Borscht and Beer
Speaking of “large-scale cases”, I recall a story.
It happened in the Clinic of Faculty Surgery, “faculty” specialized mainly in urgent abdominal surgery. Let me clarify what that means - it’s when there’s a problem in the abdomen that requires immediate surgery.
Things like appendicitis, strangulated hernia, or, for instance, when a gallstone has blocked the outflow of bile, causing bile to flow back into the bloodstream, and the bladder is on the verge of bursting. In surgical jargon, all this is called “acute abdomen”.
At that time, the Military Medical Academy (abbreviated as VMA) had its own ambulances that brought in “thematic” patients - cases from all over the city that fell under the clinic’s profile and were necessary for demonstration purposes in the educational process.
So, the duty captain-clinician who came to this call, literally a minute after examining the patient, called back to the clinic, hysterically demanding that they immediately send a second car with a special stretcher and four cadets to help him. Urgently! Very urgently, because train movement on the Petrogradskaya metro line had been halted.
Mikhail Aleksandrovich demonstrated an “acute abdomen”, although in everyday terms his belly was flat as a runway and shifting like a sand dune. This immense yellow mass filled almost the entire aisle of the stopped subway train.
There was no one else there, except for the doctor, and the ladies in uniform and the cops driving away the onlookers who had packed onto the platform of the overcrowded station.
Mikhail Aleksandrovich could no longer stand up, and they couldn’t pull him out of the train by his arms and legs, just as they couldn’t fit him onto a regular stretcher, one of those available at the first-aid station at every station. Because with a height of almost one meter eighty, Mikhail Aleksandrovich’s weight was approaching three hundred kilos!
Mikhail Aleksandrovich was a homebody, a lover of the sofa, television and books. He worked as a duty electrician/CPSU officer, or more precisely, as an operator of the central control panel (CCP) at some intricate substation.
Of all the duties, the main one was assigned to him - to sit tirelessly for twelve hours on a chair in a windowless room in front of a huge control panel with countless light bulbs, and if a light bulb flickered or went out, immediately call the duty team to that place.
Mikhail Aleksandrovich himself did not fix anything. The pay at this place was so-so, and no one was eager to go there - it was incredibly boring to sit there, and watching TV was strictly forbidden, so the electrician on duty listened to the radio and constantly chewed something to while away the time.
But getting to work was no problem - every day a small bus from their substation, a half-freight, half-passenger duty vehicle appeared under his window and obligingly honked, and after the shift it took Mishka home.
In fact, it wasn’t just him - many electricians were often picked up like this. But if others were picked up often, he was picked up always.
People understood how hard it was for their colleague! This was a semi-legal service, a kind of extra payment for the boredom. On this day, disaster struck.
For the first time in many years of work, Aleksandrych forgot his “lunchbox”! A large package with cutlets, boiled potatoes, hard-boiled eggs, sandwiches, three packets of milk, as well as a dozen candies and a bunch of bagels and crackers, carefully prepared by his wife the night before, was still lying in the refrigerator.
Instead, Mishka grabbed a bag of dry alabaster plaster that he had been keeping since time immemorial and which he had promised to bring to someone at work.
Out of habit, he took the bundle in his hands and felt at ease, slammed the door, and, panting heavily, trudged to the elevator. He lived on the third floor, but, as you can imagine, he always used the elevator. And he somehow completely forgot about the second package where his breakfast, also known as lunch, dinner and afternoon snack, was rested.
By the middle of the shift, when it was time for the main “snack”, the pangs of hunger turned into real torture.
Mishka rummaged through all the drawers at the central control panel, but found nothing there except for a miserable, grimy caramel.
Having slurped the candy as tenderly as possible and trying to prolong the pleasure, he looked into the trash can - yesterday his wife gave him chicken and maybe there were some bones left... But no, the cleaning lady had already managed to empty everything.
A small curled-up piece of lard was stuck to the bottom. This was definitely from last week. The candy dissolved entirely, coating his tongue with rancid jam.
A second later, his mouth was completely empty. Mishka looked around furtively - there was no one behind the open doors.
He put his hand in the trash can, carefully tore off the greasy lard and quickly stuck it in his mouth. The bitter taste of salt was superimposed on the cloying caramel residue.
“As bad as fat without bread,” his mother-in-law’s saying came to mind, and the crackling immediately slipped down his gullet.
These finds did not satisfy his hunger, on the contrary, they awakened some kind of frantic rumbling in his intestines, which made it completely unbearable. Mishka carefully licked the candy wrapper, and with a resigned sigh, dropped it into the trash.
In general, this day turned out to be depressingly lousy.
Towards the end of the shift, the duty team arrived, joyfully announcing that “the engine of the bus had seized up” and that City Energy Department would urgently send them another machine tomorrow. And all work was cancelled for today.
They had already called Mishka’s replacement, who had shown up to work early due to force majeure and finally let the hungry giant go his separate ways.
Mishka puffed like a locomotive and quickly, as fast as his build allowed, trudged towards the exit. In fact, he hated traveling around the city on his own, and the last time he had taken the metro was probably a couple of years ago.
Halfway to the station, shortness of breath took its toll, and Aleksandrych sat down heavily on a bench in the first park he came across.
A minute later, the guy he had brought the alabaster to ran past. He noticed Mishka and immediately suggested coming over for a small drink.
Why not! With pleasure. Mishka, like an overgrown Winnie the Pooh, swallowed.
Visiting is good, especially since it’s only to the next building, and there won’t be any torture with stairs - the apartment is on the first floor.
Behind the treasured door, instead of the expected delicious aromas of something fried, the smell of paint hit his nose. Unfortunately, the guy’s wife went on vacation with the children, and he was temporarily a bachelor, doing minor apartment repairs. Such work gave him a respectable reason not to cook anything himself - the main place for repairs was the kitchen.
Out of all the provisions his wife had prepared before leaving, there was only one healthy pot of borscht left. And men, in such situations, often become like children - they first eat all the second courses, then they gobble up the sausage, while the soup stands until it sours, unless someone heats it up for them and serves it on the table in a plate.
In short, there wasn’t even any bread for the borscht - the only crust left was used to “sniff” the hidden bottle of vodka.
The host saw Mishka’s hungry look and teased him: “Oh Mishka, eat it, don’t be shy! You can eat it al l- I’ll pour that borscht down the toilet anyway, it’ll probably spoil tomorrow. Help me out, why let it go to waste?!”
And Mishka ate. He ate to his heart’s content. The borscht was thin, it was sour, but overall quite tasty. The pot was emptying quickly.
His colleague looked at such a miracle and only gasped with delight, egging him on. Finally, the hunger retreated, Mishka had eaten his fill.
The grateful host volunteered to walk Mishka to the metro. They wandered slowly, decorously, and there was the station. And on the patch of ground in front of it was a kiosk with draft beer.
Well, let’s have a glass as a farewell. It didn’t work out to be a glass, it was either five or six, or maybe more - who was counting? Fortunately, there was a bathroom nearby, so there were no problems with nature’s call.
They stood there until closing - white St. Petersburg nights steal the evening time unnoticed.
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Finally, they said their goodbyes.
Misha tucked his stomach in with his left hand and somehow managed to squeeze his right hand into his trouser pocket. Pressed from all sides by folds of fat, his hand felt the change. Phew, here it is - the long-awaited five-kopeck coin.
Alexandrych did not like squeezing through the predatory doors. He dropped the coin into the outer turnstile, where the passage was wider, puffed past the attendant and cautiously stepped onto the escalator, reliably blocking it for everyone wanting to run down
The worst thing remained - getting off the escalator.
He looked enviously at the flock of young students cheerfully jumping over the “comb” somewhere ahead. The dangerous line was getting closer and closer.
Mishka concentrated and took a critical step. His body swayed, but nothing happened - he did not fall, did not lose his balance.Thank God, he got away with it.
Having guessed in advance the place where the carriage would stop, from which it would be closest for him to get off at his station, Mishka stopped, involuntarily wincing from the surprised glances of passers-by - his figure clearly attracted attention.
However, there were not many people at the station, and soon a train arrived, which was also full of empty seats.
Well, the most difficult part of his forced journey today was over. Mishka had already managed to sweat, as if a bucket of water had been poured on him.
He sighed with relief, went into the carriage and, anticipating how the pleasant cold leatherette would touch his sticky back, plopped down on the seat with pleasure.
There was no pleasure.
Something terrible happened - as if a stake had been driven into his stomach.
A sharp pain pierced him - the kind that people describe as twisting. He would have twisted if not for his massive body.
His stomach heavily sagged to the side, pulling his entire body along. He had no strength to stand up, and Mikhail Aleksandrovich fell, and then, on top of the pain, such weakness suddenly came over him that he could not even call for help.
Misha wheezed, then began to whine pitifully. People jumped out of their seats and tried to lift him. All they managed was to turn Misha onto his back.
In this position, it was even harder for him to lie than on his side, his wheezing turned into a loud, constricted rasping mixed with a whistle, as if his body was being inflated with a bicycle pump.
Someone pulled the emergency brake, the train screeched its brakes, and the driver’s menacing voice was heard from the selector.
Having realized what was happening, the driver started the train again, promising an ambulance at the next station.
At the nearest station, two half-witted cops came running with a stretcher, but they couldn’t pull Misha out of the car either. The situation was unpleasant - the whole line was at a standstill, causing a human traffic jam in the underground city.
That is why they redirected the first available ambulance there, luckily with our Klinord.
Klinord turned out to be a smart guy, he quickly recognized that this giant fat man had an “acute abdomen” and not a standard heart problem. That’s why he decided to evacuate the patient to his home “Faculty.”
Additional help in the form of four healthy fellows in cadet uniforms with folding NShB-2 (“wide canvas stretchers” in the old military supply nomenclature) arrived in just minutes. The stretcher would not fit in the aisle next to the body - there was little space.
They had to put a regular stretcher under it, and put a couple of people at the edges of the stomach. Somehow they carried the carcass out of the car and already on the platform they rolled it onto the NShB.
Then on the escalator they put the head end on the step, and held the legs, taking turns and trying to keep the body as horizontal as possible. At least the lady controlling the escalator turned it off, allowing the team to board and disembark. Six of them dragged him to the ambulance, and even then their hands turned white from the strain.
Finally, the carcass was in the Clinic. Fat people usually suffer from high blood pressure, but here it is low and keeps falling, and the pulse, on the contrary, is growing.
Wow, it has gone off the scale at over one hundred and thirty!
This is usually the case with blood loss. The surgeon on duty tries to feel the stomach through the fat. The doctor’s hands stamp on the giant folds, disappearing into the soft waves of the fatty quagmire.
Finally, he manages to dig down to the abdominal wall. The stomach is hard as a board. If our hero were three times lighter, he would probably writhe like an eel in pain, but as it is, he only squeals shrilly, convulsively beating his hands, like a whale washed up on the beach.
The surgeon in charge winces - the clinical picture is not very clear.
Well, let’s do a laparocentesis on him. This is a tiny surgery with a purely diagnostic purpose - a small incision is made in the abdomen, then a hook is inserted into this hole, the anterior abdominal wall is hooked to it and raised into a “tent”.
A special instrument, a laparoscope, is inserted into the resulting space, if it is necessary to have a better view, then the abdomen is additionally pumped with sterile gas and all the organs are calmly examined.
You can also insert a regular IV tube, connect a syringe to it and take the contents of the abdominal cavity for analysis. In general, it is dry there - any liquid is located exclusively inside the intestines.
Somewhere in the clinic they found a thick piece of acrylic plexiglass, over a meter and a half wide and three centimeters thick.
They washed it with a disinfectant solution, wiped it with alcohol, put it on the operating table, covered it with sterile oilcloth and sheets on top, and only then rolled our oversized patient.
They did a laparocentesis, hooked the abdominal wall - the hook disappeared into the fat up to the handle. Two people had to pull this mass, and even then without much success.
Almost nothing is visible inside. Normally, a kind of muslin mesh with fatty inclusions lies on the internal organs - it is called the greater omentum. So, Mikhail Aleksandrovich’s omentum was shiny, impassable heavy hummocks of whitish fat, along which a sparse web of blood vessels ran.
They gave gas to the belly to the maximum. Somewhere along the very edge of the omentum, a strip of liquid appeared. They tried to suck out a couple of milliliters with a syringe. A strange liquid - reddish, cloudy.
They gave the patient a preliminary diagnosis of “perforated gastric ulcer”, quickly put him under anesthesia and went to a real laparotomy - an operation where the anterior abdominal wall is widely opened exactly along the midline of the abdomen. An anesthesiologist came up with a laryngoscope blade.
The nurse-anesthetist injected a drug into the vein, the patient went limp, now we need to quickly stick a tube into his trachea, and then turn off muscle tone with special muscle relaxant drugs and immediately connect him to an artificial ventilation apparatus.
The person is literally paralyzed and can no longer breathe on his own, air will be supplied to his lungs by a machine. But nothing will interfere with the surgeon’s work.
It’s easy to say, quickly - this patient has a second and third chin, and each one is heavier than a good buttock, and what a graceful neck - like the most thoroughbred boar at the peak of fattening. Such a thing barely bends and does not encourage fast work.
And the fat itself! Fat is a depot for most drugs. Underdo the drug - the person will die from pain shock, overdo it - he will die from an overdose.
The required dose is usually calculated based on body weight. A normal body. Here we have 70% fat.
Due to its chemical and biological nature, fat absorbs drugs like a sponge and releases them slowly. The line between “very little” and “overdose” becomes very shaky, vague. And the less clear this this line is, the more nervous the anesthesiologist gets.
He plays with his jaw muscles, chatters his teeth and instead of strict and clear schemes, begins to rely only on his own intuition. Well, finally the anesthesia has been given, the machine is working...
Guys, let’s go!
At first, the leading surgeon at the table was Lieutenant Colonel Fedotkin, a hysterical personality, showering everyone and everything with some kind of deliberate quasi-intelligence.
As if reciting a prayer, he read a lecture to the cadets gathered around about seeing the hidden beauty in every body.
Surgical masks conceal facial expressions, but you can hear the cadets giggling ambiguously behind his back.
Fedotkin hesitantly dragged the scalpel across the surgical field. The wound instantly gaped open, revealing bright yellow, as if granulated edges of the most powerful subcutaneous fat. Clamps were applied to the rare vessels, and the surgeon slashed again.
No “anatomy” appeared - the yellow ravine simply noticeably deepened. The lieutenant colonel’s hands disappeared into the wound and hesitantly groped along the bottom - monotonous subcutaneous fat everywhere.
Fedotkin mumbled something plaintively incoherent and cut the body again. The effect was the same - fat! Fedotkin raised his hands: “The case is serious, call the professor!”
The cadets giggled again.
The professor arrived.
He assessed the situation. “Yes, the case is bulky, literally and figuratively. Cover the wound with sterile dressing - I’ll wash myself and continue. You’ll assist!”
A couple of minutes later, the cadets respectfully stepped aside. Dripping pervomur on the floor, the professor quickly walked to the operating nurse, dried himself with a sterile towel, took the robe on his shoulders, put his hands in the gloves provided.
Someone obligingly tied his belt, someone adjusted his glasses. A step to the table and the operation rushed with unprecedented speed.
The white line of the abdomen became visible - a strong tendon that divides the abdominal wall into symmetrical halves. This aponeurosis is opened literally in one movement, the hands of the assistants move the heavy layer of the omentum and underneath appeared...
Borscht!!!
More precisely, intestines floating in borscht, and a strong smell of beer immediately spreads throughout the operating room
One of the cadets mutters in confusion, “Zhigulevskoye beer, I suppose ...”
The professor discontentedly throws out “who is this expert here”, and the snickering turned into hissing. Everyone is now more concerned not about the type of beer, but the very reason for the presence of this vinaigrette in the abdominal cavity.
Is it really a perforated ulcer, where a fistula forms in the stomach wall, through which the contents pour out?
No, everything is simpler. During the revision of the stomach, no ulcer was found. The stomach was really as it should be!
The volume of a normal stomach is about a liter, well, one and a half. This one is much more than three.
A wineskin, not a stomach!
For a person who has completed a course in normal anatomy, this makes an impression, even if it is empty.
And on the front wall of this “receptacle”, somewhere about five centimeters from the lesser curvature, there was a huge, palm-sizedRUPTURE!
Filled to capacity with borscht and beer, the stomach simply burst when Mikhail Alexandrovich plopped down onto a seat in the subway.
The tear was sutured, the belly was washed from the borscht. Then they fought infectious complications long and hard. But our giant survived.
During the lengthy and painful postoperative period, he even lost a fair amount of weight - before discharge, excess skin hung on him like huge burdocks.
Here, however, the chief of staff performed a little trick - he stitched up our fat man’s stomach very cleverly, so that the three-liter wineskin became a small pouch the size of a fist.
Whether he wants to or not, for the rest of his life he will have to eat a maximum of half a bowl of soup - nothing more would fit at once.
The most radical cure for obesity.
Here one might joke about immoderate gluttony, but it’s not that simple. It is a disease.
Gluttony cannot be attributed solely to personal debauchery, although this is the most important factor. Genetics and psychology also play a role here.
At the nicest department of the Academy - the Department of Children’s Diseases, we saw a poignant scene - an iron grate, and crying children behind it.
Crying from hunger, because this peaceful department conducted significant military research - studying the impact of nutrition on the development of army conscripts.
After all, every soldier was once a child. And the fact that some will be unfit for conscription sometimes becomes clear already at a very early age.
Or limitedly fit - what such children grow into can only be called a soldier in mockery - they can neither do push-ups, nor run, nor pull themselves up! Despite the fact that they are not sick with anything.
The only reason for their disability is excess weight.
So they created a special department where they tried to treat such children. We came to the department and heard the hungry cries of well-fed eighty-kilogram strongmen who were reaching out to us from behind the bars with their hands, pleading “soldier, give me a candy.”
And the bars were absolutely necessary in this case, so that compassionate children from other departments would not give them their cookies.
The “muscle-bound” were not allowed to receive their mothers’ parcels, and they tried not to allow mothers themselves into this department very often - after all, torture by hunger, even partial, is sometimes much harder for a mother than for a child.
In Stalin’s time there were practically none of these children, they appeared towards the end of the Khrushchev era, in Brezhnev’s time they became a problem, and after Perestroika it was as if a dam had burst.
Every fifth Russian is now overweight, although not to such an extreme as Mikhail Alexandrovich.
Therefore, I would like to give all mothers one such simple advice - in 99% of cases, if your child has not finished his meal, do not force him to! This will do him a great favor.
“Eat well, you will grow big” is a double-edged sword. You will grow big in any case, but if you eat very well, you can easily grow very big.
After all, adults often unconsciously measure children’s portions based not on the needs of their children, but purely on their own perceptions.
Blasphemous or not, we live in an age of food abundance, and so while this age lasts, the place of uneaten porridge is in the garbage can, not in the stomach.
After all, the number of lipocytes (fat cells) is laid down during childhood, and the rest of our lives we mainly change their quality, intensively pumping fat into them.
When there are many such cells, and they are also filled to the brim, we get three-hundred-kilo Mikhail Alexandrovich, with the risk of bursting just by sitting down in the subway.
