6.12.1913  -  12.12.2002

Books of N.M.Amosov

Diary. March 6, 1982

No entries for more than half a year. I did not feel quite myself. I did not want to write about the clinic, and there was no other topic I felt like saying anything about. I simply worked on my "digressions"; I polished them in the event that I could use them later.

In July, I managed to rectify the situation at last. I performed almost all the operations with the AIK machine myself — sometimes four operations a day. I controlled everything and sat at bedsides till late at night. The results improved slowly but surely. Cerebral complications disappeared.

But my mood did not improve. I was oppressed by mysteriousness and hopelessnes. If we had managed to reduce the mortality rate substantially for nine months, why had it increased again? When I analyzed the situation without emotions, I failed to find any essential regresses in treating patients that fatal June. If we did not know the causes, there would be no hope of correcting the situation, of achieving stable results and moral comfort.

Therefore, I made up my mind to have a vacation in August, a real vacation, for two whole months. I did not intend to call the clinic. I wanted to see whether I could live without surgery. True, I was afraid of becoming detrained, so I operated for three days in a row, nine operations, all of them successful. Once again I went to the country house with Lida to see what would it be like (Lida went there almost every day) and, once again I did not like it. Therefore, I stayed in my study the whole of August. I even liked it — no moral obligations. If I wanted, I thought of lofty matters, then watched TV when I got tired of reading. To stretch my legs, I went to bookshops to buy new books, records or to have a look at new electronic gadgets. In the evening, I went to Goncharka with Cherie (in the summertime, this waste land saves dog-lovers from persecution by other citizens and yardmen).

But the deaths did not leave me in peace.

Fedorovsky was dying.

It was rather painful for me to visit him even once a week. He has been operated on by Professor Shalimov (an academician). The tumour was inoperable, as had been predicted. He made an anastomosis between the stomach and the duodenum. No doubt the patient was told that it had been a radical operation...

And he believed it. There you are with your instinct for life! The tumour could be palpatated easily; vomiting continued, cachexia was increasing, whereas he, an experienced, sober-minded professor and surgeon put all his hopes on improvement almost until the day he died. And he did not even mention the hidden pills...

He was buried on 20 August. I pitied him, though he was an old man! Another photograph was added to the pantheon under the glass on my desk. Boris Kotochigov, Arkady Bocharov, Kirill Simonyan, Vadim Evgenievich, Yuri Dold-Mikhailik, Yulik Berezov, and now Fedorovsky. Next to them is a photograph of the late Cherie I; I do not think they would be offended by such company... They are all in front of me as if they were alive and supporting me still.

Enough of deaths.


There was an unexpected change in my relations with nature, to be more correct, with my country house, that occurred in September. Lida asked me to go there and to sharpen the scythe. I went there and sharpened the scythe. Then I decided to try it — mowed in earnest for an hour. My muscles recalled the former habitual movements. And there it dawned upon me: how good it was to work with my hands! I had a totally different impression of the forest, apple trees, and birds.

"You know what, Lida, perhaps I will go there once again if you find me some work to do."

There was a lot to do there: lumber that had not been used during the reconstruction of the country house the previous winter (without my participation) was lying about. It had to be collected and turned into fire wood. That was men's work.

Thus, through the fatigue in my hands and my back, I felt a thirst for simple manual labour. I thought this thirst had died out long ago...

We planned to bring our things and live there the rest of September while I was still on vacation, but that did not materialize, since Cherie did not want to stay.

We made up our minds in the middle of the day, packed our bags, put the lead on the dog, and headed for the commuter train.

Cherie got nervous amidst all these preparations, since this process upset her schedule. When we turned from Shevchenko Boulevard on to Pirogovskaya Street, she began to pull back. And when we got to Saksagansky Street, and the tram passed by, she sat down and would not budge, irrespective of how we scolded and pushed her. The people around thoroughly enjoyed this spectacle. We had to turn home. Later, we took her the whole of autumn for a "rendezvouz with the tram," hoping to school her, but nothing doing: she would pull back, raise up on her haunches and bite. She would not even allow herself to be bribed with a sausage. A psychopath.

But I worked well at the country house that autumn. I went there on Saturdays right up till New Year and put everything in order. We planned to spend the summer there. If need be, I would walk Cherie all the way to the country house (fifty kilometres was mere child's play!).

Lida retired about then and wanted a vegetable garden. I had my own plans to do some carpentry and plumbing (I wondered where it came from — nature? Labour? Isolation from people? It couldn't be the land itself!).

I broke off my vacation on September 5 and began to operate normally — one or two days a week, three operations a day, conferences and rounds on Fridays. At the end of the month, our whole team went to the city of Gorky for the All-Union Conference of Heart Surgeons. That was even more important for us than the Minsk Congress. There were reports, symposia, discussions.

Up to the end of the year, work in the clinic was satisfactory to put it mildly. We failed to close the summer's gap, but managed to hold the positions steady. There had been substantial changes as compared with the previous year.

AH reports were in the past. Here are the figures: 2,400 operations, 802 with an artificial circulation (611 in 1980). Unfortunately, there are no more than a dozen clinics of our type the world over, so comparisons are difficult. Overall mortality rate — 5.1 per cent. In 1979, it was 7.3 per cent and 5.8 in 1960. There had been changes. I operated more than the other surgeons — 272 operations, 168 of them valvular prostheses. Unfortunately, every fifth patient died, so I had no moral comfort. The only consolation was that they were all high-risk cases — three-fourths of them were repeats, and two of the valve prostheses were mine. In general, I had never performed so many complicated operations in my life — I had set a new record.

And I was sixty-nine already. True, my cholesterol level was fine. But there is no need to deceive myself — I was aging rapidly. Sometimes it seemed that if I stopped for a minute, I would go to pieces. I would not take risks, but I wouldn't stop. For the time being. (Sometimes I wanted to so badly!) I had to prove my hypothesis: "Aging is detraining." I planned to operate until I was seventy at least, but if I had another June like the previous year, I would give up surgery.

Up till now, everything was like the year before, but a bit sadder.