And day by day. 21 June, President Putin awarded the Denis Protsenko and three of his colleagues the title of Hero of Labor. The award ceremony will take place later. It is not until the celebrations. The doctors continues to shift. Whether labor, or combat.
– did Not notice at the admissions crowds of carriages “ambulance”, Denis Nikolaevich. Released?
– In Kommunarka still daily receives about thirty patients. At the end of April, at the peak, we had sixty hospitalizations per day. I know that our colleagues in the 15th the hospital every day taking up to a hundred people, many of whom were kislorodozawisimam. It’s a big load, enormous.
I can Probably say that was released in comparison with that period. Most of the Moscow hospitals has returned to the same rhythm, we’re still working on the COVID-19 and community-acquired pneumonia.
– For these months there was a feeling that swam, losing control of the situation?
– never! And we, the doctors, and the Department of health of Moscow worked together, which was quick to respond to problems and found a solution.
because Of this, by the way, are very embarrassed, I did almost a symbol of the fight against COVID, although plowed all the same.
– Someone had to take on this role.
– Understand, but still hard. I did what they taught me. As an anesthesiologist-resuscitator, and head of the hospital organized the emergency aid in the special conditions. That’s all.
the Chest in the bunker-rushed, I promise you.
But fame got almost space.
I don’t know what to do with it… the Merit is not mine, but of our team. Not only 40 minutes from the hospital, and all physicians of Moscow.
It would be strange if you hadn’t said something like that.
– But in the face of something you know. Billboards with your picture all over Moscow hang. Now here’s the star of the Hero was awarded…
– Totally not ready for this, even could not imagine. Although, of course, pleased that the noted.
But, by the way, the medal is not handed. I have a dress code suitable no will probably have the occasion to buy a suit. Usually go in jeans, the blazer…
Listening to the inner feelings and can honestly say I don’t feel like a hero. On the other hand, understand that it is very important for my parents. They are proud of, and I am pleased. Eighty percent of the Star – to their credit. Genetics, upbringing, education…
Unable to explain what is good and what is bad.
– You’re inbred?
– Yes, mA degree in microbiologist, the father – maxillofacial surgeon, the elder brother Alexey cogenerator.
– With the Star, we assume, to understand, and the fact that the story coronavirus – at�� the long haul, were you ready?
the City was preparing for a possible threat, but the scale of the disaster we appreciated immediately. In early February, was attended by professional skepticism. In Asia a similar outbreak occur constantly. Remember, MERS has swept across the Middle East, we have it is not much affected. So this time it was a question.
But when flashed Italy… About those days me on WhatsApp I received a call from an unknown number, and the girl-an anesthesiologist with Russian roots, who is married to an Italian, choking from excitement voice began to shout into the phone: “Denis Nikolaevich, found your phone and want to warn you that soon awaits Russia! Start to prepare…”
we had a closed group in Telegram: SARS – Community of anaesthesiologists in the capital.
– a Curious acronym…
– Yes, a play on words, deliberately chose the title, in tune with the SARS – severe respiratory syndrome.
the group included physicians not only from Moscow but also from other regions, we discussed difficult cases, doing remote consultations. In the medical discussions there is a delicate ethical issue, therefore, SARS and was closed to outsiders.
But when Anna, the same colleague from Italy called me and told me what was happening in Lombardy, we made the difficult decision, make our group open. And in a cozy chat and a half thousand of anaesthesiologists, who for three years has virtually knew each other for a few hours appeared fourteen thousand subscribers.
Anna started to upload there data, we began to share all the information available. Probably in March, it was one of the most popular resources on the subject COVID-19. And further to our chat prekratilis guys-translators. They organized their group and we began to translate articles in different languages – Japanese, Chinese, Italian. In English we read ourselves. Today it must know any self-respecting doctor. It is impossible to develop modern, not being bilingual, not mastered to perfection the foreign language. At least one…
since the end of February we began to take in the theme of the novel coronavirus.
When it was determined that Kommunarka will be coveny hospital?
– This is a management decision, is quite obvious and logical. Prior to the opening of the hospital in the regular profile remained three weeks. Already placed furniture and equipment, the guys checked its operation. We were on a low start, March 15 at Kommunarka had to move the first Oncology departments.
remember: ten o’clock in the morning on March 1 called the Deputy head of the Department of health of Moscow Alexey Sergeyevich Tokarev and told me that at noon, meet at the project the whole team, including staff maternity��about home, part of the 40th hospital. That Sunday and the following night we spent together. Was prepared, and about two o’clock in the morning on March 2, received the first patient.
– With the coronavirus?
to be high – risk. The first month Kommunarka worked as a observational hospital. We were lucky to those who were under suspicion, and we’re two weeks were karantinirovanija them here.
And on April 1 began a full story, when they began to arrive almost one hundred percent davidnyc patients.
How much did you have conscientious objectors among doctors?
– a Little. Maybe ten people. Many colleagues in the older age group we are asked not to come. In order not to risk their health.
– How did you react?
– Completely relaxed. Much more honest to say, as is, than to imitate the work that fails. With respect to people who decided not to hide the truth. For this, too, requires a certain courage.
moreover, they continued to work in our other units, nebovidy.
because of the refusal to go into the “red zone” nobody was fired. If someone left, it is only on their own.
– And you, when the fear disappeared, Denys?
– Yes, it was not. And what, please tell me to be afraid of?
now, I am 44 years old.
I wasn’t going to. The situation is properly evaluated. Taking into account the age risk factor of severe course of the disease was minimal. If I’m 80 years old, moreover, I suffer shortness of breath and have diabetes mellitus, then going without a protective suit in “red zone” would have looked crazy.
why do you beard not shaved? Violation!
– Strictly speaking, in the rules nothing like this recorded, but I cut, shortened.
is this a beard? So – the bristles a couple of inches.
– ten Years probably already. Used to…
While it is recognized that the availability of extra facial hair increases the risk of leakage of personal protective equipment.
What number are you sick?
– Wednesday 1 April, if I’m not mistaken.
Joke a Day humor is not gone…
First thought when I learned about the positive test? Freaking out?
– Has started to cough and understand what is coming. Today coveny cough with nothing to confuse. Learned to distinguish. Spoke in April-may and colleagues, someone from heads of the intensive care unit, and heard on the other end of the characteristic cough, cough. This cough special intonation. Not deep hacking, and the like would surface. Plus the nagging feeling of irritation. Once it is possible to make the diagnosis.
– And you caught it?
– Yes. And closed in the office and the reception room where the Secretary sits, used as a gateway. I girls put food on my way out, I decreasesl, ventilate the room… With domestic assault, we quickly figured out.
the next morning I started the meds. Then there was no negative reviews for hydroxychloroquine, began to accept it. Horror, of course, what he feels…
was it Uncomfortable?
– Well, dyspepsia, discomfort in the upper abdomen, nausea and so on… that can’t taste food and smell of Cologne. I just shortened the beard, cut the machine under unity.
And two weeks later received two negative test and lifted the blockade, returned to full work.
– of Course. The disease proceeded typically, but not heavy. Therefore, it could not fall out of the process.
We advanced! Organized remote inspection, introducing a concept called “the helmet of resuscitation”. It can be used to consult at a distance. A device worn on the head of the doctor, has a built-in camera with a resolution high definition microphone. The helmet connects to wifi and private channel transmits signals at the tablet. I can virtually be anywhere near any patients, with the most severe. This system we quickly launched in other hospitals of Moscow, led remote consultations.
Putin was in Kommunarka long before you fell ill?
I think for the week. Date mixed up in my head, it is necessary in the calendar to watch. Think the President came on March 24.
– His visit was a surprise for you?
Can you tell me how it was. I was going to meet Sergei Sobyanin. That day morning was in the Institute Sklifosovsky, we had a joint crawl with academician Sergey Petrikov, Director of Sklifa. There has accumulated a lot of heavy patients, and I’m not only a physician Kommunarka, but the chief anesthesiologist-resuscitator of Moscow. Our communication was very important, not for any supervision, control, but rather as the exchange of experience. COVID-19 – a disease of new treatment protocols only written…
in short, I was on a planned bypass in the “red zone” Sklifa. IPhone are not taken, the assistant left the city. In the hospital we use rubberized devices of IP-telephony, which are then processed in Sklif in covenham case use the radio.
And so, therefore, we go out, I stretch the iPhone hard and say, well, look who is calling you, Denys… Among a heap of unknown callers see a number of the health Minister and the mayor.
I dialed Sergei Sobyanin. He asked where I was, and after hearing the answer, he said: “Now comes the car. Want to talk to you. Meet me in Kommunarka”.
At the hospital, I saw the mayor and other responsible comrades… I said, “What are you doing? Go and take a guest.” Drove “Aurus”, and then I understand everythingL.
Probably will not give military secrets if I say that none of the copters do not fly around, nor any additional measures were not introduced. And so we closed territory, entrance through the checkpoint.
moreover, the doctors and nurses who saw the President only in the intensive care unit and the emergency Department, only from the evening news know who was the man in yellow protective suit, who said to them: “Thanks for the work guys, hold on!”
– Well, how? There are two people: one – in the white Size, and the second in yellow. Got to the first chamber, there lay our colleague. Many then tried hamerite, wrote, say, a setup… But it was a real patient, doctor.
– And where you caught the virus?
– certainly not in Kommunarka. Figures show that the incidence of doctors in kovenig centers in Moscow is lower than in other hospitals in the city. From the very beginning we were set up seriously.
we had 18 percent of physicians. A staff of about 800 people, of whom 570 are always present. Private pride that we didn’t lose anyone from our team.
Therefore, I am convinced that ill COVID not at work. Before infection I gave a lot of interviews, went to some external meetings. Somewhere in there picked up.
as the Project went patients?
About four and a half thousand. The vast majority – COVID-confirmed.
You take not all in a row?
– 99% of the people who treated us fall in Kommunarka in the channel and along “ambulance”. No sorting occurs. Someone comes by gravity. We don’t deny them. Man is free to make the CT and the General analysis of blood, swab, to measure the temperature. But we are not each hospitalization.
There are certain criteria. Do not accept patients with mild currents and a small amount of damage to the lung tissue.
Therefore it is not necessary to think that in Kommunarka only Lev Leshchenko was treated. Although there was a moment when we simultaneously lay the famous media person, musicians and singers. But were treated here and a lot of our medical colleagues, patients completely different social classes. We basically did not render paid services, has worked exclusively in the MHI. In Kommunarka even have a Department of paid services. Then will appear, but not during a pandemic, right?
It’s a fairy tale, like hospitalization in Kommunarka is worth three hundred thousand rubles. Somewhere flashed such misinformation.
Foreigners – we had some difficult patients – very surprised: modern hospital, single and double chamber, power package, as Aeroflot… And all this does not have to pay? How so?
And we popularly explained that emergency medical care according to the Constitution of the Russian Federation provided free of charge.
– Many people fail to save?
– About seven percent of the total��about the number hospitalized. Since March, more than three hundred thirty people.
We studied the disease, has revised some of the approaches. In particular, began to of patients maximum dosages of medications using the same drug in different proportions depending on the specific clinical situations.
– What about ventilation?
– And what you want to hear?
of Course, this life-saving strategy, but if the patient with COVID came to a ventilator, the probability that he will come down less than in the General population. So one of the tasks of anaesthesiologists and the whole team were to use other methods of improving oxygenation, the saturation of blood with oxygen, than tracheal intubation and transfer to an artificial lung ventilation.
– finally found the best Protocol?
Is early laying on his stomach and oxygen therapy. If you’ll go in the “red zone”, now two-thirds of patients we have kislorodozawisimam, and they are back up, hugging the pillow. To positive effect, need to be at least 16-18 hours a day. And this is hard physically.
So explain, assure. Well, we have free wi-fi network: oxygen in the nose, a pillow under the chest and you are welcome to read, watch videos in YouTube.
Favipiravir use? Its almost a panacea called…
– critically ill patients not prescribed only in moderate current. Its data are different. The Japanese at first said Yes. Then – no. Clinical studies show that it reduces the time of the viremia – the condition of the body when viruses enter the bloodstream and can spread throughout the body.
it is Necessary to observe…
ironically, now we have more complaints that the project is not treated.
– All Protocol, antipyretics, anti-fever drugs. If the patient has a temperature of 38 degrees, it lies on the stomach, it receives oxygen and two injections a day – anticoagulant anticoagulant therapy. All!
Instantly start claim: “I feel bad, and doctors do not treat”. But we opponents of polypharmacy – the use of a large amount of drugs.
And the second point is patients neurotransmitter the storm.
Is that supposed to mean?
– the body’s Response to the attack of dangerous viruses and bacteria. The immune system is, in fact, goes out of control. We have accumulated a large database of studies on the use of inhibitors of interleukins, biologically active drugs that block inflammation. Of course, to them it is better not to walk. A great risk of getting into intensive care.
So, magic pill yet?
– I Think it will not. One of the topics my research interests are sepsis, antibiotics, treatment of severe infections.
That’s how you think that will kill humanity – microbe Iland a virus?
– I Think the people themselves will successfully destroy.
– this is actually a very difficult question. Contagiousness, roughly speaking, the “infectiousness” viral infection, much higher than microbial. However in 2014 the who has calculated that by mid-century from infections caused by resistant to all antibiotics by microbes, is estimated to kill about fifty million people, which exceeds the number of deaths from cancer.
– A Wuhan coronavirus may be a biological weapon?
– I don’t think. Then it isn’t very powerful, you see. The index of contagiousness needs to be completely different.
At the other extreme, avidity, they do not believe in a pandemic, considering it part of the global conspiracy. What you say to them, Denys?
– In General I am very tolerant person when it does not meet the requirements of the job. Here I can say: why go without a mask and break mode is sick?
But to make someone comment on the street or in the store… In the end it is a question of education. If in a public place marking, requiring a distance of half a meter, I’ll hold her, but to those who will violate, is hardly going to interfere. Times people do not understand it can not be forced. Easier to take a step to the side.
– A vaccine COVID-19?
– It needs to find. The question is when. There is a concept – good clinical practice with certain time lags. Can we call the vaccine safe when observing her in action for a month?
– it is Better to ask a professional virologists. Not my area of expertise. But with open source you can see that on average took a year and a half. For the development, evaluation… the Vaccine needs to be effective and safe. You know, if we drink a litre of dust is likely the virus will die, but the problem is that before die the patient.
a reasonable balance – the most important thing in any development. Once I was in the USA at the factory where invent antibiotics. Every day chemists synthesize a molecule. This new drug appears every 5-7 years. Why? The reasons for the mass.
the Molecule might not work in practice or be toxic. And so on.
From the moment of synthesis at the chemical plant to the exit in clinical practice stretches very long chain. Why modern drugs are so expensive.
– What, in your opinion, better – recover or stay safe?
– the Second. You know why? No one yet knows how strong is the immune system that occurs as a result of illness.
Cases of re-infection have been recorded, although a single description Dating. Today there is no certainty that, once a refresher, you closed the subject for himself forever.
is it true that smokers are less and easier ��Aleut COVID-19?
– Not ready to say Yes or no, now we specially commend this base. To be honest, there are topics, which are reserved until I see confirmation. There is a culture of scientific publications. Need to write a paper according to certain rules using statistical machine. Then to the experts. If they see the roughness statistics, be sure to request the primary database. Only after this article will appear in a serious journal. She’s maybe a year to wait in line for publication. It is a kind of quality guarantee.
So not ready it’s so easy to say that smokers get sick less. After a couple of years will tell.
about the dog lovers?
– We didn’t spend this analyst, and I have not seen any serious articles on the subject.
Again, I’m an anesthesiologist-resuscitator and do not consider myself an expert on COVID-19. Life has forced it to sink. But certainly not forever. Why I chose this profession? Can not long sit still, to focus on one. I need some action. And not only his head, but and hands. Anesthesiologists-resuscitators do not operate, but many do catheterized, drained arteries, put all sorts of sensors and so on.
Constant motion – what I need.
– when You future profession was determined, Denys?
– In the ninth grade. Went to wash the floors in the intensive care unit and understand what will eventually come.
– You’re being led into a hospital room?
the Brother was in his first year of medical school and worked as a nurse and his student party often met in our house.
Alex chose another profession, I’m stuck in intensive care. However, in ninth grade I thought that I am looking forward to the month of romance with a night shift, but it turned out that students can only work the day shift from eight in the morning until four o’clock.
How much did you get paid?
– 64 rubles. It is 1989. Juvenile nurse in the intensive care unit acute poisoning – normal!
History is curious… I’m engaged in Ashgabat in the special school with advanced study of English and had to go to University for languages.
what my father said to me: “Listen, kid, knowledge of languages in the modern world – not a profession.” My dad had a friend, a translator, who graduated from MGIMO, and he said that it is necessary to own 5-6 languages from different groups, then you’re a polyglot and that’s your specialty. But school takes a lot of years, besides every day to do the training, otherwise languages will be gone.
in short, dad gave me an educational talk, and then on my Desk suddenly appeared “notes of a doctor” Bulgakov…
– I Guess he slipped. Matched: this book, the conversations with his brother, withthe knowledge that we are a medical family, and I mean from teenage protest do not want to continue the dynasty.
Went to the nurses to check yourself. The way it turned out.
– And his wife – colleague?
– fortunately, no. Alena – the economist.
the Child, it seems, did not follow in my footsteps.
No. For me it is very important that I have not identified what Nastia wants to be. Said daughter: “It’s your choice”. Although it Atlanterra here in Kommunarka. In June, worked as an administrator in the lab. In the “green zone”, of course.
– I also asked: “do Not change your mind, Anastasia?” Replied: “No, the doctor will not”. Say: “why come to us?”. He explained: “it is Impossible so much time to sit at home and volunteering in the hospital – the correct method of breaking isolation”. Of course, previously I reviewed the IVIG my daughter. The rate was high. She was kontaktirovat with the virus is asymptomatic, without fever and cough. So I quietly launched it here. No, there was no risk.
– Today doctors honored as heroes, but we know that from love to hatred – one step. You ready for this twist?
– From the first day. To me it seems that everyone has got into a groove. Those who are respectful of doctors, and COVID was not needed. For people who somehow suffered from the doctors either think that hurt, I think pandemic has somehow fixed the situation? Believe me, none of us considers himself a hero. We would do this in a real war, not viral. Those who lived through the nineties in medicine, and remained in the profession, not gone anywhere. It’s not a job but a way of life.
Strictly speaking, we can’t do anything else. That’s really. Only patients treated. If you leave the profession, remain a taxi to drive.
You compare the pandemic with the pendel, who COVID gave to mankind. As it is clear and strong, so we learned a lesson?
– the Important thing is that the kick came on time. We began to forget that you should always remember. Coronavirus have changed a lot, from my point of view. For example, the culture of hygiene.
Yet it seems to me that people understand that without mutual support and revenue to survive impossible. And the internal integrity has not disappeared.
do you Know how many volunteers offered us help? Or list owners you closed on quarantine restaurants that continued to free feed doctors in kovenig centers? Dozens of names! What is this business? No, of course. The desire to help, to thank. In this sense, the kick was very handy, he was able to unite our society face a serious problem.
– the Second wave can not be avoided?
– I don’t know, to be honest. Previous serious virus attack traditionally proceeded in three stages, which lasted a year or two.
As pcool this time, no one today will respond. How now immunized population, whether immune… a lot of “if”. The geography of a strange virus, according to the outbreaks. In Italy the North was underway, and the South not. Somehow very quickly caught fire in new York. Then it just suddenly died. But it is hot in Florida, Texas, California. Lesions in different areas. Otherwise, in Russia occurred: the first blow fell on inbound hub – Moscow. Capital, as they could hold. Then began the planned distribution.
it is Difficult to say what would happen next.
what setting up?
Until the end of the year will coveny center.
– There is a plan for the cleaning of the hospital and return to the profile that was originally laid: three hundred cancer beds, powerful vascular center, traumatology, neurosurgery, operating two floors, a large intensive care unit, continuation of construction, and acceptance in the next couple of years the adjacent buildings.
How they should be?
Nine. While there are four.
– Rebuild, and start a normal, not emergency work?
– I Have a specialty, such that all are in haste. Again without pathos again, that critical care medicine is always hard patients night consultation, the urgency.
of Course, over time, fatigue accumulates. Recently I was invited to the TV show “Hundred questions to the adult”, where the guys ask the guest about all, any, most unexpected topics. Nastya was also among the participants, took it with him on the record. The daughter said, “Dad, we will have a vacation this year?”
– What was the response?
– I Hope it will be. Traditionally, we rested in the summer, and in 2020, things went differently. I want to believe that in September, barring any conflicts, will be able to translate the spirit.
– How many hours usually sleep?
– I have enough for five or six. I – a lark, Wake up five minutes before the alarm. It rings at 5.15 am. Fall asleep closer to midnight.
nothing else. I think in this mode they live most of the doctors in the world. In the West doctors plow very much. If you not the workaholic, you will not become a good professional. One-hundred percent.
so, waking up at a quarter past five in the morning, and then, Denys?
– a Cup of coffee, analysis of operational email and to work. If there is no rain, the food itself was on the bike in bad weather, by car.
When you get to the Kommunarka?
Around seven in the morning. And then twisting until the evening.
– What you have, by the way, iron horse?
a Year ago, when there was an understanding that children’s dreams and the real need around the city begin to overlap. Probably every boy dreams of a moped or motorcycle. I am no exception. To forty-three years with the iron, as you put it, the horse is not evolved, and suddenly realized that in Kommunarka from Belarus, where I live, easier to get in the saddle. To the case treated fundamentally all winter twice a week, worked in the evenings in the indoor hangar, studied the safe and professional driving of the motorcycle, which is very important.
By the way, the choice of brand is also largely associated with the same. Harley rarely get into an accident. He goes slowly, steadily, solidly, that minimizes the risks. My average speed around town is 80 kilometers per hour. If faster, feel uncomfortable. Winning is not at the expense of speed and maneuver, including drive aisle in traffic.
Your personal record?
says the same: I have no purpose to drive fast. Usually travel from Belarus for 35 minutes.
some biker club?
– No, of course. I have a motorbike and it is written: Lone Wolf, no club.
Lone wolf, then?
Clubs – the same sect, a kind of religion. And I’m an atheist.
– As probably the majority of doctors.
– Not a fact. For example, my father’s age came to faith. Very personal, sensitive area.
Returning to Harley-Davidson, I will say that I have friends-motorcyclists with whom I communicate. If possible, head out to Suzdal for the motor festival.
you Know what else is good bike? As I drive, turn my phone off to avoid distractions behind the wheel of anything extraneous. A rare opportunity to be alone with him. At least half an hour. Have learned to appreciate.