Stories of Ordinary Medicine: Doctor with blue blood

I usually ask about the family origins at the beginning, but yours is documented sufficiently. You were born in 1950 into the aristocratic Belcredi family, whose property includes, among other things, the castle in Brno Líšeň. How do you remember your childhood?
The fifties were not pleasant. When you constantly had searches coming to your house, strangers searching your apartment and messing up all your things, you remember that as a child. My father spent three years in the labour camp and was under constant surveillance. I remember when I was six years old, they sent an agent to our house as a provocation with a message to give the impression that he wanted to transfer us abroad. My father refused and tore up the letter, but the next day my parents were arrested anyway. For not reporting the agent. Later, when they learned his name, they tried to call attention to him, but they only got themselves into more trouble. Things didn't start to get better until around 1963.

Your father Ludvík Hugo Belcredi was the oldest of five siblings and the only one who did not emigrate after the communists came to power and he tried to take care of the Líšeň estate. Apart from the fact that he had the necessary agricultural education, do you think that a certain duty of the eldest of the descendants attached him to Líšeň?
I think so. Even though the communists confiscated his land, he rented it from them and continued to farm it. Three months before he was sent to the camp, he even received a decoration from President Zápotocký for exceeding the grain supply. But then they arrested him, saying that he had sabotaged the deliveries... And even after his release, they didn't leave him alone, they picked him up every now and then. We might have met the Salms, who were robbed of their castle in Rájec nad Svitavou. The communists had already confiscated it and the Salms lived there only in a rented attic, but the communists first arrested Hugo Salm, and then, since my parents were friends, they arrested them too. Why? I don't know, they probably assumed that the nobles would rob each other's homes... In the end, the real thief was caught fairly soon.

You spent your entire childhood here in Líšeň Castle?
No, we didn't start living here until 1955. Until then, we stayed with my grandmother. But don't think we lived here like nobility. We only had a small room downstairs in the courtyard for the staff of the castle administration. In the fifties, it was used for the university's Department of Military, among other things. When I was studying at the medical faculty, Professor (Bořivoj) Semrád told me how he and his class used to come here for exercises, and that he remembered us kids running around...

Parents often inspire their kids to become a doctor, but in your family I have traced the links to medicine only to your great-grandmother Marie, Baroness of Franckenstein, who was said to have been very popular in Líšeň for her care of the sick, and then to your aunt Marie, born Kouřilová, who also studied at the Faculty of Medicine in Brno, but she could hardly have influenced you...
No, because my aunt and uncle emigrated to Australia and we didn't see them until the 1960s, when they first returned. But some professors told me they remembered her from her studies. By the way, my aunt died this year...

...and the only information I could find was that your dad worked as a janitor in Úrazová nemocnice Brno. So I was wondering if you didn't fell into the hospital environment when you went to see him as a kid...
No, I didn't, because he didn't become a janitor until later. Before that, he was a tram conductor or a warehouseman. The communists always assigned him a job, and after a while they decided that it was too good or too pleasant for him, so they moved him somewhere else... At one time he even worked in the university canteen menza.

So where did your relationship with medicine come from?
Well, my mother studied it. But she didn't graduate because she got kicked out in her first year. She worked in the post office most of her life. My grandfather was fired from his job, my uncle managed to study law, but he couldn't pursue it... The reasons were the same for all family members: noble birth. Personally, I might have been more interested in history than medicine, but I was aware that in the nineteen-sixties I had the last chance to be accepted somewhere. I wouldn't have stood a chance under normalization. So I had to choose a field where they accepted more people, which was medicine. My patient in later years was Professor (František) Hejl, a historian, and he told me that they only accepted five to ten people for history, but they still didn't accept anyone according to the entrance exam, because there were ten people who had some communist intercessor.

So you had medicine as a contingency plan, and you took it at your mercy...
No, not really, I enjoyed it eventually. And in the end, it turned out well, because doctors were still doctors under the normalization. Maybe in a lesser position, but they were still doctors. Whereas those who were inconvenient to the regime from other faculties ended up as stokers or window cleaners. History then became a hobby for me.

How easy or difficult was it to get into medical school in the late 1960s?
At that time it was very easy! I took the admission test in the morning and by the afternoon the rankings were posted.

Your brother Ludvík studied archaeology, but he found it more difficult to get in, didn't he?
He's four years younger, so by the time he finished high school, normalization was already in full swing and he had it much worse. He applied to archaeology three times and was rejected three times. The aforementioned Professor Hejl told him that there was no point in trying, that he would never get through the Communist Party. But he advised him to apply to Prague, saying that he had checked that there the surname Belcredi would not matter, and that after a year he could transfer to Brno because the Communist Party no longer approved of it. If they hadn't accepted me in '69, I wouldn't have had a chance either. I graduated the first year in the atmosphere of the Prague Spring. It was in the second year, when the professors were fired. When I was in the fourth year, the Socialist Youth Union was founded at the faculty, and in the fifth year it was already unpleasant, and various interrogations began...

You mean interrogations of you, on the faculty?
Yes, I used to be summoned by the management and questioned about what I did when and where, what I thought... (smiles) But I don't think these interrogations were organised by the faculty. From what I heard years later, the State Security tasked the management to try to get me fired somehow. But the faculty leaders, although communist, still replied that they could not find any reason to expel me from the studies.

Politics aside, how do you remember your studies?
It was OK. The environment was quite pleasant, most of the students were of the same opinion and we knew about those who were not. But there weren't many of them. And they also knew that they were in the minority, so they didn't express themselves very much. Most of them were repeaters, repeating a year, and they needed help with some activity outside of their studies. Until that fifth year, it was a nice time...

Your niece said in an interview that "what it means to be a nobleman has been forgotten by the generation before us", that is you. Still, the surname Belcredi attracted attention even when you were studying, didn't it?
We didn't have any property then, so no one could ask me for anything. Apart from the interrogations, I can't even complain that I was discriminated against in terms of grades. I must say that even the most committed communists treated me quite well. Fortunately, I didn't come across (Bohumil) Potrusil, for example, who caused fear during his lectures, when he often strayed into politics... We didn't go to his surgical lectures much. (laughs) It wasn't like today, when students take partial exams throughout their studies. For example, we started in the third year and the exam was only the state exam in the sixth year. And nobody monitored the attendance at lectures.

Which teachers do you like to remember?
For example, the aforementioned Professor Semrád, whom we had from the third to the sixth year in the Department of Internal medicine. Or professor (Jaroslav) Švejda, he was still a professor from the old school, as they say... I also remember professor (Karel) Uhlíř in urology, how he used to hand himself a cigar held with a surgical clamps right during surgery... (laughs)

What did you enjoy or not enjoy most about your studies?
I didn't really enjoy the classes in the first years, which you just had to learn. Applied disciplines were more fun later on, internal medicine or neurology for example. After all, I started to go into internal medicine already during the studies...

Where did your steps lead after graduation?
I spent one and a half years in Jihlava, where I worked in psychiatry as an intern. A place in Brno was out of the question for me after my studies for political reasons. I contacted several hospitals, but most of them didn't even reply. Jihlava was one of the few places that wrote me back and were willing to accept me. In November of '76, I returned to Brno, to the hospital in Koliště. I was quite lucky, although at that time it was the case that those who were not cadre reserves - which were only communists - were only assigned to the district anyway. Then in the eighties I moved to the Zahradníkova polyclinic. At that time, the doctor who was supposed to do cardiology had disappeared, so they were looking for someone willing to take his place. They got a tip about me and I told them I would take it if they could get me a second degree attestation. And because the director at Zahradnikova was an influential doctor on the town committee, she managed to get it through. So in 1982 I got my second degree attestation.

What did the hospital in Koliště look like back then? The building is abandoned now, if I'm not mistaken...
Yes, I don't understand why. Back then, there was an ophthalmology, a cervical, a neurology, an internal medicine and a dermathology ward in the next building. The level was quite good, because it was a detached department of the second internal medicine department at Pekařská Street, so professor (Karel) Svoboda worked there after he was fired, and the head was associate professor (Dušan) Mrkos. In preparation for the attestation, I then returned to Koliště for another three months. And I was also in Prague for three months, where I was prepared by Professor (Ratmír) Rath, the father of the convicted (David) Rath. At that time, doctors who did not come from university hospitals took a three-month course at the IKEM, where Rath Sr. worked, and he was the main examiner for the second degree attestations in internal medicine. So I was rather prepared for him, as we were informed throughout the course what strategy to adopt and what Professor Rath did not like to hear. I can't complain about him though, he even wrote a letter of recommendation for me.

Why did you make it a condition of your joining Zahradníkova that you secure a second degree attestation?
I thought it would get me back to the hospital, to the University Hospital's internal medicine department. At that time, very few people had a second degree, because only the cadre reserve staff could do it. The communists didn't approve anyone else. I was only allowed to do it because I agreed to go to Zahradnikova, where they needed someone. When I did the attestation, I was even interviewed by Professor (Lambert) Klabusay in the hospital, but then everything somehow fell asleep. Later I learned from two sources that I was turned down by (Jan) Placheta, the director of the Regional Office of National Health, who said that I wouldn't get anywhere in the hospital.

Do I understand correctly that most of your life you have been involved in cardiology?
Yes, I did most of it, but I am not a cardiologist. There was an intensive care unit, a kind of coronary care unit - one of the first ones - at Koliště, and a large part of the colleagues I worked under were cardiologists. However, I got my certification in internal medicine. Also, until the 1990s, there were practically only two specialized internists-cardiologists... But I liked acute medicine at that time...

At that time? So you stopped enjoying it later?
When you're young, you want to explore as much as you can. When you're older, you're more afraid of discovering something. (smiles)

What problems have you solved most often?
Routine cardiac examinations, cardiac failure or ischemic disease, various arrhythmias - there were a lot of "paroxysmals" at that time... But endocrinology also had a good reputation at Koliště, so I was quite well educated in it as well, and then I was also involved in it at Zahradníkova.

What technologies have brought major changes to your work?
The revolutionary one was the CT scan, but for a long time it served only a small group of people and it took time for it to become more widespread. Of course, ultrasound was fundamental and brought a completely different perspective. I remember what a disaster a kidney tumour used to be, which was impossible to detect, but with ultrasound you can now catch it quite easily at an early stage. One of my classmates who emigrated to America in the 1985 described to us what conditions were like overseas. While in our country there were only CTs in Brno, Prague and Hradec Králové, and only one MRI for the whole republic, he got to a hospital in a city of some twenty thousand inhabitants, and there they were already using both routinely.

You never considered emigrating?
I used to say to myself in my youth that if I didn't get accepted to the faculty of medicine, I would disappear abroad, but since I was accepted, I didn't think about it later. If I could have worked in a hospital, I think I would have preferred it, but...

What do you mean?
That I'd enjoy it more. It's somewhat a routine in the outpatient clinic. Occasionally something interesting comes up, but in a hospital, the work is more varied. Every patient is different, so you're always learning and keeping in touch. Whereas in the outpatient clinic, you're seeing several people per patient who are just fine.

Sounds a bit like you were not enjoying it. Yet on the internet you can find only positive reviews about you, I even found a comment that you are "the best internist in Moravia"...
(laughs) When I came from Koliště to Zahradníkova, I used to do things in the outpatient clinic that I used to do in the hospital. For example, I used to do all kinds of punctures on an outpatient basis, but over time I got overwhelmed because other colleagues sent everyone to me... And of course, if I didn't enjoy my work, I wouldn't do it.

You mentioned a classmate who emigrated to America. How many of those were there? And did they run away right after they graduated?
Kučera went to America, Jirka Holan lives somewhere in Slovenia, I'm still in contact with them... Tesařík, Holubec, Pavel Grimm went to Switzerland... Sauermannová was in America, Jansová did haematology somewhere in Switzerland too... After my studies, one after the other, quite a lot of them...

Heart disease has long been the most common cause of death in the Czech Republic since the 1940s. What options did you have in the 1970s and 1980s to prevent myocardial infarctions?
Until there were angioplasties, "coronary care" could save arrhythmias. The patient was scanned and could be resuscitated immediately at the moment of the arrhythmia. That helped, but the actual cause couldn't be addressed. I know some colleagues had tried to do coronary angiography and angioplasty before the Velvet Revolution, but they couldn't see the vessels properly. After the revolution, however, there was a rapid development. Doctor (Ladislav) Groch rented premises at Žlutý Kopec, where he had an angioline and he was the first one who started doing angioplasties in Brno. Then it started to spread - to Pekařská Street, to Bohunice...

A major risk factor for heart disease is lifestyle. To what extent was it an issue at a time when, for example, smoking in public places was quite common?
Smoking was persecuted even then. I guess I can't say whether people had better or worse lifestyles than today, but many diseases move into older age. In general, life is getting longer... When I started, seeing a patient over 80 was scarce!

How did the events of the revolutionary year 1989 affect you?
For me, the opportunity to finally get into a hospital opened up at that time. My colleagues even urged me to audition. But after the experience of the eighties, when it was obvious that I would not get into the hospital, I stopped trying and didn't even keep up my theoretical knowledge much. So when the opportunity came again after the revolution, I was already lacking behind, and in competition with younger colleagues... In addition, we started to have family issues with the property when we got back the castle here in Líšeň in restitution, and so I stayed at Zahradníkova until I retired.

So the family inheritance eventually affected your professional career...
I considered getting into the hospital, but another factor was that I couldn't travel anywhere all my life. I was tempted to travel, and I knew that if I became more involved in medicine, I probably couldn't afford it. My classmate Aleš Trnka and I travelled around the world for twenty years. Another classmate with whom we travelled like this was Bořek Crha, an orthopaedic surgeon... Unfortunately, Aleš is no longer with us, but I have travelled to over a hundred countries.

And today, in retirement, you enjoy not only traveling but also the noble life in the castle, right?
Well... The noble families I knew have passed away. We were few in Moravia - the Salms, the Mensdorff, the Strachwitzes and us. My father was still in contact with them, but the Salms had all emigrated by the end of the sixties and I have practically no contact with their successors.

I have to say, compared to how it looked back when we used to run around here as kids, you have managed to fix up the castle and its surroundings very nicely!
In the late 80's it was a total ruin. Under the communists, apart from the military department, there was a Zetor for a while, the national committee was based here and even something called the peace museum. Until the Revolution, there were also two dentist's offices here... I lived for years in the housing estate, in Kotlanova, and we were only able to move here in the 1996. I was putting this place together with my brother and my mother, who did a tremendous job. Even the communist chairman of the unified agricultural cooperative told us that there was nothing we could do, that he had burned all the documentation. But my father had copied everything, so my mother then had an inventory of all the property ready and could start acting as soon as the restitution became due. Curiously enough, my mother learned that the communists hadn't even finished the transfer of the confiscated property during the previous regime, so we were still listed as owners in the land registry. (smiles) The only exception was the castle. She had already been seeking extradition before the revolution, although the authorities did not respond to her requests. Today, apart from living here, we run a small guesthouse. We rent out the inn that is here, and there is a horse team - we used to run that ourselves, but now we rent it out...

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