1961: Russian doctor in Antarctica removes his own appendix

October 1, 2014 • 12:52 pm

This short piece from the Atlantic was first published in 2011, but it’s been going the rounds, and I found it so amazing that I had to post it.

The story: in 1961, Soviet doctor Leonid Rogozov was spending the winter at a Russian base in Antarctica when he fell ill, diagnosing himself with appendicitis.  He was the only doctor on the base, and evacuation was impossible as it was winter, too dark and cold for planes to land.

There were only two alternatives: operate on himself, or die. He chose the former. The Atlantic has some excerpts from his journal, both before (first paragraph) and after (last two paragraphs) the surgery:

I did not sleep at all last night. It hurts like the devil! A snowstorm whipping through my soul, wailing like a hundred jackals. Still no obvious symptoms that perforation is imminent, but an oppressive feeling of foreboding hangs over me … This is it … I have to think through the only possible way out: to operate on myself … It’s almost impossible … but I can’t just fold my arms and give up.

. . . I worked without gloves. It was hard to see. The mirror helps, but it also hinders — after all, it’s showing things backwards. I work mainly by touch. The bleeding is quite heavy, but I take my time — I try to work surely. Opening the peritoneum, I injured the blind gut and had to sew it up. Suddenly it flashed through my mind: there are more injuries here and I didn’t notice them … I grow weaker and weaker, my head starts to spin. Every 4-5 minutes I rest for 20-25 seconds. Finally, here it is, the cursed appendage! With horror I notice the dark stain at its base. That means just a day longer and it would have burst and …

At the worst moment of removing the appendix I flagged: my heart seized up and noticeably slowed; my hands felt like rubber. Well, I thought, it’s going to end badly. And all that was left was removing the appendix … And then I realised that, basically, I was already saved.

Here’s a photo:

Russian surgeon-thumb-600x384-44559

The Atlantic reports that Rogozov survived, and died in St. Petersburg in 2000 at age 66.

I asked a friend who is a doctor if Rogozov could have used any kind of anesthetic (even if they had one), and he replied:

No. He would have had to do that without anesthesia. I wouldn’t have thought it possible. The psychological and physical impact of cutting oneself would be hard enough to manage, but to perform an operation in the right order, while losing blood! I can’t imagine it. Goes to show you what you can do when you feel you have to.

I then asked for clarification because my question was ambiguous: could he have used a local anesthetic? The reply:

Local anesthesia, like lidocaine, could have been used, but I don’t know if it had been introduced by 1961. But even if he did have a local anesthetic like lidocaine available, he would have only been able to use it on the skin and superficial subcutaneous tissues. Once the scalpel went deeper, he would have really felt it.

This reminds me a bit of Jerri Nielson, the American doctor who, in late May of 1999, found a lump in her breast while spending the winter at a base in Antarctica. She performed a biopsy on herself (results inconclusive), but then medical equipment was parachuted in since winter evacuation was impossible.  A better biopsy was done and the scans sent to the U.S., where breast cancer was confirmed. After giving herself hormone treatment and chemotherapy (materials also airdropped in), she was finally evacuated to the States in October. I didn’t know the outcome, but was sad to learn, when looking this up, that the cancer eventually returned, killing her in 2009 at age 57.


44 thoughts on “1961: Russian doctor in Antarctica removes his own appendix

  1. I certainly admire the doctor and his story is incredible, but the first thing that sprang to my mind was, couldn’t he get the other non-doctors at the base to help? What about the guy who took that picture of him?

    Maybe an M.D. can chime in on this…is there some reason you’d rather do it yourself, even given the pain and distraction you’ll be suffering, rather than have someone else do even the simple stuff like swabbing up the blood so you could see better, or handing you instruments?

    1. A couple of “assistants helped with sterilising equipment ; one assistant operated retractors ; one assistant held a mirror (with the problem of it inverting the field of view ; memo to self – prepare a periscope) ; the assistants were briefed on (ready-prepared) drugs to inject in the event of the (ehemm) “surgical team” losing consciousness. The operation took 2 hours, and the surgical team commended the assistants for their “stamina and presence of mind”.

  2. I seem to remember hearing a story about an American doctor who was ship-wrecked and at sea in a lifeboat in the Pacific towards the end of WWII. There were several others in the boat as well and he removed his own appendix and survived. I suppose having others around you would help ease the anguish, if not the pain,but Jesus H. Christ !!!!

  3. Thank goodness he diagnosed himself correctly!

    Courage, youth, knowledge, skill, appraisal of odds, and an astonishing ability to focus/to be in the moment worked together to his advantage.

  4. In the 2003 Royal Navy drama “Master and Commander”, Dr. Maturin, the Darwin-analog character in the film, successfully operates on himself. While cruising among the Galapagos, he is accidentally shot on board the ship. He is taken ashore one of the islands, where he successfully removes the bullet and clothing debris from his wound. Perhaps the scene was inspired by Rogozov’s experience. (Maturin was played by Paul Bettany, who went on to play the actual Darwin in “Creation” six years later.)

    1. Yes. But there is a glaring problem with the sugury performed by Dr. Maturin, a problem that really bugs me – when you open the chest cavity there is no longer vacuum created by the diaphragm or by expanding the chest. Or in simpler terms you can’t breathe. You have to use artificial ventilation when operating on an open chest cavity. So aside from all the other issues about pain when doing open heart surgery and the problems of using a mirror, Dr. Maturin could not have operated on himself with the chest cavity open because he wouldn’t have been able to breathe.

      1. It is just a film…

        … however, Patrick O’Brian, who wrote the books on which the film is based, generally wrote by fictionalising real events, at least in the early volumes. The earlier scene where Maturin performs a craniectomy to relieve pressure on his brain comes directly from the first book which means it probably really happened at some point in the history of the Royal Navy.

      2. I remember the scene as being a front abdominal wound. Intercostal/diaphragmal breathing should be possible. Many people are chiefly abdominal breathers but they should still be able to breathe ‘from the ribs’ for the duration of such an operation if the diaphragm is not punctured.
        Another anaesthetic possibility is that of a spinal anaesthetic (novocaine would do) which would have removed all sensation below the vertebra concerned (also paralysing the legs for a time). It should remove the pain at least. Once through the abdominal wall, the pain sensation might be less than imagined.
        It would of course require a certain level of courage, but the alternate prospect, of dying slowly and in pain of peritonitis, could also be a stimulus. One offers a chance of survival, the other is almost guaranteed to prove fatal.
        No easy choices. Only one option really.

      3. “It is just a film…

        … however, Patrick O’Brian, who wrote the books on which the film is based, generally wrote by fictionalising real events, at least in the early volumes. “

        “I remember the scene as being a front abdominal wound.

        Indeed, the film did change it. I was thinking of the scene in the book, and failed to note the distinction. I’m guessing the film changed the scene to make it more plausible than the original open chest surgery. The original is in book “HMS Surprise” where Dr. Maturin was wounded with “the bullet right under the pericardium – flattened and deflected”. He operated on himself,”‘You will have to raise the rib, M’Alister,’ said Stephen. ‘Take a good grip with the square retractor. Up: harder, harder. Snip the cartilage ‘”

        Yes, he’s *talking* the whole time he operates on his open chest in the book. Sigh…

        As the the Russian, he’s hard core for real. I just can’t imagine it myself. I couldn’t bring myself to watch the movie about the guy who cut his own arm off, either. Shudder.

        1. Watching James Franco saw his arm off in 127 Hours wasn’t all that bad because you know from the start that the actual guy lived to tell about it. Plus I had to see it because i’ve hiked right near there, though not in the actual skinny slot canyon he fell into ( thankfully).

  5. This reminds me of the Mad Magazine Final Exams.

    For med school: Remove your own appendix. You will find a dissection kit under your seat.

    The other one I remember was Sociology: Discuss the social implications of the end of the world.

    There were several others, too. L

  6. Courage and desperation can spurn amazing action. Reminds me of Aron Ralston who cut off his arm with a dull knife when it was trapped by a boulder.

    1. I’m thinking of an associate who scuba-dived out of a cave crawling on a broken knee and a broken arm for the above-water sections (5 separate sections), while the intervening 4 diving sections he had the joys of trying to hold his gag in place with a broken jaw and smashed teeth.
      Obviously,there was no room for anyone to assist him, except on the very last section coming out to Moonlight.
      “Well, it was that, or die.” was his summary of the situation. Focusses the mind, just ever so slightly.

        1. A friend of mine cut off his own hand. It was trapped when his tractor rolled down a hill with him in it at the back of his farm. His wife was away, so he knew no one would find him. He’s always extremely phlegmatic about it. Needs must and all that.

          The Russian doctor was clearly one of those special people imo. Most aren’t even capable of wintering over in the Antarctic – he just gets on and removes his own appendix.

    1. And I thought my dad was a badass for removing an appendix through the vagina in rural Alaska. (decades before it was reported in the literature, BTW.) Not even in the same league as this stuff.

  7. Incredible story!

    I do remember Jeri Nielson’s story, and am sorry to hear the coda.

    As Jerry knows, my appendix did perforate about three weeks ago, and had I been anywhere near knives–or perhaps, had my fingernails been sharper–I’d have been quite tempted to tear it out myself. Instead I chose writhing on the couch while waiting for the ambulance…

    1. Oh poor you. I had appendicitis when I was a kid but it cleared up on its own. Looking back, it’s a good thing it did because I never even went to the gut doctor until a week of pain had gone by. I guess my parents thought it was a virus. I don’t remember the exact pain but it was close to the worst pain I’ve ever had.

      I’m also highly irrational in the face of pain. I don’t like dealing with it. I will tolerate it if there is an end in sight (my dentists are always telling me to tell them if something hurst because I don’t have to endure anything but I remeber dentists in the 70s who yelled at you if you spoke and whose assistants held you down hard before you even got s chance to move. Yesterday, during 5 hours of root canal work, I maxed out on the freezing then got a prescription for the pain after. I hope you got some nice meds post op!

      1. Sometimes the anaesthetics work better than others. During the first of my two root canals, when I was in my 20s, the stuff just didn’t take, and when I told the dentist I could feel everything, he yold me it was in my head. I said yeah, in my teeth! Finally convinced him to give it another try, as much as I hate novocaine needles. 2nd shot worked thankfully. Idiot dentist!

        1. I had a similar experience in ’74 when I was only 16 years old. The dentist was standing on a nerve while wearing spikes, refusing to believe I could feel anything. I thought it was a tough day, but now I realize not so much.

        2. Ugh. I have learned not to take crap from dentists that don’t consider your pain. I go to a really great clinic now and they make the patient the priority (go figure). They also have lots of different stuff to give you if you react badly (some give me the shakes) or it doesn’t take. They also don’t willy nilly prescribe narcotics. I’m surprised some of my friends get Vicodin for the smallest of procedures.

          1. I nicknamed my childhood dentist “The Butcher”. I sometimes think he watered down his Novocaine. Or he was similar to the dentist from the movie Little Shop of Horrors. (A sadist)

            I went through four dentists in the last four years looking for dentists that consider my pain, use science based evidence and wasn’t constantly trying to push high end procedures and cosmetic enhancements. I stopped going to the second to last because the hygienist loved her sonic scalar and was perhaps the most painful cleanings I ever had in my life. She went on vacation and I realized it wasn’t me, it was her and her damn sonic scalar.

            The third to last was always giving the hard sell for expensive cosmetic work, and every single bill wound up having significant charges not covered by my very good dental plan which had only rarely happened before. I switched dentists and it stopped.

          2. Yeah, good dentists are hard to find. My childhood dentist was bat shit crazy. When I was 3, I had to have a tooth removed. I remember for some reason during the procedure, he just went and stared out the window. I was a fairly quiet child so you can imagine, when I asked him a question (don’t know what it was) and he yelled at me “shut up”, he was the crazy one. I remember it really scared me because I never had an adult speak harshly to me like that who wasn’t a parent and with him being a man, it was that much scarier because his voice was much deeper.

            He also never let my mother be in the room with me and with her being young and new to the country, she just thought she should listen to him. I often tell her that I hope I don’t have repressed memories of more sinister things he did to me.

            I still have what is called an “amalgam tattoo” in one of my gums because of his sloppy filing work on a baby tooth.

            Fortunately for me, he went totally nuts and took off without warning to go live in Florida. Or maybe he was fleeing the authorities – he seemed dangerous enough to have done something bad.

            I too used to fear cleanings since all the hygienists I had hurt me. When I found my current dentist group, I asked to be frozen during cleanings. But then my hygienist convinced me to try without freezing & I learned that getting your teeth cleaned shouldn’t hurt & that normal hygienists don’t put you through agony!

            I too feared dentists up-selling you on procedures you didn’t need and was so afraid of this, I went to non profit dentists where students worked on you. Students even removed my impacted wisdom teeth, all with freezing only. I confirmed this dastardly behaviour when I worked in local government and helped with dental technology. The people there knew of all the dentists in town & which ones pulled this crap. So glad I found a good group of people!

          3. I’ve got a wonderful dentist now, although he had to retire early because a piece of ceiling fell on his head at Disneyworld (don’t think it was in It’s a Small World)and his neck was too sore to stand for all those hours. I think he got very little in compensation from Disney…The replacement he got (dental school buddy) is very good, too. My previous one took off with no notice to any of his staff. Maybe dentistry makes one prone to mental illness because people hate you so much. I did see some stats once that dentists have a higher than expected suicide rate.

  8. I’ll add that lidocaine has been around since WW2, and the prototypes novocaine and cocaine for much longer, so yes, local anesthetics would have been available.

    An open surgery like this would be made easier with local anesthetic, although obviously it would not be completely pain free. Cutaneous pain at the skin level can be virtually eliminated with lidocaine, as well as most of the subcutaneous and muscular pain, but the visceral pain at the peritoneum and bowel itself is harder to abate with lidocaine. Visceral pain is different– it’s a vague sensation, often associated with nausea– but still quite debilitating.

    I know this because in obstetrics there are (rare) cases even today of C-sections done under local anesthetic when there is fetal distress and no anesthesiologist available. Fortunately, in my 20 yrs I have not had to perform one, but colleagues have and report that it is possible although made difficult.

    The other issue is muscle relaxation, an important part of any abdominal surgery, which certainly would be suboptimal using local anesthetic. Even with a good spinal, muscle relaxation often is poor. I have done many c-sections with poor muscle relaxation and the issue is that as the abdominal muscles involuntarily tighten in response to pain, the patient does not feel it but the muscles push all the intestines out of the incision making it difficult to close the wound.

    Also of note is that I totally understand that these expeditions take a physician for the sake of the scientists, but I wonder at what point the physician realizes that there is no physician for him! (or her). Lol.

  9. From the aviation perspective, the problem of access in the winter is cold, not darkness. The workhorse for air transport in the Antarctic is the LC-130 Hercules. It is only rated to -40º. They had to wait almost until spring before going in to get Dr. Jerri Nielson out.

    On the other hand, the de Havilland Twin Otter is good to -50ºC. When Dr. Ron Sheminski passed a gallstone and got pancreatitis in 2001, he couldn’t wait that long. Ken Borek Air of Calgary was able to get in with his replacement and take him out with a Twin Otter, though not without difficulties.

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