6.12.1913  -  12.12.2002

Books of N.M.Amosov

Diary. February, 7, 1983

This book has been written as the events and reflections took place. I reread it and saw that there was no end to it.

And, in general, I am in a disturbing state of mind. Hesitations. The manuscript stood by itself; it was reread from time to time, chapters were added without definite plans. But... (always these "buts" and "suddenlys") this summer, an assistant of Raduga Publishers' Editor-in-Chief met with me and asked: "Have you got anything to offer?" So I gave him the manuscript with the words: "Have a look at this." They liked what I had written, and vanity prompted me on to the path of sin. As a result, you are reading these lines.

And now I am waiting and blushing in advace as if I were stripping In the middle Kreschatik Street. It is not at all pleasant, particularly if you take into consideration my age and other circumstances. One of them is the "myth of Amosoff," the world-famous surgeon, talented scientist, inventor and cyberneticist. Writer. Athlete. Public figure. See how many roles have been given to me by other people. But the reality is much more modest. I am known nationally as a surgeon, not internationally (people know me from my popular science books). Apologies concerning the inventor (the exception is the first AIK machine and artificial heart valves). Cyberneticist? An amateur one, without the necessary knowledge of mathematics. A writer? No, I would never call myself a writer. There is only one role I would like to play in my life — that of an honest worker. But it was not always that I could be one.

I am looking for excuses to publish these notes. For instance, why can't I use the reason that they will allow people to understand and appraise doctors better. If any of them masters this "science," then it is quite possible that he will think of his own nature, will find his weak points and try to correct them. Perhaps he will have a broader outlook on the world... At the same time, it is very difficult to admit that this book might give readers pleasure. Difficult because it is not joy, but suffering that purges the soul.

Enough of this inferiority complex. This book has to have an end. The boundary of the next stage in life is the essence of ideas...

Let's begin with the main event in my life: I have almost given up surgery. I can imagine my readers' response: "He has betrayed the main cause of his life." It is namely this feeling that is with me constantly, since I have got accustomed to thinking that, "If you can work for the good of others, you must do so."

But I could not continue.

Back in March, I wrote: "I feel that if I have another spell like the one last June, I will not be able to stand it, and I will leave."

Well, that is what happened.

I was greatly distressed. I began to operate less — one day a week, three operations, and only on high-risk patients. I stopped operating on children, but implanted valvular prostheses in hopeless patients.

I will not describe everything. I felt too bad.

At the end of June, the World Congress of Cardiologists was held in Moscow. A brilliant congress, although there was not much talk about surgery.

But there was Shumway's report from the Stanford University on new successes in heart transplants. (This I have already mentioned.) The results were like ours during valvular prosthetics. He has performed complex transplants on six patients — hearts and lungs. Four are still alive.

I did not stay till the end of the congress, since I was scheduled to operate, although our team's report had yet to be presented (Gennady Knyshev did it).

Two operations and two deaths in succession.

This involved only adult patients with rheumatism and coronary disease... It is always tempting to write them off to circumstances, but I won't attempt to deceive myself.

Apparently, the general tone of my work had decreased as I began to work less. Three days of surgery a week were insufficient. I knew what I had to do: practically live at the clinic and analyze each detail strictly. (Only then would I be able to achieve a slight improvement. But only a "slight" one.)

They would say:

"Where's the hitch? Keep moving, be strict..."

But I did not do it. On July 1, I announced at the conference:

"I am taking a three-month vacation. First a vacation, and then we'll see. Gennady Knyshev is given full authority in my absence."

It was very difficult to make this decision. I said "three months" but thought of leaving for good. I did not know whether I could live without surgery. I did not have any experience in that, since I had never given it up for more than a month.

No doubt the decision was well thought of.

My successor should receive all rights and full responsibility. I would have to see how he worked and support and help him while I could, correct him or replace him if there was any threat to the clinic.

One of Parkinson's laws reads: a leader leaves not when he does not have any strength to go on working, but while his deputy is not so old as to lose initiative and energy. (If he has them in the first place, no doubt.)

Another thing: right now I had to free time for creative work on the "problems" that interested me. It would be too late in five years to take them up cold turkey. (By the way, none of my relatives or friends treated these "problems" seriously or had any faith in my ability to tackle them.) I have no illusions about the final results, but still these problems interest me.

See how sensible I was. I felt like a deserter and feared that the clinic would do worse.

But I learned to avoil this feeling. Rather strange it was — pity and relief as if I had buried a man dear to me who had been sick for a long time.

A new life began. Back in June I managed to trick Cherie into getting in the car and Sasha, my nephew, moved us to our country house. We lived there for four months. Perhaps these months were the happiest in as many years as I can remember.

I did not have to think of patients; nobody died. There was no telephone or visitors. I was free. And then I had to decide how to use that freedom. No problem: modeling of social systems at the global level. Unlike the well-known models, I wanted to include into them not only economic factors, but the human and civic psyche as well and ideology into the bargain. I will not want to give more details, the work is still in process. The same Sasha (he is an economist) brought me a pile of statistical reference book> on economics, and I dug in. I had to design a draft of the model so as later to feed it into a computer for a survey. I had calculations to make. Every day I worked on these calculations — thinking and reading, and calculating for six hours in a row. Then I worked for two or three hours in my workshop and made many useful things — shelves, benches, tables, a timber shed. You may think (with malicious joy) that I had become quite bourgeois. No, far from it. I was simply "performing manual operations."

I discovered nature anew. Every morning, rather early Cherie and I would go running along forest paths, and in the evenings, we would go walking again...

I walked in the forest more than ever before.

June, the fresh greenery of the oaks alternating with the dark pines needles. An undergrowth of young birch trees. Then came mature August, and later, the yellows and crimson of the end of September, the faded colours of late autumn. And all this is different in different weather. In the clear early morning the forest is permeated with the first rays of the sun. Then there were those marvellous water-coloured dawns with fog and rain. And apart from that, there are different noises in the forest, the singing of birds, and a broad range of smells. No, I cannot describe it, these pictures before my eyes; I cannot chose proper words. It would be a pity to spoil this beauty.

We had a big orchard and a vegetable garden, but I am not a gardener. Gardening is for women — that's what we used to say in Olkhovoye. However, I began to feel that plants were alive and had an existence of their own. I think I will begin to do some gardening soon. Once I killed a snake by the house and loathed myself for it.

Once a week, I went to town to give seminars in cybernetics, I had to supervise the activities of my section which I had abandoned during the surgical years. It turned out that the staff had been working responsibly all those years. I had no intention of spoiling their life by supervising them too much; I would do my own research.

Sometimes I dropped into the clinic but did not go any further than my office. From time to time, I would give advice to my patients, providing they asked for it. They did not do so too often.

That was the way the summer and part of autumn passed.

In October, everything got dull. We had to return to the city.

I did not want to operate and did my best to resist the urge. But it is very difficult to escape the beaten path. Pressure was exerted from all sides... From top to bottom: "You don't have the right to stop while you can still work. There cannot be Amosoff's clinic without Amosoff." Patients came: "We have put all our hopes on you." The old timers looked at me with reproach.

I had to give in: one operating day, one operation on a patient from the Bendet's department. I did not want to interfere in daily minor events or in supervising the clinic. I'd have only to keep an eye and give advice.

That's the way I live now. Not too good or bad. I operate only on high risk patients, repeated valvular prostheses.

One operation seemed too dull, so I began to operate twice a day. Then thrice a day. I came home late at night. The long interruption had not told on my surgical technique. I did not make any mistakes and operated rather quickly. But at the same time, there were still many post-op complications: therefore, not a trace remained of my summer's rest.

That's all sad, too.

I will not say anything else of life. I have come to the boundary of a new stage. In front of me is science for the sake of pleasure, the writing of books and meditation.

When I wrote this, it seemed that everything had been decided. And when I operated three patients next morning and when they all had good prospects for recovery, I began to have my doubts. "May be it's too early for the next stage..."

Tomorrow I will perform three operations.


What intricate turns life takes! Once again everything has changed.

An Institute for Heart Surgery was founded on the basis of our clinic. I was offered the post of director.

I did not want it, since it undermined all my plans for a quiet and interesting old age (reading, thinking, modeling, writing, and meditation). But how could I refuse, since, in fact, I could really manage the clinic better than the others for the time being.

And thus, from the second half of April, I began to work as never before. The goal: to peform a thousand more operations a year. ("Using the same premises" as they say at industrial enterprises.) There are many patients, and no one but us can save them. A thousand lives — isn't that a good price for giving up a quiet old age? I know there will be misfortunes, but there will be happiness, no doubt, and we'll just have to live and see how much.