“Devoting myself to Reconstructive Surgery has been a very good mistake”

Although some of his contributions have gone around the world, the true legacy of the 'surgeon with the golden hands' fades into everyday life, escaping public recognition and the eyes of the world. In the aphony of his operating rooms, he does not simply mend the torn tissue or restore what time or adversity has torn apart. With each incision or suture, Dr. Cavadas shapes destinies and reconstructs lost dignities, changing the lives of thousands of people each year. However, he was not always clear that his destiny was Reconstructive Surgery. In fact, as a student, he chose Plastic Surgery without knowing what Reconstructive Surgery was. For him, this choice that led him to embrace his true vocation 'was a very good mistake.'

Why did you choose to dedicate yourself to Reconstructive Surgery?

I was attracted to surgery when I was studying Medicine. I opted for plastic surgery without knowing what Reconstructive Surgery was. It was a very right mistake, like almost everything in my life. Reconstructive Surgery is a peculiar specialty, which can be as broad or narrow as you want, and in the end, for me, it turned out to be the best specialty: the broadest, the most complex and also the most rewarding. In my case, I opted for a broad approach and dedicated myself to extremely complex cases that require experience and training in bordering areas such as orthopedic, vascular or neurosurgery. These complex cases are addressed on a daily basis. What is transcended to the media represents barely a thousandth fraction of what is done daily.

What qualities should someone possess to dedicate themselves to Reconstructive Surgery?

The essential thing is to have an infinite capacity for work, a constant willingness to study, an inclination, probably psychiatric, to adopt the problems of others as one's own and genuinely care about them, as well as a desire to complicate one's life to improve that of others. And it doesn't require large resources or a large team to do the job well. It is enough to have a good anesthetist, a competent instrumentalist and a moderately adequate hospital in which to carry out the work. Few people are needed, but they are eager to work.

What interest does Reconstructive Surgery arouse among residents who finish the specialty?

There are very few people interested in it, which results in a small number of people dedicated to it. 95% of doctors who complete the specialty of Plastic and Reconstructive Surgery in Spain are dedicated to cosmetic surgery. Because? With all due respect, because it is a simple and comfortable way to make a living. The reality is that the culture of ease and lack of vital significance predominates from an early age. Reconstructive Surgery, which is dedicated to solving complex cases, is reserved for a few romantics.

What motivates you to improve the lives of desperate patients whom the rest of the medical profession has given up on?

I have not chosen to dedicate myself to cases that others avoid or reject. It happens that, by accepting and solving complex cases, people end up looking for me. In many cases, they come to me before giving up completely. I am never the first doctor they consult; I am always the last resort. They come when everything has already failed. There, I feel the pressure that if I tell them that I can't help them, they take it as a definitive no. However, the truth is that, in the vast majority of cases, improvements can be achieved. Because Reconstructive Surgery improves.

In addition to treating these patients who come to you, 20 years ago you set the challenge of going where you were needed to repair wounds from machetes, gunshots... And you do it through the Pedro Cavadas Foundation.

Yes. It is practically contemporary with LA RAZÓN. I created it to do humanitarian surgery in East Africa, initially in Kenya, although we later moved to Tanzania. Despite being a more impoverished country, there is less risk of violence. We offer reconstructive surgery free of charge to patients in remote areas who do not have access to this type of medical care by any means.

Furthermore, we realized that, beyond surgery, there is an urgent need to improve education in these places. Education is the key for people to solve their own problems. Because it's not about white people solving black people's problems. For this reason, we launch programs to finance studies for students from remote areas who do not have access to it in exchange for good academic performance. We don't pay for studies for lazy people. This only happens in Spain, where scholarships are awarded to people who fail. It's a kind of gentlemen's agreement. Also, in exchange for, to the extent of their possibilities when they are adults, they contribute in some way to other people throughout their lives. I have many African nephews, many of them have already completed their university studies. There are doctors, journalists, economists and many teachers. Once they finish university, they fly alone. We have given them opportunities and now we say to them: 'We have financed your studies and your livelihood, we have taken you out of your village because you wanted it, we have given you running shoes and we have put you on the starting line. From now on, it's up to you.'

Do some of those doctors who are awarded a scholarship end up catching this humanitarian spirit?

It is very difficult. I have tried it on other occasions. You bring them here, you provide them with a year's stay and you train them in Reconstructive Surgery. You agree with them that, to a certain extent, they do pro bono work for the population. However, you are often wonderfully disappointed when they move to a large city in search of income, using the training you have provided for free to ensure a more comfortable life for their families. It is almost impossible to retain a doctor with special training that probably no other surgeon in that country possesses, in remote areas, and who shares your humanitarian enthusiasm.

With all this activity in Spain and Tanzania, what space does it leave for your family life?

I would love to work less, but the patients keep coming. What do I do with them? I might start rejecting some cases. At some point, I will have to start doing it because although helping to improve the lives of others is laudable, at this age you realize that you have lived more than half your life.

In your opinion, what are the most serious deficiencies in our health system?

I don't know of any country where people sing the praises of the health system, no matter how good it is. The Spanish health system was very good, now it has gotten a little worse. Although it is not perfect, it is still infinitely better than healthcare in most countries. What we must keep in mind is that the key is not to spend excessively on equipment, but to have professionals capable of using those resources. We talk about smart operating rooms, but it is not the operating room that needs to be smart. I would prefer that the operating room be simple, but that my doctor be smart. True intelligence does not reside in devices or machinery.

How is the field of Surgery changing?

Surgery is progressively giving way to medicine. Fewer and fewer problems are solved through surgical procedures, and more pathologies that used to be treated surgically now find solutions in medical treatments. It's a natural evolution. The more we know about a disease, the less we treat it with a knife.

What are the most promising techniques or technologies and what future outlook do they lead us towards?

One of them is reconstructive transplantology, but it is still far from becoming a common clinical procedure. It still faces numerous pharmacological problems. The same happens with regenerative medicine and stem cells, which, so far, have very limited applications. Will they be useful? Yes, but it will be decades before that happens.

That will be when surgery recedes, to the point where some entire specialties disappear. In fact, some are already practically obsolete, as is the case of oncological surgery. In a few years, malignant tumors will not be treated with surgery or radiotherapy, but as a medical problem. This is the normal evolution. On the other hand, specialties that used to be marginal, such as clinical immunology or genetics, will acquire greater relevance.