A Brilliant Career. A Fatal Error.

When doctors err, it is typically the patient who suffers. The blunder made by Dr. Vladimir Bekhterev, however, put no one else but the doctor himself in danger. And shortly thereafter, eerie circumstances saw the end of his immensely successful life, which began in a village in Tatarstan on January 20, 1857.

When Bekhterev was nine years old, his father succumbed to tuberculosis. Though his father’s early death made life more difficult for the boy, his mother and two brothers, Bekhterev was in little need of paternal discipline. Bookish and diligent from an early age, he also showed a precocious interest in science.

At 16, he moved to St. Petersburg, where he enrolled at the Imperial Medical and Surgical Academy (now called the S.M. Kirov Military Medical Academy). According to Elena Bozhkova (writing in a recent issue of The Lancet Neurology journal), shortly into his college tenure, Bekhterev, suffering from emotional distress, checked himself into a local clinic for four weeks. Bozhkova adds that one of Bekhterev’s Russian biographers concluded that this period in the clinic sparked the budding scientist’s longstanding interest in neuropathology.

Upon completion of his undergraduate studies in 1878, Bekhterev chose to remain at the Academy in St. Petersburg and pursue the subject of brain structure, about which scant information was known at the time. After receiving his Medical Doctorate in 1881, he became an associate professor at the Academy. Three years later he headed to France and Germany to receive training in neurology from some of Europe’s foremost experts. After returning to Russia, he accepted the position of Professor of Psychiatry at Kazan Federal University (then called Kazan Imperial University). There he established Russia’s first laboratory dedicated to investigating the relationship between brain morphology and mental illness.

At Kazan, where he became Chair of Psychiatry, Bekhterev emerged as a leading Russian scientist. Among his neurological achievements was his discovery of the superior vestibular nucleus, also known as the Bekhterev nucleus. He was also the first to describe several afflictions, including an arthritis of the spinal column known as Bekhterev’s disease (also referred to as Ankylosing spondylitis). Additionally, the “Bekhterev sign” is used to describe a predicament in which the patient retains voluntary movement in the face but suffers paralysis of automatic facial movement.

For decades, Bekhterev maintained a torrid pace of writing and publishing scientific articles. First appearing in 1893, his book Conduction Paths in the Spinal Cord and Brain – which then provided the world’s most comprehensive knowledge on the human brain – made him a medical celebrity. Right around the time this book first saw publication, Bekhterev returned to his alma mater in St. Petersburg, where he headed the Department of Nervous and Mental Diseases. Ensuing significant books by Bekhterev include Objective Psychology, which first appeared in 1907, and General Principles of Human Reflexology (Bekhterev preferred to use the word “Reflexology” instead of “Psychology”), which first appeared in 1917.

One popular quote, attributed to a prominent German scientist at the time, had it that: “Only two know the mystery of brain structure and organization: God and Bekhterev.” Such a remark gives a clear indication of the esteem that Bekhterev commanded. Though physiologist Ivan Pavlov won a Nobel Prize, some contend that Bekhterev (who never became a Nobel Laureate) was even more influential during his lifetime. Their careers had considerable overlap, as they each independently formulated a theory of conditioned reflexes. On a personal level, the two began as friends, then became rivals, and from there the relationship further deteriorated.

Bekhterev married twice: with his first wife, Natalya Bazilevskaya, he had six children. Soon after her death, he remarried but had no children with second wife Berta Gurdzhi. Indeed, there was not much opportunity to have additional children, as the doctor would be dead within a year.

On December 24, 1927, the 70-year-old Bekhterev – who was in Moscow to attend the First Congress of Neurologists and Psychiatrists of Soviet Russia – fulfilled a request to visit Joseph Stalin and examine the leader’s left arm, which had been impaired since childhood. Hours later, Bekhterev justified his late arrival to a meeting with colleagues by informing them that he had been occupied with the task of “examining a paranoiac with a withered arm.”

That same evening, the famous doctor attended a performance of the Bolshoi Ballet. During intermission, according to Roger K. Thomas, writing for the Encyclopedia of the History of Psychological Theories, “strangers approached Bekhterev, conversed with him, and gave him something to eat (possibly ice cream).” Shortly thereafter, the doctor was complaining of stomach pain. His condition rapidly deteriorated, and by the night’s end he had died of respiratory failure. Despite the objections of family members, the remains of Bekhterev – who had been in good health until the day of his death – were quickly cremated.

Such a demise was highly suspicious indeed, and the fact that ensuing years saw suppression of his works only further suggests that the doctor ran afoul of somebody very important and died under crooked circumstances. The scope of his achievement, though, was so wide that even the most powerful of people could not completely expunge his memory. And so the St. Petersburg Bekhterev Psychoneurological Research Institute, which he established, still bears his name. Also extant is the Russian-language medical journal, The Bekhterev Review of Psychiatry and Medical Psychology.

The suppression of his works did have an effect, however, and to a significant extent, it thwarted his influence abroad. Until as recently as year 2000, the only English translation of Bekhterev’s masterwork was a 1932 abridged version of his General Principles of Human Reflexology.

Even brilliant persons can made boneheaded blunders. In the case of Vladimir Bekhterev, his mistake likely cost him not only his life but also much of his legacy. And it just goes to show that it is ill-advised for a doctor to talk openly about a patient – all the more so when that patient is Joseph Stalin.