Welcome to House of History. Have you ever heard of the Chilean settlement Villas Las Estrellas? Well, I’d be surprised if you have. This settlement is located on King George Island in the Antarctic region. During the summer around 150 people live there, and during winter the settlement is inhabited by approximately 80.
The conditions on the island are harsh, with temperatures easily reaching sub-zero degrees and without any form of wildlife. Nevertheless, the settlement has a post office, a school and homes of course. It is mainly inhabited by scientists and Chile’s air force and navy personnel. Now, this settlement is fascinating because there is a very curious requirement for all those that live there, including the children. Because the nearest major hospital is over 1000 kilometres away, in order to move to the island, every long-term resident has to have their appendix removed. There are doctors on the island, but none are specialised surgeons.
This rule wasn’t thought up on a whim. As a matter of fact, there are cases in history of explorers that developed appendicitis while far away from civilisation. Without a capable surgeon on the team, severe appendicitis meant certain death. Right, so obviously developing appendicitis on an exploration to Antarctica is horrible. Still, a 27-year-old Soviet general practitioner that took part in the sixth Soviet Antarctic Expedition in 1960 truly drew the short end of the stick. Because, well, he was the only doctor on the team and as his illness grew progressively worse, he was left with only one option to survive.
This general practitioner, Leonid Rogozov, had interrupted his training to become a surgeon in order to join the Sixth Soviet Antarctic Expedition in 1960. He was the only doctor on the team and together with 12 researchers, the expedition group was tasked with building a new base at the Schirmacher Oasis, about 75 kilometres removed from the Antarctic coast. Four months in, in January 1961 the station was up and running. Now, this was in the midst of the severe winter months Antarctica is notorious for, and the group decided to sit out the harshest of the winter.
But on the 29th of April, Rogozov started to experienced classic signs of appendicitis. Weakness, tiredness and nausea. The next day a distinct irritation began to develop on the right side of his abdomen. As a general practitioner and surgeon-in-training Rogozov had operated many people with appendicitis. And in reality, it was a routine operation, it still is. The thing is, it isn’t an ordinary operation when you’re in the middle of Antarctica. The boat trip to get there had taken 36 days, and the ship would not return for another year. Taking an aeroplane wasn’t possible because it was the middle of winter and blizzards made it impossible to take off. Rogozov’s situation rapidly grew worse, and as the only doctor, he realized the gravity of the situation: if the appendix burst it would near certainly kill him. As such, all abandoned in Antarctica Rogozov was stuck with an impossible choice between life and death: he would have to operate on himself.
At that time it wasn’t known if it was humanly possible to operate on oneself and, well, it certainly would hurt terribly because he couldn’t sedate himself. In addition, the commander of the expedition had to request official permission from Moscow because all this happened during the height of the Cold War, and a botched operation would put a dent in the prestige of the mission. Then again, without the surgery Rogozov would undoubtedly die, so even in Moscow they probably realised they had no other option.
As the symptoms worsened considerably, Rogozov made his decision: he had to perform an auto-appendectomy on himself. Now Rogozov wrote a diary while he was at the station. His diary the night before the operation read: “”I did not sleep at all last night. It hurts like the devil! A snowstorm whipping through my soul, wailing like 100 jackals.”
“Still no obvious symptoms that perforation is imminent, but an oppressive feeling of foreboding hangs over me… This is it… I have to think through the only possible way out – to operate on myself… It’s almost impossible… but I can’t just fold my arms and give up.”
Fortunately for Rogozov, there were 12 other men. Although they didn’t have any real medical knowledge he assigned them specific tasks for the operation as he worked out a detailed plan for the surgical procedure. Two close aides had to position the lamp a certain way and hand instruments when he requested them. In the unfortunate event that he would pass out, he even taught them how to inject adrenalin and perform artificial ventilation. Because he would have to operate ‘from above’, an unusual angle, an assistant had to hold a mirror so Rogozov could see what he was doing.
As I mentioned, Rogozov couldn’t sedate himself. He managed to apply a local anaesthetic but could not take any as he was performing the surgery in order not to get cloudy. Rogozov later said about the moments leading up to the surgery:
“My poor assistants! At the last minute, I looked over at them. They stood there in their surgical whites, whiter than white themselves. I was scared too. But when I picked up the needle with the novocaine and gave myself the first injection, somehow I automatically switched into operating mode, and from that point on I didn’t notice anything else.”
As for using the mirror, the upside-down view made operating more difficult, so Rogozov quickly switched to working by touch without gloves, instead of sight. Now during the operation, the bleeding was rather intense and there were several moments where Rogozov thought he would pass out and bleed to death. He later wrote:
“The bleeding is quite heavy, but I take my time… Opening the peritoneum, I injured the blind gut and had to sew it up,” I grow weaker and weaker, my head starts to spin. Every four to five minutes I rest for 20 – 25 seconds. Finally here it is, the cursed appendage! With horror I notice the dark stain at its base. That means just a day longer and it would have burst… My heart seized up and noticeably slowed, my hands felt like rubber. Well, I thought, it’s going to end badly and all that was left was removing the appendix.”
After the 2-hour surgery, Rogozov managed to remove his appendix, and as his notes reveal if he had waited one more day, it would have burst which would have ended in certain death. After he removed the appendix, he recovered just two weeks before he managed to pick up his regular duties. The British medical journal published a case report about Rogozov’s auto-appendectomy in the Antarctic; I’ll post the link in the description if you want to read through the full account of the surgery.
After his surgery, the men held out until the agreed-upon time to leave Antarctica. But due to an extreme polar winter, the ship couldn’t pick them up, which meant the entire team would be stuck in the base for another year. Fortunately, they ended up being airlifted out, albeit slightly later than planned and due to the bad weather one of the planes nearly crashed.
Regardless of Rogozov’s heroic feat that became a media spectacle in the Soviet Union and abroad, Rogozov didn’t have many pleasant memories of the expedition. He later stated he felt saddened that he wasted two years of his life in the icy abandoned place, which had lost its mystery within the first month. Due to the height of the Cold War Rogozov’s story was a welcome one after another success: just 3 weeks before his self-surgery Yuri Gagarin had become the first man in orbit. Both men were 27 and both became somewhat of the embodiment of a Soviet hero.
Upon his return, Rogozov didn’t seek a public life. He received the Order of the Red Banner of Labour, a prestigious award for exceptional achievements. And, well, ever since participants of expeditions to the Antarctic are subject to a thorough medical examination because of the risk involved. Rogozov’s story explains the rule for the Chilean town on the Arctic island as well: without a hospital closeby it is safer and better to remove an appendix preemptively.
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