"You, they say, are you cleaning the bellies?": An excerpt from the book of the Soviet surgeon

2024 Author: Malcolm Clapton | [email protected]. Last modified: 2023-12-17 03:44

A story about plastic surgery during perestroika.

Sometimes fame can play a bad joke with a surgeon. For example, friends and even strangers begin to contact with requests for an operation that does not quite correspond to his profile, which he himself would not do, and it is not always convenient to refuse.

This happened in the midst of perestroika. I worked as the head of the educational department at the Department of Surgery of the Faculty of Advanced Training for Physicians. By that time, I was an assistant professor, candidate of medical sciences, supervised the trauma, surgical and intensive care departments and lectured on surgery. Since I was already over sixty, I rarely operated on, being more involved in teaching: I gave lectures, conducted practical classes, and sometimes arranged demonstration operations.

Nadezhda worked as the manager of a small grocery store on the outskirts of the city and was treated by my wife, an otorhinolaryngologist (in common parlance, this difficult to pronounce word is usually abbreviated to "lora" or such doctors are called "ear, throat, nose"). She was a moderately well-fed brown-haired woman of about forty, dressing tastefully and moderately using cosmetics. She often helped us out in those years when food was tight. Tamara Petrovna and I visited her store only at her invitation and left with bags full of scarce products. And everything was in short supply at that time: sausage, cheese, fish, butter, meat. We were grateful to her and willingly helped when she had health problems. On our next visit to her, while I was sitting on the sidelines, he and his wife were talking animatedly about something, and then I heard:

- Well, you talk to Yuri Olegovich, maybe he will help you with something!

Nadezhda told me about her stomach pains that have not gone away for several months. Physicians diagnosed her with chronic pancreatitis, the surgeon professor confirmed this diagnosis, but the treatment was not successful. From her story, which I directed in the right direction, I caught the mention of all the symptoms of duodenal ulcer and recommended to do a gastroscopy, which at that time was just beginning to spread. I was even surprised that the consulting professor did not assign this examination method to her. On our next visit, she saw me and exclaimed:

- Yuri Olegovich, you are just like an X-ray, you immediately saw the ulcer!

And she handed me the results of gastroscopy, confirming my diagnosis.

Now this woman was standing in my office. After talking about this and that, she outlined the reason for her visit, while undressing without a shadow of embarrassment, and soon appeared before me with a bare stomach. Clutching the protruding part of her abdomen in her hand, she complained:

- Here, admire! What it is?! The stomach sticks out, and all because of the fat. Well, take this fat away for me! she pleaded.

I examined her belly. It really protruded strongly forward and even hung a little in the form of a fat fold. If you remove it, the belly will not bulge out. In this she was right.

For a long time, few used the services of plastic surgery in the Soviet state, despite the fact that the first cosmetology clinic in Moscow appeared back in 1930. The initiative to create the first clinic belonged to Molotov's wife Polina Zhemchuzhina, who came up with this idea during a trip to France.

The official Soviet ideology implied that the builder of communism should think not about the beauty of the face, but about the purity of ideals. The patients of plastic surgeons were mainly scouts who needed to change their appearance, movie stars and spouses of dignitaries. Despite the fact that everyone could sign up for a paid operation, the wait sometimes dragged on for years. As the ideology weakened, the population's interest in plastic surgery increased.

I must say that plastic surgery in the USSR was at a high level: just remember that thanks to plastic surgery, Lyubov Orlova, at the age of seventy-one, already terminally ill, was able to play the role of a twenty-year-old girl in her last film Starling and Lear.

The fact is that none of our surgeons, including myself, was engaged in plastic surgery, and I immediately recommended Nadezhda to contact specialists in this field. Hearing this, she exclaimed:

- Well, no, Yuri Olegovich. I visited these surgeons, asked around the patients whom they operated on. No, I will not go to them. Only to you. I know you, I heard reviews about you and I will only trust you with my belly!

I tried my best to dissuade her from this venture, painted terrible pictures of complications, frightened that after the operation suppuration, sepsis may occur, and subsequently an ugly scar will remain in the entire abdomen. I insisted that later she would hate me and would write complaints to all instances. But it was all in vain. "Well, what can I do," I thought, "I'll have to operate." And he sent her to hospital.

Before the operation, I was very tense. The technical side bothered me a little, but the possible postoperative complications did not go out of my head. Ekaterina Olegovna volunteered to assist me. I drew a green line of incisions from the right abdominal wall to the left so that the edges of the wound could be brought together without tension. Having made an incision to the full depth of the fat layer, I separated it from the aponeurosis and completely removed it together with the skin. The fat layer was about nine centimeters thick. A huge wound was formed, as wide as the palm of an adult man. Having stopped the bleeding, I first sewed up the bottom layer of the wound for the fatty tissue remaining on its edges, then the second layer. The third row of stitches was applied at the very skin and finally put a cosmetic inner suture on the entire wound. The skin lay down without tension, the edges of the wound were tightly connected and in the form of a thin strip ran from the right wall to the left.

Contrary to my fears, the postoperative period went well. Both I and the patient were happy. A few months later, Nadezhda came for an examination together with a woman of about fifty, a plump blonde, an artist of one of the theaters. I examined the seam and was satisfied - a thin strip remained from the scar, the stomach was slightly pulled in. However, it turned out that Nadezhda brought a new patient with her, who began to persuade me to perform the same operation on her:

- No, just look! After all, I go on stage and cannot turn in profile to the audience, since my stomach protrudes forward half of my body, - she said, undressing.

Exposing her belly, she came up, and I examined her. Indeed, a fold with subcutaneous tissue hung on the stomach in the form of a large apron. I began to convince the woman to go to plastic surgeons. However, she did not want to listen to my objections and, with the support of Nadezhda, nevertheless persuaded me to carry out the operation. Ekaterina Olegovna and I performed exactly the same operation as for Nadezhda. And this time the postoperative period went smoothly, and the cosmetic seam was almost invisible. A grateful patient left the clinic, promising to make my wife and me into avid theatergoers.

A few more months passed, and already this artist brought to me a familiar woman of about sixty, her neighbor. And again it was necessary to remove the fatty fold on the stomach. "That was all I needed!" - I thought. Further events developed in the same way as in the two previous cases. As a result, Ekaterina Olegovna and I performed the third similar operation.

There is such a concept in medicine as medical secrecy. However, for its observance, it is necessary that all parties remain silent. What happens often in hospitals, in operating rooms, somehow becomes the property of many people.

The rumor spread throughout the city that I perfectly remove excess belly fat. There was no liposuction in those days, and there were as many people who wanted to get rid of fat. I soon learned that the nurses of our hospital and their acquaintances were lining up for the operation, and some women doctors themselves began to contact me with similar requests. I denied it as best I could. It got to the point that one day at dinner, my wife gave out:

- You, they say, remove the bellies? So I'm also thinking about removing the fat! And in our hospital, many people want to make an appointment with you for an operation!

- Well, I do not! Enough with me! And you, Brutus, there too! - I was indignant.

I must note that these operations are not a harsh necessity and are not performed for medical reasons, but solely at the request of the patient.

The presence of a fatty fold on the abdomen does not lead to a catastrophe and does not pose a threat to life or health.

But if after the operation there is any serious complication, then the patient's complaints will follow and the surgeon can be prosecuted. There have been such cases in plastic surgery. That is why I tried to refuse such operations. Yes, I had to sew on the cut off nose, ear on duty, and once to suture the scrotum, which a mental patient cut himself, but there were good reasons for that. Plastic surgeons in every possible way protect themselves from troubles and take a signature from the patient that in case of complications he will not make claims. Now plastic surgery is a profitable business, it is equipped with the appropriate equipment, surgeons undergo special training. But it's too late for me to retrain, let the youth develop plastic surgery. Good luck to them!

Yuri Abramov, a candidate of medical sciences from Novosibirsk, has devoted more than 40 years of his life to surgery. In his book "Saving Lives Is My Profession" he collected amusing stories from everyday work, interesting facts about Soviet medicine and practical advice on how to take care of your health.