LivingValentin Fuster:

Valentin Fuster:

From his New York office at Mount Sinai Hospital, Dr. Valentín Fuster directs the Cardiovascular Institute. It is 5 o’clock in the afternoon and like every day, you will spend twelve hours in the medical center. You won’t be home until 8pm at the earliest.
With how busy you were, you only needed to preside over the North American cardiologists.
-Yes, but it’s worth it. The Heart Association, which I have chaired since June 21, aims to educate the public about cardiovascular health, preventing many diseases. It also serves to encourage research and raise money to develop it.

Can you have any quality of life working so many hours?
-Quality of life is a very personal concept? You smile ?. It consists in finding oneself satisfied with oneself. And I enjoy what I do. So you will see.

There will be something for which he has no time.
-In general, in this society time has been lost to think. And we need it to find the answer to every problem.
I am in front of one of the most awarded doctors in the world: Gruntzing Prize, from the European Society of Cardiology (1992); Scientific Distinction from the American College of Cardiology (1993); Lewis A. Conner Cardiovascular Research Award (1995); Prince of Asturias Award (1996).

He was awarded the Prince of Asturias Award for “clarifying acute ischemic pathology”. In short, what is it?
-It is about myocardial infarction, the number one cause of death in Western countries. Our group of researchers has dedicated themselves to learning about the mechanisms that produce it and to improving the treatment of coronary heart disease.

And how far do you plan to go?
-In three years we will be able to see coronary disease through magnetic resonance imaging, that is, through a non-aggressive system, unlike the current ones. We will be able to see everything: the arteries, their walls, the coronary physiology as a whole … Thanks to this, doctors will soon be able to diagnose a heart attack before it occurs.

Will there be preventive checkups?
-It would be the ideal, but unfortunately we are very far from that today. For example, there is the paradox that patients who have already suffered a coronary event, who have a higher level of risk of suffering another incident of this type, do not necessarily have adequate preventive standards. Only 30 percent of those patients are treated properly in this country.

Why?
-That’s a good question. Well maybe because there is not enough preventive awareness. And because the current organization and media do not allow it. For example: if you have had a heart attack and are a smoker, the doctor does not have time to talk with you and convince you not to smoke. Equipment is needed to monitor patients and that is very expensive.
He came to the United States in 1972 and stayed there. In Minnesota, first; at Harvard, later; and in New York, finally. “The United States has given me the opportunity to advance professionally, without any barrier. Of course you have to work hard to get ahead, here they don’t give anything away.”

How is the difference with Spain most noticeable?
– In that here there are many more opportunities to do things. In Europe, in general, there is a higher quality of life but fewer professional possibilities. Perhaps because Americans place the emphasis, we would say, on mastering the quantity of life. Europeans, on the other hand, are more interested in our own personal tranquility.

Working in such a technologically advanced environment, you are famous for defending the so-called “clinical eye” of physicians.
-Evidently. In the clinical diagnosis of any patient, two fundamental factors intervene that the technique cannot appreciate: the psychological, which comes from how the patient perceives his own disease, and the contemplation of the disease as a process. The doctor must integrate all the observed elements in order to understand the disease itself, as a whole. Understand me?

Will heart disease ever disappear?
-No, they won’t go away. What happens now is that, although heart disease continues to exist, its manifestation appears later and later, at an older age.

Is this why our life expectancy increases?
-One of the reasons why life is getting longer is that there is less mortality due to heart disease. Prevention prolongs the period before the onset of the disease; We also have treatments that allow us to live longer and longer.

From the theoretical point of view, will death cease to be inevitable?
-Death as a human phenomenon is inevitable, but life will continue to extend more and more. The interesting thing is to come to understand that moment when the human organism decides not to fight anymore, which is when death occurs. Possibly, this biological reaction of abandonment is due to a genetic mechanism. At a given moment all the defense mechanisms of the individual fail. If we increase its defense capacity, the life span will also increase.

So is genetic medicine the panacea?
-It will not be a panacea, but it will allow us to better understand the organism’s resistance to certain traumas and diseases.

Is the incidence of tobacco in coronary heart disease great, even for so-called passive smokers?
-It is a highly debated topic, although I personally think it is important. The restrictive attitude of the US government towards tobacco has been due precisely to the pressure of passive smokers, since the first studies showed that breathing tobacco smoke could lead to coronary heart disease.

Doesn’t that contrast with the little awareness that there is in Spain on the subject?
-It is that they are two different cultures: Americans stop smoking because they believe that they will live longer this way. The European, on the other hand, will not stop doing it if he likes it, because he prefers to live less but more content.

Let’s talk about alcohol. They have recently said that drinking wine is good for your health.
– Studies have been done that suggest that drinking red wine, when not in excess, can be a preventive element of heart disease. Perhaps because of its antioxidant effect. The truth is that in Mediterranean countries, which have a very varied diet that includes wine, there are fewer heart diseases.

What is the antioxidant effect?
-One of the causes of coronary heart disease is a biochemical oxidation process. Any diet that prevents this oxidation, including wine in moderate doses, can also prevent the risk of cardiac incidence.
Dr. Fuster has been out of Spain since the day he completed his postgraduate degree in Edinburgh. Curiously, there he came out of university anonymity thanks to sports. “It took me a lot to get started in the Anglo-Saxon culture until I saw my teammates play tennis. Then I said to myself: this is mine!”
That boy from Barcelona defeated them all. “My medical career really began there,” he laughs. “I got their respect and the first letters of recommendation to be taken seriously academically.” With the time that has passed, he would not like it to happen to the young people of today like him, who was never able to work in Spain again for lack of interesting job opportunities. “A lot of investment in research is still needed and that young people have the possibility of training abroad and returning with a guaranteed job.”

And how do you get that?
-I now have an interview with the Minister of Education and Culture, Esperanza Aguirre. I will present my points of view to promote research in Spain. Although I must say that when it comes to clinical medicine, the country is doing very well, at least in the cardiovascular sector, which is the one I know.

The interview, like the afternoon, comes to an end. On the table of Dr. Fuster accumulates fifty faxes received throughout the day, many of which have yet to respond. Despite that, he still has time for him to write his reflections “of an observant man”, of a person who “believes in transcendence.” “I have been fortunate – he says – to treat many people: rich, poor, scientists, politicians … And I have realized that there is excessive personalism, a general lack of transcendence. We have to transcend outside of ourselves to understand that we are all imperfect. We must open ourselves more to other points of view, understand more other cultures. Spirituality? Yes, for me all that is spirituality; yes, that’s why I believe in spirituality. “

Enrique Arias Vega placeholder image

This interview was published in December 1997, in number 199 of VERY Interesting .

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