Why I became a surgeon, and then a medical director

Why did I become a medical director? That’s a good question. The answer takes me back to when I was just five years old. Even though there were no doctors in my family, I felt a strong pull towards surgery. Why, you ask? Well, I was deeply influenced by American TV series.

Two years later, at the age of seven, I found myself in La Princesa Hospital, a teaching institution in the heart of Madrid. I was fighting peritonitis, the result of a delayed diagnosis of appendicitis. It was 1970, a time when modern diagnostic tools like ultrasound and CT scans were not available, and there were only a few antibiotics to choose from. After two surgeries, my recovery was slow but steady. During this time, Sister Filomena García kept my spirits high with her amusing stories. One story that stuck with me was about a renowned surgery professor, Hipólito Durán-Sacristan. He had recently moved to the San Carlos Clinical Hospital from Valladolid, where he had been the youngest University rector. This story set my path: I was destined to become a surgeon and a professor of surgery at Hospital Clínico San Carlos and Universidad Complutense de Madrid.

The next leg of my journey began at Hospital Clínico San Carlos. I studied medicine and became an intern in the Department of Surgery under Prof. Durán-Sacristan. My determination to fulfill my dream was unwavering, and after finishing my medical studies, I passed the national exam that allowed me to become a surgery resident. Interestingly, Prof. Durán-Sacristan had retired two years earlier, but one of his disciples, Prof. Represa, had been appointed chair. His support over my professional career has been fundamental. I am also greatly indebted to Prof. Elisabeth Vincent-Hamelin, my Ph.D. advisor, who played a significant role in my academic journey.

During my residency, I had the opportunity to take a clinical rotation at Beth Israel Deaconess Medical Centre (BIDMC) in Boston, thanks to Julio Garcia Aguilar, the current chief of the division of colorectal surgery at Memorial Sloak Kettering in New York. It was 1994. I learned a great deal from him and Jeffrey Matthews, who was an associate professor of surgery at Harvard Medical School at that time, and is now chair of the University of Chicago Department of Surgery. In 1996, I returned to Boston to complete a surgical research fellowship, and I was deeply influenced by the BIDMC management style: human first. It was somewhat different from the traditional “American way”.

As I delved deeper into surgery, I saw significant challenges. I was fascinated by epithelial biology and ran my own lab at Hospital Clinico, but I was increasingly concerned about the state of healthcare, the growing depersonalization of care, and the slow pace of digital transformation. I realized that innovation was crucial to push changes forward. I believed in patient-centered decision-making and leveraging technology to improve care and outcomes. Alongside my dear friend, Dr. Madhu Prasad, I made the decision to leave surgical biology behind and venture into the realm of surgical technology.

To drive innovation, I pursued a master’s degree in health services management. However, I soon realized that to push my plans forward, I needed a leadership position. These plans involved improving care processes and technologies such as robotics, high intensity focused ultrasound (HIFU), and a simulation centre, the Smart Health Centre.

Despite the challenges posed by the SARS-CoV-2 pandemic, I managed to fulfill these projects. I saw firsthand how these technologies could improve patient care and outcomes, bring the human touch back into healthcare, and accelerate the digital transformation of our systems.

Then came the time to step back. I had achieved my goals. It was time for the next generation to take the baton. Every step of my professional life was a conscious, premeditated decision. I wouldn’t have it any other way.

But here’s the thing: surgeons shouldn’t just operate and research. We are stewards of our communities, and we need to get involved in management to add value to our practice. We can and should contribute to the global spread of value-based surgery. I don’t know if my journey will inspire others to continue pushing for improvements in healthcare. But let’s not forget, surgery goes beyond just using a scalpel; it’s essentially a premeditated commitment to caring for our patients, contributing to our communities, and standing by our colleagues.