In 1968, in the city of Kurgan, the bell rang in the office of Dr. Gavriil Ilizarov: Soviet sports star Valery Brumel asked for help. For several years after the accident on a motorcycle he is disabled. More than 20-ti operations in leading clinics, and no one successful. And what can he, an ordinary surgeon from Kurgan, who is not recognized in the Moscow higher medical circles, calling him "a mechanic from surgery"?
Today almost everyone knows about Gavriil Ilizarov. His miraculous apparatus brought thousands of patients back to life, including soldiers. It is today. But the Kurgan surgeon had to prove his case for thirty long years.
The doctor saw this long-legged guy only in the newspapers. Smiling world champion in high jump, the country's pride awaited the terrible fate of a patient with osteomyelitis after an accident and a series of unsuccessful operations. As Brumel tells in his autobiographical book, he stepped down from the steps of the institute, where he studied and saw a familiar girl who had recently bought a red Java. He asked to let him down on a motorcycle. Brumel loved speed. He sat back, holding a bag with textbooks in one hand, and the other hand held the girl by the waist. It was raining, there was wet asphalt, and for some reason at that moment Valeria got the idea that they would go either to Sklifosovsky hospital or to the cemetery. But he could not stop the rapid run of the motorcycle. They drove into the tunnel, according to Valery, oil was spilled on the road, the bike drifted, and he lost consciousness.
He awoke from the fact that a frightened companion braked him, they almost ran over a truck, braked sharply, then another car stopped. Valery, holding in his hand a leg dangling on some tendons, got into a passenger car, and they went to Sklifosovsky hospital, where the doctors operated on him using the old methods and could not do anything to ease his agony. An inflammation of the bone began, which was hidden from Valery, and it was only by chance that he learned about this terrible diagnosis. He was given an apparatus that only resembled the Ilizarov apparatus, and in fact the Moscow scientist Zaitsev, as Valery writes in his book, simply stole the idea of Ilizarov and tried to treat people with the help of his alleged invention.
Once Valery saw a man, whose leg was also shackled in a real Ilizarov apparatus. And he noticed the main thing - the spokes stood there crosswise, and not in parallel.
Brumel's leg was shortened by three centimeters. Hundreds of patients with a similar disease left the Ilizarov clinic healthy.
The road to success with Ilizarov was a long one.
In his autobiography, Gabriel wrote that he came from a peasant family, he spent all his childhood in northern Azerbaijan, in the small mountain village of Husar. The family, in which there were six small children, lived in poverty. They moved here, to their father’s homeland after the tragic events in Belovezh (Poland), where Father Gabriel served in the Red Army and met his future wife, Golda Abramovna. Their first child, Gabriel, was born in 1921 year.
The whole economy is a small garden cultivated on rocky, mountainous soil. All events in the world were learned from the stories of alien people. Father Gabriel teased sheep and handed over to the son of shepherds as the eldest in the family.
“My father died early and I, as the eldest son, had to support my family,” Ilizarov wrote in his autobiography. “Sheeping sheep, selling brushwood, sowing and selling crops.”
He was able to go to school only in 12 years (although he indicated in his biography that he had gone to school for ten years) when the younger brothers grew up. But it was a shame to go to the first class, so he went straight to the fifth. He studied easily, for the year he mastered the program of four classes and had already thought to quit school, as the case intervened in his fate. Once he starved eagerly to eat pears, not paying attention to their strange color. And they were sprayed with blue vitriol against insect pests. “And at night, trouble struck me — pain, vomiting, high fever,” Ilizarov wrote in his autobiography. The family was preparing for the worst. A paramedic called by his parents stated severe poisoning. The paramedic made the boy drink countless cups of boiled water, gave an injection, and the pain disappeared. And in the morning he was almost recovered.
The boy thought it was a miracle (there was a feeling of a miracle), and he wanted to become a miracle worker, to give people health. “Until then, I, who did not encounter medicine, was completely shocked,” he recalled.
And for this you had to learn. School Gabriel graduated with a gold medal and ahead of time. He was in a hurry to quickly become a doctor.
Gabriel Ilizarov entered the medical institute easily and enthusiastically began to study: he was lost in the library, studying books on physiology, anatomy, stories medicine. Particularly fond of the works of Ilya Mechnikov. After reading "Sketches of human nature" and "Sketches of optimism," he discovered the main truth: the main cause of the disease should be found in pessimism. It is this property that makes people unhappy. “Indeed, happiness is like health: when you do not notice it, it means it is there,” wrote Gabriel in his diary.
“I was a student at the Crimean Medical Institute when the war broke out. It was ordered to evacuate to the east. On the way, I decided to visit my relatives with a friend. First we met grandfather Mahmut. When he heard where we were going, he said: “Do not go home. All your relatives are healthy. But they slaughter a single goat - that is the custom. Do not take the last. Mahmut took him to his place, fed him what he could, gave them on the road and said: “There is only one account between people - good. I made it to you, you - to another, the other - to the third. Good will go in a circle and someday return to me. The more good you do, son, the sooner it will come to you. ”
The circle of good made by Gabriel Ilizarov is immeasurable. But first he gets to Armavir, and then to Kyzyl-Orda.
The 1941 war of the year forced me to go through an accelerated program: in 1944, Gabriel received a medical degree.
“There was a war,” he writes. “I asked to go to the front, but they told me that in the outback, in the rear, it’s not easier, people need to be saved from disease.”
Instead of the front, many graduates were sent to the rear: Elizarov traveled to Siberia, to the village of Dolgovka, which is only 15 kilometers from Kurgan. He is appointed immediately by the head physician and is allocated for living a long hut into two owners, divided by a porch. He transports a mother and two sisters here. Especially loves horses. In order to tune in properly for the operation, I went to the horses and sat with them for a long time. And only then he began to work for heavy operations, which were difficult to carry out in the rural outback: there was not enough medicine and equipment. Gabriel reads a lot of medical literature, is additionally studying at the Kemerovo Medical Institute for Surgery. One of his colleagues said that it was the method of fastening the wheel rim on a simple carriage and became the starting point for his brilliant idea.
But so far, the real incarnation was far away. Every day he went to work on the only village street that was endless and long was called Shegon. The hospital was heated by a stove, there were only two wards, there was no electricity for a long time. The lamps were filled with kerosene, and under their light operations were carried out: sometimes during the day, sometimes at night.
It was the main district hospital for the whole huge district. Here, in Dolgovka, Ilizarov had to treat the flu, cut out appendicitis, take delivery. He managed everything and tried to help every patient. Here, as he subsequently wrote, he first learned independence.
Front-line soldiers returned to the village, many of them on crutches, with their hands or feet plastered. But even after removing the plaster, the crutches did not throw: the broken bones either did not grow together at all, or they did not grow together correctly. Sometimes in such cases, the head physician dropped his hands: how can I help? How to regain health? Gypsum dressings helped a little. Maybe the case in the wrong fixation of broken bones and gypsum is not the only method? Ilizarov again took up books on medicine. He began to think how to make a reliable clamp to fix the crippled leg or arm.
The first idea of a broken bone with the help of external means was suggested by Hippocrates: strong dogwood rods had to keep the bone in a stationary state until splicing occurred. But this idea hung in the air for two and a half millennia. The Englishman Case tried to strengthen the plaster with steel: a metal rod was implanted into the bone, which, after recovery, had to be removed. Most often the bone was broken again - such experiments again and again turned out to be unsuccessful. “The development of metalosteosynthesis ideas lasted for several decades and cost hundreds of crippled people,” Professor Vasily Chaklin expressed his point of view on a centuries-old problem.
The task of creating an apparatus for firm fixation of the bone did not give Ilizarov peace, but he could do research only in the evenings when he finished his main work in the hospital. Soon assistants appeared to him: several graduates of medical institutes were sent from Kurgan Obzdravlis.
Gabriel Abramovich began to travel more often outside the district: he spent more and more time in libraries. So in one of his trips he met a graduate of a medical institute and returned home with his wife. But the marriage was unsuccessful, his wife soon left, taking her son with her. The second wife, too, could not stand the full immersion of her husband in the profession and left.
One day, Ilizarov saw a curious publication in a foreign journal: in 1948, a new device was invented in England. A metal needle was passed through the bone, which was fixed with rods. But complete fixation did not work. At the slightest pressure, the bone broke again. Such types of apparatus were not universal, but were intended to fix a certain type of fracture. But it was impossible for all cases in traumatology and orthopedics to design their apparatus.
For his experiments, a young doctor equipped a laboratory in his barn. He invented the details: for this he had to study in parallel the resistance of metals and plumbing.
The main idea of the design of the Ilizarov apparatus came at night: the wheel of a bicycle, the wheel of a conventional chaise — this is where the perfect fixation of the hub in the wheel center takes place. The device must be composed of rings and cross spokes. He jumped out of bed and rushed into the workshop. Spade shovel became a bone. Such a simple solution - steel rings should keep the bone in the center: the ring should be placed over the fracture, and the second ring - under the fracture. The distance between them is provided by threaded rods, which are adjusted by turning the nuts. By morning the model was ready. But how and on whom to check it?
Gabriel Ilizarov found this guy at a local club, where he looked into music: the harmonist on the scene famously stretched furs, forcing the entire hall to dance. When the dances were over, the harmonist pulled out crutches from under the chair and hobbled to the exit. The doctor caught up with him already on the street and offered to have an operation. The guy agreed immediately: his leg had hurt since childhood - tuberculosis of the knee joint. His desire to get rid of years of suffering outweighed any risk. It was risky to make a difficult operation in the conditions of a district hospital, but Gavriil Abramovich decided.
A couple of months later, the happy harmonist himself famously danced himself in the same club, without crutches.
Gabriel Abramovich was sure: he was on the right track. But a scientific base was needed for research and work. Fortunately, a promising doctor was noticed at the regional level and offered him the position of orthopedic traumatologist in the regional hospital in Kurgan. They gave eight, forty, then 100 beds. As part-time work, he was still considered an onboard surgeon of the sanitary aviation. For several hundred hours he flew on an airplane for emergency calls.
And in between flights and on duty, he will improve his apparatus.
Here, in Kurgan, with the help of local craftsmen, Ivan Kalachev and Grigory Nikolayev managed to bring the device to mind. Ilizarov met with factory technologists, meticulously questioning them about steel grades, about the properties and whims of the metal, and technical features. And finally, the day came when he decided to use his apparatus. An 1952 operation saved a young woman from joint tuberculosis.
This mechanical apparatus so organically used the biological possibilities of man that it became ingenious for many years. He could build the missing pieces of bone in a direction. The results were astounding: patients with severe fractures of the legs rose on the second or fourth day and, relying on crutches, left the wards to get some fresh air, and a month later they left the hospital on healthy legs.
To be continued ...