The word heart brings us innumerable resonances about the world of feelings and affectivity. the neuroscientist Antonio Damasio, evidence that feeling is essential to know. And it is precisely from the feelings of the author of the work that we present, that we will delve into the knowledge of the exciting world of Cardiovascular Surgery. The practice of medicine It has occupied innumerable pages, literary or essayistic. The vision that the book of Maxence van der Meersch Bodies and Souls; another is the treatment of disease in The Magic Mountain of Thomas Mann, as a kind of initiation path. Among the works of essayists we would highlight Pedro Laín Entralgo, author of Release of Conscienceof deep frankness, as is the book by our writer, with which we believe he accredits sufficient merits to place him in the great Spanish tradition of humanist doctors, such as Marañón or Laín.
Between the essay and the novel, we could consider the work of the eminent Madrid cardiovascular surgeon, Manuel Calleja Hernandez 40 years with an open heart. Confessions of a cardiac surgeon of the Spanish Public Health. A book that is also what the heart symbolizes, a book of feelings.
A brilliant professional career, which began with training in Jimenez Diaz Foundation and completed in USA and UK, its performance in 5 large hospitals in our country, being Head of Service in 3 of them. He is the author of 5 books and countless papers and communications, as well as publications in the most prestigious national and international magazines. They constitute the essence of a curriculum that demonstrates a deep knowledge of the specialty of cardiovascular surgery and that places the author in the best position to offer us a complete, truthful and emotional testimony about it.
We are not aware of other books that offer such a complete vision of the development of the vocation of cardiovascular surgeon in Spanish Public Health taking into account social and personal circumstances. The structure of the book, in its 27 chapters, is a success to present us, in a pleasant and close way, the different aspects of the world of the specialty. There are two large areas that form the backbone of this work: The human dimension, with stories of the professional life of the author and his feelings about the performance of such a self-sacrificing and demanding specialty; and on the other hand, those around the Health system and its organization, can definitely be improved. For this, Dr. Calleja becomes a chronicler who delves into everything that surrounds him, without partisan interests, only guided by his eagerness to reach the truth and the background of things.
An elegant and flowing style makes it easy to immerse yourself in the world of cardiovascular surgery. We are witnessing the history of exciting advances in the specialty. The loneliness of the surgeon it is something inherent to a profession in which decisions are made based on probabilities, and absolute certainty in the success of an intervention is not possible. Operations have the fatal risk of death And it is then that the surgeon, who has been honored by everyone with his successes, finds himself heartbreakingly lonely. It is something that has to be known by the population, ignorant of what hides such a self-sacrificing profession. This would contribute to the current and excessive aggressive attitude towards the doctor shift towards greater understanding.
It is a specialty that requires great commitment, with an intense working day and night shifts or calls for urgent interventions; long operations between eight and fourteen hours, who need to be rested and in the best psychophysical conditions, to “always use themselves fully, as if they were facing the only patient who is going to operate in their life”, acting with speed and economy of gestures surgical procedures and maintaining temperance, good sense and determination. Some very high demands that on many occasions put the resistance capacities of the surgeon to the limit. Without forgetting the importance of a good multidisciplinary team, as the final guarantee of success.
Surgeon Personalities
With this book the reader comes to have an exhaustive vision of what the exercise of Cardiovascular Surgery entails in all its dimensions. interesting chapters dedicated to patients and the doctor-patient relationship, teachers, the personalities of the surgeonswhat it means to have a position of responsibility, euthanasia, nurses, transplants and the need to have a performance to go against the clock, among others; they constitute the tesserae of the most complete mosaic of the specialty. Through them the reader attends the revelation of the most intimate and exciting aspects of the practice of Medicine.
We know the evolution of a specialty from its early days to the present day and we get closer to the great cardiovascular surgeons in history, such as the Dr. René Favaloro and his tragic fate; or the Dr. Castaneda.
In this book of deep experiences, there is no lack of reflections on the religious feeling provoked by borderline situations experienced by the author and that lead him to consider that helping others is the truly transcendental thing in life. Although the author declares himself an agnostic, we cannot fail to consider the spirituality inherent in the great satisfaction he feels when making others happy.
Curious is the chapter dedicated to the clinical sessions, of fine insight, with thirteen archetypes or ways of behaving in them, from the erudite, arrogant, bluffing, theoretician… to the insistent or charitable.
We found those exciting aspects of cardiovascular surgery that escape a scientific explanation and open the doors to other levels of understanding. Such is the case of the traits or inclinations that some transplant recipients acquire from the heart donor.
In his story, Dr. Calleja’s attitude reminds us of that of the philosopher, who seeks to expose the facts with complete truthfulness in order to achieve a true vision of the different factors that are the object of his fine analysis.
Demystification of public health
A special mention deserves the exercise of Demystification of the Spanish Public Health- considered by the media and other actors as one of the best in the world-, pointing out its successes but also its shortcomings, placing the health system on its fair terms and highlighting the excellence of its professionals as one of the keys to its success. It does not matter to Dr. Calleja to be or not politically correct or demolish the myths that Spanish healthcare is one of the best healthcare in the world. He bravely assumes the consequences of his attitude, knowing that the search for the truth and having his own criteria is incompatible with attitudes of complacency and sometimes its price is loneliness or misunderstanding.
The performance of positions of responsibility in public health is often questioned if an honest, coherent attitude and allied with the truth is maintained. The author tells us the cDid you hear that in his case he had to be faithful to some principles whom he could not resign even at the cost of being dismissed from office. This exalts his status as a great professional and human being.
transplants
Especially interesting is the chapter dedicated to transplants in which, with a style close to a thriller, he narrates the hectic pace of the actions that take place from the collection, once the existence of a heart to be transplanted is notified, to the intervention and transplantation of the same.
The reflections of the author at the end of the book are also revealing, evidencing the great dedication that medicine requires and particularly the practice of cardiovascular surgery, when wondering if it is compatible with a reasonable family and social life. It is good that public opinion knows that the fatigue of long hours in the operating room does not predispose the surgeon to the best conditions for enjoying his free time like other citizens. And if we add to this some salaries well below the European averagewe can only recognize and admire the great vocation and dedication of these professionals.
Fernando Mesquida Garrido
’40 years with an open heart’: the trajectory of a cardiac surgeon