If you grow up in a family of doctors, and even within the grounds of a hospital, surrounded on all sides by white coats, a career in medicine seems almost inevitable. Professor Miloš Janeček's story, however, shows that even the path towards fulfilling what appears to be a straightforward destiny can be winding and full of unexpected obstacles. It is every bit as rich and wide-ranging as the account of the still-practising orthopaedic surgeon who, alongside five decades of medical practice, also spent a period in politics, most notably six years as a member of the Senate of the Parliament of the Czech Republic. In both roles, he left a significant mark behind him. Yet unlike his political engagement, which he recalls with a certain bitterness, medicine, as he says, has never let him down.
As a rule, I begin by asking whether medicine is a profession that runs in the family. From what I have found, your grandparents were butchers specialising in smoked meats, while your parents were both doctors. Is that right?
Yes, although it was not only my parents who influenced me. We lived on Mendel Square in Brno. Where the entrance to St Anne's Hospital is today, next to the pharmacy – which, by the way, I find rather tasteless – there used to be a huge metal gate instead of a barrier, and a block of flats for doctors, occupied by the families of young physicians in their early thirties. My parents lived there, as did Professor of Surgery Jaromír Uhlíř, the head of the urology department, Dr Hošek, and many others. The only non-doctor was Mr Hanák, the mortuary attendant, whose wife was the caretaker and residents' representative. So from early childhood I was surrounded by doctors and grew up alongside their children.
Even if you had wanted to, there was no escaping the medical profession...
Not quite. One of my closest lifelong friends became an engineer, but it is true that it had a certain influence. We often talked about work at home, although my father always used to joke, "My wife isn't a doctor – she's a dentist." (smiles) In the days when my mother was studying, there was only general medicine; dentistry did not exist as a separate course. My father wanted to pursue an academic career, so although she began at the internal medicine clinic, she eventually stepped back as the mother of three children and devoted herself to dentistry instead.
How did it happen that, although you were from Brno, you were born in Jihlava?
My father was... how shall I put it? Adventurous is probably too strong a word, but let's say he was rather restless. Immediately after the war, he started working at the orthopaedic clinic under Professor Bedřich Frejka, which was a prestigious position in the 1950s. He was then offered the opportunity to develop the orthopaedic department in Jihlava, and agreed to go there for a year. But then they told him he would also have to serve as hospital director, as there wasn't one at the time. In the end, he spent two years in Jihlava, during which I was born. When I was about six months old, my parents returned to Brno. My secondary school leaving certificate originally even stated that I had been born in Brno, but I later had it corrected so that no one would think I had forged it. So I consider myself a Brno native, shaped for nineteen years by the area around Mendel Square and St Anne's Hospital.
So how much was it expected that, after secondary school, you would apply to medical school?
Looking back, my parents and all those circles around them undoubtedly had an influence, but they never pushed me into anything. I was the youngest of the three siblings, and I had the advantage that my father's parental zeal had already been spent on my sister and brother. By the time it came to me, my parents largely let me find my own way, in the best sense of the phrase. Although I took mathematics and physics in my school-leaving exams, I was really more of a humanities person. So what were my options? Philosophy was very much in the "best avoided" category at the time, which left law and medicine. I knew nothing about law, and the prospect of working as a lawyer at the Zbrojovka engineering works did not particularly appeal to me, so medicine remained. What's more, my father was then working at the University of Greifswald in East Germany, and he persuaded me to apply there. So, in the spring of 1968, I was matriculated at Ernst Moritz Arndt University in Greifswald and accepted to its medical faculty. Then came 21 August 1968. We were all rounded up and, under the supervision of the East German army, taken to the Czechoslovak-German border, where we were told to go home.
“During my first lecture in Germany, I could understand only one out of every fifteen words the lecturer said.”
Miloš Janeček
Were you able to transfer automatically to the medical faculty in Brno?
Well, things were rather up in the air for a while. Then I asked my father what was actually going to happen with my university studies. (laughs) Was I going to study in Brno or in Germany? In September 1968, nobody really knew what was going to happen. By then, the entrance examinations and interviews had already taken place. In the end, it was resolved by my officially transferring from one university to the other. So I graduated from the Faculty of Medicine in Brno without ever having to sit an entrance interview there.
Your Wikipedia entry says that you studied in Germany between 1971 and 1972. So that's incorrect?
No, that's correct – that came later! I enrolled in Brno and started my studies as normal, but in my fourth year my father began persuading me again that I should try studying in Germany. By then I had a bit more sense, and I thought that, if nothing else, I would at least learn German over the course of those ten months. At the back of my mind, I suspected it probably would not be easy to transfer halfway through a degree. At the first lecture, I understood every fifteenth word the lecturer said, but gradually I got the hang of it. Otherwise, though, the courses were not entirely compatible, so when I returned to Brno I actually had to repeat the year I had spent in Germany. At the time, that really bothered me psychologically because my entire study group was now a year ahead of me. On the other hand, that experience meant that throughout the rest of my career I focused on the German-speaking countries, and I came to realise that the year abroad had been well worth it.
What was the atmosphere like in East Germany at the time? Professor Peter Wendsche, the founder and head of the Spinal Unit at the Brno Traumatology Hospital, who travelled in the opposite direction, recalled in an interview for Czech Radio that he had felt freer in Czechoslovakia than in East Germany...
I can't really judge that. I lived in something of a student bubble, and politics passed me by completely. I had a very good friend, the daughter of the local professor of gynaecology, who was a passionate football supporter and a great lover of beer. So whenever I travelled back to Germany from Brno, my father would always remind me to bring him a crate of Pilsner beer. And he would say to me, in his deep voice, "You are not a football fan - that's bad." (smiles)
Did your father divide his time between Greifswald and Brno?
At that time, the University of Greifswald had a Brüderschaft – a partnership – with the university in Brno. One of their elderly professors was retiring, so they approached Brno and asked them to send an orthopaedic surgeon who could take over from him and, over the course of a year or two, help raise the department's standards. My father, being the adventurous sort, immediately agreed, saying he would work both in Brno and in Germany. Later on, though, I came to realise myself that trying to sit on two chairs at once simply doesn't work. In Brno, his opponents kept putting obstacles in his way, while his friends reported everything back to him in Germany. After about two years, he had to decide what to do next...
It sounds as though you and your father were very close...
Yes, I spent a great deal of time with him. Unfortunately, just as we were reaching the point where our professional lives might have come together, he died. So when it comes to work, we never really had the chance to collaborate closely. Looking back now, though, I understand that he was happier in Germany, for two reasons. First, he was better off financially there than he was here. Even so, although he came from what you could call poorer family background, he was never driven by money. More importantly, he had a position there that allowed him to build something. I remember him describing how he wanted to establish a bone marrow bank in what had once been the clinic's kitchen, with meals to be delivered from elsewhere instead. "You asked me to come here and build something, so here's the plan. If you don't want it, just say so. I'll pack my bags tomorrow and go back to Brno." Whenever things became difficult, he would travel to Berlin and go to the ministry. They would pick up the phone, call Greifswald and give them a dressing-down, asking why they had invited him in the first place if they had no intention of supporting him. During meetings of the academic council, colleagues would come up to him and say, "Professor Janeček, you say it – you can. We'd only get told off." (smiles) So he modernised the clinic, expanded it with a new building, got everything running properly, and he was happy there. It was only towards the end that his health began to fail... A few years ago, I was invited back for the clinic's sixtieth anniversary and gave a lecture entitled The Janeček Legacy in Greifswald. The clinic has since moved to a new campus, while the old buildings have been left to decay...
Let's turn to your own studies in Brno. What are your memories of them?
I can still see myself walking out of my very first exam. It was physics, and I got a first-class mark. At grammar school I had known far more physics than they expected of us at the medical faculty in the first semester, so I felt on top of the world. Of course, that soon began to change...
Do you mean the demands of the course, or the situation in society?
Take the spring of 1969, for example. It was a harsh time. By then we were eighteen or nineteen and beginning to understand what was happening. One of my classmates was Laďa Kruta. His father was removed from his post as head of the Department of Physiology, and Professor Lubomír Malinovský took over the Department of Anatomy after Professor Přemysl Poláček... Even the name sounded suspicious! People used to say he had changed it...
One witness recalled that his original surname had been Miller...
Well, there you are! More importantly, though, we had previously enjoyed going to lectures because they were genuinely interesting. Once Malinovský started lecturing, people stopped attending, so they introduced compulsory attendance and everyone had to sign in. We would sit there listening to Malinovský and think to ourselves, Who exactly do you think you are? Those were the changes of 1969 and 1970... Malinovský remained head of the department until 1990, and in the 1990s he later worked at a university in Rome...
Who else do you remember?
I had enormous respect for Professor Jaromír Vašků, even though the only exam I ever failed at the first attempt was his – experimental pathophysiology. Professor Vašků had been a lifelong friend of my father's, and although I still hadn't finished reading the latest course notes, my father insisted that I go to the exam because I already had a slot booked. He said, "Go on, Professor Vašků will pass you." I answered two questions perfectly, but I didn't know the third one at all. So he failed me. Afterwards, my father and I had words about it, as you can imagine... In 1969, I was even present at a meeting between Professor Vašků and Professor Christiaan Barnard, who visited Brno at his invitation. (The South African cardiac surgeon Christiaan Barnard performed the world's first successful heart transplant in 1967 – editor's note.) At the time, the dean's office was on Komenský Square, and in the basement there was a bull called Hasan with an artificial heart, noisily bellowing...
“They brought in a diabetic patient with a gangrenous leg. The anaesthetists refused to give him a general anaesthetic, so Mr Nešpůrek said he would show me what a Pirogov amputation looked like. He packed the leg in ice, infiltrated it with local anaesthetic, performed the amputation in ten or fifteen minutes, put in a few stitches, and that was that.”
Miloš Janeček
I can imagine that having the surname Janeček must have carried a certain weight when it came to exams...
Take my ENT exam with Professor Miroslav Přívara. The syllabus was only a slim booklet. Everyone else revised it over a weekend at the Sokol swimming pool, while I spent a whole week on it, from morning until night, because I kept imagining Professor Přívara meeting my father on the stairs of our building and telling him what an idiot of a son he had who knew nothing... In many ways, my entire time at medical school was shaped by where I had grown up and by the people around me. One of the few pieces of advice my father gave me before he died was this: "Remember one thing. The people who liked me will be your friends. And the people who didn't like me will make it clear that they don't like you either – even though they'll have no reason." And that's more or less exactly how it turned out.
Didn't you already feel that while you were a student?
No, not really. Medical school itself was fairly straightforward, and especially in the later years the clinical teachers were very supportive. Besides, during my studies I came across far more people who had liked my father, and I worked hard to make sure I brought neither him nor myself into disrepute. (laughs)
After graduating, you joined the military hospital, although only briefly. Had you already decided that orthopaedics was the specialty you wanted to pursue?
If I could go back now, I probably wouldn't choose orthopaedics. I'd opt for a different specialty where I could simply be an anonymous Janeček. But this is another example of how much my father influenced the start of my career. At the time, the director of Brno University Hospital was Associate Professor Stanislav Peřestý. He had married a Russian woman – we all called her Kalka (Klavdia Ivanovna Peřestá) – who was a gynaecologist and, unlike him, absolutely wonderful... Standa Peřestý was an associate professor of surgery, but people used to say that whenever he was due to operate on an appendix, he came down with diarrhoea and someone else had to do the operation. Whether that was actually true, I don't know. On the other hand, he genuinely enjoyed teaching medical students. The head of the orthopaedic clinic was then Associate Professor Zdeněk Bozděch, and my father arranged a position for me there, with the understanding that I would start on 1 September.
So what happened? Why didn't you?
A fortnight before I was due to start, I went to the hospital's personnel department, where they told me I had been assigned to forensic medicine. I said there must be some mistake, but they insisted there wasn't – that Associate Professor Peřestý had said the only vacancy for me was in forensic medicine. When I got home, I told my father that I wanted to operate on the living, not the dead. Once he had recovered from the shock, he went off to sort something out. When he came back, he said there was no getting past Peřestý, so instead I would join the surgery department at the military hospital, where one of his friends, Dr Miroslav Nešpůrek, was head of department. They had known each other through North Korea, where my father had spent two years on what today would be called a mission...
At the beginning of the 1950s, during the Korean War?
Mr Nešpůrek was there as a soldier during the war. My father went later, after the conflict had ended, as a doctor. My poor mother always remembered it vividly. My father came home one day and said, "What would you say if I went to Korea for a year as a doctor?" My mother replied that he must be out of his mind – he had three children at home! And he simply answered, "I'm flying out the day after tomorrow." That was just the kind of man my father was. (smiles)
So, through this rather roundabout chain of events, your career began among soldiers...
...and only afterwards did I discover the real reason – and just how absurd life can be. My father had fallen out of favour with Peřestý, and that was why I was refused a place at the orthopaedic clinic. So, in September 1975, I started in the surgery department of the military hospital. I arrived there feeling thoroughly dejected, and no sooner had I been issued my uniform than I was given my first admission. Yet those turned out to be the two happiest years of my surgical training. Mr Nešpůrek was an outstanding surgeon. He had been expelled from the Communist Party, but he was simply indispensable, so the military had no choice but to keep him. Because of my father, he took me under his wing. Apart from one doctor, everyone there had completed both levels of surgical specialist training, and they had little interest in dealing with the "routine" cases. I, on the other hand, was young, eager to perform every possible procedure, and had no children at home, so they knew I threw myself into everything with enthusiasm. Nešpůrek took me with him on call, taught me how to operate, and showed me what he called "war surgery"...
That must have been an extraordinary education!
They brought in a diabetic patient with a gangrenous leg. The anaesthetists refused to give him a general anaesthetic, so Mr Nešpůrek said he would show me what a Pirogov amputation looked like. He packed the leg in ice, infiltrated it with local anaesthetic, performed the amputation in ten or fifteen minutes, put in a few stitches, and that was that. You never forget something like that. I learned things there that I drew on throughout my entire professional career. And it was also at the military hospital that I met my wife, who has selflessly supported – and put up with – my passion for surgery and orthopaedics ever since.
In the end, though, you did eventually make it to orthopaedics at the university hospital...
Because they realised what Peřestý was like, they dismissed him, and Associate Professor Bozděch got in touch to ask whether I was still interested in orthopaedics. I realised that, because of my physical disability, surgery might not actually have been the ideal choice for me. It was also a very different field from what it is today, when there are many more specialised branches. So I said that I was interested. And by then I had already completed two years of experience that meant I knew more than my peers who had spent those two years in orthopaedics.
What disability are you referring to?
I can show you! (Reveals a large scar on the back of his thigh.) In 1955–1956, while my father was in Korea, my mother was knocked down by a cyclist at a pedestrian crossing. She suffered a brain haemorrhage and ended up in the surgical intensive care unit. At the time – speaking somewhat ironically – that meant you were connected to an ECG and they waited to see what would happen; occasionally a neurologist would look into your eye. There were no MRI scans, CT scans, ultrasounds or anything like that... My father was in Korea, my mother was in hospital, and so I spent the holidays with my grandmother in Opatovice. My grandfather had been conscripted during the First World War and died in Russia, and my grandmother was what you might call a simple village woman. One day she was bathing me in a wash tub and said: "Boy, you've got one side of your bottom bigger than the other!" When my parents returned, they started looking into it, and it turned out that I had a tumour – not a malignant one, but one that kept recurring in the area of the sciatic nerve. Over the course of four years and four operations, they gradually removed it, and as a child I went through cytostatic treatment, chemotherapy, having a bald head, and so on. When it reached the area behind my knee, they already had a betatron machine at Žluťák (Masaryk Memorial Cancer Institute), so they irradiated me and that was the end of it. To this day, whenever I drive past there, I always bow my head in thanks. However, as a result of all that, my leg was affected, and I was never able to ice skate or ski, for example. It didn't really bother me until 1990, but when the borders opened and my friends started going skiing in the Alps, it did begin to annoy me a little. (smiles)
How did you experience such a diagnosis as a child?
When I later spent about twelve years at the clinic also treating bone tumours in children, I realised from my own experience that children perceive these things differently. If I had to go through something like that at the age of forty, I think I would have been driven to despair... Children don't see it that way; for them, it is simply the way things are. But I also used to tell my own children not to underestimate how perceptive their own children are. I remember when we went to Hradec Králové for what was probably my third operation, where there was a specialist neurosurgeon. My father reassured me that we were only going there for an examination, that they would just have a look at me and then we would go home. But as soon as we entered Hradec Králové, he stopped the car and took me into a toy shop. At that moment I realised it was not going to be just an examination. (laughs) To this day I remember the little toy car with a headlight that he bought me then, and how I played with it in hospital after the operation. I also remember that the clock in the operating theatre showed 9:20 when I was falling asleep under anaesthesia. Children's memories are very sensitive in this respect, but at the same time children simply do not understand many of the things happening around them.
So ultimately it turned out well, considering what options there were for treating tumours at the time, didn't it?
They were extremely limited! But yes, it turned out well, although I was left with a physical disability, which actually ended up influencing the direction of my career as well. I enjoyed surgery, and orthopaedics is a surgical specialty, but one that is planned. You can schedule everything; it does not have to happen at one or two in the morning... So in the end I joined the orthopaedic clinic. It was interesting, and we had both successes and failures... I experienced, for example, a young boy with Ewing's sarcoma dying while I was on call, and I had to tell his parents... Many years later, already at the trauma hospital, a nurse came up to me and said: "You were the one on duty when my brother died back then."
“My admission to the party was discussed by the committee of the Socialist Youth Union, which was actually against it. Like the majority of students – not only at the medical faculty – I had not really done much for the organisation.”
Miloš Janeček
What did you focus on most at the orthopaedic clinic?
Mostly bone tumours and soft tissue tumours. But we also performed osteotomies, paediatric orthopaedic procedures – in short, a broad range of operations... In November 1979, I performed my first hip replacement... There was a great deal of variety. One of the few areas that passed me by was spinal surgery, which was Professor Otto Vlach's field. Later, the clinic was divided and he moved to Bohunice...
...while you stayed at Pekařská?
Yes. At the time, the division was driven by politics. Vlach had a strong position and, at one point, was the highest-ranking party official at the faculty. By contrast, Bozděch was the only non-party head of a clinic at the entire university at that time. But Vlach treated him very fairly, and he built a new department in Bohunice, where spinal surgery became the number one speciality. Vlach focused mainly on scoliosis, and people travelled to Brno from abroad to see him because he had such a strong reputation...
By the way, what was your own relationship with the Communist Party?
I will start again with my father, whose own father left for war when he was still young. He grew up only with his mother, and so already at grammar school he had... today I would describe it as having tendencies typical of revolutionary youth. Which is understandable. When you grow up with very little, you are more aware of social injustice. At the time, he was involved in distributing some leaflets, and as a result he was expelled from grammar school in Brno. Fortunately, he was able to transfer to the grammar school in Boskovice. That turned out to be a fateful event, because that was where he met my mother, and after finishing school they both went on to study medicine in Brno. The war interrupted their studies, but afterwards they completed them. My father started in orthopaedics, while my mother switched from internal medicine to dentistry and caring for the family. So my father was a member of the Party, but I don't feel that he particularly used it to his advantage. When he later went to Greifswald, I think that saved him. Because if he had been at home in August 1968, he was exactly the kind of person who would have taken it very hard... Later on, it was not really discussed as much anymore...
And what about you? How did it work with you?
Well, that is another story that sounds unbelievable. When I was in my fifth year of medical school, my father came to me with a piece of paper and said: "Sign this." It was an application to join the Communist Party. Until then, like everyone else, I had been an ordinary member of the Pioneer movement, and later of the Czechoslovak Socialist Youth Union and the Socialist Youth Union, and I simply could not understand what I would do in the Communist Party... I remember it as if it were yesterday. He said: "It will come in handy for you." So I signed... My admission was then discussed by the committee of the Socialist Youth Union, which was actually against it. Like the majority of students – not only at the medical faculty – I had not really done much for the organisation. I was an ordinary member and paid my dues, and that was all. The second problem was that people were accepted as members only after a two-year probationary period. But when you were halfway through your fifth year, there was no way I could complete the process while still at the faculty, and I could not be accepted anywhere else either – it simply was not possible. So that was somehow resolved as well, and the outcome was that, despite all the objections at the faculty, I was accepted as a candidate member of the Communist Party, and became a full member somewhat later, already as a young doctor at the military hospital. They were much happier about it there.
Did your membership cause you any problems after the revolution? It is well known that the new regime wanted to get rid of the old structures, and according to your biography, in 1990 you moved from Brno to Havlíčkův Brod...
Given my membership, I have a completely clear conscience as far as I am concerned. But in life you have friends and enemies. At the clinic at the time, there was one person who simply could not accept the fact that I was an assistant professor. And when 1990 came, he wrote a letter saying what a criminal I was and so on, and started going around showing it to my colleagues... You would have had to experience that period to understand it. People were afraid. Nobody knew what would happen after November, whether things might somehow go back to the way they were... The character of this person can be illustrated by a story. We were sitting in the library, where there was a picture of Gustáv Husák hanging on the wall, and he said to a colleague who was almost two metres tall that he should take it down because he was taller. He did not even have the courage to say that it was over and take the picture down himself! So this was the person who was campaigning against me and writing all sorts of things... As a result, I went to see Professor Vlach, who was himself being treated very harshly, and he said to me: "Don't worry about it. Take a diazepam every morning and in a year you'll see that everything will be different." I told my wife about it at home, and she asked whether I had gone mad... But we were partners, we had small children, we lived together, so in the end I did not take any pills and I resigned from the clinic. To paraphrase Zdeněk Svěrák from Empties – the movie, I no longer enjoyed going there. And yet, when I left, I had absolutely no idea what was going to happen.
So what did happen? Havlíčkův Brod?
My great lifelong friend Jiří Stryhal was head of department in Havlíčkův Brod. He went to see the director, told him he needed Janeček, and so, at the age of forty, I started working there. Every Monday morning at five o'clock I would board the workers' train, spend the week sleeping in a hostel, and return to Brno on Fridays. My children were still very young at the time, and they actually enjoyed it because I always bought them chewing gum or chocolate at the railway station.
Looking back professionally, how do you remember your time in Havlíčkův Brod?
I introduced knee joint replacement surgery there, so from a professional point of view it was a very good experience and it made sense. The other matter was my free time. But there was an orthopaedic colleague there called Akram Sandakli, I believe he was from Syria, and because he was alone there as well, we became friends and spent time together. After about a year and three quarters, however, Professor Jaroslav Michek, who was then director of the trauma hospital, called me and asked whether I would like to establish an orthopaedic department there...
So in the end, things somehow settled down again after all...
Exactly. But it could have turned out differently, although I have probably been somewhat naive throughout my life... A year after I had started in Havlíčkův Brod, they advertised the position of head of department in Jihlava, and Jirka Stryhal persuaded me to apply, saying that with my experience nobody stood a chance against me. But they had already chosen a local veteran. The hospital director then took me aside and said: "Doctor, please don't be offended, but you are simply too good for us. We don't need someone like you here." (laughs)
“Imagine you are a university professor with a forty-year career behind you as a surgeon and orthopaedic specialist, and suddenly you are standing in a square handing out leaflets. Then someone who knows you comes along and says: ,Professor, do you really need this?ʻ”
Miloš Janeček
So you headed back home to Brno, to build up orthopaedics at the Trauma Hospital...
That was Professor Michek's vision. He had also been politically involved in the past, so they wanted to get rid of him as well, which they eventually succeeded in doing, although he remained at the hospital as a professor of surgery. He had a clear vision for the development of the Trauma Hospital, and orthopaedics was part of it. However, the orthopaedic department itself was only established under the leadership of director Petr Zelníček.
You actually spent roughly half of your professional life at St Anne's and the other half at the Trauma Hospital. How would you compare your time at the two?
From a medical point of view, St Anne's was more varied, because the orthopaedics there was much broader and richer. The Trauma Hospital, by contrast, was more focused and goal-oriented. On top of that, after the revolution, technologies that we had never even dreamed of before suddenly started arriving. Suddenly we could attend seminars by Johnson & Johnson about hip replacements and things like that... And they even gave you a sandwich and a Coca-Cola at them! Today that must sound ridiculous to you, but before that I had only ever experienced anything like it abroad...
During socialism, did you have opportunities to go abroad for professional training?
Once Associate Professor Bozděch came to me and asked whether I would like to go on a one-month placement in Hamburg. They had invited him, but because of his age he no longer felt up to it, so he offered it to me instead. So I started up my Škoda 105 S – which my young daughter called Šedivka ("Little Grey One") because of its colour – and set off. In Hamburg they welcomed me warmly, arranged accommodation, provided me with clothes, and then told me where to park. The Germans had nothing but Mercedes cars there, and among them was my Šedivka, the little 105. (laughs) But they had – how should I put it? – a strong sense of social responsibility, and when they saw this "poor man" from Czechoslovakia, they not only invited me to dinners but, most importantly, gave me an incredible amount of professional attention. I had a similar experience during a placement in Vienna, where at the age of thirty-eight I literally arrived carrying a loaf of bread and a stick of salami under my arm. I remember one of the doctors coming up to me in the dining room and saying: "Doctor, this place isn't for you." I froze, wondering whose seat I had taken, and he continued: "Doctors sit over there; this is for the nursing staff." You have to understand, I was used to the works canteen in Brno, but I took my tray and moved a little further away, where it was exactly the same. (laughs) Experiences like that also helped me realise that professional life beyond the border was essentially the same as at home. People were the same, behaved the same way, and spoke to me as an equal partner. I was able to gain a great deal of professional knowledge. So although I lived in a student residence there, the expertise and contacts proved valuable over time.
How did the Communist Party approach these trips abroad?
It was involved in them in some way. And there would have had to be some seriously delusional person sitting there if they had thought that Janeček was going to stay in Vienna and leave behind his wife, two small children and a quarter of a house in Brno. Above all, Bozděch always vouched for me... By the way, Bozděch was an extraordinary enthusiast. He devoted everything to his work! He wanted a son so that he could have another orthopaedic surgeon in the family, but in the end he had a daughter who became a dentist... But I digress. The first time I went abroad like this was in 1979, to a clinic in Switzerland where we had acquaintances. Their son, who was the same age as me, had died, and they were convinced that I wanted to stay there. They had even started looking for a flat for me, but I didn't want to... When I think about it, 1979 was a decisive year for me. Everything could have changed, but I have never regretted my decision to stay in Czechoslovakia. My older brother emigrated with his family to Munich in 1986 and still lives there today. He is on his own now – his wife has died and his daughters have left home. Whenever he comes to visit me in Brno, he always says that he feels at home here, although he does not regret emigrating. He has not had a bad life, but he ended up alone in Munich. Whereas when I take my grandchildren down to Mendel Square, they already know where Grandpa went to school...
We have slightly moved away from your time at the Trauma Hospital, where you eventually became director...
I started at the Trauma Hospital as an orthopaedic surgeon, which was not easy because, whereas departments elsewhere were usually focused on "orthopaedics and musculoskeletal trauma", the Trauma Hospital had trauma surgeons who were expected to be able to treat you regardless of whether you had injured your head, chest, abdomen, limbs – anything. Which I could not do, because I had never worked in that way. I was skilled in limb trauma and, at the same time, I could handle more complex cases that some of my colleagues could not, so we were a kind of mixed team there. After Michek, Petr Zelníček became director, and for two or three years we had something of a professional debate, but always in a constructive way. He was a traditional surgeon, and I had to convince him that orthopaedics had a future. While trauma surgery was struggling, there was money in joint replacement surgery... In the end, I managed to push through the establishment of an orthopaedic department at the hospital, and Zelníček entrusted me with running it. This was at a time when there was a major boom in joint replacement surgery. Suddenly we were also able to travel more, and naturally I was drawn towards German-speaking countries again... And when you give a lecture in Berlin at the congress of the German Society for Orthopaedics and Trauma Surgery, and afterwards you can discuss it with their experts and defend your presentation, then at the age of forty-five or fifty you say to yourself: "Yes, it was worth it."
At that time you were also working towards your associate professorship, weren't you?
Yes. At that time, computer-assisted surgery was beginning to develop, and I was the first person in the country to take it up. Thanks to the support of companies such as Johnson & Johnson and B. Braun, we managed to equip the department very well and could start performing computer-assisted knee replacement procedures, which became the subject of my associate professorship thesis. And thanks to Professor Michek, eventually also my professorship. I was never particularly career-driven, but Michek had such determination and drive that he eventually persuaded me to go for a full professorship as well...
A significant part of your career, however, is connected not only with medicine but also with politics. What convinced you to join the Social Democratic Party in 2003?
I was not particularly keen on it, but then the Social Democrats started approaching my friends and recruiting them... Bohoušek Fišer (Bohumil Fišer, a graduate of the Faculty of Medicine at Masaryk University, where he worked at the Institute of Physiology. Between 2000 and 2002 he served as Minister of Health in Miloš Zeman's government – author's note.), Václav Grulich (Minister of the Interior in Miloš Zeman's government from 1998 to 2000 – author's note)... When I hear people today explaining why they went into politics, I just laugh... "Who else should be there if not you? You are educated, intelligent, you understand the issues, you can help healthcare!" When I think back on it now... They all meant well, of course, but I had no previous political experience. In the end I agreed. The Social Democratic Party corresponded with my way of thinking, I attended some meetings and so on, and then the so-called Orange Tsunami came, and they approached me with the idea that I should run for the Senate. I had no idea what I would do there...
Was your political activity in any way connected with the fact that you became director of the Trauma Hospital in 2005?
When Zelníček retired, I took part in the standard selection process at the Ministry of Health and won. Let us say I came into it from the position of professor and head of orthopaedics. I had some idea of how to run a hospital, but in my then fifty-plus years of wisdom – if you can call it that – I did not realise that above me there was a minister and other people who had different ideas and with whom I would have to communicate. Which I did not do, and so instructions began coming from above saying that the hospital should be run differently. Eventually this escalated to the point where the then Minister of Health, Tomáš Julínek, wanted to close the Trauma Hospital and move everything to Bohunice. Today I understand his position to some extent. In fact, if he had behaved normally at the time, rather than with the arrogance that was typical of him, I think we might have achieved something meaningful together. My vision was what the Trauma Hospital is today: an active municipal hospital focused on trauma care, not polytrauma.
Your medical vision collided with political reality...
That is one way of putting it. I knew how hospitals in Brno worked and what they did, but the politicians had a different idea, and the outcome was that Julínek removed me from the position of director. In the end, that actually led me into the Senate. Because the whole affair was covered in the media, I was well known in Brno, and the Social Democrats nominated me for the Senate. I won the election quite convincingly, although I was somewhat pushed into it by the people around me...
What do you mean?
Imagine you are a university professor with a forty-year career behind you as a surgeon and orthopaedic specialist, and suddenly you are standing in a square handing out leaflets. Then someone who knows you comes along and says: "Professor, do you really need this?" So I hesitated. At home, my wife and children were against it for the first time; perhaps they somehow sensed in advance how it would turn out... But I won. The Social Democrats were delighted, I became a senator, moved to Prague and was thrown into it...
What kind of change was it?
If you are susceptible to it, it can be dazzling. You get a diplomatic passport, a sign saying "Senate" for your car, so you can park practically anywhere... I admit that I once took advantage of it. My father-in-law called to say that he was not feeling well, and on the way to him I was driving a little faster than I should have. A young police officer stopped me, saw the sign and said: "You are a senator? I've never actually seen a real one before. Go on, then!" (laughs) But that was just a funny little episode.
What ambitions did you have when you entered the Senate?
I thought that, now that I was there, I should do something. But in the end, only small things could really be achieved... I became chairman of the health committee and supported legislation that made sense, but I was a member of the Social Democratic Party parliamentary group, and that meant the political line was already determined. That applies to all parties even today. Nowadays, I would vote for the Senate to be abolished altogether. For example, there would be a decision that a healthcare delegation was going to Vietnam. When I travelled to conferences from the clinic, we always reviewed them afterwards. We discussed what the point had been and what they had brought us, so it was clear that the trip had a purpose and was not simply an excursion. So naturally I would ask: what are we going to do in Vietnam? At the time, there was some former Czechoslovak hospital there, built back in the socialist era, and the Vietnamese wanted to revive it. So you fly to Vietnam, business class, you are driven around in a limousine, they take you everywhere, show you various things, you sign something, then you return home and discover that, in reality, you had simply been on a trip. Why? It had no real purpose. And so gradually I lost my drive. I had always been used to working in a way where there were tangible results left behind me.
Nevertheless, you did manage to save the Trauma Hospital. That is not insignificant, is it?
That is the main reason why I tell myself that I was not there for nothing. It became something of the leitmotif of my time in the Senate. Julínek had planned to transfer it to Bohunice by the end of 2008. In the end, this was prevented thanks to Michal Hašek, Jeroným Tejc, Roman Onderka and myself. I dealt with it as a newly elected senator at the time, and I think I can say that if I had not been present at those negotiations in Prague, the Trauma Hospital would not have survived. What would have happened afterwards, I do not know. Yes, I managed to help with smaller things as well, but this is the main thing that reassures me that, as a senator, I can perhaps have a clear conscience.
You eventually spent six years in the Senate, between 2008 and 2014. At that time, there were also other graduates of the Faculty of Medicine at Masaryk University among the senators, whether it was Tomáš Julínek himself or, like you, Jan Žaloudík for the Social Democrats. Later, Roman Kraus, who has since died, entered the Senate for the Civic Democrats. At the time of the events you describe, he was director of the university hospital in Bohunice...
Julínek and Kraus were contemporaries and close friends. Like me, they had both attended grammar school at Koněvka (Vídeňská Street). Of course I knew Roman as well. When I worked at St Anne's Clinic, for example, he spent about a year doing anaesthesia there. We were involved in joint operations, and at the time he was a great guy... I do not want to comment on it too much, because people say you should only speak well of the dead, but during the planned transfer of the Trauma Hospital our paths crossed quite brutally... It also became a case that dragged on for years afterwards, and his role was not a positive one for the Trauma Hospital.
What did you mean when you said that today you partly understand Minister Julínek's intentions at the time?
I understand that the Trauma Hospital was, in its day, a trauma centre even for the most serious injuries, but time showed that it did not have the necessary facilities and infrastructure for that role. However, there was no reason to abolish it completely. It could have continued dealing with ordinary injuries, while more complex cases could have been handled in Bohunice. The Ministry did not want to understand that, and presented it as though they wanted to close the hospital entirely, which was what we opposed. And today my vision has long since come true. The trauma centre is located at Brno University Hospital in Bohunice, and the Trauma Hospital continues to operate as a modern municipal hospital.
“Medicine has never betrayed me in my life. Never. Whenever I felt miserable or had some problems, work was able to absorb me so completely that I forgot everything else around me.”
Miloš Janeček
After you were removed from the position of director of the Trauma Hospital, you continued as a doctor and head of the Department of Traumatology, didn't you?
Yes, after Peter Wendsche. Although there were again pressures from Bohunice, where the trauma surgery clinic is located, and they wanted us to close down. But Jan Žaloudík, who was dean of the faculty at the time, understood that it was in the faculty's interest to maintain both clinics. So I won the selection process, and it just happened that I remained head of the clinic until I was sixty-five. Towards the end, the director was Karel Doležal, who was also a member of the Social Democratic Party. But once again, envy, backstabbing and intrigues entered the picture, and I had had enough. A friend became an enemy, I left the Social Democratic Party and ended my time at the Trauma Hospital. Everything is about people, which was also demonstrated by the later development of the Social Democratic Party and its gradual decline... I was already of retirement age and thought I would see whether anything else came along or not. Eventually, I received an offer from Boskovice, and given my mother's origins, I accepted it as a kind of historical challenge. I became the managing director of Boskovice Hospital. I had a clear vision. I presented what needed to be done and where the hospital should be heading, so that the petty disputes between Blansko and Boskovice could finally stop. But once again, politics got involved. Patients, doctors and nurses suddenly moved into the background because one politician wanted one thing and another wanted something else. Then elections came, a new party took control of the town leadership, and that was the end of it... By the time I was approaching seventy, I had had enough. Today I only travel once a week to work in an outpatient clinic run by my friend Ivo Okáč. But Boskovice still bothers me, because given its location, size and possibilities, the hospital is ideally placed to be a high-quality facility.
People say that being a politician is a diagnosis. Did your political involvement leave you disillusioned?
No, I would not put it that way... People also say that if you want to live with wolves, you have to howl with them, and I think that is absolutely true in politics. You have to be prepared for that. You are a member of a certain bloc that is trying to achieve something, and you cannot stand against it even if you have the most brilliant idea in the world. The collective will not allow you to step outside the line. And if you do, it spits you out. In the best-case scenario, you leave without shame. In the worst case, you leave with shame attached to you... However, I do not agree with the claim that politics itself is dirty. Only the people who practise it can be dirty. Everyone invokes the good of the nation, freedom, democracy and equality, but when you look at reality, it often appears completely different.
Was medicine a kind of support for you during your political years?
I do not want this to sound exaggerated, but medicine has never betrayed me in my life. Never. Whenever I felt miserable or had some problems, work was able to absorb me so completely that I forgot everything else around me. My wife was also a great lifelong support. She was a nurse and an operating theatre instrument nurse. She understood me, and even when she did not always agree with me, she always helped.
Does anyone among your descendants continue your medical legacy?
Yes. My daughter is a doctor; she works in rehabilitation in Blansko. My son is an engineer – an economist and manager – and he also works part-time for the Brno emergency service as a paramedic. I think that as Janeček III – a third-generation orthopaedic surgeon – he would have been good, but during the crucial period when he would have needed to knuckle down at school, he simply did not have it in him to sit down and study. I always told him that if he was interested, medicine required hours of sitting and learning. Anatomy is a thousand years old, and in those thousand years nothing about it has changed; you simply have to learn it. Today he sometimes regrets that he did not put more into it, but paramedics are needed too. I also have grandchildren – the youngest, Jakub, is two and a half years old, so perhaps the succession will happen in another generation. But by then I will be watching it all from a little cloud in the orthopaedic heaven.
Dr. Miloš Růžička spent the first half of his professional career at the First Surgical Clinic in Brno, but after the revolution he fell under the spell of the Middle East. Temporary stays for professional reasons eventually turned into a fourteen-year period of his life.
Dr. Karel Belcredi is a representative of the seventh generation of an originally Italian noble family settled in Moravia. Not the first to study medicine, but the first to actually finish the studies. However a noble origin, did not ensure living in a castle or any other privileges under the communist regime. On the contrary.
