Pulmonologist, paediatrician and reference in tuberculosis and public health in Catalonia.

With a career of more than 30 years linked to Serveis Clínics and 50 years to the control of TB from a clinical, community and public health perspective, Dr. Neus Altet is a key figure not only in the history of our center but also in the approach to tuberculosis in Catalonia. Throughout his career he has developed an extensive care, teaching and research activity in the field of tuberculosis, participating in studies and reference projects related to the prevention, diagnosis and community control of the disease. For Serveis Clínics, she is also a highly esteemed professional by the entire team and a reference for many generations of professionals linked to tuberculosis and public health. Recently retired, we miss her very much, both professionally and personally. Her legacy is immense, but above all the human footprint she has left on so many people and teams that have shared her path stands out.

Neus, do you remember the first moment when tuberculosis entered your professional life? What struck you from that moment?

In my beginnings, I knew a case first-hand, which involved me many hours of reading, looking for evidence and looking at different studies and solutions, in order to be able to treat that patient in the best possible way. From the first moment it seemed to me an exciting, endless struggle and tuberculosis captivated me. I thought it was the story of the suffering of human beings in the course of time led us to the relationship of a disease that was a death sentence for the people who suffered from it and I thought it was a fascinating struggle, which was worth dedicating ourselves to.

After so many years accompanying people, what would you say they have taught you?

After so many years, I sincerely believe that I have learned more from patients than they have been able to learn from me. TB is a disease that often comes at times of great vulnerability, and the people who have suffered from it have taught me a constant lesson in humility, resilience and dignity. I have met people who faced the disease in very difficult situations, with economic, family or social problems, and who nevertheless maintained an admirable ability to move forward. They have taught me that behind each diagnosis there is a unique story, fears, hopes and a different way of understanding life. They have also made me understand the importance of listening…

“People who have suffered from tuberculosis have taught me a constant lesson of humility, resilience and dignity”

Medicine is not only about diagnosing and prescribing treatments, it is also about understanding the person in front of you. Many times a conversation, a look or a sign of confidence are as valuable as any medicine. If there is one thing my patients have taught me, it is that health and illness are part of a much more complex reality than books or scientific articles. I have always been reminded that medicine is, first and foremost, a profoundly human profession. And this is probably the most important legacy I take with me after a lifetime dedicated to the fight against tuberculosis. It could be said that, when I think about my career, I don’t just remember clinical cases or published research, I remember people above all. They are the ones who have really given meaning to a lifetime of work.

Behind every diagnosis there is a life story. Is there a person or experience that has particularly marked you and that you still remember today?

A relative, an uncle of my mother’s, was diagnosed and admitted to the Sanatorium of Terrassa in 1950. He was not cured and ended up dying of his tuberculosis. It touched me very closely and I remember that my family suffered a lot. I have also had patients with whom we still maintain friendships, such as some patients from Burgos who came to visit the unit expressly and we became very friends. TB has contributed a lot to my life, in every way: personally and professionally.

“I remember people above all, they are the ones who have really given meaning to a lifetime of work”

You have seen changes in treatment, social contexts and ways of working. How do you think the way of understanding and experiencing tuberculosis has also evolved?

Obviously, the changes have been very important, mainly with the drugs used, the diagnostic techniques and the health control of people. But good follow-up, especially the regularity of taking medication is often, in some special type of patients, difficult to achieve and requires a “close control” of these behaviors. Research is evolving, the evidence provides a very effective improvement in treatments but there is still a long way to go and the determinants of the health of many people hinder the success of these treatments.

When you think about the new generations that are now starting out in this field, what message would you convey to them?

It’s a complicated question to answer… Tuberculosis is not exactly a disease of the “rich” as some others may be and, often, the same funds for research are not available as cancer or HIV at other times. But it is an exciting disease, which still needs a lot of struggle and which gives a lot of satisfaction. Perhaps, the most complicated thing is to convey to the patient that they must understand that the bacillus that produces the disease lives with them and that the correct intake of medication and its good adherence are the only measures that can end the bacillus.

Looking back, what are you most proud of the role that Serveis Clínics has played in accompanying and caring for so many people?

Obviously, the role of Serveis Clínics has been essential to obtain the care and attention of patients with tuberculosis, and therefore, to reduce the great impact of this pandemic in our country. I lived through the beginning of this wonderful center and I believe that all of us who have been part of it or are part of it, can be proud of the key role it plays in the fight against this disease in Catalonia. Serveis Clínics, has become crucial in the treatment of tuberculosis and other diseases in people who are in very complex situations and therefore it is a reference center that I am sure will continue to grow.

And to finish this interesting interview… You, personally, have left you a whole life dedicated to this reality?

For me, tuberculosis has been one of the pillars of my life… I have learned and enjoyed a lot, I have done research with excellent professionals and it has allowed me to grow personally and professionally. In addition, it has been a passion shared with the love of my life, Dr. Alcaide, and therefore to talk about tuberculosis is to talk about him too. We have had to learn how to implement strategies to better control the transmission of the bacillus, to adapt our professional lives to improve patient follow-up, to control risk factors, medication intake and understand the reality of each person. And I have been able to do this both with my husband and with incredible colleagues. Professionally, you can’t ask for more.