Interview with the boss – Nikolaos Bechrakis in conversation with KAKS
KAKS: Professor Bechrakis, please imagine the following situation: Parents’ evening at the clinic, the mothers and fathers of RB patients are there, want to get to know you.
What would you say to them?
Nikolaos Bechrakis: I would tell my parents who I am.
I would tell them what I do.
I would tell them how I work.
KAKS: Excuse us, Professor, for interrupting you right now.
Let’s ask more specifically: Who are you?
Nikolaus Bechrakis (laughs): I see.
I am Nikolaos Bechrakis.
Married.
Father of two sons.
I studied medicine in Homburg and Berlin, where I gained my doctorate in 1995 and habilitated in 2001.
And four years later I was appointed professor at the Charité.
As part of my further training, I was at Johns Hopkins Hospital in Baltimore and in Glasgow.
I was born in Switzerland in 1964, but grew up in Greece and attended the German School in Athens.
My parents attached great importance to this.
That’s why I speak German without an accent.
I have Greek and German citizenship.
KAKS: After many years in management positions in Berlin and Innsbruck, you have now landed in the Ruhr region.
Why Essen?
Why did you follow the call to come here?
Nikolaos Bechrakis: The hospital contacted me.
At a time when I had already been working in Innsbruck for ten years.
I had a job there for life.
But the change seemed attractive enough for me to join a stronghold of ophthalmology.
You have to know that even during my time in Berlin, the senior physicians were always talking about Essen.
KAKS: We’re still at the parents’ evening.
And your interview.
The group wants to find out more, such as who is wearing the white doctor’s coat.
Social skills are also in demand in medicine, aren’t they?
Nikolaos Bechrakis: Absolutely.
And yet I will tell you that medical expertise is the most important thing for me.
Empathy is also important, of course, but it comes second.
And treating patients and staff with respect is also essential.
KAKS: Does a modern physician have to emphasize collaborative strengths – or are they in your DNA?
Nikolaos Bechrakis: They are clearly part of my personality.
And in my DNA.
I bring them with me from my parents.
Through my upbringing.
These strengths are lived, so to speak, and they prove their worth when critical situations arise.
KAKS: And working in a clinic also means stress…
Nikolaos Bechrakis: Of course.
But if I didn’t want that … I was aware that the work here in Essen would be tough.
Ophthalmology is not the easiest medical specialty.
It can lead to the most complicated and stressful cases.
It’s about the eye, sometimes it’s a matter of life and death.
I’m challenged both medically and mentally.
KAKS: Do you know this psychologically stressful situation in the doctor-patient relationship from the other side as well?
Nikolaos Bechrakis: Oh yes.
My mother’s death was not easy.
Watching her die was very difficult.
Yes, I know the other side very well.
KAKS: An experience that is certainly formative.
And important when you, as a treating doctor, talk to parents today who are worried about their child or their child’s eyesight.
We want to find out more about this in a moment.
But first, a very simple question: Why the eye?
Why did you choose this organ as a young doctor?
Nikolaos Bechrakis: I’m simply pre-disposed to that (laughs).
My father was an ophthalmologist in Greece, where he still lives today.
My sister is also an ophthalmologist, by the way.
She practices in Bonn.
KAKS: As the new Director of the Eye Clinic, you are sure to bring new ideas to Essen that are important for the staff.
And for the patients too.
What are they?
Nikolaos Bechrakis: I’ll tell you how it is: I’m going to look at the day-to-day running of the clinic for a while.
I need the expertise to understand processes and then slowly improve where I think there is a need.
I’m not going to set any tight time horizons.
The medical and nursing skills are there – at a high level.
The environment should be pleasant in this high-performance operation that we are.
The infrastructural resources – they could be improved.
KAKS: What role does the Children’s Eye Cancer Foundation play?
Nikolaos Bechrakis: A very big one – in a team of patients and doctors.
You can’t deliver cutting-edge medicine if the patient doesn’t participate.
The foundation can help on many levels; disseminating information, supporting parents.
KAKS: The foundation is already doing quite well (laughs).
We still need patience to make changes to the infrastructure.
We have understood that.
Time is an important factor anyway – in everything.
What is the importance of time, which is often not available, in the day-to-day running of a clinic?
Nikolaos Bechrakis: It plays a major role.
Children and parents have a great sense of whether you are 100 percent with them.
Or whether you’re under time pressure.
But let me tell you: Whether you spend 5, 15 or 50 minutes with a patient, this time belongs to them with full concentration and attention and dealing with their individual problem.
KAKS: Afraid of routine?
Nikolaos Bechrakis: Routine is actually important.
Of course, you can’t lose sight of what’s new.
You have to recognize the outliers in medicine.
That’s why a foundation of standards is important.
We have meetings every morning.
These are routine processes.
We discuss what is important.
The way in which this is organized can be varied.
I advocate a culture of communication that is simple, transparent and fearless.
KAKS: Sounds great.
Without fear?
That’s already a problem for many people elsewhere.
But in medicine?
Here the error is perhaps immense…
Nikolaos Bechrakis: That’s right.
But we have to talk about it.
And not fear punishment, but strive for improvement.
A working atmosphere can be changed with time and care.
And one thing is paramount: the patient is always the boss.
KAKS: And how is Essen, how is your department set up for “the boss”?
Nikolaos Bechrakis: Perfect.
Interdisciplinary perfection.
There is no other way.
Working together, we achieve customized therapies for patients.
KAKS: What are your medical dreams?
Nikolaos Bechrakis: I helped introduce proton therapy in Germany in 1998.
Now, together with Professor Timmermann, I am in the process of applying proton radiation to the eye here in Essen.
From 2019, irradiation of eye tumors will also be introduced for adults.
One of my major goals is to improve the chances of survival for adult melanoma patients.
It’s very good for children.
In adults, we have achieved a lot in the last 20 years in terms of eye and vision preservation.
But we also need to improve the likelihood of survival.
This can only be achieved through a fundamental understanding of the biology of tumor cells.
Further research and interdisciplinary work will reduce the likelihood of metastasis and the resulting death.
KAKS: Is there one case in your medical career that you never forget and that immediately comes to mind when you are asked?
Nikolaos Bechrakis: Yes. An RB patient who I treated for the first time shortly after his birth in Berlin over 20 years ago. One of the most exciting situations and one of the biggest post-oncology problems I have ever had to solve. The boy – who is now 23 years old – was born with a bilateral retinoblastoma. We treated him; one eye had to be removed, the other was successfully irradiated and treated with chemotherapy. About 15 years later, when I was working at the University Eye Clinic in Innsbruck, a dangerous hemorrhage occurred in this single eye. The situation was dramatic, the 15-year-old boy went blind from one day to the next. I had to solve this situation. I knew that it depended on me whether this person would be able to see for the rest of his life or not.
KAKS: And???
KAKS: Professor ….
Nikolaos Bechrakis: He can see and read and organize his life the way he wants to.
KAKS: It’s not hard to imagine how grateful this family must be to you.
In any case, thank you for the interview.
With a brilliant ending.
Hope is also an important part of therapy.
We look forward to welcoming you at the next RB meeting.
The interview was conducted by Sabine Kuenzel