The conferral of honorary citizenship to Monte San Giusto
Of Luca Patrassi
Professor Massimo Massetti is the professor of Cardiac Surgery at the Catholic University of Rome and director of the Gemelli Cardiac Surgery Department in Rome. He has just been awarded the honorary citizenship of Monte San Giustoa town that saw him as a resident for a few years with his family, his father was commander of the police station.
Massimo Massetti with the mayor of Monte San Giusto Andrea Gentili
Professor Massetti, the roots are not lost. What memories do you have?
«I spent more than four years in Monte San Giusto, from the seventh grade to the second high school, I lived my adolescence in a particular period for Monte San Giusto in which the footwear business exploded: everyone, from grandparents to kids, contributed to this economic dynamic. We lived the value of work and we all knew each other, friendship was a value. The experience of the community of Monte San Giusto has been truly useful and I would say formative, I met people with whom I continued to interact over the years, those values on which this friendship was built were really very important, after forty years reviewing and reliving certain relationships is as if there had never been an interruption».
Training course in Siena, first prestigious assignments abroad and then returning to Italy, he is currently the director of the Gemini Cardiac Surgery in Rome, thanks to the Gelmini law for the “return of brains”. Has anything changed in recent years or abroad continues to be an obligatory stage for establishing oneself, especially for young people?
«In 1992 I chose to go to France, at that time it represented the most advanced country in terms of cardiac surgery techniques and therapies. In those years these exoduses to learn very specialized trades were very topical. I underwent an important training course, I acquired skills that allowed me to return, recalled with a special law, the one you mention, from the Cattolica to Rome, finding a country which, from a medical point of view and from my specialty, had made a lot of progress. I have now been here for ten years and I have to say that the level and performance of cardiovascular specialists today are equivalent to those found in the Anglo-Saxon countries of Northern Europe and in France itself. The technologies are available in all countries even if the volumes of activity are different, thanks to globalization, the dynamics of research and teaching which is based on the sharing of international knowledge, the level of care offered today in Italy does not has nothing to envy to that of other countries. Today, the need to expatriate to train for excellence in some specialties is no longer topical, as it was in the ’90s».
Massimo Masetti
Have you always thought about being a doctor? The shortage of doctors and specialists can be resolved by abolishing the limited number of medicines, should there be other selection criteria or does merit remain an untreatable criterion?
«Specialization in Italy has always suffered from poor planning at the central level. In the 1990s and 2000s, access to specialist courses was always wide despite the limited number of people available, there was never programming based on needs and so we arrived at a time when there was no longer a replacement generational. Now a solution is being sought and I think that in the coming years there will be better consistency between trained doctors and the need to cover territories or structures with these specific skills”
Is a patient more of a face or more of a pathology to deal with? Does the passage in the white coat ward still make sense or is everything resolved in the operating room?
«My great ambition of these years, to be a doctor not only as a specialist who goes into the operating room but to take charge of the patient at 360 degrees, the patient is a person who has experienced his pathology and needs to be understood, including: we need to integrate all this information that comes from the patient as sick to the more biological ones. The cure is not just fixing the diseased part of an organ but taking charge of the general problems of a patient who is experiencing a path of suffering. Treating the sick, not just the disease: this is how I interpret my job».
He often repeats, and he also did it in Monte San Giusto, that medicine must move from the cure of the disease to taking charge of the patient in his various aspects, including psychological ones. As?
«It is not easy, the healthcare organization does not easily foresee this interpretation of being a doctor who takes care of the patient and not just the disease. In hospitals today everything is organized in such a way that services are provided, therefore we have specialist units, hospitals and often the patient travels from one specialist to another, from one hospital to another, to be treated: this piecemeal medicine, this fragmentation of care is at the origin of the discomfort that patients experience because then the care provided very often does not correspond to the care perceived by the patient. The ambition is to change the paradigm of care, not to treat only with services but to take charge of the health problem, the structures do not expect the patient to be seen in his entirety. What we are doing at the Gemelli Polyclinic is implementing a series of changes that pass through clinical-care pathways. It is no longer the patient who has to move, but it is the resources that are organized to give the patient the most appropriate response”.
You are the director of the Gemini Cardiac Surgery, but also the president of a non-profit organization, “Donate life with your heart”: are they, or should they be, complementary or distinct and distant functions? Is volunteering an Italian excellence, “exploited” by the public system to cover deficiencies in services?
«The third sector is a pillar of our country. The will of individuals to contribute to the well-being of citizens: in terms of health, this volunteering takes the form of initiatives such as those that we carry out with our association called “Give life with the heart”. We have created “Sundays of the heart”, a group of volunteers who are doctors, nurses, volunteers and go to disadvantaged suburbs to carry out free visits to people who are in social discomfort and the last thing they do is to heal themselves. In our opinion, this activity should be an integral part of every citizen of our country who should experience this voluntary activity as a duty”.
When it comes to health care, items related to the construction of new hospitals, new technologies, and hiring are often combined. Is it an outdated view? Is the human aspect of care a landing place that someone else besides you asks for?
«I can’t answer positively, the vision of medicine of the future is unfortunately still confined to some circles and specific to some people: there are few of us who consider that to change this situation of great crisis, even in terms of access to treatment, the paradigm of treatment itself must be changed , only in this way can we recreate that economic sustainability while maintaining a high quality of care, involves calling into question the organization of the national health system which, as an instrument, has been the flagship for many years but which today is no longer in able to guarantee free universal care precisely because the fundamental element which is economic sustainability has been lost, there is no more money”.
What do you recommend to a young person who thinks of becoming a doctor?
«My advice is to follow his passion, his intuition, his will. This is a job that can be done like a pianist who can create a piece of music or interpret and then write and modify based on inspiration. The doctor, also because he is guided by scientific research, can interpret his future profession according to what he feels. If he has great motivation, principles based on sensitivity towards the suffering person, if he is driven by the will to heal, to cure, to alleviate, well, this is the most beautiful job in the world. If instead one approaches this profession to make a career, for the aspiration of social status or economic gain, this is, in my opinion, wrong».
What do you recommend for those who are not doctors to live well, at least from the point of view of lifestyles?
«The best cure is prevention, the best way to treat the heart is to take care of it when it’s not sick. So my answer is that the heart, I speak for my specialty but also for other health problems, is a wonderful machine, a hydraulic pump that works thanks to a refined electrical system that drives it. As a pump and as an electrical system, over the years and with continuous work, it undergoes wear and tear that leads to the development of diseases. The best way not to get sick is to have a correct lifestyle, avoid risk factors and lead a balanced life”.
The thing that made you most proud in these years?
«Having created a surgical school in recent years: when I returned to Gemelli, as director, I took the students in Medicine who I graduated and then trained in the five years of specialization and who I then largely hired. In these ten years I have created a group that truly represents my school in terms of skills and methods of treatment, and I am truly proud of this».
A goal you set yourself?
«The goal that I have set myself in the last ten years of my professional life is very ambitious, it is to be able to initiate this paradigm shift in a healthcare system that is in a deep crisis and needs answers. In my small way, and with my small contribution, I would like to start changing this paradigm of care that is centered on performance and transform it into a paradigm that treats the patient and not just the disease. This is my greatest project, my greatest ambition: I hope to be able to achieve it».