When the measurements change

I must get inspired for the conversation. For that I need to find something interesting, something virtuous in the biography of the hero of my review. Just with these expectations I read his biography. <<The chief of Neurosurgical department of the Central Military Hospital of Ministry of Defense, candidate of medical science, captain Arman Hakobyan was born in doctors’ family. He graduated from Yerevan state Medical Institute after which he graduated Saint Petersburg’s Postgraduate Academy. A year later he defended his thesis on <<The Treatment of Hemorrhagic Insults>>. It is clear. He has a classical biography. Witnessing his parents’ humanitarian work he had dreamt to become a doctor since childhood.

I didn’t like the school. According to my Mother learning meant to learn excellently, best of all. But I got satisfactory marks. It was difficult to make me do something. My father was a psychologist and my mother was a psychiatrist and they both realized that I must find the way of life myself and the only right thing to do was not to disturb me. I had a fame of a disobedient pupil. I wasted my organizational abilities to incite disorder and conflicts of interschool scale. However, to fly in parachute from the height of 1.000 meters was more pleasant than even the most successful disorder at school. I was 14 when I last flew after which I always dreamt of flying. God created the human and gave him ability to walk. While flying you get rid of rules of nature. Moreover, you dictate the nature the rule of your will.

Nevertheless, Mother could make her son dream of what she dreamt. She did it so gently, so imperceptibly that the boy did not even doubt that he was being directed. His mother was a psychiatrist and his patients were people whose <<perception of world differed from others’>>. So, the Body-Psychiatry department (the first in Armenia) created in Republican hospital by doctor Gayane Margaryan’s initiative and efforts was a step to destroy the wall differing the worlds of extraordinary and ordinary people (sick and healthy people).

I went to the medical Institute with the intention to become a psychiatrist. I would lie if I say that I was excited with that idea. Until I was in the fourth year I enjoyed the student’s life completely. In the fourth year the practical stage of studies started. In hospital I saw doctor-patient relationship. I saw a human helping another human. I saw a human become the savior of the other, I respected that profession and decided to become a doctor.
I had good progress at Saint Petersburg postgraduate academy. I already had an aim and it was something like flying in parachute. If I have decided, if I need it, I must fly (even from the height of 1.000 meters). Very few people can defend the thesis one year after graduating from the academy. I had chosen neurosurgery as it was one of the least studied branches of medicine. It requires creative work, improvise, it requires a big risk, there is a mystery in it.

Once I was asked what the years of studying at the academy gave me. I thought I would speak of professional skills, knowledge. At that period the most important achievement for me was the fact that I discovered the formula of being strong. (I always wanted to be strong. Before that I thought doctor’s profession was a demonstration of own strength and excellence). I understood that the strongest person is the one who can not only rise but also raise others. The one who can not only be respected but also respect others. This is the biggest lesson I have ever had in my life.

And the moral codex of the doctor became complete step by step, drop by drop on the way of his own experience, emotions, achievements, mistakes, failures and successes. It became a creed, a lifestyle…

In Saint Petersburg one of my supervisors (a famous specialist) told. <<The monkey can also be taught to operate, but first of all we must teach when there is no need to operate>>. The operation is a craft, a manual work. Nowadays the result of the operation depends on technology, modernity of medical equipment. The patient recovers more easily and earlier when he is confident that he will be cured, when he sees that the doctor does his best for him to get over the illness. On Sundays I usually go to hospital and visit every ward. The patients understand that they are in the centre of attention, that the doctor is with them and they are inspired by that idea. The inspiration is more powerful than the operation and other pills. It is the doctor’s attitude towards the patient that turns a craftsman into a doctor.

After graduating from Saint Petersburg Postgraduate Academy and defending his thesis Arman Hakobyan returns to Armenia and after working in Republican hospital for two years he starts his service in the armed forces appreciating the exclusive value of the army, he has come to the army to contribute to the formation of the army.

I didn’t come to the army by my own imitative. I was recruited when it was decided to recruit the candidates of science. I continued working for the armed forces because the army’s medical service was equipped by the most modern equipment and we could provide a high-qualified medical aid. As for neurosurgical department, it has the most modern technology. (The civil hospitals of Armenia can’t have that level in coming 10 years). This kind of equipment is exclusive in the region, as well and it gives you the opportunity to do the most invasive neurosurgery, to do such hard operations as endoscopic removal of intervertebral cartilage rupture in case of vertebra disease and filling them with bone cement and so on. I have had numerous trainings abroad, I have worked with European leading surgeons invited to Armenia and I can say confidently that the neurosurgical department of the Central Military Hospital of Ministry of Defense meets the highest standards with its equipment and quality of health care.

The army’s medical service is in the new stage of its development where the military medicine is not regarded as a battle field medicine. Following the experience of the developed countries it is likely to become the most developed and leading structure of country’s medical system. Diagnostics, X-ray diagnosis, neurosurgery, blood transfusion, resuscitation…the army’s medical service has no competitor in Armenia in these and a number of other directions.

As a doctor I have a great feeling of self-satisfaction as due to the modern equipment I can use all my skills, go parallel with all the developments. I will not feel calm if I know that there is a method which can have positive influence on the results of neurosurgery and we are not able to apply it.

I think he didn’t tell the most important thing. Something that will give you a chance to understand what the doctor feels before entering the surgery, when all the indices, as he says, are against life or the probability to live is very small. What feelings does he have when anyway he manages to win…

You should not allow the patient to become the pivot of your life. Your mind shouldn’t be busy with the operation you have done or you are going to do while you are at home, in the street, receiving guests or having a fun. The neurosurgeon is a person who lives in the boundary of life and death, whose life is an endless chain of challenges. For neurosurgeon the risk is a professional debt. (If there is at least one percent opportunity to save the patient we use that chance). I cannot explain what the doctor feels when he tells the patient’s relatives «I am sorry. I did my best». I cannot explain what the doctor feels when there is nearly no chance for the patient to live but he comes out of the surgery victoriously and just at that time all the hesitations retreat. The doubt «Was it worth to live so hard» becomes absurd and ridiculous.

I don’t ask a new question but the surgeon fluently changes the subject of the conversation. And this ending reflects more precisely the image of the soul of the person who lives on different poles.

While studying in Saint Petersburg one of my professors had a heart attack and it was necessary to move him from one hospital to another. However at that difficult time for him none of his relatives was with him. We – his students were his only relatives. I haven’t seen more tragic scene than the one when a person is left alone, helpless and without any appreciation.

When a person does not struggle for his life, when he does not want to live, you need big efforts to save his life. However, there is also the opposite version, when the patient does not want to give up, does not lose the great wish to live, a miracle happens. He lives despite all the calculations against him.

I have a daughter. She is 12. She is an extraordinary girl. She is not like other girls of her age. She writes poems. She has published a poem entitled «The argument of Poets», she takes part in «Greens’» movement. I must spare more time for her, to be closer to her feelings, dreams, concerns and aspirations…

The time that I spend on hospital is untouchable. If our hospital is repaired it will become the best hospital in our republic. It is a great luck that I serve in the army and I don’t have to think of the income that this or that operation could bring to hospital. I don’t have to count the efficiency of medical service. When they start to count the incomes the medicine gets a huge moral impact. Unfortunately, as a result of it the patient is affected.

Recently I operated a soldier. I inserted an implant of 8.000 Euros in his spine. The patient returned to life. So, besides being happy about the fact that he had recovered, he was happier about the fact that the state had not left him alone, he was protected and appreciated. If there is a necessity, he will go to the battle field with the implant in his spine. He was so enthusiastic and powerful.

If there wasn’t the neurosurgical department of Military Hospital our patients would have to leave for a European country and spend 50-60 thousand Euros to get such kind of medical service. The officer and the soldier being on the border must be confident that their family members’ h
One day I will fly in the parachute again. There above the sky the measurements are different. Then you look for these measurements on the ground for all your life.