After years of vocation in medical profession May exist multiple motivations. But sometimes the reason that leads a person to choose a career in public service is marked by history. A history impregnated in the genes and thatIt can be passed from one generation to another.
That’s why when you ask George Hruza (Prague, 1956), American dermatologist specialized in Moh’s reconstruction and surgerys, why he studied Medicine, smiles and begins with a story that takes us to a Nazi concentration camp, Mauthausen. There, her young mother, Judita Ilkovics, one of her 200 survivors, witnessed the massacre of her companions, after having lost her parents and grandparents gassed in Auschwitz.
«When the Nazi soldiers called the prisoners to take them out of the barracks, two people ignored the request: a Jewish doctor who was with a patient. He explained to the soldiers that he had to amputate his leg or else he would die. They told him that if he came out, they would not kill him. But this doctor was determined to finish his surgery before doing so, even though if he did so, he would save his own life. My mother witnessed him being shot in the head. In front of everyone. And she, at that moment, felt that she wanted to be a doctor.
Hruza recounts that moment when the vocation to “do something for another person becomes more important than oneself.” That not only impregnated the genes of his mother, but it would do the same with him and with those of his sister, Eva (radiologist). Perhaps these would be reinforced by those of her father, Zdenek Hruza, whom Judita would meet at medical school in Prague.
That drive for public service already included in his DNA led him to correct inequities at United Healthcare Medicare Advantage (UHMA), Missouri’s largest Medicare Advantage plan. At UHMA, more than half of the available dermatologists were eliminated, which meant that many elderly patients had lost access to specialists who had cared for them for decades. Hruza mobilized the media and managed to take the case to the Capitol in Washington DC to return this type of medical care to “these vulnerable groups.”
“We must be more aware of our skin and its health,” he says. While it is true that people “are now more responsible with the care they must maintain during sun exposure than 10 or 20 years ago, there is still a lot of work ahead.” Awareness is something that he highlights on several occasions in the talk with EL MUNDO a while before participating in the Symposium on Mohs Surgery, organized by the International Dermatological Clinic together with the Ramón Areces Foundation a week ago.
Key Ideas from George Hruza
- Precision. Mohs surgery has proven effective in surgically removing basal and squamous cell skin tumors “with a success rate of around 98%.”
- recommendations. The dermatologist insists on monitoring changes in our skin. “If we get to the injury early, we need to remove it enough. But if we let it go, the situation becomes complicated.”
- Professional without borders. He has treated tens of thousands of patients not only in the city of St. Louis, where he settled and lives with his family, but also in places as far away as Australia and the Middle East.
- Israel-Palestine War. He is impressed by the number of volunteers “there are willing to enter the war zone” and “risk their lives to help the Palestinians.” And he adds that “I have been on the verge of going.”
«It is very easy to observe yourself. Just like women do with breast cancer. We must take a moment, at least once a month – he specifies – to see if there are new spots or moles. Was this here before? If you see alterations and suspect that something is strange, go to the doctor. Early detection is life insurance.
With a mother who first leaned towards Pediatrics and then Psychiatry and a pathologist father dedicated to clinical research, the following question is inevitable:
-What made you dedicate yourself to Dermatology?
-In medical school they taught us to do physical medical examinations. One of them was to look for abnormalities through the stethoscope by listening to the heart and lungs. We were practicing how I should do it and I couldn’t. I didn’t hear the different cadences of the heartbeats. They said to me: “Do you hear it?” And he answered: “No, I don’t hear it.”
This is how George Hruza became a reference in dermatology
Far from taking him away from his goal of becoming a doctor, it only made him choose a specialty. “If I can’t hear, I can see,” he says bluntly as he points to the skin on his hand or the bald spot on his head. “I realized that the best thing about Dermatology is noticing small changes in the skin that go unnoticed because we assume they have always been there.”
Hruza emphasizes that «The skin is the window to the rest of the body, it protects us, but it is also where we can see superficial injuries that respond to internal problems. At that time he did not even think that the scalpel would become a tool that he would master to eliminate skin tumors. “I was surprised that at that time the patients were not cured, only the problem was eliminated, but they kept coming back to the consultation.”
Here surgery became vitally important. This doctor of Jewish origin, who had lived in the United States since he was 14, trained in New York and, thanks to several scholarships, would define his training at Harvard Medical School and at the University of Wisconsin-Madison under the tutelage of Fred Mohs. Together with him he was able to learn key surgical techniques to treat skin cancer, especially basal cell carcinoma, squamous cell carcinoma and some types of melanoma.
Currently, the micrographic surgery developed by Fred Mohs for the precise removal of skin cancer It is considered the most effective approach when it comes to skin lesions. malignancies that are not melanoma. «It consists of a specialized surgical technique in which the layers of affected tissue are progressively removed. “Then you evaluate with immediate microscopy techniques to determine if there are remains of cancer cells.”
Hruza uses the skin that peeks out from under his shirt sleeve to explain through gestures how it is a process that «it is removed only where there is injury“, is about peel off “layer by layer” only the areas in which “there are cancer cells».
This, assures the disciple of Fred Mohs, “allows us narrowly eliminate cancer while we preserve as much as possible healthy tissue that remains around. He is happy about this step, which is becoming “more and more precise,” because “sometimes it’s just a matter of scraping and eliminating. Others, we can apply cold techniques to eliminate it. Thanks to these new advances, “patients maintain a better appearance” because “there are no longer large scars.”
An odyssey to leave Europe and reach the US
Becoming one of the current references in Dermatology and Mohs Surgery was not easy either. Until landing in New York, Hruza’s family toured Europe from south to north fleeing the totalitarian dictatorship that the Soviet Union had imposed in the now former Republic of Czechoslovakia, where he was born.
By then, Judita and Zdenek feared for their children and the impact of living under government-organized terror, as well as fear, indoctrination, discrimination, and censorship. His parents considered the possibility of deserting, but the authorities permits were not issued so that all family members go out together. The opportunity arose when his father was offered a one-year visiting professorship at New York University School of Medicine.
Once Zdenek crossed the Atlantic, They planned an escape for the whole family through messages coded with the keyword “Arapaho,” by the Arapaho National Forest in Colorado. Therefore, Hruza, together with her mother and sister, left Czechoslovakia through Hungary and Yugoslavia towards Austria. They crossed West Germany, passed through Denmark, and finally settled in Sweden. They arrived in Stockholm on December 31, 1966.
Hruza is currently Associate Professor of Dermatology and Otolaryngology at St. Louis University in Missouri. There he is the medical director of the Center for Laser and Dermatologic Surgery and the Chesterfield Ambulatory Surgery Center. At 68 years old he begins to frequently hear the question of when he is going to retire. «Even some patients tell me that, but I am comfortable with what I do. For me it is my day and day and it is not difficult for me because I really enjoy my vocation.
That he could not accurately hear the pumping of the heart sharpened his sense of sight in the field of Dermatology. “I have witnessed how techniques have evolved, how we have become increasingly more expert in interventions and how treatments, such as immunotherapy, have become available that can save patients’ lives.”
«Do you know what really saves lives and heals? Early detection»
But, “do you know what really saves lives and heals?” He asks this question and rushes to give an answer: “Early detection.” He stresses that we must be more aware that the skin accumulates damage from years of unprotected sun exposure. «Yesterday I went for a walk around the city [Madrid] and I felt like the sun was hitting my head. “I was without cream and I told my colleagues to move to the shady sidewalk.”
Taking care of yourself is essential to avoid the scalpel. But there are certain cancers, such as those that develop on the face, “that do not go away.” when you burn from spending a few hours in the sunthat is the damage that is seen; but for Below is where the cells are changing and give rise to carcinomas. Here it refers to jobs, such as agriculture or construction, in which there are continued exposure to the sun, ultraviolet radiation, where “the damage appears 20 years later.” He highlights that this type of tumor appears in “older people, in grandparents, whom we can cure after an intervention of a few hours and allow them to return to their grandchildren.”
The impact of skin cancer is different here than in the US. “Squamous cell tumor has a significant impact in my country, more people die than from melanoma,” he emphasizes. The incidence of skin cancer has increased by 40% in the last four years, according to the Spanish Academy of Dermatology and Venereology (AEDV). Annually, more than 78,000 new patients are diagnosed in our country and it is expected that In 2040, melanoma will become the second tumor in global incidence.
“Behind this new case, there is a failure in prevention.” Hruza has also been part of the board of directors of the American Academy of Dermatology and from there he puts figures from his country on the table: one in five Americans will develop skin cancer before age 70, having five or more sunburns doubles the risk of melanoma. But, highlight the positive: «When detect in timethe rate of Five-year survival of melanoma is 99%».