First doctor to deal with AIDS patients points to advances in the realm of health

The best ambassador abroad Greek surgery could have, Vassilis Golematis has been to Europe, America, Australia, South Africa and Asia as guest lecturer. He has given dozens of talks, promoted collaborations in the area of education – such as that with the famous surgeon M.E. De Bakey of Houston University – and has set up extensive training programs in which Greek students were sent to recognized institutes abroad. As a doctor, he wrote history when he was among the first to operate on patients with AIDS at a time when other hospitals would shun them. Professor, were there any references to your stance on patients with AIDS in the foreign, as well as in the Greek press? There was, I’ve been told (I didn’t see it myself), a reference in the New York Times, which said that «the good news about AIDS comes from the land of Hippocrates and the Ippocrateio Hospital.» There were reports in the Greek press and the Ethnikos Kirikas of New York. At that time, the phenomenon of doctors, especially surgeons, turning AIDS patients away was well-known. Until recently, a sick surgeon could infect a patient. Now surgeons themselves are in danger, and precautions are needed. In our clinic, right from the start, we treated patients with special infections, AIDS and hepatitis C. The support from our nursing staff was truly moving. At the same time, we launched a campaign to teach surgeons how they should operate on each patient, «dressed like astronauts,» as I used to say. It was in the context of these efforts that I published my first book [«AIDS and Hepatitis»] in 1990 and a second, together with Professor De Vita, in 1996. Everyone agrees that you were decisive in promoting modern medical attitudes in this country, which opted for interventions that involved less loss of blood. I lived and worked in a period during which many pioneering methods were introduced into medicine, such as endoscopes and surgical staplers. In the 1980s, we set up the diagnostic and interventional endoscopy unit and introduced the use of surgical staplers in digestive tract operations. This was especially useful with patients with cancer of the large intestine, thus avoiding crippling bodily functions, such as surgical removal of the anus. There followed, at the end of the 1980s / beginning of the 1990s, the laparoscopy technique, a method that caused less blood loss and required shorter hospital stays. We were among the first to use it at the Ippocrateio Hospital, and we have trained many Greek doctors, as well as foreign ones, chiefly from Balkan countries. You were honored by the American Surgical Association chiefly for your contribution to the training of medical students and new surgeons. Do you miss your students in your new duties? Very much. I can’t describe my joy and pride when the directors of laboratories and clinics in which Greek students do their training send me letters congratulating me on their high level of knowledge, standards and performance. I’ve always believed that we are under obligation to point the way to the young. Our duty is to take a horse to water; however, it makes its own decision whether to drink or not. During my 15 years of service at the Ippocrateio [Hospital], I tried to organize the training of students and new doctors as best as I could, with regular educational seminars, post-training lessons and lectures. The program of student exchange with recognized medical institutes abroad was highly successful. At times, we were sending 40 students a year for post-education training abroad. What is your opinion of Greek medicine? I think, and I’m talking chiefly about the university, that it’s at a pretty high level. I believe that Attica Hospital, which houses the university clinics, will turn into a veritable hothouse of knowledge. In 10 years’ time, it will be the Johns Hopkins of Greece. The necessary infrastructure is certainly there. All it needs are goals and a vision. Are you of the same mind about training standards? We know that during your term as chairman of the Central Health Council, you worked on a draft bill to change the system as it exists today. Indeed, we drew up a bill on postgraduate training and lifelong learning and evaluation, and it was passed by the legislative committee. This is the future of medicine. As with pilots, so doctors, especially surgeons, must be evaluated at regular intervals. But Professor Ilias Lambiris of the University of Patras was responsible for the bill, which took five years to draw up. All the medical associations agreed to the content of the bill, and that wasn’t easy, because a doctor’s role is changing. A surgeon is now a surgeon and pathologist rolled into one. At the same time, strict criteria were set for clinics that bestow specialist degrees. These clinics have to be evaluated because many clinics, both surgical and pathological, lack the infrastructure to teach specializations. Today, when 60 percent of operations are interventional in nature, there are still clinics that grant specialist diplomas without being able to train doctors in laparoscopy. This, of course, cannot continue. A good health system means properly trained doctors. Most doctors, more or less, have common sense, but correct education, supervision and evaluation is needed. This is the message that has to get through.