By Lloyd Kramer

Sometimes a wish can become a reality. I had a vision that the Novgorod Alliance could host a Russian pediatric orthopedist in the United States. This visit would allow the individual to learn western approach to pediatric orthopedics and put what they learned into practice in their hospital and practice of medicine. After several failed attempts to initiate this idea, I stopped pursuit.

One afternoon, I met William Austin on a tennis court. Will works for the Shriners Hospital for Children in Tampa, Florida as the Director of Development. I told him about my idea and he was very encouraging. He introduced me to key administrative people in the Shriners organization. Each individual was receptive to the idea of a visit and allowed me to proceed in finding the appropriate candidate from Velikiy Novgorod, Russia.

Dmitry, the cook, preparing Shashlik for the guests at his “Farewell Party”.

During our visit to Velikiy Novgorod in September 2006, I asked Dr. Tatiana Solovyeva if there was a pediatric orthopedist who spoke English. The next day she introduced me to Dr. Dmitry Lobko. Dr. Lobko invited Dr. Morgan and me to the Regional Pediatric Hospital where he presented four complex cases to us and answered questions about different options for each case. Dr. Lobko interacted very nicely with the children who were patients as we made rounds through the hospital ward. It was obvious to me that Dr. Lobko would be an excellent choice for the first Russian pediatric orthopedic physician to visit the United States as a guest of the Novgorod Alliance and the Shriners Hospital for Children.

Dr. Lobko arrived in Tampa, Florida at midnight after a long trip. His first comment to us was, “You must really like Novgorod a lot to do this trip every year!”

The first week Dr. Lobko visited the orthopedic offices of Drs. Moor and Morgan to observe private practice. He also observed Dr. Moor doing arthroscopic procedures.

John Moor, Dima, Roman and Larisa Rozin

The second through fifth weeks were spent at the Shriners Hospital for Children in Tampa, Florida. Dr. Dennis Grogan, Chief of Pediatric Orthopedics, and his staff hosted Dr. Lobko during his visit. Dr. Lobko observed numerous surgical procedures each week. He saw patients in the outpatient department and visited the orthotic/prosthetic laboratory. The librarian from the Shriners Hospital donated a large number of pediatric orthopedic texts for Dr. Lobko’s hospital.

Dmitry’s final week was spent with Dr. Sheila Love and her staff at the All Children’s Hospital in St. Petersburg, Florida where he observed complex orthopedic procedures and participated in outpatient clinics.

Weekends were spent with Lloyd and Judy Kramer. Special cultural activities Dmitry enjoyed included a visit to the beach, a jazz performance at Selby Gardens, the Ringling Museum and the Mote Aquarium. Numerous parties were held to introduce Dmitry to friends and family.

Wherever Dr. Lobko visited, he was well received. His great smile and friendly personality made the visit a very pleasant one.

Karen and Randall Morgan, John and Krista Moor, Kramers and Dmitry

We need to thank all the people who invited Dr. Lobko into their homes, hospitals and clinics. As we watched Dr. Lobko become more comfortable with his surroundings, his English improved rapidly. Watching him visit with his wife and son by video E-mail was a very special treat for all of us. The contact with his family made the 6 weeks go by a bit quicker.

The following letter, written by Dr. Lobko, is most insightful as to how special he felt this visit was for him.

An essay about my trip to America.

It seemed to me unbelievable and very easy at the same time… to happen to me.

It was unbelievable because of the fact that I never expected such a thing happen to me for real. And it was easy because I never expected that thing happen to me without any complex arrangement. It happened as if it was meant for me. As if I was a particular person. And I was not (but I hope I will be someday).

At the very start (taking planes and further) I was a little bit frightened… to be alone in a foreign country etc. But from the very moment when I was met by Lloyd and Judy I realized that I would not be alone! And sometimes I really wished my further education steps to be delayed for a while letting me enjoy their company more.

1st week was quite hard to get used to the things going around. The main problem was my English, both conversational and medical. I spent 3 days with John Moore and 1 day with Randal Morgan. And sometimes I had a feeling that I understood not a word (especially from what Dr. Moore said). But now it is obvious that I was getting then a great supply for my mind to assimilate and use for the rest of the time. It was the first times I saw an American doctors work, and heard them speak. I was a sponge then, getting knowing about the way they work (examining a patient, performing operations, whatever else) and the way they talk (about what they were doing, explaining things to patients etc). And of course I should line out arthroscopy surgery cases I saw then. They really enhanced a surgery mind of mine. This week is also remarkable for making friends with Dr. Rosin who has Russian backgrounds and is a very intelligent person and very skilled orthopedics radiologist. Without his guidance on orthopedics MRI features I would not create a whole image of orthopedic science and facilities in the USA.

At Shriners Hospitals for Children in Tampa I spent the next four weeks. It took about a week to observe the whole place. The hospital contains small town facilities and infrastructure. I was pretty much amazed with the efficiency with which different services collaborate with each other for patient’s benefit. Clinics, surgery, prosthetic and orthotic department, rehab department, laboratory etc. Sometimes it is very hard to provide a step-by-step treatment of an orthopedic disorder tying together different medical facilities, but the problem does not seem to exist at all at Shriners. I enjoyed very much the time spent in clinic with doctors Grogan, Kim, Mausel and all the nurses. And it was also very interesting to observe rehab department facilities and prosthetic-orthotic department working process (which I visited three times). It was a real surprise to have an opportunity to choose and take back with me some of the books donated to the library. Having some books right there and reading them in the evenings helped me much to understand many things going around at working time. And of course, visiting surgery was the most important thing for me there. Watching doctors Grogan, Kim, Leffar, Hess, Kabal work performing spine, pelvis, hand, plastic surgery and knee arthroscopy was fascinating and useful. It was also very useful to see simple procedures, the way they are being done, the results for the reason to compare all these with what my colleagues and I did in Novgorod. Some of the days at Shriners did not seem to be loaded much with work and study and it was difficult to find some place to go without having a good guide. But I always had some pages to go through.

Observing All Children’s Hospital in St. Petersburg last week of my visit was an icing on the cake. There I met a very friendly and professional team of doctors, PAs, nurses. I enjoyed very much being with them at clinics and in the surgery. I had a feeling that they treated me like a person they knew for a long time and as a doctor they saw performing operations (but all they really knew about me was my stories and my opinion on some of their cases). We had conversations and discussions about cases and methods of treatment. I was shown the latest spine surgery method that used infrared navigation and 3-dimension MRI image model. I also showed pictures of how we treat some orthopedic disorders and proved that some simple methods could also be efficient.

I am sure that the study I began in the USA is still going although I am back already. And I also believe that both sides can benefit from continuing communication. And it would be great if sometime it were possible to create a program allowing practical surgery training.

And it still seems to me unbelievable and easy…
Thank you very much.

Lobko Dmitry, MD. Novgorod the Great. RF.