Of luck and inspiration

Many of you see Diego Gonzalez Rivas as a maverick pioneer in Minimally Invasive Thoracic Surgery, a masterful educator in operative technique, or simply the rock-star of Thoracic Surgery. I happen to know him as one of my best friends inside and outside the world of surgery. And I am luckier than you because I have seen some sides of this man that you may never see. Let me share just four of these sides of ‘xiao gan’ (little Gonzalez) with you.

Diligence

Diego did not become a superstar surgeon through luck or serendipity. He did it the old-fashioned way through lots of hard work. Many evenings in Shanghai, as other colleagues succumb to fatigue and even after the legions of his fans have left, Diego remains keen to operate more and gladly takes on cases when others can barely stand. Even between his many operations during the day, he does not rest. Immediately on coming out of the operating room, he is already editing videos or planning his next paper. And no matter how late he leaves work, he always turns up on time the next morning—eager for more work and more opportunities to improve himself. During the early days of developing Uniportal VATS, Diego and his team would even work long after hours in the animal lab, honing the skills which would later go on to benefit so many patients. This tireless drive to practise his art, and then practise some more, is not often seen by others, but it is one of the keys to his prolific success. Those who envy him should try spending a day in his shoes, and see if they don’t end up completely exhausted.

Never self-satisfied

It is easy for anyone achieving the success he has to be complacent, but Diego is never content to rest on his laurels. It was his relentless pursuit to find a better way to perform thoracic surgery that drove him around the world to learn from some of the greatest practitioners of VATS: McKenna, D’Amico, Walker, Rocco, and others. Not satisfied with conventional VATS, he went on to perfect Uniportal VATS. But even with that, he was not fulfilled. He pushed the envelope with complex sleeve resections using this technique, and today he remains keen to explore the possibilities of non-intubated surgery and subxiphoid VATS. These techniques may or may not succeed, but it takes surgical pioneers willing to try them to find out the answer. This seeking to always improve oneself is a fine example for all surgeons to follow, and great news for our patients of tomorrow.

Sensibility

Advocates of a new approach are often criticized as being reckless or acting like ‘cowboys’. Although some have viewed Diego in this way, this could hardly be further from the truth. Even though he is an avid adventurer and sportsman, when he realized that motorcycle racing could jeopardize his surgical career—he simply quit. When he realized that his health depended on it, he immediately went on a super-healthy diet, lost weight, and never put it back on—something the rest of us only think about but never do. Most astonishingly, when he embarked on these resolutions, he always kept himself committed and dedicated to the program, exercising a level of self-discipline most people can only marvel at. This sensible approach to life extends to his surgery. Despite his obvious enthusiasm for advanced VATS techniques, he has never failed to draw the line for himself and those he teaches on when to fall back on conventional approaches, on when to convert. He is unafraid to admit that even he needs to abandon the Uniportal approach on occasion, and cautions that what he demonstrates may not be suitable for everyone.

Generosity

On a recent trip to his hometown of A Coruna, I (or actually my airline) lost a couple of posters I was bringing to a major conference. In the midst of his own busy clinical schedule and his running of an amazing surgical workshop, he went far out of his way to personally help me get the posters reprinted—almost missing a very important meeting of his own to ensure his friend (me) got what was needed. Those posters that he ‘saved’ eventually won a major prize at the conference I was going to, and this would not have been possible without Diego’s selfless generosity with his time and effort. I am happy to say that Diego’s big-heartedness is not limited to his friends. While some artists may jealously keep their skills to themselves, Diego has enthusiastically broadcast his techniques to the world. Whether it is through his online videos, the countless training programs he organizes, or his personally proctoring colleagues in centres on every continent, he generously shares all his experience so that everyone has a chance to do exactly what he does. Why wouldn’t we all welcome Kasparov coaching us on how to play chess? Or Eddie Van Halen giving private lessons to budding rock guitarists? But how many stars like that would give up their own time to teach?

Diego’s diligence, never being self-satisfied, sensibility and generosity are often unfairly overshadowed by his technical wizardly and his (dare I say it) celebrity. But the sum total of these characteristics means one thing for me. They add up to him being an inspiration for fellow surgeons. I have often told him that if it were not for these qualities of his that inspired me forwards, I would have been quite content to perform 2- or 3-port VATS for the rest of my own career. Knowing him personally has spurred me to also do better and I credit him for making me Keep Calm and Think Uniportal all these years.

I shall remain luckier than most of you. But the fact that you are holding this book and are about to read it means that you will also have a chance to get closer to my dear brother Diego. In these collected papers of his, you will find his diligence, never being self-satisfied, sensibility and generosity shining through. You will learn about Uniportal VATS from the master. But more than that, I hope you will be as inspired as I am.

Acknowledgments

Funding: None.

Footnote

Provenance and Peer Review: This article was commissioned by the editorial office, Video-Assisted Thoracic Surgery. The article did not undergo external peer review.

Conflicts of Interest: The author has completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/vats.2016.08.10). The author has no conflicts of interest to declare.

This editorial is preface of the new book This is life: the journey of uniportal VATS.

Ethical Statement: The author is accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.