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Shortly afterward Zhores Medvedev was notified to report for "a routine checkup" at the local psychiatric clinic at Obninsk, where he discovered that he was registered as an outpatient with a record of "incipient schizophrenia" accompanied by "paranoid delusions of reforming society." Since the authorities had broken their part of the bargain, Medvedev wrote an account of his ordeal; Roy added his own diary of the affair. This document was brought out in Russian last week by Macmillan, Ltd. of London. An English translation will be published in the U.S. by Alfred A. Knopf on Dec. 1, under the title A Question of Madness.
One of Zhores Medvedev's foremost fears is that the Soviet government may be experimenting with a sinister new form of repression, which he calls "psychoadaptation," as a means of controlling dissent. In A Question of Madness he writes:
"Totalitarian centralization of the medical service, while introducing the progressive principle of free health care for all, has also made it possible to use medicine as a means of government control and political regulation. Medical 'dossiers' in clinics and hospitals are available to government officials, and a growing number of institutions and agencies ask for reports about a person's state of health with details of his past medical history and symptoms. Psychiatrists are playing an increasingly important role in all this; they may secretly veto a young person's entry to an academic institution, or a trip abroad —even only as a tourist—or pronounce on his suitability for many categories of employment. The medical record kept in a clinic or outpatient department may cause a man as much trouble as a court conviction or Jewish origin."
The Medvedev book is an articulate, dispassionate argument that such practices violate Soviet legality, and that "the inhumane use of medicine for political purposes" threatens to undermine the ethics of doctors and the morale of patients. "People are beginning to be afraid of psychiatric hospitals, resorting to them only in cases of extreme necessity," writes Zhores. "If things go on like this, it will end with healthy, sane people sitting in madhouses while dangerous mental cases will walk about freely, denied the treatment they need."
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A Question of Madness ends with an appeal on behalf of dissidents who are still locked up in prison asylums and in many cases undergoing brutal pseudomedical treatment with debilitating drugs. One dissenter who has fared far worse than Medvedev is the philologist Vladimir Bukovsky, 28. Since 1963 he has suffered a number of what Medvedev calls "psychiatric reprisals" as well as imprisonment for his activities in the Soviet civil rights movement.
Not that Zhores Medvedev is off the hook. Thanks to the intervention of some of the most illustrious members of the Soviet Union's scientific elite, Medvedev was allowed last October to take a relatively minor job as a senior research fellow in a laboratory at an institute of the Lenin Agricultural Academy near Obninsk. But he was given that job on a probationary basis. As a psychiatric outpatient registered with the local clinic, he is subject to a summons for another "checkup" at any time.