- a conversation with Dr. Gergő Józsa, Head of the Paediatric Traumatology Unit of the Department of Paediatrics
“Anyone who deals with children all day long remains a bit of a child himself deep down,” says paediatric traumatologist Dr. Gergő Józsa, who, along with his colleagues, receives children with accidental and burn injuries from all over South Transdanubia. We talked to the head of the Paediatric Traumatology Unit of the Department of Paediatrics in Pécs about child-friendly care, the development of paediatric traumatology, and team-building activities.
Written by Miklós Stemler
Dr. Gergő Józsa has had quite an adventurous path, playing football at the national team level as an adolescent, training to become a veterinarian in high school, and becoming a paediatric traumatologist. But the different career paths are linked by the determination and willpower that helped him reach the national team as a child, work alongside his veterinary godfather as a high school student, and now he is doing his utmost to promote child-friendly trauma care and the attitude and expertise needed to implement it.
“I was a sort of apprentice to my godfather, assisted him during parturitions and surgeries, and did a lot of other things in the clinic.” - Gergő Józsa recalls his first encounter with medicine. After that, his apparent first choice was the University of Veterinary Medicine for further studies, but after he was accepted for a fee-paying training, which was too much of a financial burden for his family, he decided to study at the Medical School in Pécs, which he now considers a lucky, one might even say an inevitable turn of events.
Gergő Józsa knew two things from the beginning of his studies: he wanted to choose a profession in manual medicine and work with children as a doctor because he always found a common voice with them. “As a paediatrician, you can remain a bit of a child and retain something from the playfulness of childhood. A couple of years ago, a surprise Christmas video was made for the doctors at the Department of Paediatrics, and my son answered the question of what I do by saying that daddy plays with children all day. Yes, that is one way to put it.”
By the end of his university years, there was no question that the young doctor, originally from Vác, would stay in Pécs after meeting his then-girlfriend, now his wife. He started his residency in paediatric surgery, and two important professional encounters led him to paediatric traumatology and hand surgery.
“I completed my practice with Tamás Kassai, Head of the Paediatric Traumatology Department at the National Traumatology Institute, who provided me with vital professional knowledge and shaped my approach. To this day, I consider him my mentor; we perform serious hand developmental disorder surgeries together in Budapest and here in Pécs. Individuals supporting a young doctor professionally and as a person are significant, and the selflessness with which Dr. Kassai shares his knowledge is exemplary, as is the dedication with which he reaches out to children who have suffered accidental injuries. It is also important to mention the name of Professor Antal Renner, who provided significant support during my specialist training in hand surgery.”
Although paediatric traumatology is a specialized field, it is by no means small, as it includes children with all kinds of accidental injuries, burns, and hand injuries, and consists of the surgical treatment of various hand developmental disorders as well. Moreover, it is a relatively new and emerging medical profession, which often must take its rightful role.
“This is an interesting question because, in many places in the country, traumatologists also treat paediatric patients, whereas in Pécs, it is the paediatric surgeons who treat them; we are the ones who treat patients under the age of eighteen. Just as adult surgery has specialized and divided into smaller areas as medicine has developed, so has paediatric surgery with paediatric traumatology as one of its areas.”
In addition to the fact that children typically suffer different types of injuries than adults do, they also require different treatment, which makes it unfortunate for both the staff and the young patients when injured children are admitted to adult emergency care.
“Many colleagues in adult traumatology are afraid of child patients, so to speak because apart from the fact that they tend to have different fracture patterns, communication with them is also completely different than talking with an adult patient, who usually comes into the consulting room and tells us what happened to them and where it hurts. It goes without saying that this is completely different in the case of a young child aged five or six or even younger. On the other hand, however, a traumatologist is much more experienced in treating accidental injuries than a paediatric surgeon. I know from my example that I had to learn a lot about traumatology to be able to provide the right care. In addition, adolescence is a real frontier field because the body undergoes a major transformation. All this requires constant harmonization and collaboration between adult and paediatric care professionals to do our job in the best possible way.”
In addition to medical considerations, there is another compelling reason why it is essential to provide dedicated paediatric trauma care, which is, to put it most simply, to avoid further traumatizing children who have already been traumatized.
“Being in the hospital, even as an adult, is stressful, but for a child, it is a much more serious emotional shock – just think of the experience of sitting next to a drunk, injured patient in the emergency waiting room. This cannot be called child-friendly care.”
This is not a made-up example because, in many places, it is not possible to separate children and adults with accidental injuries for various reasons. The practice in Pécs, on the other hand, favors children's interests from the moment they arrive at the hospital.
“It is vital to build trust even before we start treating them. Children and their relatives arrive in a waiting room where the walls are covered with paintings, they can watch a story on a wall-mounted monitor, and the staff knows their specific needs so that they can be diagnosed in a much less stressful environment. It does not mean that we are the only ones who can treat or are the best at treating them, as I always tell my traumatology colleagues in hospitals in the area, but fortunately, we have these conditions.”
The work of Gergő Józsa and his colleagues is praised by the fact that they have patients not only from the classical health care service area but also from more and more distant hospitals due to the possibilities available in Pécs since here they can receive surgical procedures and therapies that are mostly not available in the country. These include, for example, absorbable implants, which are used in greater numbers in Pécs and at the National Traumatology Institute in Budapest.
“The huge advantage of these implants is that there is no need for another operation to remove them, but they are also more expensive than conventional ones. Fortunately, through participation in international studies and the support of the leadership of the Clinical Center, we can purchase these, and we have paid specific attention to introducing this option to nearby hospitals. We now consult with our traumatology colleagues daily about when to use them and send the injured child to us. This kind of professional cooperation was not common before, although it is the most important thing: what is best for the children.”
In addition to absorbable implants, several new methods have been introduced recently at the Paediatric Traumatology Unit in Pécs, all promoting child-friendly care. These include tissue glue, which makes the treatment of many injuries painless, and a new method of treating burns, which has significantly reduced the number of dressing changes requiring anaesthesia and the length of time spent in the hospital.
Of course, a committed team is essential for all this because, as Gergő Józsa says, it is not individual surgical feats that are needed, or rather, those alone are not enough.
“It takes a lot of work for the surgeon to operate, whether it is preoperative diagnostics, administrative work, or assistance during the operation. There is also a considerable role for the nurses working in the unit, the physiotherapists helping with rehabilitation, and, in some instances, the psychologists helping cope with the trauma. It is a lot of people working together in a coordinated way.
In addition, cooperation outside the unit is also very important. Examples include our collaboration with the Institute for Translational Medicine, where we are working with András Garami on new methods of treating burns, and the UP 3D Printing and Visualisation Centre, where we are working with Péter Maróti’s team to create bone models for the treatment of different fractures and research the qualities of different implants.”
It is also critical to find new talent to keep and further develop the team, and Gergő Józsa is very active in this area.
“I had the opportunity to try my hand at being a lecturer at the Department of Anatomy during my university years, where I taught for ten years, and it was a great foundation. Then, with the help of my colleague and friend Zsolt Juhász, I was able to work with TDK students before my specialist exam, and since then, many have written and are writing their theses with me – fortunately, there is a great interest in a career in paediatric traumatology.”
It is probably evident from the above that Gergő Józsa does not finish work after his shift. For him, healing, research, and teaching are life-long missions, which also mean great physical and mental strain.
“People often ask me how I manage, and I can say that I could not do it without the support of my family. I am lucky because my wife supports me in everything and is equally dedicated as an ophthalmologist. Our two wonderful sons are also fine with »daddy playing with the kids all day. « It is important to recharge at home and start work the next day with renewed energy. In addition, the children I treat are a huge emotional boost, and I do not need a thank you, just a drawing or a gesture. A child's smile is the best feedback I get in my daily work.”
Recharging is also important because Gergő Józsa is planning for the long term for himself and the whole of paediatric traumatology in Pécs.
“Of course, it would be an exaggeration to talk about a school or an activity of establishing a new school of thought, but I have in mind the example of Professor András Pintér, who put paediatric surgery in Pécs on a new footing and made it internationally known, and whose legacy will remain with us for a long time through his students. Of course, this will require decades of hard, persistent work, but it is certainly a worthy goal.”
Photo:
Lajos KALMÁR