Editor-in-Chief: Janusz Ostrowski IAHN Bulletin is the official E-Newsletter of the International Association for the History of Nephrology
INTRODUCTION Time passes quickly, and so, here I am presenting you with the fourth issue of the official Bulletin of the International Association for the History of Nephrology. Much to our regret, this year did not start the way we all would like it to have. At the very end of 2019, after the unforgettable congress in Larissa, Greece, the sad news of Charles George, the former IAHN President, passing away was broken. Garabed Eknoyan gave a moving account of this in the 3rd issue of the Bulletin. The beginning of this year was no better either when the Czech professor, a long-standing member of the IAHN and just-elected Councillor of the Association, our dear colleague and friend Sylvie Opatrna died following a severe disease. Immediately afterwards, the world came to a hold in the grip of the SARS-Cov-2 pandemic claiming hundreds of lives worldwide. As I am writing this, the outcome and the future of the epidemic is still unknown, which is far from upbeat information. The pandemic managed to shatter our plans for the first six months of the year. We did not celebrate the World Kidney Day; Katka Derzsiova was forced to postpone to today-unknown term the conference dedicated to our friend Miroslav Mydlik; a number of national and international congresses got either cancelled or put off and the 57 ERA-EDTA Congress was held online, which must be regarded as a respectable success of the organisers. Who knows, it might be the path that all our scientific events will follow in the future. A number of our members took part in this virtual congress as well. The current pandemic has activated researchers worldwide leaving us with the hope of them finding a cure or vaccine to combat it. It is our hope even more so that Covid-19 complications also concern the urinary system. Having said that, wishing health to all of you seems more than relevant. Stay healthy and stay together. Janusz Ostrowski
January 1, 2020 Dear family and friends, I did it. As of today, after 51 years in academia, I am a retired Distinguished Emeritus Professor of Medicine at Baylor College of Medicine! I don’t know about the Distinguished, but do about the Emeritus part. I no longer am salaried. Even the pittance I was being paid will cease. I no longer have private health insurance. It is now all up to Medicare and the Supplemental Coverage for which I will be paying monthly. I no longer have medical practice insurance coverage through Baylor. No more playing doctor for me. What I am going to miss though is my parking spot. I have been parking at the main entrance of the medical school ever since I came to Houston in 1968. Now I will have to pay for parking in a remote garage alongside everyone else. No more high-end classy parking space for me. What will I celebrate most? Not having to complete the flood of forms generated under the guise of quality assurance by an ever enlarging and domineering insurance companies-hospital business complex looking for things to do for their bottom line while detracting doctors from providing patient care. The question I am asked is what will I do with my free time now that I will have no externally imposed schedule. The answer? What I have been doing all along. As most of you know, I have been reducing my clinical responsibilities since 2003 when I gave up rounding on free standing dialysis facilities. Then, over time I gave up rounding on General Medicine and four years ago rounding on the in-hospital Renal Service. Essentially, over the recent past I have attended only in Renal Clinic once a week and paid at 10% of a full-time employee, hence the pittance of the salary I will be losing. Yes, I will miss my interaction with the fellows in clinic but that will be compensated by relief from the demands and frustrations of providing service at a public county clinic. Essentially, my ‘retirement’ has been a gradual affair and I expect little change in what I will do with my ‘free’ time. My greatest pleasure has come from working on the history of nephrology. Getting up early in the mornings when not
No. 4, June 2020
Janusz Ostrowski Professor, Centre of Postgraduate Medical Education, Warsaw, Poland
Board of the International Association for the History of Nephrology Iwannis Stefanidis – President Janusz Ostrowski – Past President Ayse Balat – President Elect Vincenzo Savica – Treasurer Councillors: Achmet Aciduman Maria Kalientzidou Sylvie Opatrna Biagio Ricciardi Przemysław Rutkowski Davide Viggiano
In memoriam: Charles Raymond Pax George (1940-2019) The IAHN has lost one of its leading members in the field of the history of nephrology: Charles George. He died in London shortly after attending the IAHN meeting in Larissa last September, during emergency surgery to treat active bacterial endocarditis. Just a few days previously, he had been awarded the fellowship of the Royal College of Physicians of London, and a few of us had the pleasure of dining with him and Elizabeth in the College. He is - and long will be - much missed. Charles was born in Killora, NSW, Australia and attended school and university in Sydney, graduating in 1966 and being awarded FRACP in 1975. He began work in nephrology almost by accident, and never stopped. He worked in Seattle with haemodialysis pioneer Belding Scribner, then at Guys with myself and Chisholm Ogg in London, doing research on platelet physiology in renal disease. He went back to a post in the Concord Hospital in Sydney in 1973, where he spent his working life there as a renal physician. Charles set up a haemodialysis unit and a transplant programme. He realised the special needs of Aboriginal Australians, in whom renal failure is so common, pioneering the use of the disposable dialysis REDY unit for use in often primitive outback dwellings, where water was in short supply. Early on he developed an interest in medical history which naturally focussed on Nephrology. He was a meticulous researcher, chasing down obscure references and delighting in original notebooks and documents. He also favouredoriginal and sometimes controversial conclusions to his work. He obtained a degree in history in the 1995 for a critical look at the work of John Jacob Abe, l and later achieved a PhD. He was the only member of the IAHN with a degree also in History. He delighted in words and language, and assembled an impressive bibliography. He became a President of the IAHN having been a founder member in 1994. He assembled an impressive collection of old books dealing with nephrology which visitors could trawl through.
Obituary Former Head of the Nephrological Laboratory at the 4th Internal Clinic and Nephrology Clinic of the University Hospital of L. Pasteur and P.J. Šafárik University Medical Faculty in Košice, Slovak Republic Email: katka.derzsiova@gmail.com Introduction Professor Sylvie Opatrná MD, PhD, was a prominent personality of Czech Nephrology, an expert in peritoneal dialysis (Figure 1). She was born on November 9, 1959 in Rokycany, in Czechoslovakia and died on February 4, 2020 in Pilsen, the Czech Republic. After finishing high school in 1979 she started medical studies and successfully graduated from the Charles University Faculty of Medicine in Pilsen, in 1985. After graduation she joined as staff member the 1st Department of Internal Medicine of the Faculty Hospital and the Charles University Faculty of Medicine in Pilsen. At that time, that Department was lead by Professor Karel Opatrný Sen, MD, DSc.
Figure 2. President Václav Klaus appoints Sylvie Opatrná Full Professor of Internal Medicine (2010)
Figure 3. Sylvie Opatrná received the Silver Medal of the Charles University, from Professor Tomáš Zima, Rector of the University (2019).
Covid-19 an epoch-defining event impacts education and science We are living during an epoch-defining event; a seismic event. All schools and universities have been closed in Europe, USA and Australia; cities are deserted. The impact on education and science is unpredictable. The question is: will we be able to return to previous standards? A loss is foreseen, although, at all levels, education is being delivered online (1). But campuses are not just places to study, they are places for critical learning through direct interaction as requested by training of autonomous thinking (Julian Barnes, the sense of and ending, 2011). The Covid-19 pandemic in Italy On March 20, 2020, seemingly a century ago as judged by the speed of the virus compared with slowness of our bureaucracy, an editorial by Mario Molinari, the Editor-in-chief of La Stampa in Turin, was published in The Guardian ; it was elegantly translated by Catherine Hornby. Some experts, quoted here, indicate where we are and what changes are expected in the future. “Last week, Italy became the first European country to go into complete lockdown to protect its citizens from a pandemic attack. Previously, such a scenario was just an academic hypothesis for national security experts. Now what Italy is doing can become a model for other countries threatened by the same enemy: corona virus”(2). What did we learn? “We must then invest in health like we do in security that means rethinking national budgets to dedicate strategic resources to research, development and training in the medical sector and also to the purchase of materials destined to become crucial supplies. The second lesson coming from Italy’s experience of the pandemic is the crucial importance of collaboration
In memoriam Prof. Andrzej Wojtczak , the outstanding Polish internist, nephrologist, specialist in public health, researcher and academic teacher died on 20 May 2020. Andrzej Wojtczak was born on 11 Dec. 1933. He stepped on his medical path at the Faculty of Medicine at the Poznań Medical Academy, where in 1955 he received a diploma with a distinction. Immediately after graduation, he started to work as an assistant at the II Internal Medicine Clinic of the Medical Academy in Poznań. As early as in 1957, he obtained the first degree, and in 1961 the second degree of specialisation in internal medicine. During this period, he did scientific internships at excellent centres of nephrology in the United States, which resulted in his obtaining a PhD in medical sciences in 1962 for the dissertation titled Clinical Importance of the Evaluation of Acid-Base Balance Disturbances . In 1966, he obtained a habilitation based on the work Pyelonephritis in Light of Function Testing . In April 1970, he became Head of the Clinic of Nephrology at the Internal Medicine Institute of his alma mater. However, in February 1972 he was appointed the director of the Department of Medical Education and Science at the Ministry of Health and Social Welfare, also acting as head of the Internal Medicine Clinic at the Institute of Tuberculosis and Lung Diseases in Warsaw. In the same year he obtained the academic title of a professor of medical sciences. In 1974-78 he was also a scientific consultant at the Department of Nephrology at the Medical Academy in Lublin, co-organising the local dialysis centre. During the clinical work, Professor Andrzej Wojtczak was the supervisor of the doctorates of future eminent nephrologists and professors, Stanisław Czekalski and Maciej Krzymański, as well as the supervisor of the future renowned professors and nephrologists, Andrzej Księga and Lucyna Janicka. The ministerial nomination was the beginning of his interest in topics related to public health. In 1978-1986 he worked at the Regional Office of the World Health Organisation in Copenhagen, and then became Head of the Department of International Health Problems at the Centre of Postgraduate Medical Education (CMKP) in Warsaw. In 1989-1991, in the Government of Prime Minister Tadeusz Mazowiecki, he was the Undersecretary of State in the Ministry of Health. In 1991, he returned to work at the CMKP, where he became Head of the School of Public Health. In 1995, he became the Executive Director of the WHO Centre for Health Research in Kobe, Japan. In the years 1999–2002 he was the director for the International Problems of Medical Education in New York. In 2006, he started working at the current Collegium Mazovia Innovative School of Higher Education in Siedlce, where he worked until his death. These functions are only some of those held by the Professor. Professor Andrzej Wojtczak was the author or co-author of over 500 publications in renowned Polish and foreign medical journals concerning mainly acid- base balance disorders, clinical nephrology, renal replacement therapy, as well as public health. He was also the author of many chapters in textbooks such as Internal Medicine and Diagnostics in Internal Medicine edited by Edward Szczeklik or Clinical Dietetics edited by Jan Hasik. He himself was the editor- in-chief of the third volume of the textbook Internal Medicine, used by large numbers of doctors preparing for the specialisation exam in internal medicine. Professor Andrzej Wojtczak was a member of many scientific societies both Polish and foreign. The most important of them include: Warsaw Scientific Society, Polish Medical Association, the International Society of Nephrology, the Polish Society of Social Medicine and Public Health. In many of them he received honorary memberships. In the Polish Society of Nephrology he received it in October 2019 during the Congress in Poznań. For his outstanding scientific, didactic and organisational achievements, he was awarded, among others Commander's, Officer's and Knight’s Crosses of the Order of Polonia Restituta, Gold Cross of Merit, honorary badge For merits for health protection and Gold Medal for Long Service. Professor Andrzej Wojtczak made a respectable, impressive contribution to the development of medicine in Poland and worldwide, especially in such areas as internal medicine, clinical nephrology and public health. Janusz Ostrowski
The History of Nephrology at the 2020 ERA-EDTA Congress. This year the annual ERA-EDTA congress has been dramatically different from the other years. Due to the COVID- 19 pandemic, the meeting could not be done in presence, and was therefore fully virtual, or, better, social contacts occurred only mediated by a computer. The computer today is almost the equivalent of the telepathic societies in most Sci-Fi novels: people communicate at distance, without moving from their desks. So, somehow this congress symbolizes a change in our community. Should we fear that in the future some historians will indicate this as the first step that has changed the nephrological community? Well, today I have two-three "virtual" meetings per week to discuss several projects with collaborators often at far distances, and lectures (and exams) with classes of about 60 students from all over Italy, which would be unfeasible otherwise. There are caveats, though, which we shall take into consideration. Also this year the ERA-EDTA congress hosted a session on History of nephrology during which Janusz Ostrowski, acting as the IAHN Ambassador, gave a well-received speech titled “Selected Milestones in Nephrology-related clinical chemistry”. The session on the History of Nephrology also comprised several posters among which the history of veterinary renal physiology (Diamandopoulos), history of paroxysmal nocturnal hemoglobinuria (Gembillo) and the history of artificial intelligence (Tasic). Finally, the poster by Athanasios Diamandopulos (Greece) about the history of urines specific gravity tests received a prize as the best poster. From the speech by prof. Diamandopoulos I have learned about the role of Archimedes (3rd century BC), necessary for the development of the hydrometer and urinometer. I also liked the mention of the treatise “Actuarius de urinis” (13th century AD).
Garabed Eknoyan Professor at Baylor College of Medicine, Houston, Texas, USA
a soul is moving (1.00-2.00 AM) and with a fresh cup of coffee in hand heading to work at my computer for the next three to four hours has been a delight. I have managed to write 2-3 articles a year and intend to continue to do so. That is not much to brag about but it is not bad. Over the years, most of my hard- earned research papers have been variously quoted. But, as with all science it is what is new that matters while the old is forgotten; so, most of my early publications now go unmentioned and what is worse even I have trouble recalling them. On the other hand, it has been rewarding to see the reverse happening with the historical articles I have been writing. They do not seem to fade away and over time seem to be quoted even more. Actually, they are now referenced on Google! Importantly, they have broadened my horizons and I am better at it now than when I first ventured into the history of nephrology in the 1990s. My other joy has been traveling and I intend to keep doing it. But, unlike people who have worked full time, retire at a relatively young age, make a bucket list and embark on exploring the world, I have been traveling all along. According to my United Airlines mileage program I have logged in some 2,250,000 miles! For sure, there is no end to how much more there is to see but there is really little important stuff left unexplored for me. Besides, at my age traveling is becoming difficult to cope with. I now do it for the companionship of family and friends it provides rather than just sightseeing, and I love it. So, I will keep it up despite the apparent increasing length of the airport hallways I have to walk to get to my gate now that I am nearing 85. And if that gets harder to do, I will start using the transport carts airlines provide. To tell the truth, I do not know what lies ahead for me after today and all of this may sound arrogant or self-deceiving. In the course of the development of any individual there are critical phases which are periods of transition. They are episodes with beginnings, middles, and ends. We often remember also stand out. I still remember the day I graduated from medical school and the day my beloved wife passed away. But middles are generally muddy. They tend to recede and get lost, except perhaps that of midlife crisis. I had mine at age 50 when I went through a depression for several months. If that be a true marker of my midlife then I may well live to be 100! So, today is actually the beginning of a new transition phase in my development. As to how I will fare henceforth remains to be seen. I fully realize that physically I am not the man I was at 50 when I had my midlife crisis. But I do feel that I am essentially the same person I was then and intend to spend the days left for me doing what I always have enjoyed doing. I know this is easier said than done and that aging is a reality, but I will do my best not to let chronology define me. I have been lucky in that regard. Yes, I am somewhat chubbier, a bit balder and my skin is beginning to bruise easily but the rest of my body is still in decent working order. Yes, I am slower in writing and do forget but I still can finish manuscripts that are acceptable for publication. For sure, in some ways I am no longer the man I had been, but in other ways I am now more than what I had been. So, when I can no more write new articles, I will start reading all the books I have bought but never opened. And, when I can no longer travel, I will get out my old picture albums and re-live the good times I have had and shared with loved ones. We will see how it goes. I will keep you appraised of what happens. Until then, have a very Marvelous New Year and thank you for being one of the people who has added meaning to the various phases that my life has been so far. (published with permission of The Bulletin of the European Association of Professors Emeriti 2020;1(1): 6-7.) Garabed Eknoyan
Garabed Eknoyan, Professor at Baylor College of Medicine Announces Retirement from the Academia with a Letter to Friends
Stewart Cameron Emeritus Professor, Department of Nephrology and Transplantation, King’s College, London, UK
Katarina Derzsiova Ing. Dipl., Former Head of the Laboratory, IV Internal Clinic, University Hospital of. L. Pasteur, Košice, Slovak Republic
Postgraduate Education Sylvie Opatrná passed the examination for admittance to the board in internal medicine in 1988 and specialization in nephrology in 1994. In 2000 she successfully discussed the PhD thesis on "Selected aspects of metabolism of patients treated by continuous ambulatory peritoneal dialysis" at the Charles University of Faculty of Medicine in Pilsen. In 2002 she was promoted as an Associate Professor in Internal Medicine at the Charles University of Medical Faculty in Pilsen. The topic of her habilitation thesis was "Some clinical aspects of peritoneal dialysis“. In 2010 she was appointed Full Professor of Internal Medicine by the President of the Czech Republic Václav Klaus (Figure 2). Positions Covered From 1988 to 1995 Sylvie Opatrná was physician at the 1st Department of Internal Medicine of the Faculty Hospital in Pilsen. In cooperation with her husband, Professor Karel Opatrný Jr., she established a program of peritoneal dialysis that under her leadership became the largest in the Czech Republic. In 1995 she became the Head of Peritoneal Dialysis Unit at the 1st Department of Internal Medicine of Faculty Hospital. Peritoneal Dialysis Unit where she trained not less than fifty doctors and ninety nurses who spread the method over the country. At the same time she served as a lecturer (1995–2002), Associate Professor (2003–2010) and Full Professor at the Charles University Medical Faculty and Teaching Hospital in Pilsen until her premature death in 2020. At the Charles University she served as Vice-Rector for Long Life Education and Equal Opportunities (2010-2011); Scientific Board Member of the Charles University Pilsen (2009-2018); Member Ethic Committee of the Teaching Hospital Pilsen (2012-2020) and as Guest-lecturer at the Institute for Postgraduate Education of Physicians and Pharmacologists in Prague (1996-2020). She served also on the Board for Doctoral Theses in Internal Medicine at the Faculty of Medicine in Pilsen (2003 -2020) and in the Accreditation Commission for Specialized Education in Nephrology of the Ministry of Health of the Czech Republic (2011-2020). Positions in Scientific Societies Professor Sylvie Opatrná was Councillor (2006-2020) and General Secretary (2008-2010) of the Czech Society of Nephrology; Councilor of the International Association for the History of Nephrology (IAHN), (2010-2013). In the last IAHN Congress in Larisa, Greece (September 2019) she was re- elected to the IAHN Board. She was a Member of the Czech Society of Internal Medicine, Czech Society of Transplantation, International Society of Peritoneal Dialysis, European Renal Association- European Dialysis and Transplantation Association and of the American Society of Nephrology. Publications, Editorial and Reviewer Activities Sylvie Opatrná published some forty papers in Postgraduální Nefrologie (Postgraduate Nephrology). All of them were cited in international journals. She also served (1995-2020) as Deputy Editor-in-Chief of Aktuality v nefrologii (Current Issues in Nephrology), a Member of the Editorial Board of Medicína po promócii (Post-Graduate Medicine), Svet praktickej Mediciny (World Practical Medicine) and Postgraduální Nefrologie (Postgraduate Nephrology). In addition she was a reviewer of Peritoneal Dialysis International; Nephrology Dialysis Transplantation; Vnitřní Lékařství (Internal Medicine); Kidney and Blood Pressure Research; Therapeutic Apheresis Dialysis. Finally she was a reviewer of the Charles University Grant Agency and of Grant Agency of the Ministry of Health of the Czech Republic. Scientific Activities The studies of Sylvie Opatrná were focused on clinical nephrology, especially on the treatment of patients with chronic renal failure using peritoneal dialysis. She served as Physician-in-Chief of training place "Peritoneal Dialysis“ at the Institute of Postgraduate Education of Physicians and Pharmacologists in Prague (1998-2011). Her main interest was for biocompatibility of peritoneal dialysis solutions. Furthermore in association with Professor Karel Opatrný Jr., they completed a series of projects. Replacement and support of vital organs (1994-2004); Anemia in patients with chronic renal failure (1998-1999); Relation of fibrinolysis to metabolic disorders in chronic renal failure (1998-2000). The most important results of the grant projects as well as her own experiences with the CAPD method were presented at national and international congresses in Europe and in the USA. She published sixty papers, in national and international journals and delivered over 120 presentations, frequently as invited speaker. She wrote several chapters in textbooks, including (i) Peritoneální Dialýza/Peritoneal Dialysis (1993) of Sylvie Sulková et al, (ii) Praktická nefrologie/Practical Nephrology 2nd Edition (2006) of Vladimir Teplan et al, and (iii) Klinická Nefrologie/Clinical Nephrology 1st Edition (2006) of Vladimír Tesař & Otto Schück et al. Sylvie Opatrná also served in various Scientific and Organizing Committees of National and International Meetings including Annual Meeting of the Czech Society of Nephrology; Jan Brod Memorial Meeting of the Czech Society of Nephrology; Prague EuroPD Meeting (2005); International Society of Blood Purification Annual Meeting in Prague (2007), and the National Symposium on Peritoneal Dialysis (1999-2009). Honours Sylvie Opatrná was awarded by the Czech Medical Society, Regional Association of Western Bohemia for the best scientific presentation in 1993 "Modern Peritoneal Dialysis in Clinical Practice“. She also received the Silver Medal of the Charles University for outstanding lifelong studies and clinical care in nephrology and superb teaching at Charles University. The medal was awarded during the meeting of the Scientific Council of Charles University on November 28, 2019 (Figure 3). Other Interests and Actvities Sylvie was interested in history in general, she liked to learn about new countries, their history and customs. From the medical point of view, she was mainly interested in the history of nephrology and internal medicine. She was also interested in fine arts, theatre, classical music, literature and so on. Time for hobbies was very short, but she enjoyed walking with her daughters, Sylvie and Veronika, and their pet dog Aron. Conclusions Sylvie Opatrná will be remembered forever, not only as a prominent nephrologist but also as a good and close friend of many Czech and Slovak nephrologists and also of many outstanding foreign nephrologists. In the death of Professor Sylvie Opatrná the Medical Society in Pilsen, the whole Czech and Slovak Society of Nephrology as well as the International Society of Nephrology have lost a professionally prominent personality. Sylvie will survive forever in the hearts of her daughters, Veronika and Sylvie. They were with their beloved mother until her last breathing. In her life Sylvie had also to overcome a personal tragedy, the death of her husband, Professor Karel Opatrný Jr, internationally recognized expert in nephrology in 2006. After husband's death, she devoted all her attention to her daughters both successful physicians, and to her university duties. It was this difficult period, but she was successful in 2010. Dear Sylvie, allow me, as close friend the last goodbye. Thank you Sylvie also for your excellent and human cooperation with Professor Miroslav Mydlík, and his group and for your presence over the years at the international meetings in Kosice. Katarina Derzsiova
The Impact of Covid-19 on Education and Science An Achievable goal for our Universities
Natale G. De Santo, MD Emeritus Professor, University of Campania Luigi Vanvitelli, Naples, Italy
between citizens and official institutions. There is also a third element to the Italian experience: it is reflected in the people at their windows and in balconies, who at midday last Saturday collectively applauded the doctors and nurses who are key figures in the fight against the virus”(2). Indeed, the Editor-in-Chief of La Stampa shows that our globalized world imposes on the growth of social and health policies. Solidarity is constrained as are bilateral collaborations. The Minister of health was the first to ask for common directives and had difficulty in getting the first meeting organized. Now Italy will be seen as a cutting-edge laboratory in which all these actions are strengthened and thus their impact can be fully appreciated. We have also learned that deaths from the virus in women aged over 50 constituted 30% of deaths. This has great meaning in terms of the biology of the virus, in term of resistance to the virus and in terms of the social impact (to be investigated). Mariana Mazzucato, a economist with dual Italian-US citicenship is Professor in Economics of Innovation and Public Value at University College London. She wrote in the Guardian: “The world is in a critical state. The Covid-19 pandemic is rapidly spreading across countries with scale of severity not seen since the devastating Spanish flu in 1918. Unless coordinated global action is taken to contain it, thye contagion will soon become an economic and financial disaster too… But we now have an opportunity to use this crisis as a way to understand how to do capitalism differently. The requires a rethink of what government are for”(3). The death of the generation who performed the Italian economic miracle The President of the Italian Republic, Sergio Mattarella, a former professor of Parliamentary Law at the University of Rome, on March 21, thanked Frank- Walter Steinmeier, President of the Federal Republic of Germany, for the provision of medical equipment, and strongly wished “Germany and other countries to escape the painful Italian path… Here, in numerous territories, along with the many deaths, it has decimated the older generation made up of those people who are, for the youngest, the point of reference not only for affection but also in everyday life”. Francesco Forte, 92 years old Emeritus Professor of Economics at the University La Sapienza in Rome a man with an intimidating CV as well as a state minister of economic affair commented “The dead, on average, are 80 years old . They are those who attended schools with dilapidated classrooms, not warmed in winter. Yet they are those who performed the Italian economic miracle, Italy being, like Japan and Germany, an aged society. In Japan and Germany there has been less decimation of old people, probably because of the more common use of computers for everyday activities; so, they transact rent payment and make purchases from home. The Darwinian sickle of death exterminates those at higher risk. They are worn down but they belong to the generation that built Italy, those of the, so-called, Italian miracle. We shall repay them. I suppose that those more at risk are aged people with low incomes, with lower education, they mostly live in suburbs or in villages with fever services, they had the most demanding jobs, they were commuters, used to getting up very early in the morning. We can’t wash our hands of them”(4). Dying without tenderness, without religious assistance In Europe there has been a long discussion about end of life care. Helping patients to die in peace, hand-in-hand with their loved ones appears as a second goal. It seems that the problems outlined in 1982 by Norbert Elias in The Loneliness of the Dying , has found a solution. Dying is a personal process encompassing the tenderness for, and of, friends and family; writing last wills has been impossible. Adult, old and very old patients affected by Covid-19 die without tenderness: no family, no friends, no priests are admitted into intensive care units. At the Hospital of Bergamo, a physician prayed with a dying patient and blessed him in the name of the family. In Lombardy 12,5% of patients infected with Corona virus died; not enough places in cemeteries, not enough coffins, not enough burial workers. We need Renaissance scholars In Florence in the XIV century there were a number of outbreaks of plaque. People died in the streets, although the government had increased the number of hospitals and bought enough granaries to feed the population. However, the city rose again. The general structure of the city was maintained, the university produced people like those mentioned in Contro gli specialist (Against specialists) by Guliano da Empoli in 2013: “In Florence in the XIV Century the initial group of humanists rejected scholasticism and looked for a culture bridging philosophy and poetry, science and arts. This generated the works of Filippo Bruneleschi, Leonardo and Leon Battista Alberti”. We are sure that modern universities, which mix science and philosophy and biology and medicine systems by adopting complexity as a method, will again produce a new cradle of Renaissance scholars who will soon fill the gaps. Europe will shine again, and will definitely learn, not only to cope with globalization, but also with the effects of the enemies of globalization, including the disasters generated by viruses. Covid-19 pandemic reaffirms the value of science People watching TV programs about Covid-19 are attentive to virologists, epidemiologists, specialists in infectious diseases and anesthesiologists more than ever before. This is the case even in Italy where populists against vaccination have produced disasters in recent years. It was encouraging to see Professor Antony Fauci, Director of the National Institute of Allergy and a member the White House Corona Virus Task Force, at the age of 80, taking the liberty of gently correcting Trump about the Covid-19 pandemic. “Stay at home”and the moral social value of work Whilst urging people to stay at home many have had to continue to work but are not protected against Covid-19 infection or against economic hardship. There are passive victims. Many allow us to survive, others work for us but without social protection; they are paid normally but are exposed to a higher risk which they are obliged to accept. There are numerous groups: doctors, nurses, laboratory technicians, pharmacists, journalists, police and army personnel; then there are those who provide vital services such as water, gas and electricity suppliers , transport workers (metro, bus, train, taxi), supermarket and food shop workers, newspaper vendors and those who work in agricultural and pharmaceutical fields. These are all obliged to support a minimal survival economy. They protect our health; their health is not protected. The social, moral sense of their work is reaffirmed. We understand that their work is not a “union problem”; it is our problem since it allows us to “stay at home”(5). To that list I would personally add priests of all religions. I would like to transfer the problems of all these workers, who are forced to save those of us “stay at home”, to the European Institute of Public Law and to the European Parliament and in so doing honour those workers with the use of our legal culture. “the day will enter in the night” Jorge Luis Borges References: 1 . Grove J. How student mobility could recover from Covid-19. The Times Higher Education, London, March 20, 2020 2 . Molinari M. Coronavirus has taught Italy hard lessons. Other countries must learn from us. The Guardian, London, March 20, 2020. 3 . Mazzuccato M. The Covid-19 crisis is a chance to do capitalism differently. The Guardian, London, March 20, 2020. 4 . Forte F. Massacre of the elderly, a heritage. Il Giornale. Milan, March 23, 2020, 12. 5 . Mauro E. Il lavoro degli altri/The work of others. La Republica, Milan, March 2, 2020, 31. (published with permission of The Bulletin of the European Association of Professors Emeriti 2020;1(2): 19-20.) Natale G. De Santo
Davide Viggiano Professor, University of Campania Luigi Vanvitelli, Naples, Italy
I found fascinating the report by Guido Gembillo et al. (Italy) about a possible first case of paroxysmal nocturnal hemoglobinuria already in 1793 by Charles Stewart, arriving by steps today with the use of Eculizumab (anti C5). I like also to mention the poster on the history of artificial intelligence by Danijela Tasic et al. from Serbia: a rather recent history, as it starts with McCulloch and Pitts in 1943. This poster made me think that indeed the idea of a “computer intelligence” is much older (even before Babbage) and I even think about some earlier device of artificial computing back to ancient Greece, if we take into account the famous Antikythera mechanism. So far, food for the brain! Somehow I feel strange about this “virtual” experience. On one side I do not feel I have lost important scientific or medical messages by attending the lectures at home, from my computer. Many excellent presentations gave exciting news in the field, as in the other years. So, yes, congress has been informative, as in the past. However, on the human side, the difference is notable. After all, the meeting is also an appointment among old friends, and the after-congress social events are as important as the scientific content itself. I confess missing all of this. Davide Viggiano
He was excellent company, and always up for an argument or a discussion, the two blending effortlessly, but thoughtful and balanced. A brief essay into politics was not however successful. In his later years he spent half of his time in Oxford in England, a country of which he was now also a citizen. He was accompanied at many IAHN meetings by his wife Elizabeth , née Gordon, whose company we all enjoyed. He is survived by her, two sons and two daughters. Stewart Cameron
(photo Janusz Ostrowski)
(photo Janusz Ostrowski)
Professor Sylvie Opatrná a prominent nephrologist of the Czech Republic (1959-2020)
Figure 1. Sylvie Opatrná, MD, PhD and Professor (1959-2020)