Dr. Alfonso Castro Beiras died unexpectedly in early February of this year. His professional career, his impact on the Spanish Society of Cardiology and, above all, his exceptional and multifaceted personality are difficult to summarize in a few lines; it is even more difficult to fill the gap left by his absence.
Alfonso was born in Santiago de Compostela, a city in northwestern Spain and site of the university where he studied medicine with brilliant results, obtaining the special commencement award. After that, he moved to Madrid, to Clínica Puerta de Hierro, a hospital that had been instituted a few years earlier by a group of visionaries under the direction of José María Segovia de Arana, who also died recently. After his rotating internship and a period during which he was inclined to go into internal medicine in the department of Juan López de Letona, he finally decided on cardiology, and spent his residency in the department directed by Manuel de Artaza. It was a small department, most of whose members had studied at the prestigious Instituto Nacional de Cardiología in Mexico; in contrast, cardiac catheterization, under the direction of Valentín Martín Júdez, came from the British school. These two influences, one more clinical, the other more technical, helped create a special atmosphere, intellectually stimulating and hierarchically liberal, which was further enhanced by the magnificent surgery performed by great figures under the direction of Diego Figuera. One of the individuals who contributed decisively to this special scenario, in which many Spanish cardiologists were trained, was Alfonso, first as a resident and, later, as an associate physician in the department in which his career had taken shape. A few years later, he returned to his native Galicia to establish the specialty of cardiology at the Hospital Juan Canalejo, in the city of A Coruña. The adventure was not easy at a time when Spanish medicine was dominated by the large hospitals of Madrid and Barcelona. However, eventually, after overcoming more than a few difficulties, and with the help of cardiologists and surgeons who also came from Clínica Puerta de Hierro, and many others who had been trained under his direction in A Coruña, he created a department that is now a benchmark for the management of heart disease in Spain. More than 250 journals articles, as well as numerous books and doctoral theses that he directed, are evidence of his research capacity. A full professor of cardiology and promoter of the Instituto Universitario de Ciencias da Saúde (Health Sciences) de la Universidade da Coruña, Alfonso Castro was president of the Spanish Society of Cardiology from 1997 to 1999 and is remembered as one of its great presidents. During his mandate, he undertook a series of reforms and improvements in the infrastructure of the Spanish Society of Cardiology that culminated with the inauguration of its present headquarters, La Casa del Corazón in Madrid.
All these facts reflect the high professional standards of a cardiologist but, undoubtedly, they are of little use; they are too cold to help those who did not know him to attain a deeper understanding of his personality. Alfonso was a great physician but, beyond his field of knowledge, he was a wise man, in the sense in which Fromm defined the term, in contrast to a learned man, who merely acquires knowledge as one would store his possessions. In Alfonso, knowledge was a tool that broadened his view of the world and transformed him—if this were possible—into someone closer to things as they really are, with a greater understanding of human weakness. That enabled him to be a leader, but not a distant leader; he did not attempt to exercise his leadership by any means other than persuasion; at the same time, he was able, without even trying, to make people feel they were truly needed and that their opinions were important. Moreover, he belonged to that rare class of leaders who do not limit themselves to analyzing the exact reasons for change, but are able to foresee, guide, and channel that change. And not only in medicine, but in society in its broadest sense, since his ever-active curiosity led him to be constantly attentive to every innovation in the fields that he considered relevant. Perhaps for that reason, he was an indispensable advisor to the highest health policy makers, regardless of their political stands. His subtle irony—linked in part to that of his fellow Galician and colleague of the same name, Alfonso Castelao—was never used to hurt or make fun of others, but was filled with warm affection for them. His intellectual brilliance, sometimes astounding, was frequently tempered voluntarily by his amiable, close, unassuming nature, which enabled him to explain the most complex medical concepts in a comprehensible manner. It goes without saying that this characteristic, together with many others, conferred him with the quality that leads patients to refer to a doctor as “my doctor”. His keen clinical sense went beyond the mechanistic concept of disease, as he cared about the human beings who suffered from it and the circumstances that could modulate it, penetrating to depths that clinical practice guidelines are unable to reach; his long coexistence with disease, including his own experience, had taught him the therapeutic value of personal contact, which patients perceive as genuine interest in their problems. And all in the context of a practice marked by a quality that is seriously under threat in the highly exacting medicine of today: common sense. The common sense that led him to quote another great clinician, whose affirmation could be translated as, “The physician should know about the latest, but apply the next to the latest”. An excellent host, a magnificent conversationalist, he always knew how to create the right atmosphere, with the indispensable aid of Carmen, his wife, companion, and friend, to make any gathering he attended a warm and friendly event.
There is no doubt that Alfonso Castro Beiras left his mark on Spanish cardiology, but not the ephemeral tracks on the road that will inexorably be erased by time, but a trail pointing toward the future that lives on in those who knew him and were his disciples, whose acts will be imbued with his style and his example. And, of course, in the medical society he presided over and that owes him so much for its here and now.
Rest in peace.