Utente:Ariannacioschi/Sandbox

He was remembered as the head of a new kind of experimental surgical school. From the character, the surgeon and the head of school Pietro valdoni took shape the “leggenda valdoni” in the medical rooms of policlinico Umberto I of Rome. He treated Palmiro Togliatti, pope pio XII, Giovanni xxiii and paolo vi.

The character

Pietro Valdoni represents the incarnation of the professional scientist, erudite and followed university Professor, researcher and essayist of considerable commitment. Valdoni with his natural charisma created interest and credibility around him that at a certain point transformed into a great school which still today remains a point of reference for modern doctors and surgeons. Consecrated professor in the prestigious Surgical Clinic of the old masters Roberto Alessandri and Francesco Durante who constitutes the fiore all’occhiello of the Policlinico Umberto I of Rome in the theoretical and even more practical teaching of surgery. Pietro Valdoni has impressed with his work, culture and innovative force a new model of doing surgery characterizing an era of European and worldwide medicine. “You are born as a surgeon, but then you have to become one”: in this famous quote there is all the philosophy and awareness of his understanding of being a surgeon.

For Valdoni surgery wasn’t just a profession but a choice of life, a feeling and a being in the awareness that an operation was never a clinical routine but the creative possibility of being able to save a human life.

Throughout his career Valdoni has always been tormented between the urge to dare to innovate and the hesitation for it, and in his anxiety for innovation; he always let himself be guided by the principle that his technical choices were always intended as the most appropriate for patients, he would never have opted for a choice dictated only by his desire to experience.

He was adored by his students for his authoritativeness, not for his authority. He deceived them into thinking that his meeting with John XXIII had softened him up, he talked about his coming closer to the Faith, but instead he went on to explain to us that he took care of Pius XII's hiatal hernia but decided it was not opportune to intervene. Even with Pope John XXIII he gave up trying: he was too old and obese to endure the total ablation of the stomach. He made the clinical diagnosis of a tumour instantly, without the need for x-rays, and this was later confirmed by an x-ray of the digestive tract. Being the great doctor that he was, wanted him to confront him in choosing not to intervene his rival Achille Mario Dogliotti. He removed Paul VII's hypertrophied prostate in an operating theatre set up for the occasion in the Vatican.

He was a “tough” and icy man but he was actually very proud of his school, his team, his students to whom, in rare moments of confidence, he said: “you are dear to me as my children, I spend more time with you than with them”. He knew he was the Master and he was giving them a lot therefore he demanded great availability, precision and sense of duty.

“You learnt by watching him, but it was almost impossible to follow his gestures, because he had an insane speed of execution and you would get mentally confused over his latex gloves, he held out his hand without taking his eyes off the patient's body and the instrument technician had to know, without speaking, which iron to pass on.”

One of his best students Gianfranco Fegiz, in an interview with Repubblica in 1987, remembered that the Professor suggested to his students to take responsibility for themselves: “Try to do as much as you can personally, because you can trust others but not as much as you can trust yourself.”

Biography and career

Pietro Valdoni was born in Trieste at the beginning of the last century on February the 22nd 1900 when his land was still under the Habsburg control and, having completed his high school studies in his hometown, in 1918 enrolls in the faculty of medicine and surgery at the University of Vienna.

Two years after the end of the Great War (1914-1918) Valdoni decides to continue his studies in Italy by moving to Bologna where he attends his third year (1920-1921). His student odyssey ends in Rome where he graduates with honors (con il massimo dei voti) in 1924 with a thesis on orthopedic clinic which competed for the prize of the Girolami Foundation.

In 1925 he becomes assistant at the surgical clinic in Rome directed by Professor Roberto Alessandri. Valdoni is immediately appreciated for his cultural skills, for his great sense of duty and love for the profession and for his dedication to patients and respect for their suffering. Then he wins the role of permanent assistant in the clinic which he holds until the 28th of October 1939. In those years he obtains two important awards: the enrollment in the honor roll (albo d’onore) of assistants (14th of March 1933) and the scientific industriousness award for 1934-1935, 1935-1936, 1936-1937. Inevitable for the reconfirmantion of his positions his registration with the National Fascist Party.

In 1938 he is called to teach in a surgical clinic in Cagliari and, having ranked first in the competition for the chair of surgical pathology at the University of Sassari, the following year in Modena and Reggio Emilia.

In 1941, during the Second World War, he is called to direct the Institute of Surgical Pathology in Florence where he remained until the end of 1944.

In this period he starts to write his “Surgical Pathology Manual” published in Milan in 1951.

In 1945 he finally returns to Rome as Professor of Surgical Pathology and fifteen years later (1959-1970) as director of the surgical clinic. After the attack of the 14th of July 1948 to the secretary of the Italian Communist Party Palmiro Togliatti, Pietro Valdoni performs a thoracotomy for the extraction of a bullet and saves his life.

Salvatore Rocca Rossetti, the “Master of a generation of Urologist” was nonetheless pupil of Valdoni and describing this event in an interview said: “When Togliatti got shot, the Professor was testing orally and I was the next one to get questioned. They called him from the Policlinico asking for immediate help, he rushed away and disappeared… Couple days after we knew that the exams where suspended and another day later by we knew why: for the surgical operation of the honorable Togliatti, who got hit in the lung”.

Holder of the chairs of special surgical pathology, general surgical clinic and therapy from 1946 to 1970, Valdoni actively collaborates in the specialization schools in surgery, thoracic surgery, gastroenterology, liver and metabolic diseases, orthopedics, traumatology, oncology and infectious diseases. Under his direction from 1948 to 1970, the Roman Surgical Clinic is totally renovated even in the spaces.

In 1959 in Rome as the director of the Surgical Clinic claiming that it was no longer structurally competitive and inadequate to the progression he wanted to impose in the sector thanks to his personal prestige requested and obtained funds from the Ministry of Public Works to build a new surgical clinic equipped with the most modern equipment which will open in 1960 showing to be a model of functionality. The new building of the Surgical Clinic and two classrooms of the old building are dedicated to him. Valdoni perceived on the one hand the importance of modern diagnostic techniques, equipping his institute with a modern service of radiology and nuclear medicine, histopathology and endoscopy; on the other hand the urgency of innovative teaching methods exploiting the potential of surgical cinema. In 1959 his documentary “Open heart intracardiac Surgery” was awarded by the jury of the IV Review of specialized Cinematography.

Valdoni, throughout his long career, published numerous scientific writings and books; he received innumerable honors and scientific certificates, honorary degrees from various foreign medical faculties. Professor Valdoni also becomes president of the Italian Society of Surgery and President of the Superior Health Council. From his first marriage to Margherita De Grisogono, who died prematurely of cancer in 1963, Valdoni had five children: Rosanna, Marina, Pietro Giorgio, Francesco and Laura. In 1968 he married Vera Lodi in second marriage. In 1970, having reached the age limits, he left all the public offices, including the school he founded, and retired from the profession. He hoped to be able to finally spend more time with his family or travelling the world without any surgical conferences to do but sadly this wasn’t the case for him. The great surgeon died in 1976 of lung cancer, self-diagnosed and treated with a therapy he himself developed.

The surgeon

“Being a surgeon is not a profession, it is a choice of life” The added value of Valdoni must be recognized in his surgical versatility that made him work on the various organs of the human body: from the gastro-enteric system to the cardiovascular system, the urinary and the respiratory system. First of all it must be said that Pietro Valdoni had an excellent diagnostic ability, almost infallible. This ability was supported by a rigorous preparation and a deep knowledge of anatomy, semiology and pathogenesis of diseases, a very careful evaluation of the laboratory tests and the results of instrumental diagnostics, above all his innate intuition that allowed him to orient himself even in the most difficult and complex cases. Already in 1935 his intervention of pulmonary embolectomy became a national event. Valdoni was also known throughout the world for his closed-heart and then open-heart operations, then hypothermia, and extracorporeal circulation. In order to see Valdoni's operations, surgeons from all over the world came to Rome, such as the American Blalock, and the surgeon Christian Barnard started to talk about heart transplants, especially in South Africa. Barnard had been a pupil of Valdoni in Rome for some time and Valdoni's assistants, led by Felice Virno, insisted that heart transplants should also be performed in Rome at the prestigious Institute of Clinical Surgery. Then in 1939 he was the first one in Europe to engage in the ligation (legatura) of the Botallo arterial duct responsible for the so-called “blue disease”. In the 1940s he performed operations for pulmonary tuberculosis, pleural empyema, vertebral tuberculosis and his first pulmonary lobectomy. The first cases of complex congenital heart disease operations follow, such as the Tetralogy of Fallot. Then, again the first in Italy, he performs a mitral commissurotomy according to the Blalock technique and he begins to use cardiopulmonary bypass to perform heart operations. In the early fifties it was time for the first radical cancer operations of the esophagus and the cardia and then, first in Europe, he performed a spinal cord transposition operation (Pott disease). Not to mention the huge number of endocrine surgical operations, neurosurgery and pelvic surgery: hepatic, pancreatic, gastro-enteric and renal operations always bringing innovative techniques.

The school

Pietro Valdoni was not the first, he was not the only one, and he will not be the last to create a school in the medical field; certainly, however, and this makes him valuable, he left a particular mark, somewhat more incisive than the greats of medicine themselves, because he conceived his school primarily as a model of life, then of vocation and finally of surgery. Valdoni immediately realised that progress in surgery would never have made a qualitative leap with routine, even if valid, in the operating theatre: the thrust would come from the organization of work, from working as a team, from the involvement of many medical figures around the same operating table, the true test bed for the knowledge acquired. He therefore immediately understood the importance of the departmental and interdepartmental concept of surgery, interpreted as teamwork: so not only surgeons but also operators in other specialities and all aimed at self-sufficiency. Inaugurating a tradition of close collaboration, rather than writing its own interpenetration between two disciplines, which has set a school throughout Italy and which still endures today, such as cardiology and cardiac surgery. The second strong point, in promoting his school of surgery, is based on an aspect of great formative value the practice of assigning to each individual student a specific task that, always great in the field of general surgery, commits each to follow world literature on a specific sector and to develop scientific research on the assigned topic, to then and report in the scientific meetings of the master himself promoted presided. With Valdoni, the new Institute became a true polyclinic in Policlinico Umberto I , with numerous departments, operating rooms, radiological laboratories, a general medicine clinic, a library, an enclosure, a museum and all kinds of special annexed services, certainly paying homage to Guido Baccelli, the creator of Policlinico. .And in this large and complex department, Pietro Valdoni was able to show all his enterprising and innovative surgical vitality, refined incisive, bringing gastroenterological surgery, thoraco-pulmonary, vascular, visceral and large vessel surgery to international levels, but especially cardiac surgery. Together with the other great clinical surgeon from Turin, Achille Mario Dogliotti, he introduced modern surgery to Italy, which he practiced from 1956 to 1970, the year he retired. From the prestigious school of Pietro Valdoni, great surgeons of the calibre of Paolo Biocca graduated, excelling in thoraco-pulmonary and oncological surgery, as did Luciano Provenzale, an excellent general surgeon to whom the master entrusted the nascent sector of cardiac surgery.

The original First Surgical Clinic “Pietro Valdoni” (Prima Clinica Chirurgica "Pietro Valdoni") was built in the early 1960s. The building was situated in Policlinico Umberto I (via Baglivi) in Rome. It was one of the most modern clinic of that period and it represented a model of “a hospital in the hospital”. Pietro Valdoni gave importance to iconographic documentation: for this reason in this Surgical Clinic he activated a photographic and cinematographic laboratory where the first scientific films were shot. The Surgical Clinic included: four care floors and 200 beds, four operating rooms with two observatories (one upstairs and one to the side). In each operating room there were sterilization, narcosis and doctors preparation services and cameras to follow surgeries. In addition there was a big sterilization room with a thermostatic stove and three autoclaves.

Bibliography

• Article in the Treccani Encyclopedia:

• Gaudio C., Mantova E., 2016. “Pietro Valdoni: l’uomo, il chirurgo, l’innovatore”. Roma: Nuova Cultura.

• Himetop: http://himetop.wikidot.com/pietro-valdoni

• Italian annals of surgery: https://www.annaliitalianidichirurgia.it/prodotto/pietro-valdoni