hospitals’ tasks. Military-Medical Academies were founded in Vienna and Berlin, and Russia’s Medical-Surgical Academy became central to Russian efforts after the Crimean War to reform medicine in the spirit of scientific positivism. Alexander II’s Minister of War, Count Dmitrii Miliutin, secured generous funding for the reform and renovation of the Academy’s faculty, facilities, and curriculum. The Academy enjoyed a golden age in the 1860s. Its specialized teaching clinic; newly modernized physiological, chemical, and clinical labs; reformist administration; and newly hired faculty transformed it into a center for modern experimental inquiry. By the time of Pavlov’s matriculation, the luster of that decade had faded—but it had become Russia’s acknowledged center for scientific medicine.1
Looking past medical school to a career in physiology, Pavlov had his eye on one key feature of the reformed Academy—its Institute of Physicians. In 1858, Tsar Alexander II had approved Dubovitskii’s proposal that, instead of being immediately deployed with their classmates to regiments in various corners of the empire, the best ten physicians in each year’s graduating class would discharge their service obligation at the Academy’s hospital clinic while studying for three years at its elite Institute of Physicians. Working under the advisor of their choice, these promising graduates would develop their scientific skills and submit a doctoral thesis. The top three doctoral recipients would then be sent abroad for two years to absorb research and teaching skills in the best Western European medical institutions and laboratories.2
For somebody uninterested in medical practice, Pavlov’s enrollment at the Academy was somewhat of a gamble. He would endure three years of medical school (having passed out of the first two years of the five-year curriculum by virtue of his university science studies) as a wager on his ability to place within the top ten of the graduating class and then, three years later, within the top three of that elite group. Success would be rewarded with three years of graduate study, two years among Europe’s leading physiologists, and impressive credentials for a professorship in physiology. Should he fail to qualify for the Institute of Physicians, however, his hopes for an eventual professorship in physiology would be slim. For one thing, he would be doomed by the contractual obligation of Academy graduates to almost five years of service as a military physician. For another, he would have lost three precious years, during which his peer Vladimir Velikii, for example, was cementing relations with a powerful patron and accumulating knowledge, experience, and publications in physiology as Ovsiannikov’s assistant and protégé at the university and the Academy of Sciences, and another future competitor, Nikolai Vvedenskii, was benefiting from a similar apprenticeship to Sechenov.3
From 1875 to 1879, Pavlov endured medical school, with its lectures from 9:00 to 5:00 and practical studies into the early evening, while he sought time and facilities for the scientific research that might qualify him for the Institute. Six days a week, he hiked to the Academy from the state apartment near the university to which Dmitrii was entitled as Mendeleev’s assistant. Here, too, lived the third Pavlov brother, Petr, who had matriculated at the university in 1873 and was flourishing in his studies with zoologists Bogdanov and Vagner.
Despite his lack of enthusiasm for clinical courses, the medical milieu left a profound imprint upon Pavlov’s scientific style. Deepening the sensibilities that he had imbibed from Bernard and Tsion, it encouraged his lifelong emphasis upon whole-animal physiology. Surrounded by clinics and practitioners, Pavlov also approached the experimental animal much as a physician approached a patient, and constantly bore in mind the relationship of his physiological research to medical practice. In one series of experiments on nervous control of blood pressure in dogs, for example, he modeled the diet of his experimental animals upon that in the Academy hospital in order to facilitate “the transfer of the results of our experiments to the human organism.”4
At the Academy, he was also introduced to Joseph Lister’s recently announced principle of antiseptic surgery (the use of carbolic acid to disinfect a wound), whose advocates included the renowned professor of surgery Nikolai Sklifosovskii. As in other European medical institutions, the response to Lister at the Academy varied widely. The teacher of Pavlov’s fifth-year course in surgery, E. I. Bogdanovskii, was very skeptical, as was the head of the surgical clinic, I. O. Korzhenevskii, who ridiculed his colleague’s fear of invisible bacteria and, to emphasize the point, demonstratively put a finger he had just employed in the rectal exam of one patient into the mouth of another.
Pavlov had ample opportunity to contemplate the evolving concept of aseptic surgery as he grappled with the difficulties of keeping his experimental animals alive after surgical operations. Like most who took Lister seriously, his understanding of the role of dirt, poisons, and germs was ill-defined and idiosyncratic. In the 1870s and 1880s, he routinely blamed the “filthy” conditions in available labs for the death of his experimental animals. When he finally obtained his own lab in 1890, he would immediately create there a surgical complex that employed Listerian principles as part of the distinctive “physiological surgery” central to his mature physiological style.5
Pavlov’s situation was complicated by his alienation from the leading physiologists in the city. His passion for science and his career goals dictated that he pursue scientific research, but Tsion’s departure—and Pavlov’s hostility toward the physiologists in St. Petersburg whom he held partially responsible—left him without a mentor. He became almost an autodidact. His formal education in physiology never amounted to more than the two or three years at Tsion’s side in the university, and he was largely deprived of the informal apprenticeship in post-university years that was so valuable in seasoning, training, and expanding the horizons of young physiologists. (In one despairing letter of 1881, he dismissed his knowledge of his specialty as “pathetic.”6) During his years in the professional wilderness, from 1875 to 1890, he continued his scientific research in earnest, but did so by developing the lines of investigation and employing the techniques that he had learned from Tsion. Intellectually, he was on his own.
His search for lab facilities was also shaped by the aftermath of the episode that had terminated his apprenticeship. Ovsiannikov had temporarily assumed Tsion’s teaching duties at the Academy and his protégé Velikii assisted him with demonstrations. Tsion’s fine new lab, where Pavlov had conducted his research as a university student, was shuttered. Tsion’s former student Sergei Chir’ev, who had served there as assistant (and who had been scheduled eventually to relinquish that position to Pavlov) became assistant to Konstantin Ustimovich, the Tsion protégé who directed the physiology lab at the Academy’s Veterinary Institute.
In the fall of 1875, Pavlov began working as a volunteer in Ustimovich’s small lab. When Chir’ev defended his thesis, Pavlov replaced him as assistant. In this capacity, he demonstrated classical experiments for veterinary students and pursued his own research during the evenings. Meanwhile, Ustimovich, Chir’ev, and Pavlov waited hopefully for news of Tsion’s successor.
Working in Ustimovich’s lab, Pavlov produced seven articles on subjects he had taken up under Tsion’s tutelage. These studies of the blood vessels, pancreas, and salivary glands all involved both the mechanisms by which the nervous system controlled bodily functions and the pursuit of “normalcy” in physiological experiments. Grappling with this latter issue, he for the first time openly confronted the psyche as an obstacle to reliable experimental results.7
Not only did the physiologist’s operations disturb the notoriously sensitive pancreas, he argued in an article of 1877, they also (contrary to Bernard’s earlier finding) distorted salivary secretion. The French physiologist had been led astray, he reported, by the fact that the same stimulus that inhibited the pancreas actually excited the salivary glands, and vice versa. Yet, as Sechenov pointed out in discussion of these findings, the curare Pavlov used to sedate his dogs during these trials also rendered his animals “abnormal.”8
Innovating accordingly in trials designed to test Ludwig and Tsion’s claim that nervous mechanisms adjusted the blood vessels to maintain constant pressure under varying conditions, Pavlov avoided the use of curare by instead training his lab dogs to remain “completely peaceful” when strapped to the table to have their pressure monitored. Still, he admitted, sometimes “a psychic or physiological state” caused “deviations” in the results.9
Here he confronted the problem that, while he was attempting to study one particular physiological reaction—and was seeking results in the form of a smooth data curve—uncontrolled variables in the intact animal could wreck havoc upon experiments. In one trial, for example, when the dog’s blood pressure measured higher than expected, Pavlov determined that this had resulted from the fact that “a well-trained animal is accustomed to refraining from urination in the room”—which elicited a “psychic or physiological state” that raised its blood pressure. After it had urinated in the courtyard, he obtained the expected measurements.10
Some lab animals also experienced “fear of the unknown.” Sometimes this was easily overcome: when, through repetition, “the animal is convinced in practice ... of the safety of the measures to which it is subjected, all disturbing influences of mental activities disappear.” With other animals, however, successful experiments were virtually impossible. One dog never ceased its “desperate wailing”—and only in one trial was Pavlov able to wrest a satisfactory measurement from it.11
The problem of “normalcy,” then, raised questions of experimental technique and methodology—the resolution of which led to Pavlov’s first trip abroad. In their collaborative study of the pancreas, he and Afanas’ev had claimed to demonstrate the inhibitory action of atropine upon that gland.12 Europe’s leading expert on digestive physiology, Rudolf Heidenhain, however, rejected their claim. Pavlov saved enough rubles from his Academy stipend and his wages as Ustimovich’s assistant to travel to Breslau (now Wrocław, Poland) in summer 1877 in order to convince him. The results were disappointing. Injecting atropine into an animal equipped with the fistula designed by Bernstein was indeed accompanied by the cessation of pancreatic secretion, but Heidenhain claimed that this fistula itself inhibited the highly sensitive gland. In an animal fitted with a fistula of Heidenhain’s design, atropine failed to inhibit secretion.
Having mastered the Heidenhain fistula, Pavlov returned to St. Petersburg and repeated the experiments. Remarking on the extraordinary sensitivity of the pancreas, which he attributed to an as-yet-undiscovered nervous connection, he nevertheless determined to his own satisfaction that atropine indeed inhibited the gland and that he had failed in Breslau only because he had used an insufficient quantity of the drug. This incident reinforced Pavlov’s dissatisfaction with existing pancreatic fistulas, which generated erratic results and rapidly starved the experimental animal to death. (The fistula diverted pancreatic juice from the digestive tract and so disrupted the animal’s digestive process.) One extraordinary dog upon which he experimented had apparently set a world record by producing active pancreatic juice for ten days before expiring. “Our passionate desire to extend experimental trials on such a rare animal was foiled by its death as a result of extended starvation and a series of wounds.” As a result, “the expected resolution of many important and controversial questions” had been postponed until another such rare animal presented itself. The development of techniques to keep such valuable experimental animals alive for years, and the recognition that some animals simply made better experimental subjects than others, would become central features of Pavlov’s mature physiological style.13
On the eve of his departure for Breslau, Pavlov had learned to his disgust that the Academy’s new professor of physiology was Prince Ivan Tarkhanov. Tarkhanov offered Pavlov the position of lab assistant in Tsion’s old lab—but he indignantly refused. History, professional politics, and personal temperament were all at work here.
Only three years older than Pavlov, Tarkhanov could hardly have differed more in background and manner. Born to a celebrated family of Georgian princes, he had been schooled as a child by a French governess and various tutors before entering Tbilisi’s Classical Gymnasium. A liberal activist at St. Petersburg University, he was expelled in 1864 for participation in student demonstrations, but, perhaps due to family connections, was soon readmitted, his crime forgiven, and just five months later was admitted to the Medical-Surgical Academy.
Attracted to physiology by the same ideological currents that had lured Pavlov from the seminary, Tarkhanov studied with Ovsiannikov at the university and then with Sechenov at the academy and its Institute of Physicians. When Sechenov departed, Tarkhanov completed his thesis in Tsion’s lab, received one of the Institute’s prized fellowships, and embarked in June 1873 for two years in Europe. Returning to St. Petersburg in fall 1875, he became lecturer at the Academy in 1876–1877 and in May 1877 was selected as Tsion’s successor.
Tarkhanov had been largely absent during the “wild episode,” but Tsion loyalists despised him as a “traitor”—presumably because, after working in Tsion’s lab, he had sided with his enemies and then taken his job. Tarkhanov had still been in Petersburg (and working in Tsion’s lab) when Tsion delivered his speech on “The Heart and the Brain”—a speech that targeted views dear to both Sechenov and Tarkhanov—and no doubt had defended his own beliefs in arguments about that controversial performance. In any event, Chir’ev and another Tsion protégé, Nikolai Bakst, soon launched what one contemporary termed “an unending war” against Tarkhanov—criticizing him vehemently in all available venues.14
Unlike that pair, Pavlov did not share Tsion’s monarchist views and hatred of materialist philosophy, but he doubtless agreed with them that leftist conspirators had targeted their mentor and illegitimately conferred his professorship upon this usurping Liberal Prince. Pavlov’s loyalty to Tsion and his fierce sense of dostoinstvo would have forbidden him to embrace Tsion’s successor. Nor could he have warmed to his personal style; in sharp contrast to the raznochintsy Tsion and Pavlov, Tarkhanov possessed an aristocratic manner and exuded a sense of confidence and entitlement. For the provincial seminarian sensitive about his social origins, the popular new professor’s affect could easily be interpreted as condescension.
Explaining decades later his reasons for refusing Tarkhanov’s offer of a lab assistantship, Pavlov emphasized an incident at a meeting of the Society of Naturalists in February 1876. His version of events was this: Ovsiannikov was using a device he had seen in Ludwig’s lab to measure the urea produced by a dog’s muscular work. The anesthetized animal was bound to a wheel that, when turned, bent and unbent the dog’s legs at the joints. Through two incisions, the experimenter measured the urea content of venous and arterial blood during the trials. In Pavlov’s account, he rose from his seat and asked: “‘Excuse me, but where is the work here? What muscular work has the dog performed when its paws were moved passively?’ This speech stunned [Ovsiannikov], who realized that he had committed a great error and, essentially, had no response.” Tarkhanov rose to Ovsiannikov’s defense, dismissing the comment of “the student Pavlov” and noting that even “passive movements constitute work.” Disgusted by this display of dishonest sycophancy—and insulted by Tarkhanov’s condescending reference to him as a “student”—Pavlov walked out demonstratively. The Society’s published account confirms Pavlov’s description of Ovsiannikov’s experiment, but provides no information about the ensuing discussion. In any case, Pavlov’s later account captured his low opinion of Tarkhanov at the time, an opinion no doubt rooted in the Tsion affair and reinforced by this incident.15
Pavlov, then, refused Tarkhanov’s offer, and probably in a most hostile manner. The new professor was not merely insulted; his lectures in physiology suffered for years as a result. Pavlov had already gained rare experience with dissection and the staging of experiments from his work with Tsion and Ustimovich—so, in the absence of a paid dissector, Tarkhanov had counted upon him to prepare the experimental demonstrations for his lectures. With Pavlov’s refusal, he was forced to rely on inexperienced students, and classroom experiments failed miserably for four long years until a full-time dissector was hired. So, Pavlov had not only burned his bridges to the city’s best physiological lab; he had guaranteed that the Academy’s physiologist—and his friends and colleagues—would not soon forget his impertinence.16
Pavlov’s account of the incident at the Society of Naturalists also reveals his disdain for Ovsiannikov and his indifference toward cultivating this powerful academician with whom, until Tsion’s demise, he had apparently enjoyed good relations. Ovsiannikov had lectured to Pavlov’s university class on general anatomy and had recommended that Pavlov and Afanas’ev receive the gold medal for their research on the pancreas. But he was also considered a member of the liberal party that had ousted Tsion and had played a starring role in a very bitter moment for Pavlov by appearing at the Academy’s auditorium to the hearty cheers of students to replace Tsion as their lecturer in physiology.
Pavlov could hardly have endeared himself to Ovsiannikov by his article of 1877 for the Academy’s Military-Medical Journal in which he used the senior physiologist’s research as an object lesson in bad scientific method. In “On the Vessel-Regulating Centers in the Spine,” he credited Ovsiannikov with discovering the “probable” truth that “a certain place in the medulla oblongata contains a certain ganglial mass that influences all the vessels of the body,” but dwelled upon his unproven assertion that such a center existed only in the medulla oblongata. Adopting a distinctly preachy tone, Pavlov devoted several pages to a discussion of Ovsiannikov’s error as an illustration of Bernard’s principle that “negative experiments” proved little. Ovsiannikov had severed various parts of the medulla oblongata and the spine in rabbits, and, based upon the presence or absence of reflexive changes in the vessels after these operations, had concluded that only the medulla oblongata—and not the spine—contained nervous centers controlling the vessels. He should not have so easily reached this conclusion, Pavlov commented, since the operations themselves might have paralyzed the spinal centers or interfered with physiological functions in unforeseen ways. “The animal organism is such a complex machine,” he reminded Ovsiannikov, “it is so complexly dependent upon surrounding conditions, that the investigator is always in danger of ... influencing precisely that part of the apparatus in which he is interested.” Thus the history of this issue illustrated “very important rules for correct physiological thinking and experimentation” that had unfortunately “still not been implanted in the minds of physiologists.” Ovsiannikov’s reaction to this bit of instruction is unrecorded.17
Pavlov may have reluctantly viewed Sechenov as the third member of St. Petersburg physiology’s anti-Tsion troika. Although Sechenov had originally recommended Tsion as his successor at the Academy, he remained Tsion’s ideological antagonist and, in 1876, replaced him as St. Petersburg University’s physiologist. According to one of Pavlov’s later coworkers, Sechenov and Pavlov disliked each other and their relations were always “cool.” Despite the intensive efforts of later generations of Soviet historians—who sought to connect these two iconic Russian physiologists--no evidence of cordial relations between them has ever been discovered. Nor does it exist in Pavlov’s extensive personal papers. Pavlov’s attitude toward Sechenov was probably ambivalent—he certainly respected him as a man, a scientist, and as one of the original inspirations for his own decision to abandon the seminary for science. Yet he never sought his company, counsel, or support. His attempt to cast himself as Sechenov’s spiritual successor would begin only years later, after the death of this figure who was already being lauded as the “Father of Russian Physiology.”18
While conducting experiments on pancreatic secretion in late December 1877, Pavlov received tragic news from Riazan: his brother Petr had been killed in a hunting accident. Having graduated earlier that year, Petr had just been appointed curator of the university’s Zoological Cabinet and awarded a stipend for a trip abroad. Before departing, he decided to visit his parents for Christmas. Dmitrii joined him, but Ivan—busy with his experiments and, no doubt, unenthusiastic about seeing his father—stayed behind. Accompanied by their younger brother, thirteen-year-old Sergei, Dmitrii and Petr embarked on a hunting trip through the snowy Riazan woods, seeking to enrich Petr’s ornithological collection. When Sergei fell into a ravine and was unable to climb out, Petr extended his musket to him, stock first and uncocked, in order to pull him up. Either the hammer caught on Sergei’s pouch or the young boy himself inadvertently raised it. The musket discharged into Petr’s breast. His brothers dragged him home, where he suffered for two days before dying in the early hours of December 31. Petr’s death traumatized the family. The parents blamed Sergei, exacerbating the guilt feelings that contributed to his sad and unhappy life. Pavlov would speak frequently over the years with deep grief about this tragic example of the unhappy role of sluchainosti in human life.19
His professional position had meanwhile become untenable. Ustimovich was leaving the Academy and his lab was closing. Physiology would henceforth be taught jointly to both medical and veterinary students by Tarkhanov. Pavlov needed to find a lab in which to work and, with his stipend expiring, a means of earning a living.
Stol’nikov came to his rescue. Pavlov’s friend from university days had entered the Academy one year before Pavlov had, concentrated on studies of internal medicine, graduated from medical school with honors, and gained entrance to the Institute of Physicians. Most important, he enjoyed the confidence of his mentor, the academy’s eminent professor of therapeutic clinical medicine, Sergei Botkin. Pavlov had taken Botkin’s course but had formed no relationship with him. Now Stol’nikov put in a good word for his friend and introduced him to St. Petersburg’s most powerful medical figure.
Botkin was at this time overwhelmed by the consequences of his success. He had been one of the first Russians to visit Western Europe during the Reform Era, studying in the late 1850s both with leading clinicians and with Bernard, Ludwig, and the founder of cellular pathology, Rudolf Virchow. There he had also met Sechenov, forming a lifelong friendship interrupted only by a bitter argument about whether molecules (Sechenov’s contention) or cells (Botkin’s) comprised the basic unit of living beings. After serving under surgeon Nikolai Pirogov during the Crimean War, he had joined the Academy’s faculty in 1860, organizing there Russia’s first clinical lab and ambulatory service, and working closely with the institution’s reformist triumvirate.
In his Course on the Clinic of Infectious Diseases (1867), his journal Archives for the Clinic of Internal Diseases, and some seventy-five works on therapeutics, infectious disease, experimental pathology, and pharmacology, Botkin proselytized for a scientific, particularly physiological, approach to medicine. For Botkin, the bedside physician needed to draw upon pathological anatomy and, particularly, physiology to evaluate the patient, but also needed to treat not just the disease but the patient as a whole. In his bedside teaching, he emphasized that a disease in one organ generated difficulties throughout the body and that the patient presented a unity of physical and psychical processes. An untiring organizer, he both supported progressive causes and became a trusted member of the tsarist establishment—founding the Epidemiological Society (1865), serving on the Ministry of Internal Affairs’ Medical Council (from 1866), and helping to organize the Women’s Physicians Courses (1872).
When Pavlov met Botkin in 1878, the professor was exhausted from his duties to the imperial family. A medical consultant to the tsarist court since 1870, he had become personal physician to the Empress Maria Alexandrovna in 1872 when she fell seriously ill with what Botkin diagnosed as inflammation of the lungs. Throughout the 1870s, he accompanied her for several months annually to the Crimea, Italy, and French and Swiss resorts. Appearing at the Winter Palace almost weekly, he became a presence in court circles. In 1877 he was appointed official counselor to the tsar and traveled with Alexander II to the Balkans, attending to the tsar and reviewing medical services at the front. He returned to St. Petersburg with his nerves shot “not so much from climatic conditions as from moral suffering and homesickness.” His ten-year tenure as president of the Society of Russian Physicians began the following year.
The overwhelmed professor could particularly use the services of an energetic young physiologist in two of his projects. The first was at the St. George’s Commune of Sisters of Mercy, where he had organized ambulatory and hospital services for the indigent. Here Botkin had also created a school for feldshers (medical paraprofessionals), and he offered Pavlov a position teaching physiology there, which provided badly needed income until the school closed in 1882.
Botkin had also created several modest labs on academy grounds. One of these, housed in a wooden cottage in the courtyard of his clinic, was devoted to animal experiments to test the action of various plants and medicines. According to one observer, it hardly merited the description “laboratory,” since it was “little adapted to the carrying out of scientific investigations and very poorly equipped, and of complicated physiological apparatus possessing only one old kymograph.” The modest facility played an important role, however, in Botkin’s research interests and his training of Institute physicians, but, overloaded with other responsibilities, he rarely stopped by, and needed somebody to manage it.20
Sometime in 1878, Botkin hired Pavlov for that task. At the time, Botkin was primarily interested in the action of various substances that might be used to treat the heart and vascular system. His practice was to mention his interest in a particular plant or drug to one of his many interns who, as Institute physicians, were pursuing a doctoral thesis, and leave it to Pavlov and the intern to explore experimentally the action of that substance. Pavlov would himself use Botkin’s lab to collaborate with Stol’nikov in 1879 on a study of the effect of heat on the excitability of nerves. More important, this position became his lifeline until 1887.
Incorporation into Botkin’s network proved crucial to the young scientist, who, by his fierce loyalty to his exiled mentor, had alienated himself from the city’s leading physiologists. The physicians around Botkin and the interns that passed through the commune’s hospital and the courtyard lab produced a network of friends and professional supporters. Physician David Kamenskii; otolaryngologist Nikolai Simanovskii and his wife, experimentalist and physician Ekaterina Shumova-Simanovskaia; Academy professor, oculist, and fellow Riazanite Vladimir Dobrovol’skii; neurologist Alexander Timofeev (later Director of the Alexander III Home for the Care of the Mentally Ill); and two physicians at the Commune’s hospital, Nikolai Bogoiavlenskii and Vladimir Dobrovol’skii became friends, resources, and professional allies. Viacheslav Manassein, the Botkin protégé who was Professor of Therapeutics at the Academy and editor of Russia’s leading medical professional journal, Physician, and Sergei Luk’ianov, later a Professor of Pathology at Warsaw University, Director of St. Petersburg’s Imperial Institute of Experimental Medicine, and Head Procurator of the Holy Synod, also became important supporters. Pavlov’s career and scientific style would owe much to his becoming the physiologist, not of the University and the Society of Naturalists, but rather of the Medical-Surgical Academy and the Society of Russian Physicians.
With the outbreak of the Russo-Turkish War in 1877, the Medical-Surgical Academy rushed Pavlov’s medical class through their coursework and to the front, administering their final exams in April 1878, six months earlier than originally scheduled, and graduating students who passed at least one third of them. Perhaps because he was engrossed in lab research rather than his medical studies, Pavlov was among only six students who failed to do so. Other than avoiding the front, that failure had no impact upon his career. He remained in medical school for another semester (without stipend) while managing Botkin’s lab, and took his final exams the following year (by which time the war was over).
This time he passed easily, with a mixture of “entirely satisfactory” (the highest grade) and “satisfactory” evaluations. His grades on “theoretical subjects” were better—six “entirely satisfactory” out of fifteen, with only four superlative performances out of eighteen in the “practical” subjects, which interested him much less. Tarkhanov awarded him the highest grade for his exam in physiology (which, appropriately, concerned bile), a rating that Pavlov also earned in most subjects related to surgery (pathological and therapeutic surgery, minor surgery on animals, and forensic surgery on corpses). Professor Merzheevskii found him only “satisfactory” on the theory of nervous and mental diseases, but “entirely satisfactory” in clinical psychiatry. Pavlov was no doubt pleased to secure a simple “pass” in practical exams on such subjects as gynecology, ophthalmology, and the prescribing of medicines. He received his medical degree with distinction on December 19, 1879.21
He was now formally obligated to repay the costs of his medical education by serving as a military physician for four years and seven and one-half months, which he hoped to do as a member of the Institute of Physicians. Eighteen candidates applied that year, writing an essay on the theme formulated by pathologist Viktor Pashutin: “A characterization of metamorphosis in the feverish organism and evaluation of the most important theories of the fever process.” In a closed ballot on January 23, 1880, the faculty committee chose seven winners, including Pavlov (with thirteen votes for him and five against). He would, then, discharge his service obligation at the Academy’s clinical hospital as a member of the Institute. That same month, he was also awarded a gold medal for independent scientific investigations by a faculty commission that included both Tarkhanov and Manassein.22
He had successfully negotiated the unwelcome burdens of medical school while pursuing his scientific interests on his own. Pavlov’s affection for and gratitude to Tsion remained, as did the scars from his destruction, yet he had found, though not a mentor, a new and powerful patron who had positioned him within the most influential network in Russian medicine. He had every reason to hope that, after three years of graduate study, he would qualify for two exciting years in the labs of Western Europe.
His thoughts, however, were elsewhere. He had fallen in love.