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Where there is no law, but every man does what is right in his own eyes, there is the least of real liberty
Henry M. Robert

Passions for surgeon Mykola Amosov

Vasyl Bratus’ last interview on his colleague and friend
9 December, 2008 - 00:00

Mykola Amosov would have been 95 last Saturday. When it was still October, it suddenly occurred to me that I need to describe the talented medicine reformer’s professional and human traits through the eyes of Prof. Vasyl Bratus, a well-known surgeon, ex-minister of public health for two terms, and a corresponding member of the National Academy of Science and the Academy of Medical Sciences.

I called the professor on his home phone and he immediately agreed to see me. We discussed the facets of Amosov’s character for about two hours. Although my interviewee was quite alert for his age of 90 something, he admitted that every day seemed to be tweaking out a thread of his life. I wrote down on the same day what I had heard. Two days later Bratus departed this life. So this was his last interview.

“All of us, doctors, especially surgeons, know each other more or less well,: Bratus says pensively, “but a day always comes, when a certain episode suddenly produces a spark that strikes up a friendship. This is the way I met Mykola Amosov in early 1957.”

“Naturally, both as Ukraine’s minister of public health in 1954-56 and a as surgeon who practices almost every day, I took interest in this striking personality. As soon as Amosov moved to Kyiv in the early 1950s, he showed himself as a versatile innovator. For example, he was the first in Ukraine to administer endotracheal anesthesia.

“In 1953 Amosov was elected head of the Kyiv Medical In­sti­tute’s Sur­gery De­part­ment. Work was going on very well, but he saw the development of thoracic surgery as his chief goal. The first department of this kind, with Amosov as its head, was established in 1956 at the Kyiv In-Service Medical Education Institute. Meanwhile, I was appointed rector of this institute in 1957, after my first stint as the [public health] minister.

“After some time, I received Amosov who came, as he said, to personally meet me. I can say that we immediately liked each other-as war veterans, surgeons and almost peers, for he was only three years my senior. I was still aware that Amosov’s visit was something more than just a courtesy call. Indeed, we began to speak about a problem that was very important for Amosov, for he had almost completely focused on cardiac surgery, — to manufacture an experimental heart-lung machine (HLM, a.k.a. pump oxygenator). The prospect of designing a mechanical ‘heart substitute’ in Ukraine looked attractive, naturally. What prompted this unusual work was Amosov’s recent participation in the International Congress of Surgeons in Mexico, where he saw an HLM functioning in the operation room. The machine opened unheard — of horizons in cardiac surgery. As Amosov was an engineer by his second profession, he made a drawing of the HLM immediately after he had seen it.”

What happened next?

“Back in Kyiv, Amosov got down to designing the machine in his characteristic purposeful manner. He recruited a number of engineers and shop-floor workers from a Sviatoshyno plant. Funding was the real problem, so Amosov turned to me for help. The idea struck me, too, but the institute’s existing tables of organization did not allow me to open such vacancies. ‘How many employees would you like to have in the team?’ I asked Amosov. Surprisingly, it was a question of only seven enthusiasts. I was in no way willing to put the matter on hold, so I immediately suggested a way out: establishing the position of senior laboratory assistant at seven different departments in order to actually pay salaries to Amosov’s team. I must have broken some formal rules, but subsequent events showed that I had been right. Naturally, the pay was very modest. Still, the machine was made.

“I think this peculiar streak in Amosov’s research provided a basis for his famous novella Thoughts and Heart. I must point out that, although I am also not deprived of the inclination to write, this is a totally different level of literary aptitude.

“Now we saw each other quite often and struck up a warm and friendly relationship-for years to come. It was in fact a triple alliance of Amosov, Fedorkovsky, also a great surgeon, and me.”

Mr. Bratus, what do you remember best from this friendship?

“Obviously, one of the central lines of our conversations was Amosov’s attempts to broaden the scope of cardiac surgery. He invented and put into practice nonthrombotic prostheses for treating mitral valve disorders. As I was again appointed minister, I helped build new premises for Amosov’s clinic. And, naturally, there was a growing intention to turn this clinic into an institute of cardiovascular surgery. Amosov took a dim view of being, quite logically, appointed director of the latter, although he later proved to be a nice organizer. He took no interest in and felt overburdened with administrative work. He wished to do surgery and, to a lesser extent, cybernetics. Finally, under the pressure of the Ukrainian leadership and, above all, [First Secretary of Ukraine’s Communist Party] Volodymyr Shcherbytsky, Amosov took over as the institute director, but when he decided it was time to abandon this post, he resolutely did so.”

We cannot help omitting a dramatic event in Amosov’s clinic, associated with one more of his projects...

“Well, let us get down to this story. Prof. Dmytro Panchenko, head of our institute’s Department of Nervous Diseases, set up a biotron, something like a room with controlled air pressure, on the premises of a regional hospital’s neurological ward. Incidentally, I saw similar chambers in France, but they played no significant role in medicine. Instead, it dawned upon Amosov to use this chamber in cardiac surgery because an increased content of oxygen is supposed to improve the result of an operation. The institute still remembers a tragic event in connection with this chamber. Amosov described all this honestly and truthfully in his memoirs. He agonized very much over this. Well, as the saying goes, a great destiny is a great sacrifice.

“Amosov and I were in contact and phoned each other all through the years. Here are a few more touches. We used to exchange Soviet-era holiday greetings by way of sending postcards. Writing once this kind of message, I decided, just for a change, do begin with Amosov’s titles: Deputy of the USSR Supreme Council, Hero of Socialist Labor, etc. Then I was told that when he received this card, he felt terribly hurt, seeing in the address formula something that runs counter to genuine respect. When we met, he said with a reproach, ‘How dared you!’

“Here is another fact. Amosov was never elected a full-time member of the USSR Academy of Medical Sciences. Once, on my way back from a surgeons’ congress, I was traveling in the same train compartment with very close associates of Boris Petrovsky, the USSR’s Minister of Public Health. When we knocked back a glass or two, I asked them what hindered the election of Amosov as academician. The answer was: ‘He is too clever, you see...’”