Dr. János Schuller

My mother was a renowned foreign trader, and my father was a Béla Balázs award-winning film director and cinematographer who made beautiful art films and developed technical inventions that allowed for special shots. The beauty of creation captivated me as a child, and I also felt that it would be a worthy task to continue my father’s work, but in the end, all that remained of this was my attraction to photography. I also got my deep love of music from him. I still remember how I looked up to him as a little child when he put the vinyl record on the player, and we sat down together to listen to classical masterpieces, mainly the works of Beethoven, Chopin and Wagner.

How did he get from this artistic family environment to a much more realistic medicine?

A very real situation, a common family tragedy, made me realize how vulnerable a person is. My father’s sister became seriously ill with cancer, and then, unfortunately, we lost her. As an eighth-grade boy, I thought I should dedicate my life to research. I seriously believed that I would discover a cure for cancer. Since I was a good student, my father decided that I should continue to the mathematics department of István High School, saying that a palm tree grows under a load. It was truly an excellent intellectual development, but I had to work hard for every palm leaf: Almost every student in the class was in the top five or six places in the regional mathematics competition in their district – in this team, I was no longer in the top group in mathematics. However, I eventually grew up to the task. I did manage to win the school physics competition, and I was very proud of that.

However, thanks to this, I think my path to university was quite straightforward…

That's true. I managed to achieve the maximum admission score of 20 at the time and was thus admitted to the Faculty of Medicine. The real struggle came only then, because logical thinking was no longer enough there. And memorization is not my world. The anatomy exam is still one of my nightmares, while I happily studied many other theoretical subjects. I remember: there was an anatomical diagram with 45 “spikes” marking the parts of a given organ, and at least 40 of them had to be known accurately. Well, I would have rather read the physiology book three times than memorize the anatomical formulas. In my life, I liked to be able to deduce things, which is why I felt close to research. Then, from the third year - with the appearance of clinical subjects - direct healing became increasingly important to me. My friends and I practically made it a competition to learn the textbooks of the subjects we considered most important from almost the first word to the last, in order to become better doctors. Such subjects were primarily physiology, pathophysiology, then pharmacology and internal medicine. During my university years, I thought a lot about what specialty to specialize in: I was torn between three specialties: surgery, internal medicine, and gynecology.

What motivated you to decide on internal medicine?

I felt that an internist had to know everything. Of course, I already knew that this profession consists of several smaller parts, but I was very excited by its complexity. Today, I know that it is impossible to “know everything,” since knowledge is expanding explosively, and it is impossible for someone to understand in depth the diseases of the heart, lungs, kidneys, gastrointestinal system, hormonal system, and hematopoietic system. Yet, it is the internist (and a good family doctor) who sets this as their goal the most. A good internist knows at least one or a few smaller areas very well, follows the medical literature, and strives to be at least well-versed in other specialties; he is the one who “looks at the patient as a whole” and integrates the various examination findings. In addition to the university, I regularly visited one of the internal medicine departments of Péterfy Hospital to study, where I received a lot from the older doctors, both professionally and personally. The head of the department, Dr. István Márton, was an honorary associate professor, previously an eminent colleague of the famous and renowned Professor Imre Magyar. He proclaimed: “With us, the patient comes first” – and this was indeed the case. I could also thank my enthusiasm there that although 70 of us applied for 5 internal medicine positions in Budapest at the time of my graduation, I was among the lucky ones. I worked at Uzsoki Hospital for 2 and a half years, also under an excellent department head, and then, after a position became vacant, I was able to return to Péterfy Hospital, to work with my paternal mentor. I admired his knowledge and the humility with which he addressed his patients.

You carried this spirit forward, but later sought new challenges in a new place...

That's right. After my mentor retired, two excellent chief physicians of the László Hospital, Dr. András Szalka and Dr. Gyula Prinz, approached me with a job offer. We had met them earlier, during our infectology internship before the internal medicine specialist exam. This was a huge change after caring for mostly elderly internal medicine patients. Not many doctors even know that modern infectology is not at all the same as treating classic infectious diseases. An incredibly colorful and fascinating world, which was still a particularly undeservedly neglected area of ​​internal medicine education at the time. This also meant that I had to build from the very basics, which was a truly serious challenge.

Did gastroenterology also become your interest here?

Not quite. I had already been eyeing it at Péterfy Hospital, and at the suggestion of my boss, I started learning gastrointestinal reflections from excellent masters, but I got my real opportunity at László Hospital. The main profile of our department was the treatment of liver diseases, so I delved into this under the guidance of my excellent boss, Dr. László Telegdy, chief physician, and in the process I really fell in love with hepatology.

This is a challenging field that is not about easy successes.

It is a challenging but also exciting field, in which enormous progress has occurred, especially in the last 15-20 years. For example, I had a patient who contracted one of the most common infections, hepatitis B, and unfortunately, by the time he came to me, he had all the complications of end-stage liver disease. Since the 1980s, new antiviral drugs have been available worldwide, primarily as a result of research into the cure for AIDS, and this patient - who almost died of cirrhosis of the liver - has been getting better year after year. As his condition required it, we used other, complementary treatments, until finally there were no complications, then we slowly stopped taking the drugs, and he was able to live in good physical condition for another 16 years, and in the end he did not die of liver disease. We really became deep human friends during this long time. It hurts that we lost him.

This story also shows that it is characteristic of the work of an internist to have a closer relationship with his patients. Does this require continuous spiritual care?

Is this really the case? An internist has many patients suffering from chronic diseases, whom he meets regularly from time to time. Hospital treatment also often takes longer. This is one of the beauties of our work, as a completely different quality of doctor-patient relationship can develop. This is particularly important to me. Of course, it is also true that because of this, I experience much more difficult moments when the patient's condition deteriorates or I lose him. I always keep in mind that I can establish the best cooperation with the patient, as this is the only way to be effective. If mutual sympathy and respect develop with the patient, it brings special joy to my work.

How big a challenge and difficulty was it that after a while he became the professional leader of his medical colleagues?

The appointment as head of department was another glove that I felt I had to take on. Of course, it was a difficult learning process. I had to realize that it is not enough for a head of department, a chief physician, to strive for high-level straw knowledge, it is not enough to set a human example. Boundaries need to be set, rigor is also needed – and I admit, these were not in my genes. …and I'm not proud of that. I would approach it differently today… However, I can look back on it with confidence, as I stood up to the hospital management much more firmly for the patients, nurses and doctors of the department. Meanwhile, the entire hospital was undergoing continuous reorganization, which made our operations significantly more difficult. Despite all this, during my 10 years as the department manager, I received many beautiful moments and confirmations from patients and relatives, when they expressed their appreciation for the work of the department. Finally, changes occurred in the hospital's organizational structure that were difficult for me to accept, which made me feel it was time to change. I complied with an old request and became a full-time doctor in a private healthcare institution.

Did you adapt to this easily?

I really like the transparency, constructivism and efficiency of private healthcare. It is not difficult to get used to this. As well as the fact that human energy is less scattered, I can devote more of my time to patients. However, in addition to outpatients, I very quickly started to miss hospital work and treating liver patients. I solved the latter by going to the Uzsoki Street Hospital once a week to order, where I not only deal with outpatient liver patients, but also participate as a consultant in solving the hepatological problems of patients in various departments. The current invitation from the Róbert Hospital is a real gift, since we are establishing internal medicine inpatient care with my management. Chief Physician Szakonyi contacted me a few years ago, but the real task has now come to me: to establish an inpatient department that is also constantly expanding in its profile.

This means an exciting but busy future. Do you have the techniques to recharge after a hard day?

My father's legacy, classical music, has remained an essential part of my life. I only pick up a camera when I'm on vacation and capturing family events, but I still feel happy when I can take pictures. My greatest relaxation is going on nature walks on the weekend. My wife is also a doctor, so we are similarly busy. Two of our three children have already left home, but big family conversations still mean a lot to us.