A Matter of Life and Death. Sue Armstrong
‘I don’t think you should come.’ And we said, ‘What d’you mean? Of course we’ll come – all the family! Nanny and all her family too.’ We were in the front row, and the story was about a disturbed child, who is disturbed because his parents are academics and flying all over the place, and he commits suicide in the middle of the stage because his parents forgot his birthday. We never forgot his birthday! We said, ‘We’re going to get out every single photo album with pictures of him blowing out candles at his birthday.’ And then we couldn’t find the damn albums. [we both laugh]
It’s hard dealing with teenagers. I could have killed them all. [laughs] They’re lovely now, absolutely wonderful.
And what about your Argentinian family? You say your grandparents came from Eastern Europe – under what circumstances?
You know, a lot of people emigrated at the turn of the century from Russia and Poland and places. I think it was just chance where they ended up. We grew up thinking of ourselves as completely Argentinian. But now we have been here much longer than we were in Argentina and the children are more English than Argentinian.
My family were lovely middle-class types. A very friendly, Jewish family. My mother was very intellectual; my father was a lawyer and then a judge. They were never practising Jews, so I don’t know when our Jewish faith stopped meaning anything. We know it as our roots, that’s all. My husband comes from a very similar background, but not wealthy at all. His father had a great intellect.
And how did your families fare during the dictatorships?
It was very hard. Daniel’s brother, my brother-in-law, is one of the ‘disappeared’. It was the mid-1970s. He was taken away in front of his father. They said, ‘If he has done nothing he will come back.’ He had done nothing, but he never came back. They most probably threw him in the Atlantic, and they never recovered the body. I think when he was taken away it virtually killed his father – he died some years later, but I think he died of a broken heart.
Culturally, as Latin Americans, how did you find working with people here?
Everything is so civilised here, and the culture… I mean we’re spoilt here; it’s amazing.
Finally, Dame Julia, what specifically are you working on at the moment?
Right, the biggest challenge at the moment … There is lots of research being done all over the place on cultured cells two-dimensionally in a Petri dish. But we are three-dimensional beings, so therefore we need to learn how we can culture in three dimensions – because the cells talk to each other, and talk to the surrounding tissue.
This is another area where we have strong collaboration with engineers, because we need to grow the cells in what is called a ‘bioreactor’. The best example of a bioreactor is the womb. The development of the baby in the womb is controlled by all these natural signals in the three-dimensional environment. We need to grow the cells in this kind of way, and people can’t do that at the moment, so that’s what the challenge is. Not mine alone, but for everyone working in this field.
As far as you’re concerned, is this the future?
I think regenerative medicine – in my unbiased opinion – will rewrite the books of medicine. Of course! I mean, that’s where we should be going.
‘CHILDREN ARE NOT JUST LITTLE ADULTS’
Miguel Reyes-Múgica
Chief of Pathology and Head of Laboratories, Children’s Hospital, Pittsburgh; Professor of Pathology and Marjory K. Harmer Chair in Pediatric Pathology, University of Pittsburgh
Miguel Reyes-Múgica grew up in relative privilege in a small town in Mexico, where both his parents were doctors. As a child he would accompany his father on visits to patients in rich and poor homes, and his experiences kindled in him a strong social conscience and a desire to follow in his parents’ footsteps. At medical school in Mexico City he fell under the spell of Dr Ruy Pérez-Tamayo, one of Latin America’s leading intellectuals. ‘He was professor of pathology, and when I took that course in my second year I immediately knew I was going to be a pathologist. I wanted to be just like him in many respects,’ he says.
Another big influence on his career was the earthquake of 1985 that levelled much of Mexico City and killed many of his colleagues. When the general hospital where he was about to start work was threatened with demolition, he went instead to the National Institute of Pediatrics, one of the largest and busiest paediatric hospitals in Latin America. It was a time when paediatric pathology was gaining recognition as a vital specialisation in its own right.
Reyes-Múgica went to the United States in 1990 for a year’s research, but for personal reasons never returned to work in Mexico. He went to Yale in 1994, where, as director of the programme in paediatric and developmental pathology, his personal focus was childhood tumours and melanocytic lesions (giant pigmented birthmarks with a potential to turn malignant) in children, the latter sparked by an extraordinary case he had seen in a baby in Mexico.
I was very close to my parents, and particularly to my father. He was more of a friend than a parent at times. He was a well-read man and, although not very religious, we would speak about life and death, and he helped me to discover my own path in medicine. At that time there were no structured programmes of specialisation in Mexico, so he was a generalist, but a very knowledgeable generalist who would take on any kind of case. My mother was more surgically oriented, so they complemented each other. Her hospital was at San Cristóbal de las Casas in Chiapas, where the Zapatista Revolution started in 1990. I grew up mostly in that small town, although I was born in Mexico City.
What sort of social environment was it?
There are many indigenous people there, and the relationship between the more Spanish-looking people and the indigenous natives has never been easy. But my mother and father would see patients from all strata, from the well-off to the very poor people – frequently, you know, payments were in the form of a chicken, a bag of eggs, fruits or things like that. My father labelled me a communist when I was about 11! I guess I developed a little social conscience when I saw the differences in the standards of living.
I was expelled from my high school for rebelling when I was 15, and my father put me to work with his parents, who ran some butcheries in the local market. I used to go with my grandfather to buy cattle, and we would slaughter them, and then we would do a complete post-mortem. So my first contact with cutting and looking at flesh really was there.
You say ‘post-mortem’, but, I mean, butchery is a lot different, surely?
Oh, a post-mortem in a human, an ‘autopsy’, is absolutely different from butchery. But it was an animal: it was muscle, it was viscera, it was handling a knife, it was knowing the different types of tissues from a macroscopic, naked eye, perspective, and recognising when something is not how you expect it to be. I recognise that experience as a very important influence on my personal development in pathology, and I can tell you that when I cut an organ, not only in autopsy but also in surgical pathology – which, by the way, is what we do most of the time; we are not ‘death doctors’ – the residents usually express surprise at the way I handle the knife.
And then you tell them, ‘Well, I learnt on cattle’!
Yes, exactly. Even though I am a paediatric pathologist and usually handle smaller organs, I use a longer knife, and I can cut very thin slices without injuring myself. I am a very neat pathologist.
So how did you not end up becoming a master butcher?!
Well, I had to go back to school. So my father and I made a deal and I went to a military school in Mexico City, where I spent a year fighting my way out of little troubles every day. After a year I left and went