In the early 80's, the name Germans Trias i Pujol was proposed for the hospital that was being built on the land of Can Ruti. But who were these brothers for their name to be chosen?

They were children of Badalona who became outstanding, innovative surgeons and university professors committed to improve university education. Joaquim and Antoni Trias i Pujol were born in 1888 and 1891, respectively. At that time, surgery as such was being born thanks to anesthesia and Lister's ideas about antisepsis (and later asepsis), and it was being introduced at home by Salvador Cardenal and Miquel Fargas, who dared to perform the first laparotomies in the country.

Training and personalities

When the subjects of this biography earned their bachelor's degree, Joaquim in 1910 and Antoni in 1914, this phase was already consolidated in Barcelona; materials were already being sterilized and surgeons wore gloves, coats and masks; Cardenal could do gastric surgery, Ribas i Ribas often performed gallbladder surgery, and Raventos was beginning with rectal surgery. Fargas, who focused on gynecology, was also leading a difficult university reform, an effort that strongly influenced Antoni who, in addition to becoming part of his family, was an enthusiastic and successful follower.

The oldest Trias brother, Joaquim, after finishing his medical and pharmaceutical studies, got his PhD in Madrid in 1911. On that same year, he became a military doctor, and as captain in the war in Morocco, he gained experience in war surgery. He returned in 1916 and earned the chair in Topographical Anatomy and Operative Surgery in Granada. In 1920, after Zaragoza, he transferred to Barcelona, where he became professor of Surgical Pathology in the new Clinic Hospital. Both in his lectures and publications, he showed a special interest in explaining himself and the bases of surgery, especially surgical anatomy and physiopathology.

Meanwhile, Antoni was professor of Surgical Pathology in Salamanca in 1920, where he already ignited controversy regarding teaching, and where he became friends with Miguel de Unamuno.By 1927 he had moved to Barcelona and reunited with his brother at the hospital and the Fargas clinic, and together they began mature efforts to renew their surroundings, each in his own way. Because it should be pointed out that they had clearly different personality traits: Joaquim had analytical skills focused mainly on understanding both scientific phenomena and people. Antoni, on the other hand, tended towards action, the right and timely decision. However, they had many things in common: a quick critical mind; a taste for the combination of intelligence and goodness; a passion for developing the art of conversation; a healthy sense of humour; and a dignified calm displayed both in good and bad times.

Contributions

They also had a similar attitude towards surgery. Abandoning the general practice of quick surgery, they opted for a more meticulous approach (e.g., in hemostasis and manipulation) that quickly showed their superiority. In Joaquim's own words, the success of a surgical procedure depended more on being respecful rather than brilliant. This defining characteristic caused it to be the only surgical school to speak of, and soon fundamental initiatives arose from it. Antoni saw the radical significance of anesthesia as a specialization and assigned it to Dr. J. Miguel full time after he completed his training in Oxford. This made the everything else possible, for example, incorporating through Dr. A. Caralps one of the first hyperpressure devices to make thoracic surgery possible. Also, neurosurgery flourished under Dr. A. Ley, who had trained in Estonia and Boston.

Dr. Rodríguez Arias was assigned to angiosurgery. With the same idea in mind, Antoni Trias focused on basic nursing training and fostered a model school. Joaquim, his sight on emergency services understood as a civic need, wanted to improve traumatology practice, which was being performed under quite confusing criteria. He travelled to Viena with Jimeno Vidal to see Buhler, and when he returned, he organized a renown emergency service and a specialized dispensary. It was only logical for him to become the first president of the Spanish Society of Orthopedic Surgery and Traumatology. In addition, this school's experience at the Clinic hospital had a key influence on the appropriate treatment of many injured patients, because the idea of treating open fractures as if they already were osteomyelitis with Orr's occlusive technique was adapted by surgeons of the Republican army. Later made systematic and known by Josep Trueta, it gained wide recognition during the World War. The Trias brothers, together with Corachan and Ribas, founded the Surgery Journal of Barcelona and the Surgical Society Newsletter to welcome scientific debate, and they fostered the Medical Sciences Academy, which they presided.

One of their fundamental contributions was a university reform experience that is still admired today: the first Autonomos University. Antoni took care of organizing the Trustees, laying down the foundations and defending themselves against the reactions of some people. Joaquim, as Dean (for nine years), and August Pi Sunyer, helped transform the Medical School. They opened its doors and most of the centres (Sant Pau, Sagrat Cor) to eminent men who had been pushed to the sidelines: Puig Sureda, Emili Mira, Lluís Sayé, Ribas i Ribas, Manuel Corachán, Jacint Raventós, Ignasi Barraquer and others. They introduced the idea of hiring professors, taking exams, organizing classes by subject areas, prioritizing practical teaching, giving students access to the faculty, while fostering bilingualism and open debate. It was an exciting path that soon raised the level of teaching, and by following a more English/American model, promoted a rich symbiosis between university and society.

But this thrilling impetus was cut short by the consequences of the war, and both brothers joined the great intellectual exodus that followed it. Joaquim was 51 years old when he exiled himself to France, where he continued operating until the German troops occupied the territory. Then he exiled himself to Andorra, where he organized the first operating room at his own home. He returned to Spain in 1947, although his professorship and service had been taken from him. In 1948, he went to jail for refusing to break his professional secret about one of his patients, and he was not released until the clamour of a European campaign made him an example of civic courage and moral integrity. In 1954, he was hired as surgery professor in Mendoza, Argentina, where he was able to go back to his beloved university life.

Antoni, by contrast, decided to settle himself in exile after 1939, as many other professionals, in Latin America, in Bogota, where he continued to work with the same enthusiasm.

A representative name

Joaquim, after a jovial old age enjoying his walks through his beloved hills of Canyet and la Conreria, died in Barcelona in 1964. Antoni, still active despite his age, died suddenly in the summer of 1970 in a coastal village.

This is a brief sketch of the two Trias i Pujol brothers, whose name was selected for a reference and university hospital like ours.

 

Marc Antoni Broggi