A MENTOR, says Oprah Winfrey, is “someone who allows you to see the hope inside yourself”. Hope was among the first things that struck Dr Claudio Jiménez, neurologist at Simón Bolívar Hospital in Bogotá, Colombia, when he met the young Argentinian doctor, Dr Ignacio Girolimini. Right after he noticed a strong resemblance to Lionel Messi.
“Ignacio had a will, and his hope was evident,” he says.
The two doctors met under auspices of the ROPU South America Mentoring Programme which is managed by Deborah Ferreras, Angels team leader for South America, and Cardiovascular Medical Manager Alejandro Lakowsky.
Dr Girolimini wanted to improve stroke care in his small town. Dr Jiménez, who has transformed stroke care at his own hospital in Bogotá, was appointed as his mentor. Elsewhere in this issue you can read more about both these doctors. Here is how this mentorship unfolded, in their own words.
Dr Claudio Jiménez:
I believe that all the work we’ve have been able to do in our institution and the experience we have gained achieves its real value when it is shared. So, why do I think it is worth getting involved in a mentoring program to help build stroke centers and networks in Latin America? The reason is not only that these are needed, or that medicine is a common good for humanity, but that it is an obligation to share successful experiences beyond the narrow borders of “us” and “we”.
When I met Ignacio, the first thing I thought was, “But he looks like Messi!!” My next thought was that it is the same for all of us who have to start from nothing and want to change the care processes for people who suffer a stroke. I had all the same doubts at the beginning of building our team and finally our stroke centre. So we began a dialogue that started from what for me is a premise in this type of venture:
“Ignacio, they will tell you a thousand times that the plan is not viable. You must keep believing that you can, until you achieve it, because you will achieve it.”
And with this expression of panic mixed with enormous hope he told me: “Let’s go to work, we already have a tomograph!”
I saw a human being willing to invest his time in caring for what he defines as “the critical moment of our existence”.
Dr Sheila Martins always says that “will and a tomograph” are all that is required to treat a stroke. Ignacio had a will, and his hope was evident. I firmly believe that these are the two things that move us. Where there is will and hope we have the fundamental tools for success. Then we learn to tolerate failure and overcome resistance. Ignacio possessed these basic and necessary attributes.
Something else that is very important, and that Ignacio does with absolute naturalness, is that the work of the leader is key, but the trick is to be an example. They say when you’re a good leader people don’t follow orders, they follow suit. Ignacio is always the first to take a case, always willing to answer the call for a stroke code, and this permeates the whole group – the desire to do the same and work tirelessly to help the patient.
The challenges of stroke are universal. It always starts with one or two people who want to implement a care protocol. Then there are technological limitations, which fortunately in Ignacio’s case was resolved with the donation of a CT scanner to his hospital.
Administering drugs to reperfuse patients with acute ischaemic stroke is one thing. It’s another thing to collect data, manage it, analyse it and use it so the team grows. For a single doctor to carry out the clinical work and then having to load data into Excel tables on his nights or free weekends, that is a barrier. Once again Ignacio has taken on that job, but as the population learns how to recognise stroke system and the patient volume grows, that can become untenable.
Then there all the limitations of the healthcare systems in our regions – whether or not a patient has social security or arrives at a hospital that cannot treat them and then has to be transferred to a centre that has tomography. This is why we spend time talking about stroke networks. Networks are the only way to end the terrible access barrier to reperfusion therapies in acute stroke.
The Angels mentoring programme is more than a beautiful initiative, it is a global need. It is very important that the experience of doctors be shared beyond studies in medical journals, which are of course key to the development of our science. However, we must invest in transferring our experience directly to people and groups of people who need it, especially in communities with difficult access to resources.
I have had mentors throughout my professional life, from my undergraduate studies to my training as a neurologist and neurophysiologist. But if I have to name someone who helped me develop the skills I have today and find the tools I possess, it is undoubtedly Dr Liselotte Menke Barea, a neurologist in Porto Alegre, Brazil. She was the head of the service when I was training there and her personality, her discipline and her delicacy in dealing with patients totally transformed my way of practicing medicine.
Dr Ignacio Girolimini
What motivated you to apply for this mentorship programme; what did you hope to achieve?
In the first instance, we found ourselves without a clear guideline on how to proceed, how to unite efforts and give order to the multiplicity of tasks that we had to carry out. An EMS doctor, Dr Carlos Ruffini, suggested that I present our project for the mentoring programme.
We hoped to have a guide and receive help with organising and consolidating the project of establishing a stroke unit in our hospital.
What did you know about Dr Jiménez before your association began?
Prior to our work together I did not know Dr. Jiménez or his impressive work in Bogotá.
Please describe your first meeting with Dr Jiménez and your initial impressions of him.
Meeting Claudio was a great experience. He is a person with a lot of commitment, knowledge, passion and above all empathy for his colleagues in situations similar to his.
What qualities did you observe in him that make him a successful mentor?
His dedication and commitment, always with the conviction that our reality in Latin America can and should be changed, and that we can aspire to offer comprehensive and quality care to our stroke patients.
How did his mentorship impact the breakthrough in stroke care at your hospital?
I am very grateful for the support of Dr. Jiménez in backing us in the formation of the stroke unit. It has been very helpful when it comes to consolidating ourselves as a work team and not just a temporary one-man initiative.
How do you see the value of this kind of programme, and do you see yourself as a future mentor to younger doctors?
Programmes like this are essential, above all to support those of us who are far from large cities or centres of high complexity. I am completely available to give back everything they have given us, and I would be delighted share our experience.
