The Kremlin hospital celebrates its 60th anniversary. It was here that Soviet leaders, members of the Politburo, writers and actors were treated. The slightest ailment of one of the elite became the subject of study by Soviet and foreign doctors.
Why did Lenin not trust domestic specialists, what kind of patient did Khrushchev turn out to be, and was it difficult to force Brezhnev to go to the pool every morning?
Vladimir Lenin
Lenin's health worsened in 1921. According to contemporaries, he suffered from dizziness and lost consciousness more than once. Vladimir Ilyich worked “exhaustively” and wrote to Gorky: “I’m so tired that I can’t do anything.” Maria Ulyanova recalled: “Vladimir Ilyich came in the evening, or rather at night, at about 2 o’clock, completely exhausted, pale, sometimes he could not even speak or eat, but only poured himself a cup of hot milk and drank it, walking around the kitchen where we usually had dinner.”The Soviet leader was examined by famous specialists from Germany. At first, they believed that his illness was due solely to overwork. In May 1922, Lenin's condition worsened. According to surgeon Yuri Lopukhin, the cause could have been an assassination attempt in August 1918. Then Lenin was seriously wounded, he was operated on by the Latvian surgeon Vladimir Mints. Some experts claimed that the illness was related to lead poisoning due to a bullet in the right shoulder.
Otfried Förster, one of the founders of German neurosurgery, became Vladimir Ilyich’s chief physician. He wrote a dissertation on movement disorders in pathologies of the nervous system. In treating Lenin, the doctor relied not on medications, but on long walks and special “calming” exercises. In the late 1920s, the name Foerster was known to the medical community around the world. It should be noted that Lenin was skeptical about his compatriot doctors. “God forbid from comrade doctors in general, Bolshevik doctors in particular! Really, in 99 cases out of 100, fellow doctors are “donkeys,” as a good doctor once told me. I assure you that treatment (except for minor cases) should only be done by first-class celebrities. Trying a Bolshevik’s invention on yourself is terrible,” he told Gorky.
Despite walking and exercising, Lenin suffered from severe headaches. Brief paralysis occurred right hand or legs. Professor G.I. Rossolimo said that the disease has a “peculiarity that is not characteristic of the usual picture of general cerebral arteriosclerosis.” In January 1924, after deterioration, Vladimir Ilyich died.
Joseph Stalin
The medical report stated that the cause of Stalin's death was a cerebral hemorrhage. Some biographers note that the leader’s attitude towards medicine was disdainful. He trusted his health only to the chief Kremlin therapist - academician Vladimir Vinogradov. In 1952, Vinogradov was arrested in the “Doctors’ Case” and accused of working for American intelligence. Now there was no one to examine the Soviet leader. Svetlana Alliluyeva recalled: “On December 21, 1952, I saw my father for the last time. He looked bad. Apparently he felt signs of illness. Obviously he felt high blood pressure, but there were no doctors. Vinogradov was arrested, but he didn’t trust anyone else and didn’t let anyone get close to him.”
Joseph Vissarionovich died on March 5, 1953.
Nikita Khrushchev
The Secretary General was different good health and rarely looked into the Kremlevka. Already in old age, Nikita Sergeevich developed coronary heart disease. He was admitted to the hospital with a heart attack. Cardiologist Evgeniy Chazov, who treated several leaders of the USSR, wrote about Khrushchev’s stay in the hospital: “Khrushchev was in the hospital on Granovsky Street due to a myocardial infarction. One late evening I was in the department and needed a nurse. Looking into the medical staff’s room, I saw a strange picture: the nurses on duty and orderlies were sitting around an old patient, wrapped in a hospital gown, who was loudly proving something to them and asking with passion: “Well, is your life better under Brezhnev?”
Chazov also advised Yuri Andropov, noting low level training of a number of “Kremlin” doctors: “The local doctors and consultants, without understanding the nature of the disease, decided that Andropov was suffering from severe hypertension, complicated by acute myocardial infarction, and raised the question of his transfer to disability. Fate was being decided political career Andropov, and therefore his life. Tareev and I, considering that Andropov long time suffered from kidney disease, it was decided that in this case We are talking about increased production of the hormone aldosterone (aldosteronism). This disorder was little known then. Soviet doctors. Research on this hormone at that time was carried out only at the institute that I headed. The analysis confirmed our assumption, and the prescribed drug aldactone, which reduces the content of this hormone, not only led to normalization blood pressure, but also restored the electrocardiogram. It turned out that it did not indicate a heart attack, but only indicated a change in the content of potassium ion in the heart muscle. As a result of the treatment, not only did Andropov’s well-being improve, but the issue of disability was completely removed, and he returned to work again.” It is worth noting that Chazov invited foreign specialists to treat the Secretary General.
Leonid Brezhnev
Leonid Ilyich suffered from a disease of the cardiovascular system. According to eyewitnesses, since the early 1970s, logical inconsistencies were sometimes observed in the speech of the Soviet leader. This is how Chazov wrote about it: “Losing the ability analytical thinking, speed of reaction, Brezhnev more and more often could not withstand workloads, difficult situations. Disruptions occurred that were no longer possible to hide. They tried to explain them in different ways: violation cerebral circulation, heart attacks."
Brezhnev's attending physician was Mikhail Kosarev. He noted that the Soviet leader abused sedatives. On Kosarev’s recommendation, the Secretary General began going to the pool every morning. Already in old age, he quit smoking and weaned himself off pills, which affected his diction and caused muscle weakness.
In March 1982, an accident occurred in Tashkent - a structure on which people were standing collapsed on Brezhnev. His collarbone was broken. In November of the same year he appeared in public for the last time. The politician died on the night of November 10 from cardiac arrest.
The series of stories about great doctors continues Hematologist Nikita Shklovsky-Kordi:
Why were global programs to harvest bone marrow in case of nuclear war closed?
— So, Nikita Efimovich, 1972, a protocol for the treatment of Donald Pinkel’s childhood leukemia appeared. How was this implemented in the USSR?
— The leading Soviet hematologist Andrei Ivanovich Vorobyov at that time, as they said, “played the box” - he had to work in the clinic of the Third Directorate. It was a very closed clinic (hence “box”) - such offers were difficult to refuse in Soviet times. Although he said that his parents were imprisoned and he could not be a party member, he did not wriggle out. (In 1936, A.I. Vorobyov’s father was shot, and his mother was sentenced to ten years in the camps. The “Institute of Biophysics” with a departmental closed hospital with 200 beds was under the jurisdiction of the Third Main Directorate of the Ministry of Health - the Atomic Ministry - "Sredmash" - and was specially engaged in rehabilitation of workers “suffered from the radiation factor” - Note auto).
But, on the other hand, there were much more opportunities to conduct serious therapy there.
Before Vorobyov, the Institute of Biophysics believed that acute radiation sickness was, first of all, a disease of the nervous system.
Andrei Ivanovich fundamentally changed these ideas and created a system of biological dosimetry: an algorithm that allows one to retrospectively reconstruct the radiation dose based on the clinical signs of the disease. By physical methods It was practically impossible to measure this dose. An accident is always a mess: people go where they shouldn’t and don’t take a dosimeter with them. And the dosimeters were designed for small doses; during accidents they went off scale.
At A.I. Vorobyova had a brilliant colleague - Dr. Marina Davydovna Brilliant. She looked after the patients very carefully and, every day, when she did a blood test for them, she recorded the results on a temperature sheet. All doctors in the world are taught to keep such a list, but few do it.
M.D. Diamond and A.I. Vorobiev discovered that in acute radiation sickness, the leukocyte curve—the change in the number of peripheral blood leukocytes over time—reflects the dose general exposure, which the patient received for bone marrow. Observation of victims in large numbers radiation accidents of that time allowed them to learn how to determine the emergency radiation dose with an accuracy of several tens of rads and formulate this in the form of instructions.
During Chernobyl, Andrei Ivanovich’s student discharged fifteen thousand people from hospitals in Ukraine in one day - because he could appreciate upper limit the radiation dose they received, from which it directly followed that health care they won't need it.
On the other hand, it became clear who could not be cured - with a total dose of more than six hundred rads, the bone marrow was not restored, and the success of bone marrow transplantation in case of emergency radiation was excluded.
This was also proven by A.I. Vorobyov and his colleagues and closed the Soviet and world programs for the procurement of bone marrow in case nuclear war.
— As I understand it, when Chernobyl happened, all of Academician Vorobyov’s research was very useful?
- And how! Andrei Ivanovich gave a lecture on acute radiation sickness to all hematology cadets at his department at the Institute for Advanced Medical Studies. I first heard it at medical school, and while already working for him, I sat at this lecture in April 1986 - just before the accident. And someone chuckled:
- Why do we say we need this?
Vorobyov answered very decisively:
“Tomorrow some station will collapse, you will all be on the front line and will treat these patients.”
And so it happened.
Chernobyl nuclear power plant, after the explosion and before conservation. Photo: ria.ru
And then Vorobiev became the main person responsible for the clinical part of Chernobyl. Two hundred people were treated in the sixth hospital, and no serious mistakes were made there, except that they were not given a blood test on the May holidays. And international experts R. Gale and Tarasaki were allowed there due to the fact that Vorobyov was not afraid of openness.
Andrei Ivanovich Vorobyov is a hero not only of saving the lives of victims, but also a champion of understanding the Chernobyl experience.
— And in peacetime, these studies were continued - as a treatment for leukemia, and not for acute radiation sickness?
— Yes, Academician Vorobiev very soon created a program for the treatment of lymphogranulomatosis with chemotherapy and radiation at the same time. It was an absolutely innovative program, ahead of its time, but as a complication, ten percent of patients developed acute myeloid leukemia. Then this program was stopped and then came to us from abroad with a modification - chemistry and radiation were postponed by a month. This gave brilliant results.
The first thing Vorobyov did when he became director Central Institute blood transfusion is resuscitation for oncological and, in particular, hematological patients. There, chemotherapy began with artificial ventilation and hemodialysis.
This is how the “medicine of the future” was formed, capable of taking on whole line important functions human body and help withstand the toxic load of chemotherapy. The institute began to be called the “Center for Hematology and Intensive Care” - during perestroika, it was sometimes possible to change the names in accordance with the meaning.
As a result, Vorobiev achieved that lymphogranulomatosis began to be cured in 90% of cases, and some types of lymphosarcoma - in 80%.
This happened due to the fact that he took full responsibility for clinical researches, without waiting for endless approval procedures.
“All because Vorobyov managed to explain to his superiors”
— I understand that this later came in handy during Chernobyl. But what does this have to do with children?
— Vorobiev remained the most experienced specialist in radiation sickness - then there were fewer accidents, and he came to Sredmash just at the moment when our nuclear industry was transferred from the hands of the scientific creators to the hands of operating engineers.
There were many accidents then and, accordingly, many sick people. We learned from them.
But still, these were random patients. And here Andrei Ivanovich managed to explain to his superiors that the model of radiation sickness is acute leukemia and get permission to admit children with acute leukemia to his closed clinic.
When the Total Therapy program appeared, Vorobyov, in the same year, slightly changed the protocol to suit his real opportunities, treated several dozen children. The protocol included the need to destroy leukemia cells that had “settled” in the membranes of the brain and spinal cord. Pinkel had radiation for this.
But, since Vorobyov did not have a suitable irradiator for the head and spine, he prevented neuroleukemia not with x-rays, but with chemotherapy - he injected three cytostatics into the cerebrospinal fluid at once. By the way, a few years later the Americans modified the protocol in the same way.
And a miracle happened that pediatric hematologists could not believe in - 50% of cases of complete cure for acute lymphoblastic leukemia in children - just as it was said in Pinkel’s publication.
Despite the fact that Vorobyov was publicly accused of being subject to the “corrupt influence of the West,” at least ten of these first cured people live in Russia today.
We are friends with one of them, a film director and restaurateur, and she invites us to celebrate the holiday of her life, it is known who gave it to her. And the holiday has been going on for more than forty years.
Great doctors may have different methods
— Pinkel was a democratic doctor who insisted on the patient’s duty to know his diagnosis. And Vorobiev? What's even better?
— Yes, and in his clinic, for example, there was a special documentation regime, when the patient’s card was placed in a folder on the door of the room and was available to him and his family. This was a great step, and very few in world medicine have reached this point today.
Our last conversation about Pinkel was illustrated by the website Miloserdie.ru with a photograph of the pompous entrance to St. Jude with a huge statue. This is a picture of today's regression: the first St. Jude building was surprisingly modest and proportionate to small patients.
But the laboratories there were spacious - in contrast to what I saw in the USA when I got there in 1989 - luxurious hospital lobbies and closets of research departments.
In St. Jude Original, Pinkel took an epochal step comparable to Pinel, who removed the chains from psychiatric patients. Pinkel put the medical history in the hands of the patient and his parents - so that there would be no conflict between the doctor and his patient. secret.
Andrei Ivanovich Vorobyov is a completely different person - he is a paternalistic doctor. He told his patients this: “We know what is wrong with you, and we will do everything that is necessary.” And the patient, when he hears this, does not argue, because
Every sick person - both small and large - wants to have parents. If you have such happiness - a doctor who is your father and mother - it is a rare patient who will refuse this.
- Nikita Efimovich, but in the current conditions, when an oncology patient must receive a quota, wait for a place in federal center and to make his way there, when he is transferred from region to region, he should know his diagnosis and the list of procedures that he needs.
- Undoubtedly. And Andrei Ivanovich is one of those people who understands this well. Of the people I know, the one best prepared for remote treatment was eighty-seven-year-old Doctor Vorobiev. He is ready to consult patients by phone, Skype - whatever you like. He has one goal - to help the patient, and if new means can be used for this, he uses it.
Today A.I. Vorobiev says that the patient must become much more active and take many things into his own hands - first of all - collecting and storing medical records, ensuring continuity treatment.
Without this, everything is in vain, just like thinking without memory falls apart. The literacy of patients has increased and at the same time the organizational capabilities of the doctor have decreased. That is, today the patient must be responsible for collecting and storing medical information.
Another thing is that Vorobyov always says: “You cannot take away a person’s last hope.” Not because he ever took it away, but there are people who do it, and not without pleasure. In Harrison's textbook, the Bible of American medicine, there is, for example, the following statement:
“A misanthrope may be a good diagnostician, but he will never be a good doctor.”
There is also psychological protection: a person does not hear what he does not want to hear. All current “informed consent” does not take into account what exactly the person heard and accepted. Formally, you informed him, but you don’t know what he learned from it. I think, supreme success“Informed consent” - mutual understanding between doctor and patients, were the words of the parents of Pinkel’s young patients: “We know that our children will die. But do your best to understand how to treat other children.” This is where the healing took place. These are not random words in the Universe!
The point is not to tell a person that he is dying. Personally, I tell patients who ask me about death directly:
“You know, today you are sick, but I seem to be healthy. But tomorrow is tomorrow for both of us.”
So we discuss what we know about the diagnosis and what we will do.
In the West, a person is also not informed about a diagnosis in such a way that he has nowhere to run. Because a catastrophe for a person is a lack of meaning.
And a constructive path is a search for the meaning of today’s life, with any diagnosis, and people who are looking for this meaning with you.
The main advantage and main disadvantage of a doctor
Doctor Fedor Petrovich Gaaz. Image from lecourrierderussie.com
In world practice, medical research has begun to slow itself down. They are overgrown with a huge bureaucracy, commissions and committees, which believe that good can only be compared with very good, and risky cannot be compared. This dulls the role of the doctor-researcher - after all, Dr. Haass said: “ Hurry up to do good".
Vorobiev openly believes that he is doing an “experiment” with each patient: he treats each one as if it were the first time, because all patients are complex. But patients become complex only when the doctor works with them only after the requirements for making a diagnosis have been met. Then, when treatment is prescribed, the doctor follows the protocol, but with each patient, within the framework of the protocol, he looks for what can be done better.
Vorobyov is the genius of the council. He takes his own opinion into account last, and even treats the “breaths” of someone else’s thoughts with great attention and is ready to hear it, even if this requires a change in the entire concept of treatment.
Vorobiev considers the main quality necessary for a doctor to be focus on the patient. And most dangerous flaw which a doctor may have is stubbornness.
So try to please him!
Medicine “for the nose” - a relapse of the Middle Ages
"Hippocrates: Medicine Becomes Science" by Tom Robert, ser. 20th century. Image from casosgalenos.com
— You said that ideally a medical history is written as an essay, and the patient participates in its creation. But this results in a huge amount of information that is impossible to analyze in the current flow conditions.
- History of the disease, how it developed in late XIX century, this is an example of a successful approach to describing complex object. As they say in mathematics, “decision making with insufficient and unreliable information.” And here you cannot follow the symptom.
Our pharmacies are experiencing a relapse of the Middle Ages: medicines “for the nose”, “for the eyes” and “for the back” are the complete opposite of science.
The scientific approach is different: you listen to the patient’s complaints, ask about how he lived and was ill, and then examine him according to a plan that is the same throughout the world: the respiratory system, the digestive system, the endocrine system, etc., and only after that you put forward a hypothesis about the diagnosis and see how to check it: order additional tests.
A good doctor always goes through a systemic examination algorithm, the problem is that now they have become worse at recording their findings and conclusions, but this is the main thing creative result doctor's work!
Alas, medical history is being replaced by reporting forms.
The amount of information that laboratory and instrumental tests provide in modern medical history is enormous. But they are scattered and can only be integrated by a person - a doctor. Task information systems– help to find connections, present information to the doctor in a convenient form. The temperature sheets kept by M.D. Brilliant are the simplest example of such a system - and how it worked!
As A.I. says Vorobyov: “the most terrible condition in medicine is the lack of diagnosis.”
In No. 1 for 2016, readers of Rodina have already become acquainted with interesting details of the life of the Kremlin leaders from the new book “Medicine and Power. Medical and Sanitary Administration of the Kremlin,” prepared by the creative team of the Center for Press and Public Relations of the Federal Security Service of Russia. Next up is a magazine version of one of the chapters of the publication, dedicated to the organization of recreation for the Soviet elite.
"Don't be shy about the monetary terms..."
Issues of special medical care and organization of recreation became especially acute for the Bolsheviks after graduation. Civil War- in 1921. In the recent past, most of the leading officials of the RSFSR were professional revolutionaries; many of them went through the underground, prisons and exile. These high-ranking patients, according to medical councils, had a whole bunch of chronic diseases. Therefore, treatment and rest of representatives senior management occupied an important place in the activities of the People's Commissariat of Health and the Kremlin Sanitary Supervision Department.
Gradually, over several years, higher authorities party and Soviet power created a certain system in this area, which was then constantly reformed and improved. The working division of the Central Committee apparatus, which carried out decisions on sending responsible comrades to treatment and rest, became the UD - Administration of the Affairs of the Central Committee of the RCP (b) (since 1925, the CPSU (b)). Thus, with the participation of representatives of the UD at a meeting of the Organizing Bureau of the Central Committee of the RCP (b) on January 1, 1921, the “Zemlyachka’s proposal on the procedure for sending patients to resorts” was discussed Soviet Republic"1. Responsibilities for medical support for the highest Soviet state and party activists, in accordance with the regulations approved on April 26, 1921 by the People's Commissar of Health N.A. Semashko, were assigned to the Sanitary Department of the Kremlin and the houses of the All-Russian Central Executive Committee.
In mid-1921, a resort and sanatorium commission of the Central Committee was created under the UD. From now on, problems that arose, as a rule, were resolved quickly and positively through the highest party authorities - the Politburo, the Organizing Bureau, the Secretariat of the Central Committee. So, on March 6, 1922, the Politburo of the Central Committee of the RCP (b) discussed Lenin’s proposal “On the leave of Comrade Rudzutaku” by telephone poll. They decided: “To oblige Comrade Rudzutak to immediately go to the sanatorium and not to leave there until the congress, observing the strictest regime. To oblige Comrade Voytsik to organize immediately enhanced nutrition and treatment for Comrade Rudzutak in one better sanatorium. Secretary of the Central Committee (V. Molotov)" 2.
At the end of February 1922, the Politburo decided to conduct an urgent medical examination of the country's top leadership. For this purpose, the most prominent doctors from Germany were invited to Moscow. March 1, Plenipotentiary Representative of the RSFSR in Germany N.N. Krestinsky received an urgent encrypted telegram: “Berlin. Krestinsky. The Central Committee instructs you to obtain an immediate departure to Moscow to examine a group of responsible comrades, two doctors Kremperrer (Klemperer - Author) and Zerster (Förster - Author). Do not be shy about the monetary conditions. Stalin, Molotov" 3.
Dzerzhinsky - to the Crimea, Stalin - to the Caucasus
The Germans arrived and discovered many different diseases among the Bolsheviks. April 10, 1922 People's Commissar of Health N.A. Semashko sent a memo to the Politburo (the spelling of the document has been preserved): “As a result of the examination of our responsible party comrades by the Council of German doctors, I propose that the Politburo adopt the following resolution:
2. Oblige t.t. Tumanova, Yakovleva, Sergusheva, Razmirovich, Sakharov, Sapronov, Dzerzhinsky, Khotamsky, Ibragimov, Malashkin, Yakovenko, Krivov, Mikhailov, Samoilova, Bokiy and Andreeva (number 16 in pencil - Author) go in May. to Crimea; t.t. Pavlovich, Sulimov, Galkin, Minkov, Karpinsky, Eltsin, Rozovsky, Volin, Gorbunov, Sokolov, Yurovsky, Unshlikht, Kiselev, Sokolnikov, Stalin, Kamenev, Kutuzov, Frumkin, Yagoda, Shlyapnikov, Fomin, Solovyov, Meshcheryakov, Sedogo, Bogdanov, Karklin, Smidovich, Solts, Preobrazhensky, Syromolotov, Antonov-Avseenko, Khinchuk, Aninst, Bubnov (number 34 in pencil - Author) in May. to the Caucasus. The People's Commissariat of Health will provide them with favorable treatment conditions from loans issued by the Central Committee for the treatment of party comrades...
3. Oblige t.t. Meshcheryakov, Cherlyunchikevich, Shkiryatov, Smirnova N.A. (number 4 in pencil. - Auto.) immediately go to a sanatorium in Riga for treatment.
4. Oblige the Central Committee to provide enhanced nutrition from its fund to those mentioned in the list of the council of German doctors.
5. The implementation of all these measures is entrusted to the Central Committee doctor, Comrade Ramonov, in the medical department, and Comrade Wojciech, in the economic department. General observation assign to Comrade Semashko" 4.
On the same day, by a resolution of the Council of People's Commissars of the RSFSR (clause 1 of Protocol No. 863), comrade. Semashko for sanatorium treatment of responsible employees was allocated "... from the reserve fund of the Council of People's Commissars, three hundred and sixty billion rubles, according to the last paragraph of the estimate of the Tax Committee of Healthcare" 5.
In some cases, the allocation of a certain amount of money for an operation and subsequent treatment was decided by the secretary of the Central Committee. So, on November 24, 1922, to Stalin regarding the treatment of his wife Z.I. Lilina was addressed by a member of the Politburo, Chairman of the Executive Committee of the Comintern and the Petrograd Provincial Council G.E. Zinoviev: “Z.I. Lilina became seriously ill. The doctors demanded to travel abroad for the operation - she flatly refused due to the costs. The operation (very difficult) was done in St. Petersburg. Now the professors, the hospital, etc. need to be paid (everything is very expensive ) at least five hundred (500) gold rubles. I had to get the money. But I have nothing. I have not received and never receive from newspapers, or from the Comintern, etc. - only from the St. Petersburg Council a very small bet. It is also impossible to remain in debt to surgeons, hospitals, etc. In view of this situation, I very much ask you to help with the funds that, it seems, the Central Committee has for such cases - if possible. I will wait for a few words in response. With whom. priv. G. Zinoviev." Resolution on the document: "To T. Riskin or Comrade Ksenofontov. Satisfy. Secret. Central Committee Stalin. 24 November." At the bottom of the letter there is a note: “Issued on 28 December one million rubles.” 6.
All inclusive
In October 1923, the UD entered into an agreement with the People's Commissariat of Health to provide places for sick party workers in the best sanatoriums in the country. The agreement provided for the placement of party workers undergoing treatment, if possible, in separate rooms, their delivery from the station (pier) and back by cars, the provision of a varied diet of at least 5,000 calories per day, the provision of bed linen, and medical consultations by the best medical specialists 7 . Places were provided exclusively for the most active and overworked members of the RCP who fell ill, with qualifications no lower than members of the provincial and regional committees 8 .
On July 4, 1924, at a meeting of the Secretariat of the Central Committee of the RCP (b), the issue of resort and sanatorium treatment for party workers was considered. From now on, the main work on the recreation of the Bolshevik elite was concentrated in the Medical Commission of the Party Central Committee. The commission worked three times a week consisting of the “Chairman, member of the Central Control Commission Comrade S.I. Filler and members Comrades A.N. Poskrebyshev, I.K. Ksenofontov, as well as the doctor of the Central Committee Comrade E.D. Pogosyants and representative of the Organizational and Distribution Department of the Central Committee, i.e. E.Ya. Evgeniev." At each meeting, an average of 80-100 applications were considered, but it was not possible to satisfy all requests. The inner circle was usually not refused - here is the request of the young Stalinist secretary Boris Bazhanov, who in 1928 would flee to Iran and then to the West: “Head of the Bureau of the Secretariat of the Central Committee of the RCP to Comrade Nazaretyan. Due to extreme overwork, I ask you to grant me a month and a half leave with the provision of benefits and being sent on vacation with his wife to the Maryino rest home. I have been working in the Central Committee for 2 years. I have not used either vacation or benefits during this time. Assistant Secretary of the Central Committee Bazhanov. December 10, 1923." Resolution on the document: “I agree. I. Stalin” 9.
In January 1925, the Resort (Treatment) Commission was removed from the subordination of the Administration and officially renamed the Medical Commission of the Central Committee with reassignment to the Secretariat of the Central Committee. In the same year, the rest conditions of responsible comrades began to be more strictly limited. Until now, the timing of holiday trips and the reasons for them were often very exotic. Thus, on April 10, 1924, Lenin’s elder sister received, signed by the head of the Kremlin hospital A.Yu. Kanel gave an interesting information: “We certify that Comrade Anna Ilyinichna Elizarova is suffering initial form arteriosclerosis involving renal vessels. Needs systematic treatment with rest for at least three months." On April 22, based on this certificate, the Secretariat of the Central Committee, signed by Stalin and Molotov, decided: "Give leave to Comrade. Elizarova for three months, with maintenance and payment for treatment" 10.
All good things must come to an end, and on May 29, 1925, at a meeting of the Organizing Bureau, it was decided: “... to establish a month’s leave for responsible employees of the Central Committee - an increase in the period is allowed only in cases of the conclusion of a medical commission with the corresponding resolution of the Secretariat of the Central Committee” 11.
About Trotsky's health
In the second half of 1926, a resolution was adopted by the Organizing Bureau of the Central Committee of the All-Union Communist Party of Bolsheviks, according to which the Medical Commission of the Central Committee was abolished, and in return, to serve the party activists of the USSR, the Medical Commission of the People's Commissariat of Health was established, that is, under the department of the energetic People's Commissar Semashko. From now on the number Soviet leaders, who were supposed to rest and receive treatment at a high level, was steadily declining. The main criterion in those years, and in subsequent years, was the position held, and not merits in the past.
However, there have always been exceptions. When L.D. Trotsky was removed in October 1926 from the Politburo of the Central Committee of the All-Union Communist Party of Bolsheviks, permission to another vacation it was already given to him by the Council of People's Commissars of the USSR. In the minutes of the meeting of the Council of People's Commissars of the USSR dated March 1, 1927, it is written: “To grant the Chairman of the State Concession Committee (State Concession Committee. - Author) Comrade Trotsky, according to the conclusion of the doctors, leave for two months” 12. This point of the protocol was adopted on the basis of a certificate issued by a consultation of professors at the Kremlin Sanitary Department. In the conclusion of the specialists, it was noted that during the examination of Trotsky the following were observed:
"1. ...rises in temperature during mental and physical stress reach almost daily up to 37.0, with rapid remissions with profuse sweating. As the temperature rises, the state of health deteriorates sharply and general weakness is noticed...
4. The presence of a weakly positive tuberculin reaction undoubtedly indicates a latent tuberculosis infection, but all clinical picture of the present disease and the anamnestic data of recent years do not provide sufficient grounds for the diagnosis of an active tuberculosis process..." 13.
The health of the “big leaders” in the second half of the 1920s. became more interested. On medical topics in 1926, at meetings of the Politburo of the Central Committee of the All-Union Communist Party of Bolsheviks, 45 issues were discussed, in 1927 - 35; in 1928 - 38; in 1929 - 53 14. The Kremlin's sanitary department began to issue official bulletins "On the state of health of responsible employees", which were sent to a special list to a narrow circle senior management. The task of providing high-quality medical care for the assigned contingent was brought to the fore. On November 1, 1928, the Kremlin Sanitary Department was reorganized into the Kremlin Medical and Sanitary Department (Lechsanupr).
Near and far dachas
For operational rest Soviet leaders The estates near Moscow that had survived the revolution began to be actively used. Thus, after renovation in 1923, the former estate of A. Ruppert became a holiday home (state dacha) of the Council of People's Commissars of the USSR, where its chairman from 1924 to 1930, A.I., was on a country holiday. Rykov. In the mid-1930s. this facility became known as the Lipki state dacha near Moscow, which Stalin occasionally visited. If the dacha in Volynskoye is in subdivisions state protection for its close location to the Moscow Kremlin it was called “Near”, then the security officers called the dacha in Lipki “Far” - this historical name was also fixed among the political and military leadership of the country. It should be noted that the holiday home of the Central Executive Committee of the USSR "Volynskoye" - the former estate of the Knopps, was located on the right bank of the Setun River, and the more famous state dacha in Volynskoye - "Blizhnaya", in which Stalin lived for almost two decades (from December 1933 to March 1953), was built by architect M.I. Merzhanov on the left bank of this small river.
The most in an active way For recreation, the party and Soviet elite used resort places in the Caucasus and Crimea, where almost all members of the Politburo regularly visited. They also did not forget about abroad - they preferred to receive treatment in Germany, with which, after the Treaty of Rapallo in 1922, the Soviet side developed relations in many areas. Closer abroad, in newly independent Estonia and Latvia, known to readers Soviet newspapers Due to its inveterate anti-Soviet policies, not just anyone, but personally the Central Committee of the RCP (b) maintained two of its rest homes - in Riga and Revel (Tallinn).
The holiday home of the Central Committee of the RCP(b) on the Riga seaside operated successfully for three seasons (1921-1923) and enjoyed well-deserved success among representatives of the Soviet party and state activists. At the same time, it was recognized that it was very expensive for the state. This was the main reason for its closure, as well as the rest house in Revel, which was destined to operate only for the 1922 season.
The author of the idea to acquire his own recreation center on the Riga seaside was the Bolshevik Yakov Ganetsky, known for his adventurous habits. On May 16, 1921, the plenipotentiary mission of the RSFSR in Latvia sent the following note to the Central Committee of the RCP(b):
“Dear comrades. According to your instructions, I am preparing a dacha in Riga on the seaside - a holiday home for visiting responsible comrades. Comrades can come only with the permission of the Central Committee. The procedure is established as follows. The Secretary of the Central Committee gives this comrade a note to the head of the visa department of the People's Commissariat of Foreign Affairs, Comrade Shantsev, approximately with the following content: Comrade... is sent with the consent of Comrade Ganetsky to the city of Riga for (1 month and two weeks, etc.) Secretary of the Central Committee (...).
All comrades traveling to Riga must have a bed with them.
I am attaching herewith an approximate estimate for the maintenance of a holiday home, from which it is clear that for 30 people for four months it will cost 2,760,000 rubles, and for 50 people. - 4.600.000 rub. Here we mean five-hundred tsarist banknotes. I ask you to send the indicated amount to me in Riga through the NKVT in 2-3 installments. An accurate report of the holiday home's activities and expenses will be sent to you monthly.
With communist greetings Ganetsky.
Hiring and maintaining a holiday home will cost approximately a month
So
On July 16, a positive response from the Central Committee came from Moscow to Riga: Ganetsky’s estimate was approved exactly in the amount he requested - 500-ruble Nikolaev bills made a quick trip to Latvia to the delight of the vacationing Bolsheviks 16.
Subsequently, the experience of establishing Soviet medical and health institutions abroad was not forgotten and was used after the war in the second half of the 1940s.
* In comparable prices of February 2016, this amount corresponds to 540,000 rubles.
Notes
1. RGASPI. F. 17. Op. 112. D. 103. L. 11.
2. Ibid. Op. 3. D. 277. L. 2.
3. Ibid. Op. 84. D. 406. L. 9.
4. Ibid. Op. 112. D. 318. L. 26.
5. Ibid. L. 28, 30-31.
6. Ibid. Op. 82. D. 41. L. 66.
7. Ibid. D. 94. L. 11.
8. Ibid. Op. 82. D. 94. L.16.
9. Ibid. Op. 120. D. 1. L. 31.
10. Ibid. Op. 112. D. 533. L. 140-141.
11. Ibid. D. 665. L. 210.
12. Ibid. Op. 113. D. 269. L. 239.
13. Ibid. L. 240-240 rev.
14. Politburo of the Central Committee of the RCP (b) - Central Committee of the All-Union Communist Party (b). Meeting agendas. 1919-1952: Catalog / T. 1. 1919-1929. M., 2000.
15. RGASPI. F. 17. Op. 84. D. 53. L. 74-75.
16. Ibid. L. 97-98.
Since today is the anniversary of the collapse of the USSR and Soviet system, let's remember Soviet medicine, supposedly “good” and supposedly “free”.
IN Western world A former Soviet man, like a horse, is recognized by his teeth. If you see a person of Eastern European appearance on the streets of London, Paris or New York, they immediately look at the mouth to clarify the diagnosis. There, in the mouths of former Soviets, there is always a mess going on. Seal traditional medicine. Even the Poles, Czechs and Bulgarians, that is, comrades who have gone a little further from socialism than us, have neater mouths.
In Latin rima oris. Or "mouth gap".
This is what Soviet dentists called our mouths. “Open your mouth!” - a man in a white coat barked imperiously, seating a man with a face white with fear under the drilling machine...
Yesterday I saw a campaign banner by the roadside from the leader of one of our few parliamentary parties: “Let’s bring back decent free healthcare!” Probably, before we had decent medicine, but today it is no good. Oh, I wish this leader could go to a Soviet clinic for at least an hour. Better dental.
Any exploitation of false longing for non-existent Soviet happiness must be punished with at least a ruble, because playing on Soviet mythology results in infantilization of the population. It ceases to really perceive the world and its responsibility for it, preferring to escape from reality into the languid past.
People who believe that there was good free medicine in the USSR are twice mistaken, because it was not free and it was not good either.
The income level of Soviet citizens lagged behind almost all countries except Africa, India, China and Latin American juntas. For free medicine free education and free apartments soviet man paid at least 2/3 of his real earnings. In the early 1970s, each Soviet person had less than 65 rubles of net income, which even in the Party Central Committee was considered to be living below the poverty line. This is how 3/4 of the country's population lived. And 40% did not even reach the subsistence level.
Men in Soviet time were fleeced by the state brazenly, hypocritically, and cruelly. And for all those modest benefits that the state called free, they paid in full. And then they paid above the norm.
In 1965, ten tablets of chloramphenicol cost 64 kopecks, while their production, according to the State Planning Committee, cost the state only 18 kopecks. The famous Soviet “head remedy” based on analgin, banned in Europe, and even more dangerous pyramidon and caffeine, cost 45 kopecks in pharmacies, and 8 kopecks were spent on its production. It was called “Troychatka”.
Imagine that today a blister of antediluvian citramone would cost more than 100 rubles. What was truly affordable in the Brezhnev pharmacy were iodine and brilliant green - 4 kopecks.
These simple remedies, plus cough lozenges, cough tablets, penicillin and the bronchodilator solutan - these are, perhaps, all the medicines that an ordinary Soviet citizen knew. In the 1970s, they were joined by noshpa and Indian festal, but they were sold through connections or at exorbitant prices. IN major cities According to the recipe, they could prepare sulfur powder, calendula tincture or anti-acne lotion. In small cities there were interruptions even with the pyramidon.
Remember the satirical miniature by Kartsev and Ilchenko “Warehouse”.
Pyramidon and analgin were already known then for their severe side effects. Noshpa outside the socialist camp was considered a placebo with long-term side effects, including on the intrauterine development of the child. Festal is today called a pseudo-medicine.
All greenery Soviet Union disinfected scratches, while in the rest of the world it was used to dry the edges of wounds. Soviet drug addicts made “vint” from solutan.
Contrary to the memories of patriots, even these meager medicines were not free in Soviet times. All pharmacies in the USSR were divided into outpatient, that is, self-supporting, and hospital. In the first, medicines were sold for money. Pensioners at the pharmacy were entitled to only one benefit - out-of-turn service. Disabled people and war veterans, disabled people of the first two groups and children under one year old received medicines free of charge. Group III disabled people and children from one to three years old were given a discount. Beneficiaries formed their own queue.
Diabetics bought their own insulin. And seriously ill patients also bought pain relief. Both were chronically unavailable in pharmacies; injections were often obtained only at a doctor’s appointment. The luckiest ones, with connections and money, injected insulin at home from reusable syringes. They were boiled. As a rule, there was one syringe per family, and they took care of it. By the way, diabetics Soviet country Life was very bad: the insulin was homemade and couldn’t cope with the carbohydrate diet. The country lived on potatoes, pasta and bread. Only two products were produced for diabetics - sorbitol and buckwheat. Both were not given out free of charge, but were sold at market prices. And according to recipes.
Buckwheat - according to the recipe! Did you know?
In the Soviet Union, it was necessary to live young and healthy, because any disease brought a person to the sidelines. The words “cancer”, “stroke”, cerebral palsy in Russia are still synonymous with death or lifelong misfortune, because they were not treated in the USSR, people died quietly, secretly, children with cerebral palsy were hidden.
This is because there were no effective medicines freely available outside of Moscow, and in Moscow they were rare and expensive. Soviet people they died not only from strokes, but also from diseases that are ridiculous by today’s standards: bronchitis, pancreatitis, asthma, from inflammation of the plenum, from a simple cut on the hand or an abscess.
There were no good antibiotics available for public sale, which is why a huge share of child mortality was due to respiratory diseases. There were no drugs like pancreatin. Asthmatics were injected with hormones in the hospital, during a planned hospitalization, the person could not relieve the asthma attack himself. Chief Engineer The housing office from Mamin's film "The Fountain" used an inhaler for asthmatics - a miracle unprecedented even in the late Soviet Union.
People watched the film and understood that this wonderful romantic was an ordinary thief, because the inhaler, and even with a prescription, was not given to thieves.
Any more or less serious illness resulted in huge expenses, even if the person was admitted to a hospital: medicines in the hospital, like other shortages, were obtained through connections. It happened that tests were done through acquaintances and procedures were carried out for bribes. Clinics often had no reagents, no laboratory equipment, and no dressing material. What was available was distributed corruptly, taken home by staff.
They carried everything: droppers for crafts, bandages for reserve, alcohol for vodka, tweezers, lancets, clamps for the kitchen. A person who ended up in a Soviet hospital without money or acquaintances could simply lie under a glucose drip for 20 days, since there was often nothing in hospitals. Almost everyone had to lie like this, because people with a salary of up to 135 rubles, that is, at least 4/5 of the population, did not have access to the illegal drug market.
However, even the medicines distributed through connections hardly treated anyone, because they were Soviet medicines. Truly effective Western drugs penetrated illegally - mainly through traveling diplomats, athletes, and trade mission workers. And they were a drop in the ocean. We produced almost nothing. In a closed country, science was also closed. The technical, medical, natural science intelligentsia did not know foreign languages, and the damned bourgeoisie did not translate their publications into Russian. Contrary to proud myths, the Soviet pharmaceutical industry did not make any breakthrough discoveries.
Today, about 5 thousand effective original drugs are known in the world of evidence-based medicine. Of these, less than twenty were discovered by Soviet pharmacology.
The KGB had a powerful pharmaceutical intelligence service - security officers from all over the world brought other people's developments to the Union.
Against the backdrop of a total shortage of pharmaceuticals, the Soviet people were treated with whatever was necessary. Nowadays it is common to remember salt rooms in schools, wet salt mats in kindergartens, morning exercises before classes. This is all very good, of course. But apart from salt treatments and massage mats, there was virtually nothing in the country.
Visiting doctors was free, but what kind of doctors did they see in regular hospitals and clinics? They also did not know languages. They were taught by teachers who themselves learned in isolation from world science. Therefore, various obscurantist medical practices flourished in the Union. Especially in the field of physical therapy.
UHF, polarized light, electrophoresis, UV, electrosleep, cups, leeches and mustard plasters were perhaps the only weapons of the Soviet doctor.
They fought against all diseases - from the consequences of perinatal hypoxia and pathologies of placental development to ischemia and osteoporosis.
A sick Soviet worker came under double pressure. On the one hand, helpless medicine awaited him, which took a month and a half to treat ear inflammation or mastitis. On the other hand, the poor guy was lying in wait sick leave. The country had standard periods for being on sick leave. After a heart attack and ischemia, 20 days of rest were given. For all illnesses, sick leave had to be extended every three days; it was forbidden to stay on sick leave for more than 10 days without a medical commission.
For colds and acute respiratory viral infections without a fever, sick leave was not required - they went to work snotty. Longer than seven calendar days It was impossible to sit at home with a sick child - sick leave was closed, even if the child had whooping cough. For two years, being on sick leave for more than a week was collectively not encouraged; everyone knew this and took time off at their own expense.
Paid sick leave in in full only to people with extensive experience - over eight years. In Soviet times, people got sick with their own money. But dues to the trade union were required to be paid - 1% of the salary, including vacation pay. The teacher paid 12–14 rubles a year to the trade fund. And I was sick 2.5 working days a year. And once every ten years I went on a trip to a sanatorium. That is, the Soviet people paid for their medical care themselves.
Things were a little better in departmental hospitals - valuable workers were taken care of, so bosses went on sick leave several times a year. But another problem was lurking in the special institutions - they received scarce Western equipment and Western medicines. For this reason, good hospitals were extremely corrupt, jobs were grain-based and distributed among their own. And where there is a lot of cronyism, there is no place for qualifications. And they stole more in special hospitals than in district ones.
I personally know the family former judge Supreme Court and the family of one of the first secretaries of the regional committee of a non-poor region. Both were afraid to be treated in departmental clinics.
What can we say about ordinary outpatient clinics and hospitals? These establishments were scary. Chambers for 12 people and one toilet for two departments are the standard design of the clinic. In maternity hospitals there were ten people in a ward. There were five to ten chairs in the maternity room.
Soviet obstetrics and pediatrics are the main enemies of Soviet citizens. All pediatrics in the first year of a child’s life was aimed at separating the baby from the mother as early as possible so that she could enter production as quickly as possible. Therefore, until the 1960s, a woman did not have the right to babysit for more than three months. Then she was given first six months, then a year, but unpaid leave.
Until 1982, a woman could stay at home with her child in the first year of life only at her own expense.
At the same time, all obstetrics in the USSR was organized so that a woman would go on maternity leave as late as possible. For this purpose, antenatal clinics specifically reduced the duration of pregnancy and issued a certificate stating that it was time to go on maternity leave at 39 weeks. Women gave birth without having time to deliver this certificate to their accounting department.
However, obstetrics and pediatrics were not the most terrible areas of Soviet medicine - otolaryngology and dentistry were more terrible. ENT doctors performed almost all operations without anesthesia: puncture of the nasal sinuses, removal of tonsils, tonsils, adenoids, puncture of the eardrum, cleaning of the middle ear - all in best case scenario with novocaine, that is, live.
And in the USSR, teeth were treated using pre-war machines, cement fillings were placed, the nerve was removed with arsenic, and the pain was anesthetized with the same novocaine. People were afraid of this kind of dentistry. Any effective anesthesia, foreign fillings or good prosthetics cost more than a worker’s monthly salary and appeared only in large cities; there was a queue for them for years to come. War veterans and disabled people, and labor veterans received preferential places in the queue. A woman under 60 did not have the opportunity to get teeth inserted without a huge bribe - she could not get through the beneficiaries.
People who are yearning for today free medicine, they simply don’t remember the millions of toothless mouths. And in Soviet times they didn’t suffer from anything serious.
Surprisingly, both ultra-liberal and ultra-conservative our citizens today equally criticize modern medicine for the fact that it does not live up to Soviet medicine. And thank God, I’ll tell you that it doesn’t live up to it!
Almost all diseases without exception are now treated in Russia without crazy queues and bribes. Yes, our medicine is not of a Western level. Yes, not everything is free. Yes, not everyone is treated with everything. But the situation is not as bad as some nostalgic alarmists imagine. At least parents today don't have to sell their wedding rings to pay the nurse for injections.
Maybe that’s why hospitals these days are so far from ideal that they are constantly compared not with American or European clinics, but with Soviet institutions, where people were 12 people in a ward and where medications cost literally more expensive than gold?
Soviet healthcare cannot stand any comparison with modern healthcare. Moreover, if only because over the course of several decades, medicine and medical practice throughout the world have made a breakthrough. And in our country too. Denying the superiority of post-Soviet healthcare, people, in addition to common sense, deny progress. Because even if the USSR was a super-open power, its medicine would still seem backward to us. Just because of progress.
Memories of good Soviet medicine are of the same romantic order as longing for Brezhnev's ice cream. Most of those who today still have the strength to discuss the advantages of socialist health care were young in the USSR, for this reason they were happy and, by the way, very healthy. They simply did not have time to encounter the system. And, to be honest, they have nothing to compare Russian medicine with. But for those who really want to compare, I advise you to risk pulling out a tooth without anesthesia. I have never heard of such bold experimenters in the 21st century.
About how they were treated in Soviet times political elite, Academician Evgeny Chazov, who headed the 4th Main Directorate of the USSR Ministry of Health for 20 years, told AiF readers, and in 1987-1990. - Minister of Health of the USSR.
Is a heart attack good for you?
“AiF”: - Evgeniy Ivanovich, in the USSR the rulers promoted domestic medicine, therefore, when Brezhnev had a heart attack, he ordered the construction of a Cardiac Center. This is true?
Evgeny Chazov:- Not really. Brezhnev had a heart attack in his youth, when he worked in Moldova as secretary of the Republican Central Committee. In the mid-1970s, my colleagues and I often visited him at his dacha in Zarechye - he then had health problems. The visits took place in the morning and ended with a tea party, which was organized by Brezhnev’s wife. One day he remembered that he had suffered a heart attack. They began to discuss modern methods treatment, and the conversation turned to health care issues in general. I told him about our proposal to create a special cardiology service - already at that time, mortality from cardiovascular diseases occupied one of the first places. After listening carefully, he was surprised that the Ministry of Health could not resolve this issue. And within a week, these proposals with Brezhnev’s visa were discussed at all levels of government. And the fact that none of the Soviet leaders ever went abroad for treatment is indeed true. On the one hand, they probably didn’t want foreigners to find out about their state of health. On the other hand, they believed that we already had everything: a high level of medicine, outstanding specialists recognized throughout the world. Moreover, there was even a certain ban on inviting foreign specialists to the country. Out of 19 leaders various countries, whom I treated, only three - Brezhnev, Andropov, Chernenko (I don’t count Khrushchev) - were Soviet. And the rest are leaders of foreign states.
What the press didn’t write about me then... For example, that I supposedly killed Brezhnev, Andropov and Chernenko so that Gorbachev would come to power. But in medicine, decisions on the most complex cases are accepted collectively. So, many academicians took part in the treatment of those whom I “killed”. And at the meeting of the Academy medical sciences I showed that very article and said: “ Dear colleagues, the 12 academicians sitting here, it turns out, are criminals, murderers. That's what Pravda said. Everyone started talking. The president of the academy wrote a letter to the newspaper: “Are you creating a new “doctors’ business”?” And Pravda, I note, published this letter along with an apology.
Are overseas doctors in fashion?
“AiF”: - But starting with Boris Yeltsin, our leaders prefer to be treated by foreign specialists. It was you who invited the American heart surgeon Michael DeBakey to see him?
E.Ch.:- Andropov was the first. When at the end of his life he developed serious problems health problems, he asked to arrange a consultation with the participation of foreign specialists. We invited Professor Rubin from New York General Hospital, a world-renowned kidney specialist. And he confirmed all our diagnoses and the correctness of treatment. And Yeltsin had surgery with us. By the way, Chernomyrdin also performed operations in Russia. I actually asked my friend DeBakey to come to Yeltsin. Yeltsin liked him. But Yeltsin’s entourage was not satisfied with his verdict and decided to invite German specialists for consultation. When they saw Michael and me, they became nervous. In Germany, I am an honorary member of two universities, everyone knows me there, and suddenly they were sent to supervise me and our outstanding cardiac surgeon and academician Renat Akchurin, with whom we were supposed to operate. The Germans sat silently throughout the entire operation, literally pressed against the wall. As soon as we left the operating room, Michael immediately began applauding himself. He really performed the operation brilliantly. The heart didn’t even have to be artificially restarted - it repaired itself and “started up.” And the first of ours whom DeBakey operated on was great mathematician Mstislav Keldysh. Then I turned to DeBakey as the author of the treatment method that was required for such a diagnosis as Keldysh’s. But that is another story.
P.S. How is medicine today different from what it was half a century ago? How was Marshal Zhukov saved? Read about this and much more in the continuation of the interview with Academician E. Chazov in the following issues.
Material prepared by: Yulia Borta, Savely Kashnitsky, Dmitry Skurzhansky, Vitaly Tseplyaev, Lydia Yudina
Prepared by: Sergey Koval