Despite his youth and inexperience, Dr. Mikhail Polyakov’s (Leonid Bichevin) arrival in the village of N. in the fall of 1917 is heralded with relief by the townspeople, who have suffered through a difficult year without a physician. Inheriting a skeleton staff of two nurses and a paramedic from his mysterious, absent predecessor, Polyakov is quickly confronted with a litany of patients experiencing serious ailments. The one apparent blessing he discovers in his tour of the facilities – a well-stocked pharmacy – soon proves to be quite the opposite. Within hours of his arrival, Polyakov’s admirable efforts to save a man dying of diphtheria leave the doctor himself in need of a vaccination and a fateful shot of morphine. Over the course of the winter, stress, isolation and perhaps even boredom lead him into a tangle of vice that includes regular drug abuse, dalliances with patients and a doomed affair with the attractive nurse Anna (Ingeborga Dapkunaite) who later shares his addiction. His escalating acts of medical malfeasance and growing inability to conceal his habit finally lead Polyakov to seek treatment in Moscow, where he is forced to contend simultaneously with the reality of impending national revolution and the extent of his own degeneration.