DR ROGOZOV PERFORMS SELF SURGERY

Our today’s post tells a story just as remark­able — a young Russ­ian sur­geon Leonid Rogo­zov, stranded in  Antarc­tica with the Sixth Soviet Antarc­tic Expe­di­tion, in 1961 per­forms a self-operation: under local anes­the­sia, sur­rounded by a bunch of guys whose only expe­ri­ence with med­i­cine was sit­ting in a dentist’s chair, the 27th years old doc­tor removes his own appendix.

rogozovappendectomy2

Dr Rogo­zov had a very promis­ing start, but had left for the expe­di­tion shortly before hav­ing to present his the­sis on new meth­ods of oper­at­ing can­cer. He was the only med­ical per­son in the expe­di­tion, and in the down­time he also per­formed driver’s and meteorologist’s duties. Six weeks after the arrival to the base, he started feel­ing ill: weak­ness came, then nau­sea, then abdom­i­nal pain along with body  tem­per­a­ture ris­ing. The diag­no­sis was easy: it was clearly a case of acute appen­dici­tis — but the clos­est med­ical help was about 800 km away. Dr Rogo­zov wrote in his diary:

I did not sleep at all last night.  It hurts like the devil!  A snow­storm whip­ping through my soul, wail­ing like a hun­dred jack­als.  Still no obvi­ous symp­toms that per­fo­ra­tion is immi­nent, but an oppres­sive feel­ing of fore­bod­ing hangs over me… This is it… I have to think through the only pos­si­ble way out:  to oper­ate on myself… It’s almost impos­si­ble… but I can’t just fold my arms and give up.

Soviet Antarc­tic Expe­di­tion site four years prior to Dr Rogozov’s events

All the avail­able con­ser­v­a­tive treat­ment was applied (antibi­otics,local cool­ing), but the gen­eral con­di­tion was get­ting worse.And so the prepa­ra­tions for the surgery began. In his diary  he describes these events in  plain, almost emo­tion­less lan­guage: how the guys found out, how he told them what was about to hap­pen, what they were to do. Fol­low­ing Dr Rogozov’z instruc­tions, the team mem­bers assem­bled an impro­vised oper­at­ing the­atre. They moved every­thing out of the room, leav­ing only the bed, two tables, and a table lamp. The aerol­o­gists Fedor Kabot and Robert Pyzhov flooded the room thor­oughly with ultra­vi­o­let light­ing and ster­ilised the bed linen and instruments.

In the event that Rogo­zov lost con­scious­ness, he instructed his team how to inject him with drugs using the syringes he had pre­pared. Then he gave the main helpers a sur­gi­cal wash him­self, dis­in­fectedtheir hands, and put on their rub­ber gloves for them. And so it began: with the team’s mete­o­rol­o­gist hold­ing the retrac­tors, a dri­ver to hold the mir­ror and other sci­en­tists pass­ing sur­gi­cal imple­ments, he sat in a reclined posi­tion and cut out his own appen­dix under local anesthetic.

The oper­a­tion went on for two hours.

One of his assis­tants, the sta­tion direc­tor Vladislav Ger­bovich, later recalled in his diary:

When Leonid had made the inci­sion and was manip­u­lat­ing hisown innards as he removed the appen­dix, his intes­tine gur­gled,which was highly unpleas­ant for us; it made one want to turnaway, flee, not look — but I kept my head and stayed. He him­self was calm and focused on his work, but sweat was run­ning down his face and he fre­quently asked us to wipe his fore­head … By the end of the surgery he was very pale and obvi­ously tired, but he fin­ished every­thing off.

Half way through the oper­a­tion Dr Rogo­zov passed out, but was able to continue.

halfway through the surgery the assis­tants asked for a photo cam­era to be brought in

Once  oper­a­tion was com­plete, he took sleep­ing tablets and lay down for a rest. The next day his tem­per­a­ture was 38.1°C; he described hiscon­di­tion as “mod­er­ately poor” but over­all he felt bet­ter.  He con­tin­ued tak­ing antibi­otics. After five days his tem­per­a­ture was nor­mal; after a week he removed the stitches. Within two weeks he was ableto return to his nor­mal duties and to his diary.

Those very instru­ments — on a museum dis­play nowadays

A remark­able extract from Doctor’s diary:

I worked with­out gloves. It was hard to see. The mir­ror helps,but it also hin­ders — after all, it’s show­ing things back­wards. I work mainly by touch. The bleed­ing is quite heavy, but I take my time — I try to work surely. Open­ing the peri­toneum, I injured the blind gut and had to sew it up. Sud­denly it flashedthrough my mind: there are more injuries here and I didn’tnotice them … I grow weaker and weaker, my head starts tospin. Every 4 – 5 min­utes I rest for 20 – 25 sec­onds. Finally, here it is, the cursed appendage! With hor­ror I notice the dark stain at its base. That means just a day longer and it would have burst and …

At the worst moment of remov­ing the appen­dix I flagged: myheart seized up and notice­ably slowed; my hands felt like rub­ber. Well, I thought, it’s going to end badly. And all that was left was remov­ing the appen­dix …

And then I realised that, basi­cally, I was already saved.

Dr Leonid Rogozov

About a year later he left Antarc­tica for home: 29 May 1962 the ship docked at Leningrad har­bour. The next day Dr Rogo­zov returned to his work at the clinic — and shortly after he suc­cess­fully defended his dis­ser­ta­tion. He worked and taught in the Depart­ment of Gen­eral Surgery of the First Leningrad Med­ical Insti­tute. He never returned to the Antarc­tic and died in St Peters­burg, as Leningrad had by then become, on 21 Sep­tem­ber 2000.

“A job like any other, a life like any other”

This self oper­a­tion was prob­a­bly the first such suc­cess­ful act under­taken out of hos­pi­tal set­tings, with no pos­si­bil­ity of out­side help, and with­out any other med­ical pro­fes­sional around. It remains an exam­ple of deter­mi­na­tion and the human will for life. In later years Rogo­zov him­self rejected glo­ri­fi­ca­tion of his deed. When thoughts like these were put to him, he usu­ally answered with a smile and the words: “A job like any other, a life like any other”.