In 2024, the Medical Chamber, as well as the Faculty of Medicine and the entire Masaryk University, will commemorate 105 years since its foundation. However, its existence has not been continuous, marked by the Second World War and political changes that caused the Association to be de facto non-existent between 1952 and 1989. An exception is the few months between November 1968 and January 1970, when a group of students attempted to revive the Association's activities at the Faculty. Among them was the then twenty-two-year-old Jiří Šustáček. The retired head of the surgical department of the hospital in Nové Město na Moravě celebrated his 80th birthday last February and, sitting in his armchair in his study, where he used to visit patients in the summer, he recalled in a sonorous voice that would not be lost even on the theatre stage, not only the years spent in the classrooms of the Brno Faculty of Medicine...
Doctor, you're the first Šustáček I've met. Can you tell me the origin of your unusual surname?
It is said that in the monastery in Žďár nad Sázavou, which was founded by the Cistercians in the thirteenth century and is one of the oldest in the country, there was once a monk who did not quite fulfill his monastic duties and ran after women. So they took away his kutna, threw him out of the monastery and sent him to Řečice to manage the granaries. And because he was so fond of women, they started calling him Šustáček, and so the Šustáček family was founded in the Highlands. Today, there are two hundred and seventy of us in the country, most of us in the Novoměstský region.
When were you born and how do you remember your childhood?
I was born in February 1944 and my father died when I was three months old. My mother was left on her own with my brother and me, and since there were no widow's pensions after the war, it was a hard life. There wasn't much in general. There was a point system in the stores, so for example, you could get ten blankets of candy per month per child in the grocery store - the clerk would cut off your points, and you still paid for them, of course. This was already in place during the Reich, during the Protectorate of Böhmen und Mähren... I went to the municipal school in my native Radešínská Svratka, where there was a two-class five-year school. Then I attended an eight-year school in Bobrová, after which I was admitted to the chemical industrial school in Brno, Vranovská, in Husovice. There I also graduated in sixty-two and went to work at Lachema Brno.
How did you make the turn from chemistry to medicine?
In Lachema I worked with a man named František Eichler, who had already studied medicine. But his father was a cloth merchant after the war and when nationalization came, he kept some of the substances at home. They found out, arrested him and threw František out of medicine. But he had a lot of books and textbooks that he used to bring and tell me about: "Justýn, you'd make a pretty good doctor!" Why he called me Justýne, I don't know, but I got into those books, and one day I ran from work to the faculty for an interview, and they took me.
Was it that easy?
Of course I had to prepare. I took about two weeks off to study. But in those days, there were admissions committees that interviewed candidates - and I see it as a step backwards that they don't do that anymore, because you can get to know the person better. That committee had about six members, and the first thing they asked me was why I wanted to study medicine. Then they tried biology, chemistry, physics...
What did you tell them?
That I think it is a meaningful vocation in which one can help one's fellow human beings in their time of need. I don't know what could be more useful... And I must mention that I was accepted without anyone in my family being a member of the Communist Party! I add this because I used to hear people say that they were not accepted because they went to church, but it was just that they couldn't afford it...
How do you remember your studies at the faculty? Your peers, whom I had the opportunity to talk to, mention Professor Žlábek, for example...
He was already retired when I was studying, but he was still coming among the students. Tyrolean hats were fashionable at the time, and I remember one day I burst into the autopsy room, looking for a friend, wearing this hat. Professor Žlábek was there and he asked me how dare I go to the autopsy room wearing a hat, if I had no respect for the dead! (smiles) He was a great humanist and a very rare person! I also remember Professor Jaromír Vašků, the head of the Department of Pathological Physiology. I took an exam with him in my third year, and because I had a background in chemistry, he offered me a position as an assistant. For the rest of my studies I was employed there for three years for 750 crowns a month, which was a lot of money then!
Professor Vashku was said to be very principled, resolute and strict...
Yes, as an examiner he was strict and demanding. He was also a scientist who did real science. He had a good colleague in Montreal, Canada, Professor (Hans Hugo) Bruno Selye, whom he used to visit, and they were scientific contacts! In Brno, for example, we did experiments with dogs, trying to replace the heart with an artificial heart. We even had a calf that lived for half a year with this artificial heart, so it worked. The attempt was to give artificial hearts to patients whose own hearts were failing to the extent that they would die. However, if they lasted six months with the artificial heart, they could get a donor for a real heart. It was a big project, and as a student, I was involved in the chemistry of it. By the way, Professor Vašků even had a crocodile in his basement - a caiman that he brought from South America...
Where did you go after graduation?
I was supposed to go to work at the Urology clinic in Brno with Professor (Karel) Uhlíř, but because I was still active in the 1960s, they didn't take me. So I went to New Town in Moravia to ask at the surgery, but they didn't take me there either...
By activities, do you mean your activities in the Association of Brno Medics, which you helped found in November 1968? Did you try to continue the tradition of the original Society of Czechoslovak Medics, which was dissolved in 1952?
In the 1960s, the Czechoslovak Youth Union (CSM) collapsed, legitimations were returned, and even my colleagues and I went on strike for three weeks in lecture halls. There we also agreed to found the Association of Brno Medics. I had an ID card with the number ten. And yes, we wanted to continue the tradition of the original association, but most of all we wanted to have our own organisation through which we could influence the events at the faculty and speak into the study process. To say, for example, what we would like to see in the lectures, or to speak up if we felt that some scripts were not sufficient. Because I don't remember anyone from CSM speaking up for us...
“For us, in the 1960s, it was mainly about the idea of freedom of the press, freedom of speech and freedom in general, so that, for example, in the schools cadres would not be given priority, but that educated and valuable people would take up positions.”
Jiří Šustáček
In these politically and socially tense times, did you have ambitions to influence, for example, the composition of the faculty?
We would not have dared to do that, there was a great respect for the teachers. I can't say one bad word about a single lecturer or the head of the clinic. They were real capacities. For example, the examination in ophthalmology with Professor (Jan) Vanýsek was a great experience for me... I can also remember Professor (Karel) Mazanc in histology... These were all personalities who, despite the onset of the communist regime, still had that pre-war academicism manifested in their education, behaviour and attitude to students. They remained the same. Now I can think of Professor (Octavian) Wagner, the head of the Institute of Medical Chemistry. Already as emeritus, he used to come to the faculty every day, take a walk, come to our laboratories to talk, and smoke partisan cigarettes... It was a completely different atmosphere and a different academic culture than today! For example, I can't imagine at all that in our time we would have studied two colleges, as some young people have today, when I hear that someone is studying law and, for example, a philosophy faculty... Every college should have such a level that the student devotes themselves fully to it! But let me not digress, as far as people are concerned, I really can't say a single unkind word about anyone. As I mentioned, no one in my family was a member of the Communist Party, yet I got somewhere and everyone was kind to me without me getting involved in any way. So my experience has been that history is guided by the ruling party of the moment, and it gets a little skewed by not telling it like it was. Sure, in the fifties the communists were hanging each other, but some things like free health care, no tuition or dorms at eighty crowns a month and a shilling card for thirty, lunch and dinner for 2.70... I think it was much better arranged for students than now...
Despite this, the Brno Medics' Association was opposed to the Soviet occupation, some of its members were later politically persecuted, and by January 1970 it had disappeared again. That doesn't sound entirely idyllic...
I remember that when the normalisation period came, there was a boy living in the dormitory who put together the Union of Socialist Youth and our association disappeared because it was dissolved. But by whom, I don't know. I guess the students got scared and started going to the Socialist Youth Union and the medical association was maybe seen as something hostile and it was abolished like many other things at that time. But I certainly don't see it as some kind of injustice or that somebody was taking revenge on us.
During the short period of its existence, the Association of Brno Medics reportedly also took the initiative to rename the university, which was then named after Jan Evangelista Purkyně, back to Masaryk University...
I don't remember. But Jan Evangelista Purkyně is our most famous scientist in the world, so I never felt this need for the university to be Masaryk University again, even though it was founded as such. And I don't know of any of the professors who had this need. In this connection, I remember one of my classmates, a certain Oleg Konopetsky, who joined us at the age of thirty-five, but originally he had started his studies much earlier, so he still had an index with the Masaryk University header. Purkyně, however, was someone before whom the whole nation should bow, and I think he was better known in the scientific world than Masaryk. There was no shame in going to a university bearing his name.
Were there any ideological camps among the students?
Well, sure, politics is always discussed, especially by guys. The changes initiated in the 1960s seemed very realistic and could have been implemented if it hadn't been for the intervention of the Warsaw Pact. After a lifetime of experience, I think that the ideals of the Prague Spring were more bearable for everyone than the philosophy of the ordinary revolution, the so-called Velvet Revolution. The main economist in the country at that time was Ota Šik, who then emigrated to England, but Professor (Václav) Klaus did not invite him back after the revolution as one of the best economists in the Czech Republic. Šik's economic philosophy was completely different - he wanted to privatize people into a certain amount of wealth, which, if it reached a level that threatened the power of the state, would be taxed so much that it would not grow any further. But we, as students, had slightly different ideals at the time - mainly freedom - and we didn't mix property into those ideals. For us, it was more about the idea of freedom of the press, freedom of speech and freedom in general, so that, for example, in the schools, cadres were not given priority, but that educated and valuable people took up positions.
“Surgery is a beautiful activity - from the doctor's point of view, less so from the patient's point of view.”
Jiří Šustáček
So how did you perceive the events of August 1968?
Very negatively, of course! We didn't do anything wrong, we just wanted a change that would be for the better in any case, because not only the communists would decide everything. We wanted decisions to be made by people who were educated and had an overview of the world. Our idea of revolution was not so much political or concerned with property, our revolution was a revolution for freedom.
But although you mentioned that you did not perceive any injustice or revenge, you admit that you did not get a place in urology after graduation precisely because of your activity in the association. How am I to understand that?
Well, yes... I was active, I was on the committee of the association... I wanted to do something surgical after my studies and Professor Uhlíř arranged for me to go to urology with Professor Vašků, although he had to tell me later that I would not be accepted... But he did not tell me the reason. So I went to Nové Město, at that time the director was a certain Mr. Jurnečka, but even here they did not take me, they said that they had no room, although they did accept some new people after me... So I had to go to the psychiatric hospital in Jihlava, or as it was called then, to the lunatic asylum. I was there for half a year, and although psychiatry is a beautiful field, I wasn't enjoying it. At that time I also completed the usual "round" and in the surgery I met the chief surgeon Juříček, who asked me if I would like to stay with him. That was my dream! Dr. Juříček was a member of the District Committee of the Communist Party of Czechoslovakia, but he was such a good and kind man that when I finally left for Nové Město, he told me that I could come back to him any time. And I have been doing surgery ever since!
In the end, you ended up in Nové Město na Moravě anyway...
It was a different time, the seventies. I had an old mother, so I wanted to be closer to her. I joined professor (Miroslav) Mann, who was also a graduate of the Brno Faculty of Medicine, after whom I became the chief, and I worked normally as one did then. Nowadays doctors go home after work, that didn't exist then. We went on duty on Friday morning and on Monday evening we went home, we slept in the hospital...
Since its foundation in the early 1940s, the Nové Město hospital was said to be one of the most modern in Moravia and in the 1970s it had a strong position in the field of science and research...
Professor Mann was instrumental in this. He built the ECHO, or Experimental Surgical Department, and a kennel with about fifteen dogs and did research - a state scientific task - on wound healing and pancreas transplantation. We were trying to operate just on dogs. For example, with the Knitting Research Institute in Brno, we developed artificial vascular prostheses, so-called microfiber prostheses. They made them, we sewed them on the dog, opened him up a year later, removed the prosthesis and put a new one on. That's how you learn vascular surgery. The research was really going on here! But after the revolution it was closed down because they came down on us from above, saying that it was a communist relic to do research somewhere in the district. But it could have been rented out and the hospital could have made a profit...
In the archives one can read that you had links all over the world, including the United States, the Soviet Union or Japan...
Yes, thanks to research on vascular prostheses and pancreas transplantation, because we developed the implantation of the pancreatic duct into the intestine, for which we invented a special suture... Those were good years! We were often at work late into the evening, without wage compensation, because we simply enjoyed it and the management of the District Institute of National Health supported us.
I've also read that doctors from African countries used to come here for internships...
Not from Africa, but I remember two doctors from Nicaragua, where there was a socialist revolution at the time. One of them even did my appendix and when he said goodbye, he gave me a big hat as a present and said: "That's what our soldier wears in the jungle." I still have it and I used to hunt with it as a hunter. (smiles)
When did you become chief here?
First day of 1991. First, in '89, my colleagues said I had to be director here, so I did it part-time for a year, and in November 1990 I auditioned for chief of surgery.
You didn't want to be director?
No, I didn't do medicine for that reason... I didn't find directorship very satisfying and it was impossible to combine it with being a surgeon anyway. You have to enjoy your work and if you want to be successful in your career or job or achieve something, you have to have a pull in your field.
What did you enjoy most about being a surgeon?
Internal medicine is practically just theory, you could say. But surgery is nice in that it's a combination of theory, which you have to know perfectly, but at the same time you work with your hands. And operating is a beautiful activity - from the doctor's point of view, less so from the patient's point of view. And I repeat, one must enjoy one's work. When I was a chief surgeon, it used to happen that we operated until nine o'clock in the evening. I didn't want anything extra for that as a chief, but I went to the director to plead for my colleagues and he told me to let them put the hours on their report as if they were on duty. And you know what? In the fifteen years I was chief, none of my colleagues wrote those extra hours down. Because they enjoyed it, we had a good team, and they liked the work.
Recalling the recent protests by doctors, I wonder to what extent such a thing is conceivable for today's young generation of doctors...
I wouldn't say very much... I don't mean to generalise, I myself hated it when someone used to say "The young ones of today", but times are different and money has been idealised a bit. That's why I don't recognize these big revolutions of doctors who, when a microphone is put to their mouths, don't start talking about their field, but immediately start talking like retired prostitutes about how bad they are and how poor they are. But I didn't do medicine to build three mansions and drive a Tesla. I know being a doctor is hard work and it's a sacrifice, but that's what I went into it with! I'm gonna have to work at night, because people get sick at night. Someone's not going to work nights? The Hippocratic Oath says nothing about that.
Surgery is physically demanding and requires some skill. Would you say that one must have a talent for it as well?
Yes, one should be a little - as they say - gifted by God. He must be skilled, a surgeon cannot do without skill. I have had colleagues who were not so skilful, so then as a boss I didn't let them operate so much or I assigned them only simpler operations. I was responsible for 165 people, because we didn't have urology or orthopaedics here, so we did everything as a team and we still did it to a high standard. And by having one chief and only one head nurse with me, we had perhaps the most cost-effective surgical operation in the country. Especially in the district, it's important when everybody can do a little bit of everything.
“I know being a doctor is hard work and that it's a sacrifice, but that's what I went into it with! I'm not doing medicine so I can build three mansions and drive a Tesla.”
Jiří Šustáček
You have won many awards throughout your career. Is there one that you value more than another, or is patient recognition your favorite?
It's true that a thank you from a patient is more than anything. That's a fact. But when you're recognized by society, it's also a great thing to be happy about. For example, I have been named an honorary member of the Czech Surgical Society, an honorary member of the Slovak Surgical Society, I have a medal from Professor Kukula, a medal from the University of Košice, there is more. But I don't say this to boast, for God's sake, others decided that...
Certainly, the interest in the Meeting of Czech and Slovak Surgeons, which you have been organising for many years, is a certain appreciation, isn't it?
Of course. Sometimes up to 450 surgeons from the Czech Republic and Slovakia have come. It is true that last year I was not so involved in the organisation and I am passing on the baton.
But you still go to work today...
Yes, until recently I went to work not every day, but regularly. But I don't operate big things anymore. I do minor surgeries like carpal tunnels, ingrown toenails, excision of lesions and other minor surgery. If a man feels up to it, let him work. You gain new experience every year, and even if I had been doing it for a thousand years, I'm sure I would have learned new things even then. But at the same time, one has to have some self-reflection and be able to admit that the physical - and maybe even the mental - stamina is not what it used to be. And you have to remember that every surgeon, every operation can have complications. I've never had a complaint against me in my entire life, so I wouldn't want to screw up something at the end of my career, only to have younger colleagues pointing at me and saying, "See him, old man, he screwed up because he's not supposed to do it anymore!"
Finally, let me ask you if any of your descendants have continued your legacy and are also involved in medicine...
One of my sons was killed in a car accident, and he was the president of the Bohemian Spotted Cattle Breeders Association. He won the Mendel Medal for breeding and was well known all over the world for his promotion of spotted cattle. His younger son is a trained teacher and he and his wife run a language school. He promised to at least give medical school a try, but always came back saying that somehow it didn't work out. I think he said that because he wanted to make me happy, but he didn't really want to study medicine. And I didn't force him. But my daughter is a doctor. She works in Nové Město in Moravia in the emergency room, she is certified in palliative medicine and pain medicine. She even graduated in Brno!
For 51 years, Dr. František Bárta cared for patients of the now defunct pulmonary sanatorium - later a hospital for the long-term ill - on Bucht Hill near Nové Město na Moravě, of which he was the director for two decades.
Despite her - from the point of view of the communist regime - "incorrect origin", Dr Jiřina Jedličková developed into a renowned hematologist at the Third Internal Medicine Clinic of the St.Anne's University Hospital and the regional surgeon for hematology, and later, in the 1990s, the head of the local blood bank.
