Medicine: Mustard Plasters to Heart Surgery

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"Eight miles away, on the city's southeastern outskirts, is the Soviet Union's most imposing medical institution: the Cancer Research Center of the Academy of Medical Sciences. Back in 1969 proceeds from the Soviet Union's annual day of voluntary work, called the subbotnik, were turned over to the academy for a new cancer center. About $128 million was contributed to help build a huge complex covering three city blocks, with 1,000 beds for patients. A staff of 4,000 works with the best equipment, purchased from all over the world. In the radiation therapy department, the doctors are particularly proud of their high-energy electron and proton accelerator from France. Professor Nikolai Trapeznikov, the center's deputy director-general, stresses that the work here is mostly experimental: 'For routine treatment there are 250 other specialized cancer hospitals in the Soviet Union, almost one in every large city.'

"In a wooded area in northern Moscow stands the Research Institute of Transplantation and Artificial Organs. Though its present quarters are two decades old and cramped, the scientific equipment is the newest and best, from the U.S., West Germany, Italy and the Soviet Union. Jokes its director, famed Surgeon Valeri Shumakov: 'Our equipment is an international team.' The institute does most of the kidney transplants in the Soviet Union (sometimes exchanging the organs with European and American hospitals), and will soon begin doing liver transplants and resume attempts at pancreas transplants as well."

Yet outside showplace institutions, medical care is surprisingly primitive for a developed country. Most Soviet physicians are unaware of current medical developments outside their country, largely because of limited access to foreign professional publications. Boston Endocrinologist Aron Lurie, who has been tutoring émigré doctors, reports that a standard teaching tool in the U.S.S.R. is the 1950 edition of Harrison's Principles of Internal Medicine. When asked why Soviet doctors did not use more up-to-date editions, Lurie's exile students replied that translations are costly, and besides, said one, "not much new has happened in medicine since 1950."

Apart from the leading institutes, Soviet hospitals are mostly old, dilapidated and sometimes incredibly filthy. Drugs, equipment and techniques that Americans take for granted are rare or lacking in the U.S.S.R. Most blood tests are done manually rather than by automated equipment, and doctors must sometimes wait three or four days for the results. Disposable syringes and needles are virtually nonexistent. There are few kidney dialysis machines, and most physicians have not seen a CAT scanner, the computerized X-ray machine that is the rage among doctors in the West. Medications frequently run out.

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