A Lady in High Heels

Julia Kachalova

      In these tumultuous days of ruined plans and devalued aspirations, when most of us lose direction and lack a sense of our purpose; our minds and hearts are badly in need of examples of meaningful human lives. Neither Greek heroes nor Hollywood celebrities will serve this end. What we need is some model neighbors who live their whole lives irrespective of whatever hell may go on around them like those of our own, but with more passion to live, more self-criticism, and more courage.
      Sophia Sergeyevna Selitskaya was born in 1922. Professor Sergey Appolinarievich Selitsky, her father, was a renowned gynecologist of the time. Decisive and openminded, he would never accept any trade-offs on principal or precarious issues. As a medical celebrity, he used to feel protected against contingencies that might arise from his straightforward behavior. Eventually, however, national-scale persecutions were deployed to suppress freethinkers, and his name would no longer shield Professor Selitsky and his family. In 1935, Sergey Selitsky, his wife and two their daughters were expelled from Moscow and ordered to South Volga region. Their exile was rather timely, for few years later they would not go this easily. By the time the war commenced, the Selitsky family was back in Moscow.
      Sophia's mother, Vera Nikolayevna, was a practicing pediatrician. She was very soft and humble, deeply religious, and openhearted person. While on good terms with seemingly everyone, she was especially affectionate with children. Many family albums of Selitsky are composed solely of her young patients' photos with words of gratitude.
      In Sophia, diverse qualities inherited from her parents produced a bizarre colorful mix. As a young girl, she began to demonstrate her inclinations towards leadership: she was always the first in street gangs of teenagers; she was a goalkeeper in her school hockey team; she was full with joy and unusual humor.
      "Granny was a general insulting practitioner," her grandson laughs, "Sometimes I can't keep from repeating some wordings of hers. She would bring you down in such a brainy manner that you'd have no idea that, in fact, she was insulting. She would simply add "baby" to it... Her favorite approaches to put it forward were, "Now, baby, hold on and listen to me," and "Now, baby, you're going to learn something from me." Well, I learned it from her how you tell folks what you want and still never offend them. The only thing I can't replicate is that "baby" of hers."
      As a fresh medical school graduate, Sophia Selitskaya was directed to practice at a rural hospital in Karelia. Wonderful places, hearty folks — all those memories would stay with her for years. Four years later, doctor Selitskaya returned to Moscow. By then, she was a skillful and experienced clinician. In Moscow her professional growth was tremendous, due to her unique talent as a surgeon, inbred communicability, and rare determination. The goal she posed before herself was to win respect of her colleagues that would be at least equal to her father’s renown in national medical society.
      In 1963, after professor Aleksandrov's death, Sophia Selitskaya was appointed a head gynecologist at Sklifosovsky Emergency Care Institute in Moscow. Later she would share with her friends that she was not at all sure about her ability to cope with this role: how would she manage the clinic? How would she adapt herself to new settings? With professor Aleksandrov at that post, the gynecology clinic of Sklifosovsky Institute used to be highly praised as the best one in Moscow and year after year demonstrate the best performance measures and health outcomes. Was she competent enough to maintain the high standing of the clinic? Her doubts were rather explainable after all, emergency surgery is something fairly distinct from regular non-emergency care. When you deal with a preauthorized admission, you have enough time to examine the patient and get him ready for an operation. With an emergency case, every second of delay may be paid with the cost of a patient's life. Therefore, maximum self-mobilization is required to response to any clinical situation in an adequate and timely fashion. Clinical decisions should be made in practically no time, while responsibility for these decisions reside on you. There could be no time to seek expert opinion and advice in such an environment.
      For some time, the majority of honored elderly doctors would not acknowledge their new colleague and even tried to push her out of the Institute. On of her associates recalled that "when Sophia Selitskaya joined us back in sixties, she was, at first, strongly opposed by institute's medical authorities of that time. You know, our organization would not accept anyone, unless a new colleague have proved his or her real fondness of the Institute and desire to expend much effort to its benefit."
      Many newcomers leave as soon as they understand their inability to meet tight requirements imposed by their new employment. Sometimes it would take them just a few months to recognize that they have made a mistake to assume clinical responsibilities similar to those in a field hospital in exchange for a regular compensation. In fact, working here is extremely time- and labor-consuming job. Those who survive their trial period, however, usually hold on it for years and decades. Among them was Sophia Selitskaya who eventually entered the list of most celebrated and brilliant surgeons of Sklifosovsky Institute.
      Of course, it took years to win colleagues' esteem. At first, she encountered strong disbelief in her competence to replace Dr. Aleksandrov in his position. The opinion that "a woman would hardly make a good surgeon" has always prevailed among physicians. Selitskaya's adaptation in the new organization was further complicated with her shockingly independent habits. She would boldly reject any colleagues' attempts to make her "know her place". In this she was as impolitic as her father used to be. She would never give up and openly state her opinion. Even her appearance was somewhat extraordinary.
      "She was a lady of a royal posture. And she was always dressed in a peculiar, yet handsome fashion - all those gowns with mink straps, and her black buckled coat with fox collar, and her small turban-like hats. There was nothing of a show-off in her, however, it was all so stylish and so becoming on her. All her dresses, costumes, coats were tailored fast in the waist," says another colleague of Selitskaya. "I remember us traveling together by train, when a Ukrainian lady conductor that happened by simply stopped and couldn't help but admire: "My gosh! What a shape! She's like a guitar!" Choosing right clothes and wearing them right was one of her personal gifts. Until her last days, she was always on high heels. And she was the only surgeon in the institute who was always in shoes with high heels when she operated her patients."
      The first to learn about Sophia Selitskaya talents in other fields, than dress and look well, were her colleagues in gynecology department. "Professional knowledge is not enough to make a good surgeon," her colleague says. "In addition, it takes some inborn gift. Soon after her appointment to the position of our department head, we had to admit that she was born with golden hands. She was equally brilliant both in operation rooms and in managing complications."
      "She used to be the first on the ward in the morning", nurses add. "Sometimes, we happened to be late, and she would be at our patients' bedside already. We tried to evade her then and hardly dared to say hello. And she would turn up from a patient and encourage us with her usual friendly "how are you, girls"." Mikhail Sergeyevich Aleksandrov, her precursor, exercised utter strictness - no chat, no tea during work hours was admitted. Sophia Sergeyevna was of somewhat different opinion; she believed that a good talk at the tea table is the best recreation after an operation is completed. At the same time, while on the job, she imposed strict discipline, though in a friendly manner. She always was the last to enter the operation room, and her requirement was that throughout an operation everyone was silent. "She never gave any directions as for what instrument she would need next or what you should do. She required that everyone should follow the course of surgery and perform their due functions," her assistance says. "Whenever someone was distracted, she would immediately notice it and instruct: "You seem not to follow the job, baby."
      With Selitskaya as gynecology head at Sklifosovsky Institute, the department always demonstrated excellent clinical performance and outcomes, regardless of highly complicated patient case mix. Many surgeons have learned much from her - both from professional point of view and the one of her hearty attitude to her patients and their families. "Sometimes, when a severe case was admitted for emergency operation, troubled relatives would make everyone mad with countless phone calls about the patient's condition and progress: "How's she? Did she survive the operation? Are there any improvements?" And Sophia Sergeyevna would never lose temper and always reassure them: "What's the matter, baby, cool down. She's much better, and you have nothing to worry about."
      Patients responded with the like affection in her address. Anton, Selitskaya's grandson, recounts the story of a patient who was operated over ten years ago, and "since then, every year, she always brings an apple pie on the day of operation". Another example: a woman from God-knows-where turned up with a baby at her breast. "I have a cancer", she said, "and my husband is gone. For Christ sake, do anything that I could raise him." Well, granny operated her. Twenty years later, that same woman visited granny together with her grown-up son. They made all the way back to Moscow, so she could show her son the doctor who had saved her life, and thank Granny for that, and tell her that she fulfilled the promise on her part.
      Whenever I visited Granny on her birthdays, her telephone always went red-hot with congratulations from her former patients. She would count such calls with bars in her notebook, grumbling something like "crazy people" after each call! - not to show that she was happy that patients remembered her and were grateful years after the encounter. In recent years, however, she began to appreciate such calls, maybe, because they somewhat reduced in number... But it was not her fault; simply the new generation is different. Even then, they counted up to 90 calls a day."
      Sudden changes in her moods and attitudes made Sophia Selitskaya somewhat unpredictable in her behavior, but she was never deceptive, or sly, or compromising in what she said and did. In Soviet times, Sklifosovsky Institute saw only two professors who were not members of the communist party, and Sophia Selitskaya was one of them. In this respect, she replicated her father; she always told what she thought and was not afraid of being straightforward with either her best friends or executives in a position to terminate her medical career. Many deemed her to be an unpleasant character, but not to respect her was beyond human power.
      "Colleagues frequently asked her if she could see their friends and relatives, and she would never turn them down," her grandson says. "But, if such a solicitor happened to be out of her good graces, her answer might as well be something like, "O'key, baby, bring your patient here. But mind, baby, if not for her, I would never speak a word to you, because I prefer to keep out of such shit as you are." With this type of phrasing she could address anyone, including chief executives of the institute. And yet, everyone seemed to particularly respect her for being this straightforward. She was the only one who was allowed to smoke at medical board meetings. No one could dare it, and she would simply bring with her a small ashtray with a lid and smoke right in the conference room, and no one mentioned. Of course, the primary source of universal respect paid to her was her professional aptitude - she was the best specialist in surgical gynecology. But I want to depict something else - what a grand character she was!"
      The continuous inflow of small gifts from patients and families was immediately redirected to her colleagues and friends, their children and so forth down to some occasional passer-by. "Sometimes she even made people feel uncomfortable. It was enough to occasionally mention something like "what a wonderful thing", and she was already handing it onto you: "You really like it, baby? So have it." Those souvenirs that she had not handed over yet were displayed on her desk. She liked her house to be full of guests, and so it was on weekends. Granny was a great cook", Anton continues. Her preferred dishes were sturgeon a la monastery and turkey stuffed with apples - she was economic about food. "Complete diet is a principal component of good health, baby, so help yourself,' thus she used to instruct me. By the way, in past two years we had much argument about my diet. I preferred to exclude any meat from my daily ration, and she deemed it to be a crime against my body. She despised vegetable oil as a cheap and inadequate substitute for full-cholesterol cream butter. Whenever I visited her, there would be a large skillet of veal and a can of cowberry jam awaiting me. Funny, she believed that, without cowberry jam, fried veal would be far not so tasty as with it."
      Her affectionate attitude to people was most visible in small things. "Her memory was fantastic," a floor nurse says."She remembered all of us who used to work in her department throughout the period of her rule here. Moreover, she remembered how many children each of us had. And she would always take part in us... I recall, once she burst in nurses' recreation room with the request, "Now, girls, come on and tell me all about your collector's hobbies." As for me, I used to collect imported soup brands, and, you know, it was back in those years when it was not far as easy as just go and buy. Moreover, when it all happened I was employed for few days only. Well, to my utter surprise, when my next shift came, Sophia Sergeyevna approached me with two pieces of imported soap and handed them to me, saying, "Enjoy it, baby."
      She was active and express in her love to those around her till the very last days of hers, regardless of heavy thumps of doom that kept knocking on her door throughout the past decade. One by one, she lost her mother, beloved niece, her only son, elder grandson... By the end of her days, she was living alone, and the only family of hers was her colleagues, which is far more than mere calling organization a "second family" as some do.
      After all, she had never had a family in its traditional sense. Her first marriage went ruin soon after her son was born. Sophia's second experience with marriage undertaken far in her middle age was also a failure.
      After her mother's death, she lived alone, but her son and two grandsons were frequent and awaited visitors. Moreover, Sergey, her son, had chosen medical career and eventually became Sophia's assistant. And then, the trouble burst in violently. Sergey suddenly died at the age of forty. In that time of grief, Sophia Sergeyevna would not blame life for what it had for her and turn away from the world. She ordered that funeral service was held at home, and dozens came to support her: relatives, friends, associates, and every person employed in her clinical department where her son had worked... A nurse who was present at the service recollects that all of a sudden Sophia Sergeyevna stood up and begged her pardon. "What for? I don’t remember. Perhaps, some affront in the operation room, like throwing an instrument at me or crude words... The point is, would you expect someone to remember such things in that situation - it’s incredible!" Anton adds: "She was always smiling, even in most tragic situations. In particular, when my father died. She looked unhappy for a day or two, and then she was smiling again as if nothing happened. What else would you expect of her when nothing could be corrected? On the next day after the funeral she was at work again. That was the only way for her to keep going. I wonder, would she endure daddy's death if not for her work..."
      That was not the last funeral in her life. Four years later, Sophia's elder grandson died in an accident. She had serious health problems by then, but kept on performing all her functions at clinic as if nothing was wrong with her. "She had a number of illnesses," says Anton. And she would never complain about them. At home, she could hardly walk. Well, she mocked it, saying that she had a hard day at work standing for hours at the operation table and now her feet ask for some rest. Though her apartment was located at a five-minute walk distance from the Institute, they had to send a car to pick her."
      Whenever Sophia Sergeyevna had to stay at home - be it for disease or on vacation - colleagues visited her. "In public she always tried to look strong and never complained about anything," Sophia's friend says. "Once she confessed to me that it was at home where she felt most uncomfortable. "You know, she said, when I'm home alone, I feel like crying, and often do." After that, we tried to visit her at home as often as we could."
      It was only a week before her death when Sophia Sergeyevna performed her last surgery. And her very last days she spent in the same Institute, though in bed instead of at operation table. She kept on smiling and trying to assure her colleagues that she! was going to be well soon and resume her regular activities. She would not make it known to anyone, including her closest friends, what inhu-man pain she suffered in fact.
      Sophia Sergeyevna Selitskaya died on September 9, 1998. With Sophia Sergeyevna gone, an entire epoch ended for Sklifosovsky Institute - the spirit, and the traditions, and the glory of that heroic generation of hers were gone irreversibly. But we can still keep the memory of them. The memory that will prevent us from being cowardly selfish in our self-pity with a whisper so tender and familiar: "What's up, baby? Stop your crazy fantasies and listen to me."