For the sixth episode, we are honored to invite Prof. Jürgen Behr, the Chair and Director of Department of Medicine V (Respiratory Medicine), University Hospital Munich, Medical faculty – LMU, to our program of The World’s Great Doctors. In the interview, Prof. Behr kindly gave advice to those who would like to specialize in respiratory medicine and shared his insights in Covid-19.
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1. Why did you decide to pursue a career in medicine and why, in particular, did you decide to specialize in Respiratory Medicine?
When I started to ask myself what I would do as a profession during my life, I really had the impact and my wish to help other people irrespective of their race, their gender, their religion. This was a motivation that really brought me to medicine.Later on, when I already had more insight into medicine, I also was fascinated by the biology and all the mechanisms that are behind this human body, which is of so many complexity that I was curious to learn and to understand what is going on and how we could really fight diseases. These were my my initial thoughts.
Later on, I already had the feeling that I had the talent to categorize and to dissect problems in medicine and to do a systematic scientific approach to that, which is also very fruitful and satisfying for me. This is the other part.
So I chose medicine for doing good things for other people and understanding biology, dissecting problems and doing scientific work on the other hand.
When I did my doctorate thesis, I came in touch with respiratory medicine and I also did some teaching for students about blood gas analysis. So I got into this by learning more and more about the lung. I finally thought it would be a good idea to specialize in respiratory medicine. Even more so as there were a lot of unsolved problems, and a wide spectrum of different diseases in this entity of respiratory medicine, which were very fascinating for me, like interstitial lung diseases and collagen vascular disease. The spectrum of respiratory medicine is so wide that I really thought that would be a very good thing to to get into that.
2. How did your youth influence your career?
Indeed, I come from a family which has no insight into medicine so far. The first who really got into human medicine was my brother, who is 5 years older than me. When he started his studies in human medicine, I was still at school. But I had the opportunity to see his books, looking into what he was learning. He was very fascinated by his studies, so I got introduced to this field and I felt that would be something I'm also happy with. So I decided to get into human medicine as well. It was a good decision as we both did a very good career in that. Quite different from me, he is a neurosurgeon very well known for the implantation of devices for patients with the loss of hearing and he is also a university professor in medicine.
3. Who have been you greatest influences? What have they taught you and how have they inspired you?
Indeed, there were several very important persons during my career.
The very first one was my doctor father. He was a physiologist and I did 4 years in his laboratory. He was a fascinating person because he had a very clear mind. He taught me how to dissect problems and to systematically look into what's going on. I think this was my very first and important contact with scientific work. This really fascinated me. He was a person who really inspired me to get into academic medicine.
And then during my clinical education, I also had clinical teachers who were very important for me in teaching me. That it is very important that the first thing you have to think of is to do things in favor of our patients. The patient always is the leading person in what we are doing. As physicians and doctors, we are really obliged to help our patients. This is the first, and only if this is done, then you can go for other works, like science and writing papers and all that. So it's really something I learned here and They also lived it. They really showed me that it is important to get in touch with the patients and to know what is need of and how we can help.
4. What is your proudest career achievement to date and why?
Obviously my proudest achievement is my current position as the Chair of Respiratory Medicine and full university professor at the Ludwig Maximilian University of Munich which is a renowned and world-leading university. I'm very happy to be here and to have the opportunity to contribute with my knowledge and my enthusiasm to also the success of this institution. I'm serving as a university professor also for my university and this is my attitude to it.
And on the other hand, I'm of course very proud to be part of this group of people. There are not so many people worldwide to have this kind of opportunity doing medicine and doing respiratory medicine on this level of scientific research.
5. What advice would you give to someone hoping to start a career in Pulmonology?
First of all, I would congratulate him., for this is a good choice.
Looking at respiratory medicine, it has so many facets like allergology, immune diseases, autoimmune diseases, infections, chronic diseases, but also oncology, and environmental induced diseases. There are so many aspects in internal medicine and also a big link to intensive care medicine, which is also very important. But also a link to, for example, cardiovascular disease like pulmonary hypertension and other diseases, which are very fascinating. And also we know there are a lot of rare diseases, in the lung diseases. There are more than eighty rare diseases are known. So There's a lot of to understand and to investigate and to learn. And therefore, I think doing respiratory medicine is really something very satisfactory.
So I first would congratulate, and second I would say you need to understand or ask yourself
what kind of career you are looking at. Is it more a clinical career? Is it more a scientific or an academic career? With this in mind, you should look for a team where you know there is really the expertise to get educated at the best level you can. And then you should try to join this team.
So first of all, congratulations. Second, ask yourself, what is your own goal? What would you like to do? You should try to find out what is your own goal. And then you should try to apply for a team. That is next to what you want to achieve.
This is how I would approach it today.
6. The COVID-19 pandemic is one of the biggest challenges facing modern healthcare. What impact do you see this having on the field of Respiratory Medicine?
I think the pandemic did show the world how important respiratory medicine is. It has a lot of impulses to scientific work in respiratory medicine and development of new treatments, new ways to fight all the respiratory failure in acute and chronic disease. It makes the world really aware of the lung as an important and life-necessary organ.
It's really something that's had and will have even more impact in the future, and show the world that it has to be more invested into understanding and how to treat the lung and the respiratory system.
As you may know, there was a long years when respiratory medicine was not so much funded as other fields in internal medicine, for example. So It's really important that now, as this pandemic showed, that this is a very important part, and for the future, maybe even more important, since other pandemics may arise. The respiratory system always is in contact with the surrounding air, so it's always in danger to get affected by also by poisons or by viruses or by smoke and so on. There's a lot of ways how the lungs can be injured. So I think it is very important to make the world aware that we have to take care of the air we are living in. This is also an important impulse.
We have to take this pandemic as a first sign that more has to happen, not only with regards to pandemic, but also with regards to our climate or surrounding air. This is also very important.
7. When will be the pandemic be over worldwide?
This is a good question. Currently, we are already facing the 4th wave in Germany. Today I went to the ward in the morning and the number of COVID patients doubled over the weekend. The number of patients in the ward is going up. And I think we still are within the pandemic and. It's not yet over.
Also, if you look into other countries where there's even less vaccination and less health care, these countries are even more would still within the pandemic.
So I think we will have to deal with the COVID-19 virus for the next years, I don't see that it's really completely over. I think we will manage to control it. But we probably will not overcome it in a sense that is away.
Therefore, I think it's very important to really get people vaccinated, which is still the golden way to overcome or to at least control the pandemic. And of course, improving our ways, how to treat the infection is also important. And I was also involved in a very early study regarding two drugs for early treatment of severe COVID-19 infection. And this is already now has been shown that is prolonging life and improving outcomes in this infection.
I think it's really you can do a lot, but we have to still face the effect that we are within the pandemic and it's not over yet.
8. What do you think of China's efforts against Covid-19?
Looking from outside, I also have impression that China is doing extremely good, even better than many other countries. And I think the reason why is that they are very stringent. They are following very close all the regulations that are post on the people. And this is quite different in the other countries where there are many people who don't take it so serious. I think this is something that's different in China. In this respect, China is doing better right now. So I think it's also an achievement of the statesmen and of the doctors who give the right advice to the statesmen.
9. The World Health Organization (WHO) lists four lung diseases among the top ten causes of death. What’s your opinion on this and how can international collaboration contribute to this issue?
I think that's very important Information.
The question is, why are lung diseases four of the world-leading causes of death? And I think the reason is we still have no remedy for these diseases. We can reduce symptoms, we can improve something, but indeed, we don't have a cure for most of the diseases.
And chronic lung diseases are one of the most severe diseases. And therefore, I think we have to really invest much more money and to get more funding for respiratory research trying to solve these problems and to find more effective treatments and if possible cures for chronic lung diseases.
Among those chronic lung diseases, COPD for example, there is a primary treatment that is not to smoke. So it's also important that the international community would try to ban tobacco. Of course, there is a lot of contradictory argument because this is also an economic question. Tobacco economics is very important. So we have to fight these different aspects. And I think if you want to get the numbers of lung diseases down like lung cancer and COPD but also interstitial lung diseases, which are partially induced by tobacco smoke. One of the really important things that we should try is to get an international ban on tobacco, which is not in sight right now, of course, but this is something I think would be necessary.
On the other hand, there must be more scientific work, more work at the universities and also more institutions. For example, in Germany, not every university has a department of respiratory medicine, which is of course not good because you don't have people who are educated and people who are doing scientific work in this field. And therefore, I think we also have to get more people doing respiratory medicine and being educated in this specialty.
So there's a lot of different aspects. We need young people who are doing respiratory medicine and who are doing also scientific work in this respect. We need policies regarding tobacco banning. We also need universities to get people educated.
It's a lot of different steps we have to go. The international community would be also very helpful if there would be more cooperation and if we could support each other in the international community as well.
10. You have been an active member of a number of leading organizations or societies in the field of respiratory; how has this helped to shape your career?
Well, I think it was very important. Indeed, having contact with international colleagues and in meantime, also friends all over the world is very important to get input and also to get feedback from what you're doing and to compare your results with other people.
I think this was very fruitful for both sides. And it is also a very good feeling to have people all over the world that are engaged in similar scientific work and in patient care, and you can exchange with them. And It's also important to learn about the different approaches in different countries, for example, and to really have a reflection of what you're doing, and what you could do better and learn from others is always a good idea. So you really should be open-minded and really also question your own approaches, and ask what you can do better.
This is something I learned from all my colleagues.
It's always reassuring and I'm also very proud to be within these societies and these groups of people who are very engaged in trying to solve problems and medical problems. This is something that's really also a big motivation to go on with all that work.
11. As a university professor and Chief and consultant at two renowned hospitals, how do you balance your professional life and personal life?
I have to say for many years and still, the balance between my professional life and my private life is way in favor of my professional life. I have working days of 13 to 14 hours. And as you can imagine, only a little time is left for my family and my wife.
Nonetheless, I think I have managed to really be present as a father and as a husband at home. My wife was very supportive, who had a lot of understanding for my obligations and for all my enthusiastic work as well. She also felt that my professional success also had a positive impact on our family. In the end, I think I'm managed to really be at present for my children as well as a father. I'm aware that the time I had for them, was probably not enough, but it was sufficient to be a figure for their or a person who is really responsible for that.
So I think we have a very good relationship within our family. Now that my children are already adults, and they are out of our family home already. But it's still a very good relationship and very close. I think, in the end, it worked out. But It was a high input for the professional life, and still (laugh).
12. What would you have been if you had not been a medical doctor?
A second option would have been to become a pilot. But I'm very happy that I was had the opportunity to become a medical doctor. I think it's better. But pilot would also be something I could have imagined.
13. What are your interests and hobbies outside medicine?
First of all, I spent most of my time with my family, with my wife. As you may know, Munich is very near to the Alps, the mountains. So we like to hike, to go into the nature, to enjoy nature, and to go into the mountains and have tours, also together with my children if they have time.
Besides that, as I said, I'm also a glider pilot so I also do gliding in the mountain, in the Alps, which is very nice with fascinating views. You don't have a motor, so you are really have to to use the wings and the aerodynamic, which is something also very fascinating.