
Chapter 02: Becoming a Doctor
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Description
Here Dr. Hortobagyi sketches his scientific and medical education, beginning with the observation that he never thought of any other profession than medicine even as young person.
Dr. Hortobagyi observes that his mother wanted to be a doctor but couldn’t because of limits on women’s choices at the time. She had an impact on his own choice of profession because she gave him books on science and medicine when he was young.
Dr. Hortobagyi then notes that he had very good science teachers in middle school and, under the Colombian educational system, had made a commitment to his profession by his senior year in high school. He talks about his medical education at the Universidad Nacional de Colombia, Bogota (M.D. conferred in 1970). The Colombian system gave Dr. Hortobagyi an accelerated medical education. By the time he was a college freshman, he had the equivalent of a clerkship at the University hospital –the only charity hospital in the city and the only one with a real emergency room. It was a very busy hospital, and during his clerkship in ob/gyn, the delivery room sometimes handled a hundred babies a day. (At times there were two women in a bed.) By the time he received his M.D., Dr. Hortobagyi had delivered 80-110 babies. Dr. Hortobagyi also explains that surgery attracted him and that he has a “type A” personality, which is perfect for a surgeon. He describes his emergency room rotations: 24 hours on, 12 hours off for ten weeks, a system that gave very intensive hands-on training.
Identifier
HortobagyiGN_01_20121130_C02
Publication Date
11-30-2012
Publisher
The Making Cancer History® Voices Oral History Collection, The University of Texas MD Anderson Cancer Center
City
Houston, Texas
Interview Session
Gabriel Hortobagyi, MD, Oral History Interview, November 30, 2012
Topics Covered
The Interview Subject's Story - Educational PathCharacter, Values, Beliefs, Talents Personal Background Professional Path Inspirations to Practice Science/Medicine Influences from People and Life Experiences Professional Values, Ethics, Purpose Professional Practice The Professional at Work Formative Experiences
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.
Disciplines
History of Science, Technology, and Medicine | Oncology | Oral History
Transcript
Tacey Ann Rosolowski, PhD:
And tell me how you became interested in the sciences and in medicine in particular. When did you know that you were going to focus in that area?
Gabriel Hortobagyi, MD:
I never knew otherwise.
Tacey Ann Rosolowski, PhD:
How did that happen?
Gabriel Hortobagyi, MD:
In retrospect—and I think this is just my hypothesis. Whether it’s true or not I don’t know. My mother’s father was a judge in Hungary, so it was sort of the equivalent of a federal judge in the eastern part of Hungary. And my mother grew up as an only child, and she wanted to be a doctor. But you know, in the 1920s that was not fashionable nor considered proper. So she was rapidly either dissuaded or forbidden to do that. But I think she never really gave up on it.
Tacey Ann Rosolowski, PhD:
What made you think that?
Gabriel Hortobagyi, MD:
Because from very early on I kept on being given books about science, about scientists, about medicine. While I was still in middle school, I was reading about scientific discoveries and medical stories and archeology and biology and physics and that stuff. And that’s not the usual stuff that mothers give children unless they themselves, I think, have an interest in it. Now as it is, I was and am an avid reader, so I read a lot. And I sort of took it for granted that that was the only thing that would be of interest to me. So, by the time we were in high school, everybody in my class knew that I was going to medical school.
Tacey Ann Rosolowski, PhD:
What were the areas in which you felt you particularly excelled at that time?
Gabriel Hortobagyi, MD:
I was a pretty good student. I was a pretty good student, and I was very fortunate because in my high school we had very good teachers in sciences. So, biology, chemistry, physics were very strong. And so, in Colombia the system is a little different. College and medical school are not separate. You sort of commit very early on, so by the time you are in your senior year in high school you have to commit. You either go to medical school or you become a lawyer or an architect or—I don’t know—a mechanic or street sweeper or something. So, I knew I was going to be a doctor. I applied to one single medical school. I got in at the top of my class, and I never thought of it as being—I saw my daughters many years later agonize about what they wanted to do, and they weren’t sure. And even in the middle of college they were still not sure what they wanted to do. That never happened to me. I never understood that. In all fairness to them, I had far fewer options than they did. When I was finishing high school, if you wanted a professional career—well, what were your options? You became a physician or a dentist or an engineer or a lawyer or an architect. That was it. When I accompanied my oldest daughter for her college interviews about ten to twelve years ago, I remember going to UT in Austin and sitting down with the counselor—who was wonderful by the way—but she presented us with about 1000 different options that my daughter could focus on, and that was mind-boggling. Of course, it was mind-boggling for my daughter because she was expecting some guidance, and what she got was the smorgasbord of you are in the candy store. You just pick what candy you like. So, for me it was much easier. It was much easier, and I never gave it a second thought. I was very happy, and I’m still very happy. I wouldn’t do it any other way if I had the opportunity again.
Tacey Ann Rosolowski, PhD:
So you received your BS—and I want to make sure I say this right—the Colegio Helvetia?
Gabriel Hortobagyi, MD:
So that’s a—that’s the K through twelve school.
Tacey Ann Rosolowski, PhD:
Oh, okay. So that’s actually our equivalent of elementary, junior high, and high school.
Gabriel Hortobagyi, MD:
Correct.
Tacey Ann Rosolowski, PhD:
And that was 1963 you finished that program.
Gabriel Hortobagyi, MD:
That’s correct.
Tacey Ann Rosolowski, PhD:
And then you went to the National University of Colombia in Bogota, receiving your MD in 1970.
Gabriel Hortobagyi, MD:
That’s correct.
Tacey Ann Rosolowski, PhD:
And did you have a sense of your specialization during that time in medical school?
Gabriel Hortobagyi, MD:
So that—that was less straightforward. That medical school at the time I attended it was the number one medical school in Colombia. And the University Hospital happened to be the only charity hospital in Bogota. It was a huge complex of about 3000 beds, and it was the place where if you were run over by a car or stabbed or shot or poisoned or whatever, you ended up in that emergency room because it was the only real emergency room in the city. At that time the city was small. It was about two million people. But as you can imagine—serving a city of two million people where the majority of the people were poor or lower middle class in terms of socioeconomic status—it was incredibly busy. So, your medical education was accelerated simply because of the volume and because there were never enough hands to do everything. So what would be the equivalent of the clerkships—the clinical clerkships in the US—we actually started informally very early on. So, when I was a first year medical student, which would be the equivalent of first year in college when most kids here take English and—
Tacey Ann Rosolowski, PhD:
Basic bio.
Gabriel Hortobagyi, MD:
—basic bio and stuff like that, I would go to class. And then in the evenings, some friends and I would head down to the emergency room to the University Hospital where the residents and interns were absolutely delighted to see us. And they would tell us, “Who do you want to suture?” And we would spend three- or four-hours stitching people up who had a broken scalp or whatever and doing the menial job that in the US you don’t get to do until you are an intern.
Tacey Ann Rosolowski, PhD:
Right.
Gabriel Hortobagyi, MD:
When we got to our clinical clerkship in OB/GYN, the OB/GYN component of our hospital was a separate building where about 180 deliveries took place every day. You were only admitted if you reached a certain level of dilatation, so many of the little kids were born in the taxi at the entrance because there was no room. Many days there were two women per bed. So, the medical student did many of the deliveries because the nurses—the nurse midwives and the interns and residents only did the more complicated stuff, so we got to do a lot of the deliveries. So, by the time I finished medical school and before my internship I had probably delivered—I don’t know—eighty, 100 kids—all uncomplicated deliveries and whatnot.
Tacey Ann Rosolowski, PhD:
Is that when your interest in treating women began to take shape?
Gabriel Hortobagyi, MD:
No, not really. Not really. And in fact, with the exception of those who dedicate their lives to OB/GYN, most other physicians will tell you that that is not one of the most attractive specialties. But what did attract my attention during my training was surgery. I had outstanding surgical teachers, and they were not only extremely good technically, but they were very bright physicians. They knew their science. They knew their biology. So, they approached it not from the point of view of, “Gee, let’s do one more surgery,” but “How can we take care of this problem and what is the best way? And if it comes to surgery, yes, we will do that.” But that was not the major focus for them. So, I loved that. I loved the rapid pace of that. At any one point in time, we had five surgical—ten surgical teams. And at any one point in time two surgical teams were on call, and they were busy. They were busy. Surgery went on twenty-four/seven. And as a medical student and as an intern and as a resident, you got to do a lot.
Tacey Ann Rosolowski, PhD:
And it is interesting because it sounds like you were developing the hand skills for surgery pretty early.
Gabriel Hortobagyi, MD:
Yes.
Tacey Ann Rosolowski, PhD:
And then were also working in this really vibrant intellectual environment where people were kind of taking a more global perspective on it. Was that also an interdisciplinarity where there are different treatments that were being applied by the individuals involved?
Gabriel Hortobagyi, MD:
No. We are talking about the 1960s. It was a pretty classical—pretty old-fashioned medical education in that sense. But I did get a lot of steering towards surgery both because of my own interests—I’ve always had sort of a Type A personality. I take charge of stuff, and that is sort of ideal for a surgeon. So, I did that, and then I did my internship and my one year of rotating internship in that same hospital.
Tacey Ann Rosolowski, PhD:
So that’s the hospital San Juan de Dios.
Gabriel Hortobagyi, MD:
San Juan de Dios.
Tacey Ann Rosolowski, PhD:
Yeah.
Gabriel Hortobagyi, MD:
Exactly. That was—during that year I did not go home. Someone from my home would stop by once a week to pick up my laundry and bring me some goodies, but the rest of the time I spent there.
Tacey Ann Rosolowski, PhD:
Would you like me to pause the recorder while you take—
Gabriel Hortobagyi, MD:
No. Thank you. And it was because we were so busy and our—
Tacey Ann Rosolowski, PhD:
So you basically—from 1969 to 1970 you never went home.
Gabriel Hortobagyi, MD:
Right. Now my family lived in the same city, but it was a number of blocks away. And so for instance—so we had five rotations each for about ten weeks. The emergency room rotation sticks out in my mind because we were on call—meaning in the emergency room—twenty-four hours, and then we were given twelve hours off, and then the next twenty-four hours on, then the next twelve hours off. If you think through that, it means that your sleep cycle is totally screwed up for ten weeks because one day you get to sleep during the day, and one day you get to sleep at night. One day you get to sleep during the day—if you get to sleep, because very often after finishing your call you still had other things to do. So, it was very intense hands-on training. Now in the internal medicine rotation, we were assigned probably twenty, twenty-five patients in an open ward. And you were it. You had to take care of those people. Now the residents who were above you supervised and helped, but they also had other obligations like that, so it was very busy. So, you didn’t go dating or you didn’t go to the movies, or you didn’t go out dancing or drinking or—you know, none of the stuff that twenty-some-year-olds do normally. But it gave a very good foundation to be a physician.
Recommended Citation
Hortobagyi, Gabriel N. MD and Rosolowski, Tacey A. PhD, "Chapter 02: Becoming a Doctor" (2012). Interview Chapters. 1107.
https://openworks.mdanderson.org/mchv_interviewchapters/1107
Conditions Governing Access
Open
