A DAY IN THE LIFE OF A DOCTOR

A DAY IN THE LIFE OF A DOCTOR

Dr. Ksenia Kisselincheva
 

In December the streets of Sofia are suddenly dipped in darkness which makes shop signs and signs of restaurants and cafes stand out more radiant and bright. I am walking along Sheinovo street a few blocks off Eagle’s bridge and passing by the National Television headquarters, I notice the hectic hustle of cars and people coming and going. Here you can sense the accelerating tempo of night life in the city, otherwise lethargic. A shrill peal of laughter mingled with banging car doors and husky horns blown at full blast. But I am heading off to the maternity clinic in Sheinovo street and I am hurrying down to my destination.

It is a large building of the mid-thirties with a few spacious verandahs and a big yard. At the moment all lights seem to be on - as if  it is on a twenty- four- hour vigil over frail human life just   delivered or yet to be delivered into the world. I bump into a brand new dad awkwardly hugging a bouquet of flowers, then I check in at the security desk and ask about the office for the doctors on duty. It is easy to find - on the first floor the second door on the left. I am ushered into a room which looks more like a reception room rather than a physician’s office.

There she is, in her sparkling white overalls, with the serene smile of a Nordic Madonna. Dr Elena Baydanova-Vassileva introduces me to her colleagues and offers me some tea. There are four of them - one is watching a football match on Eurosport, another one is giving instructions on the phone, a third one is commenting on the condition of a woman about to have a caesarian. There is an atmosphere of intense participation and partnership. Dr Vassileva suggests taking me round the hospital so that I can get an immediate feeling of her working environment. She calls the clinic her ‘second home’. Later on, when I am to learn more about her life I am to become aware that this remark made in a light joking manner is not very much of an exaggeration. It’s a bit like going to a fancy dress ball - I imagine myself as a midwife - green overalls, rubber slippers and a white bonnet.

I feel more comfortable and at ease, more of an insider than an intruder. It’s a chance to have a different perspective on patients. Then you realize how much they crave for warm reassurance and how much they appreciate it when they get it. I notice that Dr Vassileva has a special way with the patients we visit. In a minute or two she manages to put them at ease, she explains to them in a soothing voice what is coming next and reassures them that everything will end well. Occasionally, she cracks a joke and leaves them happy and laughing. Everywhere is neat and clean-something that is not so commonly met in our medical institutions-the corridors, the sick rooms, the operating theatre, the intensive ward and the surgery. My companion throws a quick glance at her watch - I gather it’s time to join her colleagues in the operating theatre.

The medical profession is unlike that of a painter or a writer. It is not a lonely job though the burden of personal responsibility is immense. It involves the team-work of good specialists in different fields - surgeons, anesthesiologists, pediatricians, midwives. And no allowances are made for errors or omissions since what is at stake is human life. The riddle, called human life which initially attracted Elena to the medical profession.

I am back to the anonymous darkness of the street. The lights are on all over the building, they seem brighter than ever, as if a perennial vigil over human life so that ‘death shall have no dominion’...

On the following night I went to visit her at her proper home in a block of flats, just off the Tsarigradsko shosse. Her husband had recently died. He was an eminent literary figure whom I had known from books and periodicals. He was nicknamed ‘Ferdussi’  by some loving friends because he had a striking resemblance to the ancient Greek poet in the Mephistophelian outline of his nose.  Elena had just made some cheese pie which she treated me. After that we had tea with brandy since the temperature was 10 degrees centigrade below zero. Her living room overlooked the central park which looked like a white tapestry against the backdrop of the winter sky. You could instantly recognize by the set up of the living room that my hostess had a passion for the fine arts, for antiques  and for old and rare books. She could not help showing me her latest acquisition - on our literary life in the 20s. And, later on, to my surprise, it turned out she had a passion for driving. Driving through the maze of the heavy traffic made her forgetful of all her problems and she was thrilled by the challenges of the ever changing road puzzle. 

What made her choose to become a doctor?  Elena starts explaining to me that it goes as far back as her childhood. They had a doctor in the family, her mother’s sister who was a pediatrician. As a little girl, Elena loved to browse through her aunt’s professional books, to contemplate the pictures and illustrations.  She loved to listen to Dr S. Toncheva  discuss in detail the health state of her patients. A physician is not like any other employee,  she or he never stops thinking about her patients.

I was curious to know about her aunt’s response when she heard about Elena’s decision to study medicine. ‘She was extremely glad to hear it. But she warned me it was a tough choice’. At this time Elena was a romantic, living in a dream world of her own and no practical considerations would intimidate her.

Did she make the right choice? After 20 years of medical practice she has no regrets about it. She said to me that if she were given another chance she would make the same choice.

What are the things that give her strength to carry on despite all the difficulties? Elena is definite that one of the driving forces in her life is the example of her teachers at university. To mention only a few-for example professor Karl Ognianov, educated in Germany, a model of professional excellence and personal integrity. He introduced “ex sanguino transfusio”. Another name worth mentioning, this is professor Yarakov , known as the theoretician of  Bulgarian obstetrics. Elena remembers with a sense of recognition how good he was at warning his students against passing fashionable trends. “What he said in his books is all of lasting value” - she pointed out.

And there are also the living models among her colleagues who carry on the high standard, set by the previous generation. The present director of the Sheinovo clinic, professor Konakchiev, has established for himself a name as an excellent diagnostician and operator. There are some distinguished specialists among women too. Associate professor  Maria Popova is one among them - a brilliant surgeon in the area of oncology.

So far the Sheinovo clinic has kept its reputation throughout the 50 years of its history as one of the best medical institutions in the country. In spite of the dramatic drop of child birth during the last 10 years, the hospital is permanently fully occupied and there are about 2000 births per year. As I already mentioned , the hygienic standard  and the technological equipment are up to scratch. As I found out there are hardly any complaints of post‑natal infections as the case certainly is with some other places. “We have all up-to -date methods and conditions for treatment.  Apart from the technical equipment and the highly qualified staff we make sure to supply all the medicines and consumptives from reputable pharmaceutical firms. Most of the stuff is bought by us but some of it donated by sponsors - ”The Future for Bulgaria” foundation, the Spanish embassy, celebrities like pop singer Sylvie Vartan from France.

The Sheinovo clinic embraces a variety of medical activities, apart from functioning as a maternity hospital. For example there is a section dealing with in vitro insemination under the guidance of Dr Tabakova. So far their rate of success is high - close to 50%. There is another section dealing with menopausal medicine where women can have control check ups, consultancy  and treatment - anything from smear tests to HRT.

We browsed through a few more antiquarian books and we had more tea with Metaxa brandy. As in any activity, professional routine builds up to climaxes of achievement when you say to yourself  “Yes, I have arrived. I have passed the test.” For Elena too, after a successful child birth, she feels like a student who has passed his test. A highlight of transient exhilaration which makes all the efforts worthwhile.

Actually, even the so called “normal” pregnancies and births are hardly ever non-problematic. But, certainly, the pathological pregnancies provide more hazards and it is often an uphill struggle to bring them to successful end. Recently Dr Vassileva has been grappling with two such cases. One of them, after a series of complications, is expected with childbirth in less than a month. Elena admits she sometimes thinks of what happens to the babies after she brings them forth into the world. Will the have normal conditions of development or will some of them be deserted by their parents as it is becoming an increasingly common practice?  But, on second thought, she realizes her duty and responsibility goes as far as the medical side of the child birth is concerned. The further fate of such a child is the responsibility of society at large. Dr Vassileva thinks that non governmental organizations do a great deal in this respect. The work they do in orphanages, in schools and hospitals, for lonely mothers and battered wives. And she can’t help admitting she appreciates the role women play in these organizations.

Moreover Elena describes herself as a born optimist. Her wish to become a doctor grew out of a youthful dream. She believes that most human endeavors that are worthwhile grow out of a dream. Don’t love and children grow out of dreams after all? But to make dreams come true it takes courage and perseverance. And a lot more.

Elena thinks herself lucky because she imbibed the example of her parents as she grew up. There was a lot of affection and solidarity around her and it gave her a sense of security for a lifetime. And how about her own marriage to the professor in literature.

Elena met him in 1982 and she was immediately captivated by his legendary literary aura. At the time he was a key figure who played a major role in the mainstream of literary life. He introduced her into another world where big issues of world spiritual culture were being discussed and where she met extraordinary personalities who had an impact on her outlook. She and her husband both shared a passion for books of all kinds. And certainly they shared a love for their son Vladimir. And the professor managed to pass on to his wife and son his admiration for Italian literature and culture. Now Elena is reading an Italian book and Vladimir is studying at the Italian lyceum in Gorna Banya. And it is not surprising that he dreams of going to university in Rome - maybe the same university where his dad taught the Bulgarian language in the course of three years.

Why didn’t they have more than one child? Elena explains in a light-hearted manner that medicine is like a demanding lover, it expects no less than the whole of you. Very often - she now remembers - when she had to go on duty she left her little boy crying. She remembers very well one incident when the boy got bruised while playing and he came home crying. But she was bound to go on night duty. She gave instructions to her mother what to do and off she went. But when out of the door she felt confused and thought to herself: “I take care of strangers but I leave my own child without my care”. But then an inner voice spoke within her “If you are kind enough to take care of strangers, God will take care of your child”.

And on this coming Christmas Eve she will be on duty at the clinic. She will have an early celebration with her parents and son and then she will go on vigil. In her mind she will join her family and all people in celebrating the mysterious birth of God’s son while at the same time she is to assist the oncoming of frail human life which still fascinates her as an unraveled riddle as it did in her early youth.                                                                                                                  

Sofia Western News Monthly, 1998