Acad. Dr. Petya Vasileva is from that category of doctors who have the mission, knowledge and talent to bring back the light to people who lived in darkness for years. "It's great when a person sees in front of your eyes," says the manager of the Specialized Eye Hospital "Acad. Pashev" - training base of the Medical University - Sofia. And this happens every day in her practice. "I look people in the eye. Everything is written in them: intelligence, kindness, sincerity, even lying. The eye is the most perfect organ, a masterpiece of evolution. They are a wonderful portrait of a person, a window to the brain and a mirror of the soul," says the famous ophthalmologist.
Academician Vasileva, what is specific about your speci alty?
- The question could be considered in a technological and an emotional aspect. The emotional, in my opinion, is the most important thing for a person. It is not by chance that there are so many proverbs: "Keep it like your eye", "…like your pupil", and Schiller said that "to die is nothing, because everyone dies, but to live in darkness - this is the misfortune"! There was an American study on phobias in which the fear of losing sight came first, followed by the fear of cancer and death. This is really a leading fear in people, let's not forget that it is also the most severe disability. When we lose our sight, only then do we understand how much we have lost - along with other things and the impossibility to educate and improve professionally, to lead a fulfilling social life. And what about the inability to enjoy nature?! When a person comes to me with a severe eye problem, I never forget to ask myself: Will he continue to enjoy all these benefits?!
You mentioned that you are very technologically dependent…
- To examine the eye, we need very specialized equipment, and to treat it - even more specialized. Another feature is that with us, millimeters also matter, and everything must be very fine. Let's say, elsewhere in the body, a hemorrhage, even of 10-15 cm, is not fatal, while in the eye, things are different. All vision takes place in only 2 square millimeters - in the macula. We have to take into account these subtle structural-spatial relationships, the eye is a specific organ, very subtle and, I would say, to a certain extent - perfect. Take all the bionics that try to emulate the eye - nothing comes close to even a fraction of its features. Our eye can adapt to brightness up to 1 million times, well, there's just no device that can do that. Take the memorization of visual information - what computer could do that perfectly and for life?! It is good for people to think more often about what a great achievement of nature the eye is.
Does anyone control the quality of the operations performed by you - and your colleagues?
- No, there is no quality control of the examination, the treatment, the operation in our country! No one cares if the patient is sighted or blind from this operation! There is no country in the world without quality control in medicine - only
in our country it's like a broken yard
In Germany, France, Austria they have registers in which they are obliged to describe what happened to the patient during the operation, all his results. They will come here to control us, if any patient goes to complain, notice, not praise us…
We have no disease registers, medicine has been fragmented, both horizontal and vertical connections have been lost. Total irresponsibility prevails in our country. I had a patient the other day who was blind in one eye, the doctor told her it was her fault that she moved during the operation… Sorry, she's under general anesthesia, where is she supposed to move if you're doing a good job?!
I call that dishonesty…
What should we see well in life?
- Above all, I think we should think positively, I myself am an incorrigible optimist. We have a wonderful country, wonderful people. I love my patients so much! Each of them is close to me and they feel it, they are calm, whatever procedure I have to do for them. Bad people are rare that I meet in my life. Kindness, honesty are my favorite things to meet. It is increasingly difficult to "see" them, but they are there.
You have many students…
- I consider my mission to be teaching. And if we love our people, we must train those after us. I have long since overcome the selfishness of not "giving" my craft - especially for surgery. In many private hospitals, only one person operates, the others serve him… True, it is much easier to operate yourself than to teach, but that's how I see things.
Are you optimistic about the future of he althcare in our country?
- Unfortunately, I think many of us are quite far from striving for perfection. To a large extent, Bulgarians are slaves to the lack of income, to misery, to bitivism, to the lack of means to live -
we are economic slaves
This we must overcome to become perfect. That's why doctors go abroad - because of the salaries. Food is cheap there, but here?! Even for it there are not enough funds… If there are no fundamental changes, he alth care will sink further and further due to incompetence. It is not possible for a poor country to pay its doctors well, this is not exactly the mechanism by which it does it now.
Macular degeneration…
- It is the most common cause of reduced vision and incurable blindness and disability among the elderly population in developed countries. The disease occurs in people over 50-55 years of age. The first signs are a disturbance in central vision - difficulty reading and watching TV, distortion of images, a dark spot in front of the eye. Gradually, vision decreases more significantly and the ability to read is lost. However, patients can move independently as their peripheral vision is preserved.
Do you know the causes of the disease?
- The causes of the disease are not fully understood. Its very name indicates the role of premature aging of the retina. It was established that the pathological process develops in the central part of the retina - the macula, where there is the greatest visual load, the most intensive exchange of visual pigments and energy requirements for the visual process. Risk factors for this disorder in metabolism are heredity, smoking, increased cholesterol, increased exposure to ultraviolet radiation, vascular damage to the body, disturbances in lipid metabolism, excess weight, etc.
Is it treatable?
- People need to know that this disease is curable! There is a treatment for which we are waging a two-year struggle to have it regulated by the He alth Insurance Fund.
Until 10 years ago, there was no treatment for him. But a happy coincidence changed that: in America, a man is being treated for colon cancer. They give him intravenous injections.
At one point he says - I saw
And before that he had not seen. It turns out that the doctors cured his macular degeneration. After experiments and observations, ophthalmologists began to administer the injection directly into the eye, in small doses, once a month. People are browsing and that's great, but pharmaceutical companies see this fact as an opportunity to make a lot of money. A small package of a modified preparation specially for the eyes appears, which costs ten times as much. From BGN 200 to BGN 2,500 for a one-time treatment. A huge difference… Then the politicians enter the game, as a result of which we are forbidden to use this medicine for the treatment of eye diseases, but only the expensive one. Most people don't have the financial means, they can't get treatment, and their alternative is to go blind. Several people a day come here and cry. This is inhuman behavior! In the world, both preparations are used and both types of treatment are covered by funds.
