- Could you please tell us a little bit about yourself?
I was born in a small village called Murlo on the outskirts of Siena, a very old medieval town in Central Tuscany. After an education in Mechanical Engineering, I decided to pursue a career in medicine and I qualified from the University of Siena (one of the oldest in the world) in 1979. Immediately after obtaining my qualification, I decided to move to the United Kingdom to learn English since I could not speak the language at all, and subsequently I realised that this was the best place for me to train as a heart surgeon.
After an initial training in general surgery, I enrolled into a cardiothoracic program in Cardiff in Wales. I then spent a year in Holland in Rotterdam at the Thoraxcenter and in 1989 I was appointed to my first substantive position in the University of Sheffield as a Consultant/Senior Lecturer. In 1992, I was appointed to the British Heart Foundation Chair of Cardiac Surgery in Bristol where I have been ever since. During the last 6 years, I worked part-time in Bristol and I also held the position of Chair of Cardiac Surgery at Imperial College London, a position that I resigned in January 2016.
I am married to a Welsh girl Rosalind, a nurse I met when working in the cardiac intensive care unit in Cardiff. We have three children: Jonathan is 30 and is working in a financial company and is a very keen musician. Timothy is 28, medically qualified but unsure of what he wants to do in terms of training and career. The youngest is Simon 22, who is studying at King’s College London for a degree in war studies and international relations.
- Could you please tell us about your research work?
The aim of my research work has always been to try to identify problems in clinical practice and understand the mechanism by which they occur, often utilising the expertise of basic scientists and with a bit of luck use this knowledge to implement changes in clinical practice. I am best known for my work on the pathophysiology and treatment of saphenous vein coronary artery bypass graft failure, the development of off-pump coronary artery bypass surgery and studies in myocardial protection and cardiopulmonary bypass in adults and paediatric surgery. More recently I have been leading on identify causes and means to reduce bleeding and the need for transfusion, and how to reduce the incidence and improve treatment in patients experiencing post-operative acute renal failure.
- Could you tell us a little bit about your life as a surgeon?
As explained before I qualified from medical school in Italy, soon after I moved to the United Kingdom and after an initial period of work in London I completed most of my training at the University Hospital of Wales in Cardiff. I also spent an additional year training in Rotterdam. My work now is split between academia and clinical. I am an adult cardiac surgeon who performs all the routine surgical procedures including emergencies. Over the years, I have been trying to reconcile my busy clinical schedule with academic activities. It is a rather unusual position, but at the same time I feel very fortunate of having the opportunity to collaborate with clinicians and basic scientists and that goes from biochemists, pharmacologists, physiologists and engineers.
- Could you describe how you balance both research and surgical careers?
To balance research and surgery is not an easy undertaking; as a surgeon it is easy to get involved in more and more clinical work. Operating is something that a surgeon enjoys. It is much easier to do an operation than write a project or a grant proposal to obtain money to do the study. The secret is to maintain a 50:50 balance between the two.
- Why did you get involved in research?
I got involved with research at a very early stage, as a junior trainee interested in complications after surgery. My main aim has always been to try to improve early and long-term outcome of cardiac surgery in adults and paediatrics, hence the various areas of interest that I have developed over the last 30 years.
- What do you find most fascinating about your research?
Research is fascinating because it allows you to look at things from a completely different angle, and most important to explore mechanisms, which lead to complications and interact with people from very different disciplines. I could not see myself as a full time surgeon for 30 years without an academic interest.
- What was the most memorable moment in your life as a surgeon and researcher?
I like to believe I have contributed to improve clinical practice through research. Perhaps one of the highlights was our publication of the BACHAS trial in the Lancet that provided evidence for the effectiveness of off-pump coronary artery bypass surgery.
- What advice would you give to the young doctors/scientists who aspire to take your career pathway?
My advice to young doctors or scientists is “have enthusiasm”. What you need to pursue a clinical or an academic career is to be enthusiastic, curious, and flexible, be able to interact with people from different disciplines and most important, to remember you are not the centre of the universe. Particularly at an early stage in your career; giving an analogy with Formula 1, you are not going to be the driver, at the best you may be the guy who changes the wheel at the pit-stop. You have to understand that you need to get on with people because they are the ones who will help you to develop as a clinician and an academic.
- In your opinion what are the most important qualities that a surgeon and a researcher should have?
There are many qualities that you need as a surgeon and as a researcher. As a surgeon, you have to have some manual dexterity and having received proper training. As a researcher you need to understand the methodology of research. Both these are a developing process which do not happen overnight. The most important things to remember apart from the curiosity and the enthusiasm is the humility to understand that you are learning and you do not have all the answers. In fact most of the time you don’t have any of the answers. So in short be curious, be friendly, be humble and be prepared to listen to people and you will go far.