One of this year’s Honorary ESA Memberships has been awarded to Professor Fernando Gilsanz. He is currently head of Anaesthesia, Surgical Intensive Care and Pain Treatment and University Hospital La Paz, Madrid Medical School. Universidad Autónoma. Madrid. Spain, where he is also a Vice-Director of the Department of Surgery.
Q: Fernando, congratulations on the award of your Honorary Membership. Please tell us how you felt when you knew that you had been nominated?
A: I initially felt embarrassed. When you receive an honour, you know that a friend or colleague nominates you, and you are old enough to have more friends than foes in the committees! However, of course I was delighted and I will always be in debt to the ESA, EBA/UEMS and SEDAR, but even more to those anaesthesiologists who had the idea of nominating me!
Q: Tell us how you first became interested in the speciality of anaesthesia. How different were things in our speciality at that time?
A: My first postgraduate training was in internal medicine. I was brought up in an academic family with professors in medicine. I was looking for my own place in medicine. During those years, in the Department of Anaesthesia of the “Hospital Puerta de Hierro” in Madrid, there were two consultants in anaesthesia, Dr Fernando Avello and Dr Alfonso Ascorve, who had trained in the UK. I found out that they anaesthetised patients with a great knowledge of physiology, pharmacology, and internal medicine. They were pioneers of modern anaesthesia and intensive care. They anticipated what is now known as perioperative anaesthesia and intensive care. So I decided to become one of their residents. I will always be in debt to them. Anaesthesia in those days was absolutely different in “Hospital Puerta de Hierro” than in the rest of Spain. We were up to date with what was published in the international journals. Due to those circumstances, I became involved in anaesthesia for the rest of my life.
Q: Tell us about some of your early training experiences, including your time working in the UK, and how you became interested in research.
A: I always thought that travelling abroad is an excellent way of learning and also of being less nationalist. I went to Newcastle-upon-Tyne in northern England to improve my training in intensive care medicine with Dr Joseph Stoddart, the consultant leading the ICU, one of the founding fathers of intensive care in the UK. He was an excellent teacher and a generous professional. Some years later, as a consultant involved in neuroanaesthesia and neuro-intensive care, I was granted with a fellowship to work as a research fellow with the late Prof Gordon McDowell. I was involved in basic science research (including measurement of intracranial pressure and cerebral blood flow) and treatment of patients with head injury. I was delighted to work with one of the neuroanaesthesiologists that changed the practice of neuroanaesthesia.
Q: You have published more than 300 papers on anaesthesia in your career, both internationally and in Spain. What are some of your research projects that you are most proud of?
A: I have always enjoyed writing, I apologise for all the paper I have used, those poor trees! All the members of my family, especially those that are involved in the practice of medicine, we have challenged one to each other on the quality of our original papers. This explains the number of papers. If you write in PubMed the name Gilsanz, I think you will be impressed.
I am proud of my articles on pheochromocytoma and myocardiopathy, the effects of anaesthetic drugs and techniques on intracranial pressure and cerebral elastance, inhalation induction of anaesthesia, inhalation bolus and finally of those on obstetric anaesthesia of the team I have the pleasure to lead.
Q: What do you consider as some of the most important developments in anaesthesia since the start of your career?
A: From my point of view, the most important developments in anaesthesia have been: improvements in training (duration, competence based, CUSUM, simulation etc), new drugs (with less side effects, well known PK/PD, introduction of total intravenous anaesthesia), new monitoring equipment (basic monitoring, pulse oximetry, capnography, non-invasive monitoring, ultrasounds), quality and safety in anaesthesia (Helsinki Declaration, confidential enquiries, closed claims, standards of practice, guidelines), and basic and clinical research in close contact with basic scientists. Quite a lot of things for such a short time!
Q: Some of our Spanish delegates will recognise you as the Chairman of our European Diploma in Anaesthesia and Intensive Care (EDAIC) in Madrid, Spain. How much do you think that our EDAIC system is helping improve the training of anaesthesiologists worldwide?
A: I have been involved with the European Diploma of Anaesthesia and Intensive Care, since 1990, many years ago, within the European Academy. The Chairman of the Examination Committee was John Zorab, at that time. I have examined in Strasbourg (Prof Jean Claude Otteni), Nice (Prof Grimaud), Barcelona, Valencia, London, Madrid and other places. I would like to acknowledge exam committee friends Prof AP Adams, Prof Hugo van Aken, Prof. Thomas Pasch, Sir Peter Simpson, Dr David Cochrane, Prof Philippe Schepperel, Dr E. Buchser, Prof Silvia Fitzal, Prof JP Haberer, Prof E. van Gessel, Prof Zeev Goldik, and many others. Also I would like to thank the members of the EBA /UEMS for the endorsement of the EDAIC.
For many years, so far without success, I have been a great defender of the EDAIC, in Europe and especially in Spain. I have proposed many times that the EDAIC must be the official exam of our specialty in Spain. I am still fighting today. Nowadays with the help of the other Spanish colleagues, I am more optimistic. In those countries where politicians are involved in scientific decisions, it is very difficult to convince them of the importance of separating medicine from politics. The way we train our residents is a scientific and professional decision and not a governmental one. I am looking forward to the day when an anaesthesiologist with the EDAIC will be Prime Minister in Spain. Then things will change! I cannot understand why something so simple as signing a document in the Spanish Ministry of Health and Education saying that the EDAIC is the official diploma is so difficult?
Q: What are some of the sessions that you are most interested in at Euroanaesthesia 2019?
A: Obstetric anaesthesia, basic sciences, posters and free papers presentation of the residents of the department of anaesthesia of the hospital where I work. And of course I enjoyed the Sir Robert Macintosh Lecture very much!
Thank you Fernando, congratulations on your Honorary Membership and enjoy the rest of the congress!