A significant event recently took place in Moscow. A longtime friend of the Epiphany Council, chairman of the Moscow Society of Orthodox Doctors, Alexander Viktorovich Nedostup, whose articles are constantly published on the website, introduced the public to an unexpected manifestation of his talent.

Irina Tishina, the chairman of the board of the Turgenev Society in the family estate “Turgenevo”, and the host of a recent poetry evening, talks about this.

February 12, 2018 at the House of Russian Abroad. A. Solzhenitsyn hosted a creative evening with the famous cardiologist, poet A.V. Unavailable.

Alas, until now the name of the poet Alexander Nedostup was familiar only to a narrow circle of friends and professional reviewer, poet and critic Sergei Arutyunov, associate professor of the department of literary excellence at the Literary Institute. A.M. Gorky. The few admirers of Nedostup’s poetry have been rightly perplexed for many years: why is the poetry and prose of this undoubtedly talented author inaccessible (forgive the involuntary pun) to wide layers of domestic readers and admirers of the literary word?

Apparently, it was a matter of the special modesty of our hero, who did not consider his “poems,” as he likes to characterize his poetry, worthy of distribution. WITH God's help we corrected this misunderstanding: Alexander Viktorovich’s creative evening in the crowded large conference hall of the House of Russian Abroad was truly triumphant. Surrounded by close people: fellow teachers, medical students and literary students, former patients and their relatives, who are grateful to the God-given cardiologist Dr. Nedostup for saving their lives.

Alexander Viktorovich Nedostup - Doctor of Medical Sciences, Professor of Moscow State Medical University named after. I.M. Sechenova, author of more than five hundred scientific papers and monographs, member of the Main Medical Commission of the Ministry of Defense of the Russian Federation for the selection and training of cosmonauts, member of the Council of Medical Ethics under the Moscow Patriarchate. A special place in the life of the professor is occupied by his activities in the executive committee of the Society of Orthodox Doctors of Russia, where Alexander Viktorovich heads the Moscow branch.

This is his kind of special service to people, the continuation of the traditions of enlightenment and missionary work of his ancestors on his mother’s side - representatives of the Orthodox clergy. It was in this regard that it was no coincidence that we held a creative evening of Alexander Nedostup in the year of the bicentenary of the birth of Ivan Sergeevich Turgenev, the heir to the family estate in the village of Turgenevo, Tula province, Chern district.

Alexander Viktorovich's great-great-grandfather Fr. Vladimir (Govorov) served as a priest in Turgenev’s beautiful Church of the Entry of the Blessed Virgin Mary into the Temple. And he was, according to the temple chronicler, “a brilliant improviser and poet.” This is how, almost a century and a half later, the gift of priest Govorov (and the surname, which “speaks” of the direct relationship of its bearer to the Word of God!) was passed on to his respected great-great-grandson.

Not so long ago, Alexander Viktorovich visited Turgenev’s places, where the grave of priest Govorov was restored behind the temple being restored for Turgenev’s honor. Through the efforts of the chairman of the Tula Local Lore Society, an employee of the Bezhin Meadow Museum-Reserve, Tamara Georgievskaya, an extensive genealogy of Doctor Nedostup was created, the example of which especially shows how the formation of the intelligentsia took place from among the educated zemstvo clergy - the intelligentsia that gave the Fatherland outstanding doctors, cultural figures, and engineers who continued the spiritual traditions of missionary and service to society.

A.V. Inaccessibility was honored by the keeper of the archives from the Turgenev-Laurits house, the donor of the Bezhin Meadow Museum-Reserve, L.F. Kurilo. By coincidence, Lyubov Fedorovna - Doctor of Biological Sciences, a famous Russian geneticist - together with the hero of the evening, was a member of the Moscow Patriarchate Council on Medical Ethics. At the evening, the archpriest of the Church of the Archangel Michael at the clinics on Devichye Pole, Fr. Alexy (Garkusha). Poet Sergei Arutyunov speaks about the power of Alexander Viktorovich’s artistic word, confirming his points by reading his poems.

The poems of Alexander Nedostup were performed both by the author and by theater and film actress Olga Tokarskaya. A fragment of the surprisingly deep poem “Transition” was presented in a recording by the author’s wife, Honored Artist of Russia, Olga Fomicheva. Olga Georgievna, a faithful companion and inspiration, passed away three years ago. In memory of his wife, Alexander Viktorovich annually gathers friends and admirers of her acting talent at the L.N. Museum. Tolstoy, where her creative evenings often took place.

It would be unthinkable to listen to the lyrics of Alexander Viktorovich - as delicate, inspired, intelligent as the author himself - without an organic musical accompaniment. Frederic Chopin, the hero of several poems by Alexander Nedostup, was performed by the laureate of international competitions, soloist of the Moscow Philharmonic, Alexander Kalagorov.

Composer Vladimir Bagrov presented a phonogram of his melodies based on the poems of Alexander Nedostup especially for the poet’s creative evening.

The guests of the evening were happy to hear three wonderful “songs,” as the poet calls them, in his own performance. It was very touching and heartfelt, emotional and spiritual, it was very cultural, like everything that this unique person does - the true creator of our great, full of Spirit, Russian culture.

Societies of Orthodox doctors are today organized and created in various regions of Russia. The activities of these public Orthodox organizations are known both for their work in the International Christmas educational readings, and for solving current problems of biomedical ethics together with deputies of the State Duma, and for participation in church-wide movements. Many of us, due to our physical weakness, had to be patients of Orthodox doctors and nurses.

The Moscow Society of Orthodox Doctors has existed for 11 years and has about a hundred permanent members - doctors of various specialties, among whom there are many candidates and doctors of science; both medical students and secondary medical staff, and priests, including former doctors. The creation of an Orthodox medical society under the auspices of the Department of Social Ministry and Church Charity of the Moscow Patriarchate was blessed by Archimandrite Kirill (Pavlov), confessor of the Holy Trinity-Sergius Lavra.

We will try to talk about various aspects of the work of the Society of Orthodox Doctors of Moscow, St. Petersburg and other regions in our magazine, including in response to your letters and requests. Today we will dwell on a question that every Orthodox Christian probably asks himself, especially when he is forced to be a patient.

What is Orthodox medicine? What should you expect from an Orthodox doctor?

These and other questions are answered by Alexander Viktorovich NEDOSTUP, Doctor of Medical Sciences, Professor of the Moscow medical academy named after I.M. Sechenova, chairman of the Moscow Society of Orthodox Doctors, co-chairman of the Church-Public Council on Biomedical Ethics under the Moscow Patriarchate.

What is missing in Orthodox medicine?

This is where I would like to start. Sometimes there are situations when you realize that what people imagine about Orthodox medicine is not exactly what it actually has. There was such a case in my practice. A certain person calls me at work and asks me to consult his sick boy about heart disease or to arrange a consultation with a cardiac surgeon. I suggest doing a fresh electrocardiogram, I wonder how long ago an ultrasound examination of the heart was performed. He asks in surprise: “So you have the same thing: again X-rays, ultrasound, etc., and again treat with pills?” “Well, how else can heart disease be treated?” - I ask a question. “I thought that you were treated with herbs and something else special, you are an Orthodox doctor...” - the disappointed sigh of the interlocutor can be heard in the telephone receiver.

I feel: a person understands that Orthodox medicine is something else, different from medicine, as a science in general, and Orthodox doctors are something like “traditional healers”, advertisements for whose services are full of all means today mass media. There, by the way, they do not skimp on lies, calling these charlatans Orthodox, placing advertisements against the backdrop of Orthodox icons, speculating on the names of Orthodox saints. Apparently, among people who have come to God, to the Orthodox faith, there is an opinion that an Orthodox doctor should treat exclusively with herbs and, if not spells, then, in any case, prayer.

This is not entirely true. We do not deny herbal medicine, but only as an integral part of prescriptions.

What is Orthodox medicine?

In order to understand what Orthodox medicine is, you need to understand what medicine in general is. Medicine consists of several parts. We can talk about medicine as a system of social relations between the patient, society and the doctor. Medicine is also the actual healing of a sick person. Finally, medicine necessarily includes subjects: the sick person and the doctor.

Who is an Orthodox doctor?

Such a doctor must not only believe, but strive to live according to the Commandments of God - and not only in his personal life, but must apply them to his professional activities. The profession of a doctor requires a lot. First, an Orthodox doctor must strive to be a good professional. Since he is a believer, he must take his professional responsibilities to carry out the divine work - healing with honor. Secondly, an Orthodox doctor must love the person he is treating, at least feel sorry for him, in any case, he must keep his heart open to the sick person. And it is important that the doctor be a free healer. This is not so simple: in our time, both the state and the patients themselves are pushing the doctor towards the temptations of side pay, since the real salary today in public medicine is simply ridiculous. Thank God, most doctors do not engage in bribery. However, everything I have listed can be characteristic of any decent doctor: both an atheist and a Muslim.

An Orthodox doctor, among other things, must have an Orthodox concept of what life and death are, what illness and healing are, and how all this relates. We must clearly understand that it is necessary to treat not only the body and soul, but also the spirit itself. There cannot be a physical or mental illness without spiritual damage. We know that the overwhelming majority of our illnesses are retribution for our sins. Therefore, healing and restoration of human integrity is possible only in the trinity. This is for us Orthodox people, understandable, but our society as a whole does not understand this, and many believers who recently came to the Church do not realize this either. The difference between an Orthodox doctor and his colleagues is that he must be aware of all this. And we must have a good idea of ​​where the powers of a doctor end and the duties of a priest begin. A patient can only be treated together with a priest. An Orthodox doctor must be guided by the fact that his work is a matter of love and service to man, and therefore to God. The Russian philosopher Ivan Aleksandrovich Ilyin said this very well.

Orthodox patient.

A person who needs medical help must understand that he bears his suffering as a kind of permission from God for the sins that he has committed. Illness may even be an easier retribution for sins, and in the next world, perhaps, suffering endured with patience will reduce the measure of responsibility. It often happens that children are sick for the sins of their parents and as punishment for their parents. Sometimes illness is given to a person to bring him to his senses and bring him closer to God. You have to understand that people around you can reason like this: this person is so bright, so sinless, why does he suffer so hard? We must not forget about our general bodily damage, which was initially acquired by man along with original sin. Those who sin little also get sick. It happens that priests, known for the height of their spiritual life, who, during confession, take upon themselves the sins of the penitents, pray for their spiritual children, suffer greatly, especially at the end of their earthly life. A sick person who considers himself Orthodox must understand all this and begin communication with a doctor with absolution in the Church, with unction.

Healing as healing for the whole person

We are engaged in healing the body - doctors of various disciplines: therapists, cardiologists, dermatologists and other specialists; healing of the soul - the field of psychiatry; spiritual healing is the responsibility of the priest. Moreover, an Orthodox doctor must understand in time that a person needs a priest, try to carefully remind the patient about this, and bring him together with the priest. Then healing will be complete. It is clear that medicine in its mental-somatic embodiment, that is, when it comes to psychiatry, diseases of the heart, stomach, kidneys, has no relation to what belongs to the spiritual sphere, spiritual illness. Therefore, we have no right to say that there is Orthodox cardiology, Orthodox dermatology, venereology, urology, etc. In the part where the disease is not directly related to the spirit, the Orthodox doctor remains an ordinary specialist. This is very important. The skeptical attitude of an Orthodox person to conventional methods of treatment and research of the body often arises when the doctor does not show proper attention, interest, or compassion to the patient. Many people imagine such a doctor as some kind of appendage to soulless equipment, which itself can make a diagnosis and prescribe medications. Then the person is looking for something else, not realizing that the equipment is an extension of the hands, eyes, ears of the doctor himself, and then the soul of the doctor himself must be connected. Both doctors and patients often forget about this.

"Black Square"

Only some professions can be purely Orthodox, including Orthodox medicine, Orthodox pedagogy, Orthodox art. Where we are talking about contact with the life of the spirit, there may be an Orthodox specialist. A teacher deals with the education of the soul, and so does an artist. Is this significant? Are there creations opposed to the Creator? As much as you like. “Black Square” by Malevich, for example, or those artists who exhibited blasphemous works at the Sakharov Center, or the same abstractionists. When the disintegration of form, the destruction of God’s creation is depicted, then, in my opinion, this is already a departure from God. I asked what art is, from their point of view, of many people in the arts, for example, the outstanding musician Svyatoslav Teofilovich Richter, the prominent art critic Viktor Mikhailovich Vasilenko and others, and they said approximately the same: “art is the revelation of God in the world around us, ways of knowing God." When an artist, a cultural figure, even an actor, approaches this understanding, he is Orthodox, but if he only shows disgust, abomination, if he poetizes evil, then he is not Orthodox.

Medicine in the light of social relationships

Medicine is also a state institute with certain funding, organizational principles, construction. In addition to healing, medicine also includes prevention and medical examination. But what does all this have to do with religion? The most direct.

Financing

The fact that the cost of treatment is now being transferred to the shoulders of the poor, semi-poor and destitute people, doesn’t this have something to do with the Divine principle? The healthcare system that existed under Soviet rule is still closer to God than the medicine that is supposedly being created now in order to “return Russia to a civilized society.” Such a return is more like entering the kingdom of the Antichrist, because taking the last money from a person for what society is obliged to give to its suffering, sick citizen is a crime. A civilized society, in my opinion, should act as good Samaritan. Actually, that’s how it used to be: contributions went into the state pot. The state carved out what was left from rockets and heavy metallurgy for medicine. There wasn’t enough, but still, more or less everyone received equal medical care. The commercialization of our medicine is a shame.

Doctor-patient relationship

We used to have what was called a system of paternalism. Paternal system: the doctor, like a caring father or mother, took care of and responsibility for the sick person, and the patient trusted the doctor. What is happening now is diametrically opposed and is based on legal principles characteristic of the Western world. They are based on Roman law and the Catholic religion. We are approaching what is happening in America: contact between a doctor and a patient begins with the meeting of lawyers - a representative of the patient and a representative of the doctor. Over a cup of coffee, they conclude an agreement: what the doctor is obliged to do, what the patient is obliged to do, and what will happen if these obligations are not fulfilled. Strangers, for a certain fee, discuss the following questions: under what conditions can a doctor appear in court, what money and what should be paid and collected?!

We already have the so-called “informed consent”, when the patient gives a signature that he is familiar with what kind of disease he has, how it will be treated, what complications, side effects, treatment there may be, as well as that he knows all this and agrees to the proposed examination and treatment. Can the average patient really know and foresee everything? Of course not. However, after the conclusion of the contract, in the event of complications, the patient can no longer make any claims. On the other hand, patients are taught that if something is wrong with you, you can sue. The doctor will have to prove that the patient had, for example, severe pneumonia and that he had to choose to take responsibility for the inevitable share of risk when using an antibiotic, that an allergy is less damaging than possible complications, and perhaps death. These are elements of legal relations with which the doctor can not only protect himself from the patient’s attacks, but sometimes also relieve himself of responsibility. All this is very far from the Orthodox approach to treatment. The kind of trusting relationships that have traditionally developed in our country are emerging.

Clinical examination

For us it has always been quite well established. The patient was called for examination and reminded that he was sick. This medical examination also includes spiritual issues. Are you living right? Do you smoke, drink alcohol to excess, do you commit fornication? All this applies to disease prevention. But now we have lost both prevention and medical examination in general.

Islets Orthodox attitude to healing

When the doctor and the patient call on the priest, when the three of them enter into an alliance against the disease, when the patient gathers together, repents, and partakes of the Holy Gifts, the doctor and the priest pray for the health of the sick person, and the patient remembers them in his prayers, and all together they try to overcome the disease, understanding that everything is in the hands of the Lord, then we can talk about Orthodox medicine, because a person has a soul, body and spirit. In addition, the doctor must act as a specialist, applying the knowledge that his medical training and his teachers (both believers and non-believers) have invested in him and which he has acquired in the course of his professional activities.

But we now have practically no Orthodox hospitals, except for the hospital of St. Alexis of Moscow. Even an Orthodox branch is difficult to create. So Orthodox medicine is theoretically possible, but in practice it appears only in islands where these conditions are met.

Now we are trying to collect a database with the coordinates of Orthodox doctors at the Moscow Society, but this is extremely difficult to do in the conditions of the capital, we have neither special employees nor premises for this.

And yet, we ask Orthodox doctors to respond and report themselves by email:

or phone/fax: 248-63-53

Perhaps together we can do more.

Moscow Medical Academy named after I.M. Sechenov

The rector of our medical academy, academician Mikhail Aleksandrovich Paltsev, himself was the initiator of the revival of hospital churches at the Devichye Pole clinics. In everything related to the spiritual care of the sick and suffering, he always meets halfway; now we have three churches at the academy: a large one in the name of Michael the Archangel, a small one in the name of Demetrius of Prilutsky, and the surgical center has its own home church. Looking at the management, and the whole team began to catch up, priests regularly visit the clinic. Meetings of the medical section of the International Christmas Readings are also held on the territory of our academy.

Free prayer book

We Orthodox doctors often pray for our patients in our hospital churches. The rector of the Church of St. Demetrius of Prilutsky is Archpriest Kirill Chernetsky. In the past, he was also a general practitioner. When in the 60s he was preparing to defend his Ph.D. dissertation, he was noted for his religious beliefs. He was offered a choice: either to believe and leave Soviet medicine, or to continue his medical practice and scientific research, but abandon religious beliefs or at least hide them. The Orthodox doctor chose to leave secular medicine. He became a doctor at the Holy Trinity Sergius Lavra. Later he graduated from theological seminary, then the academy and became a very good priest, while remaining an experienced doctor. Recently, for his free ascetic service, our priest was awarded the Order St. Sergius Radonezh, this is the third church award.

It is necessary to educate children in faith from childhood.

It is necessary that there be Orthodox education in school, it is necessary to introduce the Fundamentals of Orthodox culture everywhere in secondary state educational institutions, in addition, in medical universities - the fundamentals of the Orthodox faith, only then can we count on some positive changes not only in medicine. However, in medicine, perhaps, first of all.

About the problems of medicine in the modern world, about Orthodox doctors and Orthodox patients. Alexander Viktorovich Inaccessible.
VZh No. 7-8 (38) 2006, pp. 44-45

Alexander Viktorovich LACK OF ACCESS– cardiologist, doctor of medical sciences, professor. Works at the Moscow Medical Academy named after I.M. Sechenov. Heads the Society of Orthodox Doctors of Moscow.

Someone commands: “Discharge!” – and the patient begins to turn blue

– We were one of the very first in the USSR who began to master defibrillation. The three of us did this: Abram Lvovich Syrkin, my peer Isabella Vasilievna Mayevskaya and me.

Scary. Alarming. Of course, there was excitement. Give anesthesia so that breathing does not stop, if possible. But it stopped, I had to do it artificial respiration. Then the discharge itself: now the equipment has been improved, but the first devices were rougher, more rigid, and there were cases when, in response to the discharge, cardiac arrest occurred, and the patient was sent to intensive care.

I remember a case when we got to the intensive care unit, gave anesthesia, the patient’s heartbeat was desperate, and he urgently needed to be “taken off” from this.

Abram Lvovich dangles his legs, sitting on the windowsill, and says: “What a wonderful technique! It’s hard for a person - one moment, and he’s completely fine, and there’s a good rhythm.”

Someone commands: “Discharge!” He presses a button, and the patient begins to turn blue, his pupils dilate, Abram Lvovich jumps off the windowsill, literally flies off, and begins...

Actually, in such cases, all you had to do was give one more shock, almost always it restored the rhythm, but you had to live through this painful second.

- Did you save so-and-so?

― They saved me, of course. They kept a journal in which all these incidents were recorded. We stopped at something like two thousand: we realized that we no longer had to write it down. By the way, there were no receipts from patients stating that “if anything happens, no one is to blame, I have been warned,” as is now customary. There were complications and there were troubles, but there was not a single complaint against us, not a single sideways glance.

Our wonderful teachers taught by example that when you come to the clinic, you must first put on a robe and run into the room: “Good morning! How are you?". Moreover, there is no need to feign excessive enthusiasm - people will understand that this is a tune. One should not show excessive concern; one must find some kind of middle ground.

Once I came in, I went on a round during the working day. As he was leaving, he ran in again: “How is it, is everything okay here? Nothing? Fine. What are you reading? “Okay, happy, see you in the morning.” The person understands that you communicate with him, treat him as a person, worry about him, and try to help.

It is very difficult to cultivate pity for a patient

- What is the most important quality for a doctor?

― Recently, more and more often I ask my students the question: “What do you think is the most important thing in the medical profession?” They say different things: that hard work, the amount of knowledge, memory, and so on are very important.

I say that all this is correct, but the most initial, fundamental value is pity for the patient. If you do not experience this, if this feeling is not inherent in you, then it is very difficult to cultivate it. To put it more sublimely, the doctor must love the patient. Students have been told this since their first year, since open doors, but it is very difficult to implement this in practice.

Everything is like in the Gospel: “thou shalt love the Lord thy God” and “thou shalt love thy neighbor as thyself.” But it is very difficult to love a person. You can even become despondent, deciding that you do not live up to this high demands. We must at least strive to achieve this measure, and we can start with pity: after all, you can feel sorry for anyone, even someone repulsive.

Medicine is not only a huge amount of knowledge, it is also ethical principles that need to be cultivated. But is it possible to educate, teach compassion, pity for people? It seems to me that this should rather be some kind of immanent feeling.

- But you still somehow try to teach pity and humanity to your students?

― Even 130-140 years ago, the great Russian therapist Grigory Antonovich Zakharyin taught that modern semiotics, that is, the study of symptoms and syndromes of diseases, is extremely extensive. He told the students: “Don’t let yourself get sick from too much knowledge.” Today, the volume of knowledge has increased several times.

We must have time to explain the theory, and show how it is applied to the patient in practice, and discuss controversial issues, and check the level of knowledge. It’s a pity that in all this we often don’t have time to get to know the students better, talk, and then they run off to the next class and the school day ends.

Medicine cannot be reduced only to the sum of some knowledge and the ability to manage it. It will not be possible to simply apply the contours of diseases constructed in our minds to the patient and receive a ready-made diagnosis as a result. The human qualities of a doctor, which lie outside the scientific plane, are extremely important for his successful work. How will he work with the patient? Will he be able to find an approach to him, some key to his character?

About three years ago, guys who were graduating from college came to me with a camera and said: “Alexander Viktorovich, let’s talk, can we?” - "Let's".

We talked about seemingly distant topics that actually had a direct bearing on medical work - about art, about something else, and how it relates to our profession. We felt very good, interesting, and they said: “What a pity that we never said that before!” There is not enough time. New academic disciplines are emerging and therapy is running out. We grumble, of course, but we understand that this is necessary.

- Can your work be called a ministry?

― This work never lets go. You never feel like you've come home and it's all over. You never have the right to turn off your mobile phone; calls occur frequently.

- And they call at night?

― And at night. Sometimes they also call so that you say: “You’ve already taken something, okay, call 03. Go, open the door to the landing, open it slightly and go lie down. Lie down, and we’ll talk to you.” Of course, there are such cases. This is normal, otherwise what kind of doctor are you?

In other professions, they probably also sit and think at night, but here you feel a stricter responsibility for a person, and this is not easy. I try to instill this attitude in students, but this is instilled not with words, but with my own example.

You need to take care, but sometimes you can’t

- Which medicines that have appeared do you think are the most important?

― Of course, these are antibiotics - I don’t know what we would do without them. Hormones. Psychotropic drugs - before, there was nothing special except valerian. Antiarrhythmic drugs are also very important, antitumor therapy.

- It is believed that the problem of high mortality from cardiovascular diseases is typical for most developed countries.

― People often live incorrectly: physical culture They exercise little and eat incorrectly.

- Now, in my opinion, all everyone does is run and go to fitness.

― Well, not all, of course, but many. I think this should play some positive role. There are too many negative factors: environmental problems, unhealthy diet, overeating, side effects of medications. And of course, something that is unique to humans is depression. Very different in nature, very different in manifestations, they contribute to the development of very different diseases - just like unbelief, by the way.

Religion in the West is dying. My friends came from Germany, they say that more or less people still go to our Orthodox churches, but the churches and churches are empty. This is a property of the “civilized” world, because life in it is not organized according to the laws of God.

This gives a person a latent feeling that he is not living like this. This problem presses, presses, spreads around, and then some kind of vasomotor or respiratory center– and, as a result, hypertension occurs.

- A lot of people, especiallyAbout men die from cardiovascular diseases at a fairly young age. ..

― I recall lines from David Samoilov, with whom we were well acquainted:

And sometimes it’s in vain

I let my passions subside

And that you can't be careful

And that you can’t be careful.

You have to take care, but sometimes you can’t. When a man with a grenade gets up from a trench, he can no longer take care. And in other cases it is impossible - when, for example, a doctor goes to see an infectious patient. But out of stupidity, you don’t need to worsen your condition yourself.

A simple example: a teenager has just recovered from the flu, went to school and took part in cross-country. There may be heart complications, and he himself must understand that he should take care. An unprepared, physically undeveloped young man suddenly subjects himself to significant physical stress: his friends persuade him to go scuba diving, but he does not know how to breathe properly in it, he was not taught this.

In this case, you can and should take care of yourself. But if someone’s life is in danger or we are talking about ideals that mean more to you than life, then you won’t be able to take care.

I was looking for a family connection with Theophan the Recluse

- What is the main lesson you learned from your parents?

― My parents had a tremendous influence on me, but it is very difficult to formalize what was learned in the family... I remember how my mother said that at home, in the family, a person should show maximum good manners, maximum care for others, maximum caution, because when he comes home, a person very often relaxes, lets himself go and allows himself what he would never allow himself on the outside. I think about this often. At home you need to be very attentive to your loved ones. This is very important.

– Was anyone in your family involved in medicine?

– My parents had nothing to do with medicine. Mom graduated from the Automotive Institute, but was a library worker, working as a bibliographer in the department of the history of science and technology of the Central Political Library. She was from the family of a priest, and at that time such people were deprived of certain rights.

The severe repressions did not affect my mother’s family, but already at the age of six she heard the terrible phrase “concentration camp.” My grandfather, who was a priest, was arrested in 1918. His name was Father Alexander Raevsky, they gave me the name in his honor. What saved my grandfather was that his wife Tatyana Ivanovna Rusakova (Govorova on her mother’s side) remembered that the head or deputy head of the Tula Cheka sang with her grandfather in the church choir in the Church of the Mother of God of the Sign at an arms factory somewhere in Zarechye. Grandfather was also the rector of the Church of St. Nikita the Martyr in the center of Tula.

My father was from Muscovites. However, he was originally from near Poltava - that’s where his surname came from. My father came from a large family with five children. After serving in the army, he remained in Moscow as a military personnel. Mom had five sisters. The eldest of them, Galina, entered the medical faculty of Moscow University, the future medical institute. Subsequently, she became a professor, a fairly prominent cardiologist - she was one of the founders of the study of myocardial infarction in our country. And her husband was Evgeny Mikhailovich Tareev ( famous Soviet therapist. – Approx. runits).

- Is the internal medicine clinic named after him?

― Yes, he led it. He was a Hero Socialist Labor, three times laureate of State Prizes. Moreover, he was from a religious background - his father, Mikhail Mikhailovich Tareev, was a famous theologian, teacher at the Moscow Theological Academy, philosopher, and eternal opponent of Pavel Florensky.

Evgeniy Mikhailovich had two more brothers, but they were technicians by profession. And he himself was one of the “last Mohicans” of our great Russian clinic of internal diseases. Of course, there are still good doctors, but today's therapists are more inclined to one discipline.

Let's say I gravitate more towards cardiology, someone is more interested in nephrology, that is, kidney disease, and someone has an interest in pulmonology. And these “last Mohicans” were somehow able to grasp everything entirely; they had enough level and breadth of knowledge to assimilate even then an incredibly vast amount of medical knowledge in the clinic of internal medicine.

- Is anything known about your more distant ancestors?

― I have already mentioned that my maternal great-grandmother bore the surname Govorova. When I began to study spiritual literature, I thought that St. Theophan the Recluse, who also bore this surname, was from the same places as her - Yelets, Orel, Tula. Maybe I'm somehow related to him?

I tried to find this connection, but nothing worked. Then I stopped and thought that it was not fitting for me to look for a distant connection with St. Theophan, even if it existed. Who am I compared to him?

But my friends were intrigued by the story and helped me.

Pediatrician Natalya Gennadievna Ushakova found my great-great-grandfather on the Internet - the father of great-grandmother Natalya Vladimirovna Govorova. He was a priest, and his name was Vladimir Vasilyevich Govorov. He was the rector of the church in the Turgenevo estate (not Spasskoye-Lutovinovo, but Turgenevo; there is now a museum there). In addition to priestly service, he also wrote poetry.

Contemporaries said: “We have two wonderful writers in the Tula province. We are not talking about Ivan Sergeevich Turgenev, but Father Vladimir is also a distinguished poet.” In addition, he was a member of the Imperial Russian Geographical Society, which recently turned one hundred years old. He was accepted there as an honorary member for making weather forecasts for the Tula province - how he published them, however, is unknown. He was such a versatile man.

– What is friendship for you?

“I remember an incident when in the tenth grade I was in love, as expected, and asked: “What do you think love is?” The girl said without hesitation: “Mutual sympathy between two hearts.” She took this definition from some calendar. It’s the same with the question of friendship - it’s mutual disposition, mutual interest, mutual agreement on fundamental issues.

You can’t deny Stalin’s role in the Victory, but you can’t throw out repression either

– Your childhood was during the war years...

― Yes. Surprisingly, I remember the bombings, I remember the blue lights. I remember the radio - a black plate, from which in the mornings they played the unknown anthem of the Soviet Union - it didn’t exist yet, and not “The Internationale”, which was the party anthem, but “Get up, huge country!” Of course, I knew all the words from the age of two or three, like the rest of my generation.

I quite clearly remember Levitan’s voice and the words from the Information Bureau report, the same every day: “Fierce fighting continues in the Volokolamsk direction.” Volokolamsk direction is Moscow. The feat of 28 Panfilov heroes - this was at the same time. They stood to the death, held back and held back. And even if there were not 28, but more - say, 128 - what does it matter? They died, they did not allow the Nazis to approach Moscow. This is sacred.

I remember how in the winter of 1941–1942 the pipes burst due to very severe cold, water gushed out, and it became terribly cold. The house opposite was bombed; it then lay in ruins until about 1950. My mother and I went there, picked up bricks, my father made a stove out of them, put a pipe through the window - and we heated this stove, but it was still cold. What saved us was that one of my aunts invited us to her place, and we survived that winter.

I remember how, after the Kursk Bulge, captured Germans walked through Moscow. It was summer, it was hot, I was capricious, my mother took me away, and I did not see this column, but I remember this day very well.

I remember the first fireworks display, it was also 1943. I then lived at the dacha of Evgeniy Mikhailovich Tareev in Zagoryanka. All the adults came out and looked towards Moscow, thinking they would see fireworks, but, of course, they saw nothing. Then there were many such fireworks: there was an avalanche of attacks on the West, ours took city after city, and in the evening there were sometimes up to five to seven fireworks. We took a more or less large city - fireworks! Half an hour later, again the song “Wide is my native country,” Levitan, and again fireworks!

I also remember Victory Day. At night it was announced that surrender had been signed. The illuminated entrance was no longer darkened. People running out onto the site because it was impossible to sit at home. And all this day there are fireworks.

- The next stage in history is after the death of Stalin, the “thaw”.

― After Stalin's death, many felt that things had become lighter. I also remember his funeral very well: a terrible avalanche, just a human anthill on Lubyanka and down to Teatralnaya Square... Then there was the 20th Congress, which hit us very hard.

I had my own evolution of views on Stalin’s personality. First, complete acceptance of the general line of the party, then hesitation associated with condemnation. Then general trends towards some kind of whitewashing appeared. Later, finally, I formed my very clear impression that this is a person who will never receive an unambiguous assessment in history.

Stalin has a lot of bad things on his conscience, and at the same time, he has very serious victories in his military account - including the defeat of the Leninist Guard (forgive those who disagree with me, who believe, like the Trotskyists, that Russia is brushwood for the furnace of the revolution). It is impossible to deny Stalin’s role in the victory in the Great Patriotic War - but at the same time, collectivization and repression cannot be erased from memory either.

- Did you conduct an examination of Stalin’s latest medical history?

― Yes, at the request of the leadership of the Central State Archive. In 2003, on the occasion of the 50th anniversary of Stalin’s death, some publication was being prepared for publication, but it was never published due to lack of funds. Some books are still appearing, research is being conducted to find out the real reason Stalin's death - whether it was a murder or not.

After studying the documents, I came to a clear conclusion. I held in my hands this medical history, which cannot be called a medical history in the modern sense. These were sheets held together with a binder or a paper clip, on which entries were made every 15, 20 or 30 minutes. The nurses and doctors on duty wrote; decisions of the councils were entered there. You could see how worried all these people were, how they repeated the same thing, how their hands trembled, their handwriting changed. Theoretically, of course, you can fake any medical history, but you can’t fake it that way. Indeed, it was a severe stroke, pressure that did not decrease, because there was nothing to reduce it, there were no drugs.

Having become interested in Stalin's health, I also studied his medical history from the party archives, dated 1926. The forms themselves, apparently, were old, pre-revolutionary, because there was such a column - religion. Stalin wrote: Orthodox. I wonder if he wrote this sincerely or was he joking?

As young people, we were simpler: if we said teach, we teach

- Did you immediately choose medicine or were there any other options?

― From the outside it seems that with such a family, when the aunt and uncle are doctors, there was not much choice, but this is not so. In my youth I became interested in nuclear physics. I was very interested in the atomic bomb, I read a lot on this topic. It was widely known then: the first nuclear bomb had recently been detonated, then a hydrogen one. Although I graduated from school with a gold medal, I did not have a particular love for the exact sciences, and I soon realized that it was better for me not to meddle in this area.

I loved literature, and I was going to study to be a journalist. Besides, I was already trying to write some poetry. But then I realized - even then, in 1956 - that as a journalist I would have to write about what was “needed”, and not about what I considered necessary and interesting, and I abandoned thoughts about journalism. Thoughts about “serious” philology also disappeared: comparing some ancient Bulgarian units of literature with ancient Russian ones seemed very boring.

Those with a gold medal were admitted to the institute without exams, after an interview. I passed it without any success. I was asked: “What subjects do you like?” I named literature, and then I thought about it, because I couldn’t call history a favorite subject in our then Soviet editorial office. I named physics, and they asked me the question - what is black light? And I still don’t really know what it is.

Then they asked me what was the last representative of critical realism that I knew. I began to think, who is there? Turgenev? No, later, of course. Bitter? This is already the founder of socialist realism - not that. They told me - Korolenko. Korolenko, of course, I read something, but not enough: “Children of the Underground,” a small excerpt from “The History of My Contemporary.” Then they asked me something in English, I said something, and they accepted me.

I believe that all these questions during admission cannot reveal the main criterion for selecting a future physician - the ability to compassion, pity.

A year before I graduated from college, in April 1961, Gagarin flew into space. This made a great impression on me, and I still remain partial to this area of ​​human history. A little later, in 1963, I was very close to going to work at the Institute of Space Medicine.

It’s not for nothing that astronauts are given “stars”: it’s both dangerous and scary, and the endurance must be colossal. Why do you like it? I don’t understand how anyone could not like it - it’s such a real thing.

- Where were you assigned after graduation?

― I didn’t have any particular difficulties, because starting from the fifth year, some guys were selected, they began to teach the language, and prepare them to work as doctors abroad. This never happened, but the members of this group immediately got into residency.

- Do you remember the moment when you internally felt that you had done right choice? That medicine is your path?

― Medical education is structured very wisely: step by step, slowly, slowly they bring you to the patient - to look after them a little, wipe them down, take the duck out. Acquaintance with anatomy begins with corpses. The first glimpses of real medicine happen in the third year, and from the fourth year it becomes really interesting.

During our studies, we didn’t particularly analyze this, but today’s youth analyze everything, they are pragmatists... You know, I was struck by the answer of goalkeeper Lev Yashin to the question of what is the difference between the sports youth of his time and today. Yashin said: “We were simpler.” This is very correct.

That’s what happened to us: they told us “virgin lands” – that means virgin lands. Did they tell you to teach it? This is what we teach. Without thinking about why this is necessary. I just couldn’t bring myself to learn topographic anatomy - only surgeons need it, and I already understood that I wouldn’t be a surgeon.

Perhaps they will tell me that simplicity may be worse than theft, but it is probably better for society that its members should be simpler. At the same time, society needs thinking people. It happens that in the sixth year a student comes up and says: “Alexander Viktorovich, you won’t have me next semester, I’ll leave medical institute, I’m interested in something else.” Then I say: “I don’t blame you, I’m even glad in some ways, because there will be one less bad doctor, and your profession will gain good specialist" But this happens rarely.

- It seems to me that it is important to cultivate a critical view not only of oneself, but also of the world around us.

― Any educator must have the wisdom to find the balance between laying the foundations and being critical of oneself and the world. Returning to the topic of love and pity for one's neighbor, I will say that it is necessary to cultivate religious feelings as well - and from such an age, so that later it is not too late.

Recently we have all observed rejection, even a certain hatred, of the “Fundamentals of Orthodox Culture”, characteristic of a certain part of our society. But a long time ago, back in 988, the answer was found to the question of what are the foundations of our psychology, our national idea, and, if you like, the meaning of the existence of our country. Our foundation is Orthodoxy.

Doctors with a capital letter

- Tell us about your teachers

- Among the teachers, we must first of all highlight therapists and cardiologists, although other teachers were excellent: in normal anatomy, assistant Vladko, in propaedeutics of internal diseases, Ksenia Ivanovna Shirokova...

In first place among the names of teachers for me is the name of Vladimir Nikitich Vinogradov. All of us who lived and worked in his era consider ourselves Vinogradovites, although we worked under him for a very short time. Starting from the lectures that we listened to and ending with the moment of his departure, it was five years - the fourth, fifth, sixth year and two years of residency, when he already had his rounds, and we already understood who was in front of us.

Vinogradov was a representative of traditional Russian medicine, based on the finest observation of the patient. Each patient had an individual approach - this continued the line of G. A. Zakharyin. The scientific line became a continuation of the line of S.P. Botkin. They often tried to pit these doctors against each other, which is wrong. A.P. Chekhov said: “In Russia now there are two great therapists - Zakharyin and Botkin. Of these, I would liken Zakharyin to Tolstoy, and Botkin to Turgenev.”

Another of the great therapists of that time was A. A. Ostroumov. The founder of Russian cardiology, Dmitry Dmitrievich Pletnev, said that our entire clinic of internal diseases rests on three founders: Botkin, Zakharyin and Ostroumov.

Vladimir Nikitich Vinogradov was, first of all, a Doctor with a capital letter. He left behind a thin book of scientific works and a huge school that masterfully knew how to treat and treat the sick.

There are a lot of interesting stories about him. When Madame Churchill, who flew to Moscow during the war as a political figure, fell ill, Stalin, personal doctor whom Vinogradov was, sent her to him. Vladimir Nikitich spent about three hours with her. She came out completely shocked and said that she would never go to any other doctor in Europe again, and later flew to Moscow several times to see Vinogradov.

When we talked with him, he was, of course, no longer the same as he was in the prime of his activity, because he survived the arrest and imprisonment, which lasted about two months. Having been arrested in the doctors' case, he signed everything right away, because he understood the consequences of refusal: one of our professors had a broken nose after interrogation. He signed that he was a spy - English, Japanese, etc. He himself said: “I sat and read. Then they came to me and said: “Vladimir Nikitich, you are free. We believe you as before."

It is worth mentioning our faculty therapeutic clinic - the oldest therapeutic clinic in Russia. At one time it was led by Maxim Petrovich Konchalovsky, brother of the artist Pyotr Konchalovsky. Many of the most famous doctors studied and worked there, including Evgeniy Mikhailovich Tareev.

When Vinogradov and almost the entire entrance of medical professors, in which Tareev lived, were arrested, he was ready for arrest. He warned the family and said that the arrested doctors were not guilty of anything. He was put in place of Vladimir Nikitich Vinogradov - in charge of this clinic. He was upset, felt very uncomfortable, but could not disobey.

When on April 10, late in the evening, a radio message was heard that the doctors’ case had been closed, all of them had been amnestied and rehabilitated, Evgeniy Mikhailovich tried to pick up his things from the clinic as quickly as possible, because he understood that Vladimir Nikitich would come in the morning. He had time, collected all his things, and with two briefcases was going down the stairs from the second floor when he met Vinogradov rising towards him.

How they looked at each other, I don’t know, but they were both extremely wise people and understood the strength of the circumstances that put them in this Shakespearean position - against each other. I don’t know what they said to each other, and whether they said it at all or not, whether they shook hands or not, but Vinogradov and his wife Olga Fedorovna appeared at Yevgeny Mikhailovich’s dacha.

I once found such a meeting - they were emphatically attentive to each other and polite. Vinogradov ended this meeting with this wonderful phrase: “I flatter myself with the hope, dear Evgeny Mikhailovich, that our meetings will continue.” So there was no hostility between them.

When I realized that I would go to therapy, I needed to go to a circle to prepare myself better than in lectures. I started with propaedeutics from Professor Vasilenko, also a great therapist and one of the defendants in the doctors’ case. Uncle Zhenya told me: “You know, go to the faculty therapy with Vladimir Nikitich.” He didn’t say why, he didn’t say that this was a great clinic - and it really is great.

I went and listened to Vladimir Nikitich’s lectures - it was always a special event, the entire department came to listen to them. He worried, prepared, rehearsed, did nothing else that day - and this in his declining years. I will never in my life forget how I was sitting somewhere in the second row, taking notes, and he came up to me and said: “Remember,” and looks menacingly, “that a lung abscess is a consequence of untreated pneumonia!” And he shakes his finger in front of my nose. I was terrified, but I remembered it before today.

He was used to always ending his lectures with applause. How did he do it? One of our professors, Abram Lvovich Syrkin, said: “I remember how he gave a lecture on stomach cancer. The prognosis is bad. I think, what kind of applause can there be here? And Vinogradov said this: “When they come last days, and you will understand that you will no longer be able to do anything radical, you must at least do everything to make the patient feel better, relieve pain, console him, give him a little hope. So that the patient dies blessing the doctor.” Applause and he leaves."

The entire clinic gathered for Vladimir Nikitich’s rounds. Under no circumstances was it possible to peek into the medical history - you had to know everything by heart. He was incredibly strict sometimes. The first round in my life - I report to him about a patient with pulmonary pathology. He says: “Tell me, does your patient smoke?”

I am so ashamed, I feel guilty that he smokes, and, smiling pitifully, I say: “He smokes, Vladimir Nikitich.” And he said to me: “Are you smiling? You will make me smile! You will fly out of my clinic!”

At the same time, he stopped me, a boy, in the corridor and congratulated me on my first article in the journal Therapeutic Archive. I thought he didn’t even know who I was! He said: “Congratulations, yesterday the editorial board of the journal “Therapeutic Archive” approved your article for publication. Congratulations".

It happened that the doctor could not report properly, the anamnesis was collected poorly, and then Vladimir Nikitich began to ask himself. We stood around and listened to how he did it - with attention to all the details, to every little thing. Sometimes there were real scandals because someone allowed themselves to look at or consult a patient while work was going on in the wards. There are stories that he tore up poorly written medical records, but I don't think that's true.

Vinogradov was very strict, but he protected his own people so much! On Monday mornings, he would bring an armful of magazines for his graduate students, call them in, and give them something to read. This was very valuable, because there was no trace of the Internet, and you couldn’t subscribe to foreign magazines. When someone needed help with housing, he would put on the Star, go somewhere and return with a warrant. He got the tram that woke up the sick in the morning to be removed from Bolshaya Pirogovka.

- Whose name would you name next after Vinogradov?

― The name is Vitaly Grigorievich Popov. He was a man of enormous stature, with a peculiar male beauty. He was originally from the provinces, and he was a real man in the most positive sense of the word. He was a student of Dmitry Dmitrievich Pletnev, the founder of Russian cardiology, whose fate was very tragic. Dmitry Dmitrievich headed our clinic from 1917 to 1922.

Then, thanks to his enormous medical knowledge and talent, he became a doctor of the then elite. Due to court intrigues, he was repressed and went through the Bukharin trial of 1938. He was accused of murdering Gorky, Menzhinsky and someone else and was given 25 years. When the Germans approached Orel, by order of the State Defense Committee headed by Stalin, 161 people were shot. Among them was Dmitry Dmitrievich Pletnev.

Vitaly Grigorievich Popov is a student of Pletnev, a student of the same faculty therapy. He went to the front and was captured in the fall of 1941. He did not leave with the retreating troops, but remained with the wounded and sick. He spent all four years of the war in captivity, behaved heroically there - not only treated people, but also gave documents to those who died to healthy people who were threatened with execution. So he saved a lot of people. The Americans released Vitaly Grigorievich, and this could have led to serious consequences, but Vladimir Nikitich Vinogradov took him in.

This was a Doctor with such a capital letter that it couldn’t be more. He absorbed all the best that was in Vinogradov’s school. Vitaly Grigorievich led a circle with us once a week. He loved to treat patients, was an excellent psychologist and an extremely sophisticated diagnostician. He talked to us as equals, sometimes he allowed himself strong word. I remember that I was once unable to listen to a vice and called out to him: “Vitaly Grigorievich, I can’t hear it, listen to what’s here.” - “Why don’t you hear such things!” It was so embarrassing! After that I listened and listened.

I managed to work with Vitaly Grigorievich for ten years, not counting visiting his circle. He and Vladimir Nikitich were the initiators of hospitalization of patients with severe myocardial infarction complicated by cardiogenic shock. Before this, it was customary to leave such patients at home; they were afraid to touch them.

I think that the author of this innovation was Vitaly Grigorievich, and Vladimir Nikitich, as a person keenly aware of everything new, supported it. After this quantity deaths immediately decreased by three times. This was the first Soviet cardiac resuscitation. Our clinic was very quickly, within six months, followed by the Myasnikovskaya Clinic, 59th Hospital, P.E. Lukomsky and others.

Vinogradov's clinic was very innovative. Along with special attention to the patient, Vladimir Nikitich very actively introduced everything new. The first bronchoscopy in the clinic of internal diseases - Vinogradov. First gastroscopy – Vinogradov. The first cardiac sounding in therapy - Vinogradov. The first use of penicillin for infective endocarditis- Vinogradov. He was such a person - both an innovator and a conservative at the same time, an extraordinary figure.

Vitaly Grigorievich Popov subsequently left the clinic, became one of the leading cardiologists of the IV department, received the Hero Star, but he never forgot his own. When I came there to see them, he blurted out and kissed: “You’re one of our people, Vinogradovskys.” A real man, a real expert in his field, an amazing doctor.

- Who else would you name among the real teachers?

- I would like to mention Professor Abram Lvovich Syrkin - he is also a Vinogradovite, a student of Vladimir Nikitich himself, as well as Vitaly Grigorievich Popov, and my teacher. This was the Vinogradov school at its best - attention to the patient, depth of comprehension, internal discipline.

I will never forget the case when one patient experienced clinical death. On the day when all this happened, Abram Lvovich stayed overnight sitting next to her. I came in the morning, the patient was alive, everything was better. When I was about to leave, Abram Lvovich said to me: “Alexander Viktorovich, would you like to repeat my day yesterday today?” This is how we were raised.

Vera Georgievna Spesivtseva, Professor Smolensky, Professor Danilyuk... You can remember many prominent specialists, heads of departments.

Portraits of people with traits of personal holiness

- Tell us about the people whose faces we see in the portraits on your walls. Why are they precious to you?

― All these portraits hang here among the icons, and they are united by what is called holiness. Father Sergius Zheludkov said about such people: “This is a person with undoubted traits of personal holiness.” Sometimes these traits are not very noticeable, but, from my point of view, they are present in everyone presented here.

Here's my wife. Valentin Grigorievich Rasputin with his merciful, pitying, compassionate, kind heart - of course, there was a place for him here. This is Grand Duchess Olga - shot in the Ipatiev House. Her brother, Tsarevich Alexei.

Olya Romanova is a girl who lived next to Nord-Ost and ran there as soon as information about hostage-taking was received, to persuade these hostage-takers to release at least the women and children. She was brutally killed. Saint? Holy.

Is Zhenya Rodionov, who didn’t take off his cross, a saint? Saint. He has not yet been canonized for a number of reasons, but the people venerate him as a saint, there is an icon of him.

Lyubov Vasilievna, mother.

My friend Leonard, who received a prison sentence for the truth, for his understanding of the best in the fate of his Motherland. Whether he was right or wrong, he was consistent.

― Audrey Hepburn and Chekhov are here too?

― Yes. Audrey Hepburn is among the saints not only because she is a wonderful person, a wonderful charming actress, but because she went to Africa on a mission at over 50 years old. It was felt that from her lips the call to donate funds to starving children would be especially powerful.

Having seen these starving people, she then went there more than fifty times to perform, and simply as a member of these charitable groups. She was exposed to the mad African sun and died of intestinal cancer. Saint? Holy. Someone said at her funeral that God had another angel. How could her portrait not be here?

Anton Pavlovich Chekhov is not a saint, but he is very much loved. He was mentally very an unusual person: he had such compassion for people that without tears it is impossible to read his works or watch performances based on his plays.

Elizaveta Fedorovna - it’s clear why she is a saint. There is also no need to talk about the holiness of Doctor Fyodor Petrovich Gaaz, as well as the holiness of Metropolitan John of St. Petersburg and Ladoga. Who else had such love for Russia?

Father Rafail (Berestov) is a holy man in behavior, very brave, sometimes too harsh towards those towards whom there was no need to be harsh.

Elder Kirill (Pavlov), Hero of the Soviet Union, whom I was lucky enough to treat.

Father Gennady Ogryzkov, rector of the Church of the Lesser Ascension - what a loving priest! He never turned anyone away or refused, although it was very difficult for him - with his bad heart. We met after his first clinical death, which was still in Bryusovsky Lane. A wonderful person.

This is elder Nikolai Guryanov with the cat Lipa in his arms. They said that the cat died, he was thrown into the trash, and Father Nikolai revived him.

His Holiness Patriarch Alexy II, with whom I had a chance to talk a little. He came across as a very wise man. I will never forget how he prayed on October 3, 1993 before Vladimir icon Mother of God, who was transferred to the Yelokhov Cathedral, so that in the end he lost consciousness.

Father John Krestyankin - I read and heard a lot about him, about his endless love.

The recently canonized Evgeniy Sergeevich Botkin, an executed physician who did not leave his charges, accepted death voluntarily. He was canonized through the great efforts of Professor Alexander Grigorievich Chuchalin, the main pulmonologist, an Orthodox man. There is no need to postpone for long the canonization of other servants who died in the Ipatiev basement - the maid Demidova, the footman Trupp, the cook.

- Do you often meet such people - with traits of personal holiness?

― There are, and there are not so few of them, fortunately. For example, at the Turgenevo estate I encountered two absolutely wonderful people - a mother and daughter. They constitute the synod of clergy of the Tula province from time immemorial to the present day. Four volumes have already been published, each with 800-900 pages, very well published.

When they gave me the first two volumes brought from there, I thought that there was some kind of archival department that dealt with this. But in fact, these are two women - teacher Tamara Vladimirovna Georgievskaya and her daughter Maria Vitalievna, she is an artist. They are studying archive data, and yet thousands and thousands of clergy are mentioned there.

I found my ancestors there too. Nobody helps them - neither the civil authorities, nor the Church. They have no sponsors - they do everything at their own expense. I told Tamara Vladimirovna that she has not only earned church orders, but also sets an example of a person with undoubted traits of personal holiness.

I entered the temple and felt that I didn’t need to explain anything to anyone

- What qualities in people do you consider the most valuable?

― Maximum decency in relationships. Hard work. Honesty.

- In your opinion, what happens to these qualities - decency, hard work, honesty - in the modern world? Do you see them around you less today?

― It is very difficult to evaluate the society in which you live. Previously, the time was different, the requirements were different. If we recall recent examples from army life, when a person calls fire on himself, when the 9th company confronts an enemy in a gorge who has a significant numerical advantage - after all, no one specifically taught them or edified them! The whole system of life teaches this.

I really want to hope that we are not losing the main thing. From my point of view, what is important is what His Holiness the Patriarch said recently at the consecration of the Alexander Nevsky Cathedral (I think it was at MGIMO). He said this: “Apparently, Russia will be the last country that will defend Christianity in the world.”

Not Orthodoxy, Christianity. This is a very serious phrase, very deep, which obliges us to a lot.

Father Kirill (Pavlov), whom I treated for a long time together with my friends, more than once said about the last times in the history of mankind: “I probably won’t live long enough, but you will live long.” It is clear how serious the demands are on those who will live in these times.

— There was a period in your life when you were in close contact with dissident circles. What didn’t suit you then about the world around you?

― Now this is all perceived somewhat differently, but then the main thing that didn’t suit me was “a scarf thrown over my mouth.” Why was it impossible to publish or even mention Gumilyov? Why was Akhmatova's Requiem banned? All this was rewritten, typed on a typewriter.

The non-discussability of some stages of history also did not suit me. Diktat of the party, Central Committee. But today I understand that a country like ours can only be an empire, it can only be governed harshly. Clear boundaries must be set - what is possible and what is not, otherwise we will begin to fall apart. There's no getting around this.

- Don’t we have strict governance of the country now? We have, in my opinion, more prisoners in prisons now than at any time in history.

― I will answer in the words of A.K. Tolstoy:

Walking can be slippery

On other stones.

So, about what is close,

We'd better keep silent.

When the era of perestroika began, they were going to abolish the supremacy of the party. Former dissidents, I won’t name names, said: “What are they doing? You can’t do this!” And I understood that it was impossible. But what happened happened. At that time, practicing medicine was a great happiness; I was glad that I did not become a journalist or historian.

- Or a philosopher.

― Or a philosopher. As they joked earlier, paraphrasing Lenin’s definition of matter according to “Materialism and Empirio-Criticism”: matter is an objective reality, given to us in sensation. To this they added: “By God.”

- Do you remember how your meeting with the Church took place?

― I have already mentioned that on my mother’s side all were priests. In the family, faith was practiced: I always had an icon tied to my crib, I was taught to read “Our Father” and “Rejoice to the Virgin Mary.” I read, but without any emotion. There was a gymnasium textbook at home, “The Law of God,” and I read it.

During my student years, I ended up in the Rublev Museum, which was not yet a Rublev Museum. There was once a concentration camp there, then there were living quarters, then some kind of shooting gallery, and then I came there - I looked, everything was somehow different, what new buildings were there. And in the central Assumption Cathedral of the Savior there are these very black boards and a very pleasant woman sits.

I say: “Can I take a look?” - "Can". I began to look - like a sheep at the new gate, of course. She said: “Maybe I can tell you a little?” - “Thank you, tell me.” She taught the first lesson in icon painting. There was no literature then, there was only Alpatov’s book “Rublev” and Viktor Nikitovich Lazarev. I walked into the church, shuddering: I’ll stand on the threshold, light a candle, and go outside somewhere.

Then a colossal tragedy happened in my life, and I didn’t know what to do or where to go, because there was no way out. There was nothing at all. I was walking the streets after work, walking and walking, and on Ordynka I came across a temple in honor of the icon “Joy of All Who Sorrow.” It was already deep autumn. Churches are empty on weekdays, there are lamps burning and the choir is singing. For the first time, I felt like I had let go, that I didn’t have to tell or explain anything to anyone.

I began to slowly go into church and read tamizdat. Relevant acquaintances appeared. Then I met wonderful people from dissident circles, but they were only church dissidents. I met a wonderful priest, Father Sergius Zheludkov, whom I later treated. Actually, that’s how I entered the Church.

Another colossal milestone was meeting Elder Kirill (Pavlov). I spent twenty years next to him and with my friends - with the surgeon Viktor Nikolaevich Leonov, with Anatoly Dmitrievich Dragavits, who gave him a stimulator, with Viktor Nikitich - this is the doctor who treated him in the IV department. Of course, I tried to learn a lot from him, so in that sense I was lucky.

- Were you invited to Father Kirill as a doctor, or did you come on your own?

― As a doctor, I have never heard anything about this man. And he went on vacation to Crimea, already suffering from a severe cold, and swam in the sea there, and it was in September. Got double pneumonia. Mom asked: “We need to fly and see a wonderful man from the Lavra, an archimandrite.” I myself was sick on my feet at the time and didn’t want to fly, but I did.

I found this picture: Father Kirill was lying in a cramped room with a fever in his unbuttoned shirt and smiling. About ten people in this little room look at him with horror and alarm. I must say that my visit was actually unnecessary, because it was led by a very good doctor. He did everything right.

I lived there for a while and flew away, but somehow Father Kirill remembered me, and he invited me to his Lavra. He had some health issues. We talked about health, and then there was tea in the cell and conversations. He gave me something to read. This is a man of exceptional love, exceptional kindness, exceptional wisdom.

I think that Pavlov’s house in Volgograd is his home. There were probably several Pavlovs there. It seems that he led the defense of this house for some time. One of my patients clearly remembers that on a memorial plaque behind the glass, with an ink pencil in a wooden frame, it was written: “Here heroic Soviet soldiers held the defense from such and such to such and such under the command of Ivan Dmitrievich Pavlov.” I do not rule out the presence of someone else from the garrison of that house who also bore the surname Pavlov.

Father Kirill told me that he found a Gospel in the ruins of Stalingrad. And, having gone to the front as an unbeliever, he read the Gospel, and everything turned upside down: he realized that he was a believer. He himself said that he walked with the Gospel through the war and was not afraid of anything.

They wanted to enroll him in the party, but he realized that he didn’t need to be there. I went to the political department and said: “I’ll wait, I’m not ready.” They started shouting at him, information about his admission to the party had already appeared in front-line newspapers. They threatened: “You’ll go on the landing!” In the landing - this is on the armor, before the first machine-gun burst. He was apparently very loved at the top, and in the end he was simply transferred to another unit.

In the summer of the same year he ended up on the Kursk Bulge, and ended the war in Vienna. In the Yelokhovskaya church, where he arrived with an overcoat, having been demobilized, he asked someone: “Where do they train to be priests here?” - “Go to Novodevichy, the first seminary opened there.” So he went.

- Which temple are you visiting now?

― St. Demetrius of Prilutsky, who is next to us. It was opened thanks, among other things, to some of my initiatives. It started with the fact that in 1989, rector Mikhail Aleksandrovich Paltsev, the former secretary of the party organization, called me and said that he wanted to restore the Church of the Archangel Michael, and he asked me to create a “twenty”. The initiative had to come from 20 people who would submit an application stating that they wanted to practice religious worship and asked to open a temple for these purposes.

Before the revolution, in the 90s of the 19th century, our church was a chapel for funeral services for the dead, which is why the first porch is so large, there were coffins there. Then the altar part was very quickly added, and it became the temple of Demetrius of Prilutsky, the Vologda miracle worker. It existed in this capacity until the 20s.

Then there was everything in this building: a laboratory, a department of topographic anatomy, and surgery. The great Russian scientist Vladimir Petrovich Demikhov worked there and transplanted the first organs. He was a great scientist, although an unbeliever. We hung a memorial plaque in his honor: “In this temple, during the persecution of the church, the great Russian scientist V.P. Demikhov conducted the world's first successful experiments on organ transplantation. Eternal memory to the devotee of science." Then there was a printing house, then there was a laboratory for our course, and next to it there was a warehouse for dirty linen and an oxygen substation.

One day I was walking with my student friend Lyusya Soboleva, we passed by, and I said: “How nice it would be to make a church here!” Therefore, when we started talking about the Church of the Archangel Michael, I remembered the building of this temple. After all, everything is there: heating, water. Before that, I was at the foundation stone of the Church of the Kazan Icon of the Mother of God on Red Square, and it was said there that in five years a new temple would stand here.

I thought, if at this rate they are building a temple on the main square of the country, then how long will it last for us - 10-15 years? And here there is already an almost finished temple. Vladimir Petrovich thought for just a second and said: “Okay, let there be two churches.”

The conversation took place in December 1990, and in 1991 the temple had already opened - very good, very cozy. Everyone was evicted from there very quickly. Vladimir Petrovich said: “I’ll whitewash it, I’ll whitewash it, I’ll repair it, and then we’ll do the rest ourselves.” The floors are earthen, covered with roofing felt and boards. There is no iconostasis - a plywood one was built somehow. Six months later there was already the first service - there was not even a throne yet.

The priest who was assigned here was wonderful. I knew him for many years; in Soviet times he led a gospel study group. Father Kirill Chernetsky, Kirill Vladimirovich, is a former doctor of the Chekhovian type, very religious, very humble, meek, and a great man of prayer. Now the rector of the Church of the Archangel Michael and a priest from this temple come here, but there is no priest.

- Why is this temple especially dear to you?

― There are wonderful icons there. It’s simply impossible not to talk about one of them. Everyone knows the Sovereign Icon of the Mother of God, revealed on the day of the abdication of the sovereign. And this icon is the Jerusalem Icon of the Mother of God, reminiscent of the Sovereign Icon. She came to us from customs, where she was taken away during an attempt to take her away. On its back there is a very significant inscription: this icon was painted in the holy city of Jerusalem and consecrated on January 9, 1905, that is, on the day the workers’ demonstration was shot, on the day the Russian Revolution began.

I believe that this icon is a blessing from the Mother of God for Russia on her Golgotha. There are not many people in our church, because there is a monastery and large churches nearby.

Euthanasia or a good painkiller - how to find an argument

- You are a deeply religious person. Do any discussions arise with colleagues on the topic of science, faith, soul?

― I think this is hopeless, this is a dispute between Ostap Bender and the priest. I gave one young graduate student who doesn’t believe in God and feels some kind of anxiety about this to read various books, but so far I can’t convince her. However, if God calls, man himself will come to Him.

I know one woman who just woke up in the morning and thought in surprise: “Why did I think that I was an unbeliever when I am a believer?” After suddenly realizing that she was a believer, she immediately went to be baptized.

Recently our doctor spoke about euthanasia. I don't agree with him.

– It’s difficult to find a non-religious argument against this.

― There are very few people who are not religious at all. Father Sergiy Zheludkov said: “There is a small part of stubborn atheists, not a very large part of believers, and in the middle is what I call the “god of physicists.” They are smart enough, wise, they understand that there is something there, there was something in the beginning, the first shock, the Big Bang, but they don’t go further than that.”

And then it starts: “What about Auschwitz?” and off we go, and it’s very difficult to argue with that. “Why do children get sick?” Answer so that he understands - about original sin, about the original bodily damage that extends to children. “Why, why such cruelty? Why did someone sin there, but this little one is paying the price, why?” Try to answer - you won’t answer.

One smart doctor, psychiatrist Dmitry Ivanovich Ragulsky, once said very well: “What do they say: euthanasia, euthanasia? A very good painkiller, a very good sleeping pill, a little sedative - and the problem will almost completely go away.”

Passive euthanasia – what is it? Okay, let's not interfere - let the patient leave. Let’s say, a patient is lying behind the wall in the intensive care unit, bleeding occurs, the pressure drops, and what – the doctor will say: “Well, let it be”?! Or a severe arrhythmia, which will go away in another hour. Let him go?! No, the doctor will run to do defibrillation or something else.

“At the same time, it is very difficult for us to refuse treatment in principle – this is especially noticeable in pediatric oncology.

― I had a case when I was with a boy of 18-19 years old with severe congenital defect hearts. He had an attack of severe palpitations, which his heart could no longer bear. There was a dilemma: to shock or not. We were just beginning to master this, but we were already succeeding, we already knew that the method was amazing. But we understood that with such a heart there is a very high probability that this discharge will lead to the heart fibrillating, that is, there will be disorderly contractions, hemodynamic zero, no ejection, stop. And if you don’t, he will die soon from the same stop.

This boy's mother was nearby, she understood everything. I had to decide what to do. If you do it, you will think: “Yes, you shouldn’t have!”, but if you don’t do it, you will think: “But it was possible!”

I stood and stood, then I said: “We’ll still try. I'll come now." I went to my office on the second floor in the old clinic and simply began to pray to God: “Lord, direct it in your own way, make it happen as it should. I don't know what needs to be decided. I don't know what to do. Help! He crossed himself and went. I arrive there and find out that my heart has just stopped on its own. Resuscitation is underway, but it is not possible to start it, and it was not possible to save him. God decided to take the guy.

God created man to share His joy

― I would like to talk about your understanding of death.

― Father Sergius Zheludkov has a wonderful book “Why Am I a Christian?” He said that there are two types of faith - female and male. The female type is acceptance without reasoning. It’s like Tvardovsky:

The hero sleeps, snores, period,

Accepts everything as it is.

A man needs to answer the most painful questions, otherwise he cannot do anything. Some of them can only be answered with this: “This is beyond reasonable.” You won’t understand, don’t try, and those who didn’t break their teeth over it. And then, this is faith. There has always been, is and will be something unprovable, although sometimes this faith is a thousand times stronger than positive knowledge.

- What is the meaning of life if it is finite?

― Human nature has changed since the Fall, as we know. Adam and Eve were initially happy in their ignorance, then they tasted this apple - whether this is a fact or an allegory, I don’t know - but the Lord said: “You will give birth to your children in pain.” Human nature has become damaged. This imperfection of human nature from birth is the cause of disease.

– You work on the line between life and death, where one movement can mean a death sentence for a person. How do you cope with this burden?

― For me, the most serious explanation of illness and death, giving ground under my feet, was what I said - this original damage. Man is born within the bounds of a mandatory law that he will eventually grow old and disappear. The question is, why? What is all this for then? I believe that God created man so that he could share with Him the joy of contemplating His creation. “And God saw that it was good” - and, it seems to me, he wanted someone else to see it. It is an act of love, mercy, compassion.

The second reason, as it seems to me, God called man to life is to make him in some way His co-creator, to entrust him with finishing something. And the meaning of human existence is to make this world, which has become imperfect, better. That's why the Lord gave people the greatest feeling - love.

This is what a person lives for: to love, to know God and himself within the limits that are possible.

I don’t remember whose metaphor this is, when a man stands on the ocean shore with a candle in his hand on a dark night and tries to describe what he sees. Something similar can be said about attempts to describe God.

Maxim Gorky Luka is asked in “At the Lower Depths”: why do people live? And he very quickly answers: “Oh - people live for the best, dear! Here, let’s say, there live carpenters and they are all rubbish people... And from them a carpenter is born... such a carpenter as the earth has never seen before - he has surpassed everyone, and there is no equal to him among carpenters<…>So do all the others... - they live for the best! Everyone thinks that they live for themselves, but it turns out that they live for the best!” That is, such improvement, growth, ascent.

I think if there was a clear answer to this question, we would all know it.

- But death is always a tragedy, a loss. Christ himself wept when he heard about the death of his friend Lazarus.

― Like a Man, he cried. Because a person should cry when he hears about death, about the finitude of life - this is normal. And if he doesn’t cry, he’s an insensitive stuffed animal.

- Or is still in the extreme stage of shock. Was your life in danger? Have you ever had such moments in which you realized that it seemed like everything?

― I remember very vividly and very firmly one moment when I was walking as a little boy, a preschooler. There was still a war in Moscow, and I went out into the streets, which was generally not very encouraged. I was standing on the street, it was in the Taganka area, and a car was coming with boards. She began to turn around, and the boards that protruded over the side of the back wall passed right in front of her face. Then I realized that just one more second, a little closer - that’s all. This is what I always remember. Although, if you think about it, anything probably happened. Because sometimes you don’t know that you were on the edge. Thank God you don't know.

Photo by Anna Danilova

After the publication of the editorial plan for the current year, there was only one letter in our mail, in which the reader expressed bewilderment: why would a historical and local history magazine devote entire blocks of articles to border guards and medicine?.. Basically, we received approval and were once again convinced that our readership the audience is interested not only in forgotten archives, but also in history in the faces, “ pain points"of today. We address one of them in this issue.
Society has not yet fully realized that it was medicine that, in the time we are living through, was at the forefront of standing for the Fatherland, and therefore for each of us. On this Kulikovo field of modernity, Good and Evil, the laws of traditional Russian life and the “new world order” irreconcilably came together. The fact that what has been said is not an exaggeration, not a hyperbole for the sake of a catchphrase, is evidenced by the conversation between the editor-in-chief of the Moscow Journal Anna Filippovna Grushina and Doctor of Medical Sciences, Professor of the Department of Internal Medicine No. 1 of the Medical Faculty of the I.M. Sechenov Moscow Medical Academy, Chairman Moscow Society of Orthodox Doctors, co-chairman of the Church-Public Council on Biomedical Ethics under the Moscow Patriarchate Alexander Viktorovich Nedostup.

Anna Grushina.Alexander Viktorovich, in our conversation there will not be many specific dates, but they are extremely important, since they eloquently say that almost all the “medical passions” that I will ask you to talk about fell on the country after the so-called “perestroika”. In a society experiencing a deep moral crisis, it became possible to use progress in biology and medicine not for the benefit, but for the detriment of people. Moreover, on such a scale that our compatriots urgently need to be protected at the legislative level. That is why the bill “On the legal foundations of bioethics and guarantees for its provision” was developed, which the State Duma has not yet adopted, and the first parliamentary hearings on it in October last year - very emotional and tense - showed that agreement is very far away. You are a participant in these hearings and are directly related to the preparation of the bill. Explain to readers what the essence of the problem is, what bioethics is.
Alexander Nedostup. This concept came to us from the West; our Orthodox community does not perceive it well. And in general it would be more correct to talk about biomedical ethics. From the standpoint of medicine, “bio” is not stamens and pistils. There is even such a shade of bioethics - this is a set of moral requirements imposed not only on medicine in all its aspects - both medical science and medical practice, but also on everything related to human biology, with the preservation of his health, and therefore - with the preservation of population. The latter is already a demographic problem... It is precisely the fact that bioethics can be understood very broadly that has become the reason for denying the need for it legal regulation. The famous ophthalmologist Academician Fedorov, for example, is perplexed: how can moral standards be legally regulated, they cannot be squeezed into some kind of framework... He is deeply wrong. There is such a moral postulate: do not kill! What normal person would question it? The proposed law on bioethics regulates issues (or violations) of moral order associated with medical activities. Its purpose is to protect the rights of the population. The trouble is that medicine has outpaced the relevant ethical standards. They urgently need to be pulled up to those distant positions that science has already occupied.
A.G.As a scientist, teacher and practicing physician, you know from the inside about the true state of affairs in modern medicine. What is it like?
A.N. The state of affairs in medicine as a social institution is depressing. It was considered in the spring of 1997 at the World Russian Council and has not gotten any better since then. The mortality rate remains high and the birth rate is low; the country is gripped by an epidemic of cardiovascular diseases, in particular heart attacks and strokes; The incidence of tuberculosis and syphilis increased sharply. The very nature of the diseases has also changed - doctors note that people have become more seriously ill. Alcoholism, which is actually encouraged by the authorities, is not decreasing, and drug addiction is growing sharply. The situation with children's health is catastrophic. At the same time, in violation of the current Constitution, the paid nature of medicine is established, with the exorbitant high cost of medicines. The medical management system has been destroyed and its financing has been disorganized. The process of extinction of the peoples of Russia (we lose from a million to one and a half million people a year) is aggravated by the activities of the Russian Family Planning Association (RAPS), which corrupts children under the pretext of sex education (including within the framework of the newly created discipline - valeology), which leads to the breakdown of families , an even greater decline in the birth rate.
I present this painful (but far from complete!) list of facts to show in what ways the task of exterminating the peoples of Russia is being solved in the medical field to please the “golden billion”. According to the materials of the fifth (Cairo) UN Population Conference (1994), the quota for us is approximately 50 million people. We are, in fact, talking about the genocide of the indigenous population of Russia. The “decent” life of the “golden billion” must be ensured by the sharply reduced all other humanity, including the remnants of the Russian people.
A.G. Now it is clear why medicine today finds itself at the epicenter of the struggle for our Fatherland.
A.N. Moreover, for the future of all humanity. For a religious person, his faith is the basis for his worldview and assessment of all current events, and their mystical meaning is obvious: the destruction of Russia as the throne of God on earth before the coming of the Antichrist. Russia is the last stronghold of Orthodoxy on Earth, a testing ground where two fundamentally different points viewpoints, two worldviews, to be more precise. Medicine only personifies the struggle of moral, political and other principles. Of course, the issues of socio-political transformation of society are of paramount importance - the current socio-political system will destroy both the peoples of Russia and Russia itself. But the activities of doctors are also extremely important: treating people, preventing diseases.
As a healing system, Russian medicine is also experiencing serious upheavals - “traditional healers”, psychics, and oriental healers have proliferated everywhere. In their “medicinal” practice, they use not only herbs, water, and thermal procedures, but also divination, conspiracies, witchcraft, and entice gullible patients into their “beliefs”... There is also a new problem for us. As I already said, medical science has gone far forward. Doctors have the opportunity to intervene in the very foundations of the origin of life, correct or stop its further development, and manipulate heredity. In a word, doctors today can simulate almost all life processes of a person - from his birth to death.
A.G. In preparation for the conversation with you, I carefully read the draft Law on Bioethics. If it were possible to print it in thousands of copies, put it in every mailbox, the entire sensible population of the country would demand to accept it immediately. At least out of a sense of self-preservation... Who prepared the bill?
A.N. State Duma - with the involvement of specialists from the most different areas: lawyers, clergy, Orthodox doctors. By the way, all over the world, problems of bioethics are discussed by the general public, and not just within the medical community. After the first hearings, the impression remained that the bill affected some corporate interests. It is especially difficult that his fierce opponents were primarily doctors - authoritative, well-known names...
In preparing the Law, we relied on traditional values. Whether Russian people recognize God or not, our ethics are based on Orthodox postulates. Opponents believe that we must be guided by “universal human values.” In other words, alien to us - American, with elements of Protestantism and who knows what else... According to certain parameters, of course, there are intersections, but in principle, this is where two ways of life, two philosophies confront each other. They say that godless ethics are generally inherent in “post-Christian culture.” But this statement is inherently flawed and has no right to exist. What is post-Christian culture, post-Christian ethics? In Christ, people were given the highest, final revelation. Consequently, this is no longer post-, but anti-Christian culture, anti-Christian ethics. People who have come to know Christ and departed from Him fall into the sin of Judas... This is the fundamental, key point in understanding and assessing everything that happens to us, including in medicine.
A.G. From a national point of view, inspired by Orthodoxy, every person is the image and likeness of God on earth. Conducting experiments on it is unacceptable! But isn't that what fetal therapy does?
A.N. Without further ado, I will answer that she is engaged in murder. "Fetus" is a fruit. Fetal therapy is treatment using extracts from a human fetus. By the way, this is one of the medical technologies that generates very large material income. In this case, the fruit must be sufficiently mature. It is not scraped out of the mother's womb, but artificial birth is induced.
A.G. And what is taken from the fetus: blood, brain?
A.N. They take different fabrics and hoods. And the brain too - for the treatment of diseases of the brain and nervous system. Apologists for fetotherapy claim that it gives a good effect, but in May last year a large scientific forum was held on this topic, at which the effectiveness of fetotherapy could not be proven.
A.G.It is impossible to comprehend: a child is removed from the mother’s womb, an extract from the brain is taken from a living person...
A.N. Currently, artificial birth is officially allowed up to 22 weeks of pregnancy. Of course, this is a person, albeit not fully formed. He is born alive. It is wrapped in plastic and placed in the freezer. I don’t know the details of the technology, but tissues are naturally taken before irreversible changes occur. They are used for different pathological conditions. For example, administered to sick children cerebral palsy. Therefore, our opponents fly into a “noble” anger: they say that fetotherapy saves people from terrible diseases...
A.G.What is done to the fetus occurs with the consent of the mother?
A.N. Yes, and this is another trump card for fetotherapy supporters: the mother agreed...
A.G . Probably for financial reward?
A.N. I don't know, but it's easy to imagine that yes. The material is expensive - one injection costs from hundreds to several thousand dollars. Moreover, these experiments, as far as I know, are carried out only in China, Mexico, and now here. In all other countries such blasphemy is prohibited.
A.G. Which clinics offer fetal therapy?
A.N. There is such an Institute of Biological Medicine. Basically, fetal tissue is used for “rejuvenation”, which is resorted to by politicians, actors, and all sorts of “stars” who are concerned about their appearance...
It seems that the Resolution adopted by the Russian Government in 1996, allowing abortions for social reasons up to 22 weeks of pregnancy, which is again prohibited in 134 countries of the world, is largely connected with this activity. The Resolution contains a list of these indications (14 points) for which it is permitted to terminate a pregnancy at such a period.
Of course, there are delicate moments that our opponents trump: you are hypocrites, you are obscurantists, a father raped a minor daughter, and you will force her to give birth?.. Yes, for such cases that require an individual approach, all legal nuances must be worked out, but the glaring The resolution signed by Chernomyrdin in May 1996 must be cancelled. Although now in the bill “On Health Care in the Russian Federation”, almost unanimously adopted by the Duma in the first reading, this Resolution is repeated! And according to it, a single mother has the right to get rid of the child in the 22nd week of pregnancy, as if 12 weeks were not enough for her to think about it... Persons below the poverty line also have this right, or if there are already three children in the family, and so on further. Quite an extensive list. Given our general poverty, it covers almost the entire population of the country. The demographic situation is such that the state's number one task should be to protect and increase the population, and it issues laws aimed at the destruction of unborn children. The rampant criminal structures now have a very profitable business line. Doesn't this fit into the genocide program? As we can see, the plan is clearly being implemented and is directly related to bioethics.
A.G.Some people are ready to commit a crime in order to get rid of a child in the womb. Others agree to test tube conception just to have a child. A test tube man is strange, unnatural, but for many women this is the only hope for motherhood...
A.N. Some of our clergy deny this way of a person’s birth as not commanded by God. And even more broadly: God did not give children - and there is no need to do anything. I think this is a vulnerable position. Let's say a woman has an adhesive process after inflammation. It is enough to cut a certain adhesion to restore the possibility of childbearing. Why not do this? The problem here is different.
When male and female reproductive cells meet “in vitro”, the process of fusion and formation of an embryo occurs (in medical language - a zygote). To “guarantee” a woman, several zygotes are implanted; as a rule, more than one takes root. Now we need to consciously scrape out the “extra” implanted embryos, that is, have an abortion. In addition, some zygotes remain unvaccinated, outside the mother's body. No one knows what to do with them: destroy them, flush them down the drain? They are frozen, and tens, if not hundreds of thousands of such proto-embryos have already been accumulated in the world. According to some provisions of Western bioethics, it is believed that a human being is spiritualized from the 14th day after conception, when the embryo develops what neurologists call a “nervous stripe”: the nervous system begins to develop - a kind of container for feeling. Orthodox people are convinced that a being is spiritualized from the moment of conception... Tens of thousands of “frozen” souls cry out to Heaven.
As we see, not everything is simple with in vitro out-of-body fertilization, that is, with “test tube conception.” True, there is a technique by which only one embryo is implanted and one fetus is obtained. In this case, perhaps some doubts will disappear. In general, such issues should be resolved by the Church-Public Council on Biomedical Ethics, created last year under the Moscow Patriarchate. I understand that we are again giving reason for attacks: here they are - the obscurantist Jesuits, slowing down the progress of science... In a word, those who are erecting another barrier at which believers and non-believers will meet.
A.G.I am on the same side of the barrier with you, but now I will try to act as an opponent and express the arguments that you will probably hear. The Soviet Union had the most advanced atomic weapons, so they were afraid of us, they took us into account (I would like to hope that someone respected us). If at one time, guided solely by humane considerations, we had stopped scientific development in this area, we would have been swept off the face of the earth long ago. Today's genocide is a clear confirmation of this. It’s the same in medicine. At one time, the cloned sheep Dolly was shown endlessly on TV. The experience was a success. We will not do this, but the West will successfully continue the experiment, moving from pigs and sheep to humans, raising an army of robot slaves or robot warriors... Could this happen or is it from the realm of unscientific fiction?
A.N. We have already heard this argument from the chairman of the Geopolitics Committee of the State Duma, Mr. Mitrofanov. He repeated almost three times at the Duma meeting on cloning that the United States would ban cloning, but would give money to another country for these experiments, the fruits of which they could then use, and we would remain on the sidelines and fall behind... Meanwhile, scientists in Russia are ready for conducting cloning experiments. I especially want to emphasize that this work is expensive, and a positive result is a matter of chance. Dolly the sheep was born on, it seems, the 278th attempt.
Many prominent scientists say that cloning is not economically profitable. At the same time, we do not get an exact copy of a living individual, but only a biological double. God knows where this will lead. By cloning a person, instead of Einstein, you can get a recidivist bugbear. An external copy does not mean a repetition of the inner nature, a repetition of the psychophysical, mental qualities of the “original”. (Even the notorious sheep Dolly turned out to be not aggressive like a sheep: she gave birth to lambs and for some reason killed one.)
Argumentation and moral imperatives are extremely important here. It would be nice if I had to argue only with people guided by scientific ambitions. But then one of our famous public theologians suddenly declared that there is no theological justification for the ban on cloning. How not, if this is the way to desecrate Christ?!
A.G . But work on human cloning is still underway?
A.N. In South Korea, scientists obtained a proto-embryo by cloning, but at the level of multicellular development something forced them to stop. I'll say more. A cubic millimeter of blood was scraped off the Shroud of Turin. The gender was determined to be male, and the blood type was IV. The Vatican imposed a ban on further work and thereby stopped the insolence of those who tried to obtain some kind of “duplicate” of Christ. I think that if someone nevertheless dares to move on, the Lord Himself will stop him.
By the way, genetics today can do something worse than cloning. For example, create a person who has no memory. One can imagine that it would be easy to turn such people into executioners, unconscious, immoral murderers. We have gone too far, science lives on its own. This is the most terrible danger.
A.G.The law on bioethics contains a clause on the presumption of disagreement of a person (or his relatives) to take some organ or tissue from him for transplantation to a needy patient. Please explain what a “presumption of disagreement” is, how many organ transplant operations are performed in our country?
A.N. And before there were few of them, and now there are even fewer: there is no money either for operations or for subsequent drug treatment to prevent rejection of transplanted organs. These are expensive drugs. No one has any objections to the transplant itself. But the moment of taking a donor organ is a moral, ethical issue. A heart, for example, can be taken from a person only when his brain is declared dead. By law, the parameters of brain death must be determined using almost three dozen different tests. In real life they are usually not carried out. But that’s not even the point. In the current criminogenic situation, various crimes are possible due to organ transplantation. In pursuit of the desired organ, if a reward is promised for it, one may, for example, not make the necessary efforts to save the person...
In this regard, the authors of the bill on bioethics believe that our organs cannot be taken without the person’s lifetime consent. In America, by the way, the law requires the consent of the donor to remove an organ after his death. Approximately half of the US population gave this consent. We don't have such a law. What does this lead to? Some government and public figures claim that they have documents confirming that after October 4, 1993, Moscow centers where victims of the White House shootings were taken illegally exported human organs and tissues abroad. This is an illustration of the “presumption of disagreement” and the fact that we are long overdue for the adoption of the Bioethics Law.
A.G.It is clear that we will not be able to dwell on each of the points specified in the bill. But it’s impossible to ignore the fact that literally the whole country is covered dangerous epidemic- I'm talking about occult medicine, about psychics, biohealers.
A.N. I think that many so-called psychics are sincerely deluding themselves into thinking that they are helping people. There are also charlatans who make money from the misfortune of others. I do not exclude that some small part of psychics really knows how to help a patient, but we must not forget about the exchange of spiritual energies.
When people are in contact (healer and patient), the spiritual essence of one interacts with the spiritual essence of the other. There are no sinless people, and the consequences of such contact can be the most unexpected, and not always useful spiritually or physically. This is confirmed by traced cases of extrasensory influence: after a temporary improvement, a sharp deterioration often occurred. The person is supposedly being “treated,” but the time for diagnosis and real treatment is running out, which can lead to serious consequences. The phenomenon of extrasensory perception exists, but it is dangerous, and therefore Russian Orthodox Church warns against practicing healing, witchcraft, and magic. The Law on Bioethics also has such a clause.
By the way, the Duma is now going to discuss the Law on Bioenergy and Information Well-Being of the Population. A noble goal, a noble name, but what does this law offer? Issue licenses to all magicians and sorcerers, streamline their activities...
A.G.That is, take taxes from them.
A.N. Absolutely right.
A.G. A lucrative place, it’s called... I read in one of the medical magazines that there are a lot of people suffering mentally in the country now. Is this society's response to social upheaval?
A.N. I think social upheaval is one of the important reasons. In general mental illness, in my opinion, appear somewhere at the junction of the mental and spiritual in a person. However, it is better to talk about this with a believing psychiatrist. Here I see something else that is significant. In churches you can sometimes meet mentally ill people, but they are spiritually healthy. Our society is seriously ill spiritually, although there are many mental illnesses. The country is under stress. Now there seems to be a decrease in mortality. Sociologists (Professor Igor Alekseevich Gundarov) explain this by saying that people began to gradually adapt to existing circumstances.
A.G.If we have come out of shock, this is already hope... Alexander Viktorovich, I will now ask you, perhaps, not a completely correct question. I think that he is not the only one who occupies me. I often reread the book of Archbishop Luke (Voino-Yasenetsky) “Spirit, Soul and Body” and come to the conclusion that diseases or health of the heart reflect the state of the soul. What do you say about this? Are you a cardiologist, a churchgoer?
A.N. This question would be answered more thoroughly by doctors observing people with heart transplants. Such patients seem to change their general attitude towards life, they become more religious. But I don’t know that their spirituality would change dramatically. It is better to talk about this topic with the rector of the Church of St. Seraphim of Sarov at the Institute of Transplantology, Father Anatoly Berestov. He is also a well-known person in medicine - a professor, a neurologist, but I won’t dare to elaborate. Of course, the heart is a special organ in a person: the heart languishes, the heart is capable of feeling at a distance, which, apparently, led Archbishop Luke, a world-famous surgeon, to the conclusion you are talking about.
A.G. The magazine “Doctor” published your article with Professor V.I. Makolkin about Doctor Zakharyin, whom the pre-revolutionary democratic press ( sister the current one!) undeservedly slandered him, presented him as some kind of monster... Dr. Zakharyin, during a round, if necessary, could spend an hour or two at the patient’s bedside. A high example of not only professional, but also spiritual healing! There is no doubt that these noble traditions are alive to this day, although the sudden transition to paid medicine has become an insurmountable test in this regard for other representatives of the medical class.
A.N. You gave an example of not only mental, but also spiritual healing, although spiritual healing is not our task, but that of the priests. But the doctor must feel when it is enough to talk to the patient himself, and when it is necessary to advise him to go to church so that the disease can be treated... The best traditions of Russian medicine have not died, you are right. The vast majority of doctors work not out of fear, but out of conscience. Often without a salary, without medicines and the necessary tools, at the limit of their capabilities. There are medical scientists who manage to conduct scientific research in conditions that cannot be described. What is it: the great patience inherent in our people, or silent submission; a sign of the death of the country or another test that we will overcome again thanks to the Christian humility of such people. Doctors certainly bear their own cross. Of course, there are also bribe-takers, lovers of profit, but I don’t want to talk about them - they are not the people who personify our medicine today.
A.G. Are you from a family of doctors? Dynasties are not uncommon in medicine.
A.N. No. Mom was a librarian, father was an engineer. All distant relatives on the maternal side are Tula and Oryol priests, and on the father’s side - Zamoskvoretsk residents and Poltava peasants. On my maternal side I had a wonderful relative - a famous therapist, academician Evgeny Mikhailovich Tareev. The largest therapist, Hero of Socialist Labor, laureate of various awards. His wife, my aunt, Galina Aleksandrovna Raevskaya, was also a famous cardiologist. E.M. Tareev died at the age of 91. There is his clinic on Pirogovka. From childhood, looking at him, I understood how to work. These were the best lessons: I learned from Evgeniy Mikhailovich not so much medicine, but an understanding of what the work of a doctor and scientist is in general. He was an unbeliever, although he grew up in Sergiev Posad, next to the Lavra, and his father, a famous professor of theology, taught at the Moscow Theological Academy. I remember this incident: Academician Tareev stands in front of a shelf with his books, and above it is a shelf with the works of his theologian father. And he tells me, pointing to his books: “This will all be forgotten, it will pass.” And about my father’s books: “But this will remain.”
A.G.It is known that the Russian soul is always Christian. Even the moral code of the builder of communism, according to which the country lived in the dramatic twentieth century, is nothing more than a distorted Sermon on the Mount. They lived in every way - both scary and godless, but for their own friends! That’s why they were able to win in the Great Patriotic War... You said that there were many priests in your maternal family. What was their fate after the revolution?
A.N. Most of them died in camps; few died of natural causes. Grandfather - Archpriest Alexander Ivanovich Raevsky - was a priest at arms factories in Tula, director of a parish school, chairman of the Tula Temperance Society. In 1916, a law was passed obliging everyone who worked in parochial schools to receive a pedagogical education. And my grandfather, at just over 40 years old, entered the Faculty of Natural Sciences at the Pedagogical Institute. I studied with great interest and pleasure. He collected a good library and knew the publisher Sytin. Grandmother, they say, sang wonderfully. The future Patriarch Alexy I loved listening to romances performed by her. By the way, my grandmother Tatyana Ivanovna, as a girl, bore the surname Rusakova, and on her mother’s side was Govorova. Both the Rusakovs and the Govorovs are well-known priestly families. Since Saint Theophan, the recluse of Vyshensky, came from the same Central Russian places (Eletsk) and bore the surname Govorov, I dare to think that my grandmother had something to do with the family of Bishop Theophan.
In 1918, my grandfather was imprisoned. What saved him was that the head of the Tula Cheka was a man who sang in his church choir as a boy. My grandmother went to ask for my grandfather, he grabbed his head and ordered him to let go. My grandfather died of typhus in 1922, he was only 48 years old.
A.G. You studied at the institute after the war. It was a hard time, and now it’s not easy either, although it’s not easy in a completely different way. Are today's students similar to you back then?
A.N. For the most part, they know very little. I'm talking about the general outlook - literature, music, art. This causes serious harm to the specialty. We, citing the example of Dr. Zakharyin, have already said that a doctor treats not only with medications... I instill in students: a high professional level is the fundamental principle, but you must be able to communicate with both a janitor and an academician... What can you do here? We grew up in a time when classical music was mandatory and played on the radio. good speech. What is being presented to young people now, what are they receiving through the media? But this is our shift, our children. Their personal development remains our primary concern. We try our best...
It is very bad that students are spiritually illiterate. Great damage to future doctors. The Society of Orthodox Doctors has been operating in Moscow for several years. When we created it, we did not specify what we would do. They began to discuss the most pressing, pressing issues. And the students became interested. Sometimes they come to meetings, listen, and absorb. Some leave, some stay, but the backbone is already there.
A.G. What issues, in addition to those we touched on today, do you consider relevant and require discussion?
A.N. For example, is it possible to use hypnosis in medical practice, because it is a direct introduction into the human psyche. Opinions were divided. Some doctors argue this way: we give sleeping pills, sedative herbs, and hypnosis is a type of sleep, nothing more. One doctor told how he treated an Afghan soldier with hypnosis. He sharply dodged the dushman's bullet and was left with a crooked neck. Psychogenic spasm. Nothing helped, and in a state of hypnotic sleep, the doctor, through suggestion, brought the soldier out of this position - the neck straightened. I believe that hypnosis is acceptable if it is carried out by an experienced doctor, a person with pure thoughts, who will not give the patient bad attitudes. Moreover, psychiatrists claim that if a hypnotic message contradicts the moral principles of the hypnotized person, it is not vaccinated: the patient begins to worry and comes out of hypnotic sleep. But allowing everyone to hypnotize is dangerous, as we will open the gates for charlatans to take advantage of.
A.G. There are now two churches open on the territory of the Clinical Campus on Devichye Pole. I know that you have a direct connection to their revival.
A.N. As a student, I went to the Church of the Archangel Michael, alas, for physical education - there was a gym there. Then a pharmacy, then they began to destroy it, and by 1978 they had almost succeeded in this - the temple turned into ruins. The Church of Demetrius of Prilutsky was more fortunate - it had a printing house, then a laboratory, a warehouse for dirty linen, but it was better preserved. When the next anniversary of the institute was celebrated in 1990, our rector, academician M.A. Paltsev, came up with a good idea - to restore the Church of the Archangel Michael. He called me to his place and asked me to create a “twenty” to begin registration of the community and restoration. I tell the rector: “Mikhail Alexandrovich, the situation with the Church of Demetrius of Prilutsky is not the same as with the Church of the Archangel Michael. There are only ruins, but here there is light, water, and warmth. Let's restore it too." He thought for just a second and answered: “Very good! Let there be two functioning churches on the territory of the academy.” So main role It was not I who played a role in the restoration of our hospital churches, but Academician Mikhail Aleksandrovich Paltsev.
A.G.Do students go there?
A.N. I dreamed about this so much, but no - they almost don’t go. What about students! Here is a striking example: once the clinic received a call that there was a bomb planted in our Central Clinical Building. In 40 minutes, the patients were evacuated - they were taken out of the wards and out of the intensive care unit. If only one of the walking patients or medical staff would turn their gaze to the temple standing nearby, come in to light a candle, and ask that the trouble pass by... Too many people have not yet discovered the religious meaning of what is happening to each of them individually and to the country as a whole.
A.G. Well, in previous times there were not many people who understood this meaning and were able to consciously resist evil. When Minin and Pozharsky went to Moscow to save the Fatherland, they did not represent the active majority at all.
A.N. They were believers and lived in a country not poisoned by the propaganda of selfishness, selfishness, and violence. We live in a different reality, we stand on the last bastions, and therefore we must fight even harder against the forces of evil. I asked one of the spiritual luminaries of modern Russia, Elder Kirill (Pavlov), a direct question: is it necessary to resist in a situation like ours? He instantly replied: “But of course! Otherwise, we will open the gates to the Antichrist with our own hands.”
A.G. “Otherwise” has a very definite meaning - it is a betrayal of God and Russia.
A.N. Certainly! Living in Russia in the 20th century is a heavy cross, but also a great mercy of God, which one must be worthy of. Figuratively speaking, today we are surrounded, but there was no order to withdraw. So we will fight. Until my last breath. This is our obedience for the sake of Russia.

Dear Alexander Viktorovich!

The editorial staff and editorial board of the Moscow Journal cordially congratulate you - a doctor by God's grace, an ascetic, a faithful son of Russia - on your wonderful anniversary! Your contribution to medical science is well known. Your high professionalism and generosity helped me regain my health. a huge number people. Your clear and clear civic position evokes deep respect and increases faith in the triumph of Good and Justice.
We wish you prosperity and happiness, new successes in your noble cause of healing people.
Many summers!

Why is the heart the most important organ from both a medical and spiritual point of view? How complex is its structure and operation? How to keep your heart healthy? What is especially dangerous for him? Is it necessary to tell patients with severe cardiac pathologies about imminent death? How to feel about a heart transplant? The wonderful doctor Alexander Viktorovich Nedostup answers these and other questions.

Seat of the soul or “cone-shaped hollow muscular organ”?

The heart is the most important physical organ of a person. The heart also occupies a central place in spiritual life, and is constantly spoken about in the Bible. The heart is given importance not only as the central sense organ, but also the most important organ of cognition, the organ of thought and perception of spiritual influences. Alexander Viktorovich, in your opinion as a cardiologist, why is such attention paid to the heart in the Holy Scriptures? In general, why is this organ the most important in both the physical and spiritual worlds?

This is not the first time I have been asked this question. I set it up for myself several times. We sometimes talk about this with our colleagues. As for the role of the heart in physical life, it is a pump that moves blood around the organs. And blood is a carrier of both oxygen and nutrients. Blood must penetrate into all nooks and crannies of the body. When blood circulation stops, a person cannot live - he dies.

Why is the heart considered the seat of a person’s spiritual life? There are many proverbs and expressions like “the heart is a prophet.” And the holy fathers talk about the heart all the time - I read these works. For example, Saint-Doctor Luke (Voino-Yasenetsky). They understood the brain as the place where the mind resides, and the heart as the place where feelings and spirit reside. But it seems that this is still such a poetic or otherwise, but an image, and the heart itself is not the container of the soul, spirit, and so on. Although this may not be the case. Because is it possible to be equal to the holy fathers?! Where is the soul located? What do we know about this? Yes, it looks like it is located seamlessly with the entire body. It is not for nothing that the spiritual essence of man does not have a physical and human image. It is distributed. These are questions to which there is no answer.

I am a physician and cardiologist. Every day I deal with patients. I know quite well how the heart works: what valves it has, what conduction system it has, how it contracts, how it beats. I know how it hurts, what changes it can undergo. And to say that this is all a container of the spirit... You know, this sounds somehow vulgar. And it’s completely incomprehensible. I think that, most likely, such ideas about the heart are connected with the fact that when a person experiences some kind of emotion, the heart immediately responds to this: it beats stronger or freezes for a moment. When feelings move, a person involuntarily places his hand on his heart. And it hurts with unpleasant emotions, with some tragic news... Of course, an inextricable connection between a person’s emotional life and his heart exists. I read a dissertation about the heart and soul, I think it was from Georgia... I read it. Smart, good, but I never found the answer there.

The heart is the organ that is responsible for a person’s faith. The main struggle for a person’s soul takes place in the heart. It contains all the good and evil that is in a person. Christ said: “From the heart come evil thoughts, murder, adultery, fornication, theft, false witness, blasphemy” (Matthew 15:19). How does medicine relate to this?

What about the brain, head, thinking? Isn't all this responsible for faith? How many great intellectuals are there - and how can all this be imagined without a head? (Laughs.)

How complex is the human heart? How unique is this organ? What are its functions? Pascal once remarked: “It is the heart, not the mind, that feels God.”

It would seem that the muscle, the valves... Meanwhile, the structure of the heart is infinitely complex

The device is infinitely complex. If you look at it formally, well, a muscle that contracts; valves that regulate blood flow in the heart itself - everything seems to be very simple. But the muscle itself will not contract. Something forces her to do this. There is, so to speak, a detail in the structure of the heart that is figuratively called the “conducting system.” These are the nerves that run through the heart: they are built quite definitely. Electric currents pass through them, causing the heart to contract. And in this “conducting system” there is an atrioventricular node - also a whole system. In Latin: atrioventricular system. And this node is so complex, so incomprehensible, so wisely and interestingly designed that we even have an aphorism: the atrioventricular node is an island of wonders in the ocean of the unknown. When you start studying this in more detail: My God! There is so much wisdom and unknown processes going on there. Amazing!

When the heart hurts

In our country, the most people die from cardiovascular diseases. Why is heart disease the number one disease, especially in Russia?

This probably applies to most civilized countries. It’s hard to say... With all the complexity, with all the wisdom that is embedded in it, the cardiovascular system is very vulnerable. That's why people get sick so often. The cardiovascular system is involved in everything: both in ensuring physical mobility and in ensuring intellectual activity, since she is engaged in transport - the supply of nutrients, oxygen, etc. And at the same time, such vulnerability! Note: as soon as a person begins to live, the heart begins to work. The fetus's heart is already working.

- In the womb?

Yes, in the womb, of course. It works until your last breath. What a colossal load he has to bear! And how sensitive this organ is, which perceives all the subtlest emotional movements of the human soul. It is finely adapted to physical demands. This is a very complex organ. And where it’s thin, that’s where it breaks! Why is this happening? This complexity creates vulnerability. Take, for example, some kind of ax. What's so difficult about it? Have you ever seen axes break? No, he lies to himself. (Laughs.) The most complex system breaks often. So it is here.

According to statistics, men most often suffer from cardiovascular diseases, and they most often die from it. Why?

Take care of men, as one journalist said. First of all, the thought arises about female sex hormones - they are protectors of the human body. This, by the way, was the basis for the use of female sex hormones as a therapeutic agent for heart diseases in general and in men in particular. But in men this gave a correspondingly awkward result, and such treatment was gradually abandoned. Female hormones have a vasodilating effect. So, the absence or small amount of female hormones is the first. The second is smoking. This is very great evil and aggression. Then, of course, the fact that men bear more stress loads. Men are warriors, men are strategists, men are bosses, men are responsible for their country, for their team. The president is usually a man after all. This means that the load is stronger and heavier on the nervous system and the heart.

- At what age should you think about your heart?

First of all, parents should think about this. When a baby is born, you need to make sure that he doesn’t get sick, catch a cold, or have pneumonia. You need to protect it - once. Temper - two. Feed correctly when he grows up and the time comes to tear him off the breast - three. Physical activity is required. Maybe send him to physical training groups so that he can exercise properly. Do not load it with ten sections! Drama club, photo club - it's too much! And there’s also language and hockey. And at school you need to explain how to behave so as not to get sick, so that your heart is healthy. I don’t know if such lessons are taught in schools now.

When to start taking care of your heart? From birth

The heart needs to be protected from birth. Talk about the dangers of smoking! I remember what kind of preventive measures my father gave me, who smoked since his high school years and died of lung cancer. I was in second grade. He called me over and asked: “Well, have you already smoked?” I say, “No, dad.” He: “Okay. Let's light up here! Why are you going to hide in the restrooms...” I took out the Belomor and lit a cigarette. He says, “Pull it in.” I coughed: “Dad, I don’t want...” - “Try it!” Have you tried it? And you know, I didn’t want to anymore! So he remained a non-smoker. This is a harsh method and it is wrong.

We need to tell you what the heart is, how important it is! What types of heart diseases are there - even in young people?

At what times of the year should people with heart disease be extremely careful? When do exacerbations occur?

Exacerbations occur all year round. Especially at a break in the weather, when there are magnetic storms. By the way, we don’t know everything about this. What do we know about infrasound? And this is a very serious thing.

I give this advice to patients: buy barometers and monitor this device

The transition from one weather regime to another is always a difficult situation: the heart has adapted to one temperature conditions, to one atmospheric pressure- and suddenly a sharp change. I have been giving this advice to patients for a long time: buy barometers and monitor this device. If the needle drops, although the weather seems to have not changed, be prepared for unpleasant sensations to begin - pressure surges, attacks of arrhythmia. When I wrote my doctorate many years ago, I studied how weather affects arrhythmia. For this, I even worked with the hydrometeorological center.

- How to help people who have had a heart attack? What's the main thing here?

There should be a gradual restoration of physical capabilities. Very fast. A few days after the heart attack. A methodologist should come and show how to start the movements. First work with a brush, then with your feet. Movements are slow. But we need to move! My teacher Vitaly Grigorievich Popov, our great cardiologist, recalled how he once came to see a patient, and the patient lay tied to the bed so as not to move. Horror! There is a whole system for rehabilitation - both physical and mental.

- How to behave with a person who has a bad heart?

We must have mercy! In general, disease prevention is extremely important! There was such a great therapist Grigory Antonovich Zakharyin. I will quote him: “Only preventive medicine and hygiene can triumphantly fight the illnesses of the masses.” This was said more than a hundred years ago.

You need to be especially careful with your family. Not with strangers, not at work, but at home!

My mother was a library worker. She said that a person should be as collected as possible, should be as careful as possible with his surroundings at home. Not with strangers, not at work, but at home! And usually we come home and unbutton all the buttons and let ourselves go. At work we walked around gritting our teeth because we couldn’t respond rudely to either our subordinates or our boss. And at home!!! The greatest wounds to a person are inflicted at home!

And when someone has a heart condition, you need to be especially careful. Be very reasonable. Don’t babysit so that the person doesn’t get offended. Don’t say: “Don’t touch this! Don't pick this up! Don’t walk, lie down...” Because with such lisp we only emphasize that the person is in a special position, and this is also traumatic. But once again we need to take care of it. There is no elevator in the house, but you need to run to the store? So think about how far he has already walked today; see if there is shortness of breath or not? And based on this, make a decision.

A special article on how to properly feed a patient. This is a complicated thing! Not the way he wants: tea in the morning, then tea again, and then dinner at night. It is necessary to feed evenly, several times a day. You need to find out from your doctor what to feed. And try to keep the patient calm. Don't worry him.

“Monks get sick more easily”

How do stress and depression affect the functioning of the heart?

Bad influence. But few people know that there is another concept - distress. Distress is negative stress. And there is such a thing as stress without distress. We cannot live without stress. As soon as the baby was born - wow! Don't want! Cold! Someone is touching me! For some reason they begin to wash it. Stress, screaming. I want to go back. In general, why do I need all this! And off we go, you know? And an adult has constant stress. When we watch sports, when we play something ourselves. When we read books, when we listen to music. Classical music is so exciting! The man listens, and he has tears! But these are happy tears! Because he simultaneously absorbs this incredible beauty. Stress is inevitable. Distress is a blow, an insult. This is what you need to avoid. This is an insult. This is terrible aggression, anger. It's a sin. No need to stress yourself out. Greater wisdom is needed.

A doctor I know wrote a dissertation on how rich people and monks cope with hypertension, asthma and ulcers. It turned out that they get sick equally often. But monks get sick more easily!

- What does “get sick easier” mean?

They do not have such oppression of spirit. For a businessman, getting sick or being out of work is a tragedy. He is worried, nervous. This is distress. And the monks are good-natured!

Do you need to know your hour of death?

If you know that a person does not have long to live, how do you tell him about it? Are you somehow preparing him for this transition?

This is a very correct and very serious question. Because after the so-called perestroika, we began to imitate the West, and not the best features of Western civilization are being adopted. They have a simple approach to this: the patient must be informed about his imminent death so that he has time to make the appropriate legal orders. We also began to inform the patient about terrible diagnosis. I don't agree with this!

- Why?

Because there was such a case - my teacher talked about it. One very courageous man, seasoned in battle and in life, was seriously ill and asked the doctor: “Doctor, you know my life. I have seen a lot, suffered a lot. I have a calm attitude towards everything - and towards death too. Tell me honestly, how long do I have left?” The doctor told him. (Pause.) The patient turned to the wall and lay there for several days. A man who has turned grey, who has gone through battles, who has seen so much! This is a common reaction among many ordinary people. Of course, there are exceptions.

They may ask: “But how can you, believers, not report imminent death? You must prepare the person! This is our hope and our hope...” But, firstly, it is still unknown what awaits us there. Will they approve of our life and behavior there? We don’t know what will happen there, and it’s actually scary. The transition is scary. We don't know anything about this. I think that even a believer should not know the hour of his death. The exception is perhaps people at the very, very respectable age, old women who have already stocked up their own linen for death and have put aside money for the funeral.

We have many believers. Everyone is baptized, but not everyone has a funeral service. They have done a good job of trying to force faith out of people in our society, and have largely succeeded in doing so. Remember how the peasants threw bells from bell towers and destroyed churches. Many today are baptized as adults. And talking about imminent death to these people, subjecting fragile faith to such stress is dangerous. You can't treat people so ruthlessly.

Of course, the patient may ask: “Doctor, how long do I have left?” But, firstly, we, doctors, ourselves, to be honest, don’t know for sure. We are not prophets. It is more or less clear how long a person will last, but there are also mistakes... They usually say this: “I won’t hide it from you: the situation is serious.”

Do you see how many doctors are around the sick? What endless detours? They don’t leave at night or during the day. Constant consultations. But we wouldn't do any of this if we didn't have any hope. We have hope. I think that our task now is to think about how to make the patient support us, doctors, and be our ally in the fight for his life. For example, ask: “I see you are wearing a cross. Are you religious?" He will answer: “Yes.” You said to him: “You’ll forgive me for such an intimate question, but have you received communion for a long time?” You know, I would advise you to ease your soul. After all, we have accumulated so many sins. Lighten your soul and it will become easier for you physically. Do you understand? And take communion after that, of course.”

Someone else's heart

What is your attitude as an Orthodox Christian to heart transplantation? In your opinion, what happens to a person who receives a heart transplant? Is it changing?

It changes, just like any person who survives a major operation changes.

I asked Father Anatoly (Berestov) if he had noticed that people change after a heart transplant. He categorically answered: “No!”

But I have a positive attitude and have repeatedly directed people to this operation - otherwise they would have died. In some ways, there is an answer to your very first question. Because if the heart were completely responsible for a person’s personality, then after a transplant, transplantation, he would be a different person. Father Anatoly (Berestov) was the rector of the church at the Institute of Transplantology. We have known him for a long time, even before his tonsure. I asked him if he had noticed that people change after a heart transplant. He categorically answered: “No!”

“There is a direct connection between sin and illness”

The purpose of the Christian life is to purify the heart. “The pure in heart will see God” - words from Holy Scripture. How do you understand this phrase? And do you talk about this with patients?

Yes... “Blessed are the pure in heart, for they will see God” (Matthew 5:8). It's about about the spirit, I think. Because those who love people are pure in spirit. And this is seen as fulfillment. God's commandments. When man sinned, he drove himself inside. But there is a conscience, and it does not calm down. This is a stagnant center. And an electric field of an incorrect charge is induced around it. Other centers are affected. The vasomotor center - that's hypertension for you. The center of regulation of the gastrointestinal tract is an ulcer. Direct connection between sin and disease.

- Alexander Viktorovich, please give our readers advice on how to monitor their hearts.

Self-medication is very dangerous! You can miss like that. And the heart is a very important organ, as you already understand. It is better to consult a doctor rather than study the Internet, which is simply dangerous.