The association had the honor of interviewing its honorary president, Dr. Manuel Pera. During the interview Dr. Pera mentioned some of the most relevant medicine related facts of his life such as the importance of his family in the search for his professional future or the enriching and recommendable experiences lived while working abroad, including not only the time he spent at the Mayo Clinic but also his less known work in Germany. The personal information provided allows us to acknowledge the doctor's great dedication towards his patients and his students.
We thank Dr. Pera for his time and all his dedication towards the association and we invite you all to read and enjoy the following interview.
Why did you decide to join the world of surgery?
In my personal case there was an important family tradition. My grandfather, my granduncle and my father were all well-known doctors, which is the reason why I lived medicine with great enthusiasm since childhood. When I started studying in Clínic Hospital I was more interested in the basic sciences like biology or chemistry. Nevertheless, the contact with patients and my initial experiences as an intern student in the surgery division aroused and consolidated my interest in surgery.
The fact that you have so many surgeons in your family made things more difficult or exigent?
Its relevance supposes a doble exigency and for that reason it has always been a bigger challenge. Specially if you study in the same center you have to demonstrate good professionalism since you are being watched more closely. At the same time, it also stimulated me to obtain a more complete formation and to move forward with experiences as relevant as completing my knowledge abroad. It's very important to be able to look back and feel acknowledged for what I've accomplished and not only for my last name.
Surgeon... Are you born a surgeon or do you become one?
As well as in any other medical specialty, at the beginning there might be a stimulating environment that guides you towards that path. However, each person's experience and the years passing by are what determines the consolidation of the vocation.
What qualities should a good surgeon have?
Obviously, it's essencial to assume the knowledge of the physiopathology of disease and the technical aspects of surgery. Nevertheless, a good professional doesn't only have to be a good technician but also has to have a good relationship with the multidisciplinary team working with him and mainly with the patient. The doctor-patient relationship is crucial to overcome the great journey that represents facing a disease, specially in oncological surgery.
How does it feel to save a person's life? And, on the contrary, how does it feel when a person loses its life after a surgical intervention?
In surgery the professionals have the maximum level of responsability since the patients are literally in the hands of the surgeon. Therefore, when you can overcome a complex and difficult problem the satisfaction is overwhelming and stimulating. At the same time, every surgical procedure has its risks and there is always the possibility of complications. Losing a patient can be lived or expressed with more or less intensity, but it's always a hard and shocking internal experience.
Are you satisfied with your whole career or is there something you would change?
Honestly, I am satisfied. Dedicating to academical surgery allowed me to meet wonderful and well-known doctors. Besides, the fact that I consolidated my training in the United States and in Canada was really impressive since it completed both my clinical and personal formation. I feel lucky because my trajectory is very consistent: I was able to dedicate to the field I sensed I was interested in since the beginning and I managed to obtain the maximum education in that same field. Globally, yes, I am satisfied.
Therefore, would you recommend your students to complete their studies abroad?
Yes, without a doubt.
As a professional, which are the goals you still hope to accomplish?
There are still many goals I hope to accomplish since there are constantly new ones emerging. You have to maintain curiosity and an interest of reaching the maximum level and of doing innovating things, even if the environment you're inserted in doesn't favour it. Nonetheless, I am aware that we are living in a time of crisis that potentially limits the possibility of developing new ideas, a very different time from the one I spent in the Mayo Clinic when the economical possibilities were very superior. Still, you have to know how to adapt to your environment and how to always keep being active.
Is it hard to always be updated?
Nowadays, the immediate access to new technologies is wonderful to get updated. At the same time, the excess of information supposes a higher exigency in matters of distinguishing the reliable sources from the ones that are not. It's undeniable that our profession depends on a constant information acquisition as well as in a constant change of our strategies in order to always keep up with the new scientific envidences, new procedures and so on.
Do you think that students leave university well prepared?
Mi personal experience tells me that, globally, the level of knowledge has increased as well as interest and dedication. It's undeniable that the MIR exam preparation compels the students to acquire an important amount of information, although I also think that practice is really important to finish the studies with a set of skills and habilities in addition to settling down good professionalism.
Do you think that the MIR exam is a fair way of choosing a medical specialty?
The sistem is more objective, however, it would be very interesting if the selection proccess was followed by an interview. The interview is essential in the Anglo-Saxon model whereas it contemplates the candidates' subjective characteristics and it allows the identification of the best one since it is always of great importance to value other skills like communication. This aspect is interesting because the institution itselft also participates in the selection.
In what level do you consider that political cuts affect healthcare quality?
We've been living in a time of economical excesses that has probably promoted a less efficient medical care, considering efficiency as the best result at the less cost. That a moment of crisis, we're aware that certain procedures may be perfomed more effectively. However, leaving what I mentioned before aside, the economical cuts undoubtly have a repercussion in healthcare quality, specially when performed indiscriminately and with no knowledge whatsoever. Analising the needs of each service is essencial before cutting since it's necessary to make sure that the services are properly managed.
Foccusing on surgery, the waitlists and the staff were directly affected by the cuts, which also represented negative repercussions on the diseases' evolution. In many hospitals, doctors are making an effort to maintain quality by being more dedicated but clearly the situation can't continue for long. It's undeniable that the impact is negative and that deterioration will keep on increasing.
You've known many healthcare models... private or public healthcare?
I am a defender of coexistence and adjusting. Public healthcare could maintain a good level of quality by being properly adjusted.
Do you believe in homeopathy or in alternative medicine?
As you know, one of the most important aspects of a patient is the emotional one. I think that in certain circumstances it might be interesting to search for alternative solutions if those solutions are only used as a complement. I only have a personal experience with acupuncture, since I used it myself while recovering from a surgical intervention.
During the interview you mentioned several examples of references that inspired you during your carrer. Do you think you are a reference to the students you teach?
In the Anglo-Saxon society the idea of giving back what you've accomplished as an act of generosity is very common. I personally like that idea and therefore I try to live by it trying to pass on what I was given. Thus, I think that my experience is important to help every student and every resident that I am responsible for. Plus, I consider that a good formation is also part of my responsability.