‘Returning to Greece is every Greek’s dream’

Dr Georgios Vrakas awarded the Young Investigator Award.

Greek consultant transplant surgeon Dr Georgios Vrakas has honoured all Greeks after being awarded the prestigious ‘Young Investigator Award’ by The Transplantation Society (TTS), a non-government organisation (NGO) that collaborates with the World Health Organisation.

The 34-year-old grandson of Greek migrants from Smyrna and Crete became a migrant himself when he left Greece in order to pursue his dream; he now works at Oxford University Hospitals NHS Trust.

Born in Drama, Dr Vrakas talks to Neos Kosmos about his decision to leave Greece, his career choices to date, the role of religion in medicine and treating cancer.

You have just been awarded an International Transplant Award. Did you expect such an honour for your work so early in your career?
Awards are a great way to remind us that our work is being noticed and become an incentive to try even harder; it was indeed a great honour to receive the Young Investigator Award at such a young age.

What is in your job description as a consultant transplant surgeon in Oxford Transplant Centre?
I perform kidney, pancreas, intestinal and abdominal wall transplants. It is a busy department that holds the worldwide record for the largest number of pancreas transplants performed annually. We are also part of the National Organ Retrieval Service in the UK.

Were there any significant events that made you choose this profession and life path?
My father is a retired general surgeon and my mother is a lawyer. I was preparing for law school but changed my mind at the last minute because I always aspired to be like my father, whom I admire for the help and hope he gave to his patients. In medical school, I became passionate about surgery, especially the innovative and challenging field of transplantation.

How would you rate the Greek public educational system?
I studied at the medical school at the University of Crete, which is regarded as one the best medical schools in Greece, and I was taken aback by the quality and level of studies offered. During my fifth year, I undertook a USMLE (style) exam and received a scholarship at Harvard University for my elective clinics (2003).

I came to the UK to work as a senior house officer alongside vascular surgeon Dr Panayiotopoulos, who continues to influence my career.

In 2006 I was offered a job alongside my father, at the Drama General Hospital. Two years later I moved to Papanikolaou General Hospital (Thessaloniki), where I worked with Professor K. Tsalis and specialised in HPB surgery while undertaking an MSc in HPB Surgery at the Dimokrition University. I completed my PhD on ‘Intestinal Preconditioning’ in 2014.

After completing my surgical residency, I moved to Guy’s Hospital in London. Professor N. Mamode, my mentor and educational supervisor, introduced me to transplantation, trained me to the highest standards and taught me transplant medicine on an academic and scientific level. I moved to Oxford in February 2013, where, under the supervision of Professor P. Friend and Mr A. Vaidya, I became involved in the intestinal transplant program; the most challenging type of transplant I have ever encountered and a field that raises more questions than answers.

Who are your patients and what are their specific needs?
My patients are people who are in need of a kidney transplant (due to renal failure), a pancreas transplant (due to diabetes) or a combination of both. Also, people on parenteral nutrition are eligible for assessment for intestinal transplantation.

How do English patients compare to Greek patients?
English patients have a completely different mentality and attitude towards life. They are respectful, compliant and well-informed when they come to see us; they ask the right questions and we can provide professional advice on top of what they have read.

How do you rate the Greek National Health system at the moment? What improvement and level of investment would you like to see in the Greek health sector?
There is a long way for the Greek National Health Service to get back to international standards. Greek hospitals are more or less bankrupt and Greek doctors cannot offer the level of care that they would like for their patients. There are lots of limitations in infrastructure and medical supplies. There is vital need for long-term planning. Short-sighted plans have no place in the health sector. Transplantation is a sad example. The funds spent for transplants are minimal although the cost to lifelong dialyse renal patients is higher than transplanting them and also improving their quality of life.

Cancer. How vital can an organ transplant be for a cancer patient and is there any progress made in terms of cancer not spreading to various organs? You have spoken about replacing all infected organs with transplants. Is this method still in testing phase and will we ever find the cure for this disease?
Transplantation for cancer is not an option for every kind of cancer. There are certain criteria that make someone eligible.

Cancers generally are multifactorial diseases and have a genetic component. Genes are altered and cell proliferation cannot be controlled. The result is a growth (tumour). Different cancers have different triggers; some are known, while others are still under investigation. There is no universal therapy, but customised treatments. Epidemic cancers should be investigated, as this would raise the alarm, especially for environmental factors.

Are there any vested interests in not finding a cure?
On the contrary, there are lots of research teams worldwide trying to find a cure for cancer. There are certain types of cancer that can now be treated with great success. However, there are also cancers that still carry an unfavourable prognosis. I therefore think that there is lots of interest in finding a cure, as this will be followed by significant profit. I think the ultimate cancer cure will be based on gene therapy (eg. epigenetics).

What have been your greatest achievements and personal highlights to date?
Becoming a consultant transplant surgeon at 34 years of age and working with mentors to whom I owe the greatest of respect and gratitude for believing in me and providing the knowledge and skills needed for this role.

When it comes to special highlights, the British Transplantation Society nominating me for the Medawar Medal in February 2014, which was a great honour, and I have also been asked to be a guest speaker at the prestigious Stanford Medicine X conference where I will be speaking about my experience on doctor-patient collaboration utilising social media, a developmental tool I regard as a very important step in our technology triumph times.

What drives and motivates you on a daily basis?
My unquenchable thirst to perform challenging operations and push the boundaries of modern transplantation is the ultimate drive for me.

What would you say has been the biggest challenge so far in your career? How did you overcome it?
Every step of my career has presented a different challenge. Practicing independently as a consultant and performing complex operations has been the biggest challenge to date. I believe that hard work and understanding limitations are equally important, therefore I never try to impress by subjecting people to unjustified risks. Nelson Mandela once said: “It always seems impossible until it is done.”

How do you view religion in your line of work? Have you lost faith or has it been reinforced through unforeseen ‘miracles’?
According to Einstein, “science without religion is lame. Religion without science is blind”. We have achieved so much scientifically that one would think that we would turn ourselves away from religion; on the contrary, religion is always present and a stern guide through life.

Where do you see yourself in 10 years on a professional and personal level?
I am hoping to have settled in both my professional and personal life. I wish to be the director of a transplant department and I hope to be married and starting a family.

Do you miss Greece? Are you planning to return?
I do miss Greece a lot and I think returning to Greece is every Greek’s dream. It still is a great country combining amazing scenery and high quality of life, even nowadays, despite the crisis. My family is still there and I do wish to go back one day when both timing and the career options are right.

Georgios will receive the ‘Young Investigator Award’ at the XXVI International Congress of the Transplantation Society (TTS 2016) Official Biennial Congress, scheduled to take place in Hong Kong on the 18-22 August 2016.