In 1986 I was just out of fellowship and a new attending at one of the bigger Pittsburgh hospitals, St. Francis Medical Center. I had also come off a year of research with Dr. Peter Safar at the Resuscitation Research Center at UPMC in Pittsburgh. Managed to write two papers as first author with Peter in the journal “Resuscitation”, which I still think is pretty cool.

At any rate, Safar liked to travel and he liked me because I was pretty wild and unpredictable in those years, having nearly been thrown out of my Fellowship for being a square peg in a round hole, and not predicted to get along well in life. To this day I think Safar saved me from a life of flipping burgers at Wendy’s. But that’s another story.

I was interested in Russian culture for whatever reason at that time and Peter routinely dragged back and forth in and out of the former Soviet Union for meetings, so in 1986 he took me with him and I took to it. I bonded with a number of Russian doctors all of whom have vanished now over the years. Someday I’ll write another book about my various travels, and the Soviet Union will be a big part of it.

I decided to learn Russian language and so took a course at Pitt and got a tutor. By the time I actually went, I could get along pretty well in airports, restaurants and hotels. Back in those days Pan Am flew into the National airport in Moscow (Domodedovo- pronounced “sheremetuvo”). For the time a very beautiful and modern facility.

The visa for entry into the USSR took months to get from an Indian travel agency in New York and was loose in your passport. They took it on entry so there was never any evidence an American was ever there. They also counted your money and you have to come out with the same amount of receipts of how much you spent to hedge the thriving black market. Each enterer was scrutinized from within a brightly lit area by an armed Soviet guard from within a cage with darkened glass windows. They had paperwork on everyone. It was very scary.

Economics was quite a lesson. Rubles were worthless. The official price of gasoline at State service stations was (something like) the equivalent of sixty cents but there was no supply. Around the corner under a bridge, there was plenty of gas from a private vendor at ten times that amount per gallon from the back of a truck. At a restaurant, they handed would-be customers a full menu, but one soon found out that whatever they ordered was out of stock. Finally you asked “what do you have?” and it was boiled beef and potatoes. Automobile owners hid their windshield wipers until needed to avoid having them stolen. Cab drivers ignored requests for a ride until one produced a pack of Marlboros, then they scrambled.

But I digress.

When I arrived at the meeting, attended by mostly Soviet Bloc doctors and scientists, everything was translated to English after spoken in Russian, which was quite ponderous (and excruciatingly boring). When Safar spoke, it was translated to Russian in real time. At the end of the last day, a young Russian doctor tentatively approached me and started a conversation in pretty good English. His name was Sergey Ermakov. He was just out of anesthesia school and had a job in his hospital in Dnepropetrovsk, in the Ukraine near Kiev. He was quite curious about me, never having seen any kind of foreigner in his life since his area was closed to foreign visitors.

We struck up a relatively brief conversation, he signed my meeting book and we agreed to communicate by letter mail (this was long before the Internet). Turns out this was a very time consuming proposition, about a month each way for a plain letter. Forget phone calls. We did this for about a year or so then I asked if there was any possibility he could come visit me here in the USA. “Probably not” was the answer. But we agreed to see what could be done.

So I had to send him an official letter of invitation for a professional visit here, detailing the objectives of his experience, how it might relate to his professional growth, that I guaranteed he would return to the USSR and so on. That letter had to be notarized by every Local, State and Federal bureaucracy, including the State Department all of which took months. When the letter finally reached him, he then had to have it examined by all the bureaucrats on his end including the KGB. Months later, they gave him permission to leave the country for ten days.

And the window of opportunity for the ten days was not the same as the window for getting an Aeroflot Airline ticket, which he couldn’t afford anyway so I had to purchase a Pan Am ticket for him. He arrived here scared insensible, all of what he saw and felt along the way was like a different world. It was quite interesting to have him around for a week. Going to a super market and purchasing anything he desired was like an LSD trip. He bought his girlfriend some pantyhose. When he finally went back, we continued to correspond until the wall came down and doctors started escaping from Russia wholesale, which would have been about 1989.

The papers for all this are buried in my junk piles somewhere but I think it must have been around 1990 when I arranged to get him out, creating a job for him at St. Francis as a research helper (he couldn’t practice medicine). He got a tiny flat across the street and started becoming Americanized.

After a while I noticed that he would disappear for a few days at a time, then resurface. I never paid any attention to any of this, as he was always otherwise bubbly and high on life. Always enthusiastic, almost hyperactive. At some point he formulated a business scheme to import Russian private-sized airplanes (jets actually) into the USA and make a profit on them. He had no clue of all the incredible problems in doing that, and was quite put out when we didn’t enthusiastically embrace (and help fund) that plan.

Sometime in the early 90s, I got an invite to speak at a 2 day program sponsored by Roche in Washington, DC for hospital pharmacists, so we drove down there. They gave us a room together and we went about sightseeing in the Capital. Then the following day I went to the meeting and he continued to look around. When I got back to the room he wasn’t there, still wasn’t there at 0200 hrs and still not there at 0600 hrs. I started getting worried, sniffed all around the hotel and nearly called the cops for a missing persons complaint.

Finally about 0800 hours on the day of departure, he dragged in reeking of booze and perfume, looking like a zombie and collapsed on the bed, instantly asleep. It dawned on me that he had been without female companionship for quite a while and probably dripped testosterone out of every orifice. So he had struck up an instant romance with a pharmacy girl and had struck the mother lode of joy and fulfillment in its most primitive form…..all night long, finally emerging with a zero sperm count and Rhabdomyolysis.

Somewhere along the way, he accumulated a girlfriend here, one of the local nurses and was gently but firmly guided into marriage at one of the local Russian Orthodox churches here in Pittsburgh. About this time, he decided to apply for a residency program. He chose neurological surgery, one of the most difficult programs in the country to get into. Applying to a bevy of them, he was routinely turned down, probably because of his less than stellar Russian training, but one or two said they’d take him if he slaved in their lab for a while and if they liked him maybe they’d consider him for a residency. Even he figured out what kind of deal that was.

So it ended up that the only residency that accepted him was in combined Psychiatry/Internal Medicine at Yale Medical Center in New Haven. Seemed like a pretty good deal, best one he was going to get, so he went up there and did pretty well. His wife went up to New Haven or he came back on alternate weekends. I saw him now and then and it seemed like everything was going well, with the exception that his family was pressuring him to find a way to get them out of Russia and into the USA, a very difficult proposition. He did manage to get his brother here but he had not done well as he never was able to deal effectively with the English language.

So one weekend, I think sometime in 1995, his wife went up there to find him despondent, holding a loaded pistol. He told his wife he had been a failure and no longer deserved to live, then shot himself in his head as his wife tried to talk him out of it, killing himself instantly.

I talked to the head of his department who related that there was some suspicion of bi-polar disease but they hadn’t quite made the connection, as he was smart enough to hide a lot of it pretty effectively. I recalled the occasions where he disappeared for a few days, the re-emerged when he got a rebound high.

So that’s the sad, Sergey saga. I still have lots of things he brought for me around my house and office; I gave some of it to his wife.

Last time I was in Russia was around 1992 I think. I really want to go back there before I die (obviously). Moscow is one of the most beautiful cities in the world. I have decided to start planning a trip to that area this summer to try and seek out any of his family that still might be in Dnepropetrovsk, said to be a beautiful city (I have photos). Also do some touring in Kiev, which is said to be an interesting visit, and tour Chernobyl. Yes, they are starting selective tours now. You can’t stay in there very long or touch anything but I think it would be a very interesting thing to do. I was just finishing my fellowship when it happened and I remember it well. It’s someplace I would really like to visit.

It’s a thousand miles from Frankfort where I can rent a motorcycle to Kiev, if they’ll let me go into Russia. Unclear as to the safety of motorcycling in the Eastern Bloc but I’m looking into it. It’s being done.