The TSS first visited Greece in 1969, staying in Athens to see the large and somewhat decrepit Evangelismos Hospital, with its three levels of patients and tri-partite surgical department, the main University Hospital, the Hippokrateion, with 600 students under the lively and revered figure of Professor Alivisatos, the Red Cross Hospital (said to be due for replacement), and the 400 bedded Greek Anti-Cancer Institute, founded in 1931, which had been badly damaged during the German Occupation. There was magnificent sightseeing, supervised by a genial Greek responding to the name of George.
A second visit was well in hand in 1992 when it had to be cancelled because British hospitals were put on stand-by to receive casualties from the impending conflict in Iraq following Saddam Hussein’s invasion of Kuwait. In the event casualties were few, there was no bacteriological warfare, and all was over by the due date of our cancelled visit.
The society’s actual second visit to Greece was in May 2008, the party of 38 staying at the Electra Palace Hotel in Athens and holding meetings in that city at the Hippocratio (aka Hippokrateion or Ippacratio), Laikon and Attico Hospitals, the latter having recently been opened in the suburbs. A good effort was made to meet and entertain us, and sessions of joint papers were held at each hospital. Especially memorable was the pioneering work on hearing, tympanometry, and Meniere’s disease at the Hippokrateion. Terry Irwin‘s talk on radiation enteritis and Paul Blair’s on endovascular stenting of aneurysms were amongst the few presentations giving outcome data on patients.
The Attico hepato-biliary unit had experience of pancreatic cystic disease and its neoplasms, and there was an interesting overview of surgical training as well as two case reports, in excellent English from medical students. Indeed, training was a key subject for both ourselves and our hosts, with mutual concern at the impact of the European Working Time Directive.
At the Laikon Hospital our well-structured programme included a detailed review of robotics in general surgery covering the da Vinci device especially and touching on the Lindbergh telesurgical laparoscopic cholecystectomy in 2001 (performed in Strasbourg by a surgeon in New York but limited by the high expense of the necessary bandwidth), delivered in perfect English with excellent slides, as were the talks on urology for general surgeons (and medical students) given by our host and our own Peter Guy, not to mention Graham Sunderland’s talk on his experiences with the Territorial Army in Iraq.
Most of the hosts’ presentations were overviews of how the service was or should be delivered (with combined medical/surgical clinics for gastro-intestinal disease, for instance) with relevant world literature. Our own Brian Ellis proposed more effective delivery of specialist services in the community.
We had an interesting tour of the Hippokrateion’s new Breast Unit by Professor George Zagrafos who proudly demonstrated his mammotome, stereotactic equipment and ultrasound, with an illuminating demonstration of a ductoscope (just purchased), all of which he was keen to promote through the local Press. There is no coordinated national screening service for any form of malignancy, and although regional facilities exist for mammography doctors rely on women to volunteer for this.
The visits to the operating theatres at the Hippokrateion (as cramped as in 1969), and the Laikon hospital (upgraded in 2004, the Olympic year) were interesting but rather laid back and the theatres appeared under-used yet at least one post-operative patient was unattended in the theatre corridor. Many surgeons in theatre gear carried their mobile phones in a pocket, accessed by Bluetooth lapel microphones. Most of the anaesthetists were female.
It was gratifying to see the large number of medical students and staff who attended the mutual paper sessions, and the obvious pleasure at our visit expressed by our hosts (who took us to represent the Royal College of Surgeons, perhaps not inappropriately as we lay claim to two Vice-Presidents-in-waiting: Bill Thomas and Linda de Cossart).
Healthcare in Greece is said to carry more private funding than any other country, and nearly half the population has health insurance. The pay is poor for State doctors of whom only University Professors can do private practice in state hospitals under the Greek health service (EYS) which imposes cumbersome restrictions: for instance, there is no tariff for day surgery, so hernia patients have to stay overnight if the hospital is to be remunerated whereas in the many private hospitals overheads are said to be kept to a minimum. A single hernia operation might give a private doctor the equivalent of a week’s salary for a state employed surgeon. Although smoking was widespread and apparently unconfined – even (or especially!) in restaurants in sharp contrast to the restrictions in the UK – the life span of Greek men and women is longer than that of the British!
The days on this 2008 visit were full and we took in the major historic sites (Sounion, Myceneum, Delphi, Corinth and its canal, and a boat trip to Aegina on what turned into a miserably wet day) as well as having instructive tours of the National Archaeological Museum, Benaki Museum, and a coach circuit of the city centre with a guided tour of the Acropolis though sadly the new Acropolis museum was not open. We also had a reception and dinner as guests of the British Ambassador Simon Gass and his wife Marianne (a Middlesex-trained nurse) at the British Embassy (once the home of the early 20th century prime minister Eletherios Venezelos), a contact which proved useful when one of our number had her handbag stolen in the hotel dining room and needed an urgent replacement passport. Our TSS dinner was in the elegant Athens Yacht Club with its fabulous views towards Piraeus.
This visit was also notable because many of us used the recently-opened Terminal Five at Heathrow, with none of the difficulties (delays and lost baggage) encountered by less fortunate travellers in preceding weeks. Technology generally stood us in good stead, particularly in the hands of our newly-appointed Secretary Terry Irwin (our established web-master) whose detailed arrangements and information about the visit were readily available through the current website.
The header image on this page was painted by Mr William Shand, from the roof of our hotel in Athens.