The voice of an epoch

In 1947 a doctoral thesis, which stood out by its liberal approach in the post-war asceticism, was suggested for the consideration of the State Commission for Academic Degrees and Titles of the USSR — at that time an institution of strict bureaucratic norms. It was the hand-written research of Nikolai Amosov, a candidate for a doctoral degree in medical science. It was not written on clean white sheets of paper, but rather on the back of medical forms. However, the topic of the research, Initial Debridement of the Knee Joint, suggested that the thesis was the work of a veteran doctor. As a result, the manuscript bypassed the typical bureaucratic procedures applied in such cases, and was admitted for defense.

Surgeon, cybernetics enthusiast, writer, and public figure — these are the six words describing Amosov that can be found on the memorial plate on the facade of one of the buildings not far from Saint Volodymyr Cathedral, where Amosov lived and worked in the last years of his life. Those words, in fact, encompass the universe of this champion of medical science and martyr of the past epoch. The name of the academician became a myth while he was still living: fixed-route taxi drivers who went to the institute of cardiac health created by him on Batyeva Hora, wrote Amosov Institute on their rout plates even though this official title appeared much later. Days and years pass but this original personality remains highly respected. Former patients who were healed thanks to Amosov’s skills, despite the peremptory verdicts of erstwhile medicine, live on. He was the first to develop modern cardio-surgery in Ukraine. Everyone who saw and listened to the marvelous knight without a nimb, without a hint of adjusting reflected his image, which symbolized honesty, commitment, and good conscience, and it never faded. One remembers, though maybe less than before, and reads the talented prose by Amosov — the mold of his soul.

However, all of that is just separate scattered shots of a big deontological film about his life and fate, which are now becoming a part of the past. The matrix of such a film was recently restored in a form of a unique bibliographical guide Mykola Mykhailovych Amosov. Lehenda Svitovoi Nauky (Mykola Amosov. International Legend of Science). The first publication of this kind was presented last year, and was approved by the National Medical Scientific Library of Ukraine. The professor Kateryna Amosova, Amosov’s daughter became the consultant for the project. In fact she was the one who initiated it. Raisa Pavlenko, director of the library and honored cultural worker of Ukraine, was the scientific editor of the publication. The compilers of the guide Lidia Kornilova and Tetiana Ostapenko made a great documentary in terms of the amount of information gathered and bibliographical treasures found among those carefully stored in the kingdom of medical books and periodicals on Lva Tolstoho Street. However, this is only a tiny part of the sources used. Kateryna Amosova and Hanna Telepova, who worked as a secretary for Amosov for a number of years, played a great role in the research by providing necessary materials from their personal collections.

The chronological list of Amosov’s works starts with the unusual thesis dating back to 1948. How did he manage to create the outline of his thesis, during that stressful period as a military surgeon, when over 40,000 wounded went through the 200-bed hospital, and both days and nights were spent at the operating table? I’d guess it was a result of a special combination of personal aptitude and the fate of seeing so much in so short a time. Of course, all the surgeries in that hospital were different, the work load for doctors was enormous, but joints damage was recorded very often. While helping wounded soldiers, the military surgeon Amosov improved the methods of wound dressing, which led to much more effective functional results than in other hospitals. This innovative technique received a positive evaluation amongst the medical formations at the front. Later, after examining the protocols and details of the operations, as well as the retrospective notes from Amosov’s memory, he summed up the data he had. He understood that the stage of thesis defense is a must in scientific advancement. Moreover, this search would become the great passion of his life.

The guide included 672 monographs, articles, digests, publications under his editorship since 1948 till 2005, and was presented to us by Russia. It also includes annotated information about 52 interviews with Amosov, which, of course, constitute a separate treasury. There are also 231 materials by different authors and publications about Amosov’s work. What emerges is an encyclopedic reflection on this outstanding personality and his missions. Looking through Holos Chasu (Voice of the Time) — incredible memoirs by Amosov, you understand that the name was not chosen by chance: the canvas of Amosov’s life is like history itself, not alienated, but alive and thrilling.

Let us now have a look at the four years during which Amosov worked as a leading surgeon of field hospital. Amosov would later write a great book about that time, in fact his memoirs V Okopah Stalingrada (In Trenches of Stalingrad) and PPG 2266. In 1946, according to the chapter “Main Dates of Life and Work” (after demobilization from the Far East, where the hospital was moved before the new war began), the future reformer of heart surgery controlled the operating corpus of the Sklifasovsky Institute. His main duties were to keep the medical equipment in a perfect condition, as he was also an engineer. Amosov was not satisfied with his responsibilities in the well-known Sklif. Probably not everyone in his situation would decide to leave desired capital, but the lines by Yevgeny Yevtushenko fit here perfectly: “I am making my career by not making it at all.” For five years, starting from 1947, at the age of 34, Mykola Amosov was head doctor in Bryansk oblast and the head of the surgical department in the oblast hospital. Incidentally, O. Shalimov, another famous doctor, headed another department of surgery in the same hospital. In hundreds of similar hospitals those were the years of constant harvest in all areas of surgery, in overcoming the aftermath of not-so-distant battles and the new challenges of the hard post-war times. However, the moment of truth was felt, perhaps, more distinctly in Bryansk. Soon, as the book on Amosov points out, an unprecedented breakthrough took place there. In 1952, in a collection of research papers by the oblast’s surgeons, Amosov published his article “Operations of pneumotectomy and lobectomy in the treatment of purulent diseases of the lungs, lung tuberculosis, and lung cancer.” This is an outline of thoracal surgery, i.e., surgery performed directly on the lungs. These approaches essentially initiated the use of an apparatus that sows the roots of the lungs, which was one of the first surgical automates.

One can also vividly see other facets of Amosov’s surgical talent — he published such works as “Operative treatment of the cardiac orifice cancer and the lower department of the esophagus” and “Creating an ‘artificial esophagus’ in cases of total gastrectomies” in the well-known Grekov Herald of Surgery, both written in 1952.

Amosov was running without delays, and in 1952 he entered his Ukrainian period, largely owing to the insight and intuition of A. Mamolat, director of the Institute for Tuberculosis. On that same Batu Hill, Amosov was elected head of the thoracal surgery department of the institute, and, for the first time in Ukraine, he saved people’s lives by performing pneumonectomies in cases of polycavernous tuberculosis.

This search, alongside the prologue to cardiac battles, was reflected in over 50 works, including his doctoral dissertation and the sensational Outlines of Thoracal Surgery. Remarkably, as early as 1955, the journal Vrachebnoe delo published Amosov’s article “Our first experience of operative treatment of patients with heart diseases.” The topic of heart surgery was now more distinct — “Heart surgery with artificial blood circulation” (1960); “Deep hypothermia combined with artificial blood circulation in heart surgery” (1964); and “An analysis of lethal complications after 1,000 surgeries with artificial blood circulation on patients with congenital heart diseases” (1968).

In 1964, Amosov published his novel Thoughts and the Heart, soon translated into numerous languages. A New York Times review called it the revelations of a truth-seeker. Now the depths of his talent as a writer began to show. In 1967, he published the science fiction novel Notes from the Future, later PPG, and A Book about Happiness and Unhappiness which discussed the chiaroscuro of surgery.

In the 1960s, the cybernetic strand of Amosov’s research crystallized. It proved to be a permanent one — he published such works as Modeling Thinking and the Psyche, Programs for Processing Medical Data, and The Method of Structural Models in Physiology. If we consider that during this period, in addition to implementing the method of artificial blood circulation, he also initiated the use of prosthetic cardiac valves – a new epoch with its own priorities and terrible risks – we are stunned by not only his expanding cybernetic explorations but also by such unexpected works as “A map of observations on the development and upbringing of small children,” “Thoughts on health,” and “The algorithm of the mind.”

The self-critical character and the power of his mighty spirit lived in such a seemingly tender and yet firm man… In his old essay “Open heart,” which is included in the book on Amosov. Yurii Shcherbak writes: “Amosov’s entire life and work were inspired by the idea of overcoming — overcoming the spirit’s and body’s weaknesses, overcoming diseases, most of which are caused by man himself, and, finally, overcoming time itself.” This is how it was.

Photos of Amosov are extremely touching, especially nowadays. The entire unique series, with special frescoes of the person and his epoch, evoke both joy and empathy. He is very different, often sad, but never indifferent. What a nice smile Amosov had! It divulges his soul, strict but with the true kindness and total commitment of a doctor. He is looking at you with his hands customarily folded — the inimitable Amosov who has returned to us in the form of this Herculian work.