doctors detect some health problems already in the late stages uh i can't tell you right now the answer is so very easy but it's one big complex problem and all these previous problems they uh indicate that you don't have a proper protection system health ukrainians are very difficult to get up and fatalistic and maybe they wait too long to seek medical help because medical education is expensive even where it is provided by the government and this also means why do they not want to seek this help but you need to understand that all over the world, the health care system is always facing problems and struggling with modern equipment. we can, with technology, we can do more and more and more, but one of the strangest paradoxes in medicine is that the more money you have the more you spend on it, the more it is worth if

you have a patient with a very complex serious disease and you treat him, then in a few years an even more complex and more expensive disease will appear, you can spend the entire state budget on the system health care but still people will continue to die in england we say that the health care system is like a bottomless barrel and the problem is that and the most difficult thing is to understand where to put this bottom in this barrel partly the problem lies in technology and equipment i.e. because you have scanners because you have different machines but also the problem lies in the distribution of whether to spend 1 million dollars to save one child with leukemia or to spend this million dollars on hip operations for the elderly people, the problem with the health system is that

you have to make a lot of choices and not just think about what to spend money on, for example, in the united states of america, the health care system is such that if you have a lot of money, you will have the best medical care in the world service, but for one person, america spends twice as much as , for example, in europe, the worst statistics, the death rate, the birth rate in the world, and this is exactly the problem lies in the distribution, because american society is very, very, very different, very much poor people in america and a poor health care system, so there is no simple answer to your question, but at the same time, you need to make a rational choice, that is, how to use the money you have for the health care system, and

we would now approach a very difficult question which consists of what concerns private e-e clinics and public ones, and i can talk about this problem endlessly, but the problem with private clinics is that the patient becomes a means of obtaining income and at the same time, in america, in such social clinics as we also we have the gospels, and the end is that the patient must be cured. well, in countries like ukraine, i fully understand that if you do not have enough money, it is very difficult to give proper treatment in public clinics. i am not against profit, the problem here is corruption, i'm talking

about corruption as such well, why does someone give bribes to someone? corruption is how to make the right decisions about where to throw money. i worked in many countries of the world. i gave lectures in pakistan and one of my pakistani colleagues told me i am lucky that you work in england, for the example of a patient, the only question you have is how can i best help him? and when we see a patient in pakistan, the only question we have is what he can afford and what we can understand and if you are a good doctor, it is very painful for you and i think that the only way that the health care system in ukraine can move forward is to understand these problems and understand that there are no simple answers, but i would not come to ukraine for 30 ugh if i didn't felt

optimism about the future of this country in a small hospice in the city of sambir near the polish border with his colleague richard clarke who is an expert in palliative medicine and we met with dedicated ukrainian doctors and nurses who created a wonderful hospice not only for those patients who are dying but for those patients who require constant care and these are very poor patients, that is, the question is not that these doctors earn money from this, er, the local government in sambor pays for everything and this was medicine at its best and i was very pleased to see it in sambor. for many years, i came to ukraine to help my colleagues, especially neurosurgeons, that is, i talked about science, technology, scanners, microscopes . but it would be good if i also helped my colleague richard clarke is also a very well-known doctor in england,

if we could, er, help the development of palliative medicine here in ukraine, of course we all have to die, and this is a very important part of medicine , which is very often overlooked in ukraine, but how doctors as nurses we must make every effort to help patients to die in the same way and normally, that is, a loving family that leaves received some positive memories of the death of their loved one, and palliative medicine, unlike neurosurgery, is not expensive, you do not need scanners and microscopes are expensive you just need good doctors and nurses not a lot of drugs and treatments and dedicated doctors and nurses who work passionately ah richard taught the medical students here yesterday and she was very already on these young students who want to become

doctors and i really hope that during the time i have left because i also now have advanced cancer i hope to help rachel who, like me, is full of enthusiasm and love to help develop this palliative medicine in ukraine, in fact, in our country there are a lot of doctors who are devoted to their profession, a lot of medical workers, but unfortunately, maybe you are right, it just so happened that we have such a system, they complain about low wages and therefore do not only the palliative care system in our country is suffering and has certain problems, we have gaps in many fields of medicine, but i was personally offended, for example, when you compared our medical system with the system that fell after you

made this comparison, has anything changed at all, i'm just curious i don't want to say that ukraine is the same third-rate country as nepal. i just wanted to say that i did not work in pali and all the health care systems have huge problems even in england from england now there is a huge problem even are going on strike that ukraine is the same as nepal, it's just a problem in the health care system the same e-e are not different all over the world the problem is how to distribute the funds we have between rich people and poor people and why do doctors go on strike in england, well, compared to ukrainian doctors, the salary is good there, so if you listen to the standard of living in england, it is significant, and let's return

to late diagnosis, because we understand that due to late diagnosis, a person loses the chance to recovery and the doctors to carry out high-quality and effective treatment, and i want for our viewers, uh, maybe there was just such a story, which was discussed in the documentary film english surgeon, a few words, nevertheless, for our viewers who do not know what it is about, this is the story of young tanya a ukrainian girl, her tumor was the largest the march had ever seen. he operated on her once for 10 hours. then for another 12 hours , he paid for her to come to london for treatment, but unfortunately he could not save her in he was visibly stunned by the film and almost penitently went to ukraine in order to ask for forgiveness from her mother katya, knowing how difficult it is in general, you always undertook the most difficult

operations and perceived them as a certain challenge, you even talked about the fact that the harder the the more difficult the operation and the more dangerous it is. the more i would like to do it. these are your words and do you really remember what was your most difficult operation, where did you perform it, after all, in ukraine or in great britain, i have performed tens of thousands of operations i i remember all these operations, but most of all i remember some of my failures than, uh, achievements, i don't remember any one operation that i would call the most difficult, i can now remind you of a whole forest of such operations, most surgeons, most of us become surgeons because what we find surgery fascinating and why. for us, it is fascinating because we do something so that the patient feels better , that's why we have such a selfish impulse, but

there is also a moral reason. well, for example, mountaineers enjoy hiking in the mountains there there is absolutely no moral reason for this. but in this psychology, which is also included here, that is, they go there because they do not like to take risks, that is why i became a neurosurgeon because of the risks , and when i became a neurosurgeon, i looked at these risks as risks for patients that i did not understand when i was young that these were my risks and although throughout my career all i wanted to do was precisely these dangerous operations and why i came to ukraine because i wanted to operate on very complex cases and precisely that did this work is even more difficult for me, but now that i am retired i teach i teach but i no longer

operate but when i was a surgeon all i wanted to do was to influence, of course, but now i don't regret it at all, i don't miss it at all, even though i am not a doctor now. i feel like a complete person because in order to perform a complex operation, you have to cut yourself off from the patient to a certain extent, we have ourselves, medical workers, professionals and their patients from below . from the problem is the difference between the love for the patient and the scientific approach, which i try to discuss in some of my books, and now this problem is especially real for me because two years ago i was asked diagnosed with prostate cancer i have not been treated but as we

say in english now i am in remission so i don't know how long i have left to live and i am almost 73 years old but even now when i am closer to death and although i have spent my whole life as a surgeon who lived next to this death and when you stand closer to this death then it makes you look back on your life and of course you understand what really matters it's your family the people you love who love you and also it's whether your life has meaning outside of your family and that's why we as doctors are very lucky i made many mistakes i did many things that shouldn't be a problem because of the chaos and many others but still will be a doctor it's great and during my lectures i try to inspire medical students who are going to become doctors i do not want

so that they would then be disappointed because what makes medicine beautiful is the people, the people you help, and as a doctor, you have a very good way of entering people's lives. there is no other profession like this, so you constantly have to choose between being kind and caring and after all , a professional in england we from the hot clark very often give lectures and it is sometimes very funny because she is engaged in palliative medicine, i am in neurosurgery and it is quite such opposite parts of medicine, he is no less we share the same views on how we should treat patients, how we should treat them, after your answer , i immediately had a lot of questions

, the first question is that you said that the doctor is from above and the patient is from below, it must be very difficult when you understand that you, as a doctor, sometimes become for you become just like god to the patient. how difficult is it in general to be able to balance and be true to the patient and, above all, to yourself? as a doctor, the answer to this question is very important, you must be able to listen to the patient every patient, another english patient is different from the ukrainian one and very different from the american one. you must understand and try to understand what the patient wants. will he, for example, consider you god and fully trust him, or does he need a lot of explanations and his problems, and very often doctors just don't know how to listen patient i hope that with experience

and over the years i have become better and of course some patients want to be treated like children, i can say from experience that most patients want to explain to them but above all, they want to feel that the doctor does not have to wait for the patient and that he respects him and simple listening is exactly how we can help patients, but listening requires time, doctors very often do not have this time very often they even pretend that there is no time and thus they try to avoid listening to the patient because when you listen to the patient, it means that you have to empathize with him and empathy is very difficult, very difficult when you use empathy, you put yourself in the patient's place and listen to yourself, it is very difficult and we very

often subconsciously try to avoid it, but very often for me and for such doctors as things, this is the most interesting, the most important and the biggest challenge in the work of a doctor, people think that i am joking when i say this, but i am not joking, management is actually easy it's all a delusion. it's all nonsense when they say that surgeons there have some golden hands when everything is done in the main in uh in neurosurgery in any other field of surgery it's making a decision communicating with patients and it's just as important communicating with colleagues with nurses and hospital workers, and everything goes wrong precisely when there is no such communication, when you come to the hospital now, you are treated by many, many different people, and this

great surgeon is only one visible part of this great medical team, and when this team does not communicate among themselves, then the patient suffers, therefore, a good operation is not just in good hands, but in good teamwork and good communication, team communication. you should avoid this post-soviet monolithic professorial of the vertical system is that our servicemen have avoided this vertical soviet tradition and soldiers on the battlefield can make their own decisions and not ask permission from the generals. oh, it's not always like that in reality

. about the fact that doctors are different and you personally, what kind of doctors were you, you still had more empathy and compassion for your patient, you gave the patient hope. were you a more serious and reserved doctor who simply operated and then prescribed further treatment and recovery. i think that i was a relatively good doctor, and of course my patients say the best about this. i have nothing to brag about myself, but i will say that before the operation it was not far from the hospital. it was an operation, a serious brain operation. i came to the hospital with an e- the evening before the operation, in order to give him some hope about the medical aspects, we

already talked with him and on my bicycle . there is one strict rule that as soon as the operation is over, we call the family and tell them about the past because my son was diagnosed with a brain tumor when he was only three months old, what a god the operation about the past was successful but my first wife and i had to wait er all day to hear her how this surgery went so my own experience i don't want other families to wait hours ago yes i hope so i try to be a compassionate doctor but no one is

100% perfect so sometimes and i have i have had enough when i was told about my own diagnosis, when i didn't know how long i had left to live, somehow i instantly remembered hundreds of patients about whom i completely forgot about whom i had for dozens of 20 years, about whom i thought that maybe i i could have done something better, and i drank during the operation and during some sympathy, but when they told me that i had a few years left in my horse, i still have, uh, that's why i have these memories of past patients, like ghosts disappeared. do you even see how many operations you performed ? can't remember them there were many, you can’t remember which one was the most difficult, i had a lot of appeals and you always went to the last what could you

advise all young specialists who are just starting their journey where this is the limit where it is necessary to go to the last and undertake the most difficult operations nevertheless, it is worth stopping somewhere we must understand our patient listen to our patient or this way you will know what he wants medical decisions must be made with the patient and not for the patient of course we as patients must be 100% sure of our a doctor, that's why our patients still need to think of us as bad, but this does not mean that we should behave like gods, our patients have an emotional need to think of us as better than we really are , so if we talk about moments when we should stop treatment, what is actually in modern medicine is a very, very big problem, so the answer to this question is, of course, communication from a technical point of view. you have to give the patient and his family a realistic idea of ​​what can

change the future treatment, and of course talk about the risks of such treatment, eh, in such discussions, you should involve the family, of course, and if you do it often enough, then such treatment will be less, and you very often talked about the fact that it was very difficult for you and you were worried about when you will become more as an older person, how will your life turn out and they wanted to cross this line when you were a doctor and became a patient and probably now that you are in the role of a patient, you have seen more of this medical system from the inside, it is difficult to be a patient and you are much easier than i thought, i knew doctors i i knew that from a technical point of view they were experts , specialists, of course i would have liked them to

show me more compassion and explain more, but everything was because of the experience i had with my son and the fact that my wife and second wife were also often in hospitals. i personally had enough experience to be on this other side. that is, it was not easy, but i would not say that it was very difficult, and although i am now teaching and teaching students, i stopped operating even before i was diagnosed, so this transition is currently happening it happened fine, fine, you immediately understood on your own what was wrong with you. did you wait too long for confirmation from the doctors ? i had symptoms for a long time. i

just turned a blind eye to it. this line from being a doctor to being a patient, that's why it's too late for me and at first i was very angry with myself because i thought that i betrayed my family and betrayed my family with my stupidity, but this life i had to accept this disease correctly understand and undergo a certain treatment because radiotherapy is now hormonal therapy, which gives a lot of side effects. but now i live a normal , normal life. i feel normal enough to come to ukraine, which i love ukraine. and tell me honestly, how are you like a doctor in our country, for example? when people find out or feel certain symptoms in themselves, they start googling. yes, i am a specialist in neurosurgery , not urology, so i really searched, and it is scary even if you yourself are a hospital doctor and even

told his patients that they can search the internet for something about their neurosurgical problems, but don't believe what you read, you would have such a good doctor who would tell you so beautifully that you simply wouldn't need to get on the internet, there is a lot of good information on the internet but there are also many bad ones, so our doctors say that you should not read about your diagnosis on the internet. it depends on the doctor. it depends on the patient. it depends on how well you tell the patient about his problems, but i personally would not forbid a patient to read on the internet, we have very little time left and i want to thank you in fact that you support our country, that you have not

come to our country for the first time while a full-scale war is going on in our country, and i have to you have a question, our neurosurgeons are currently working on the front lines and they work in hospitals in hospitals on the front line and they see the kind of injuries and wounds that by 2022 may not have been dealt with by 2022. do you consult our doctors on such issues now they do not apply and although 25 or so percent of such injuries and wounds lead to death and wounds are carried out precisely in the head immortals you cannot successfully operate on such, well, serious enough injuries, therefore the role of neurosurgery on the battlefield is very small, a very famous british neurosurgeon who is simply

an incredible person, he was here in many cities in the dnipro, in kharkiv, and conducted training on how to treat wounds received on the battlefields, it all relates to blood loss, amputations, and chest injuries therefore, as a neurosurgeon, i really have nothing to teach my fellow neurosurgeons who are currently on the front lines. well, i actually want to thank you very much for visiting us today. it is a great honor for me and it is also a great pleasure for me, please, and i invite you to of our studio, i hope that after our victory you will possibly come to ukraine and perhaps visit those cities and places that you have not been to until now. i know for a fact that i will continue to come to ukraine because i have many friends here and i will i am very proud that when i came to

ukraine 30 years ago for the first time, and it was purely by chance, i immediately understood that this is a very important country. in england, they thought i was crazy, but now they understand that the march was sane. thank you once again. thank you to all our viewers who were with us today, you started today the story of an incredible man, a neurosurgeon, and i hope that this story will teach each of you something specific . my greetings to all who are with us, yana eva melnyk , together with the news editor, i will tell you about the most important at this moment, a missile attack on one of the communities of the

kyiv region, according to the head of the regional military administration, oleksiy kuleb, the explosion rang out at exactly 7:00 a.m., while the alarm in the region was announced only 7 minutes later, the russians aimed at an energy infrastructure object, in connection with which cane