meanwhile, at the scene the rescue team: eight specialists of the Moscow oncological hospital № 62. Among them graceful Elena Novozhilova. Doctor of medical Sciences, surgeon, head of Department of tumors of the head and neck. Prize is awarded “For conducting a unique operation which saved the life of a man…”
From the memories and began our conversation with Elena Nikolaevna. She came into my kitchen by the end of the day. After two operations. Arrived in a mask and gloves – the Department received not only the planned patients, but those who caught the wretched virus in addition to the main serious illness. For them, the virus especially dangerous: on his journey he encounters virtually no obstacles, because the person deleted or larynx, or thyroid gland, or part of the esophagus… They are at particular risk. To refuse no one. Yes, and it is not accepted in the 62nd. Here is the usual routine. And in our conversation constantly wedged cell phone calls. Disable it in any case! The surgeon is something permanent. Out of time. Out of space.
Lena, unique operations don’t happen every day. Their implementation requires a surgeon special qualities? The uniqueness could be replicated?
Elena Novozhilova: I was lucky with the mentors. The head of my PhD thesis Professor, a famous cancer Institute Herzen Vladimir O. Olshansky said that the most important thing for a doctor to learn to listen to that for successful operation need only a spoon of talent in a barrel of hard work.
You’ve graduated from the Arkhangelsk medical Institute with honors. So, you had certain privileges in the choice of specialization. Usually graduates choose gynecology, plastic surgery, in the worst case therapy. By the way, your family were doctors. But nobody involved in Oncology. Especially in the area of head and neck, i.e. the throat, nose, tongue. People can’t talk, eat…
Elena Novozhilova: it’s okay to brag? I was a straight a student, head of the science club, which was led by the head of Department of hospital surgery of the Arkhangelsk Professor Vitaly Petrovich Bykov. He taught me not only the basics of surgical specialty, but have been told that a doctor, especially a surgeon, must be able to communicate with the patient. Not Lisp! And to give confidence, hope. I say that I was lucky with the mentors. It’s hard to believe, but Vitaly just convinced that I need a “beautiful, aesthetic” specialty. For example… surgical Oncology. Then, as I said, I was lucky again: got into grad school in the Center of Oncology Herzen. He’s always been a place of work of prominent people, specialists-oncologists, where my mentor was Vladimir Olegovich. And my future profession was determined, tumors of the head and neck.
do You remember your first transaction?
Elena Novozhilova: Remember. On the operating table lay a woman suffering from thyroid cancer. And though I many times assisted at such operations… No, his hands weren’t shaking. But inside, everything was upside down. It was a little scary. How many years do not work, I can say that no two people are alike. All operations are very individual. Each person has differently located nerves and vessels. All have characteristic features. The patient may not be a “case” is always a person with her character and very individual traits.
Repeatedly, the plan of operation played out in my head. But when I started the surgery, fear and uncertainty are gone. I confess to you, since I have a habit of every upcoming operation, even standard, hundredth in a row, I lose inside. Lose each input. Because, again, people are the same no. Each has its own anatomy, its own thyroid gland, the larynx has its own unique…
This play inspires confidence? The surgeon must be confident?
Elena Novozhilova: Confident – Yes! Needs. But in any case not self-confident.
the performance of your patients with a chorus of Turkish is not an accident. In the 62nd long has your choir patients…
Elena Novozhilova: Choir Piano for twenty years. Why is it needed in the Oncology hospital? Yes, because in the Department I lead, treating severe patients in whom cancer affected larynx, or pharynx. And unfortunately, after the removal of tumors of this localization, the patients lose the ability to speak, much less sing.
what did you come up with that patients not only sing in the choir, but the soloist in the choir Turkish?
Elena Novozhilova: You will explain why you need a chorus?.. No matter how great the advances in the treatment of cancer, the diagnosis of cancer usually shocks people. This shock threat. People sometimes go in himself. Even close relatives do not always survive this diagnosis of the conflict, even the decay of the family. Yes, we know that cancer is not contagious. But still many people are afraid even of the neighborhood with a cancer patient. This fear sometimes more than, say, in front of the same COVID. So the oncologist, however, any physician should be a specialist not only in their field, but also a psychologist.
You say to the patient that he had cancer of the larynx, that organ will have to be removed? Earlier it was not customary to do so. I remember when my father removed the stomach and part of esophagus cancer, when the discharge certificate was given not to him but me. Red felt-tip pen was written: “hands not to give!” Although after the surgery, the father after some time went to work, lived 15 years and died at 83.
Elena Novozhilova: Yeah like and my memory. Remember how in the certificates at the time of discharge the patient, we wrote: “the disease”. Not deciphering what it is.
Changed all the medicine. Still, the cancer diagnosis is frightening. And your sick sing in the choir…
Elena Novozhilova: entrants we suggest to listen to the choir. what’s More, we have an asset from patients attending clinic with me and are willing to participate in bypass patients, to tell them their stories. Believe me, personal example is very important. One thing I say, doctor, and quite another when the story is told of one who went through it all.
What is included in the orbit tumors of the head and neck?
Elena Novozhilova: Surgery of the oral cavity, pharynx, larynx, salivary glands, thyroid gland.
These bodies require a special approach. When you say that the surgeon is like the jeweler, I think it is wrong. The jeweler is dealing with metal. And the surgeon with a live person, its bodies, stricken with illness. You twenty-five years in Oncology practice. Can you compare the technology of treatment of the same thyroid 10-20 years ago and now?
Elena Novozhilova: the Difference is huge! Medicine is one of the fastest growing professions, methods, technologies. For example, earlier we did not know about molecular genetic technology. But they have fundamentally changed the modern approach to the treatment of many diseases. Notice, without exaggeration, the best molecular-genetic laboratory in our 62nd hospital. It is headed by Irina Demidova.
And yet, Elena, surgery for tumors of the head and neck still refers to crippling. How does one live without a larynx? How to breathe without a nose? How to tell if there is no language?
Elena Novozhilova: There is a modern rehabilitation technologies. In our meeting I came not with empty hands. Here is the device – a voice prosthesis, which allows you to return the gift of speech after the removal of the larynx.
It is available to all?
Elena Novozhilova: This is my, my colleagues pain! Since 1999, we olivem official thresholds of different organizations, begging that these devices were available for each patient, who lost her larynx. In some regions, such security is included in the MHI system. In some. But mostly the patients have to buy them for their money. It is about 30 thousand a year. And if you consider that many cancer patients with disabilities, this amount is very big for them.
Your patients in addition to cancer often suffer and respiratory diseases. And this is natural: a person whose larynx has been removed, the virus to get into the bronchi simple. And so are your patients at particular risk?
Elena Novozhilova: It really is. After removal ��of artane is the separation of the upper and lower respiratory tract. Man is no longer breathing through the nose. Sorry for physiological detail, the man on the neck hole, through which air passes, and therefore there are practically no obstacles for the virus.
How to help?
Elena Novozhilova: There are modern means of rehabilitation of breathing. There is a special device, but it is… Again “but”: the patients have to buy them for their money. And in free sale they are not.
was at the clinics, Israel, USA. I know that not only there, but also, for example, in Sweden, there are special rehabilitation system breathing after removal of the larynx.
Elena Novozhilova: I Confess that I hope that the horror of the pandemic COVID will have some positive long-term results. I do not remember, and not only when I would be on television, in the Newspapers, we talked about the heroism of doctors and nurses. Maybe, after all, the time will come when society realizes it primarily judged by the quality of education and medical care. And quite obvious – the same provision of rehabilitation funds will be available to all who need them.
And finally, since I talk about those patients who are at particular risk: first of all in this area – doctors of your speciality, dentists and endoscopists. You provided all the necessary protection? Patients as you breathe, and the infection is transmitted by airborne droplets.
Elena Novozhilova: do Not exaggerate! We are protected. Not completely. Think absolute to protect us is impossible. We do this work. And no other do not want.