Prof. Centenary Dr. Fernando Gentil. Today I was taken by surprise when reading a post from a doctor on WhatsApp that I am part of the former doctors of the AC Camargo hospital in São Paulo. https://www.jornalopcao.com.br/colunas-e-blogs/imprensa/o-medico-brasileiro-que-revolucionou-o-tratamento-do-cancer-de-mama-85838/
Certainly, many of those who work there today are unaware of the stories of men who started the true history of the hospital in its early days. Many fantastic and selfless colleagues who left their marks, that history simply cannot erase. The hospital at that time was almost a family, where everyone knew each other and cared for the excellence of oncology practice.
Unfortunately, we live in a country with no history, where the achievements of many Brazilians, whether people of the people or with icons of a generation, are not praised. Some achieved milestones in Brazilian oncology history. These are the true Brazilians who should be praised and not those who have done nothing to advance society for the progress of that country. Some illustrious strangers who worked in complete anonymity. And look, there are many of these out there.
Look at what Dr. Sálvio Pinto wrote (whom I regard as the greatest Brazilian urologist, who works in Fortaleza. But, pay attention to his name, a urologist since his birth, a predestined).
Centenary of a great surgeon - 1921-2021. Posted on 15/01/21.
Above all, an extraordinary being.
Today is the centenary of the birth of the Professor Dr. Fernando de Campelo Gentil, doctor, Ceará from a traditional local family. Graduated from the Faculty of Medicine of Praia Vermelha in 1942, in Rio de Janeiro.
First Brazilian physician to undertake formal medical residency in Oncology Surgery at Memorial Sloan-Kettering Cancer Center, New York. At the end of his residency he was invited by Dr. George T. Pack (one of the greatest oncology surgeons in the world) to be his assistant at Memorial and the Pack Medical Group. Back in Brazil, he was one of the pioneers of Oncology Surgery teaching at Hospital AC Camargo, today Cancer Center Hospital, where he trained hundreds of specialists spread throughout Brazil and Latin America. Then, the hospital's creator was invited by Prof. Antônio Prudente, its founder.
Scholar and innovator, he was the creator of several surgical techniques in oncology, having dedicated himself to conservative surgery for breast cancer (Operation Gentile). Married to the American Ellen Bunker Gentil, she had four children: Fernando, Eduardo, Patrícia and Cecília. He died early in 1989 at the age of 68. (By Dr. Sálvio Pinto)
Great memory and we were all very satisfied and homesick for this post. However, I would like to report some episodes of my relationship with this professional, which I consider to be my best friend that I was able to live with for years at the beginning of my career. I will never be able to forget him. How much I miss you.
I started attending AC Camargo since my fourth year of the Faculty of Medicine at PUC Campinas in 1979. I met him because at that time, my Faculty would be the first in Brazil to have an Oncology course in his medical training schedule , at the recently graduated Faculty of Medicine of the University. At that time, the opening of a medical school is not the game we see today, the formalities and requirements were enormous. The coordinator of the future Oncology course was appointed by Prof. Kind, it would be Prof. Dr. Américo Marques. Doctor-surgeon obstinate for perfection, to whom I owe much of my initial training in surgery that in the future I would end up following.
The first contact with the Prof. Dr. Fernando Gentil it was for him to promote a University Extension Course at PUC Campinas. I immediately accept my invitation. At that time he was responsible for the scientific department of Samuel Pessoa Academic Center. And the course materialized and was a success for those who participated. Very proud to welcome the experienced chiefs and doctors from each Department of the AC Camargo Hospital. Little did I know that one day I would be one of his doctors. I promoted another course the following year.
With this proximity, I had the opportunity to participate in the Research Center at AC Camargo with some medical-surgical studies during my medical course. This experience opened my mind to the priority of medical research.
I was formally invited to be a urologist and restructure the Urology Department of the Department of Pelvic Surgery by Dr. Fernando Gentil, because at that time two were its holders and who were already in retirement phase, the late Dr. Francisco Glicério and his assistant. At that time, he had recently completed Urology training in 1987 and before that General Surgery. I arrived at the hospital in 1989.
Initially, I had to improve my knowledge of oncology surgery and I was able to enter numerous oncology surgeries at Pelvis, an affectionate name that everyone referred to the department. Wow, it was an honor to see those experienced surgeons perform surgical juggling. Residents worked happily and with no time for all surgeries to be completed. We won't leave anything until tomorrow. They did everything, and the difficult became easy in the skilled hands of the surgeons of the Service. How many teachings and what immeasurable wealth. I had to study like never before in order to be part of that fantastic team.
During this period I started to structure the protocols for all oncological diseases related to Urology. Not an easy task. At this stage, I already had the full support of Prof. Fernando Gentil. On the other hand, as he was the youngest member of the Pelvis staff, he was monitored by all doctors belonging not only to Pelvis, but to all members of AC Camargo. How many times in the evening did I go to his house to discuss and design the treatment protocols that would be implemented at Pelvis. In his house there was a huge library, in which I immersed myself in learning. Very cool to participate in this experience.
I had to learn the principles of oncological surgery, which in a way already had a certain varnish received by the Oncology course during the Faculty of Medicine. See the importance of a quality course in student training. He arrived at 7:00 am and left at the end of the surgeries, most of the time after 21:00 pm. Detail, all without earning a cent. He spent nine months in this life, newly married and earning some as a general surgeon, who was admitted to the São Paulo City Hall, entering Friday night on 24-hour duty.
In this beginning, always with that calm and haughty voice, Dr. Fernando Gentil said to me: “You can do whatever you want in the Department, but if something goes wrong, I want to be the first to know”. Just imagine a boss saying that to you, a newbie, and the responsibility has become huge. Fortunately, I have never had to announce anything thorny in my life.
In how many oncology surgeries I have entered, hundreds. How many times have I not seen the following scene given by Dr. Gentil: "Girl, go to my closet and bring a prosthesis for breast reconstruction of this patient". Detail, the patient was from SUS. Therefore, being his, this prosthesis was provided by him, free of charge to the patient. How kind and the pleasure of helping others. I only thought about offering the best. It really was another time. Few have this attitude, the human being above all.
Today, everything is about money and we live with enormous difficulties in dealing with covenants. No more medicine for medicine. Demeaning fees and covenants led by company administrators. So, reality is hard, people who don't even know what medicine is. This is certainly what we practice today, where you are simply a number and without anyone valuing you for your good work. Even few patients can understand these things that surround their treatment.
However, after about nine months, in a Clinical Case Discussion meeting, without my waiting, the Prof. Dr. Fernando Gentil put me to be the primary surgeon for a radical cystectomy. Wow, how much honor and responsibility. I went home to study everything I could about Cystectomy, because I knew that the next day I would have a great mission "to operate this major surgery without causing any complications to the patient". In spite of everything, I won, but I had already matured to some extent in oncology surgery with the excellent surgeons who were part of the Department of Pelvic Surgery. Wow how much learning and it looks like it was yesterday.
There were countless passages that impacted me, but respect and our friendship only grew. How many times have you asked me to evaluate a patient of yours so that we can discuss the surgical approach. There I went and in the return a frank chat about the evidence of the case. I always wondered why not do it any other way. In the end, what was considered best for the patient was always done. It filled me with pride and I knew I couldn't let him down. I tried to do the best.
One day, now more relaxed in my duties, he called me in the afternoon and said: “I was talking to Professor Dr. William Fair, chairman of the Urology Service of the Memorial Sloan-Kattering Cancer Center, and said that they were performing radical cystectomy with reconstruction with ilea bladderl ”. Then he laughed and he said, "What are you laughing at?" and I replied: "I have been studying this surgery for 6 months and I am looking for the ideal case to perform it".
After 15 days, he was performing this surgery, the first in the hospital. On this day he was occupying four rooms in the operating room, all private patients. He came into my office around 13:00 pm and said, "What are you operating on?" I replied: "I'm having that surgery that we talked about", so he went almost crazy: "Let me see" and replied: "No way and with my body I covered the operating field playing with him". Wow, I felt your enormous joy and happiness at being performed that surgery in your Service. Lesson of the case, vibrate for your success and the team. Few do this when they are bosses and how many do not pose difficulties for a team member to be skating and to remain dull. This is really what we usually see in many services in our country. Pure meanness and incompetence.
As for the postoperative period, I am going crazy for the members of the hospital, because pipes come out all over the patient's abdomen: two ureteral catheters in each kidney, leaving by transfixing the ileal neo-bladder through the abdominal wall, a cystostomy, a drain in the abdominal cavity, a vesical tube in the urethra, a nasogastric tube and more vascular accesses. Nobody understood what it was because it was quite new. Gradually all drains and probes were removed. To my surprise, the patient evolved well and became continent and powerful. What do you mean, in the first surgery? As I did not know how to perform that surgery, I had a hemiprostatectomy with distal adenomectomy in its middle to proximal third and without knowing it, I preserved the neurovascular band, hence the happy result.
This patient was 48 years old and throughout his life he had 15 bladder recurrences, where he did everything that was known about adjuvant treatment on that bladder, chemotherapy and intravesical BCG. His illness started at the age of 14 in a country town. I never understood its etiopathogenesis. A true history of the evolution of non-invasive bladder cancer treatment. Pure beginner luck, but certainly a lot of spiritual help was with me that day. Dr. Gentil did not warm up with happiness and so I accomplished many others.
One day, wherever I was at the hospital, a message came for me to go see an inpatient who didn't even know what it was about. At this time, Prof. Gentil was already deceased. Who was admitted was Dr. Arthur de Souza e Sá, one of the most technical and skilled surgeons I met, assistant to Dr. Gentil. Two other indescribable surgeons were Dr. Salim Zequi Garcia and Dr. Silvio Santos Cavalcanti.
What happened, his brother on the phone talking about his urinary difficulty said he would be operated on for HPB. As Dr. Arthur, called Squirt, was well known to the Gentil family, convinced him to come to São Paulo so that he could be operated on by the young urologist who was very close to his brother. He gave no other, took the plane from Fortaleza and checked into AC Camargo. At this time I worked too much and only at 14:00 was I able to meet the patient, who didn't even know what it was about. When the surprise arrived, he was Dr. Gentil's brother. Wow, I didn't believe it.
I saw the case and it was a huge prostate, almost 100g and I decided to perform a prostate TURP despite not being 100% experienced at this time. I'll try. I did my best and it worked. The next day in the afternoon, a phone call saying he was being held by clots. I asked to remove the probe and when I got to the hospital, I remember, it was a Saturday and I was setting up my second office on Avenida Faria Lima, 35m2. The patient was comfortably seated without a tube and said that he had urinated some clots and that everything was fine now. Well, then, I let him continue like this and everything worked out.
We talked a lot about his brother and on this day he wanted why he wanted to get the surgery right. He was hospitalized as a private patient. Then I said to him, “My dear, your brother was the best medical friend I ever had, and do you think your brother would be happy for me to charge you for something? What will he tell me when I meet him? Forget it, because I just fulfilled my obligation ”. Nothing helped, the next day his son returned to Fortaleza and he came to say goodbye to me and said: "What I leave you with is just a treat and put an envelope in my pocket". Wow, I finished all my office and helped to buy some furniture. We kept talking, he always sent me lobsters and then I lost his contact.
Indeed, AC Camargo was a different hospital, and how much strength and energy it had in all its facilities. Incredible people and what a great experience I acquired. But things have changed and now there is another story that I cannot say what will happen. Logically, the friendly and familiar spirit of the hospital is over.
Dr. Gentil understood that we are passing through this life. He was a religious man and on Sundays he always participated in religious worship. He was a Catholic, but we never talked about it.
I remember receiving a phone at 2:30 am saying about his death. My night is over and sadness has befallen me. Too bad, we still had a lot to accomplish. The longing and the many happy memories, chats and discussions are unforgettable. Really, life is a passage and we have to know how to live it, but the straightness of our steps, these cannot be debased. After his death, the hospital began to take another course.
Professor Fernando de Campelo Gentil, an extraordinary being. Creator of many techniques and innovations in Oncology. May other young surgeons be able to follow in your footsteps, certain that this is how we should be as men and doctors.
However, if you would like to know more about this and other diseases of the genitourinary tract, access our content area for patients to understand and gain knowledge. There are more than 140 articles on various urological subjects available for your reading. Culture always makes a difference. You will be surprised!
Taking up references