Central Clinical Hospital No. 1 will reorganize the bed fund for the development of specialized centers
Railway Healthcare sums up the results of the annual work on the creation of high-tech medical centers based on industry hospitals. The Central Clinical Hospital No. 1 of Russian Railways has made significant progress in implementing this program.
- Viktor Frantsevich, the creation of a high-tech center involves, first of all, equipping a medical institution with appropriate equipment. How is this issue resolved in TsKB No. 1?
- In 2007, our hospital, through the care of the Russian Railways Department of Health, received a lot of modern technological equipment under the investment program. So, for work on the main territory of the hospital (Volokolamskoe highway, 84), a 64-slice computer tomograph was purchased, which allows, when preparing patients for operations, to clarify the topography of organs and their relative position with surrounding vessels.
A new magnetic resonance tomograph is currently being installed in the second territory (20, Chasovaya Street), and soon another high-tech device will appear there - an angiograph, which is necessary for diagnosing cardiovascular diseases. This will relieve doctors of the need to transport patients for angiographic examinations five kilometers to our main territory. An electrophysiological unit for the diagnosis and treatment of cardiac arrhythmia and much more have been received.
- How does the creation of centers affect the financial and economic performance of the hospital?
- If we evaluate the indicators for 2007, then we earned 74 million rubles. more than a year earlier. But this is primarily due not to the development of high-tech centers, but to a number of extraordinary solutions aimed at reducing unproductive costs.
For example, we laid off all the janitors and more than a hundred cleaning nurses and entrusted the care of cleaning the hospital and general hospital premises to third-party organizations, especially since the service in Moscow is quite well developed in this regard. As a result, we have reduced the load on wages, taxes, sick leaves, in general, under the collective agreement, and we are saving significant funds.
In addition, the efficiency of using the bed fund has increased. In 2007, one bed worked for us on average 274 days, and not 240, as in 2006. However, this cannot yet be considered an achievement - according to the norms, a bed should be occupied 340 days a year. Although the failure to comply with the standard is partly due to the overhaul.
Now we are starting the restructuring of the bed fund in order to ensure the efficiency of each bed. And this is where the development of high-tech centers should play its role.
Take, for example, the spinal center. It performs more and more unique technological operations, up to the installation of cages - modern devices that ensure the stability of the patient's spine. The number of operations in this center has more than doubled compared to 2006, and the bed has worked - so far in the only one - 340 days a year. So in the coming year, the bed fund will be significantly expanded here.
– Just this year, we will begin the second part of the planned transformations in this center – providing rehabilitation treatment before and after surgery. Our immediate plans include the creation of a rehabilitation complex that will function inseparably with the department of vertebrology. There, patients will undergo preliminary examination and rehabilitation treatment. If this treatment does not help, the patient will be transferred to the operating bed - I note that staying on it is much more expensive - and after the operation he will return to the rehabilitation bed and undergo a course under the supervision of the same staff. With the introduction of such a technique, the efficiency of the spinal center in 2008 will increase even more.
– And how has the work of the cardiology center at your hospital changed?
- In the cardiology center for the year, work has been established on the diagnosis and treatment of cardiac arrhythmias, the installation of pacemakers - temporary and permanent. The number of endovascular interventions on vessels has increased - not only the heart, but also the kidneys, lower extremities, and the carotid artery.
As part of the center in November last year, the department of anesthesiology and resuscitation of the cardioprofile for six beds was introduced and is functioning. That is, cardiac patients now go through a closed cycle: from the ambulance to the intensive care unit, then to the cardiology unit. If a heart rhythm disorder is diagnosed, he is given a pacemaker, if vascular stenosis, they are stented or ballooned.
Initially, we thought that we should complete the cycle up to coronary artery bypass grafting. I think that in 2008 we are quite capable of organizing this work. However, first it is necessary to collect statistics and determine how many railway workers need such operations. If this is a sufficiently significant contingent, we will also raise the issue of open heart surgery.
- By the way, a question that worries many of our readers: will assistance in high-tech centers of Russian Railways remain free for railway workers?
- Certainly. Despite the transformation, the majority of our patients are still railroad workers, their families and industry retirees, for whom care is provided free of charge. It's just that the policy of the Russian Railways Department of Health is aimed at making this assistance more effective and health-saving.
- High-tech equipment without personnel with the appropriate qualifications will remain a "dead weight". How is this problem solved?
- We can say that now the equipment is taken from us for a specific specialist. If there is a need to master a new technique or methodology from scratch, then we train our personnel or attract highly qualified specialists from outside.
For example, last year there was an important replenishment in the urological center - we hired an operating urologist, candidate of medical sciences Vladimir Khvorov. With his arrival, the number of open operations on the genitourinary system has significantly increased.
Moreover, the company's health department has developed a concept for creating a scientific and educational center on the basis of our hospital, on the territory along Chasovaya Street. Its purpose is advanced training and postgraduate education of doctors who come to the medical institutions of the industry. It is also planned to create retraining courses for nurses.
There is also a clinic with 200 beds. It will include a therapeutic department, a cardiological, neurological, endocrinological department, as well as a meteopathology department led by Professor Yuri Gurfinkel. His work, elucidating the effect of magnetic storms on the condition of weather-dependent patients, in particular those suffering from cardiovascular diseases, will finally acquire practical implementation.
– You mentioned the urological center. What are the prospects for its development?
– Here, the number of endourological interventions is growing, which are implemented in our hospital by the head of the center, Professor Oleg Teodorovich. With these manipulations, kidney stones are crushed into fine sand painlessly for patients using an adjustable laser beam.
The equipping of this center with other modern equipment has also moved off the dead center. The Department of Health, for example, bought a device for us to perform a bipolar transurethral resection - an operation on the prostate gland. Its peculiarity is that with the help of this device it is possible to operate on patients who have pacemakers installed.
Also, now we are planning to reorganize the operating room to transfer the urological operating room to it, which is still located in the old building. This will significantly expand its capabilities.
- In a word, this year TsKB No. 1 has a lot of work to do...
- Once the creation of high-tech centers has begun, it must be completed. The health of railway workers, as one of the main components of ensuring the safety of train traffic, is becoming increasingly important for Russian Railways. It is logical that the company's Central Clinical Hospital should be "at the forefront" of the process.
The sincerity of the poem is impressive, as if the author really found old letters that stirred up those memories that hurt with their power. Although at the time of writing the work (1859) Afanasy Fet was barely forty years old, the lines are permeated with such powerful regret and nostalgia that they make the reader's heart shrink.
The composition of the poem is built as a dialogue: the lyrical hero refers to the found letters and to the image that is hidden behind them. “Treasured features”, “mute witnesses” - this is how the author calls either the lines of the letter, or his memories of the one who wrote them. Throughout the poem, it is never indicated who is hiding behind the "old letters". However, the words "trustfulness, hope and love", the epithets "sincere", "bright, holy, young" leave no doubt that these messages are love.
The poem has a clearly defined structure. The first stanza is the background, the plot of the action. “Long forgotten, under a light layer of dust” - these circumstances indicate that all the feelings that once possessed the lyrical hero have burned out and faded away. But the memory of them remained somewhere in the innermost corner of the heart, so the “forgotten features” are immediately called “cherished”. Like a curtain pulled back, the letters immediately reveal all the memories and experiences associated with the one who wrote them. “Instantly resurrect” is possible only that which lived latently in the recesses of the soul.
The second and third stanzas are the development of the action. The lyrical hero admits that his role in this correspondence and its ending cause him shame, remorse, regret. “I am condemned by you”, “burning with the fire of shame”, “that terrible hour when we said goodbye” - all this suggests some kind of tragic denouement, circumstances that prevented reciprocation.
But in the fourth stanza - the culmination of the work - there is open repentance for his act. “I trusted the treacherous sound, - As if there is something in the world outside of love! - I boldly pushed away the hand that wrote you, I condemned myself to eternal separation ...” - these words convey the impulse of the soul, eager to correct everything with their regret and confession of guilt . Even the fact that the fourth stanza is extended by one line shows even more clearly that the lyrical hero is in a hurry to express everything, to repent of his blindness and cruelty. Until he returns to the present...
The final fifth stanza carries bitter disappointment, sadness, disbelief in happiness. Letters that stirred up such strong feelings remain just letters - outdated, lifeless. Everything that was connected with them is irretrievably gone. “The voice of forgiveness will not resurrect the soul, the burning tear will not wash away the lines,” the lyrical hero says bitterly. In the last stanza, all the painful joy caused by the discovery seems to be crossed out, and excitement gives way to indifference.
The poem is written in iambic six-foot with one unstressed foot in each line, with a cross rhyme. The size is the most suitable for a sincere live conversation: a long line allows you to display the most subtle shades of feeling, and a quick rhythm eliminates possible excessive sentimentality.
The poignant lyrics of "Old Letters", captivating with the truthfulness of experiences, rightfully makes this work of Afanasy Fet one of the key ones in his work.
Poem "Old Letters"
Long forgotten, under a light layer of dust,
Cherished features, you are again in front of me
And in the hour of mental anguish instantly resurrected
Everything that was long, long ago is lost by the soul.
Burning with the fire of shame, again meet the eyes
One trust, hope and love,
And sincere words faded patterns
From my heart to the cheeks they drive blood.
I am condemned by you, dumb witnesses
Spring of my soul and gloomy winter.
You are the same bright, holy, young,
As in that terrible hour when we said goodbye.
And I trusted the treacherous sound, -
As if there is anything in the world outside of love!
I boldly pushed away the hand that wrote you,
I condemned myself to eternal separation
And with a cold in his chest, he set off on a long journey.
Why, with the same smile of tenderness
Whisper to me about love, look into my eyes?
The voice of forgiveness will not resurrect the soul,
A burning tear will not wash away these lines.
It can be said without exaggeration that Afanasy Afanasyevich Fet and Fedor Ivanovich Tyutchev are one of the greatest poets who enriched not only Russian, but also foreign literature. Both creators glorify the concept of “true beauty”, they write about eternal things that always excite a person. The main themes of their poems are philosophical, love and landscape lyrics. And today I want to compare two of their works of love: “K. B.” Tyutchev and "Old Letters" by Fet.
A poem by Fyodor Ivanovich, entitled enigmatic
Initials, written July 26, 1870. It is dedicated to his first love - Amalia Lerchenfeld. They met in 1822 in Munich. Tyutchev was so in love that he wanted to marry a girl, but Amalia's parents married her to a colleague Fyodor Ivanovich. Now the girl was called Baroness Krüdener, which explains the title of the poem.
Many years later, the poet met with Lerchenfeld again, about which he wrote to his daughter: “Yesterday I experienced minutes of burning excitement as a result of my meeting with my ... good Amalia Krudener, who will see me in this world for the last time ...” This meeting awakened in the lyrical the hero's spiritual fullness of "those years". The hero is grateful to Amalia for this, he is elated: “There is more than one memory ... And the same love in my soul”
“I met you - and all the past ...” - the spiritual confession of the poet. The meeting with the former love made the “obsolete heart”, which became “so warm”, start up. This meeting is like spring, which awakens everything.
Like Tyutchev, Fet in his poem recalls the past, moments of old love:
“Long forgotten, under a light layer of dust,
Cherished traits, you are again in front of me ... "
But, unlike Fyodor Ivanovich, whose work is saturated with notes of sweet nostalgia and exciting sadness, but, however, “refreshing” the soul, Afanasy Afanasyevich in his poem shows much more gloomy pictures. We see guilt tormenting him, longing, even some anger at the fact that nothing can be changed. This creation of his, like the vast majority of his love poems, is dedicated to his first and, perhaps, only love - Maria Lazich. They met in 1848, but since both were poor, Fet understood that he could not provide the girl with a happy future and decided to part with her. Shortly thereafter, the girl dies a terrible death. She was burned alive by a candle that fell on her dress. Although there is no evidence that it was suicide, Afanasy Afanasyevich considered himself the culprit of what happened until the end of his life.
So, the theme of both poems are memories of past love, but if Tyutchev’s main idea can be called the return of the heart to the beautiful time of the past and the “revival” of the soul (“I remembered the golden time - and my heart felt so warm ...”), then Fet’s work shows pangs of conscience and burning regret. The poet considers himself unworthy of such love:
“The voice of forgiveness will not resurrect the soul,
A burning tear will not wash away these lines”
I have these creations caused quite conflicting emotions. Fyodor Ivanovich's poem penetrates the soul, bringing with it a warm, soft, joyful light that gives hope for something better:
“There are days, there are times,
When it suddenly blows in the spring
And something stirs in us…”
You want to dissolve in this blissful peace, forget all the hardships and just sincerely smile at all the good things that happened in your life.
The work of Afanasy Afanasyevich, on the contrary, kills all hope for a turn for the better. And the poet considers himself guilty of everything that happened:
“And I trusted the treacherous sound,
I boldly pushed away the hand that wrote you,
I condemned myself to eternal separation
And with a cold in his chest, he set off on a long journey.
The poem evokes dark, oppressive, dark emotions. It is like a merciless thunderstorm, a cruel tornado that leaves behind only a deserted, ugly land scorched by rage and guilt, on which the green grass of hope and joy can never again break through. But at the same time, the work makes you think, look back at your actions and, perhaps, change your behavior somewhere. The author says: “As if there is anything in the world outside of love,” he seems to urge the reader not to make his mistakes, showing how terrible and bleak the result can be.
When you read these creations, all the images flash in your imagination, as if you are immersed in that world and see everything “in reality”. The authors achieve such brilliance through the skillful use of various artistic and expressive means that help them most vividly and accurately reflect everything that they feel, see and want to convey to the reader. Let's look at some of them.
Many different epithets of Tyutchev (“in the obsolete heart”, “golden time”, “spiritual fullness”, “forgotten rapture”, “cute features”, “secular separation”, etc.) and Fet (“cherished features”, “ mental anguish”, “we will instantly resurrect”, “faded patterns”, “heartfelt words”, “mute witnesses”, “gloomy winter”, “brazenly pushed away”, “eternal separation”, “burning tear”, etc.) help give a certain mood to the works. Beautiful metaphors and personifications of the poems “K. B.” (“everything of the past ... came to life”, “the heart became so warm”, “the sounds that did not stop in me became more audible”, “life spoke again”, etc.) and “Old letters” (“cherished features ... instantly resurrected”, “lost by the soul”, “meet the eyes”, “faded patterns ... drive blood”, “the soul will not be resurrected and the voice of forgiveness”, “these lines will not be washed away and a burning tear”, etc.) give imagery to poems, make them come alive.
Both works have an exact, cross, predominantly female rhyme. Strophic - quatrain. "TO. B.” written in iambic tetrameter, and “Old Letters” in iambic six-meter.
Both poets dedicated their poems to the real women they loved. But if Tyutchev does not regret that his relationship with Amalia is now only a pleasant memory, then Fet is executing himself for the mistakes of the past and, I think, he would like to turn back the clock and correct what he has done.
Love for Tyutchev and Fet is the main motive of creativity, a source of inspiration and enrichment of the soul, a way of communication with the world, with all living things.
Fedor Ivanovich loved several women throughout his life. The poet's feelings for each beloved were deep, sublime, sincere and genuine. They were often accompanied by suffering, but they brought extraordinary depth, passion, selflessness into the life of the creator. If there weren’t these girls, there wouldn’t be such wonderful poems as “K. B.”, in which the poet seems to bare his soul. Tyutchev's poetry is the poetry of deep and fearless thought, invariably merged with the image conveyed by precise, bold, unusually expressive colors. In the works of Fyodor Ivanovich there is a lot of grace, plasticity, they have, according to Dobrolyubov, both “sultry passion” and “severe energy”. They are very solid, complete: when reading, one gets the impression that they were created instantly, with a single impulse.
For Fet, love, in my opinion, is a burning fire, just like his poetry is a flame in which the soul burns. The works of the poet are the fruit of his love experiences and memories, to which he gave everything that he experienced, experienced, lost. The lyrics of Afanasy Afanasyevich become the embodiment of the memory of Mary, a monument, a "living statue" of the poet's love.
Undoubtedly, both Tyutchev and Fet suffered many hardships and terrible losses. Both of them had a chance to survive the death of a beloved woman, however, in my opinion, Fyodor Ivanovich's love story is still happier. He was lucky to experience the strongest feelings for several girls. Almost throughout his life, one of his lovers was next to him. Perhaps that is why, despite the skeptical notes in the poetry of Tyutchev, who sometimes claims that all human activity is a “useless feat”, most of his works are filled with youth and indestructible love of life. Fet, who lost his love in his youth, remains only memories and the bitterness of guilt and resentment. However, each of the poets in his poem was able to reveal his thoughts, convey his mood to the reader, “bare” his soul before him.
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Other writings:
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- Meaningful plan. Tyutchev's poem "The Fountain" is a reflection on the tragic discrepancy between the desire of human thought to embrace and cognize all the laws of the Universe and the limitations of its capabilities: How greedily you rush to heaven! But the hand is invisible-fatal Your stubborn beam, refracting, Overthrows in Read More ......
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- My favorite poem of the great Russian poet Afanasy Afanasyevich Fet is his work “I came to you with greetings ...”. It is believed that of all the poets of Russia, Fet is the most difficult to study. The poet had not the most ordinary and simple fate, she was Read More ......
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- The poem was written in 1838-1839. During this period of time, many unpleasant events occur in the life of Fedor Ivanovich. Tyutchev's wife and children almost died in a fire on the Nicholas I steamer, on which they went to Turin. They managed to escape, Read More ......
The sincerity of the poem is impressive, as if the author really found old letters that stirred up those memories that hurt with their power. Although at the time of writing the work (1859) Afanasy Fet was barely forty years old, the lines are permeated with such powerful regret and nostalgia that they make the reader's heart shrink.
The composition of the poem is built as a dialogue: the lyrical hero refers to the found letters and to the image that is hidden behind them. “Treasured features”, “mute witnesses” - this is how the author calls either the lines of the letter, or his memories of the one who wrote them. Throughout the poem, it is never indicated who is hiding behind the "old letters". However, the words "trustfulness, hope and love", the epithets "sincere", "bright, holy, young" leave no doubt that these messages are love.
The poem has a clearly defined structure. The first stanza is the background, the plot of the action. “Long forgotten, under a light layer of dust” - these circumstances indicate that all the feelings that once possessed the lyrical hero have burned out and faded away. But the memory of them remained somewhere in the innermost corner of the heart, so the “forgotten features” are immediately called “cherished”. Like a curtain pulled back, the letters immediately reveal all the memories and experiences associated with the one who wrote them. “Instantly resurrect” is possible only that which lived latently in the recesses of the soul.
The second and third stanzas are the development of the action. The lyrical hero admits that his role in this correspondence and its ending cause him shame, remorse, regret. “I am condemned by you”, “burning with the fire of shame”, “that terrible hour when we said goodbye” - all this suggests some kind of tragic denouement, circumstances that prevented reciprocation.
But in the fourth stanza - the culmination of the work - there is open repentance for his act. “I trusted the treacherous sound, - As if there is something in the world outside of love! - I boldly pushed away the hand that wrote you, I condemned myself to eternal separation ...” - these words convey the impulse of the soul, eager to correct everything with their regret and confession of guilt . Even the fact that the fourth stanza is extended by one line shows even more clearly that the lyrical hero is in a hurry to express everything, to repent of his blindness and cruelty. Until he returns to the present...
The final fifth stanza carries bitter disappointment, sadness, disbelief in happiness. Letters that stirred up such strong feelings remain just letters - outdated, lifeless. Everything that was connected with them is irretrievably gone. “The voice of forgiveness will not resurrect the soul, the burning tear will not wash away the lines,” the lyrical hero says bitterly. In the last stanza, all the painful joy caused by the discovery seems to be crossed out, and excitement gives way to indifference.
The poem is written in iambic six-foot with one unstressed foot in each line, with a cross rhyme. The size is the most suitable for a sincere live conversation: a long line allows you to display the most subtle shades of feeling, and a quick rhythm eliminates possible excessive sentimentality.
The poignant lyrics of "Old Letters", captivating with the truthfulness of experiences, rightfully makes this work of Afanasy Fet one of the key ones in his work.
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The sincerity of the poem is impressive, as if the author really found old letters that stirred up those memories that hurt with their power. Although at the time of writing the work (1859) Afanasy Fet was barely forty years old, the lines are permeated with such powerful regret and nostalgia that they make the reader's heart shrink.
The composition of the poem is built as a dialogue: the lyrical hero refers to the found letters and to the image that is hidden behind them. “Treasure traits”, “mute witnesses” - this is how the author calls either the lines of the letter, or his memories of the one who wrote them. Throughout the poem, it is never indicated who is hiding behind the "old letters". However, the words “trustfulness, hope and love”, the epithets “sincere”, “bright, holy, young” leave no doubt that these messages are love ones.
The poem has a clearly defined structure. The first stanza is the background, the plot of the action. “Long forgotten, under a light layer of dust” - these circumstances indicate that all the feelings that once possessed the lyrical hero have burned out and died out. But the memory of them remained somewhere in the innermost corner of the heart, so the “forgotten features” are immediately called “cherished”. Like a curtain pulled back, the letters immediately reveal all the memories and experiences associated with the one who wrote them. “Instantly resurrect” is possible only that which lived latently in the recesses of the soul.
The second and third stanzas are the development of the action. The lyrical hero admits that his role in this correspondence and its ending cause him shame, remorse, regret. “I am condemned by you”, “burning with the fire of shame”, “that terrible hour when we said goodbye” - all this suggests some kind of tragic ending, circumstances that prevented reciprocation.
But in the fourth stanza - the culmination of the work - there is open repentance for his act. “I trusted the treacherous sound, - As if there is something in the world outside of love! - I boldly pushed away the hand that wrote you, I condemned myself to eternal separation ...” - these words convey the impulse of the soul, eager to correct everything with their regret and confession of guilt . Even the fact that the fourth stanza is extended by one line shows even more clearly that the lyrical hero is in a hurry to express everything, to repent of his blindness and cruelty. Until he returns to the present...
The final fifth stanza carries bitter disappointment, sadness, disbelief in happiness. Letters that aroused such strong feelings remain just letters - outdated, lifeless. Everything that was connected with them is irretrievably gone. “The voice of forgiveness will not resurrect the soul, the burning tear will not wash away the lines,” the lyrical hero says bitterly. In the last stanza, all the painful joy caused by the discovery seems to be crossed out, and excitement gives way to indifference.
The poem is written in iambic six-foot with one unstressed foot in each line, with a cross rhyme. The size is the most suitable for a sincere live conversation: a long line allows you to display the most subtle shades of feeling, and a quick rhythm eliminates possible excessive sentimentality.
The poignant lyrics of "Old Letters", captivating with the truthfulness of experiences, rightfully makes this work of Afanasy Fet one of the key ones in his work.
