In this „Our role models” section we are introducing medical professionals with various specializations, who have made a big impact. For the first part in this section, we had an interview with Prof. Dr. Nándor Ács, the head of the obstetrics and gynecology clinic of Semmelweis University, and vice dean of the Faculty of General Medicine.
Edited: Luca Bogner
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When did you decide to become an obstetrician-gynecologist? Was there a specific person or event , which influenced this decision?
- It is interesting, because I decided quite early. I was always interested in the questions of life and death, so like being there at birth or saving lifes. I worked for the Ambulance services for a long time while attending university, I liked the intensive care unit, and assisting complicated emergency surgical operations. The wonder of giving birth surely touches everyone’s soul. When medical students come to our clinic, and they see a delivery for the first time, I can’t quite believe there can be anyone who doesn’t feel fascinated. Obstetrics and gynecology was also appealing to me, because I always liked the adrenaline rush while working. In this specialisation, there is the childbirth part, and during gynecologic surgeries you get to do some fascinating surgeries too. I really liked abdominal surgery, after obstetrics I also had my general surgical exam. The fact that obstetrics and gynecology comes hand-in-hand, appealed to me from the beginning, and I have to say, I have never regretted my decision. Even though this is an extremely stressful specialization – gynecologists are in a worse situation,since for example someone in the intensive care unit, or a traumatologist is on call, and after that they have time to rest. But for us, it is completely unpredictable because of the child-births, we can get a call night or day, on the weekend – anytime. Despite this being hard and stressful, I am certain that I would choose it again.
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You got your second degree in health -economics. What motivated you to also get that after your medical degree?
- I simply found it interesting. A few weeks before choosing a facultative in highschool I wanted to be an economist, that would have been a very satisfying career for me. I always liked languages, I also spoke quite a few back then, so I wanted to become a diplomat. The change in this plan happened because of one person: my uncle who is also my godfather happens to be a doctor. To this day, even though he is near 90, he is practicing, consulting. I always loved to watch him work , and then he told me to think about med school, because he thought that would be a great fit for me. So mainly, the decision to become a doctor came from his influence, and the speciality came from what I have mentioned before . When I applied to medical-economics, my university career already started to get in the right direction. The head of the clinic back then, Professor Ferenc Paulin started to seriously consider me. Even though I never considered becoming a head of a clinic or department, if someone would take interest in that an economist/manager degree could come at hand.
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You are also doing research in the meantime…
- I did research on a couple of different fields. At the beginning, Professor Emil Monos – who was running the second Physiology Institution at the time – allowed me into his lab. We examined female hormonal changes in animal experiments, and their influence on the cardiovascular system. To be more specific, we examined menopause and the addition of hormones, and their effect on the cardiovascular system. I enjoyed it a lot. After that, a big opportunity arises, when Endre Czeizel reached out to me. As one of the best geneticists in Hungary in the 70’s, 80’s and 90’s, he started the registry of congenital diseases, and he examined the cause, and how one can prevent developmental disorders. Professor Czeizel asked me to work with him, we summed up ninety-thousand child-birth’s data.This included both healthy and sick children. We followed the mothers’ pregnancy; the lifestyle and the conditions: smoking habits, alcohol consumption, education, and living conditions .We researched if any illness of medication influenced the presence of a developmental disorder. We published approximately 100-150 articles in english on this topic. Since professor Czeizel passed away I continued this work with my students. This became my field of research, there are still incredibly interesting things in it.
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What possibilities are there for interested students in obstetrics and gynecology clinics ?
- Both departments at the clinic have research programs. At the department in Baross street, there is some important genetic research happening, including pregnancy pathology, aka research of pregnancy diseases,we have a quite fascinating database of endometriosis patients. There is also an ongoing female hormone system and biomechanic examinations of circulatory system research in our Üllői street clinic – in a collaboration with the Városmajor Cardiovascular Clinic and the Department of Physiology. We can give interesting topics , there are enormous perinatal departments , so if someone doesn’t necessarily wants to become a gynecologist, but a pediatrician, or someone is interested in the care of premature babies, you have the opportunity to do research in these fields also, and of course, the research of congenital diseases is still an ongoing one, that also has a lot of potential.
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How do you relax in your freetime?
- I read a lot; I really-really like to read. Also active relaxation: I like sports very much; I practice a few on an amateur level. I regularly play football with my friends, – the same group since high school, we get together to play every week – I really like skiing, occasionally running . With the Clinic we usually apply to Ultrabalaton running, and I am always a part of the team, but of course, you have to prepare for that. Besides that I like fishing; when I was a kid I used to go fishing with my grandpa, and then, when my son and my nephew started showing interest , we started going again. To be honest my family means the real refreshment to me. I have three children: my eldest daughter already finished university, she works at Orthodontic Clinic, my son is a third year, also in the Faculty of Dentistry, and my youngest daughter is in high school, momentarily considering University of Veterinary Medicine. Being with them, and my wife, is a real relaxation for me; we like to travel, visit interesting places. In the summer going to the beach, in the winter skiing.
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The World Prematurity Day took place on the 17th of november. There has been a huge development in the care of premature babies in the past few years. What can you do to help the babies in the Clinic’s Perinatal Intensive Care Unit?
- There is a lot of absolutely wonderful work being done there. Babies are born, if they are lucky, around 800-1000 grams, but there are shockingly small babies around 380-400 grams. Science has gotten to a point that us obstetrics-gynecologists learned a lot in the past thirty years about these premature babies and the ones who are about to be premature, we know a lot about how to help them after and during delivery, so they can have the best chances possible to survive. Primarily the perinatologist co-worker´s work and knowledge went through an incredible progression, so today we can say that babies born between 400-500 grams have a high chance of growing up in fact they grow up healthy. This is a very special field; when a premature baby is born, the fact that he or she is small is not the only problem, but also, their organs are undeveloped for their life outside the womb. We need to guide them through some hard first couple of weeks, while keeping them healthy. By the way, these babies are the biggest survivors, incredible fighters. This part of the profession has shown wonderful experiences; if students are interested in pediatrics, then they should absolutely check out premature healthcare – perinatology – . It’s a very hard one, but it can give wonderful experiences.
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What do you think, what will the impact be of the reformation of the Health Act on obstetrician gynecologists?
- For now, we can’t really specify much, since we haven’t seen the act’s exact implementation decrees, and it is said that there are going to be refinements. The basic idea started out with good intentions, but in this form of the act not just us, but every other profession – for example urologists, who have just made their statement on the subject – see serious risks.
In Hungary for the past few decades it has become a trend that sick people, and pregnant women prefer to go to private institutions. As we see the regulation in the act, it’s not certain if it’s going to be possible to work as a private practitioner while working at a public hospital as well. If for example someone diagnoses a patient in private care, the same doctor can’t operate on the patient in a hospital. If they dont change these requirements in the new act, I have serious concerns that most gynecologists will leave public health care. It’s not only gynecologists, but urologists, orthopedic, otorhinolaryngologists, ophthalmologists, and even for professions who people usually wouldn’t mention, like pathologists, anesthesiologists, radiologists have a second job besides their public jobs too.
If the Act stays in its current form, I am concerned about professionals with significant knowledge leaving public health care; and that applies to the Clinics too.We hope in a few weeks this clears up and we head towards a better direction