Well, ultimately what matters is whether VN would have had this bit of cultural knowledge available to him. Short of finding a specific reference to the Botkin hospital in some yet-to-be-discovered bit of writing in VN's hand, the best we can do is estimate the odds by, for example, trying to determine how well known this hospital was among emigres with whom VN might have had contact, etc. For someone who, like me, grew up in the NY City area, "Bellevue" (after Bellevue Hospital's famous psychiatric department) is synonymous with "loony bin." A character named "Bellevue" would not fail to trigger this association. (Like Rusk, for RSG and his fellow Texans--an association completely lost on me.) But, of course, this association would simple not be available to, say, a Moscovite reading this imagined novel about (say) Claire Bellevue. 

Was this Botkinskaia bol'nitsa part of VN's own network of associations when he wrote the Botkin character? Barrying the discovery of direct evidence, we'll probably never know. Perhaps VN was aware of Dr. Evgenii Botkin, for whom the hospital was named, and who was physician to the last tsar (see: http://www.alexanderpalace.org/palace/ebotkinbio.html). 

What I take away from this thread is an increased awareness of VN's fascination with syncretic signs (not necessarily symbols). He loved words and expressions that could conjure multiple, relevant associations with the denotative referent. This feature of his aesthetics, I believe, is what often drives us readers a bit batty, for we no association that seems thematically relevant can ever be completely dismissed. ("Bodkin" hasn't been referenced in this present thread, although the association has long been noted.) My own view is that it is precisely this syncretic tendency that suggests that the search for "precise solutions" is usually misguided. There is no single key, just a fascinating array of doors inviting us into a plethora of avenues of readerly pleasure.

Best,
David Powelstock

On Thu, Aug 26, 2010 at 5:19 PM, R S Gwynn <Rsgwynn1@cs.com> wrote:
I also think the Botkin hospital link a little far-fetched, but in Texas, if we say, "He's at Rusk," we mean he's loony.

I did find the juxtaposition of Botkin and Chekhov in this article interesting:

http://eng.mma.ru/about/historymma
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