Roman Shpaner: ‘Saying a doctor will earn a living everywhere is wrong’

What is ailing you, doctor?

In Russia, a lot is demanded of doctors. Everybody understands that they are ordinary people with their own worries, peculiarities of character and human needs. However, daily self-sacrifice is expected of them. “As you are a doctor, help,” people don’t often even ask: “What’s ailing you, doctor?” However, despite the high demand, the attitude to this profession is also special, especially during the COVID-19 times. Songs of gratitude for them and about them have already appeared: “Don’t fall ill, doctor, we are ill for you!” People understood this right now when many have faced the constant presence of death. Doctors, especially intensive care physicians, see it almost daily.

“Or once in two days,” Roman Shpaner corrects the correspondent. “Yes, it is probably the toughest part of our work. It is also very tough to talk with our patients’ relatives, tell them sad news or meet their endless needs. I mean I understand while the patient is in ICU, we don’t talk with him but his relatives. But not always there is an understanding. I can’t explain to concerned relatives that at times I simply have no time for long talks. I have been rather a doer since childhood...”

I understand while the patient is in ICU, we don’t talk with him but his relatives. But not always there is an understanding

A decision “for company” becomes destiny

Roman Shpaner was born to a family of an engineer and a university teacher. He graduated from the prestigious School No. 18 cum laude but didn’t even imagine he would become a surgeon or anaesthesiologist in the future. Exact sciences — physics and maths — attracted him more. In 1993, which was a tough period, it was allowed to submit documents in several universities at once — sit as many exams as you can. In high school, Roman studied Physics and Maths in the preparatory school at Kazan State University. He passed internal graduation exams so good that it became clear he could automatically without any additional trials to study both in Faculty of Mechanics and Mathematics and Faculty of Physics.

However, people who can do things at the drop of a hat often do it “for company” or because they are said, “Do not you have the guts?” The A boy’s classmates were indignant — they had to do exams during the summer and he would have a rest. So they invited him to go to the medical institute just for the sake of friendship. Roman got an A in Chemistry, and he didn’t contemplate anymore what he would be studying — only medicine.

In fact, it becomes clear in medical residency if you chose the right profession. Not everybody withstands even the beginning of work, with its sleepless nights, the state ‘on alert’, pain, deaths everywhere and colossal responsibility

“In fact, my parents wanted very much to have a doctor in the family. My elder brother also studied in the medical institute but left medicine a long time ago. I had to carry the burden,” Roman Shpaner smiles again, and it becomes clear he doesn’t regret the choice. “However, I think the catchphrase or argument: ‘A doctor will earn a living everywhere, won’t stay without a slice of bread’ wrong. It is at least stupid and irresponsible towards both yourself, your circle, future patients to choose a profession resting on these words. In fact, it becomes clear in medical residency if you chose the right profession. Not everybody withstands even the beginning of work, with its sleepless nights, the state ‘on alert’, pain, deaths everywhere and colossal responsibility.”

“On that side of the operating table”

Doctor Shpaner remembered his first surgery forever.

“I was on duty that night,” he says. “A man with a knife injury was brought. I was going to turn to my more experienced colleagues, but a nurse who was much older and more experienced than me, a 26-year-old surgeon, stopped me: ‘Can’t you insert a tube? Don’t you know how to raise blood pressure?’ I said I could, and did. In the morning, I reported on my duty to the head of the unit, and he said I did everything correctly. This was my first patient and my first practice-tested conclusion: ‘An experienced nurse is at times better than a novice doctor’”.

Sometimes those who wanted to become a surgeon but this didn’t happen due to some circumstances come to our profession. However, the specialty of anaesthesiologist has begun to be chosen more often

At the same time, Roman Shpaner had to change the profession as surgeon. When the Interregional Clinical and Diagnostic Centre opened in Kazan, he learnt they were short of anaesthesiologists. In general, there is always a deficit of them. It is soldiers of the invisible front, and their work isn’t paid as well as a surgeon’s work. Moreover, it is a scrupulous work where everything has to be carefully calculated. But somebody anyway has to assume the responsibility and make sure the patient doesn’t feel the pain and is safe:

“Sometimes those who wanted to become a surgeon but this didn’t happen due to some circumstances come to our profession. However, the specialty of anaesthesiologist has begun to be chosen more often. In the past, people from a Tatarstan district called and simply begged a doctor to let his anaesthesiologist go there on his holiday for a couple of weeks,” doctor Shpaner says.

By the way, he said how doctors joke about the tandem of surgeon and anaesthesiologist. The latter tell their colleagues: “You work with hands, while we think, that’s why we are next to the patient’s head”.

We can’t do without solidarity, this is why it is extremely important to keep the kindest relations with colleagues

About honesty and decency

Mr Shpaner thinks that a united staff is a must for doctors’ work. It is simply impossible to cope with daily testing for endurance without solidarity and understanding.

“I easily speak the same language with my colleagues — our nurses are mainly young ladies, it is easy to deal with them,” he says. “I often consult surgeons, you never know who works in the neighbouring operating theatre. We can’t do without solidarity, this is why it is extremely important to keep the kindest relations with colleagues.”

But doctor Shpaner predictably answered the question about the main quality for a human and doctor:

“Honesty and decency. It is important for me. This is what I do to people around me — colleagues, patients, relatives. I think I have the right to expect the same from them. Of course, you don’t always receive such feedback, sometimes I have to be unpleasantly surprised. But I think it is already late to change me.”

I want to come home and just rest. But your people wait for our attention, care and love. My spouse is also a medic, but she works in the Interregional Clinical and Diagnostic Centre

“Where the dead are treated”

Many doctors consider their work not second home but first, the main one. Especially today when every day of anaesthesiologists, intensive care physicians, surgeons and all doctors and medical staff is considered a working day. Families have to respect it.

“I want to come home and just rest. But your people wait for our attention, care and love. My spouse is also a medic, but she works in the Interregional Clinical and Diagnostic Centre. We used to work together, but I began working as head of the unit in the RCH in February 2019. I have three children. My boys are 16 and 11, and my little daughter is 6. We have a rule at home — we don’t discuss work, though things happen,” and the doctor told us a family story.

Once the Shpaners went on holiday to the south. The elder son was little then, he was a kindergartener. New acquaintances asked the kid: “We understood your parents are doctors, but what exactly does your dad do?” The boy: “He treats the dead”. Then he thought and added: “Well, there are live people too there”. So they laughed and understood that the head of the family was an anaesthesiologist and intensive care physician.

Another medical joke from Roman Shpaner. Neurosurgeons often have to work with a small high-speed drill to open the braincase. Colleagues ask them, do you do home repairs well? The neurosurgeon will reply in terror: “I don’t grab a drill at home, better call a repairman!”

A person can’t simply work as a doctor without sympathy for the neighbour. He won’t settle in the medical staff either

“He treated me with respect, even smiled”

It is noteworthy that the doctor doesn’t have social accounts — he has no time for it. However, his patients leave comments on the Internet. This is what we managed to learn: “A God-given anaesthesiologist and intensive care physician. Most importantly, he is a simply good, responsive and kind person. Thanks for the timely help!” Irene, 28 March 2016.

Katya, 13.09.2020: “Many thanks to this doctor! I haven’t met such good doctors who are so interested in the patient in a while. He heard my complaints out, carefully examined me, prescribed medicines and soundly answered my questions. It is an experienced and fast doctor who honestly does his duties and doesn’t waste time. The atmosphere during the appointment is very positive. God forbid if I fall ill again, I will make an appointment with the doctor. Highly recommended!”

Nikol, 21.07.2020: “I have recently had an appointment with this doctor. I can say nothing negative. Everything was relevant. He prescribed necessary medicines, treated me with respect, even smiled. He carefully examined me, explained all nuances of the treatment, the medicines work, I am already feeling better. Thanks for your help!”

We read the comments to the doctor, he loudly laughed at the words “treated me with respect, even smiled”, he almost never stops smiling except for the moment when we began talking about empathy. Do doctors need it? Does it impede them from working or help? Roman Shpaner found it difficult to clearly answer this question.

“A person can’t simply work as a doctor without sympathy for the neighbour. He won’t settle in the medical staff either. You will get exhausted professionally, as people say. I know that in the West people dramatically change their profession or specialisation every 5-6 years. You start to distract whether you want it or not to survive and be sensible, with a cool mind, clear actions. There is a ‘skin’, but it is rather protection, not indifference, apathy or even cruelty,” the doctor believes.

Yes, 24 hours a day, seven days a week, 365 days a year

Who is the real hero?

Roman Shpaner talked about COVID-19 with inspiration: “Coronavirus is interesting for me as a challenge, new reality. It is a virus that needs to be thoroughly examined, coped with, and at last we have to learn how to live with it”.

In general the doctor doesn’t consider his work heroic: “Yes, 24 hours a day, seven days a week, 365 days a year,” he calmly shrugs his shoulders. When asked what a monument he would put to hero doctors, he started to think first and only then answered that it would be the symbol of medicine, a bowl and snake, wisdom and salvation. As we met with him on 9 December, on Day of Homeland Heroes, the question arose on its own. Who is a hero for you?

“It is hard for me to say right now... For me, it is parents. My mother’s early death became a great blow for me, still memorable for me. But professionally, I often participate in a commission for doctors’ certification, a doctor has to be certified once in several years, regardless of work record. When a rural doctor from a district is present in such a professional exam, I want to exclaim: ‘I haven’t lived as much as he has been working as a doctor! How can I evaluate him?’ He should be thanked and given a bow! They are real heroes,” Roman Shpaner confidently said and immediately smiled to end the talk and rush to the operating theatre.”