In the section “Faces of our science” – Natalia Khorkova, MD, PhD, Cardiologist of the highest category, Senior Scientific Researcher of the Department of Surgical Treatment of Complex Heart Rhythm Disturbances and Pacing #2 of Tyumen Cardiology Research Center, Tomsk National Research Medical Center, Russian Academy of Sciences.
— Please, tell us how did your interest in medical science begin?
— In my childhood I wanted to become a teacher, but at the stage of graduation from school my friends submitted documents for admission to medical institute and I did the same. Studying at the institute was hard, sometimes I spent the nights, but I had no regret about it. I have to say that arrhythmology was the most complicated field in cardiology for me. The interest to science appeared later, at the time of doing my residence at Tyumen Cardiology Research Center. Now I work at the clinic combining it with scientific and pedagogical activity, so I can say that my child dream has become true.
— How did you get to Tyumen Cardiology Research Center?
— After institute graduation Vladimir Izgeim, my uncle, who was the head of oncourology department at Tyumen Regional Oncological Dispensary, offered me a job. He showed me a device that allowed me to identify patients with a high risk of developing oncopathology by blood flow, and immediately offered to do scientific work in this direction. The offer was very tempting, but I wanted to become primarily a general practitioner, not a surgeon, and I refused.
During my internship for therapy I was doing my practice at the Center. Here I was impressed by everything: work among the top-class specialists, modern equipment, and caring attitude to patients. That is why after my internship I submitted my documents for the residency at Tyumen Cardiology Research Center and I was accepted to a budget place. During the second year of my residence I have been trained at the Department of Surgical Treatment of Complex Heart Rhythm Disturbances and Pacing and learned diagnostics and treatment of patients with arrhythmias. At that period I wrote my first scientific thesis under the guidance of Aleksandr Rychkov, Professor, an experienced and sensitive research supervisor. So I stayed to work here and my training smoothly moved to a work process.
— What researches are you doing at this moment?
— For me, science is inextricably linked to clinical work. Unresolved problems in the clinic provide a basis for reflection, development of new ideas, set goals for scientific research. For example, the last five years I have been doing a study of development of thrombus formation in the left atrial appendage in patients with non-valvular atrial fibrillation. An interest to this issue appeared due to the increase in the frequency of detection of such blood clots among patients admitted to our clinic. Based on the analysis of the data about the hospitalized patients, we revealed possible clinical and echocardiographic predictors of formation thrombosis of left atrial appendage and designed a calculator for estimating such a probability. Outpatient doctors can calculate probability of thrombosis in the appendage without special diagnostic methods. Now we are studying the thrombus formation extensively, including biomarkers, hereditary predisposition, indicators of the blood coagulation system. We are planning to design algorithms of managing such patients with individual approach for choosing anticoagulants. In the future, I would like to create a center for monitoring anticoagulant therapy, the main goal of which would be to develop a personalized approach to the management of difficult patients with thrombosis and / or bleeding, including those with severe comorbid pathology.
— What is the hardest part of your job?
— Clinical work in the department takes much time and power, it is often difficult to switch from clinical activity to scientific immediately. Writing articles and reports preparation require attention, creative mood, and calm environment. These conditions are almost impossible to fulfill during work in the clinic, I often have to do science at home out of hours and weekends.
— What do you like in your profession?
— I like helping people, terminating the symptoms of their disease, improving the quality of their lives, prolonging it for many years. I am trying to communicate with patients more, to explain them all possible reasons of the disease, medications action, the intervention technique, necessity of constant drug taking, etc. I think that you can expect positive effect of treatment only in case of complete trust between a doctor and a patient.
— Do you have a hobby? What is the best rest for you?
— Since childhood, my parents grew in me a love for nature, for the forest. In summer we often went to gather mushrooms, berries and we also caught fish. Now it is not easy to get out in the forest, but if I have this opportunity, I really enjoy it. Every summer my family and I go to the sea, have active rest and gain positive energy for the next year of work.
— What qualities, in your opinion, should a cardiologist have?
— A cardiologist as any other doctor should be attentive to a patient, be respectful to the colleagues, have logical thinking and constantly update their knowledge.