For many years we have been waiting for a company to be found that will make the first stress system with an extended interface for the introduction of ECG analysis formulas. The author has been ready to consult her for a long time, but she is still not there. The appearance of a 2nd generation stress system with an extended interface has long been expected by many cardiologists as a revolution not only in the diagnosis of heart diseases, but also as the most realistic possibility of prolonging life. The history of the creation of the DC will be interesting to anyone who wants to know how such ideas are born, but especially how they are implemented. But it is also interesting in how new ideas are born and die in Russia, if they are not an airplane or a tank. Especially in the medicine...
At the Leningrad Pavlov’s Academy, I had a reputation as a freethinker, because I lived in Siberia and was often late for the start of classes. And even before my residency, I still couldn't figure out what exactly I wanted to do in medicine. Most of all, I wanted to solve complex medical problems - no matter what, as long as they were complex. I thought that the results of scientific works had already reached such a density that any medical problem could be solved in a scientific library. But I knew exactly what I would never do in my life - the ECG was the only thing that disgusted me. You had to be a complete idiot to spend your life studying a pile of curves, then to meet an incomprehensible one. But even at the prestigious academy there was nothing but tedious schoolboy cramming, which I diluted with reading Wiener's "Cybernetics", Pribram's "Languages of the Brain", Watson's "Double Helix" and other similar reading. For the social life in St. Petersburg, I enrolled in a dance school, an English Club, took piano lessons, attended lectures for art critics at the Hermitage, and in mathematics at the university. On the advice of my cousin, I ordered a new suit from the atelier in Apraksin Yard, where they sewed for diplomats, I went to Tallinn for shoes, and to Vilnius and Riga for pullovers and shirts. My precious parents pampered their late child beyond measure, paying for all my trips, orders, expenses and purchases, and I gratefully drank their blood, not denying myself anything in my travels in the Crimea, the Caucasus, the Baltic States and Ukraine. Having escaped from the wild Siberian hinterland to the magnificent Petersburg, I was just starting to live and, as much as I could, enjoyed the chic St. Petersburg galleries, great food, solid acquaintances and this, such a new life in a beautiful city. During the winter holidays, my friends and I went skiing in the Carpathians, and in May I always flew to the Crimea for two weeks. In the summer I returned to Siberia or went to Lake Baikal to fish and relax. After two years of round-the-clock cramming, having passed the anatomy, I went to work, although I received a scholarship, and my holy parents continued to send their child three doctor's salaries every month. But I still didn't have enough money. At first, like Viktor Tsoi, I drove wheelbarrows with coal in a stoker, then I started working as a paramedic in an Ambulance, and then as a doctor. Seven years in chic St. Petersburg flew by like one day and it's time to say Goodbye to the lovely city! I've lived in it for seven years, but I know almost every block, house and stone in it, and dozens of places where you can have a great snack at any time of the day. And I've been living in Moscow for more than thirty years, I've been here in almost all embassies and restaurants, and if you ask me where to eat, I'll only remember Julien in Prague, and chebureks in the eternal cheburechnaya on Myasnitskaya. This is probably because in Leningrad I lived in a dormitory and studied this city with my feet, and in Moscow I had before my eyes Vasilevsky Descent with the Kremlin from the windows of the suite, and Kutuzov Avenue and Rublevka from the windows of official cars around the clock...
I chose the residency in dermatology because there was not a single understandable disease in it, except for pubic lice, which was treated with a gray mercury ointment, popularly called "flying". A friend who saw me off cheerfully admonished me: "Decide, even if you finally have this psoriasis!" and these words of his, it seems, stuck in my ears. I was assigned to the village, but my residency took place at the Eagle dispensary, where there was a rare atlas-a determinant of all skin diseases. So, my friend's parting words stuck in my ears. Therefore, after renting a hotel room, I took a suitcase, a taxi and went to the local scientific library, which turned out to be quite decent and where I went all year by taxi with a suitcase in which hundreds of library forms had accumulated. But the longer I read, the more bewilderment possessed me - for seven years, all 66 departments of the prestigious academy did not give me anything that I could approach patients with, but which I immediately encountered in reality. I remembered our dean, pato-physiologist Petrishchev, who constantly protested against me abroad: "Ivanov will run away to capitalist country on the same day!" he persisted.
He should have done his pathophysiology, which described in detail only acute inflammation, without mentioning how it turns into chronic. What is "deafferentation" and what processes occur in the tissue where it happens. That stress can be active and passive, which depends not on gender, but on the fraction of adrenaline/norepinephrine. If it is less than 1, then the person's reaction will be violent, if it is more, he will cry. All this was present in the development of psoriasis, which was based on chronic stress. The nervous system is available to all types of information discretely - it receives a portion of it, it closes the entrance for this type of sensitivity, analyzes it and accepts (or does not accept) some kind of action -speech or motor, after which it reopens the input for this type of information. This whole act takes milliseconds, so in ordinary life we don't notice it. In case of stress, which stops only under the influence of a certain type of steroids, which work according to the type of positive feedback - only their presence stops stress. If, under stress, there is a lack of a steroid, then such "defective" stress becomes chronic. But the nervous system itself understands this state of the tpc, that information continues to flow into the nervous system. This leads to the fact that the intermediate neurons of the spinal cord, which block the input of information from sensitive neurons, receive a command to increase the inhibition of sensitive neurons so much that they lose their tone and cease to regulate the synthesis of keratogyalin (cement that binds 7 layers of epithelium into a single skin), which goes in the basal layer of skin cells. In these places, the 6 upper layers of the skin begin to peel off easily, revealing the pink basal layer of the epithelium. So there is a psoriatic plaque. This is how psoriasis begins. It remained to find what kind of steroid is missing here and why exactly. But for this, such a laboratory for steroids was already needed, which did not exist in the USSR. After my residency, I went to rest in Odessa and found a book "Steroid exchange" in a shop on Deribasovskaya Street. Now I knew among which steroids it was necessary to look for the weakness of the enzyme...
Upon returning to Siberia, I began to bypass the departments of the local academy - to be a scientist in the USSR without a supervisor meant to enroll in the city lunatics - no matter what you did, no one would need it. It was necessary to decide with whom to continue this work further and I divided it into three independent parts: skin pathology - for a dermatologist, pathology of the nervous system - for a neurologist and steroid pathology - for a biochemist. Before the last discipline, I always felt piety - it was clear from the structure of the liver enzyme how the virus inhibits it and how it should be activated. It was such an opportunity that soon presented itself to me...
The head of the Department of Skin Diseases of the Krasnoyarsk Medical Academy was then Professor Fyodor Kolpakov. I had mutual acquaintances with him and I could easily have come to him for tea, but it didn't seem quite convenient to me. After reading my writing, he was delighted, saying that it was a finished dissertation and that he would be happy to take me to residency and graduate school. However, I was warned that there is a war going on at his department (quite common in all scientific institutions of the USSR), between Russians and Jews, and the atmosphere there is quite heavy. But the main thing that did not suit me was the fact that the department was on the other side of the city. After that, I went to the head of the Department of Neurology, Slava Rulnev, whom I also knew from the stories of mutual friends, neighbors and a younger cardiologist sister who studied with him before her transfer to St. Petersburg to the very academy that I and another 7-8 people from our family later graduated from. He was a famous dude, walking around the local Broadway every night with a new skirt. He sewed all the trousers and shirts himself. Slava spoke in the sense that it would be nice for me to get acquainted with the works of his department, for which I need to become a neurologist. While my friends and family were looking for a neurologist position in local hospitals, I entered a local university at the Faculty of Mathematics and managed to finish the 1st year. I would have studied there further, but I was not credited there with the "History of the Party" and "Physical Education", which I had already passed with "excellent" in Leningrad. And this is despite the fact that I played tennis for this university at competitions! But then there was a place for a neurologist and I returned to the clinic.
But at my new place of work (after completing a specialization in neurology), cardiologists began to bother me, who refused to look at a patient with complaints of heart pain if I didn't look at him - they were panicked by patients with diencephalic syndromes. These patients are haunted by the fear of death, although their lives are not in danger. It is not easy to treat it, but all patients recover successfully. It was from them that I learned that an ECG can only detect rhythm disturbances and nothing more. It struck me. It really took them half a lifetime to first learn how to read this ECG, and then to learn about the absolute uselessness of this thing in 90% of cases. I remembered with what hope patients always looked at the doctor studying the ECG. They were unaware that he was holding an almost useless thing in his hands. It was pure comedy on the part of the doctor. And Raleigh what? The thought of the uselessness of the ECG struck me and I began to think what could be done here. Moreover, I did not have working contact with the Department of Neurology - firstly, Slava among his girls behaved like a rooster in a chicken coop, and secondly, he was interested in personal time in motor acts. The topic is very complex and its methodology has not yet been worked out. Each person's personal time flows at different speeds. The "center of time" is located in the medulla oblongata. When it was removed from cockroaches (along with the head), they always developed cancer. So, it is possible that a person may have desynchronosis as one of the causes of cancer - a part of the cells in some organ of his body suddenly falls out of a single time. In neurology, this large and complex topic seemed somewhat artificial at first, but later I saw it washed away. Anyway, intellectually I remained free, but then a curious story happened.
One day, the chief doctor announced to me that the neurological department, which I was already in charge of, had been converted into an infectious disease department for the summer - this happened not infrequently in the USSR. Stunned by the news, I asked him about the time to prepare, which resulted in the following dialogue:
- Have you had infectious diseases in honey? "What is it?" he asked.
- yes...
- Well, then you'll have enough of a night - remember how you were preparing for exams. Your luck is not to miss dysentery and typhoid fever!
And in the morning, food poisoning and toxico-infections began to flow on us.During the day, the ambulance staffed our department completely. I was afraid of only one thing - how not to miss typhoid fever, remembering what a scandal the neighbors had once. It was then that I came across two erased forms of chronic hepatitis - here they passed as "concomitant". And I remembered a case when, immediately upon arrival, between visits to departments and job searches, I got a job as a district doctor in a polyclinic nearby. I got a gorgeous plot - all with two-story houses that were built by captured Germans after the war. But one day the chief called me to him:
- The surgeon is dying of cirrhosis of the liver. He has two days left to live. He was discharged from the hospital to die at home. Take a look at it for form's sake - you need an entry in the card from the therapist.
I have always believed that a doctor is characterized by biochemical thinking - if he does not understand the biochemistry of the disease, he cannot cope with it. The structure of the enzyme itself can tell you how it will be inactivated and how to activate it. Liver enzymes, for example, could be easily activated by the fact that there are 100 years in every pharmacy. The patient turned out to be an emaciated 40-year-old man with a giant belly and yellow skin. I advised his mother (who had already been warned that he was dying) to call a surgeon with an ambulance so that he would puncture his stomach with a trocar and release all ascites, prescribed injections of “sirepar” in a double dose and told how to give an "enzyme restorer". After 20 liters of water came out of him, he cursed me for a day because of the jump in the electrolyte balance, and after 2 days he started vomiting bile - his liver started working - bile plugs flew out of the bile ducts. About 5-6 years later, we met with his mother in some hospital and she said that her son was still alive, feeling fine and took up photography. That's what the "enzyme restorer" can do - he certainly saved this person - he can be said to have returned from the Other World! My Moscow neighbor, Tolya Kashpirovsky, when my wife and I were visiting him, said that he took 5 KAMAZ thank-you letters out of a barn in Ukraine. That is, 40 tons! Knowing that only 1 out of 10 thanks, we get 400 tons. Let each letter weigh 50 grams. It turns out that he helped... 8 million sick people. The greatest of all doctors in the history of mankind! Of course, I also had my own thank-you letters, but this is a drop in the bucket, compared to Tolin's. But one - from Gali - I will hang in a frame: "Doctor! Tell me, what did you smear my lower back with 7 years ago? Now my relative has the same story!"
But, if the "restorer" has helped so radically with cirrhosis of the liver, then it should cure chronic hepatitis within 2-3 weeks. And for sure - any forms of hepatitis "restorer" clicked like nuts - bilirubin and biochemistry returned to normal within a week, and the second liver was on ultrasound as new. And I decided to sell this tool to the state at the price of an economic effect - such cases, as I knew, had already happened - and I began to collect material about its effectiveness - I constantly worked for 2-3 rates and not a lot of money would not be superfluous.
However, when 10 million patients were cured, an amount was obtained that was not only in the Ministry of Health, but also in the whole USSR. I was somewhat encouraged by Minister Eduard Nechaev, who often turned to me for help while I was working in the Duma, but Yeltsin exiled him as an ambassador somewhere and he disappeared. In 2021, I remembered about the "restorer" and again offered the Ministry of Health to test its effectiveness. And already in May 2022, I received a 4-page answer why the Ministry of Health would not do this. Then I turned to Deputy Prime Minister ms. Golikova, who oversees the health of the nation, that there are 10 million hepatitis patients in the country, while there is an effective cure. A month later, the Ministry of Health informed me that it was waiting for the material of the clinical examination of the "restorer". The bureaucracy of Russia has killed 30 years to return to its former place. And all this time millions of people were suffering in it from a curable disease...
All this time I was looking through almost all the articles on the mathematical analysis of the ECG, absolutely useless because they had a mathematical idea, but there was no clinical one – they all twisted and turned the analog ECG cycle. At that time, I was also thinking about an electronic medical history, and there it was necessary that each system of the body was represented by one sign, formula or curve - so that the state of this system was clear from one look at it. My respiratory system was represented by GEL and the Tiffno Index in % of the age norm. It was impossible to imagine the heart of a curve 10 minutes before death, claiming that "everything is normal". It turned out that the heart does not have any real indicator of the condition at all, except for the pathoanatomic act. Even the doctor here was clear that as long as the ECG is measured with rulers, there will be no clear conclusion about the real state of this system. And, since there were no stress systems with a digitized signal at that time, and I began to look for an institution with a solid computing center, simultaneously preparing a trip to the Department of biochemistry. before whom I worshipped...
The head of the Department of Biochemistry was then V.I. Kulinsky, very famous even then for his work, a future academician, "Professor Soros" and a member of the New York Academy of Sciences. He was a tall, solid, personable man who asked me just one question :
- Do I have a flame photometer?
Of course I had one. He was standing 3 meters from the door of my department - in the biochemical laboratory. This was followed by a list of references. But my plans were ruined the very next day - the hospital was closed for major repairs for 3 years! It was a tragedy for me - by that time I had already bent this hospital a little for myself and I was very comfortable in it. I came to work not by 8 o'clock, but by 9, or even by 10, drank coffee, made rounds, dictated diaries and statuses to the typist on a dictaphone, which she then printed out and if there were no punctures, nitrous oxide blowing, blockades and consultations, I was free.. I had lunch and went to a hospital nearby, where I described complex neuro-X-ray images, specialization in which I received "at the workplace" (as well as ultrasound), then I stopped by the dispensary, where I had my own office for acupuncture, did procedures and went to the hospital of the Ministry of Internal Affairs, where I had a dozen beds and I consulted patients there. If we add that at the same time I also gave a lecture course at the pedagogical academy and took all Sunday shifts in my hospital, then the picture will be complete. I honestly worked hard for 4.5 bets and thought where to find another 1/2 for the record. And then such a bummer...
By that time, I had already realized that the limited information from ECG analysis comes from the fact that cardiologists always interpret only changes in the ECG complex, but never try to extract from it what they need themselves. We should try to extract from the ECG the main thing that interests every doctor, and then isolate all its components. What interests us in the work of the heart? Myocardial potential and the state of coronary vessels. Everything else is in fine print. And this must necessarily be checked in dynamics - at maximum human tension. That is, the same bicycle ergometry. The changes should concern only the stress system itself, it should allow you to enter before the examination not only the surname, gender, age of the patient's idiagnosis, but also the ECG analysis formulas, coordinates and colors of graphs and tables. The question was what exactly and how to analyze it in an ECG. So far, I knew only one thing - it was useless to continue fiddling with the analog ECG. Here it is necessary to take an absolute - already digitized ECG, but what to do with it next? Here it was necessary to read and think a lot, abandoning everything - even his wife and son. I remembered my successful assault on psoriasis and decided to leave for 2 years as a ship's doctor on a merchant ship that would also go abroad. Which was also not easy - your whole life and all your relatives were sifted for this in a fine sieve. - First, all my relatives had to be checked by the KGB. and then I was also waiting for an exam in the district party committee. I was calm for my communist ancestors, especially for my relatives - one uncle was in the museum in the photo with Stalin, the other was a Hero of Labor. Only my older brother could mess with me here, one of whose friends found a whole bunch of books of the banned Solzhenitsyn and now he was being dragged around the table in the local KGB, trying to find out who gave them to him. I could have crossed paths with him at my brother's, which was not desirable right now. And I warned my brother that I would refrain from visiting him for the time being. I still remember his contemptuous look.
In the meantime, it was necessary to get a job somewhere again, and in such a way as to immediately leave when the authorities give the go-ahead, and a call will come from Sakhalin. That's how I found the best job in the world. I specialized in radiology (which, by the way, is very necessary for a neurologist) and began working in the waiting room of a huge, 1000-bed hospital, where almost all the departments of the medical academy were.It was an unforgettable year, which - I would very much like it to last forever After working and visiting the hospitals of the Central Committee and the Kremlin, I believe that a real doctor can only become working in such hospitals - where he has a stream of his incredible pathologies, the wildest and most incredible injuries, and where he has there is the most modern equipment and support for the departments of the Academy. I have already been invited to this hospital twice - first as a neurosurgeon, then as a neurophysiologist, but I came there as an emergency room radiologist. And I will say that there was no greater medical happiness in my life than working in the waiting room of this giant hospital. Especially on Saturdays and Sundays, when all the drunken fights, stabbings and fights happened and all their participants ended up in our emergency room. Arriving in the evening and having a hearty dinner with the goulash left by colleagues, you could rest until the morning to describe the pictures in the morning and go home. I would have worked like this every day all my life, but the schedule was two days later for the third. A year later, a call came from Sakhalin and I flew to where the ship and Japan were waiting for me..
Less than two years later, I left the sea and returned home - I knew exactly what to do and how to do it. The Academy of Non-Ferrous Metals had a computing center, and its sports complex needed a doctor. There I installed a cardiograph with a computer and made sure that myocardial ischemia occurs at all during exercise. However, soon Academician Boris Grakov, rector of the Medical Academy, offered me the position of senior researcher and a laboratory next to my house. We bought a KAMAK and started connecting a polygraph with a computer, but then the USSR collapsed and the Institute of Physics with which we collaborated fell on its side. I invited Zhirinovsky to my place and promised him to finance the EGC party from Novosibirsk to Sakhalin if he would take my healthcare reform in Russia. Which I could turn in 5 steps from a parasitic cluster of bureaucracy into a normal organization for doctors. But in the State Duma, where I went on the list under No. 3, there was a war between the Ministry and the Sanitary and Epidemiological Supervision, and the minister Eduard Nechaev literally did not leave me, begging me to write an alternative law so that the country's doctors could preserve their laboratory base. I wrote it. And, although the government, the Duma Committee on Health and some of the factions asked to vote for my law, none passed, which satisfied everyone.
Since neither dealers nor firms responded to all my calls about stress systems with an extended interface, I began to look for an option to manufacture it in Moscow. From the MVTU, whose cardiograph I saw at the exhibition, I was told that this direction was closed. Then, in the basement of the hospital near the Donskoy Monastery, I met with a representative of the group that made a "cardiometer" - a rather curious device that showed the intensity of coronary blood flow in color in the drawing of the heart. The strong mathematical and programming composition of the group coexisted with weak clinical thinking - yes, it shows coronary blood flow, but it does not have a quantitative measurement of it. Therefore, it makes sense to use it in the clinic only before and after treatment to show its effectiveness. And always with a bicycle ergometer. The device is very necessary for medical commissions, professional examinations and examinations. He can have a great future if you combine it with an exercise bike. But the clinic is not interested in him. The guy who represented the device was bursting with pride and he was offended by my coldness. Probably, that's also why, on the question of how much their company will take for the development of the ADC, he proclaimed:"Twenty thousand dollars!"
After the Duma, in 1997 I flew to Kiev to arrange the transfer of my son from a university in Siberia to a university in the Crimea. At the ministry, I met a man with whom we sailed for three days along the Dnieper from Kiev and back in the late 80s. On this vessel, the Kiev Institute of Cybernetics held a conference on medical cybernetics. He remembered my performance and asked about the fate of the device. I reported it. Then he advised me to recruit a team in Sevastopol, where at that time there were the best programmers in Ukraine. I bought an apartment on the seashore and brought a calligrapher and computers there. From 98 to 2003, I had 3 teams working for me. But it was all useless - the brightest heads were picking grapes in Germany at that time.
Then I went the other way. The Schiller stress systems that captured the Russian market have long been digitizing the ECG, and I wrote a program that, knowing several parameters of the cardiocycle, predicted at what load he would have myocardial ischemia. I sat down next to the doctor who performed the diagnosis of coronary heart disease on the "Schiller" and asked him to tell me 3 ECG indicators for each load. There came a moment when I warned that myocardial ischemia would occur during the next load.He gave a load and myocardial ischemia occurred. The doctor was shocked: he knew it was impossible, but it was happening.
After showing all this in the Crimea, I flew to Krasnoyarsk. I started with the hospital of the Ministry of Internal Affairs, where I once combined and agreed with the head of the department of the regional hospital Gankin that tomorrow he would conduct a bike test with me. At first he didn't believe me, believing that it was an accident, but we conducted this test several times with different people and everywhere my program predicted ischemia correctly. He thought about it and asked to come tomorrow. The next day Gankin met me with the head of the Department of Faculty Therapy. It was Chen, a well-known cardiologist. He didn't know me, but I knew him. Obviously, it was Gankin's supervisor and he told him everything. We sat down and were silent. Knowing the scientific mores of that time, I left the laptop with the program at home.
- How do you do it?
He asked, looking at me carefully. I understand that this is a trade secret, but understand - I have been in the profession for 50 years and I know everything about ECG. Everything that could be extracted from it has been pulled out of it for a long time. And, suddenly, you appear and show incredible things. Could you at least give us a hint of what field your work is from? Is it a marker?!.
- no.
That was the end of our conversation. I don't know what impression it made on them, but it made a colossal impression on me - for the first time in all the years of my work with an ECG, a well-known specialist realized from just one episode that he was faced with something revolutionary that did not fit into the usual schemes. I was incredibly grateful to Gankin for this conversation. Presented to myself, I almost turned into the author of The Catcher in the Rye, writing a work only for myself. Sometimes, though, I wondered why they didn't offer me money for my secret. By that time I had already done several doctoral dissertations for very decent money, giving a beautiful idea and methodology, explaining how and what to do. People came to me, knowing that I would not turn them in or give them away. I would also sell the Central Committee for good money. Obviously, they didn't have them or they were other people...
Inspired by their reaction, I went to the headquarters of the local cardiology center, where I had known its director, Academician Shulman, for a long time. But he did not greet me kindly, reminding me how at a buffet at the rector's, in his personal bar, I did not respond to some of his request. Now he was enjoying the opportunity not to react to mine either. I had to remind him that I had not come to visit him, but to check the program for coronary heart disease on their precious "Schiller". He felt better before his eyes that he was talking. not about his consultation, and he invited the head of the Department of Functional Diagnostics, Professor G.V. Matyushin, asking him to do everything I ask. We went to the operating room, where Schiller was already undergoing diagnostics, but he dismissed the graduate student and sat down himself. At first, he started fooling around, slipping fantasies instead of real numbers, but after I said that I saw his lies, he stopped. He has already defended his doctorate and left for "rhythmology". He was no longer interested in anything else in cardiology. Graduate students needed it even less. It ended with that. that I asked them for the entire archive of tests on this "Schiller" in one and a half hundred sheets. We were quite ready to part, when he asked where I had studied to be a cardiologist, and when he found out that I was a neurologist, he persuaded me to specialize in cardiology. So I also became a cardiologist, Based on the analysis of their archive, I published a book "Early diagnosis of coronary heart disease" with a circulation of two hundred copies, which I sent to cardiologists I know. The son, however, at his academy also showed it to academician A.I. Nedob, who was then the chief cardiologist of Moscow, but he honestly said that he did not understand anything there and asked permission to show it to his teacher...
The emergence of stress systems with an extended interface would make a significant improvement in the diagnosis and treatment of heart diseases. It would not be difficult for firms to produce them, but they did not do it. Why? Didn't know how? And ask?! This is the true price of our entire "civilization", which, having the conditions for development, does not develop. Yes, the Central Committee is a civilizational problem and firms cannot make this device without me, even with my writing - engineers do not know cardiology, and doctors do not know mathematics. But today I'm 76 and I don't want to do cardiology anymore - I've already done everything there, and I have more interesting tasks. But you - everyone else, if you don't make this device now, you won't make it for another 300 years. First, we need to wait until a specialist of this level appears. Secondly, when they become interested in this problem. Thirdly, when he will be able to solve it. Which is also another very big question...
I have no complaints about Russia - it specializes strictly in missiles, tanks and airplanes. I offered Putin and Mikhastin to organize the production of 2nd generation stress systems in the Russian Federation, but they refused, which is understandable - they never did the 1st here. They will then buy from others when they do... But if the United States does not make them, then no one will. The United States is obliged to make this equipment because their main strength is not bases and aircraft carriers at all, but the sum of advanced technologies and the effective organization of intellectual labor. Finally, the age-related American establishment should know that without a 2nd generation stress system, it is impossible to create life-prolonging simulators - only he determines the age of the myocardium. Moreover, for the first time only one company will produce them in the USA, and only one clinic will also study their capabilities. Then, perhaps, a firm and clinic will appear in the UK, and then in Germany. Etc. The development of new clinical equipment should follow the gradient of technological equipment. Something like this. In the meantime... Good luck to all!