Life as viewed by a poor wretch doctor: Belarus - USA

Have you ever thought about how much your life costs in the eyes of an addict who urgently needs a dose? Just imagine that you are passing by a porch where such a man sits, a 100$-note is sticking out of your pocket. Glumly that sounds but right now your life costs the same money. An addict is a sick man who practically cannot realize the consequences of his actions; he is dangerous but not like those people frantically addicted to money and material values, however. No. Of course I am not saying that to have a good salary, a prestigious car and a holiday cottage nearby the capital is bad. The question is…at what price?

The nineties were a shock therapy for Russia and all the former Soviet Union. Just then the soviet people got a cuff; some of them cannot come round until now and great many of them forfeited their lives for their innocence. Just call to mind how many fortunetellers, healers, sects, semi-doctors and semi-businessmen there were. And all these reverses stroke upon the people who had used to take everything on trust; they did not know that seeing a doctor may lead to loosing one’s money and health. Time waxed on, someone took the rap, someone went abroad and for a moment it seemed that everything was different and finally got in its positions: people became more honest, began to love each other and help each other. There seemed that after a little while people would become people; but it was far from it...

Not a long time ago I read several articles in which the US health system was criticized; I mean official venality at the highest level. Now I would like to write about the situation in Belarus but at quite another level. Not as a journalist but as a human being. I will try to compare the situation Belarus is in (thanks to democracy) with the situation in USA; and to compare the health systems of the countries, and it is for you to draw conclusions.

You will never and under no circumstances be able to give a bribe to a doctor in the USA. There is a variety of causes why you can’t do that: he does not need it, you can’t give a sum he is interested in, and this is punishable by a long term of imprisonment. To railroad a doctor is a cute business in the USA. There are even lawyer’s offices which specialize in it. You just come to their office and tell them the way a particular doctor has hurt your sensibilities, and they are working for a percent of a sum they are going to win from a hospital by court action. Thus if a lawyer considers it a profitable case he will take on it, but if a case is a non-profitable one - no well-established office will accept the challenge. This system has its benefits and implications, but the foremost benefit that blanks off all the implications is that a doctor will not diagnose you with “calx radiculitis” just to buy himself a new car.

Everyone has heard of Linda Pino who voluntarily brought herself to justice for refusing to cure a patient in order to save an insurance company’s money. Actually there were several such cases apart from Linda, at least much publicized ones I am aware of. People just brought themselves to justice for refusing to help people for the sake of tapering, and that lead to deplorable consequences. On no account I justify them and seek to do heroes of them, I warrant that everyone can tear his/her hair and do self-torture in public, but only few can take a right and courageous decision and stand against the system. The press will never write about these few and no one will hold them up as an example. With the help of one American publication I have managed to count several thousands of such people throughout the USA. All of them have different stories, yet the common point resolves to the fact that all they had a choice: to get a good financial bonus and prompt job promotion or to save a human life or sometimes even the lives of the whole family.

The system in Belarus is somewhat different. I want to notice at once that the health service in Belarus is at a very good level. We cannot even compare doctor’s wages in Belarus with wages of medical professionals in other countries; yet, as it is common to say, there are more than plenty of “heaven-born” doctors. I am only glad to say that when commenting my article “US health BURYING service reform” one of the visitors suggested that the system must to be paid for, i.e.: "You visit a doctor, pay money, he diagnoses you and treats you. Theoretically, in several years he thoroughly knows the state of your health, health ground of your family, causes of diseases and conditions you are living in. The fee level depends on the doctor’s prestige among his patients, in other words, treatment success…” That’s exactly what I would like to warn against in this article, and I will explain the reason below.

Cancer for one, big brother for other....

We will not discuss theoretical possibilities or how it could be if we followed the very proposal of one honorable reader. This method has already been practiced in Belarus; that is to say at the department of mammalogy in the Republican Center of Oncology and Medical Radiology professor Putyrsky had organized a suchlike system and yet no good came of it. I have fore-mentioned that I am writing that article not as a journalist but as an ordinary man because if I cannot look at things objectively I do not even try to write about them since professionalism disappears, and it is inadmissible for a journalist. This is precisely why I would like to apologize in advance for excessive emotions and perhaps for not exactly an objective view. But I will try to describe the situation as closely and objectively as possible.

First of all I would like to mention the fact that a healthy patient is a loss of money for a doctor who works for money. Unfortunately, when looking at his patients (female patients) L. Putyrsky cannot see single mothers or mothers of large families in them; he just sees what we see once a month when getting our wages. Sorrowful as it is but the fact remains. Generally, a health matter is a tenuous thing, who is not ready to give everything to save his or her life, or lives of our near and dear ones? I warrant that any reader will take out his/her last money from the pockets just so to save or at least to elongate his/her life. And here the most grievous things come – blackmail, extortion, derision etc. And the strangest thing to say is that people are being robbed and say thank you for it. Professor Putyrsky organized a private family office (www.doktor.by) that specializes in treatment of women suffering from cancer. At the same time he is the official chief of the science section of oncomammalogy department in the Republican Scientific and Practical Center of Oncology and Medical Radiology. At his office the professor “grinds down american cane sugar, adds starch and odorous gums from the East then packs the mixture into glossy packs” and sells it to unlucky women for fabulous tax money without a check. The worst lies in the following: the doctor performs primitive operations and eliminates lymph nodes of level 1 only, i.e. foredooming his patients to a quick death. Let me explain: if a woman suffers from breast cancer her lymph nodes of the first level get affected first, then lymph nodes of the second level and finally lymph nodes of the third level. According to the treatment records two-level or three-level lymph dissection is needed. This specialist eliminates lymph nodes of the first level only and this is by no means admissible and leads to a patient’s death. Lymph dissection of the second level is rather a complex procedure and only a good practicing surgeon can do it, but yet it is difficult and can bring more troubles…

Acquisitiveness is so high that sometimes even healthy breast ablated from cash patients. We don’t mention names of unlucky ones on the principle of moral.

In such a manner the mammalogy department of the center of oncology became Putyrsky’s private company and the State defrays its costs.

Putyrsky’s official position allows him to make use of free advertising in mass media, so he is always on TV screens and in newspapers. That allows him to pour oil on flames so that yet more women seek help from him.

What about the other specialists, those who oppose him? Where the competitors are?

He uses his own methods of taking them away (has studied under Berezovsky). Thank goodness, he does not shoot at them yet.

Let’s take an actual example and see how the professor consults people frightened by this terrible disease:

“Dear Leonid Alekseevich!

I’ve got the following problem.

My mother has died of breast cancer. In my opinion it was caused by an enormous stress caused by moving to another country.
She was treated in Borovlyany and, unfortunately it was too late when she called in aid...
I am scared of following her destiny.
I often get nervous myself although I understand that I should not.
I would like to ask you a question: what should I do in this situation. Indeed, I don’t want to have a firsthand knowledge of the horror of that terrible disease.

Thanks in advance for your answer”.

Here what the professor answers:

“Dear Irina!

Once a week I give consultations at one of the centers in Minsk. Please, make an appointment over the phone (029) 6192463 (Ekaterina Iosifovna) and we will discuss the details when we meet personally. I will offer you all the necessary advice and prescribe preventive treatment if needed. And do not be nervous so far, maybe it is not genetic cancer at all. By the way, we can check it as well. See you!

Sincerely yours,

professor Putyrsky Leonid Alekseevich!”

A non-professional could see no peculiarities in this letter. The woman is frightened and looking for help. The professor requests her to pay for the visit so that during the attendance he could tell her not to be nervous; do self-examination and everything will be OK. Legally he is right, but humanly it looks disgusting. But it is a value judgment. All the same we have decided to go farther and find out what kind of preventive treatment the professor had spoken about. But that not to be unsubstantiated let’s cite a passage from one of the specialized sites:

“Preventive mastectomy which decreases breast cancer development rate up to 90% (Hartmann et al. 1999) and ambilateral ovariotomy performed on patients older than 35 years which decreases ovarian cancer and/or breast cancer mortality among BRCA mutation carriers (Rebbeck et al. 1999) are widely accepted in foreign clinics.”

For the moment there is no genetic breast cancer preventive treatment except breast and female gonads excision. Was this the kind of preventive treatment the professor had suggested?! And maybe it was dietary supplements that could bring him good money? They will be in demand both with genetic and non genetic kinds of cancer, the main thing – is the professor’s word. Ordinary people will believe him anyway. It is hard to imagine what else the professor had in mind when he suggested preventive treatment. Perhaps the professor does not know that there is no preventive treatment… and maybe the professor is not a professor at all? It is known to the whole academic community that for getting “professorship” one needs to educate several Doctors of Philosophy (in Russia – 5, in Belarus 4 is enough). The professor under discussion has prepared none. Who knows the subject of L. Putyrsky’s doctoral dissertation? Where can we look through it? No one has seen, no one knows. It was a tough time then, in the beginning of the nineties, those who made progress then are professors now…

In conclusion

The nineties have passed. Fortunetellers and healers have moved to another level; some went to church for remission of their sins and others got professor’s ranks and continue to empty people’s pockets. By no means can one say that all of them are the same, but it is necessary to know the ropes of the system, and before giving one’s health to somebody’s hands one should measure thrice and cut once. If american doctors are crying today, we must do our best so our specialists do not cry tomorrow. Imagine yourself - hundreds of thousands dollars had been saved when people got refusals for medical treatment in the USA and just for 300$ the man in Belarus sends to death our wives, sisters, mothers etc…