Dr. Ihor Kurilets, Ukrainian co-star of the British documentary “The English Surgeon,” struggles with an outdated medical system, poverty and ignorance in his daily work at a hospital in Kyiv.
It is hardly a revelation to Ukrainians that their health-care system is poor, outdated and fails to do the job. Thanks to a British documentary, “The English Surgeon,” more people outside Ukraine know it too.
“The English Surgeon,” the award-winning documentary by Australian director Geoffrey Smith, was released in 2008. It made a star out of London-based neurosurgeon Henry Marsh, who has been coming to Ukraine for more than 15 years to donate his skills and operate on patients that the Ukrainian medical system considers hopeless.
His co-star in the movie, Ihor Kurilets, is Marsh’s lesser-known Ukrainian counterpart. Kurilets has won little fame abroad and almost none back home. After one screening in Kyiv, the filmmakers did not get any offers from television or cinemas, even though they sold out in New York recently.
“The English Surgeon” portrays the grim reality of Kurilets, an outcast of the state medical system because of his unorthodox views. His desperate patients seek salvation in his private clinic, operating in the rented wards of a state hospital.
The movie is a tale of patients’ struggles against an indifferent and clumsy medical system. Kurilets, with limited financial resources and equipment, tries to help them. Marsh struggles with ethical decisions he has to take about the patients who were diagnosed too late.
The nearly two-hour documentary told only a small slice of the story. Off screen, the 50-year-old Kurilets’ reality is even harsher and more relentless than portrayed in the movie. In an interview in late July, he said that he already had enough material for a sequel.
“The film didn’t even reach to the bottom of Ukraine’s medical problems to date,” he said. “Every day I have lines of people outside this office. They come here thinking that we are gods. But we’re not.”
He fixes medical equipment himself because “there is no service in this country.” His private clinic specializes in spine surgeries and brain tumors. Confident and upbeat, he claims that his practice outpaced other clinics in Ukraine by an average of five years in terms of experience and equipment.
The movie and his reality don’t match up in all respects. In the film, he’s portrayed as a doctor helping patients for little or no money, giving out chocolates to those lining up to see the visiting English doctor. In reality, he is charging patients, like all other doctors in Ukraine, but does it openly, above the counter.
But the movie seems, overall, like an accurate portrayal. It received standing ovations at film festivals worldwide but made little impact in Ukraine. Producer Geoffrey Smith said that he did not even get offers for community screenings, “although it is a fantastic opportunity for people to see that selflessly giving to others is its own reward and is so helpful in the age we live in.”
Kurilets describes himself as persona non grata in Ukrainian medical circles because he refuses to follow the herd. “When I came back from London, I became the enemy of the state,” he said, recalling his first attempts to integrate his British experience in Kyiv in 1993. “I had two choices: to quit medicine and go clean the streets or start everything from scratch.”
He chose to open a new page. Marsh, now 58, helped him all the way through.
“I was appalled to see a completely broken down, bankrupt medical system,” said the English surgeon, describing his first visit to Ukraine, in the documentary. Marsh had been invited to give a lecture in a medical school. “He [Kurilets] was basically questioning the official ideology of how medicine should be practiced. I set him up. The more they tried to squash him, the more I tried to help,” Marsh tells the audience, describing his early experiences in Ukraine.
Marsh dispenses advice over the phone. He imports used equipment and operating tools from Britain during his twice-a-year visits. He performs difficult surgeries that Kurilets has no experience with. Over the last couple of decades, the pair has gained a reputation as doctors who aren’t deterred even by the most difficult diagnosis.
“I saw that doctors abroad were encouraged to operate sometimes in the most mindless situations to at least try and bring people back to life. Here [in Ukraine], everything’s done to prevent risky surgeries,” Kurilets said.
Patients featured in the documentary include a young man from western Ukraine, Marian Dolishny, whose brain tumor had been diagnosed as inoperable by other Ukrainian doctors. But the duo challenged the diagnosis and opened up the man’s skull in front of the camera, and Marsh successfully removed the lump.
Dolishny stayed awake throughout the whole bloody operation, comparing the pain to a giant mosquito bite. Marsh took the metaphor even further, comparing Kurilets to a big mosquito biting the medical establishment in Ukraine.
Few neurosurgeons want to comment on Kurilets’ work. Former Health Minister Mykola Polishchuk, also a neurosurgeon, is dismissive about Kurilets. “He [Kurilets] presented our neurosurgery as stone age,” Polishchuk said. “When I was inviting foreign doctors to our Kyiv emergency clinic, they concluded that, overall, our system is suffering. But in many spheres, we are not worse than the British or the Americans.”
Some of the episodes seem to sensationalize the gloom. For example, Kurilets picks Marsh up at the airport in a Soviet “Volga” ambulance, a rare sight in Kyiv in 2007, when the movie was shot. They see patients in the clinic of Ukraine’s security forces, but prefer to call it “the former KGB hospital.”
In the film, Marsh compares the risks of treating many diseased people in Ukraine to playing a Russian roulette with two guns. It’s a choice between the risk of operating and the risk of non-operating. In either case, consequences can be dire or even catastrophic. During their joint practice in Ukraine, they had both. Kurilets said he was being sued for some surgeries that resulted in tragedy.
In the film, Marsh is often struggling with the dilemma of whether or not to take a certain risk, and even whether to tell patients the gravity of their situations. Together with Kurilets, they cannot bring themselves to tell a pretty 24-year-old woman that she will soon die. In a different episode, they travel to a foggy village to pay their respects to a mother of a girl who died after two unsuccessful operations in London. “If it happened again, I would say no [to surgery],” said Marsh, overlooking the grey cemetery.
The documentary is a troubling illustration of neglected patients in the middle of Europe, rather than in the distant and poor African continent. It is a story that makes one scared to get sick in Ukraine. Doctor Lilia Hryhorovych of the parliamentary health committee said there are good reasons to be scared.
“There are no doctors in villages; half of the staff positions are vacant in regional hospitals and in bigger centers, it’s sometimes dangerous to be operated just by any surgeon,” she said. Financing of the health sector is increasing yearly, but still falls short of at least 5 percent of the gross domestic product, a recommendation by the World Health Organization, according to Hryhorovych.
And the private sector is developing slowly due to bureaucracy and corruption. “It’s possible to open private clinics in Ukraine, but they [doctors] need to give bribes. For a new comer, it’s rather difficult. He will need to find protection and support,” she said.
Kurilets has learned this lesson the hard way. “If you are successful in this country, you have to pay for it,” he admits. The maverick doctor seems to derive wicked joy from his daily struggle. He often compares himself to a Kozak. He is reckless and passionate in his own battlefield: An operating room. To some, people like him give hope that Ukraine may recover one day.
About “The English Surgeon”
To host a screening, purchase a DVD, read more about “The English Surgeon” documentary or donate, go to http://www.theenglishsurgeon.com. To reach Ihor Kurilets, go to http://www.insc.com.ua/ (International Center of Neurosurgery in Kyiv.)
About Geoffrey Smith, the film director
Geoffrey Smith was born in Melbourne, Australia. Never at ease in “the lucky country,” however, he went travelling and discovered a talent for the moving image.
In 1987, he found himself in Haiti helping to make a documentary about the first election there in 31 years. But following the discovery of a massacre of 21 voters in a schoolyard, he was shot and wounded. Struggling to put his life back together in London, Smith decided to journey back to Haiti to find the man who had nearly killed him. This acclaimed film was subsequently shown on the BBC.
He discovered through this journey that the camera could be a powerful cathartic tool in helping people through difficult periods in their lives.
Winner of numerous awards, he has made over 22 films for all the major UK broadcasters and is drawn to observational real life dramas where deep ethical and moral dilemmas abound. Other famous works include “Your Life in Their Hands,” “The Life Savior,” “Breath of Life,” “Danger Unexploded Bomb,” etc.
