Sunday, March 25, 2012

Do It Yourself

In January of 1961, the Russian research base called Novolazarevskaya Station was opened, isolated deep in the frozen Antarctic ice cap. By the end of April, one of the 13 crewmen started displaying unmistakeable signs of appendicitis, so the base doctor, Leonid Rogozov, decided that, although the conditions would poor, he would have to conduct an emergency appendectomy on the patient. The main problem with this plan was besides being the only qualified medic on the base, the doctor was also the patient.

27-year-old Rogozov began feeling weak and nauseous on April 29, 1961, and had severe pain in his abdomen. When his temperature rose and his vomiting didn't cease by the next day, he had made his own diagnosis, and knew that the only solution was surgery. Novolazarevskaya is in Queen Maud's Land, the part of Antarctica directly south from the tip of Africa; the next closest Russian base was Mirny, which is Australian Antarctic Territory, and more than 3,700 miles away. Nearby non-Russian bases were unable to help because they lacked an airplane, and there was a blizzard closing in besides. So, Rogozov decided to perform self-surgery.

Rogozov and station director Vladislav Gerbovich assembled a team to assist in the self-surgery; the station's meteorologist would serve as the nurse of sorts, handling instruments to Rogozov and holding the wound open with retractors, and had to kneel during the entire procedure. The station mechanic held the mirror - as Rogozov wouldn't be able to see his own abdomen directly - and adjusted the lighting. Gerbovich stayed on hand in case one of the other two would faint during surgery, so he could assume their role. Rogozov gave them basic instructions on artificial respiration and prepared them for what he was going to do as best he could. They sterilized as much as they could, and Rogozov took a local anesthetic called procaine. Fifteen minutes later, he began.

Rogozov worked mainly be touch, which was why he decided not to wear gloves. He made a 10 to 12 centimeter incision in his midsection, and began feeling around for his appendix. The operation took almost two hours - far longer than normal - because Rogozov kept feeling weak and had to rest periodically to keep from passing out himself. The mechanic had to keep wiping Rogozov's forehead, and he was sweating profusely. He bled heavily, and his intestines gurgled.

Finally, he reached the appendix, which according to his later estimation was less than a day from bursting. He successfully removed it and gave himself some antibiotics. After telling his assistants how to clean the instruments, he sewed himself up. and then took some sleeping pills and a nap. Rogozov rested for several days, but recovered fully and stayed at Novolazarevskaya for more than a year. Finally, he returned to Leningrad (now St. Petersburg) and never returned to the Antarctic. He finished the dissertation he had delayed in order to take the post at Novolazarevskaya, and was awarded the Red Banner of Labour for his ordeals. Rogozov later headed the surgery department at the Leningrad/St. Petersburg Research Institute for Tubercular Pulmonology for 14 years before his death in 2000.



Links and Sources:
Wikipedia

"Self-Operation", by L.I. Rogozov, Physician, Sixth Antarctic Expedition, available online here.

Trailblazing Medicine: Sustaining Explorers During Interplanetary Missions, by Erik Seedhouse, Springer Books, 2011.

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