Focussing on trauma and the military, it is fitting to include this interview with ENT Professor and Russian Army General Yury Konstantinovich Yanov. Professor Gerard O’Donoghue had the honour of putting some questions to this eminent figure in Russian ENT, and we hope you will enjoy the following insights into his life and career.
Yury Konstantinovich Yanov.
No single sphere of human existence will develop on its own and there isn’t a single branch of science that will achieve results without a huge amount of human effort. In a certain field or aspect of knowledge, when a champion for the cause surfaces, an apologist, or luminary, then you can start to talk about breakthroughs being achieved. We must often be equipped with an inquisitive mind, show some talent and also rely on the painstaking work of just a few extremely motivated individuals. Without them, however, great discoveries would never be made.
Yury Konstantinovich Yanov spent over 40 years studying otorhinolaryngology: in the sterile working conditions of laboratories, in the dust of libraries and also in the hell of warfare. For his service in Afghanistan, incidentally, where he headed up the hospital’s ENT department, Yanov was awarded military decorations and a service weapon. Then, Yury Konstantinovich was to receive another miltary honour, nine medals, and was to produce over 200 scientific and research works, which were to include eight theses and scientific discoveries. Yanov would then be promoted to the rank of General and be awarded the title “Honoured Doctor of Russia”. It is almost impossible, therefore, to overestimate Yanov’s significance to Russian medicine.
Yury Konstantinovich, what inspired you in the 1960s to focus on ear, nose and throat problems?
When I was a child, physics fascinated me. I was really interested in the history of the propagation of sound waves and vibrations. I read books about gravity and studied the problem of balance and equilibrium. I was quite good at it all – that is to say, I was successful in various academic competitions. When the time came to choose where to go to university, I was influenced by the fact that my father was in the military and that my mother was a doctor. I went to study at the Military Medical Academy (MMA), to keep everyone happy. I plumped for otorhinolaryngology out of my passion for sound.
Tell us about your studies. Who inspired you at this time?
In my fourth year, I joined a student scientific society. Some brilliant scientists and scholars worked there at the time: Vladimir Ignatiev Voyachek and Konstantin Lvovich Khilov. Their work was both amazing and inspiring. There was also Professor Nikolai Ivanovich Ivanov, who was the Head of the ENT Department. Ivanov was a man who was truly devoted to his work. Every month, he held long discussion sessions for several hours: during these sessions, several dozen theses and scientific articles were usually discussed and he always voiced what he thought about them. We rewrote the history of disease several times – all in order to delve deeper into the subject. In terms of practical work and learning how to perform operations, carrots were used as a septum and we used onions to practise stitches.
1972: Graduate of the Military-Medical Academy.
What do you think are the milestones of your career?
I studied for six years at the MMA and then worked for a couple of years as the head of the regiment’s medical centre at Kapustin Yar. Where else can you get experience like that? Where else would you see pulmonary oedema, caused by spillages of rocket fuel? Then I went on to complete my PhD, wrote my thesis and started teaching.
In 1980, I started to do transnasal pituitary surgery at the Polenov Institute; at this time, I also started to focus on the pathology of the ear, nose and throat. Then I went to Afghanistan in the mid-1980s where I served for two years. There was a lot of heavy fighting at this time, and, for me, as head of the ENT department, I saw a lot. At the time, it was all head and neck surgery and I also acquired a lot of experience in working with gunshot wounds. What didn’t I see! I also encountered deafness a lot back then, brought about by mines and explosion-induced injuries. For many it is impossible to live through warfare and still remain human.
“An army doctor is still more doctor than soldier. Risking your life to save others is a good way to remain human, believe me.”
In some ways it is probably easier for a doctor to deal with. What are you doing during all the shooting and shelling? You are saving lives and you are focused purely on one thing – helping. I can honestly tell you that we helped everyone: we treated our servicemen and yours, Russian officers and local children, those for whom we fought, and those whom we fought against. An army doctor is still more doctor than soldier. Risking your life to save others is a good way to remain human, believe me.
1998: Head of the ENT Department of the Military-Medical Academy.
Do you only have painful memories of the war?
I think that we simply wouldn’t have survived without a certain sense of humour. When life chooses to throw these moments at you, you have to have a sense of humour. For example, an officer was brought into the hospital: he couldn’t eat, the food wouldn’t pass – some foreign object or other was blocking its path. We did an X-ray and it turned out that there was a four-star officer’s rank badge in his oesophagus! In the Russian army, when soldiers are awarded a promotion, their officer’s badge is thrown into a glass of vodka, which they then knock back.
You yourself are a General!
Yes, I was made a General later. This century, in fact. For me, if I’m honest, this came as a pleasant shock.
Yury Konstantinovich Yanov with his parents in 1950.
Yury Konstantinovich Yanov as a child in 1952.
Military doctors should not only treat patients but be able to skydive and shoot.
Performing early surgeries, without endovideosurgery.
Since 2000, you have been the Director of the ENT Research and Development Institute. How are things there?
Things at the institute are fine – busy. Our clinic offers more than 50,000 consultations and performs more than 5000 surgeries a year. People come to see us from all over Russia and sometimes 20 operations are performed a day. Historically, the Institute also runs a ‘Thesis Board’, which regularly sits to discuss and assess new scientific works.
You are not only the Director of the Institute, you are also the President of the Russian Society of Otolaryngologists. What does the Society do?
For about 15 years now we have been publishing a specialist magazine, which is, of course, a source of information for all those interested in otolaryngology. The Society is also involved in developing the standards which are used to train and assess otolaryngologists, and as an authoritative body, we are constantly amending and defining training programmes for new specialists to the field.
How do you become a good otolaryngologist?
Only hard work and sincerity with respect to your patients can help you become a great doctor. Many people won’t agree with me on this, perhaps, and would insist on maintaining a cold, detached and rational approach, as well as just looking the part. As I lived through the war, however, and saw a lot of pain, I’ve now come to the conclusion that empathy, involvement, compassion and a humane approach are far more effective in terms of results than a purely distant and scientific one.
With fellow military doctors near a monument to doctors who died during the wars.
In the operating theatre.
In the operating theatre with nurses from the anaesthesiology and surgery departments.
Professor Yanov with his “reason to live and work” – a child before cochlear implant surgery.
What has held the most interest for you?
I’ve always been interested in otology and surgery. I have always thought of the anatomy and physiology of the ear as a beautiful secret. And the theory of sound propagation? This is almost like solving one of the universe’s greatest mysteries. I enjoyed studying the pathology of the middle and inner ear, so as to be able to perform reconstructive surgery. Cochlear implants, of course, have always amazed me. Today, ear, nose and throat specialists are doing over a thousand cochlear implants a year! In 1997, however, when we successfully carried out the first implant operation – then that was a real victory for us.
You’ve done so much in your life and you’re showing no sign of slowing down – where do you get the energy?
From simple human joys. I love my family, and those closest to me try to support me in everything I do. I value my friends and I love being able to go to the theatre and being out and about in the city. And finally, I love my cats and dog! And, maybe, the thing is that I found my place in life – and in this respect, I’ve been more lucky than others. The realisation and understanding that you’ve done something useful – that people will remember you and that you will leave behind grateful students.
Professor Yanov with his family playing piano.
“With faithful friends.”
Do you follow what happens to your students?
Of course! It’s turned out that many of my students have been closely linked to recent developments in otorhinlaryngology, and now, they are all leaders in the field. Many of my former students now have PhDs in medicine or are professors, and those students who graduated from the Institute are now leading clinics in Moscow and across Russia. I often see that former students of mine are responsible for new discoveries and developments. And, of course, I follow the development of otolaryngology as much as I follow the development of my former students. I’m very happy that they’ve given me a reason to be proud.
Interviewed conducted by Gerard O’Donoghue.
Declaration of competing interests: None declared.