Light on foot. Why the doctor from Boston each year come to the city

Before meeting with Gennady Fuzailova I knew not only that he is the head of the project “Doctors unite for children”, but that “the doctor likes to joke”. About this confidentially warned the woman standing next to me at the door of the operating Department. In her voice she was saying: “get Ready”.

Fuzaylov emerged from the surgery laughing. My question is, how much time for interviews, answered shortly: “5 minutes”.

— This is not enough!

— Haggle, he smiled.

Gennady Fuzaylov from Boston. He works in the children’s ward of the Massachusetts General hospital. She’s — University hospital at Harvard medical school. With her hospital “Shriners” for children with burns, where Fuzaylov spends one day a week. There he met his first patient from Ukraine. It was in 2005, when at an American clinic for the treatment of hit Nastya Ovchar, received during the fire burns nearly 80% of the body.

— This story. I’m in a workplace with a patient, and suddenly the boss calls me in to Central radio: “Urgent for me to replace you”. In the office, I went with the thought: “Perhaps will dismiss…” But it turned out that the Shriners with Nastya came to Viktor Yushchenko. The chief said to me: “There the President, you’re the only one who speaks Russian. Come on.” I was so nervous, what was said in the end in English.

She was accompanied by a large delegation from Ukraine. Someone from the doctors then appealed to Gennady Fuzailova with a request to arrange another patient at the Boston hospital. Behind him was a third, fourth, fifth child. Just over fifty patients with complex burns. When the bill went to the tens Fuzaylova invited to Ukraine. Since 2010, he gathers a team of surgeons, anesthesiologists and nurses which go to the city to help children with burn injuries. Over seven years of work in this project, doctors from the United States and Canada have consulted thousands of children and made over two hundred operations.

Nice body, female or male, is right, like delicious food and good wine. People should not feel ashamed of his body. Children do not have. I noticed that in your burn ward at the children formed the view that they are flawed. Parents are also proud of their child. Burned children actually expelled from the social system. And there are no structures that would be involved in their rehabilitation. We are here to help children get what they have not received financial, technological or social reasons. After all, if the child with burns is not time to do the surgery, he will be crippled. A simple operation can bring humans back in line.

This is our seventh visit to Ukraine. The case run-in. The last two years we have been working in Lviv on the basis of a private clinic. For me this fact is very positive. Maybe it will encourage other businesses to do similar things. The local administration is not very happy that we have it here. They want us to come to other hospitals and lifted them up. Raise without us, what have we. We must take care of the children. I have a very specific goal, and I think, as it is effectively implemented.

The treatment consists of three stages. The first is an acute condition. At this stage, the task of the physician to give the patient to survive, so he doesn’t die. In Ukraine, the effectiveness of treatment is assessed at this first stage. Yes, the patient survived, but what kind of life awaits him? When you give statistics, this statistic is useless. It does not show the real state of Affairs. Because there is the second stage of physical rehabilitation. The child needs to move all the joints, the head, so that he could take care of themselves. How long is this stage? Ten-fifteen-twenty years. And the third psychological rehabilitation. We have the result of treatment is estimated after rehabilitation, which in Ukraine is virtually absent. What kind of work the person will be able to find after a serious injury? The goal is to bring it back, so he was a full member of society.

This requires infrastructure. When I say give us 100 Grand, we’ll fly, I know you’ll do nothing. Because you first need to educate people, and for that we need institutions. You trained doctors, trained, gave them the conditions that they work and professionals are not left. That is the infrastructure. During the year it is made, two? If people think that they have no idea about what you need to fix.

We have two large compartments two surgeons. They make a lot of transactions and pay them accordingly. You get exactly naphal. A large flow of transactions hones professionalism, gives you the ability to do standard things in a short period of time. What we do now in Lviv, is a simple operation, but tight, fast. So that doctors could learn it, should be an incentive. You have too many doctors. Remove the excess, let the rest do their job and get a decent wage.

One day we invited the anesthesiologist from Ukraine to Boston for training. She was delighted and asked: “and you can even four doctors to bring?” You can, but why? You don’t want to teach them when you get back? When knowledge monopolizers, it’s bad. Because the likelihood of success of any surgery increases when all work together. Have your doctors a totally different culture of communication.

We all make mistakes. There’s nothing you can do about it. Even the computer should be rebooted every two days and you’re that fuckin’ computer? I noticed that in Ukraine a mistake is perceived personally. So, doctors) are afraid to talk about it, b) when you start to talk about it, it all boils down to “you fool”. Where is the fool? We’re talking about the mistake, not you. The main thing to understand why it happened.

Error probability the average person — 9-10%. Doctors-professionals — 8%, pilot 5%. Pilots conducting special training for our physicians to reduce this likelihood c 8% to 5%. The correct mechanism for identifying errors contributes to their reduction. You can do that too, if you stop to take errors personally. Until then, will continue, relatively speaking, “to Park by ear”, whack the car then right, then left, until you understand the technology — look in the mirror and use the sensors.

You know, what is the effect of Swiss cheese? Take cheese and cut it into slices. In some places the holes are through and through. This is the weakest point. But there is only one slice turn in order to block the hole, and everything is not so bad. However, you first need to find a weak spot, and then a suitable slice. And that means you’ll have to disassemble the whole chain from beginning to end and think about what kind of thing easiest to change, that was the effect. This is called swiss cheese effect.

Do not leave the desert

In the office where they rest between operations, is the Board. It painted an operations schedule for the week ahead, so it’s all covered with leaves. One piece of paper — one operation. Every day between 10 and 11 stickers. Just this year, doctors operated on 54 the 52 children and two adults for the first time. Children with burns of special patients. Once injured, they will need operations. As the child grows, his bones growing and skin — no.

The doctors discuss a two-hour operation the little patient from burns fingers tightened into a fist. Now he can unclench for the first time in a long time. Two hours medical manipulations and an entirely different life ahead of you. But the project is not only operations and consultations of experts.

I feel sick when I say that I have done. When one man makes the hero, it turns out that the rest is shit. If we are talking about one, then the other is not. And here all the characters. And the volunteers who decided to help, and the doctors who come here in their vacation. Remember, Exupery wrote that adults all appreciate in the figures. So for the numbers you need to see the person. The problem you need to look through the prism of the child.

People are always asking us why we come here. Not only to save 40-50 children, but also to share the understanding that you can do it too. Only treat each other well, love each other. To find bad education is not necessary. Know the story of the fly, bee and shit? Is a bunch of crap. Above it flies the fly: “Oh, shit!” This is her element. Flies to a handful of bee — she saw the flower.

Our project is unusual. After all, what’s wrong with medical missions? The group is going to expensive doctors, they’re doing simple operations and leave. In principle it is possible, why not, if the goal is to make 30-40 operations. But think about the concept, economically? When we leave, remains a desert. I wanted different, because it’s good to be ambitious. Why not use the opportunity? And for this we need to study the problem and understand how to help in a particular case how to fill the void. It is not necessary to give a man a fish, you have to give him a fishing rod. This is my concept.

For example, lectures for doctors. We’re not trying to tell people how to work. This is a joint work. That’s the biggest value. This is our attempt to answer the question of how to improve the practice of pediatric burn medicine.

Let’s say you have $10 million for burns. In our hospital the treatment of one such patient in the acute phase is approximately $2 million When you brought the patient out of the acute period, treatment should still continue, and carry out rehabilitation, too. At this stage, treatment is cheaper. And you can send their ten million or one, or more, in the first case propeciw five people, and the second — say, twenty. But there is another option. You can do everything to prevent it, and that you need ten thousand. Where will you send money?

This does not mean that treatment and rehabilitation are not significant. The system should be. But until you build the second and third stage, which depend on reform and infrastructure, you do the first. Here I saw first — prevention of children’s burns is in shambles. In the Department there is no hot water. Tomorrow is not fixed and the day after too. But why not do what almost no cost, and today, it is logical? So there was the educational project “Against burns”. We tell the doctors and teachers of simple rules how to prevent childhood burns.

When we delved into the situation, understood that with a swoop it will not take. I came to Kiev with a $2 million, but with them and left. I said, “We need equipment buy?” But I saw that what was needed was knowledge. I was offended, they say, stole two million. I’m not taken, I will protect you. Equipment that is not able to use the same weapon. In Ukraine, we’re not going for the simplest way. It involves interaction with people. And the interaction is always more complicated than just to come to do the operation and leave. The more that we are talking about interaction with people from another culture.

Me at the press conference asked the question: “we Have a lot of talk about the fact that you steal from patients bodies. Is that true?” I started to laugh. “Not really.” In the hall is so quiet-it was quiet. “What do you mean?” — “Stealing is usually paired organs. I have still more serious. I steal women’s hearts!” And then I blame the fact that I’m a clown. Here today wrote: “You’re acting like a buffoon. You would only laugh”. And that cry, what? It’s TV, all of these pompous, asking questions that have no meaning. I want to say to them: “you Guys do stuff”.

Let’s find out what the problem is. The problem is money and reform, but it’s not me, because I am not a reformer and not a politician. And anyway, the first thing I would do would fire everyone. I somehow got to your Academy of medical Sciences and asked: “what are you Guys doing? How can you, sitting here, to heal the sick?” And they are treated. I once counseled the patient and told me that the Professor is not allowed to do it. “And he was the patient seen?” “No.” How can he not allow what he sees. No, he can of course teach students. It is one thing to teach and another to treat. These are two different specialties. To heal, we need permission and practice. If no practice, then we are not allowed to treat. And you have strange laws. And I thought, again, these professors there and they pay money so everyone is happy, everyone is nice and all need it. But it’s a circus! But in the circus you have to be a clown.

When I asked about a University Department, people frown. You have a University associated with stupidity, we have the most progressive ideas and cool guys. All University projects used at the moment. For example, the laser that we brought — the development of our hospital. So the manufacturer gave it to us for free. For the company it’s good PR, and I was happy.

On the same page with the child

Alena is the second time coming with my mom to the city to participate in the project. She was four and a half, when in the house of the grandparents where she was staying, was a fire. Then she miraculously had the sense to close the palms face, and it saved her eyes, nose and lips. Since then, Alena has gone through many operations. And now her hands are in bandages. Alena was used to the hospitals. But gradually trying to adjust to normal life. This year she went to the second class and ballroom dancing. “I have special shoes. Golden”, — she proudly tells me. And then pulls out from under the bed plastic dog: “I doctors gave. Even her head is moving, see?” “The ratio of doctors to children surprisingly touching. They even catheter will not be delivered if the child says “no,” says the mother Alena.

With children is easy if you love them. What distinguishes the adult from the child? Children feel false, because they themselves have not yet learned to hide feelings. While adults have learned — they cheat, hide their true impulses. This is the explanation why I only work with children.

I used to work in the intensive care unit for cancer patients. And there was one girl of about ten years. Clever-clever. She knew she was going to die. Let her do whatever she wanted. She often came to us and told stories. Her reflections on life was so normal, so interesting, as in “the Little Prince”. One day she told me the tale.

The elephant woke up one Sunny morning and thought: “wouldn’t it be nice if mom and hugged and kissed me.” With this thought, he went into the jungle in search of mom. First he found a rhinoceros. “Rhino, I want to be someone hugged like a mother.” “I can’t, but do not worry, there is a boa constrictor, he lives long and for sure something will come up.” But the boa decided not to become a mother elephant and offered to find owl. “Maybe what will help. Owls are wise”. He also refused: “It’s hard work”. The elephant walked through the jungle, quite desperate. And suddenly it was hailed a resounding voice. “Why are you so sad? It’s a beautiful day”. The elephant saw a one-day moth. “I can solve your problem. I’ll be your mother.” “But you live only one day.” “So, I’ll be your mum one day.” Gotta love second, minute, day, life. That’s about it, said the girl. I don’t know where she took the story. Then she died. Children differently perceive life. Adult only and a clown need to be, to all could accept.

• See also: Treatment gift. Why Ukrainians are afraid of doctors

When I am out operating, I say thank you. Thank you more than money. Why our free clinic treats children from Ukraine? Due to good relations. What else can explain? It’s hard to understand, easier to believe in stolen organs.