Max Solomonovich Kushakovsky. Life and work

Full Text

On the first winter day of December 1922, in the small Ukrainian town of Zvenigorodka, Cherkasy region, a son was born to the Kushakovsky family. He was named Max. He was the first and, as it turned out later, the only child. His father Solomon Todrosovich Kushakovsky (1887–1978), also from Zvenigorodka, began his career as a joiner’s apprentice, then worked at a furniture factory. From 1917 he worked in various elected party bodies. Max’s mother Tulchinskaya Bronislava Markovna (1898-1984) was a housewife.

Fig. 1. Max Solomonovich Ushakovsky (1922–2002).

Fig. 2. Solomon Todrosovich Kushakovsky (1887–1978), Tulchinskaya Bronislava Markovna (1898-1984).

Max grew up as a healthy and intelligent boy. He spent his childhood in Zvenigorodka, where he went to school and completed the first three grades. In 1933, the Kushakovsky family moved to the city of Vinnitsa due to a new appointment of his father as the head of the party archive. Max went to school number 18, graduating in 1940 with merits. On the advice of his father, he planned to enter a medical school, but there was a Finnish war at that time, and the country was restless. In July 1940, he was examined by the Vinnitsa Conscription Commission that declared him fit for military service but also dismissed him to “leave to arrange household chores until September 15, 1940”. In September 1940, he was drafted into the army and served as a soldier in the 524^th regiment in the town of Shuya, Ivanovo Region. Instead of lectures on medicine, classes, tests and exams, he had to comprehend artillery science.

Fig. 3. Last days in school.

From the very first days of the war, Max Kushakovsky joined the army as part of the 696^th artillery regiment that fought on the Western Front. Month of heavy fighting, retreat from the western border of the country… On July 22, 1941, his regiment entered the battle with a tank column of the Nazis on the Sozh River near the Belarusian city of Propoisk. The commander of the anti-tank arms, Sergeant Kushakovsky, together with his crew, fought to the last. Everyone died, he was seriously wounded. He woke up only in a field medical hospital, deployed in the dense forests of Bryansk, where he was taken to by PO-2 plane. There, he underwent several difficult operations to remove several hundred fragments, although doctors failed to remove them all. From August 30 to October 27, 1941, he was on rehabilitation in the evacuation hospital in Stalingrad. The certificate issued upon discharge from the hospital read: “Multiple shrapnel wounds to the face, upper jaw, torso”.

Fig. 4. Pencil portrait 1941.

After the end of treatment, he was granted a leave for 30 days in the city of Orenburg until December 1941. Even though the medical commissions at that time did not really “nitpick” about the consequences of injuries during re-examination, Sergeant Kushakovsky was still declared unfit for military service. The commission granted his request to be appointed as a hospital porter (anyway, closer to medicine), and then he served in the Chkalov evacuation hospital until mid — 1942.

Fig. 5. Diplom of Military Medical Academy with merits.

Although the war continued in the country, the government decided to send a group of veterans to the Military Medical Academy. In the fall of 1942 Sergeant M.S. Kushakovsky passed the entrance exam in chemistry (it was then the main subject) with excellent marks and was admitted to the Kuibyshev Military Medical Academy, which at that time was evacuated to the city of Chkalov. However, soon Kuibyshev Academy was disbanded. Cadet Kushakovsky, as a front-line soldier who suffered a severe wound, was transferred to the Leningrad Military Medical Academy, located in the city of Samarkand. The dormitories of the academy were as crowded as soldier’s barracks. There was not enough food, Uzbek vegetables and fruits were of some help. There was no news from relatives who were under occupation. However, none of Max’s classmates ever heard a single complaint from him. On the contrary, yesterday’s front-line soldier who celebrated his twentieth birthday in a hot Central Asian city cheered up his friends himself.

After the blockade of Leningrad was lifted in 1944, teachers and cadets of the Military Medical Academy returned to Leningrad. Education process continued. They lived in the dormitory of the Academy on Botkinskaya street. The cadet Kushakovsky was one of the best in his course, having only excellent marks in the record. Organized, self-disciplined, he was for a long time the prefect of the course, and then the commander of the training group of 30 listeners. In 1947, he graduated from the Military Medical Academy with merits, and his name was among the first to be put on Academy’s marble plaque of honor after the war.

As the best graduate, he was given the opportunity to apply for postgraduate studies. In October 1947, he passed the entrance exams and was admitted to the postgraduate course at the Department of Propaedeutics of Internal Diseases, which at that time was headed by Academician of the Academy of Medical Sciences Professor N.N. Savitsky. M.S. Kushakovsky was committed to investigate the peculiarities of hemodynamic disorders in patients with hypertension. The work went well, the first two scientific articles were published, and at the beginning of 1951 he defended his PhD. thesis on the topic “Hemodynamic disorders and the condition of the precapillary bed in advanced stages of hypertension (on the issue of adaptive mechanisms)”.

At the end of the postgraduate course, M.S. Kushakovsky continued his academic activity at the department of propaedeutics of internal diseases as a teacher. However, the young scientist believed that practical experience was vital for his further work. Having worked as a teacher for only half a year — until June 1951, he filed a report on transfer to the hospital, and was soon appointed a doctor at army hospital No. 943, located in Krasnovodsk (Turkmenistan). There he served as head of the therapeutic department for 4 years.

From the very first days of his work, Max Solomonovich proved himself to be an excellent clinician, possessing a very wide range of special clinical knowledge and an extraordinary ability for fine diagnostic analysis. There was a lot of work, and living conditions were not easy: an unusual climate, heat, sandstorms. However, Captain M.S. Kushakovsky, spending most of his time in the hospital, provided medical assistance to local fishermen, ship repairers, Nebit-Dag oil workers, and shepherds. Often, he was invited to lecture at the local medical school. It was in Krasnovodsk, he had decided on the topic of a doctoral dissertation, and he was still actively engaged in scientific work.

Fig. 6. Krasnovodsk. Head of the therapeutic department 1954.

In December 1955, being in the rank of major, M.S. Kushakovsky was dismissed from the army due to the consequences of being wounded. In February 1956, he again returned to the Department of Propaedeutics of Internal Diseases of the Military Medical Academy, where he first worked as an intern and then as an assistant. In September 1960 he received the academic title of Associate Professor. At the department, he was in charge of the clinical department, conducted practical classes with students of the 3rd and 6th years of the Military Medical Academy, lectured for military doctors of advanced courses on various sections of internal diseases, functional diagnostics of diseases of the heart and blood vessels. There he met Elena Ivanova Dorokhova, who also taught at the department and later became his life partner for many years.

For a long time, he lived in a dormitory, because he could not register in Leningrad in any way. Professors N.N. Savitsky and Z.M. Volynsky helped to solve the problem with registration. After their visit to the chairman of the City Executive Committee, Max Solomonovich was finally registered in the city, and so he became a Leningrader.

Besides teaching, all these years he was engaged in the problems of methemoglobinemia, which was closely connected with the emergence of nuclear weapons, radiation damage and radioprotective agents. During the years of work on his dissertation, he published a whole series of papers on this topic and continued studies of hypertension. Vast experimental material, as well as his clinical observations, formed the basis of his doctoral dissertation “Methemoglobinemia and the emergence of other pathological derivatives of hemoglobin. Finding new means of treatment and prevention (clinical and experimental study)”. The dissertation turned out to be very large (770 pages of text!), and comprised two volumes. As Max Solomonovich recalled, all official opponents showed obvious dissatisfaction when seeing this two-volume book. However, in 1965 the doctoral dissertation was successfully defended. On March 5, 1966 M.S. Kushakovsky was awarded the degree of Doctor of Medical Sciences.

Since 1967, professional activities of M.S. Kushakovsky took place in the State Institute of Professional Development of Physicians named after V.I. Lenin. Professor I.I. Isakov, who was then the head of the Department of Therapy No. 2, knowing Max Solomonovich well from their joint work in the therapeutic section of the Leningrad Society of Cardiology, invited him to the post of professor of the department (the academic title “Professor” was awarded to Max Solomonovich in 1968). The transition process was not easy at all. The Chairman of the Presidium of the Leningrad Scientific Society of Therapists, Academician N.S. Molchanov, chairman of the cardiology section of the society, professor A.A. Kedrov, Academician N.N. Savitsky petitioned for M.S. Kushakovsky appointment. On September 29, 1967, the Academic Council of the State Institute Professional Development of Physicians named after V.I. Lenin “recognized him as worthy of being elected to the position of professor of the Department of Therapy II” (out of 42 members of the Council, 37 voted in favor and 5 voted against).

A new stage in the life of Max Solomonovich began. He gave new lectures at all cycles conducted by the department on a wide range of issues in both therapy and cardiology. Fantastic memory, excellent knowledge of theory and extensive clinical experience were the basis for profound and extraordinary lectures in many respects. This brought great satisfaction to the listeners of the cycles, and also gradually began to attract city specialists. M.S. Kushakovsky’s clinical rounds, conducted with students of cycles of further education, clinical residents and hospital doctors, deserved no less attention. Being meticulous himself, he demanded the same from his students. On the rounds, he constantly forced the doctors to percuss and auscultate the patients. Possessing absolute hearing and using a metal stethoscope (which no one else used except for him), during auscultation of the heart, he heard things that no one else could hear (at one time he was called “the third tone”).

Recalling the years of training in clinical residency, one of the residents (now the chief therapist of a vast region in the Far East) said that from time to time the residents were knocked sideways by M.S. Kushakovsky’s questions. However, he would never tell department staff or the cadet doctors off. When something didn’t suit him (for example, the lack of an answer to a question asked, or, moreover, an incorrect answer), he would sigh, shake his head reproachfully and state, “But you need to know this!”. Sometimes, in response to a tricky question about an unusual clinical situation, after a short reflection, he would remark melancholy “It happens” (in the department this phrase has long become a household word). And one could be absolutely sure that it is very rare, but it happens. Often this was followed by an example from his own practice, sometimes from many years ago, but, nevertheless, the exact picture of the disease was recalled, and sometimes even the patient’s name.

At the same time, Max Solomonovich immediately had to fulfill a lot of other departmental duties: conducting a philosophical seminar, which was obligatory at that time, socialist competition, together with prof. I.I. Isakov, he was engaged in the scientific work of the department. Postgraduate courses began. At the same time, he took an active part in the planning of the cardiological building under construction at Hospital No. 1. A huge burden lay on his shoulders while combining work on the board of the Leningrad Society of Cardiology, duties in the problematic commission on cardiovascular pathology, etc. After the retirement of Prof. I.I. Isakov in 1974 Max Solomonovich became the head of the department of cardiology (since 1969).

Max Solomonovich devoted his entire life to science and practical healthcare. His first published scientific work was the abstract for the Military Healthcare Academy scientific conference in 1950 named “Hemodynamic disorders and the condition of the capillary bed in advanced stages of hypertension.” Issues of etiology, pathogenesis, development of modern methods of diagnosis and treatment of arterial hypertension were his research purposes. Between 1950 and 1960 alone, he published 15 articles and theses devoted to these problems.

Work at the Military Medical Academy entailed a scientific search in the field of development and application of radioprotective agents for radiation sickness. 26 papers were devoted to this issue (as well as works closed for wide public access) and published in journals “Biochemistry”, “Medical Radiology”, “Bulletin of the USSR Academy of Medical Sciences”, etc. At the same time, M.S. Kushakovsky developed another problem that was connected mainly with methemoglobinemia. The result of this work, in addition to his doctoral dissertation, was his first monograph “Clinical forms of damage to hemoglobin”, published by the publishing house “Medicina” in 1968 with a circulation of 10 000 copies. The book contained a lot of new data in this field of knowledge (e.g., a new direction in clinical medicine was suggested — “hemoglobinology”).

Fig. 7. Head Department of Cardiology prof. M.S. Kushakovsky with teachers, graduate students and clinical residents. 1981.

Fig. 8. Consultations in the intensive care unit of the city antiarrhythmic center at hospital No. 1. 1981.

Fig. 9. Diploma of the A.L. Myasnikov 1978.

While working for the Department of Therapy No. 2 of State Institute of Professional Development for Physicians named after V. I. Lenin, and then for the Department of Cardiology, Professor M.S. Kushakovsky had a great interest in the problems of cardiac arrhythmias and conduction. He used to write, this was largely due to his great impression of the book by B. Hoffman and P. Cranefield “Electrophysiology of the Heart” (1962). Kushakovsky’s first works on this topic appeared in 1970, and no later than in 1972 a textbook for cadets on clinical electrocardiography was published. It was fundamentally different from the existing works on this topic, and is very popular among doctors even today. In 1972, joint monograph “Selected Issues of Clinical Electrocardiography” was published, where M.S. Kushakovsky wrote a section on cardiac arrhythmias and conduction disorders. In 1974, monograph “Clinical electrocardiography” was published (republished in 1984). Later it received a diploma of the Prize of the USSR Academy of Medical Sciences named after A.L. Myasnikov.

Another area of interest for Prof. M.S. Kushakovsky was myocardial dystrophy. A significant part of this work was carried out jointly with Prof. L.A. Butchenko. Joint monographs “Myocardial dystrophy in athletes” (1980) and “Adaptive changes in the cardiovascular system of athletes with different orientations of the training process” (1982) were published.

In 1977, monograph “Hypertension” was published soon highly recognized among doctors. Further work on the problem of arterial hypertension allowed Max Solomonovich to issue five more editions of this book, each time substantially revised and supplemented. The latest edition of Essential Hypertension (2002) was published a week before his death. His “Atlas of Electrocardiograms. Arrhythmias and heart blocks”, written together with N.B. Zhuravleva is also highly recognized. The monograph was awarded the prize of Russian Medical Academy named after G.F. Lang and has been reprinted three more times.

Fig. 10. Diploma of the title “Honorary Cardiologist of Russia” 2001.

In his last years of life, Prof. M.S. Kushakovsky published monographs “Chronic heart failure. Idiopathic cardiomyopathies” (1997), “Heart arrhythmias (2^nd edition, 1998), “Atrial fibrillation” (1999), “Arrhythmias and heart block. Atlas of electrocardiograms” (1999), “Metabolic heart disease” (2000). In total, he published 17 monographs (including reprints) and more than 220 articles. Max Solomonovich was a member of the editorial boards of the journals Arterial Hypertension and Bulletin of Arrhythmology. For a long time, Max Solomonovich was a board member of the therapeutic and cardiological societies of Leningrad and St. Petersburg.

Prof. M.S. Kushakovsky was a scientific advisor for 30 PhD students. Dissertation topics were usually proposed by Max Solomonovich himself, based either on his own scientific interests or on promising scientific directions. In this sense, his imagination source was inexhaustible, since he read everything that had been written and was available for reading. Not being able to speak any foreign language (except Ukrainian), he nevertheless was able to understand German and English-language scientific literature. It was hard to walk around in his home. Books were everywhere — sitting in bookcases, on tables, on furniture and on the floor. It was difficult to understand how he navigated through this ocean of books and magazines.

Being his graduate student was not easy. Having brought another chapter or article, you could be sure that the next morning you would get it back with so many edits that your own text was no longer seen. Max Solomonovich did not change his habit of writing all texts by hand until the end of his life. He never used a typewriter, and, unlike many, he never accepted the computer. However, with age, as is usually the case with doctors, his handwriting remained practically unchanged, being as clear and understandable as before. Moreover, his handwritten page matched the standard sizes for a typewritten sheet, which also made it easier for his graduate students and editors of his numerous monographs. Sometimes instead of his/her own, a graduate student would receive a completely new text fully rewritten by hand by Max Solomonovich. But there were never any complaints about this. Unobtrusively, but constantly, he would check how research was being done, how records were being kept. It is characteristic that sometimes he knew the work of his students better than they themselves. In his books and articles, whenever an opportunity presented itself, he would always refer to these works.

It was extremely interesting to talk to Max Solomonovich outside work. This was a rare occasion, mainly during offsite courses. His interests were broad, and not at all limited to science. He was very fond of sports, although he himself was never particularly involved in it. He was interested in chess, figure skating, hockey and many other sports. However, his passion was football. He never missed interesting matches, and during the world championships, his attention was definitely occupied by football. In the morning, his first question would be “Did you watch the match yesterday?” followed by bewilderment on his face, if the answer was negative. He knew all the players, the results of the matches and is believed to would have been an excellent sports commentator.

Max Solomonovich always preferred classical music and was a regular at the Philharmonic’s concert hall. He knew perfectly all the operas and ballets given in our theaters, the main soloists. He always tried to get to the premieres. His favorite reading was art albums, the information from which was firmly embedded in his memory. His favorite writers were Dickens, Turgenev and Leo Tolstoy. Knowing their works perfectly well, he would often quote excerpts from them, adding a picture to life situations.

While on offsite course, he tried every possible way to replenish his knowledge about the history of these places. In the towns of Ivanovo, Pskov, Novgorod, Sochi he would participate in tours with great interest, listened to the guides most attentively. In the end, it seemed to us that the guide was not needed at all, because in his absence Max Solomonovich could tell no less. In Novgorod, he could talk for hours about the temples we examined, about the history of the Rublevsky frescoes. In the Pskov-Pechersk Lavra, we enjoyed lectures on the history of religion. In the museum of Dostoevsky, we (in addition to the guide) heard from Max Solomonovich a lot of details from the life of the writer himself and his characters. So it was, always and everywhere.

In everyday life, he was extremely undemanding, and didn’t treat down-to-earth problems seriously. But, since, as he himself said, driving in a nail was an issue for him, some difficulties arose in everyday life. He had neither a summer house nor a car. He did not know how to drive a car, and he never aspired to do so. The ear piece that fell off the glasses became a burning problem immediately, since reading was no longer possible. An urgent repair of glasses using a paper clip and a compass could temporarily improve the situation. Next, he was advised to go to the workshop and install a new screw. However, after some time, the second ear piece fell off. Inspection showed that that the paper clip performed its functions properly, and then the next one was used.

Having suffered a serious illness in 1982, Max Solomonovich had to take hormonal drugs for a long time, which, as a result, led to the development of arthrosis of the hip joint. In a sense, we probably contributed to this by putting a bicycle ergometer in his office and forcing him to use it regularly. This made life somewhat difficult, though he himself took the problem philosophically. Before the illness he used to get to the hospital by metro, and then walk from the metro station “Vasileoostrovskaya” to the department for about 3 km. On the way he was reading all the newspapers that were on the stands of Bolshoy Prospekt (according to his classmate and friend, D. I. Tsank, he developed this habit back in his student years). After the illness however he had to get to work by taxi. In the Soviet times it was affordable but after the monetary reform of the 90s, his salary was barely enough for this. Nevertheless, his working schedule remained the same, the management of the Pokrovskaya hospital also helped with transport. The transfer to half-time job as a professor of the department made it possible to travel to Vasilyevsky Island less often, but it did not change anything in the way of life. There was more time for working with literature and for publishing monographs. After the death, several manuscripts of his articles were found, as well as the monograph “Arrhythmias of the Heart”, which increased in size several times and was jam-packed with bookmarks with corrections and additions, and was completely prepared for reprinting.

Indeed, scientific merits of Max Solomonovich did not go unnoticed, although, by and large, he deserved much more recognition. His first scientific award (apart from the gold medals for school and graduation from university) was a diploma of the A.L. Myasnikov in 1978.

In 1986 he earned G.F. Lang Prize. In 1981, by order of the Minister of Health, he was awarded the “Excellence in Healthcare” badge. In those same years, an attempt was made to introduce Max Solomonovich to the rank of corresponding member of the USSR Academy of Medical Sciences. His classmates V.I. Medvedev, D.I. Tzank, I.P. Ashmarin (then, a Corresponding Member of the Academy of Medical Sciences), A.P. Kolesov (then, a member of the Presidium of the Academy of Medical Sciences), prof. V.A. Almazov (then, a member of the Supreme Council) petitioned for M.S. Kushakovsky, but, unfortunately, his candidacy was not approved. No further attempts were made.

In 1993, after leaving the post of head of the Department of Cardiology, Max Solomonovich was elected an Honorary Member of the Academic Council of the Academy and he was awarded a diploma No. 6. In 1996, by decree of the President of Russia, prof. M.S. Kushakovsky was awarded the title of “Honored Worker of Science of the Russian Federation”. In 2001, he was awarded the title of “Honorary Doctor” of the St. Petersburg Medical Academy of Postgraduate Education, as well as the title of “Honorary Cardiologist of Russia”.

He also earned military awards: he was a holder of the Orders of the Red Star, the Patriotic War, the medals For Courage, For Military Merit, For Victory over Germany, and a number of others.

Max Solomonovich was loved and admired by the staff of the department, the hospital where he had worked for 35 years, his colleagues at the Academy, and medical students. His lectures, clinical discussions, rounds have always gathered a lot of doctors’ attention. He was respected for his truly inexhaustible knowledge, constant benevolence and for being a true gentleman.

Professor Max Solomonovich Kushakovsky died suddenly on June 11, 2002. It happened unexpectedly for everyone, in the morning, when he, going to work, was waiting for a taxi that had already been called. A world-famous scientist who created a large scientific school and glorified domestic science with innovative works in the field of therapy and cardiology has passed away. In 2003, the Department of Cardiology of St. Petersburg Medical Academy of Postgraduate Education was named after him. Since 2011, after the merger of St. Petersburg Medical Academy of Postgraduate Education and Leningrad Sanitary and Hygienic Medical Institute, the combined Department of Hospital Therapy and Cardiology has born his name.

Max Solomonovich Kushakovsky will always remain in the memory of friends, colleagues and grateful students who served the same goal together with him — the protection of people’s health.

About the authors

Yuri N. Grishkin

Author for correspondence.
Email: yurigrishkin@yandex.ru
ORCID iD: 0000-0003-4655-0297
SPIN-code: 9997-2073

профессор кафедры госпитальной терапии и кардиологии им. М.С. Кушаковского

References

Supplementary files

Supplementary Files

Action

1. JATS XML

Download

2. Fig. 1. Max Solomonovich Ushakovsky (1922–2002)

Download (273KB)

Indexing metadata

3. Fig. 2. Solomon Todrosovich Kushakovsky (1887–1978), Tulchinskaya Bronislava Markovna (1898-1984)

Download (201KB)

Indexing metadata

4. Fig. 3. Last days in school.

Download (275KB)

Indexing metadata

5. Fig. 4. Pencil portrait 1941

Download (232KB)

Indexing metadata

6. Fig. 5. Diplom of Military Medical Academy with merits

Download (426KB)

Indexing metadata

7. Fig. 6. Krasnovodsk. Head of the therapeutic department 1954

Download (136KB)

Indexing metadata

8. Fig. 7. Head Department of Cardiology prof. M.S. Kushakovsky with teachers, graduate students and clinical residents.1981

Download (718KB)

Indexing metadata

9. Fig. 8. Consultations in the intensive care unit of the city antiarrhythmic center at hospital No. 1. 1981

Download (818KB)

Indexing metadata

10. Fig. 9. Diploma of the A.L. Myasnikov 1978

Download (167KB)

Indexing metadata

11. Fig. 10. Diploma of the title “Honorary Cardiologist of Russia” 2001

Download (133KB)

Indexing metadata