Miguel Brito Lança is a Med. school student whose life is deeply rooted in history and tradition.

He agreed to interrupt his continued study sessions for a stage of exams that only end on 12 July, to come and talk to me. He agreed to do so because he shows pride when talking about his family heritage and which he gets from Beja, his birthplace.

Before getting to know each other, I asked how we would recognise each other at first glance. To me, it was obvious right away that, waiting for me, seated on a bench in the hallway, was an empathetic young man with a grey backpack and who took the opportunity to open a folder that was so thick that it could hardly close.

2017, on the day of homage to Jacinto Brito Launches

The culprit of our entire conversation is his grandfather Jacinto Brito Lança, who passed away at age 92, when Miguel was around 13. A widely renowned physician nationwide in his day, he was paid tribute in 2017, as the Library of José Joaquim Fernandes Hospital, in Beja, was named in his honour. However, while still living, he had received the Health Ministry’s gold medal for distinguished Services, in 2006.

Beja… that one place that leaves its mark on everything, perhaps.

“Perhaps you don’t know that it was my grandfather (and many people don’t know this)… but it’s not just a Nobel Prize winner that endows Medicine with its raison d’être, as many before and after them arrange it,” he explains discretely but full of pride.

Paternal grandfather Jacinto is his heritage, not just that of the nation, and I’m aware of that.

Jacinto Brito Lança

The son of farming parents, Jacinto Brito Lança never denied his passion for medicine, as his life became a cyclical study of new scientific considerations, while advising other physicians on the best procedures to engage in and always humbly asserting himself as a Gastroenterologist and Internist physician par excellence. This explains his having written ground-breaking scientific articles while being renowned nationwide. Known as the pupil who sat under Professor Ducla Soares, grandfather Jacinto was a physician at Santa Maria Hospital, Professor at the Lisbon Faculty of Medicine and Clinical and Hospital Service Head. Several other duties followed, this time at the Hospital in Beja, which opened in 1970. There, he served as Director of the Medicine I Ward, while being in charge of training physicians. He headed the Blood Ward at the same Hospital, and served as the first head of the Endoscopy Unit; last but not least, he started the Dialysis Programme in Beja. Still, life in this area of the Alentejo region did not keep physician Jacinto Brito Lança from regularly making the rounds at Pulido Valente Hospital, where some medical decisions were made only after visiting certain nursing wards.

Miguel draws his knowledge and his birthright from him. He tells me that his grandfather was a remarkable semiologist, knowledgeable in making diagnostic assumptions at a time when complementary diagnostic procedures such as CAT scans or MRIs were just taking their first steps. He recalls only a few brief stories his grandfather would tell, at a time in his childhood when he was unfamiliar with technical terms, or was unaware of the stature of the person that stood before him.

However, history courses through his veins, as his memory is shorter, and he is unable to say whether what he bears means that it’s in his DNA or from hearing what was passed down to him. One thing Miguel knows: he is treading the same ground that once belonged to his grandfather, both students at the Faculty of Medicine, while only the famous Dr. Jacinto had studied at another venue, namely Campo de Santana. Miguel also knows that the Alentejo region is their cultural and ethical heritage. Ethical indeed, since the Alentejano is a Portuguese with a full heart and a wise soul, as he sees life savoured at its own pace, while giving time to time itself. And if time wishes to go further, they do not compete against each other, but respect one another. And, as an Alentejano, Miguel is no exception. Whereas grandfather Jacinto moved all of his belongings with his wife and 5 kids to Beja, Miguel was born in that land and naturally breathes it in his being today, with small expressions of his accent giving away his origins and his goodness.

Still, history is not solely about Miguel’s grandfather.

As the first son, Jacinto junior was born, at a time when his father Jacinto Brito Lança was 50. The only member of his family to have graduated from Med. school, he decided he would earn his living in Coimbra, having earned his degree in Ophthalmology; however, he left behind an old love that he would never let go of: Isabel, Miguel’s mother, she, too, a physician, but a paediatrician.

The love of physicians with a life in Beja would give rise to 4 children who would lend continuity to the pathway initially set by grandfather Jacinto.

The oldest of 4 siblings, Miguel speaks of his family with a sense of responsibility and belonging that are instinctive to him, like a feline watchful and protective of his clan, after having been himself protected and nurtured. Despite being loyal to his brothers Pedro and Vasco, it is Inês, the sister, the youngest and perkiest of the siblings, that brings a twinkle to his eye. However, there is no mischief or rivalry among them. They adore and complement each other as arteries interwoven in a single body, causing it to work more perfectly when working together.

He tells me that their mother never encouraged them to follow the family’s calling in Medicine, due to the strict, demanding training; however, because they are stubborn and since their heritage is not to be denied, sons Miguel and then Pedro would be like fish in water, just like their parents. Miguel, now in his 4th year, and Pedro, in his 2nd, are both studying in Lisbon, at the Faculty of Medicine. Then, there is Vasco, the youngest of the boys, the one more inclined to savings and numbers, according to Miguel; however, it is unknown if he might still enter Medicine, which is followed by virtually the entire family. We’ll see…

Thoughtful and in no hurry, Miguel Lança never pressured himself into choosing his future, which appears to have always been the case since childhood. When he started the 12th grade, he was asked about his career choices, and all he knew was that he would pursue studies in Science. During the summer holidays when he had to make his final choice, he said he was still unaware of the final outcome, as the words “Medicine” and “Engineering” came to mind like ping-pong balls bouncing, but whose rhythm resulted in an echo, with no reply. It was only on the very last possible day to make a selection that he chose to go to Lisbon, to FMUL. He was on holiday in the Algarve and took advantage of “the little corner in the house which was within range of the internet from the café on the floor below,” and so he made his choice. He was accepted in this first choice. Whereas he felt unafraid of his decision at the time, there are times today where a slight doubt haunts him as to whether he chose the right path. But then, he looks back at his roots and says with a smile that, “this could only be it, all the more so at Santa Maria”.

Miguel says that “he does everything at the last minute, but he’s working to improve on that” and that he is neither overly in a hurry nor hectic: because he comes from southern lands, this helps him balance the soul like the fields under a gentle warm breeze. While Lisbon is unfamiliar with that kind of rhythm, even today, 4 after his arrival here, there are those who tell him that he still walks slowly.

He loves his Faculty, which he spontaneously calls “cool” because of its countless educational, pedagogical and cultural activities, and he insists on pointing out that it’s a unique Institution, given its diversification and the number of friendships he has made. Still, he says he could never be an integral member of the Association, as his profile is altogether different. Nearing the end of his 4th year, he says he speaks practically the same medical language as his parents and, looking back at the Miguel that first entered the faculty, a profound change has occurred in him. And it’s not just because he is Monitor of Anatomy and Neuroanatomy, and since he is becoming increasingly interested in completing this new educational facet in his life, where he provides peer teaching to other students via Solvin’it ; it’s because he looks at others with growing respect.

While Miguel made an inglorious effort to meet me, at exam time, he understood that, to get to know someone, we cannot ask who the person is from a distance.

Sensible, he would say. Intelligent, he is, just as much.

A while ago, he told me that his mother didn’t want him to pursue Medicine because it would be a difficult path, and he confirmed this to be so. He even told me that he learned how to be resilient. How do you learn that?

Miguel : My mother wanted to protect us, as she didn’t want us to go through the pressure everyone experiences when getting to this point. But now she is immensely proud, of course. But that’s a good question… (he stops to think and then asks aloud) How do I learn to be resilient? It depends: at times, I think I can make a difference in the lives of others in the future, whereas there are other times when I wage confidence-related battles with myself and I get to thinking, “you can do it, you have to overcome;” still, at other times, I figure that, if others were able, then so should I be. It’s a psychological exercise because it involves just me, just my being, in silence.

Sitting for a 4-hour exam under the National Test Granting Access to Specialised Training, is this not the epitome of resilience?

Miguel: Absolutely. How can it be that in 4 hours we are deciding what we’re going to do for the rest of our lives? Of course, we are physicians by then, but the national test granting access to specialised training is, indeed, gruelling…

Do you ask for a lot of clarification from your parents?

Miguel: Quite a few clarifications, and feel greatly privileged to have parents that are both physicians. They greatly take the initiative in also wanting to explain to me the hows and whys.

How did you manage to become a Monitor, and in Anatomy, considered by many to be the most difficult subject of all?

Miguel: The Professor is the one making the choice, hence its somewhat subjective nature, and then the marks on the practical and theory exams carry their weight. I think those are the criteria… (He stops to think) It was one of my motivations for studying the subject when I was studying together with a colleague of mine, who also wanted the same thing. I applied, and fortunately my application was accepted.

Perhaps we also need to have a knack and a calling for that…

Miguel: I like that. (He smiles) Anyway. I recall first-year Anatomy and I began to realise that it was very easy for me to explain to others what I learned, but, above all, that I derived pleasure from that. And so, from that point on, I started investing in developing my teaching skills.

Miguel does our DNA contain a particle that justifies who we are in occupational terms?

Miguel: Oye… Wow… Whoa. (He laughs) That’s a very tough question. In environmental terms, without a doubt, as we are influenced by sharing experiences with others. Then when talking about DNA, I would say there’s a transfer of genes pertaining to curiosity, either with more scientific areas, or in terms of human contact. Then again, if one’s parents are more linked to the artistic sphere, that which they experience will also be more artistic. That comes from one’s experience. Now, regarding whether it’s possible to distinguish the genes that determine our occupational career, I feel there is still no answer to that question.

In occupational terms, are you afraid of any working days that await you?

Miguel: Indeed, I’m afraid of not being prepared to face complicated situations with people. And I say that with emotion. There are times when I’m studying something and I think to myself, “one day in the future, I’ll have a patient before me and I’ll have to be able to apply this idea specifically to that patient and with added responsibility.” As we keep learning throughout the study programme, I notice enormous progress in all of us, from the 1st to the 4th year. It’s as if we already had a more realistic idea of what surrounds us, as if we became different people.

And does that cause you to look differently at the person before you? Assuming that person is fragile, ill, perhaps lonely and feeling pain?

Miguel: I’ve always respected such people. However, I’m increasingly respectful and committed to taking action. The difference is that this used to raise concern and compassion, but now I have some knowledge that enables me to do something. Still, I’ve always felt emotion when seeing someone in serious condition, and then my thoughts turn to that person’s family and how vulnerable human beings can become. And so that’s why being a physician (and please forgive my presumptuousness) is truly the most beautiful career, as we have to combine several skills. At times, as time goes by in a physician’s career, respect appears to wane and I feel this is not an altogether conscious thing. Repetition causes them to become distant. I wouldn’t want to become that. I hope to never lose my motivation to be here for others. You know, sometimes I think my brother Pedro and I end up giving our parents a little motivation. We are the ones to motivate them again!

An interesting perspective. Do you refresh their routine, as if to inspire them anew?

Miguel: Because they once again believe in the essence of things. Then there are other cool things: when I meet up with my parents and study with them, I observe them and their interaction with their patients and I gain a vast amount of experience just from observing them. Have you noticed the privilege that Pedro and I have? Then there is the fact that I am there pulling for my parents, even in matters that they don’t even recall, and this gives them encouragement. My mother has many interns, but having her own son as an intern is different for her, as this forces her to look at things in a different light. Sometimes I draw her attention to the way she talks to the interns, because she is tired and doesn’t even realise her tone of voice, and she tells me I’m right. As for my father, the fact that we ask him to read some materials or to clarify some of our doubts ends up encouraging him to discover new pathways. But undoubtedly our parents teach us so much!

Do parents who are physicians always know more than their children who are also physicians?

Miguel: (Silence) Theoretically, in terms of the “molecule of the molecule” maybe not, since knowledge is recycled. However, their experience is ten times greater. What good is it to me to know the last molecule if experience has not taught me how to apply things?

Do you miss your birthplace?

Miguel: More and more… In my study programme’s first year, I went home about 5 times; in my second year, I went back around 20 times. Now in my fourth year, I go back every weekend. I feel an immense need to go home, as that’s where my safe haven is. Here in Lisbon, I don’t exactly feel at home, even though I have the right people by my side who enable me to experience something as close as possible to that feeling. In Beja it’s different: I go to the backyard, or to the kitchen, I see my family and I feel at home.

His grandfather serves as a reference in time, and in the balance between not being in a hurry and enjoying the quality of listening to life. There is also the requirement of accuracy and the ability look at others and study them in depth. He knows he will not be an attentive researcher like his grandfather Jacinto, but who knows, perhaps the latter will inspire him to follow one of his specialities in due time?

From his parents’ love story, both of whom were from the same area, and having studied in different cities but were reunited, he is aware that he might not return to Beja to establish is clinical practice, but perhaps he will find a place close to Lisbon where time is not so much of the essence tempo and silence brings him additional comfort, because he, too, has a love story that, once again, follows the genetic pathway of his loved-ones.

Miguel misses his birthplace, that much is true, and, just like in a land where water and olive trees blend, Miguel believes there is something rooted in him for which he is unsure of a scientific explanation, but which is based on a reasoning that combines logic with emotion. If the grandfather had not been who he was, and if his parents were not physicians, would Miguel be the doctor he is to become?

With each passing day, and as he grows into increasingly becoming a doctor, we will be getting to know a better human being.

After leaving this conversation, Miguel will read and re-read the topics that will be coming up on the General, Vascular and Plastic Surgery exam. I hope that this in no way undermines him, since he did not come to flaunt any kind of vanity; he was merely willing, generous with our work, and so we want for his work to be even better!

As for me, I don’t know if I passed this discrete Monitor’s test; however, when my world is enriched with every narrative that I hear, that is a gain in my path, it is time that nobody will ever take away from me. And, just as he reminded me, the idea is to savour that time, slowly…

Thank you Miguel.

Joana Sousa

Editorial Team