6.12.1913  -  12.12.2002

Books of N.M.Amosov

Diary. October, 26

Here it is — Sunday.

The last week has been rather good: 16 operations with the AIK machine, one girl (not mine) died. You can always find fault with anything if you analyze death from the viewpoint of guilt. Doctors are often displeased with such an approach. But I am sure it is the only way to do it so that nothing will be concealed, so that you can learn without allowing yourself a minute of relaxation; we must not explain death by the serious condition of our patients. (Some heads of clinics are experts at it.)

All our surgeons have returned from their vacations; there are many patients: on Friday we had 345 instead of the former 280 patients.

From now on, I will have two operations a day, two days a week. I cannot take away half of the patients from department heads, although it is much more pleasant to operate than to write. But I must think it over what is more important and interesting — I am pushing 70, after all.

I will not rewrite my notes for the last four weeks.

They contain only facts and figures on surgery, without any emotions.

They are always in abundance when you perform eight complicated operations with the AIK machine a week. But there were none of the upsetting situations that usually knock us down. September was abundant in misfortunes, but they were shared equally by all surgeons — department heads began to operate. Thank God it got easier in October. The experiment with ether narcosis and early extubation is continuing.

There were deaths this week, but only a few, and not after my operations. They were due to complications, resulting from initially critical condition of the patients. We cannot refuse to operate on high risk patients, particularly now when luck is on our side. For instance, a patient died after an operation done by Lyonya Sitara. He was operated on with my blessing, for ascitis. The heart weighed 1,100 g — four times more than normal.

There were other complications: two cases of acute renal deficiency with the tetralogy of Fallot and hepatic deficiency after valvular prosthesis. I could have written about each of these cases, but there is no need to.

My, how pleasant it was when Seryozha came to say goodbye with his mother. They were leaving for home, the boy was fine. Color had even appeared in his cheeks. This was the Seryozha whose aortic valve we sewed in with sepsis at its peak and a temperature of 40°C.

I hope that the experiment will be successful. Let's wait another week. I have to operate on four very bad patients on Friday. And it is no easier for the other surgeons. This week may spoil everything. But if we chose only easy patients, what would we be worth?

I should probably write of less dramatic developments.

For instance, of the symposium in Vilnius? Or the theses of your young scientists...

Yesterday was Saturday. Complete rest. I went for a walk on the Dnieper slopes. If I could only be a poet! Very beautiful — semi-transparent trees, the colorful mosaic of leaves. Some of them are failing, others have already fallen, and all this is lit by a low autumn sun. The panorama of the river, the distance beyond the Dnieper and pacified people on benches. It is the right time to think of eternity and the meaning of life.

I do not percieve eternity, as well as the endlessness of space, whereas the meaning of life gives food for thought. Apparently it results from rationalism, which is far from being poetic. And, probably, from aging. Time does not permit for a move; everything should be weighed.