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Kiev - El Cirujano Ingles — Transcript · YTtoTranscript

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Kiev - El Cirujano Ingles

Viento del Este · 6,676 words · 33 min read · EN

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Below is the complete, readable transcript of Kiev - El Cirujano Ingles by Viento del Este on YouTube. Read the full text, copy any part you need, or generate a transcript for any video with our free tool.

It's very difficult to take a step forward. It's difficult because you don't know if you're being brave or reckless, when you're being prudent or a coward. [Music] The English surgeon, ah. [Music]

[Music]

I like the smell and feel of wood. It's a very pleasant material to work with. It's great when you start, especially with a rough piece of wood, and you have to plan everything. You start with some boards and in the end you get something beautiful. In this case, I'm making a simple packing crate,

but I've always liked working with tools, using my hands. This is for shipping five defibrillators and an operating stool, which I've sat on to perform thousands of procedures over the years. So Igor can sit on it and it will still be useful in Ukraine. It's a good idea; nothing goes to waste. He

comes and each time brings new ideas and new medical supplies. They're medical gifts, some instruments and screws, things like that. But when we got to know each other better, I understood that this isn't medical cooperation,

something much deeper, and we're very close. His role in my life is that of an older brother.

[Music] It all started two years ago. [Music] I was Outside, I was gardening when suddenly I felt a pressure that kept getting stronger.

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I felt very weak and lost feeling in my body, starting in my head and arms, then down to my legs. I tried to scream, but I collapsed. It went black. [Music]

[Music] [Music] It stopped,

but

now I have to face it. Before, I never thought about my life; the days just went by. But now I want to live. I

first went to Kevan in 1992 when I was asked to give some lectures on neurosurgery. When I was there, I visited one of the public hospitals and was horrified to see a completely broken, bankrupt medical system. I was seeing medical problems that hadn't been seen in the West for 50 or 60 years. It was

like stepping back in a time machine. I remember talking to a Ukrainian doctor to whom I said, "I would like to help." He said, "It's a waste of time. Anything you do is a drop in the ocean. I would have to change the whole system. Go away. You can't do anything." Nothing, but I felt the opposite. No, I couldn't

accept it. I couldn't forgive myself for having seen so much suffering, and I was sure I could do something to help. The next day, by chance, I met Igor. He's

my favorite cranial group, the Cossacks, and we can compare them to neurosurgeons. There are many similarities between us because they rejoice in having won the battle, just like us, after a successful operation. Because Igor was exceptional and very determined, he was questioning the official ideology about the practice of medicine as he tried to do things better.

Logically, he had endless problems. He received death threats. He even had to sleep in a different room every night. God knows how many times his department was shut down. He was fired along with his entire team. He had to go through several investigative committees. I could have abandoned him, but I decided to support him. I brought him

to the West and told him, "Look, a brave new world full of wonderful things and modern equipment." The tougher his enemies and professional rivals were, the more obliged I felt to help him.

[Music] [Music]

I hope God uses Henry's hands to give me health and lengthen my life. [Music] There's a light out there. Okay, Patrick, start with the Head position we discussed, perfect. Where's the light? Ah, you have some punches, they're 103, Mr. Mars, but they're what, 100 pounds, 103, come on, that's what they say, 3 cu c. Thank you. You're welcome. Thank you,

I'll go put them in my bag. How many times have you told me you did three, three alone with some assistant, no, with an assistant? Perfect. Well, as it 's an elderly person, there should be a lot of space. I have a very specific approach. I would put it like this. Look, it will be a little more. Yes, more, you'll see you

can get in.

I suppose you use disposable punches. I'm trying to get them back for my friend Igor in Ukraine. Well, the plastic piece needs to be changed. I'd prefer to do the operation myself.

That's perfect. I think you can open it now. Today after Mass there will be a collection for a young man who has to undergo an operation soon. The Masses on Monday, Tuesday, and Thursday will be offered for his health. Wednesday, Friday, and Saturday will be dedicated to the Souls in Purgatory.

[Music]

'

[Music]

I thought it was in the heart, no. The tumor is not in the heart, it's in the I had something similar in my heart. Very lucky.

[Music]

[Music]

and [Music]

The most complicated thing about neurosurgery is knowing when to operate. The interventions themselves aren't that difficult, but the real difficulty is weighing the risks of operating against those of not operating. It's

like Russian roulette. We have a revolver called treatment or surgery and another revolver that implies not operating, and for the patient, that's how it is; you have to decide one of the two. Marian's epilepsy is caused by a tumor that will eventually kill him if it isn't removed. In Ukraine, they've told him it's

inoperable. I think I can save him, but during the process there's a risk to his personality, his intellect, or his ability to think. That's the kind of risk we're considering.

Stanislav Petrovic has been a great support to me since my childhood. There are very few people like him, but fortunately, they exist.

I try to fill out my work plan, but every time I log in, I have a different password. Good morning. I'm Igor Petrovic. Hey, can you do me a favor? I need a brain scan for a boy. I'm supposed to have that I write down where I am every minute of the day as if I

were at school let's try it Wednesday pass room says you can put more than one activity I might do that during the but it only lets me put one can see you within a week or can do it today but will charge you double Friday administrative meetings I should n't have to justify myself this way I

'll try to change it Damn it an improper operation has been initiated will be kept [ __ ] I can't I can't stand it seriously on something else son

no good luck good luck I

'm Henry Hello Look I'm checking the MRIs of the guy from Solov or wherever near Lev the possibility of a craniotomy When I see him I'll try to assess whether he can handle it if he'll find it very stressful or not Having holes drilled in his head The noise of the saw is very loud and quite violent you have to

hold your head very tightly everything else is going well and the plan to go to Jodoc to see Tania's mother is fine Friday it will be 13 degrees below zero during the day I'll really feel like it's winter there [Music] I'm taking some old instruments that I There are plenty of things for Igor.

I'm going to show him some very complex operations he's never done before, but what I think about most is going to see Tania's mother. You might wonder why. Because I want to see the mother of a girl who died several years ago. I've had many patients who have died, many of them children,

but I want to go see Katia. I often think about her and how... I suppose it had a lot to do with hopes, with expectations that weren't met. I clearly remember the moment I met her. She was dying when they told her to come into the consultation room. She was beautiful. Her face was

asymmetrical because half of it was paralyzed by the tumor. How can you watch a girl slowly dying from a brain tumor that, in theory, is curable because it's not cancerous? How can you do nothing? How can you tell her to go and die? You decide that despite the risk, despite the cost, you have to do something.

Hope is much more important than anything else in life, and as Katia told me, you gave us hope. It's wonderful to be able to give it. They said Tania's tumor couldn't be operated on in Ukraine, so I brought her to London, but everything went wrong during... The first operation, Tania lost up to four times her

blood volume. It was a terrible operation, but in the second intervention, when I had to remove the rest of the tumor, things ended catastrophically. Because of my operations, her last two years of life were terrible. She was left paralyzed, disabled. It couldn't have gone worse.

[Music]

Men

[Music] Today Henry arrives, and our favorite topic of conversation is: What is the meaning of life? What should one do? Should one become a teacher or a public health minister? Is it better to be a good doctor? Just be a good doctor, see the patients every day, listen to them, try to help them?

You're going to give him a check-up. We'll give him a general check-up to make sure everything is alright.

This young man is our patient. Henry

will be responsible for his operation and discounts. Maximum discount. I'll do everything possible to make it free, but the staff also need their salary. Let's see what we can do because they are very poor. Please come here.

Henry Mar doesn't have to be paid anything because he doesn't charge, but the hospital expenses, the bed, and the room do have to be paid. He arrived this morning. Yes, the plane lands at 2. So we'll be here around 4 on New Year's. He told me I'd meet him. Yes, come back at 4. Okay, very well.

We'll have to do an MRI.

Surgery is very risky, but neurosurgery is 100 times riskier. Mar has come to our clinic and is more or less okay, but he could be totally disabled tomorrow or the day after. It would be the wrong decision on our part. It's a moral responsibility, a huge responsibility. Tired? Tired a

little. Why are you tired? I got up at 2:30 in the morning in London. I came via Vienna. Why did you choose Vienna? Because there was a strike. I have a few things for you in there. Seriously, quite impressive. If everything is perfect, I mean, everything works. It's amazing the amount of stuff that gets thrown away. You wo

n't believe what I've brought you. How are you? Well, quite well. I like coming here. I like getting out of the public health system. In England, it's like this. Great. The ambulance? It's an ambulance. How's your old car? It'll take about two months to repair.

You said they're investigating you again now at the SBU hospital. What happened in the end? The usual, more or less. It's normal to be investigated in this country. If you're successful, it means your life has to be complicated. Difficult. In English, we say that if you stick your head above the parapet of the

wall, it's because

you have to take this to them and give them this form. [Music]

Although I've been to Ukraine several times, it's the first time I've seen the ice. It's exciting to see it like this. It's beautiful, and it's going to be much colder this week, right?

[Music]

I suppose one of the strangest and most ironic aspects of working with Igor is that when we first met, he was a victim of the dictatorial Soviet medical system. Now, 15 years later, he runs a humanitarian clinic with rooms rented from a KGB-run hospital.

The explanation is that things have changed a lot in Ukraine. The country is a democracy, and the KGB supports doctors who want to take Ukrainian medicine toward a new future. Everything's fine. Yes, they have karaoke for the staff at midday. [Music]

I'll take off my coat. I've been doing this for 15 years, and I still find myself in a corridor full of people. Most will have to go through Terrible operations for M is terrifying in some ways it's a shock. Hope in many cases there will be disappointments and hopes in coming here. These are the things you asked me for. I think what I've

brought you will be of interest. Here are a few disposable drills, each one is worth 90 euros and they are thrown away after one use. I'll take them all out for you to leave here. Here's the stimulator to wake you up from anesthesia. I have to take it back to London. This is

the cortical stimulator and special drills. Yes, they're all here. These are the parts of the craniotomy drill. A good toy. It's great, very good. This connects here, you see. Thank you very much, Henry. Well, could I have a coffee? Igor Petrovic, Tamara, maybe we should start seeing the patients. If not, Henry will spend the day playing with

the instruments. Passive bag. Thank you. Everyone

will have a visit. Everyone is equal. People will decide who goes first and who goes second. I have to do it. You're next. The queue is fair. You're next. Come in and sit here. Chordomas destroy bones. This can't be a chordoma if it is. You were talking about it. He says his tumor seems

benign. I was told the opposite. Are you okay? I'm

glad. In your case, it's the only option. People are waiting outside in the queue.

[Music] He's one of the children in his family.

I would say this tumor isn't operable because it's in the brainstem, in the pons. I'm sorry to say I think he has less than a year to live, but obviously, as parents or grandparents, there's

something you can do. In my opinion, there's nothing you can do but wait for him to die.

Life can be very cruel.

Thank you. I'm sorry, thank you very much. I'm sorry to have bothered you.

[Music]

[Music] I wasn't in the queue. No, I wasn't in the queue. Um, um,

you told me you would see me today, the first doctor. Here's the report you asked for.

[Music] Without surgery, he will surely die within 5 years. Operating is safer than not doing it because he will continue to worsen over time. All these cases would be operable in London. No doubt, there are risks involved, but I would feel quite safe. I would be quite sure that the risks of treatment and

surgery would be less than not operating. We translate this same situation to the circumstances here; things change, it's very difficult, much more complicated to know, that's why it's so frustrating. There are always people we can save.

So you're looking in my country, we call it an adjustable clamp. I've bought many things for the clinic at this site, for the hospital. It's

better quality than the other one, it's better finished, the metal of the screw is much better. I wish I knew the measurements. Did you buy drill B at a place like this? Do they have the 24-volt cordless one? No, no, the cordless one doesn't have enough power, right? Our goal is to achieve two things,

as we've discussed. First, we have to remove the tumor to cure your epilepsy. Absolutely nothing of the tumor can remain in your head. The problem with trying to remove the entire tumor is that there are risks, some danger. The operation could leave you paralyzed on the right side. The tumor is on the left, and that

part of the brain controls the right half of the body. The risk of causing paralysis in the right arm and right leg when removing the tumor... But there's a problem with performing this procedure in Ukraine. Normally, we give the patient general anesthesia at the beginning to open up, to do the... An incision in the head and opening the

bone. Then we wake you up and remove it. Here it's very complicated and we don't have the special medications or the highly qualified staff to do this operation. So we thought it would be much simpler and there would be a greater chance of success if you were awake during the entire operation. You'll have a better chance of success in the

procedure. Awake, I

think it will be good. We make the operation safer because the surgeon feels much braver. What I do is because I can see you and talk to you. I can ask you to move your arm or leg so we have a better chance of successfully removing the tumor. If you're under anesthesia, we can't

check the movement of your arms and legs. There will be about 10 minutes. Not painful but unpleasant. This is the moment when Dr. Cilet opens the skull bone with the saw. It makes a lot of noise and you'll feel the pressure of the drill on your head. It's uncomfortable but nothing serious. The only part of the head that feels

pain is the skin. That's all. The brain doesn't feel pain somehow. Interestingly, removing a brain tumor with local anesthesia isn't very different from going to the dentist. I think we can do it. I mean it from the heart. Okay

When do you want us to operate on you? The sooner the better. Well, we have a plan, but the most important thing is to put it into action. Yes, making plans is Soviet. Yes, the Soviet public health service does nothing but make plans, but making plans is doing nothing.

It's a new type of surgery that has never been practiced in Ukraine. He explained everything to me. The part with the drill won't be painful, but it will be very noisy. I have n't had any catastrophic results in Ukraine yet, but sooner or later, if you don't take risks, you don't achieve anything, I

suppose. And even if you tell your patients there are risks, they never want to take them. If you are kind to them, they will trust you and believe that everything will be fine. That's human nature. We all think, "That wo n't happen to me." He 's optimistic. The best thing is to be strong, may the

Lord protect you, but you also have to trust the professor. Yes, trust him.

Performing risky surgeries means losing your job and facing obstacles. Four years ago, I was unemployed for two years. It was crazy, but I didn't have a job in this country. I think trying puts you in a very difficult position because they don't offer support, and many people try to stop you. If you don't achieve good results, it will be

much easier for you to have Serious problems because you'll be left out of the system. But if Ukraine keeps exporting the most capable and intelligent people, as we've already done with 7 million people, it will be a disaster for this country.

Ready to eat. We'll be with this for 10 minutes if you like. I want to take a look at this drill. I'm sure we can use it many times. Maybe you could make a metal sleeve for it to fit. You say your mechanic died of a brain tumor. Wow, he did some very

good work. He built your operating table. This too, right? And the bar to sit on. This is his too. It's very good. What a shame because he did it too. We'll need a couple of retaining screws. I was calculating and it's incredible. My department spends about €45,000 a year on this. We use

10 a week. It costs €0 each. At least 10 a week, that's €900 a week. Times 50 is extraordinary. I use one for 10 years. Yes, I know. [Music]

You have the compressed air hose for the fan and it fits well. I've fixed it very well. We'll try it. Goodbye until tonight. Good luck. Thanks.

You like my idea? It's great. In England, I'm not the one who connects the We have someone else who does ventilation. You run the whole hospital. My job is to perform the operation. You 're privileged, privileged. I

have to take care of everything.

Go to room 21. Can you come with me to my office? You're going to have surgery.

[Applause] Who's going to watch? Let's get this straight. Nobody should be standing in front of the door. I don't want anyone here. The most important thing is that you all remain silent. Please hand out these chocolates so everyone will be quiet. Please, I beg you.

Karinca Kinca. Can you look towards us? Can you see the light? See the light shining in your eye? [Music] What? You say yes? And now you see light? No, you don't see the light. I think it's the end. We have time. It's not too late. When they're completely blind, it's too late. We have to operate on the

intracranial pressure before they lose their sight completely.

It's a typical problem of Here, because often the diagnosis is late. By the time a scan is done, the brain is already damaged, and even people with benign tumors have gone blind or suffered irreversible damage. You can have an early diagnosis if you have more machines, but even then, the test costs between 35 and 70 in Ukraine. For many

people, that's a huge sum, and they can't afford it.

[Music]

[Music] We ca

n't carry out good treatments for patients in our hospitals. How much do you think you need to start building your own hospital? It depends on the funding. Taking out a loan is possible, but it's very difficult to run a clinic if you have a mortgage, a huge debt. We 've arrived. This is the place I

dream of, right? Why is your dream your own hospital? No, it's not just a field. Well, it's a field full of dreams. This is where it will rise. Isn't it wonderful? It's exciting. This could be the decorative lake for the hospital,

so the facade of the building will be here. This is a water pipe. It's a very deep conduit, and the patient rooms will face the field. And there will be a garden, a garden in the field, in the middle of the courtyard. Wonderful! And there will be a lake. It will be situated there. It's

full of Fish, be careful, I don't know if it will be resistant, it seems quite thick to me. Are you happy, Henry? I can make one. It's very exciting, Igor. It's very important to have a good design for the hospital because they are like prisons, they are places where a small group of people do

unpleasant things to many people.

What a pleasant time, sir. [Music]

Make yourself comfortable, you will need my help. Don't worry, friend, I will be here.

I hope this day comes.

[Music] Everything inside me trembles, but somehow, I need to be able to.

[Music]

You realize that this is a very serious case, isn't it, the one we are going to work on now, Henry? It's a risky intervention. I hope the patient realizes that. The problem is that if you run a clinic that works well, nobody realizes the risk involved in the surgery. I know, but you have to tell them.

I mean, I won't do this, I'm not going to do it. They don't want to hear it. I already told them, but they answered me. You have had good results. We have asked many patients and suggested that they do, but with simpler, smaller tumors. This one is enormous. You lose enthusiasm over the

years. That's not true, it's that you keep bringing me more difficult cases. With much more difficult operations, that's the problem, that's what it's about. Every time I come, you present me with a more dangerous operation, but you told me we would progress step by step. Yes, but one day we're going to take a step

too big, damn Ukrainian Cossacks. The die is cast, let's start the operation. I'm getting a little more excited, I don't know if it's a bloodthirsty spirit or experience, I'm not sure. Surgery isn't just rational altruism, it's a very bloody activity, and surgeons choose to be so because the situation excites them in some way, it's the enjoyment of

the operation. In that sense, I think it does have similarities with the Cossacks, it's Ukrainian heroism, all that. Well, let's go into battle,

everything is possible,

Irena. Tell Mari that it will hurt a little now, like a bee sting, because they have to give her local anesthetic at home. We call the big ones bonky. They call the biggest mosquitoes bonky. A big bony is a bigger mosquito. It's a word from Western Ukraine. On this side, I'm fine, Igor. Are you okay?

How's your head? Securely held, can move, can do whatever it wants. I'll try not to disturb the doctor. No, no problem, Dr. C is comfortable there. I feel something scratching up there. Hey, like something's scratching. It keeps scratching and scratching and

scraping.

When Dr. Cilet starts drilling, you'll hear a lot of noise because the skull acts like the soundboard of a piano. It'll be very loud. [Music]

A neurosurgeon colleague did an experiment. A colleague drilled into his head to put a wire inside his skull and measure the pressure. Crazy! And he told me it was very noisy when they opened the hole in his head. I ca n't hear anything. He can't hear anything. He can't hear anything. Interesting. I can't hear anything you're saying.

No. He hears our voices over the noise. I think the 24-volt one will work better. Igor,

the battery's running low. All the holes done very well. I do n't need this at the moment. V. Okay. Let's begin the craniotomy. Do you feel pain? I'm not used to this. Used to him falling

asleep in a minute. We'll have to stop the operation if he falls asleep. We'll have to wake you up. No, no, I won't fall asleep. He won't fall asleep. He will. No, no. He wo n't. Well, now Igor is opening the skull.

Now I understand how boxers can fight for so long. Having 70 heartbeats per minute while you're lying here and they're opening your head with a saw shows great courage. We'll start removing the tumor in 5 or 10 minutes. That's the most thorough work we'll do right now. I'm tense. It always happens to me

before complicated operations. I suppose it's similar to stage fright in actors. The worst sin in surgery is mistrust, so I suppose a certain amount of anxiety is necessary, and there's always a critical moment. We can see the tumor well, but will it be easy and straightforward, or not? Well, Igor, just a moment, let's take a look.

Where is the tumor? Maybe here. Maybe here.

Thank you, Igor. Come closer and take a look. I think you can clearly see the difference. It's slightly discolored, but it's abnormal. From the MRI, we know there's a very large vein. We'll try to hold it, but I think it will be very difficult. And I suppose the edges of the tumor are like this. Let's use the

cortical stimulator. The leads go in front. The two contacts. Put them facing us. We'll put it there. It doesn't matter. It doesn't matter now. I'll place an electrode on the brain. You might feel an arm or a leg moving. Okay, very good. There it is. It's the movement. You see? Well, Mar, your hand moving is

like a puppet. All, we're ready. Look, there it is. So we're looking at motor skills. I wo n't do any more because I don't want to open it up, and we know it's safe this way because finding the movement has been easy. It's shown us where it is. And this is the tumor.

The normal brain has the consistency of a very creamy cheese, a fairly dense cheese, and the tumor makes it leathery. It's more leathery, tight, and thick. This is the tumor, Igor, a very large tumor. Irena, can you tell Marian that I've started removing the enormous tumor that has been making her life miserable for so many years? I can tell

with the aspirator that it's very firm. It's probably just the edge. All of this is part of the tumor, and it looks very good. It's clean. [Music]

Check her movements, Mar. We have to make sure, confirm that she can move the right side of her body while we continue. I know I'm not causing any damage to her arm while I remove the tumor, so I can work more calmly. Okay, fine.

Attack. He's having an attack. He's having a severe attack. Dr. Sidorenko is here. He's having an attack, a spasmodic attack. He's having an attack. What is he saying? I don't know. I can't understand him. Does

anyone want to try to understand him? I can't figure out if he's having an attack right now. You're having an attack. Could I speak to him, Dr. Sidorenko, to make sure he's okay? I have a

twinge. You have spasms in your throat. Throat. Something to drink. We can give him some water to moisten his throat. Is he

okay? Okay. Is everything okay? Does anything hurt? Or are you comfortable? The pain is gone. The pain is gone. He's okay. Very good. Great. Everything's fine. I'm glad. Everything's fine up here.

When we talk or think, billions of electrical impulses are produced that circulate through these nerve fibers, and it always seems impossible to me, even with the patient awake, to look at the physical substance that makes up the brain we are and think that I don't really understand that that is thought itself. The

feeling is crazy. It's too extraordinary, but it is. It is the most indisputable evidence of modern neuroscience. Thought is a physical process. We are our brain. It's okay. Okay. He just

moved his hand. Moves smoothly, right, Mar, I've already read. The tumor. The tumor is gone now,

okay,

dob do. [Music] [Music]

Are you tired? Not too much, no. Good night, Jena. Mr. Mars is tired. No, no, I 'm not. He's very tired, no, I 'm not. My head's freezing. That's all. I

'll bring the beer too. Domestic goddess, cardiologist, out and Goddess of the House, what a turn out. Today it was a very large tumor. So how is the patient? He's fine. Do you have any PR bottles around, Igor?

Let's go. Thank you. Now I've taught you everything I know about neurosurgery. You're a wonderful teacher. Well, you've already cleared my brain. The only problem is that we can kill patients. You can. And you probably will. That's the problem. In the conditions in Ukraine, some deaths are medically acceptable. The tumors are very large and

the conditions are difficult, but only you can decide if there are political motives. Thank you, Jena. They'll make propaganda out of the failures. To your health, thank you, thank you, Mr. Mars. Let's hope the patient recovers well. I think he will

if it's not too cold. Next week I'd like to go to Camene Polos and Jodoc. For me, it's Very important because Tania was a significant part of my life in many ways, and I often think about her and her mother. It was a lesson for us; it was a very important lesson.

Intensive care.

Well, here we have Mariam. How are you? Hello, everything is fine, fine, but with headaches. Any seizures? No, no seizures. She raises her arms, turns her palms, turns, closes her eyes. Very good. That's very good. There's nothing significant. Great, good, good, fine, it 's perfect. The only question is if we've suppressed the epilepsy. I think we

probably have, but we have to wait. We can let her sit up. Of course, she can get up and walk.

CR, do you have a headache? Yes, a little. I've been lying down all day and all night. Can she walk? Can she do whatever she wants? Let her get up and walk. Do you

think you're going to fall? Okay. Sit down. You feel a little dizzy. A little dizzy. That's because she's been in bed for a day, but it's okay. What is her IV treatment? Nothing, nothing, nothing. So it was her last chance. She looks

better than on the MRI. It's probably a low-grade glioma. She's developed epilepsy. Do you have epilepsy? No. How old are you? Because they did an MRI. Because a while ago I was bitten by a tick, thinking it could cause encephalitis. This seems to me like gliomatosis, a low-grade glioma with widespread diffuse infiltration.

It's possible at her age, 23. Of course, her future is n't good. The tumor can't be removed surgically because it's too extensive. What can we tell her? I

think the most honest answer would be nothing. I think I would do a biopsy in London and refer her to my colleagues in oncology, but the prognosis isn't good. How many years will it take? I'd say less than five. She'll probably go blind from papilledema, but I don't know if it's appropriate to tell her.

I said it could be a viral infection from the bite, an insect bite. Encephalitis is possible, it 's unlikely, but if you give her hope and she's happy, maybe it's better for her to accept that possibility. I don't know what to do or what to say. I don't know. I don't know. When I have to

give bad news to a patient, I try not to talk to them alone. It's a very delicate matter. You have to find out. Do they know? Do they fear? Do they understand? It's not easy. We can't just say it 's a malignant tumor. Goodbye takes time, and I think it's better if other family members are involved. It's

a situation that's better if we don't deal with it alone. Where is your mother? My mother is in Moscow. It would be best if you went to Moscow to be with your mother, or if she came here.

Okay, thank you, Adi. Goodbye, good luck. We have to give some hope. That's all we can do. And beautiful, and she looks good. The reality is that she will go blind and die in the next two or three years. None of us human beings can look, especially at that age, in the face of death as if it were nothing. You can't.

Many times the way to deal with people who have inoperable brain tumors is to give them hope, even if they don't have any. So there is a certain lack of honesty, although the truth is avoided without lying. It's terrible. It's

not a complicated issue. How much will it cost? Not much. What we have here is from the Metronic company.

The consultation costs much more. It's always here. It's best if you come back as soon as possible. Don't let too much time pass. What's your name? Jul Ad. See you soon. I committed what, with the passage of time, I felt was a big mistake. To a little girl, Tania, who had a huge

tumor. The biggest brain tumor I've ever seen was benign and theoretically curable, but again, the diagnosis was late, and I was too sentimental. I let my emotions get the better of me. But it's so hard to take the step. It's so hard to say no.

[Music] [Music] [ Music] I remember the day we were first in the emergency room. We were scared. We didn't know what to do or what would happen to the girl. Yes, I often think about that story because somehow I feel it was a mistake to operate on her, and if it happened to me again, I would say no,

even though I think it could also be a mistake. But I would say it, even though one always holds onto hope. [Music] [Music]

Hol has come all the way here. This is Mr. Mar, Katia. How are you? I 've brought you some flowers. We'll have to help you cross the mud. Thank you. We'll have to help you cross the mud to get home. What's your name, Uliana? You were in Kev with us. How have you grown? I didn't recognize you.

How was the trip? So you knew we were coming? Yes, you all gathered to support us. I was nervous and needed support. It's been so unexpected. It's like a dream. Translate for me a little, Igor. It's like a dream. I'm so glad to see you. I've been a bit nervous these last few

days. Tell Katia I was nervous too. I've been nervous, says

Igor Petrovic. Would you like to come and sit at the table where we sit? The table is ready. It looks great. Please sit wherever you're most comfortable. I see you have a lot of pictures of Tan on the walls. Some are of [unclear - possibly "Tan" or "Tan"], others are of Wolf and hydrotherapy.

Downstairs with the physiotherapist. I

work at the dairy. Sometimes I look after an elderly lady who lives nearby. Everyone has problems. My parents also need me to look after them. Please eat. You're not eating anything. Maybe you don't like the food. It's not delicious. It's very good. You're afraid something might go wrong with the food. It's delicious, but I'm

overwhelmed with emotion, that's why I'm not eating much. It's a good time for a drink. Sasha, would you like some more? No, thank you. No, Sasha is too young. Too young.

Everyone is served. I don't know,

Mr. [unclear - possibly "Mr. Pet"], I want to toast to your health. Now I'm going to cry. Very emotional. I understand.

She's toasting to us, and we We should toast to his family, Tania, Misha,

to your health, health,

I propose a br, you can translate, I've been here for years, I've been in many ways, I love this country as if it were my own. Igor and I have worked together trying to advance the treatment of patients with brain problems. Sometimes we succeed and sometimes we fail. Ale em poro gustar brar poros tusitos futuros nunc

dejem Inc.

We all unite, Mr. Marsh, you have moved me.

An

ah, I don't

know if I'll think about anything the day I die, but the way I see things now, I think I'll think that the most important thing in my life was that I tried to help Igor and his patients. I'll think about Tania and I'll think about Katia. What are we if we don't try to

help others? Nothing at all.

Mar is doing very well and hasn't had any seizures since her operation. Now she can look for work and help others to take care of her new kittens. Well, Igor, goodbye. Thank you very much. See you next time, whenever that is, we'll miss you like these last 15 years. We'll keep talking about you every day in the operating room.