Odrex clinic doctor Vitaliy Rusakov, who is on trial for medical negligence that could have cost the life of businessman Adnan Kivan, has begun claiming that the case against him could turn the entire medical industry upside down. Against the backdrop of constant delays in the judicial process, such statements from the doctor, who has been suspended from medical practice, look more like a symptom of a mental disorder known as megalomania, writes UNN.
Rusakov's medical negligence
Vitaliy Rusakov and his now-former colleague at the Odrex clinic, oncologist Maryna Belotserkovska, are charged under Part 1 of Article 140 of the Criminal Code of Ukraine – improper performance of professional duties by a medical worker, which could have led to the death of the patient, businessman Adnan Kivan. According to the prosecution, after surgery, the patient was not prescribed proper antibacterial therapy, and there was no timely response to postoperative complications. This could have led to the development of sepsis, which, according to the findings of the forensic medical examination, could have been the cause of death.
After Rusakov was suspended from work, he began actively blogging and recording regular videos. In them, he insists that he does not understand the essence of the charges brought against him.
During one of the court hearings, information was disclosed that the patient underwent a TAP block – an intervention that triggered the development of the infection, although the Odrex clinic clearly tried to hide this fact.
"The TAP block is not confirmed by any documents contained in the medical history. Any records are absent. We will prove that the only recorded fact is a paravertebral block performed by an anesthesiologist, not by the surgeon Rusakov. And it was performed in the spinal area, which excludes the possibility of damaging the intestines (as a TAP block could – ed.) and causing this translocation of the patient's own bacteria to cause an infection. We will prove that the medical documentation lacks data on such a manipulation (TAP block – ed.),"
At the same time, the defense does not deny that the TAP block was indeed performed and had negative consequences for the patient. Thus, Rusakov's public statements diverge somewhat from the actual state of affairs.
However, these statements are not the only ones that caught our attention. Much more interesting is Rusakov's claim that his case will have an impact on the entire industry.
The surgeon is convinced, and is trying to convince his audience, that a guilty verdict against him will inevitably lead to the collapse of the entire Ukrainian medical system. He believes that if he is found guilty, Ukrainian doctors will en masse refuse difficult patients and stop undertaking the treatment of the seriously ill.
"The opponents want to create a precedent for all doctors in Ukraine. If a disease involves fatal complications, knowing my story, all medical workers will simply refuse to treat complex oncological cases. This will lead to treatment becoming unavailable in Ukraine. I am convinced that such actions are proof that the prosecution does not want justice; they simply want to punish doctors,"
Such belief in one's own significance makes one wonder whether the doctor himself needs medical help for megalomania?
What is megalomania or grandiosity
Psychologist Iryna Basista, in a comment to UNN, explains that megalomania is most often a separate symptom that is part of a certain diagnosis.
"Megalomania in scientific literature is referred to as grandiosity, when there is an exaggerated perception of oneself, one's capabilities, and one's vision of oneself in society compared to reality. And it is more characteristic of people with personality disorders, particularly narcissistic, bipolar, or in schizophrenia. That is, it is not a separate diagnosis in itself; it is like a symptom,"
According to her, one of the ideas considered by neuroscience is that such an inadequate perception of oneself is associated with improper brain function.
"Some hormones are released excessively and there is no stabilization for this. And, accordingly, it forms—of course, it's not something that just happens suddenly, like a person lived, was healthy, everything was fine, and then they caught a high. No, it is connected with two factors: the fact that a person wants to present themselves and cannot self-stabilize, that is, they do not have such a skill, how to put it differently... self-stabilization skills,"
The psychologist also said that a person with megalomania can simultaneously state real facts and those detached from reality, without connecting them.
"These are people fixated only on themselves, if one can say so. Yes, they are very self-oriented. If we are talking, for example, about this symptomatology of narcissistic disorder, then inside the person there is a sharp 'I', great insecurity, but as a defense mechanism, there is this thing like: I can do everything, everyone is waiting for me to manifest myself, and I'm just thinking whether I need to or not,"
Instead of conclusions
The entire story surrounding the case of Odrex doctor Vitaliy Rusakov increasingly raises questions not only about the quality of the medical care he provided but also about the surgeon's perception of his own role in this case. Instead of a substantive response to the investigation's allegations and an explanation of the circumstances of the patient's treatment, the public hears claims that a verdict regarding one person is supposedly capable of destroying the entire healthcare system of Ukraine.
In reality, the judicial process should provide an answer to a much simpler question: whether specific medical workers committed violations of professional standards that could have led to grave consequences for the patient. Justice in such cases does not pose a threat to medicine; on the contrary, it is a mechanism for protecting patients and a guarantee that the medical profession will maintain public trust.
Ukrainian medicine does not depend on the fate of one surgeon, no matter how much he wants to believe it. At the same time, every doctor, regardless of position, popularity, or place of work, must be held accountable for their decisions on par with representatives of any other profession. That is why attempts to present one's own criminal case as a threat to the entire industry look not like an argument, but like the morbid fantasies of the accused himself.