In a life-or-death situation, human beings are capable of incredible feats of bravery and self-control. One of the most remarkable ever recorded was that of Leonid Rogozov, the medic at a Soviet Antarctic research station who was forced to remove his own appendix. I write about the incident at some length in Extreme Fear; to my delight, I've discovered that Rogozov's son has recently published a paper providing even more details on the case. The more I learn, the more incredible it seems.
During the late ‘50s and early ‘60s, the Cold War took on new and more literal meaning as the Unites States and Russia expanded their rivalry into the heart of Antarctica. For the small crews eking out the winter in remote stations were more isolated than if they had been in outer space: once the winter darkness descended, they would be completely isolated for months, with no way for anyone to get in or out.
Rogozov, then 27, had come to Antarctica in 1961 as part of the Sixth Soviet expedition, which established his nation's third base on the continent, the Novolazarevskaya Research Station. On April 29, with the autumnal nights quickly getting longer and a fierce storm raging all around, Rogozov began to feel ill. He woke up that morning feeling lethargic, and got weaker as the day went on. He became more and more nauseous. A faint pain in the upper part of his abdomen grew and shifted to the lower right part of his belly. He started running a fever. The diagnosis was obvious: he was suffering from acute appendicitis. Left untreated, the infection would weaken and swell the lining of his intestine until it catastrophically ruptured, flooding the internal cavity of his abdomen with feces and pus and swamping his bloodstream with toxins. Death would be inevitable, and agonizing.
The new paper by Rogozov's son quotes the elder's diary:
"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."
Rogozov took medicine to fight the infection, but the next day his condition deteriorated. His fever soared and he vomited repeatedly. The pain was getting worse. He knew that conditions were ripening for a fatal rupture. "An immediate operation was necessary to save the patient's life," Rogozov later wrote. "The only solution was to operate on myself."
The doctor had no evidence that such a feat was possible. If he failed, he would certainly die. To get him through, he would have to rely on nothing more than local anaesthesia and willpower fortified by necessity. Gathering the other members of the station, Rogozov laid out a plan. Two atmospheric scientists would be in charge of sterilizing the surgical equipment. A driver would stand next to the doctor during the operation and hold a mirror so that he could see inside his abdominal cavity. A meteorologist would hold the retractors to keep the incision open. Rogozov showed them how to inject him with drugs in case he lost consciousness, and to administer artificial respiration.
The operation began at 10 o'clock at night. Rogozov, dressed in a surgical gown and mask, lay inclined on the operating table, angled to the side so that most of his weight was on his left hip. First he injected a solution of novocaine, a local anaesthetic, into his abdomen just above the infected appendix. Once the painkiller took effect, he asked one of assistants for a scalpel and made a five-inch incision. Working by feel, he cut through skin, muscle, and fat tissue, and then used the mirror to watch the knife as he came to the delicate business of exposing the peritoneum, the membrane that surrounds the internal organs. After half an hour he felt weak and dizzy, and had to stop for a rest. Pressing on, he located the appendix, a thumblike projection from the intestine, and found that it had developed a perforation an inch across.
One of Rogozov's colleagues wrote:
"When Rogozov had made the incision and was manipulating his own innards as he removed the appendix, his intestine gurgled, which was highly unpleasant for us; it made one want to turn away, flee, not look-but I kept my head and stayed. Artemev and Teplinsky also held their places, although it later turned out they had both gone quite dizzy and were close to fainting . . . Rogozov himself was calm and focused on his work, but sweat was running down his face and he frequently asked Teplinsky to wipe his forehead . . ."
Cutting out the diseased tissue, Rogozov doused the surrounding area with antibiotics and sewed the wound shut. The whole operation had taken a little less than two hours. Rogozov's willpower had pulled him through. He had survived.
Afterward, Rogozov looked back on what he had accomplished:
"I didn't permit myself to think about anything other than the task at hand. It was necessary to steel myself, steel myself firmly and grit my teeth. I was scared. But when I picked up the needle with the novocaine and gave myself the first injection, somehow I automatically switched into operating mode, and from that point on I didn't notice anything else."
At first, the doctor's condition was quite poor, but as the days went by he improved quickly. After five days his temperature was back to normal and the inflammation in his belly had subsided. A week after the operation he removed the stitches, and a week after that he was back at work. A photograph taken after his recovery shows his seated on a snowbank next to a penguin, smiling and looking hearty:
