Leonid Rogozov clearly recognized the signs of appendicitis. After all, the 27-year-old Soviet surgeon had seen it multiple times already. But this time, there were a couple of big problems. First of all, the diagnosis took place in Antarctica during the winter, completely isolated from the outside world. Secondly, there was no other doctor at the site other than Rogozov. Lastly (and this was the biggest problem) — the patient was Rogozov himself.
“I can’t just fold my hands and give up”
Rogozov had arrived in Antarctica at the end of 1960. He was one of 12 men tasked with constructing a Soviet base in Antarctica. They finished just in time, right before the polar winter came down on them, bringing freezing temperatures and massive snow storms. It seemed that everything about the expedition was coming along just fine — until something went very wrong.
The Soviet surgeon quickly figured out he was suffering from appendicitis — an inflammation of the appendix that requires surgery. Without surgery, appendicitis can be fatal, and Rogozov knew this very well.
The young doctor interrupted a promising research career for the Antarctic expedition. He was almost due to defend his dissertation on new methods of operating on cancer of the esophagus when he left for the thrilling Antarctic expedition. An appendicitis surgery was a simple procedure and would have posed no problems to Rogozov — if the patient was someone else.
There was no escaping the base, either. Because of the snowstorms, flying was out of the question, and no ships were going in and out of Antarctica until the end of winter.
Rogozov tried to be cavalier about it. He noted in his diary:
“It seems that I have appendicitis. I am keeping quiet about it, even smiling. Why frighten my friends? Who could be of help? A polar explorer’s only encounter with medicine is likely to have been in a dentist’s chair.”
He also tried to see if he could treat himself with antibiotics, but it didn’t help much. Over the next day, his fever rose, the pain became harder to bear, and vomiting became common. The following night was hellish, and it led him to understand that there was only one possible way out of this situation: to have surgery on himself and take his own appendix.
“I did not sleep at all last night. It hurts like the devil! A snowstorm whipping through my soul, wailing like a hundred jackals. Still no obvious symptoms that perforation is imminent, but an oppressive feeling of foreboding hangs over me,” Rogozov wrote in his diary.
“. . . 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.”
Things did not get much better over the course of the next day. Rogozov couldn’t hide his condition from the other members anymore
“18.30. I’ve never felt so awful in my entire life. The building is shaking like a small toy in the storm. The guys have found out. They keep coming by to calm me down. And I’m upset with myself—I’ve spoiled everyone’s holiday. Tomorrow is May Day. And now everyone’s running around, preparing the autoclave. We have to sterilise the bedding, because we’re going to operate.”
“20.30. I’m getting worse. I’ve told the guys. Now they’ll start taking everything we don’t need out of the room.”
The surgery was carried out in an improvised space in Rogozov’s room. His fellow workers cleaned everything out of the room and disinfected it according to the doctor’s instructions. Two tables, a bed, and a table lamp were left, and the room was flooded with ultraviolet lighting to destroy as many pathogens as possible.
Rogozov then explained how the operation would work and delegated tasks: one colleague would hand him instruments; another would hold the mirror and adjust the table lamp; another would stand in reserve, in case nausea overcame the two helpers. Since Rogozov would operate on himself, he also prepared for the situation in which he would pass out, instructing his team to inject him with drugs and use specially prepared syringes for artificial ventilation. He disinfected his assistants, put on their gloves, and then sat down on the bed, reclining at about 30 degrees. The operation was set to start at approximately 2 AM local time.
Rogozov first injected himself with an anesthetic, and after 15 min, made an incision. It wasn’t perfect — his field of view was imperfect, his position was uncomfortable, and he was feverish. He worked without gloves so he could feel the instruments better. Around 30 minutes into the surgery, he started suffering from nausea and vertigo and had to take several short breaks. He was sweating intensely and had to ask his assistants to wipe his forehead every few minutes. Finally, he managed to reach his appendix and removed it — the appendix was severely inflammated and the surgery was his only chance of survival. A day longer and it would have burst, killing the surgeon. After removing it, he applied antibiotics and closed the wound. The whole surgery lasted 1 hour and 45 minutes, and was excruciating. As one of his assistants noted in his diary:
“When Rogozov had made the incision and was manipulating his own innards as he removed the appendix, his intestine gurgled, which was highly unpleasant for us; it made one want to turn away, flee, not look—but I kept my head and stayed. Artemev and Teplinsky also held their places, although it later turned out they had both gone quite dizzy and were close to fainting . . . Rogozov himself was calm and focused on his work [..] The operation ended at
4 am local time. By the end, Rogozov was very pale and obviously tired, but he finished everything off.”
Before taking a few sleeping pills, Rogozov instructed his assistants on how to wash and disinfect the instruments and the room. He then went to sleep, having performed surgery on himself.
The aftermath
When Rogozov woke up, his fever had dropped to 38.1°C (100 F) and he was feeling a bit better. He continued to take antibiotics for four days and slowly recovered. His fever slowly dropped, and after a week, he took out his stitches. Within two weeks, he made a full recovery. He later recalled how the surgery went from his perspective:
“I didn’t permit myself to think about anything other than the task at hand. It was necessary to steel myself, steel myself firmly and grit my teeth.”
“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.”
Work then continued as normal at the station and around a year later, Rogozov returned to Leningrad (today, St. Petersburg). He successfully defended his dissertation, Department of General Surgery of the First Leningrad Medical Institute. He never returned to the Antarctic.
It’s not entirely clear if Rogozov was the only person to take out his own appendix. There are a few other such incidents referenced in the literature, including one performed by Dr. Evan Kane in 1921, who believed that some surgeries (like an appendectomy) don’t require full anesthesia. He performed an appendectomy on himself to prove his point, but it was his assistants that completed the surgery. Rogozov was not aware of this event.
However, the fact that Rogozov was able to conduct the surgery in a time of great distress, in the wilderness, and without any professional help, is a stunning feat. It shows great willpower and medical ability, and although Rogozov rejected the glorification of this deed, it’s definitely one for the history books.
