For every aspiring surgeon, an important milestone is the first time you fly ‘solo’, in charge of the operating theatre, and incidentally, also in charge of the patient’s destiny. For me, this was in Gibraltar, where I was doing my six months as Junior House Surgeon, supervised by a member of the Royal College of Surgeons.
My baptism was in the form of a Russian seaman, taken off a ship in the Mediterranean as an emergency with appendicitis. (By the way, I often hear people referring to their appendix as “I had them removed.” You only have one appendix, so it is “I had it removed.)
Back to my Russian. He had a classical appendicitis and we (me) asked the operating theatre to be ready and advised the anesthetist of the forthcoming procedure.
My anesthetist was a very well experienced ‘gas man’ and he set about administering the anesthetics, beginning with an injection to put the patient to sleep, to be followed by inhaled gas to keep him asleep. There was only one problem – he wouldn’t “go under”! Just when it looked as if he was going to sleep, to allow the anesthetist to insert the endotracheal tube in his throat, the Russian would sit up and ask what was happening! (In Russian, so the translation was at best, a guess!)
The anesthetist said that he believed that the Russians drank so much vodka, their livers were capable of de-toxifying even the strongest anesthetic. This meant that he had to administer far greater quantities than usual to get the patient under.
Finally we did manage to get the operation underway, though every so often another hand would appear and get in the way, and I would have to stand back while more anesthetic was given, and the hand tucked away!
Yes, the operation was a success, and I was very proud of my handiwork, but then, after the seaman was sent to the ward I received a phone call from the Nursing Sister requesting my presence straight away. No details, just “straight away”.
With fear in my heart, I ran to the ward, to find my Russian fully dressed in his uniform, flanked by two restraining nurses. He was standing to attention and repeating the words, “Vodka, vodka, vodka!” So his liver was still in good shape, I decided.
With a promise that I would bring him a vodka in one more hour, and I would have one with him, he calmed down, and his further post-operative course was uneventful!
Now I was reminded of that nice little vodka story with a recent article in The Lancet which claimed that vodka is a major cause of early death in Russia and has a direct impact on mortality rates in men.
Over the past 30 years, changes in the availability of the national drink have been reflected in premature death statistics, say scientists.
A new forward-looking study has found that Russian men who drink three or more bottles of vodka a week are far more likely to go to an early grave than those who consume less than one.
“Russian death rates have fluctuated wildly over the past 30 years as alcohol restrictions and social stability varied under Presidents Gorbachev, Yeltsin and Putin, and the main thing driving these wild fluctuations in death was vodka,” said study co-author Professor Sir Richard Peto, from Oxford University.
The researchers asked 57,361 men in three Russian cities how much vodka they drank and watched their progress for a decade.
They estimated that, over a 20 year period, more than a third of male smokers drinking at least three half-litre bottles of vodka a week could expect to die between the ages of 35 and 54.
Excess deaths among heavy drinkers were linked to alcohol poisoning, accidents, violence, suicide, and specific diseases such as throat and liver cancer, tuberculosis, pneumonia and pancreatitis.
There were difficulties in compiling the statistics “Because some who said they were light drinkers later became heavy drinkers, and vice versa, the differences in mortality that we observed must substantially under-estimate the real hazards of persistent heavy drinking,” said co-author Dr Paul Brennan.
Something to think about perhaps while drinking vodka on the rocks?