"We're on Mars. The truth."
Academician of the Russian Academy of Sciences, President of the Bakoulev Center for Cardiovascular Surgery Leo Bokeria celebrates his 85th birthday on December 22. Now he performs open heart surgeries on a daily basis and is actively engaged in public activities. On the eve of the anniversary Leo Bokeria told "Izvestia" how he maintains his shape, when and how he began to operate, shared stories of his life and plans for his birthday and New Year.
"Our people are witty."
- You are turning 85 years old. How do you feel about this age?
- I don't feel age. I operate every day, and I do more than one open heart surgery a day, on a stopped heart. Everything I did ten years ago, I still do now. I can see normally, my hands don't shake. I haven't had any alcohol in fifteen years. I think this has helped me very seriously to maintain my health.
- You continue to work actively. What does your day consist of?
- I get up at exactly 6:22 - that's on purpose, not at 6:20 or 6:25. I shave, shower, have breakfast. My wife cooks beautifully, it's a very pleasant time of day. Then I get behind the wheel and drive to work. About fifteen minutes after I arrive, I'm usually off to the operating room. And by this time my assistants have prepared the approach to the heart - and that's it: further you connect the artificial circulation device, the patient by this time is cooled to 28 degrees, you clamp the veins, and further everything depends on what kind of operation is going on.
And I live very close to our building of the Bakoulev Center - the Vladimir Ivanovich Burakovsky Institute of Cardiology. This is my teacher, my predecessor, so I named the Institute after him. He started the construction of this building, but he passed away before its completion.
There was an interesting story with this building: for a long time there was a smooth surface in its place, something was dug somewhere, but there were no construction works. And then I went to the Mayor of Moscow at that time - Yuri Luzhkov - and explained that it was absolutely necessary for the Institute of Cardiology to have an independent building. He took it to heart, called people, and they built it very quickly and very efficiently.
And now we are the world's largest clinic in terms of open-heart surgeries, performing more than 5,000 surgeries a year - both on children and adults.
- Including your method, which has been called "Boquería's barrel"?
- For this practice of operations in the barocamera I was chosen, for example, as an honorary member of the American College of Surgeons, American College of Surgery. But the founder of this method is a Dutch scientist Itse Burema. In the 60s of last century, he proposed to operate on very heavy patients in hyperbaric oxygenation (in a closed chamber at elevated pressure and oxygen content. - "Izvestia").
This allows to increase the survival rate of patients - in a normal atmosphere the lungs can simply burst. But in Russia at that time they were afraid to perform such operations - after an accident in one of the clinics of the Soviet Union. Then there was a fire, and in such chambers increased volume of oxygen, and it increases the ability of materials to burn, so you need to be especially careful to follow the safety rules. As a result, interest in this method in our country began to die.
I became acquainted with it when we began to actively develop Soviet-American cooperation. I spoke English, which was one of the conditions of the experience exchange programs that were launched at that time. And that's how I met Itse Burema. Then he himself came to visit me.
- Why did you call the method "barrel"?
- We're a witty people. The thing is that this barocamera resembles a barrel, but in diameter it is 3 meters, and in length a little more. It is such a room, in fact, seven of us could fit in there. But find out who came up with the name, he probably won't tell you.
- And you have the title of honorary submariner because of these operations.
- Yeah, that's true. The working conditions are the same. In the chamber they are the same as at a depth of 20-30 meters, but because there is no water, this pressure is almost not felt, but the patient at this pressure is 100% protected. Take, for example, a child with transposition of large vessels (when the aorta comes from the right ventricle, and the pulmonary trunk - from the left. - "Izvestia"). Such a child looks absolutely blue, his lips are blue, his fingernails are blue, he has shortness of breath and so on. We put him in a baro-operative room, intubate him, operate, and after the operation he starts breathing normally and wakes up as a healthy child. The suture will be a little sore, but the heart is already working properly.
- How did it happen that you knew English?
- In the fourth year of medical school, I finished English courses. And that's a good story, too. I was walking down the street, saw an announcement of foreign language courses, went in, but at first they didn't want to take me on them. They told me that they didn't accept students. I went and bought a chocolate bar for the girl who was explaining it to me - I was a poor student. I brought it to her, put it down - she looked at it and said: "I realized that I can't get away from you.
The language itself was easy for me. I already knew Georgian, Mingrelian, Russian. As a result, the committee that took my English exam persuaded me to leave the medical institute for a foreign language institute.
- How do cardiovascular surgeons deal with international cooperation nowadays?
- When I was last in the USA, I had the impression that they have some attitude that they don't need to cooperate with us. Not that my colleagues told me that - they never did. But it was felt.
And I talked to our diplomats, and they said that it was because of the atmosphere against our country. Not about medicine, of course, but it still affects everyone.
"I've never counted patients and students."
- How many patients have you had?
- Never counted. Why should I? If someone needs to, let him count, we have an automated medical history in the institute.
- Where did you have your first surgical experience?
- I had my first surgery in the town where I was born, in Ochamchire (Abkhazia. - "Izvestia"). Usually from Moscow they used to send trainees to the Moscow region, but they did not let them do anything there. So I asked to go to my mother's place. And they let me go, but then asked me to bring a paper with a list of what I did there. And when I brought the paper, the institute was stunned - I had done so many operations.
And when I returned from Ochamchira, I came to Vladimir Ivanovich Burakovsky, the director of the institute. By the way, he was born in Tbilisi and spoke Georgian.
- What was the most complicated operation you had in your practice?
- You know, I do not do simple operations at all, I only do operations with artificial blood circulation. Not because I don't know how, but just to teach young people. There were, of course, difficult situations: when I finished, everything was fine, but at home the phone rang at night. After that I went to the clinic - it turned out that the complication was due to the negligence of the assistants. There were a few cases like that, literally a few, three or four.
- How long was the longest working day in your practice?
- Two days, it was surgeries. It so happened that two emergency patients were brought in. I was the director of the center at the time, and I didn't want to get my colleagues up at night. I said, I'll do it myself.
- How has the specifics of cardiovascular surgery changed over the course of your practice? How far have we come?
- We're on Mars. We are. We have a lethality rate, I think, that is lower than the most technologically advanced countries, including our direct competitors. We have a tremendous amount of experience. And in terms of compassion for the patient, there is no greater compassion than that of our people. I say this quite consciously, because I know the world well, I have been to many places and operated. And today we have provided the country with this type of care, cardiovascular surgery, in full.
A. N. Bakulev Scientific Center for Cardiovascular Surgery. A. N. Bakulev Scientific Center for Cardiovascular Surgery
- What unique operations are performed at the Bakoulev Center?
- The whole arsenal of existing world practice operations. We perform heart transplantation, all operations on a stopped heart. We perform operations with artificial blood circulation, and this is very beneficial for patients: they feel nothing, and when they wake up, they often ask whether they will always breathe as easily as at this moment. I really understand these people, and some of them could have sought help earlier and had surgery sooner.
- Who is more difficult to operate on - adults or children?
- It all depends on the heart defect. If an adult comes in with a three-valve defect, it is a very difficult operation. But if a child arrives with transposition of large vessels, it is also a very difficult operation.
- How many operations does your center perform per year?
- We do more than 5 thousand operations a year. We can do more, but for this the whole infrastructure must change. The health care system must have money, because additional surgeries are expensive. We get regular salaries, but the operation itself is very expensive - about $50,000, especially for small children.
- Do you have a lot of students?
- I haven't counted. But I know that there are many people who consider me a teacher in absentia. There are even those who were at our internship for about a month, but they say they learned from me. I don't feel sorry for them if they turned out to be good specialists.
- Your patients also become doctors. For example, the former hostage in Beslan, Zaur Kozyrev, whom you operated on.
- Yes, he became a doctor, lives and thrives, recently called me. His case, of course, was difficult, because it was a real wound. But in terms of the surgical part itself, there was nothing special: I found the bullet, it was a double-edged splinter, in the chest.
- Have you had any patients from the new territories?
- The number of patients has not increased very much. There are good centers there, these hospitals have proven their effectiveness, and it is more convenient for people to be operated on locally. There are those who are operated on in Moscow, but they have to get a quota. And the local authorities are reluctant to give them a quota, because the money is transferred to the Bakulev Center. Everything is tied up in this, it concerns not only the new territories, it concerns the old territories as well.
"It's a pity it didn't work out with soccer."
- You are doing a lot of public work now. Why do you do it, and does it not interfere with medical practice?
- I am the president of the Association of Cardiovascular Surgeons, a member of the Public Chamber of the Russian Federation since the first convocation, I am the chairman of the Commission on Health Care. And it is not difficult for me. I am a pro, and the composition of the commission is very good. And we solve important issues, we have done useful things, but I will not announce them.
The very idea of creating the chamber was incredibly right: the public has an opportunity to openly discuss problematic issues.
- You are also the president of the Health League of the Nation, where you promote a healthy lifestyle.
- And not only in it. And by the way, I came up with the name of this organization, at first it was proposed to call it a society. But I was against this idea, this name is already familiar, and no one would pay attention to it, and we had big plans, a big swing. And so I thought about it for a few days, then I remembered this word "league". I think it sounds fine. Sometimes we are called "League of Nations" for old times' sake.
And seriously, a healthy lifestyle means a healthy heart and an additional 20 years of active life. And our All-Russian background walking championship "The Man Walking", which has been held for the sixth year with the support of the Ministry of Sports of Russia and every year gathers more and more participants (this year more than 83 thousand people took part), is designed to motivate people to lead an active and healthy life. Each participant, an ordinary person, regardless of age, place of residence, level of physical fitness, became a part of a big national sports event. This is called mass sport.
- You lead a healthy lifestyle, and the New Year is coming soon. What do you usually have on your New Year's table?
- We have, to use a dirty word, a lot of stuff. My wife Olga is a great cook, a great cook. So it is very difficult to resist every time you come home from work, but I am still resisting. And on New Year's Eve there will be a holiday, there will be as much food as you want. Maybe my eldest daughter Katenka will come to us. Both of my daughters are very smart, they both graduated from the institute with honors. Katenka graduated from the First Med, that's Sechenov University. And I'm the president of the First Med Alumni Association. I'm very proud of that.
- Is there anything that you consider your main achievement?
- A lot of things. First of all, I scored a lot of goals in friendly games. I'm very proud of that. With my height, you know, it is not easy, and all Georgian guys dream of becoming footballers. It's a pity it didn't work out with soccer, really.
- What would you wish for yourself at 85?
- If possible to somehow stay in the shape I am in now. I don't want anything else. And everything will come next.
- How will you celebrate your birthday?
- Birthday, a happy holiday (laughs). With Olya alone. We're not calling anyone. It's perfect just the two of us.
Переведено сервисом «Яндекс Переводчик»
