In the third Sunday of June, Belarusian medical workers traditionally celebrate their professional holiday. This day honours the fact that doctors represent a profession with the special status of dealing with human lives.
To find out more about this esteemed and challenging profession, I spoke with Vladimir Korik, head of the Military Field Medicine Chair at Belarusian State Medical University, M. D., professor, colonel of medical service working at the 2nd Clinical Hospital, one of Minsk’s earliest established hospitals — and one of its finest.
I have known Dr. Korik for about twelve years or so. I’ve been at the 2nd Clinical Hospital’s emergency surgery department many times, both with my own health problems and visiting my friends. I’ve watched him at work during doctor’s rounds, dealing with other doctors from the department, students, and mid-level medical staff. From the first day I met him, I thought that this person was in the right place. Why? Because it becomes quickly apparent that Vladimir Korik has an excellent disposition for his profession. When talking to him, you feel protected. He speaks with his patients in a language they can understand. It wouldn’t be a mistake to say that intelligence is his innate feature. Of course, it is not just his education, but also his upbringing that has shaped him from childhood, his parents being important role models. His intelligence is subtly manifested in his voice, intonation, facial expressions and speech. I once read in a book that intelligence is not about ‘what’, but ‘how’, and is linked to a person’s inner dignity. All this pertains to Vladimir Korik, who is always tactful, delicate and respectful of people he talks to. He is a true professional.
Our interview with Vladimir Korik is about the day-to-day challenges of modern surgeons’ work, his professional history, and other representatives of this humane and noble occupation that have influenced him.
Vladimir Yevgenievich, why did you choose medicine? Maybe it was Doctor Aybolit by Korney Chukovsky that had inspired you or did you just follow your parents’ path?
— Indeed, I come from a family of doctors. My mother Galina Ivanovna is a multi-specialist. She used to work as a gynecologist, obstetrician, acupuncturist and reflexologist. My father, Yevgeny Fedorovich, was a cardiologist. He first graduated from Kyiv Military Medicine Technical School training military paramedics. This training school no longer exists. After that, he served as an officer on the Kuril Islands for five years. He met my mother when studying at Minsk Medical University. They got married as students and then went to the town of Smolevichi to work at a local hospital. I spent my entire childhood there in the hospital, so I never asked myself which profession I should choose.
Later on, my father became a chief medical officer. After we moved to Minsk, he worked in the 4th Directorate of the Health Ministry, occupying high-ranking posts. We had a large medical library at home — I studied the books attentively from childhood. Once, at the age of six, I came to my mother’s office, and entered a patient examination room where there was a woman with a gynecological problem. I didn’t lose courage and even diagnosed her. You know, my diagnosis turned out correct.
When my son was born, topographic anatomy was one of his favourite books. So, you see, Aybolit is ‘innocent’, although I did read books by Chukovsky as a child.
Did your son follow your path?
— Yes, Yevgeny is a four-year student at the General Medicine Department of the Medical University.
Do you think that this is his vocation or did you just persuade him into medicine?
— That’s what my wife thought when he decided to enter the university. When at school, Zhenya wanted to become a diplomatic official and was preparing to enter the Belarusian State University. After travelling to a scout camp he changed his mind, however. No one in our family insisted he should choose medicine, it was his own choice. I took him to show him a surgery once, we were operating on a hard [difficult] patient. I warned everyone in the pre-operating room that they should take Zhenya out of the operating room if he felt unwell. Yet, he was watching the operation from beginning to end, asking me everything. I understood then that he was interested.
Another surprise was when he was having his internship at our hospital and requested a job in the intensive care department. I didn’t tell anyone that he was my son, as I was curious to see how he’d build relationships with mid-level medical staff. To me, these are core people. Doctors perform just a tiny part of hospital work while mid-level personnel carry out the main workload — they take care of patients, control the observance of doctors’ prescriptions and have many more important responsibilities. Sadly, some doctors are not good at dealing with mid-level medical staff. The best are those who used to work as hospital attendants or male nurses themselves. My son quickly found a common language with everybody. I didn’t know that Zhenya was so tender-hearted, I revealed [realized] that seeing him taking care of and feeding helpless patients.
Doctor’s round is an important moment in the life of the emergency surgery department
Where does your family come from?
— My father is from Berezino. My grandfather was a secretary of the Berezino District Party Committee, he would organize partisan movement in Belarus during the war. He was killed at the age of 36. My grand-grandfather (from my mother’s side) was a clergyman and built a church in Glusk of Bobruisk District. People still remember and honour him.
Did you study in Minsk?
— I first studied at medical technical school #2 in Minsk, finishing with distinctions. Afterwards, I worked at the porcelain plant’s medical office as a paramedical officer for six months. After that I was called for service in the Soviet Union Armed Forces.
After a year of service, I informed my seniors that I wanted to enter the S. M. Kirov Military Medical Academy in St. Petersburg. At the time, it was one of the leading medical universities training military doctors. In Soviet times, diplomas from that institution would be recognized abroad. I graduated from the Academy with distinctions and with a gold medal — I am so proud of that. The Academy headquarters have a museum with marble slabs where gold medal holders are listed in gold every year. My name is also recorded there.
Did you have an opportunity to work abroad?
— I had many opportunities, but returned to Belarus, closer to my parents, as they were aging and needed my help. The academy graduates could choose any medical job, as we were broadly trained. Specialization was linked to military branches. For instance, the 3rd department was aviation, the 4th was maritime, and I graduated from the 2nd — land and missile corps. Arriving to any military unit, a graduate can work as a general practitioner, a dentist, a surgeon. If a military unit lacks a dentist, you would take this position. That is how broad my specialization was.
“Professor Sergey Zhidkov is an outstanding surgeon.” Preparation for the operation
What specialization did you take in Minsk?
— I wanted to be a cardiologist as therapy was my passion. I was very proud of having not read a single textbook on therapy — I only read monographs on every disease. I was offered a job at a separate medical battalion where I served for three years, and went to St. Petersburg again. I studied another three years at the Academy, at the Senior Staff Department. As they say, I studied as high as it gets. I graduated with a gold medal again. I defended my Ph. D. thesis within those three years. And my name was put on the marble slab again. So, I have two medals — one Soviet and the other one Russian.
When I returned to Minsk, I was invited to work as a senior resident physician at the main clinical military hospital’s abdominal surgery department. After six months, Sergey Zhidkov, head of the military field surgery chair and its founder, who was also the Defence Ministry chief surgeon and professor, invited me to teach at his department. Owing to Sergey Anatolievich and the city’s medical seniors, along with the military hospital, two more facilities were assigned for training attendees and students — the 4th and the 2nd hospitals. The main base is the 2nd hospital as it has emergency surgery department. There are only two such departments, in the 2nd hospital and emergency care hospital. They work 24/7.
The profession of a surgeon only suits sturdy and mentally stable people. In what situation did you understand that?
— Understanding comes with practice. Of course, a surgeon should be sturdy. Yet, in my opinion, this profession is mental stability-sensitive rather than requiring physical aptness. Many operations imply [require] that minimally invasive surgery is performed. They require very scrupulous, accurate and patient work. Sometimes, operations like this can take a long time — up to eight, ten or even more hours — with the surgeon staying at the operating room all the time. In Western countries, teams can change. Here, this practice did not settle. Perhaps, this is related to our mentality: we first complete the work and then can rest. To be honest, I haven’t seen weak-spirited surgeons. Not everyone is able to enter an operating room and ‘wound’ a patient for the sake of curing him.
What would you say about our medical school?
— It is very good, one of the strongest in the world. I do not understand people who go for treatment to the West. We should receive treatment in our home country.
Have you ever formulated any personal precepts to sustain focus during operations?
— I’ve never taken any training, nor formulated any precepts. I’ve never been an ardent believer, although I respect orthodoxy. Before any operation, I concentrate. This is not a canonical prayer to the gods. I just have my personal commencement address that I utter silently. My colleagues know that I never start a surgery until I have focused my mind, standing over a patient.
How did you discover that a surgeon should be a good psychologist? How do you withstand relatives’ emotions if, say, an operation has complications?
— If a surgeon does not know how to communicate with a patient, he shouldn’t operate. There should be total trust and understanding between physicians and patients.
Relatives’ emotions are the hardest part of our work. It’s always difficult to say that someone’s son, daughter, brother or parent has died. Any words of support or sympathy sound senseless in such moments. Doctors experience stress no less than relatives do. For the next couple of days, you keep on thinking again and again, if you’ve done everything you could to prevent the patient’s death. Self-chastising is natural for all normal doctors.
During the operation
How long did it take you to learn to distance yourself from your feelings, and when did your hair start turning grey?
— It’s impossible to distance from your feelings. Yet, the burnout syndrome, as resuscitationists and anesthesiologists call it, does exist. Feelings become less sharp over time, but you still take things up close and personal. My hair started turning grey when I was thirty-something. Well, this is always the case in our profession.
How important are personal qualities of a doctor?
— Very often, personal qualities have no impact on what your hands are able to do. This is not uncommon for surgeons. Someone can be a brilliant surgeon, but a very peculiar person, to put it mildly: peevish, unsociable, crusty. Characters differ…
Your work requires prompt response and decision-making that can be crucial for a patient’s life. Do you often rely on your intuition and belief that an operation will end well?
— In case of a scheduled operation, everything must be pre-planned, and the estimated result is 100 percent positive. Unexpected things happen though. They are usually unrelated to equipment or surgeons, but most often linked to a patients’ condition, the duration of disease, age, and, sometimes, specific anatomic features.
Like having a heart on the right side?
— This happens, too. Other organs can also be located atypically. Double anatomic structures occur. It’s quite a challenge to handle something that you’d never seen in an anatomic atlas. In situations like this, it’s absolutely normal to ask your experienced colleagues for advice. Emergency surgery, especially abdominal, has many nuances. A human abdomen is like a Pandora box: you open it and get startled. Modern computer diagnostic techniques do not always properly reflect reality, and then you have to make a decision in an instant.
Admittedly, surgeons do not have the right for being incompetent as they often deal with patients balancing between life and death. Have you ever felt guilty for death of patients?
— When you’re young, you’re not afraid of anything. It seems that your head is full of knowledge, but you have no skills. And no fears! Interestingly, life probably loves young doctors and protects them from various troubles. As you become more experienced, you grow more cautious, too. And then it seems that you know less and less, although as a matter of fact, your expertise is expanding. I think you feel so because your responsibility for your actions is growing as time passes. And you always feel bad when a patient dies, regardless of the cause.
Tell us, please, about your department.
— I’ve been working here from 2002. This is a very good department, and we work intensely because of high patient turnover. Sometimes, you visit all your 60 patients and dismiss 25 of them, but by the evening newcomers occupy all the beds. Working in this department is interesting and challenging. We work 24 hours, going like a hamster on a wheel. Not everyone is able to withstand this frantic pace, especially mid-level personnel.
Do you take night shifts?
— Several years ago, I did, but now I gave up. I’m not afraid of this work as I used to have to do night shifts several times a week. The reason I don’t do it anymore is not that I’ve become a professor. The thing is that other people should gain experience and earn money.
What do you think of exporting surgical services?
— Why not? In the world of today, clinics should earn. So it’s necessary to promote this important area.
Who are authoritative surgeons for you?
— I graduated from the university where all the professors, from all departments, both theoretical and practical, were unique pedagogues and personalities, people of encyclopaedic knowledge. I was lucky to learn from them. The system of teaching, polished for years, was so interesting that I was eagerly absorbing knowledge.
My first teacher of surgery, professor Mikhail Khanevich, is still living. He is one of our countrymen, by the way, coming from Belarus. Leonid Strukov (Pavel Napalkov’s student) is another esteemed teacher. When he was operating, I couldn’t take my eyes off him. Once I told him that I wanted him to be so little that he’d fit in my medical outfit’s breast pocket and that I’d take him out for consultation every time I needed. Strukov would answer any question.
I could name many more teachers from St. Petersburg. I also respect many Belarusian professionals, one of them is professor Zhidkov, founder of the military field surgery and an outstanding surgeon. We had a unique emergency surgeon, Dmitry Dudarev. The present head of the department, Sergey Alexandrov, is also a brilliant surgeon specializing in endoscopic surgery. He does absolutely fantastic things with laparoscopic equipment, he is a very valuable professional for our department. Norair Melkonyan is a very thoughtful and meticulous doctor with his special viewpoints who doesn’t think with stereotypes. Whenever we have an interesting patient, it’s better to assign it to Norair. He will gradually ‘unwind’ the case and identify the cause of the disease.
Have you ever seen a miraculous recovery?
— What do we consider a miraculous recovery? For me, it is a cancer patient who continues to live long and happily despite his illness. Unfortunately, I haven’t met such patients. Maybe, I will later. Yet, I’ve read religious books describing cases of miraculous healing.
A surgeon’s work is related to risks. Have you ever operated on patients with gunfire injuries? Have you operated outside a hospital?
— I haven’t operated in the field. Meanwhile, I have dealt with gunfire and stab wounds. When helping such patients, you should take into account specific things that differ from the principle of handling wounds in general surgery. Military field surgery has been classified as a separate sphere, and rightly so, because wounds inflicted with firearms radically differ from injuries that occur in peaceful life. Unfortunately, there are few professionals who know how to handle such cases.
“Sergey Alexandrov, head of the department, does absolutely fantastic things with laparoscopic equipment”
is a very thoughtful and meticulous doctor with his special viewpoints”
is satisfied with
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is an outstanding surgeon”
What is the difference between a good and mediocre surgeon?
— Being keen on the occupation. If you have no interest, you’ll never make a good doctor, be it cardiology or surgery. The ancient would say that a good doctor was like a god. A good doctor does not remain on the same level, but is evolving all the time: he reads, attends showcases, learns about new achievements in medicine and adopts best practices from leading professionals. He never ceases to improve. Young and ambitious doctors who eagerly master new technologies would easily surpass an experienced professional who stopped learning.
Why do surgeons quit their jobs?
— I’ve met such people, among them were my fellow university mates. Some realize that they’d made a wrong choice as they are not ready to sympathise and help patients. Some quit because they are unsatisfied with their earnings.
What do you as a surgeon want from your patients?
— A better understanding of us doctors. Some patients think they are so well-prepared that they are not able to properly perceive a doctor’s advice. Sometimes, a position like this might cause a conflict when a patient teaches a doctor what to do and how to do. This is a side-effect of patients’ knowledge, obtained from the internet and other sources. Previously, I would argue with such people, explaining my position. Now I just avoid conflicts, leaving people alone so that they can understand who is the doctor and who is the patient. And you know, it works! They usually find me to appologise a day after.
What qualities should one develop to make a good surgeon? What would you wish to students of Minsk, Vitebsk, Grodno and Gomel Medical Universities who choose to become surgeons?
— I don’t know what qualities to suggest one should develop. One should have a vocation, or, maybe, follow the destiny. I never thought I’d become a surgeon and never considered any surgical profession as close and appealing to me. It’s just circumstances, destiny. Or, maybe, genetics.
As a student, I would imagine that my head was a squeezed sponge. When it was released, it was soaked with water. May medical students and attendees absorb as much useful information as possible. It’ll prove useful!
By Valentina Zhdanovich