Doctors are a recurring motif throughout Pozdnychev’s narration of events. Pozdnychev is staunchly critical of doctors and the services that they provide to society—upper-class families in particular. He asserts that following their advice is what ultimately led to the tragic end of his marriage and blames them for many of the worst developments in Russian society. Doctors thereby symbolize the authority figures in 19th century Russia that seek modernization, something that Tolstoy saw as a negative.

This motif illuminates the theme of Conflict Between Social Expectation and Moral Duty. Tolstoy’s main idea in the novella is that sexual activity is immoral; doctors, throughout, enable sexual activity. They provide women with advice on how to avoid unwanted pregnancies and help to prevent STDs. The doctor characters hence uphold the social expectations of a modern society in contrast to Tolstoy’s views of moral duty.

The doctors advise Pozdnychev’s wife not to nurse her first child, and later to use contraceptives to prevent conception, allowing her to develop an identity beyond motherhood. They also recommend actions and treatments to try and combat high rates of infant mortality, whereas religious convention would instead counsel acceptance of death and faith as a balm for grief.