PT - JOURNAL ARTICLE AU - Raimo Puustinen TI - Voices to be heard—the many positions of a physician in Anton Chekhov's short story, <em>A Case History</em> AID - 10.1136/mh.26.1.37 DP - 2000 Jun 01 TA - Medical Humanities PG - 37--42 VI - 26 IP - 1 4099 - http://mh.bmj.com/content/26/1/37.short 4100 - http://mh.bmj.com/content/26/1/37.full SO - J Med Humanit2000 Jun 01; 26 AB - Anton Chekhov (1860-1904) dealt in many of his short stories and plays with various phenomena as encountered in everyday medical practice in late 19th century Russia. In A Case History (1898) Chekhov illustrates the physician's many positions in relation to his patient. According to Mikhail Bakhtin's philosophy of language, a speaker occupies a certain position from which he or she addresses the listener. A phenomenon may gain different meanings depending on the position from which it is addressed. In his story Chekhov describes how the patient was at first addressed solely from a medical point of view, without any relief to her suffering. Only when the physician was able to shift his position in a manner which offered the patient an opportunity to be heard as a person was she able to express the true nature of her illness and to find new ways for palliation and cure.