[000:00:00;00] was getting old, in fact, because unfortunately, his death was associated with an accident, our exclusive, the main secret of the invention of a world-famous scientist, while we breathe, we burn ourselves out very slowly, we visited the laboratory, looked at naked fellow countrymen, behind the revelation of the secrets of their longevity are the secrets of our longevity, such a new fashion, among those who want to prolong life, in the states they offer an extract from the stem cells of babies, it is possible theoretically to extend our century to 200 years, what else have i learned academician vladimir skulachev about the mystery of life and death? vladimir petrovich did not let old age defeat him. children from kulachev continue experiments, testing their famous father’s elixir on themselves. we are very determined to complete this work. death was invented by evolution for its own acceleration; death is not necessary for living beings. exclusive with dmitry borisov,

premiere on saturday on the first. this is the first persons podcast and i am its host, natalya loseveva. today our guest is a resuscitator, anesthesiologist, hero of labor, doctor of medical sciences, chief physician the most famous hospital in the commune, denis nikolaevich protsenko. let's talk about the profession. come on, i like it better. and when you look at a patient in intensive care, do you understand whether he will survive or not? there is such observation, intuition. no, probably, still no, probably, an external examination does not speak about a prognosis, about the current status, after all, we predict outcomes not on the basis of a subjective view, experience, or some other thing, there is a whole systematic approach, mathematically validated various condition assessment scales and prognoses these outcomes, that is, you are absolutely technocratic, absolutely, of course, are you generally

a supporter of technology? and i assume that the artificial intelligence algorithm is also probably used in one way or another in the commune. well, we are approaching them, i am very, very cautious about the technologies of artificial intelligence at the moment, not because i deny them, we use them, our specialists in radiation diagnostic methods very actively use them when processing computed tomography images and they train these systems identify certain changes, but in order to still introduce this into clinical practice , like any new drug , we didn’t invent a pill right away tomorrow , take it to the patient, no, the first phase of clinical trials is underway, the second, the third, after which permission is obtained, even after receiving permission, they are still conducting so-called post-clinical studies, i believe that the story with various applications using artificial intelligence, including clinical decision making,

before... launching a clinical practice, they must go the same way, and by and large, the purpose of these studies is exactly two: the first is to evaluate safety, the second is to evaluate effectiveness, and launch this without conducting it, without validating it and without saying that it is safe, at least by specialty anesthesiology has not approached this, you know, when there are discussions, various conferences at which issues are discussed. artificial intelligence, one of the most striking examples, which is usually given to, well, ordinary listeners, not doctors, yes, in order to force them to think a little side, let's say, of ethical complications, an example is this: a resuscitator comes to his patient, and the artificial intelligence algorithm gives him a conclusion, having analyzed all the indicators at this moment,

for all, so to speak, known symptoms, for all, for the entirety of this it makes sense now to disconnect the patient from the life support machine, because the chances of survival are scanty, and his maintenance, in this status, is very expensive for clinics and healthcare, and you, as a doctor, or the doctor who is suitable, that’s what is called feeling with the heart, yes, what else is possible... i look at this plane differently, what artificial intelligence offers in this situation is called euthanasia, which is prohibited in our country, and this is, by and large, murder, we do not we’ve come to the point, in fact, in the west there is such a concept as an end of life decision, in those countries where this is allowed, but this is also a serious question, a serious question of conversations with relatives with the final

decision being made, am i ready for such a decision? most likely not, because we have there are quite a lot of clinical observations when , according to all prognostic scales... mathematically calculated, which we use, they tell us that the risk of death is 98%, yeah, then again, our patient survives, and today we are one of such patients with you recalled roman kostamarov, in particular, in fact, this is where i started, why i am very cautious about artificial intelligence, because they are very different. and different patients in general, and humanity is heterogeneous there not only by race,

nationality, some other age, concomitant diseases, so to insert one algorithm for everyone, at the moment it seems to me that this is impossible, it is very risky, another thing is that probably then some subgroups of patients of the same age, identical in disease , here something is probably possible here... but i don’t know, we must understand perfectly well that the pneumonia of an eighty-year-old elderly patient with diabetes mellitus, with two heart attacks, with the consequences of a stroke, the pneumonia of a young athlete with the same severity will be proceed completely differently in terms of outcome, not an ethical question, if the patient, roman kostomarov, were not a famous legendary athlete, roman kostamarov, you would fight for him, in exactly the same volume, just like that on some transcendental , incredible, or would it still be, well, let’s say, such an honestly executed protocol? i answered my question to you, maybe five minutes ago, that

i hope that i’m not mistaken, and this is the message that, uh, i’m sending to my team and we ’re going along with this, which doesn’t matter to us, yet again, thank you for this? no, yes, in fact, you know from the work of our mutual friend in the shock hall that the patient is not identified without a specific place of residence, that any celebrity, getting into the shock hall, will end up on the same bed, on the same car ecmo, for the same device and we don’t have any division, i’ll just explain, nikolavich and i have known each other for many years, and it so happened, almost by accident, that my son works as a resuscitator. for which i am, of course, eternally grateful to him , so i know there may be some kind of wrong side more than others, so actually, why did i allow myself to go personal, well, because knowing the inside out, you understand perfectly well that i am absolutely not lying about

the podcasts or the first channel, and i really hope that we will be able to maintain this, god forbid, what kind of tattoos do you have on your fingers? tattoo, with certain meanings for me, can you tell me? no, it’s personal, well, well, at least what it’s about, well, it’s just completely personal, right about women or about women, but what’s personal is just a woman, isn’t it? no, it seems to me personal, a normal person is a hobby and something else, but there are simply things that , by the way, are connected, it seems to me, including with tattoo culture, which is not customary to designate and talk about the signs that you put on yourself, and when did you get all this, because well, this is the story , it’s probably been going on for five years already, this is not the only tattoo that we have, well, we won’t ask denis nikolaevich to undress in the studio now, although i think many would like to look

now to denis nikolaevich, so to speak, in all his tattoos, but this is not our program, and why did you buy a motorcycle, please tell me, already as an adult guy, and moreover, not just an adult guy, but to those specialists who see the consequences of these hobbies for motorcycles, yes, collects the bones, the pieces of crashed motorcyclists, this man, who sees the whole unsightly underside of bikerism , suddenly buys himself a bike, what kind of story was that, well, look, life doesn’t end only with some professional stories, this is the first thing, second, if you follow the logic of my professional deviation, seeing this wrong side, i’ll tell you honestly, then we need to stop walking the streets, because there are a lot of pedestrians who have been hit, we need to stop using cars, because

we also accept victims of road accidents, and so on so there are a lot of restrictions, it happened completely by accident, i understood that it was necessary, yes, that’s all medicine, medicine, it’s necessary. you need something else so as not to burn out, not to suffocate, you need some kind of thing to appear in a life that would switch you off from all this, that would disconnect you from a very close friend of mine, we’re on our way home from work, uh, he calls me, where are you, i say, i’m on my way home from work, he says, and i’m on my way to buy a motorcycle, i i say, where is it, i say, listen, well, i’ll be passing by in 3 minutes, it just happened that we went into this store, at that time he had some minimal experience riding a motorcycle, i had experience driving a scooter, all this already happened in the fall, well, in general, we left from there, having bought

each other on the helmet. by the helmet and i noticed the motorcycle that was sold there, a secondary one, as a matter of fact, all winter as a hobby we studied indoors three times a week in the evening from 9 to 11, and that is, so directly in detail, but of course, strictly speaking, definitely a very cool instructor and in fact, i continue to maintain these skills out of season... in the winter indoors, practicing something, firstly, in the end it turned out to be very convenient when we completely moved to a communal apartment, in the summer time, this is a very convenient type of transport, because today i’m coming to you, and now you live in a communal apartment, no, no, i don’t live in a communal apartment, this is a convenient type of transport, because, well, i drove here for an hour with a communal apartment :38, but what if it took 36 minutes on a bike, so this is also a temporary saving, secondly

, it cleans your brain a lot, because during the period when you get on a motorcycle, you are concentrated, you understand that, first of all, you are having fun , you are concentrated and you reboot, because sitting in car, you still constantly think about something, react to the phone, uh, start answering some messages, calls, and then in general, excuse me, these 40 minutes, i’m with myself and turn on the music? outside the city, outside the city, because in the city now on a big bike with music, it’s quite difficult to move around, a small city sporter, for me it just doesn’t mean music, and such a question is a provocation, people approach it differently, but in many ways it is there is a saying among bikers that a loud sound

saves lives. and this is one of the events maybe not the most cultural in relation to interference in yes, yes to outsiders, on the other hand, as in the joke, yes, i say, i envy, he says to his neighbors, they are forced to listen to good music, yes something like that, but in reality, if you look at this from a safety perspective, then the loud sound, it can be not only from the music, if you noticed, the exhausts on motorcycles are quite loud, they turn on. aimed at passive safety, it seems to me that this is just such an excuse, no, no, this is not an excuse, this is a fact, but what kind of music should i listen to, listen, i listen to absolutely different music, but it’s probably still the same, these are some things that i grew up with from the beatles, the purple, well,

i can listen to modern music, rap guy, in some form , when a person over 40 years old allows himself to go from extreme to extreme, because i understand, if you were an accountant there , you would get a warning, then a resuscitator will get a warning - this is from the devil to the devil, listen, well, i don’t know, i don’t think i’m an exception, i have my colleague, my friend, he is the head of the department, in one of the hospitals, he’s a little older than me, but 5 years ago he became interested in parachuting, for example, about the same thing, about the same thing, and now he’s already over 200 jumps and now he’s not just jumping with a parachute, but specifically in a wingute, this is such a flying squirrel, you know, so i don’t think that i’m an exception in this situation, but how the family reacted, to this hobby, calmly, their daughter was already taking her daughter for a ride. yes, she graduated from

school not long ago, and where did she go? she studies in raanhix, at the cool faculty, the hospitality faculty, no, she didn’t go, in fact, in many ways, i think, this is her very conscious decision, which was born just during the pandemic, because well, in principle, doctors always devote a lot of time to their work, a lot, the pandemic simply disappeared. off the radar of their families and completely immersed themselves, she very sensibly said that dad, you know, in general, i would probably like to live for myself and for my family, they accepted it normally, and so my heart didn’t ache, like... no, absolutely, absolutely didn’t sting, and i think it’s very important that the child he comes on his own, he doesn’t follow some path there, you came to moscow to go to college, yes, i transferred, i transferred in my first year, you were born in turkmenistan,

born in shkhabad, but a completely different culture, a completely different country, what was it difficult for you to rebuild, some kind of life, some conventions, when you came from ashgabat to moscow, there were no difficulties at all, what another country, born in 1975, until the nineties the soviet union, the same programs training, the same state russian language, no there was no discomfort, a fairly strong medical school, which was formed due to the fact that during the great period ... there was a large evacuation and a large number of professorial teaching staff from moscow st. petersburg medical universities were forced to move, evacuated there and many remained there, because that in general it’s warm, fruits and so on

, so i didn’t have any problems with adaptation, and i transferred to moscow in 1992, so communication... there were no problems, they say that, well, it’s considered that renematologists such forced cynics of a misanthrope, this is a fair generalization, i think not, it’s more of a protective mask, a reaction, because you can’t die with every patient, but you have to ask the question every time, have you done everything for yourself, these are two big differences, so rather after all, this is cynicism, there are some medical jokes, this is still more of an illusion than rather than the truth, after all, how do you live or cover up some medical failures for yourself, only with a detailed discussion, a mandatory team debriefing, guys, let's see where, where what, where what, where what, where what's wrong

, well, it's not just us who do this, it's generally done all over the world, there's a special one in every hospital, well, there we have it, it's called : under the subcommittee for the study of fatalities, but there in the west it is called mm, a commission, and also for the study of fatalities, this is the usual approach, you are an agnostic, an atheist, but why, i think, in fact, we probably need to return to the message of childhood, perhaps maybe, by the way, never say never, maybe i'm some kind of religion someday i will come, i don’t know which one, but still historically this has always been laid down - since childhood, in my childhood i was taught completely different values, at school, the pioneers, komsomol, atheism, and in fact, i probably grew up with this , i haven’t come to this yet, and maybe i won’t come, so i’m absolutely a materialist and an agnostic, yes

, how do you still relax, how is your weekend meeting with friends going, i don’t know, sometimes you manage to go to the cinema, very rarely, theater , i think, such, such a life, life like everyone else, communication with friends, with family, parents, what do you think about romances at work, well, between colleagues, young doctors, you generally encourage this when they work in the same department and immediately get married, have children, it turns out that it’s great, the family continues to work, work this is wonderful, because the way a young doctor lives is every day there from 7 to 5 at work with a daily schedule, a couple of times a week you stay overnight, that is, you leave for 32 hours, and so it turns out, that

we are your society - this is your hospital, your department and the number of relationships, marriages, it seems to me to be quite large in all hospitals and i think it’s great, if it doesn’t harm, then if you want to marry a doctor, you can’t get into a hospital, just become a doctor, become a doctor , it turns out this way, by the way, at some point you suddenly suddenly lost weight and it was clear that this was exactly your task, that is, you didn’t just lose weight, because there was a lot of work, but what kind of motivation was there, what kind of motivation would that be. very simple, uh, the fact that this happened in a medical term was called obesity, and then, everything is very simple, evidence -based medicine, you open, first, second, third, i was in the third decision-making phase,

i accepted it, got treatment, lost weight, and how , and how did you lose weight, tell us what special diet or program you had there, no , no, i’m not hiding it, this is bariatrics, this is a surgical intervention, let’s just explain to the audience that bariotrics is a truncation, well, it really is yes, this is a change, not just a truncation, there now there are a lot of types of interventions that are indicated for different situations, well, yes, this is because... the stomach becomes smaller, stomach reduction, and other techniques, do you want to retire, well, such a good, healthy pension, active, no, for now, according to i’m still working a little bit longer, due to my length of service i can already leave, but for now i want to work, and if , god forbid, the same shock happens again, like a pandemic or some other misfortune, again these are temporary hospitals, again work 24/7. we are in the team, i have only a few people in my memory,

who left, on the contrary, everyone strived, everyone supported each other, everyone was aware of the risk, and i think that everything will be about the same, maybe only in a new story, i wouldn’t like the media exposure that i had, to be honest , close down and do your thing, yes, yes, you’ll go on vacation, where, where , the coolest, the thrill of a motorcycle in you know what ’s in what’s where, that you sat down and went wherever you want, well, i don’t know, a couple of weeks ago on conference in st. petersburg on motorcycles with one of the anesthesiologists, resuscitators, we went to the current situation is generally very difficult to plan, but somewhere to sit down and ride into the sunset? well then, i can only wish you a very cool, driving, beautiful straight line, just not at sunset, probably at sunrise after all, because after any sunset comes sunrise and you... in your life, probably many times this showed, friends, this was a podcast of the first persons, of course, the first person of such

intensive medicine, in every sense of intensive medicine, doctor of medical sciences, hero of labor, anesthesiologist, resuscitator, doctor denis nikolaevich protsenko, and i, natalya losyeva, let's get started. oh, i can’t, play with karma, i’ve arrived, hello

, hello, welcome , in a popular way and together, come on, beautiful, only friendly, the evening

floats with a quiet song over the river. distant lightning, the factory glows, children. the train is wasted, so drive the fire, somewhere under a rowan tree, the guys are waiting for me, oh, one curly rowan, white flowers, oh, my dear little one, what did you burst into, oh, a curly rowan tree, white

flowers, oh, my dear little girl. migratory birds are flying, in the autumn distance, blue, they are flying to hot countries, and i i stay with you, and i stay with you. my forever native country, and i need the turkish coast , and i don’t need africa, i don’t need the turkish great, and i don’t need africa, i

saw a lot of countries, walking with a rifle in my hand, but i wasn’t proud. sadness than being far away from you, i changed my mind a lot with friends in a distant land, but there was no more long time than to fulfill your will, i had more worries than to fulfill your will. even if i drowned in the swamps, even if i froze on the ice, but if you tell me again, i will go through all this again, my hopes and desires,

i have bound you forever, with the harsh, unclear pale, with your... enviable fate , with your harsh and clear, with your enviable fate , migratory birds fly, looking for the gone summer, they fly to hot countries, but i don’t want to fly away , and i stay with you. my dear side, i don’t need the sun that’s alien, i don’t need someone else’s land, i don’t need the sun, it’s alien,

i don’t need someone else’s land. thank you! well done, well done, well done, like the balks

of the balshinka, like the balks of the priloshinka, on the very top, on the very top, there were tents, there were tents, tents.

the girl is carrying water. akurazhechka is a little curly girl, to the right, to the right,

like a tri-balk, he slicked it behind him, like a tri-balk, and my grandfather walked around in a shirt over his overcoat. he was wrapping up a newspaper, a homegrown tobacco plant, everything was laid out on shelves, there was order in the workshop, the child returned home in the evening on a tractor, you take me and put things in order in my soul, you could answer any

question, and save me from trouble, he never scolded us, he’ll clench his fist and threaten, about him, that’s what everyone said, this is what the country is based on, and we’ll go out slowly and call, swear on the porch. you have a homely eye right from the jar to the blush on your face, you take me by the wall, put things in order in my soul, you could answer

any question, and save me before trouble , and the fences are blown away by the wind, the rosehip is drying on the pin, i’ll get my grandfather’s accordion and play in

silence. in the times of peter the great, they were looking for silver on this land, but they discovered gold, albeit black, we are in the coal heart of russia in the city of gornikov kemerovo, how many times have you already gone down and gone up, how many times have you gone down, how many times have you succumbed, thank god, how to give the gas, there's a pedal, press it, come on, please don't disgrace me throughout

the country, buddy, this is normal, this is not normal, outwardly calm, inside i'm chattering, wow, what a class, maybe you could teach me the words, telubsky, mensen, well , what do you think, today the sun rose high, well, young man, it’s hard for you to understand, i said, i love you, the life of my own, the premiere. today on the first bourbon stirsman is a product of the stellar group. you

will wake me up at dawn, see you off. yes i will come out, i love, as soon as there is only one life, one life, one life, and so my thoughts are high, the paralysis has flown. to the music of alexey rybnikov and poems by andrei voznesensky juno and ovosi, today on the first, instructions for users on how to keep the liver healthy

in women. how is soy milk better than cow's milk, love vibes, is it true that perfumes with pheramones will help you attract a man, the program to live healthy answers all

questions, tomorrow, on the first. bograi, bowing with galava, zastamola, bowing with talaba. yes, shout again, and through

the road, promised large, kissed,

dusty high. on the weeping earth, not feeling the boots, our bloodless detachment leaves from the enemies, eating on the move, a gorse leaf, smelling it in a gulley under a viburnum bush, we can’t rest, run, run, run, our supposed friends are holed up behind a hillock and watching as they beat us, without taking your eyes off, only the long roads are completely for us, and dry your tears, rest a little. i am the russian road, move away, and i

will cover you with mud and water, but with your ears in the mud in the water right up to your eyes, after some time the enemies they caught up with us again, even stronger, they are about to kill us, but the severe frosts are rushing to our rescue, move away from the three burning tears, we are russian frosts, we will freeze, we will notice with longing, having remembered moscow, nature in war is like our own mother, but there is there is time to bury, and there is time to attack, we showed up in enemy towns, and began circling everything around, smashed it to smithereens, tore it into pieces,