The heart provides quantity of life. The brain provides quality of life. I wanted to be a tennis player so I played for maybe, four or five hours a day, and I was on a youth team in Spain. Then one day I lost the game that would have sent me to the Orange World, which is a championship like the Junior Davis Cup in Miami. The day that I lost, I put down my racket. I had the intuition that I was not going to be Rafael Nadal. So, I felt lost. In the club where I played, Tenis
Barcelona, there was a well-known doctor called Dr. Farreras Valentí. He said: "I want to talk to you". I was completely depressed. I didn't know what to do. "You'll be a great doctor." I said, "Wow, where did this guy come from? What can I say?" He had been observing me over the years because he played there in the tennis club, and I said: "If he says so, I'd better pay attention." So I decided to become a doctor. Basically, what I want to mention is the importance of a tutor, of a mentor. If somebody with that level
of intellectual quality tells you confidently that you can do this, you dive into the ocean. This has been my life: following advice from people that I trusted to guide me well. It was important to keep going. That is simply how I started, and my whole life, basically, has been following advice from people in which I have had great trust. I think you want to ask me some questions. Let's see if I'm able to answer them. I am delighted to have been with you. Let's go. Hello, Dr. Fuster. Why is education so important to you? I
believe that science, health and education are three absolutely critical words nowadays. I'll tell you why it's important. Education means that you know more and more. It has a lot of variables for moving forward in life. The more educated that you are, the more capable you are of controlling the world around you. When you are less educated, the world is controlling you. So, I would say that education is very important for confidence. To start with, it's a very personal topic. If we talk about education on a cultural level, a regional level, a country level, it's the
same. The more education there is, the more suitable logic or, simply, the greater the chance of choosing the best option. Education is fundamental and is a very important tool for self-confidence. The more we know, the more we can control about ourselves and the more we can choose the best options for ourselves. Dr., who were the maestros or mentors that you mentioned that were decisive in awakening your vocation as a doctor and a scientist? I have had so many maestros... Basically, the first was Dr. Farreras Valentí, thanks to him I became a doctor. Then I had
a very important mentor in England, in Liverpool. When The Beatles started, I was there, I was a second year medicine student, and an English pathologist showed me a slide and told me what it was. In reality, it was a blood clot from a patient who had died from a heart attack. I said: "Is this blood clot the cause of the heart attack or is it the consequence?" He said, like every humble, born doctor, "I don't know, but I'll tell you something: do your doctoral thesis on whether it is a cause or consequence of the heart
attack". I dived into the ocean again. So, that's when I went to the University of Edinburgh and I did my thesis based on the slide and on what one individual had told me I should do. Then, Dr. Farreras Valentí, who was the one that wanted me to be a doctor, had a heart attack at the age of 43 and he said: "Let's see, I know a lot about medicine, but not so much about cardiology. I want you to be a cardiologist." That was that, I'm a cardiologist. I think that I am giving a message. I
am giving the message, learn to listen. Not just... everything that everyone said, that wasn't my idea and it wasn't my life. But to know how to listen to people you feel chemistry with, people that want the best for you, I think that is absolutely fundamental. This is what... Since then, I have had many tutors, and currently, I will say, I have two tutors. People say that having a mentor or a tutor is for young people who are completely lost. Who knows who is most lost? The older we get, the more lost we become. Why? Because
the world evolves at such great speed, we have more and more responsibility and need more and more people who can really help us to make the best decisions. That is to say, I have two mentors and they tell me: "Don't go down this road. This other route is better." To me, that's very important. How can we help young people and children to recognise or identity these mentors and to find their own talent? I think that this is a generational problem. The question that you have asked is really fundamental. We are not attracting the attention of
young people or children. We just give them what they ask for. But we really don't do any in-depth study when this is the age where we can really have great influence over their future. I have worked on the group for Sesame Street, do you know it? Basically, it's an educational program, but I learned that it is between the ages of three and six when the surroundings experienced are truly fundamental for our behaviour as adults. You are sitting here, think back to when you were three to six and the experiences you had, and you will see
how that influenced who you are today. Therefore, I find it fundamental to work with these early ages because they catch on very quickly. You can, to a certain extent, continue with what the parents believe is important, right? I would say that with your children or your grandchildren, capture their attention when they are between three and six, because they pick up on everything you say. Why do children pick up languages much more quickly than their parents? Because there are very few brain centres that do not connect, so whatever you say, they retain, and it comes out
later. When you enter puberty and later on, there are many centres, they all connect and it is much more difficult to pick up on what you say, because there is a lot of confusion. Therefore, the window of opportunity is from three to six years of age. You can intervene, for example, like we do, regarding health, because health is a priority and we teach them for many hours what they have to do at these ages. Fundamental. Dr. Fuster, your son is a musician and your daughter an architect. Are you happy even though they didn't follow your
path? Delighted. I'm delighted because they are following their talent. There is nothing worse than trying to change somebody's life. We are all born with talents and with objectives, with things that attract us. I can't force my children to be doctors, for example, if my daughter loves architecture and my son loves music. What can I say? I have to accept their talent. I think that the issue you are asking me about is very important. One of the most important things in both your life and mine is to find our talent. Someone must tell you. That's why
I mention mentors and tutors. If someone wants to make progress in life, simply, with behaviour that is not neurotic, there is nothing more important than to do what you must do, to realise the talent that you have. Someone has to tell you what your talent is. If you are ambitious, forget about it, you are using something artificial. "Do what your talent does." It is the best investment that a person can make in life. For this reason, I think we are all the same in this sense, you will have one profession, I do what I do,
and somebody else will do what they have to do. I arrive at the hospital at 4:45 every morning. I am friends with all of the cleaners and those that sweep the floor. Because they are there at that time. I always think: "How interesting. They have this mission. I have another mission, but they are not so different." The reality is that that person is probably doing this because they need a salary, but you honestly can tell that they're happy because they have a place of work. I am very lucky to have been able to use my
talent on a level that society has given me, this makes me very lucky. But, what I would say is that if there is a possibility, a possibility for a person to know themselves well, and to follow the line of what they have, their talent, I think it is absolutely critical and fundamental to invest in it. Dr. Fuster, what do we know and not know about the heart? Well, what we know about the heart is that it's here and it beats. Honestly, we know very little. I am a cardiologist and people often ask: "What is the
latest scientific progress that has occurred?" I say: "Wait a minute." There are many things I don't understand and I would like to. For example, the heart beats 60, 70, 80 times a minute with four valves that open and close, blood that enters and exits, and yet, look, it's no big deal. Do you know how many times the heart beats over a life? Millions of times. On the other hand, a plane has to go to the garage all the time to see what is wrong, etc. How can the heart, which is so mechanically complex, not need
repair? We are the ones that wear it down. So, when you ask: "What do we know and not know?", we know many things about the heart, but the basis of how the heart remains intact after so many years of beating and with such complexity, for me, I just can't answer that. I have spoken to many physicists, and they don't know. This brings us to the fundamental topic, I like to say this, anyone who says that scientifically we already know everything, I'm telling you, they are ignorant. In reality, we know very little. Even about my own
speciality. You might say: "I won't go to see this guy if I have a heart problem". Well, no. You can come to me because I know the disease and how to treat it. To really study how the heart works and all of the biological bases, I assure you it is very difficult. Very difficult. Dr. Fuster, what would you tell a teenager who has started to smoke? Let's see. What would I tell a patient, for example, another question, yesterday I was visited by a patient that weighs 300 kilos. What can you say? This patient is 27
years old. You can never be negative. Point number one. Absolutely point number one. To this sixteen year old, maybe it's your daughter, that has started to smoke, don't give out and say: "This is going into your lungs, cancer and all that". Say: "Let's see. Why have you started to smoke? Let's see if we can find a solution for this." You can never be negative. As doctors, we learn this quickly. We learn it quickly because with have dialogues with patients with problems and you become sympathetic. The exact opposite of what you might think. I mean, you
must treat this person in this way: "What do you think?". Their opinion above all, not yours. "What do you think? How could you quit? What is your opinion? I understand you." Do you follow me? You must be very positive. And from there, we'll see if you're successful or not. What are the fundamental risks for the health of our hearts and how can we avoid them? For you to be able to understand me clearly, there are seven factors that are the cause of heart attacks and strokes, which is the number one cause of death in 75%
of these patients. The 7 factors are as follows: there are two mechanical ones, one is high blood pressure and the other is obesity. Then there are two chemical ones, one is high cholesterol and the other is diabetes, high blood sugar levels in the blood. Then there are three behavioural: whether you smoke or not, whether you exercise or not and how you eat. A bad diet doesn't mean obesity: a lot of salt, a lot of fat, etc. These are the seven factors: two mechanical, two chemical and three behavioural. So, the thing is: "What should I do?".
Well, this is like the heart, you know? I don't know what to tell you. What I can give you are results from the projects that we undertake. As adults, we do not change individually. Adults change when we have other adults around us. This is very important. We have carried out studies that have convinced me that, at least where health is concerned, thinking that by yourself you can change your life in a sustainable way, not overnight, "I'm fat and I have to go to a wedding and I want to be thin", that's great, but sustainability, you
can't achieve that if there aren't people around you, they can be family members or not, communities, groups... This is, simply, what we have found in all of the studies. The adult, interestingly, needs other adults in order to function. I think this is very important. We are in a society where individuality does not help the individual. Above all, I am referring to health topics. Hello, doctor. Is there any way to teach adults about healthy habits? Well, let's see. For healthy aspects... We have spoken about risks: cholesterol, high blood pressure, obesity. The first thing we have to
do is speak positively. I mean, we want you to be thin, to do exercise, to eat well, you know? We are entering an education system that is different to the classical one. We are trying to promote health rather than prevent illness. This, psychologically, we can see it has an impact. To talk to a person, to promote what is good rather than discuss what is bad. This is the first point that I wanted to make. The second point, I can tell you that it depends on the individual's age. For example, when you're older, as you grow
older and feel relatively well and have risk factors, it's difficult to change. For this, it is important to form part of a group, you know? To join in. We have a project where groups of five or ten individuals come together, they talk to each other once a month or... "You're obese, I smoke", etc. This is important to the adult. For children, there is no doubt that our experience shows that the younger the child, the more of an effect we have. Between boys and girls of three... how old are you? - Nine. - Nine years old.
We are starting a project between 9 and 11 years of age. Isabel Carvajal, you're here, raise your hand. She is the head of education for boys and girls. Al of our studies have been between three and six years of age, where we have seen the impact of working for 50 hours over a period of five months, 50 hours. We teach them how their body works. This is very important for children, for them to understand. Second: eat well. Third: physical education, sports. And fourth: how to control our emotions. From three to six years of age we
teach them that when they are older they can say no to alcohol, when they are offered tobacco, etc. So, this is the educational program that we have and honestly, it is a very successful program. What we don't know is whether this program that we are starting now, for the ages of eight to ten, a slightly different educational system, will have as much of an impact as it does among those aged three to six where there are very few brain centres that are simply working and it is very easy to have an impact at this age.
All that I am saying is that the topic of health cannot be individual for each person: "I'm going to take care of myself". You need an environment, you need a catalyst, so to speak, above all, a group, even for children, OK? Did I answer your question, are you satisfied? Alright. Speaking of children between three and six, which is the age you always use as an example, I saw that you have a character on Sesame Street. Could you tell us more about how that idea came about? Yes, I started on Sesame Street about ten years ago,
and don't remember exactly how I started, just as a medical consultant. I participated, through not alone because there was a group of us, in Cookie Monster, because he ate cookies every day of the week. We were able to convince the directors that he should eat cookies just once a week. I think this was important, and I'll tell you why: because it changed the culture on Sesame Street. Sesame Street was a general educational program, it started to get involved in HIV medical issues, AIDS in Africa and started to gain real educational ground in the area of
health. I think that this was fundamental. This was the stage when I started to contribute to projects on Sesame. So, one day they called me from New York, they asked me to go and I didn't know why. I simply went to the Sesame Street offices, and a Muppet received me upon arrival. He said: "I'm you", he was Dr. Ruster, I'm Fuster and he's Ruster. He said: "I'm Dr. Ruster", and this doctor was very successful in Spanish-speaking countries and now I think he'll go to English-speaking countries, too. So, your question really is, what is Dr. Ruster.
He's just like Cookie Monster, and it's very interesting, because there are some aspects, like, a Muppet has a heart attack and Cookie Monster helps to revive him. He talks about whether the heart is on the left or the right. All of the conversations that they have together are very attractive to children. That's Dr. Ruster. Regarding what I said before, one of the most innovative programs was launched in Colombia in the year 2009 and was extended to other countries where children from three to six were taught healthy habits. I wanted to know more about this project
and the objectives that have been met and that are hoped for. Like anything else, this is a message that I always like to give, any project we start finds barriers and difficulties. You might think you have a talent and want to achieve things, and that it will be easy, and really it's hard, but we must be persistent. This is how we start, with a lot of persistence. In reality, what happened was that I wanted to create a project in New York for children aged three to six, and the Board of Education said no, that it
was impossible to introduce 50 hours into that system. I had a very good advisor in President Clinton, because I had been the chairman of the American Heart Association and had worked with them on the issue of smoking, and he said: "In the United States, it's going to be very hard for people to approve, you want to give so many hours of messages to children from three to six, go to countries in Central America." So I decided to go to Colombia, and it wasn't easy because Sesame Street opposed the project, because all of the projects have
one control group and one action group, so we compared them. Sesame thought it wasn't ethical for one group not to receive action, but I think it's not ethical for neither group to receive action, that's how it works. There was a lot of arguing, I left Sesame, and finally they accepted me back after a few days. That's how we started the project in Colombia. The project was fantastic: 1500 children. Half of them, with 50 hours, really it was a little more, received instruction on the topics we have discussed, and the others were the control group. At
three years of age we saw that it was spectacular, truly, the attitude of these children, the knowledge, the habits, etc. Then the project came to Spain and we saw the same thing, and from Spain now we are in New York. In the United States, they have now accepted us. We are in Harlem and soon we will be all over New York, in the five districts. We are going to start the project among children aged three to six and are currently working with, I don't know, Isabel, 25,000 children in Spain, right? This means that we are
really working with a high volume already. The issue is how we are going to control the quality. But this is basically the story, and it started in Colombia. I've heard you talk about "the rule of the four T's". Why is this so important and what are they, exactly? - The four T's? - Yes. In a world like the one we live in, if you don't have four clear ideas, you sway like a flag. There are four T's which show how a person matures, and four A's that show what a person's world is like. The four
T's, the first one is, simply, time to reflect. Each one of us, at least, it's the case for me, for 15 minutes a day, I think about what is a priority and what is not. This is absolutely fundamental. It is the most important time of the day. To think to say: "I'm alone, what is important?" The second one is your talent, this is fundamental, like I said. To know what your talent is and how to apply it. The third is to transmit positivity, and the fourth is tutoring. So, really, these are the four T's. Then
there are four A's which show how we present ourselves to the world. How someone tries to help the world around them, this is fundamental, to feel useful. This is absolutely critical for what we call simply, self-esteem. There are four A's. The first is positive attitude: "I find barriers, but I will solve them." The world is full of barriers, but you can't just say, you can't get depressed, etc. You have to solve them. The second is to accept who you are, not your neighbour. If your neighbour has a Maserati, for example, and you don't have a
car because you can't, well, "I have nothing and he has a Maserati. And so what?" Do you get it? That's the second. The third one is authenticity, which means that you are the same person in the morning, in the afternoon and at night. You do not change depending on who you are talking to. I see patients that could be presidents of countries, but at the same time I see patients that are almost homeless, you know? For me, they are the same person, absolutely, and the people that work with me know that very well. There is
no difference. The difference is in how they dress, but they are the same on the inside. The president of a country has a heart attack and the poor man I see in Harlem does too, and I can say that they are the same person. The reaction, the problem, the emotional state, you are no longer... you have lost your mission, who you are, etc. This is absolutely fundamental. Authenticity. And the final and most important one is altruism. This means that, in life, I have realised that the happiest people are those who give. Not those who receive.
So these are the four A's. I think I did well, because usually I don't remember. These are the four T's and the four A's. The four T's are more personal. The four A's are about how you show yourself to the world. They are formulae that help particularly when you meditate and spend 15 minutes thinking, you know how you are functioning and you have a methodology. The problem with society is that you can lose the methodology very easily, unless you have this method of being persistent and of being yourself and controlling what is around you. We
lead increasingly frenetic lives, in fact, I've read that you work over 12 hours a day. What can we... My wife says I work 16. Goodness me. Well, for that reason, what can we do to combine a healthy life with the stress and responsibilities of everyday life? This is like a dream. Let me tell you. People say: "We have to sleep for eight hours, otherwise your brain shuts down". This is what all of the newspapers say. This topic is much more complex. Sleep is deeper or lighter. I sleep four hours a day. Ever since I was
born. By whatever gene I have inside that, well, I sleep very deeply. Don't tell me tall tales. If I have to sleep for eight hours, I go neurotic. Why? Because this is what I need given that I sleep deeply, do you understand? It's the same with anything. If I, for example, enjoy and am excited by what I do, I can work 12 hours a day and feel perfectly fine, I'm happy to work 12 or 16 hours. The important thing is that you must take care of other aspects. It's not about the hours you work, it's
about what your family does. Are you with your family? Do you see your family? Do you have a suitable qualitative and quantitative relationship? This is very important. I have a great family life. Isabel, isn't that right? I work many hours a day, but what I want to say is that you have to combine it all. The fact of working 12 hours or 8 hours or 15 hours depends on whether you're excited. I like what I do. Sometimes I would say that I would stay for even longer, but the truth is that I have a family
and other aspects, like I said. I think it is very difficult to measure these things and reach conclusions that you have to work a certain number of hours. There are people that are tired after four hours, and I think that it depends heavily on what work represents to you. I don't make any judgements. I'm trying to combine everything, to make my personal and professional life combine... It's very complicated. - I find it very hard nowadays. - I recommend the 15 minutes a day. Yes. I'll try it, I'll try it. No, I really mean it. Don't
laugh. The 15 minutes affect this topic. You think and say: "Well, what day was yesterday?". You realise what aspects work for you. If you don't have this time, you're getting on a train without knowing the destination. You get on every day and see things and react, it's a reactive. We can't react, we must proact. This is what I believe to be important, and for this, you must know yourself very well and, above all, reflect a lot. This is basically what I would say to you. Dr. Fuster, in your book, "The science of long life", you
talk a lot about happiness. How does happiness affect our health? Yes, happiness, as you know, is difficult to define, and in reality we are a little skeptical, because we all have fluctuations, all of us. But what I can say is that a person's stability gives you this feeling of self-control, of self-confidence, that I am who I am and I do what I have to do, and there are three different aspects here, let's see. Happiness is rated, no, stability is rated with 15 points. Five points means that when I get up in the morning, my day
ahead of me, I'm excited, I'm stimulated, I like what is going to happen today, I'm going to work or wherever, I'm gardening with flowers, whatever, you're stimulated, and the points go from just one, meaning that you wouldn't even get out of bed, to five points that mean: "I'm anxious to get started on the day ahead." Number one. Number two is emotional instability, meaning, some people have one emotional state one day and another the next. There are five points here too: emotional stability, every day you are more or less the same. From point one to point
five. The third is the most imporant which we see most of, it is being studied a lot, and the third is: "Does your life have a final objective?". An objective. Your family, or your religion, something you want, an objective that moves you. This is very imporant. So, when we speak of happiness, I would speak of stability, of self-control, of self-fulfillment, of self-confidence, this is what I'm talking about. These are the three levels that are being followed, and there is a score. We are already doing this in some of the projects that we are starting now.
This is the way it is measured. Basically, these three aspects are important. Doctor, the other day I saw your documentary, "Making the Rounds", and I was really drawn to the science of examining and diagnosing patients before carrying out a test. What does this involve and what can we learn from it? Well, look, the documentary... The reason for the documentary is that nowadays, the young people that we are training to be doctors and, in my case, cardiologist doctors, the problem we find is that education is very technological, so these young people don't know how to talk
to patients. All they know is how to look at machines, results, etc. In our life, a life where everything moves, the static results don't tell you what is happening. But there is one fundamental point, and it's that of what we see, a common illness, 50% of it is psychological. What I'm saying is this: if you come to see me, and tell me you have palpitations or chest pains or that you get tired when you are walking up a hill, I can already tell what you are saying, of course, it is important, but there is an
inner component which is more important or just as important, and that is how you perceive it, and how you, to a certain extent, depending on your emotional state, generate what is happening. Do you understand? Consciously or subconsciously. So, how can a person work with machines when they don't have time to talk to the patient? This is what I'm saying. So we made this documentary which basically shows patients that have been admitted to an intensive unit, where two individuals, one more senior than myself, and I, simply do our rounds. The documentary aims to explain how we
attend to each patient. By the way, we had no idea where the cameras were, what you saw on the documentary is all real. We are not talking to this patient because there is a camera behind them filming us. Of course not. For a month, they followed how we treat a patient that is in the intensive unit and simply how we attend to them. The documentary has the message, I believe, that you are getting at, which is that the treatment of the patient is as important as the technology. That is basically what it is. Yes. Dr.
Fuster, you explain very well the close relationship between the heart and the brain throughout the various stages of life. I would like you to tell us about it, please. There are two important aspects. First we'll speak about illness, then we'll speak about health. From the point of view of illness, something very recent and new, is that the same factors that affect the individual, I've said seven of them, affect the small arteries in the brain and today we've seen that a large number of people with dementia, it's because of the same risk factors that lead to
a heart attack, the seven that I said, have not been monitored and affect the small arteries in the brain, they close, and this affects the individual's cognitive state and they suffer dementia. What I want to say is that even Alzheimer's Disease, which is a much more complex illness, the way the illness progresses, accelerating more or less, is highly related to this component that I am talking about. So, currently, among 100 people, and I'm sure you know someone or have a family member with dementia, of these 100 people, 25% have Alzheimer's, but the acceleration of the
illness depends greatly on the vascular problem. 25% is a merely vascular problem, where these risk factors, out of the seven, three are important: untreated hypertension, untreated diabetes, and untreated high cholesterol. These are the most important, you know? So, 25% is Alzheimer's, 25% is the vascular ilness due to these factors, and 25% is a combination of both. This is 75% of senile dementia. Therefore, nowadays, when someone says: "I'm going to have a heart attack and I'll die quickly, so I'm not worried about it". That's great, but there are two errors here. The first error is that
the majority of heart attacks do not kill quickly. This the error number one, you might read about this in books, but it is not reality. 80% of patients survive a heart attack. There is a second point. This person, when we say: "Hey, what about your brain?", they say: "My brain is separate", and I say: "You're mistaken, because if you don't take care, the risk factors can affect cognitive ability and can lead to dementia", and people are now starting to understand this more. I think that this is a fundamental point. We have more impact nowadays, in
the year 2018, on a patient by saying "Careful, because your brain may be affected", than by saying "Careful, you might have a heart attack". Do you understand? Now people are starting to understand what quality of life means. This brings us to the other aspect, which is health. Look, what I'm going to say is so simple... But that doesn't mean it's wrong. The heart provides quantity of life. The brain provides quality of life. It's simple, remember that, because, naturally, we could say much more, but this is the reality. Our brain is very important for the quality
of life we have. Someone asked me about happiness, right? You. This is up here. It's up here. Hwever, when the heart fails, it fails, things get ugly, from a point of view of quantity of life. It can affect the quality, too. I think that for health, we must start by talking about quality of life, and for this we must place our efforts on the brain. Like, for example, the girl that asked me how we should take care of ourselves. Well, this is all related to the brain. It's a decision: I'm going to take care of
myself. I am going to take the seven risk factors into account. Every age is a little different, I want to focus on the following: many people say: "Well, I'll eat garlic, and garlic fights heart disease". "You know what? I eat dark chocolate, because white chocolate kills you". I don't know where people get these ideas. It's in the newspapers and everybody reads it. Forget it, wrong. The important thing is the seven risk factors I've mentioned, and it's important that your brain is prepared to protect you from them. This is your answer. It's not just one of
them. This is not to say, for example, I'm going to run seven miles a day, and then go to the fridge and eat whatever I want. It's very different. If we want to talk about health, which I think is the general topic that we're talking about, caring for yourself is considering the risk factors, and this is a personal decision. These personal decisions normally work when you do them as a group, with another person or other people. This is how I see things. But the entire set is important, we can't just pick one, in particular, and
just take care of that. And not say silly things about garlic and chocolate and all of that. Doctor, I wanted to ask about your work in the National Cardiovascular Research Centre and I would like you to discuss what the NCRC is and the main research or what you would highlight. I have worked a lot with illnesses, with everything I have discussed, how a heart attack is formed, a stroke, degeneration, but I reached a conclusion when I reached a more global work position, as Chairman of the World Heart Federation, when I started to visit countries with
lower economies. There I realised that, really, we could have a much bigger impact with regards to health, that they listened much more than in countries with better economies. But the aspect that really captured my attention was the importance of young people. When I was travelling in countries with poor economies, I realised that when there are so few possibilities, young people immediately catch on to things that call to them or motivate them. This lead me to completely change my own life. This was in the year 2005, when I decided to use all of the technology available
to learn about illness, to use it for health, which is what we're talking about, and to work with young people. Then they called me to see if I could run a centre in Spain and, well, I was born in Spain but I left here 45 years ago. My experience as a student of medicine was not good, it was not good, why? Because substitutes gave the classes, anyway. Well, that's what lead me to leave this country. But then, with all of my experience, I think: "Maybe I can do something here, I could do something in the
field of research and, above all, motivate people and especially young people". That is why I came to the NCRC in Madrid, here. Why? Because it is a centre that we have built from the ground up. We visited secondary schools, with 16 and 17 year olds, those that are most interested in creativity, etc., and we created the NCRC. On one hand, the NCRC is young people, and it's working, this is true, but on the other, when you see the research, we must have the most advanced technology. In this case, as we increase the number of young
people, we say: "We have to have the system, the technological system, that is most advanced in the world". But of course, we have a problem. Finding young people isn't that hard if you set your mind to it. But for technology, first you need to have money. So I went... The NCRC belongs to the government, the National Cardiovascular Research Centre is simply a public government centre, but I decided to look for private money, not from the pharmaceutical industry, I didn't want a relationship with them, but from people that had a social interest in promoting young people
and in the best technology, 14 industries joined, this is the Pro NCRC. We started with young people and the most modern technology. Then there's the second aspect: "What do we do with this?". You do molecular genetic research applied to the patient, you know? It's called translational research, applied investigation. So at the NCRC we do something that wasn't working in Spain. The researchers were divided beween those that did a lot of basic science and those that did science applied to the patient, with no connection. At the NCRC, what we have done is motivate young people, have
the most advanced technology, and here the Pro NCRC has helped us, and from a point of view of money from the state, money from the government, we wil connect the researchers on a basic molecular level to those that are more focused on the patients. We are all connected. Therefore, the NCRC is like the creation of a dream, of what you can do in a country where, in my experience, both for research and for technology, and for motivating young people, at least when I studied medicine, there is a long way to go. At the moment, I
come one day a week. I came from New York today, I feel very motivated, because when I arrive at the NCRC there are two things that are a paradox: on the plane I read the newspaper and feel depressed, absolutely depressed. As soon as I leave the newspaper and arrive at the NCRC, I'm a different person. A young atmosphere of motivated people, people that want to move forwards. This is another example of when a person feels motivated. You can take a plance once a week if you feel motivated, and this is a clear example of the
NCRC, the question that you asked me. How can we awaken scientific vocation among young people in our country? Look, one thing that I have learned in my life is to be very pragmatic and not to use big sentences, because this doesn't... I would give them the opportunity to go to a place that motivates them, because you telling them 100 things won't help. Let's see, I remember well that when I started medicine I won a prize, I don't remember why, to go and listen to neurologists at Menéndez Pelayo in Santander, I was 18, I suppose. I
went to Santander and neurology was of no real interest to me, but I sat there for four days and they paid for the trip, the prize. I sat there, like a responsible individual, and, well, I listened. This awakened my curiosity. If I am a researcher today, you can be sure that it is because of that seminar. Because I realised how much we have to learn, what needs to be done, how much we can contribute through research. This was simply a neurology event, so, I would say, if you have a child, a grandchild, and you want
to arouse their interest in something, please, send them to places where they do the things that can motivate that boy or girl, do you understand? Expose them to it, this is what happened at the NCRC, do you know how we get young people, 15 or 16 year-olds? We give them a scholarship and they come to us for a month. They see what is going on. Sure, they all want to be researchers. But this is the thing: it's not just a theory, you have to show them something to really motivate them, that is how I would
answer your question. Talking doesn't do any good, because it comes in one ear and out the other. You have to put them in the right place. Hello Doctor, my name is Nelson, I am a Physical Education teacher and I would like to know what you think the keys to motivation are and how we can use them. I have a book that, by the way, I'm not trying to sell you, but it answers your question, is called "The Circle of Motivation". I wrote it four years ago and right now it's being translated into English. It basically
consists of the following, of the fact that, when we do something new, if there is no motivation, you start and maybe you err or you don't err but you move upward and when you are on top, if you think you are very successful, you go to sleep. It's important not to go down, to keep going up. What happens, and this is very common, when someone thinks they have done it all, they fall asleep. They become passive. Then you enter the realm of frustration. So the thing is, how to stay motivated in this circle. This is
the question you asked. Motivation comes from the south west, let me tell you. Many young people ask me, when they want to see me, they say: "Hey, I'm in the south east", and I know what they mean. They are in the realm of frustration, they say so, they are coming to see me because they're in the south east, and they want to go to the south west. So you help them. The formula that I said before. Each person has their formula, but we can all move forwards if we have a methodology, thinking every day, the
four T's, the four A's, they understood that part, so, you must have a method to help you continue forwards in times of frustration, and this is basically my answer. This is in the circle of motivation, this is how you can start to go upwards again. It's important, when you're on top, not to think that you have arrived, because if you don't keep working, you will fall immediately. This is life, ups and downs. Could you give us a special tip to motivate people, maybe slightly older people, who have lost a loved one, and are now in
a state of semi-depression? Can the same techniques that you suggest be applied to young people and older people? No, it's different, it's different, this is something that as doctors we experience constantly, and particularly cardiology doctors, as we experience mortality and we see this aspect. The most important thing is our loved ones, I can tell you that. When people say: "Family is good for nothing". Good for nothing, the day that you have a problem, you'll see that the only thing you have is the people by your side. So, this is a completely different situation. At times
of great severity, at times of great pesimism, it is important to have another person or other people that you can trust, that you can rely on, and to let it out, that's what psychologists do. Basically, they get you to talk and to explain yourself, but if you can do this with someone that you have chemistry with and someone that you feel supports you, this is the most important thing at times like these. This often happens, people say, at 50, the crossroad, it's true, 50 is a tricky age, I don't want to sell but I have
another book on this. I don't want to sell my books, but I have thought about this a lot. 50 is a difficult place because you are coming from somewhere and you don't know if you have to go to another, etc. It is very important to talk to people, to have relationships, to say how you feel, to be very sincere. Friendship is sincerity, being open, that's it, right? But it's a very different area to what I have been asked. I think we have spoken about everything, but I think I have a message to give, it is
difficult to say, maybe the message I would give is that... I know it in English: first, be useful, be in a society that is familiar, whatever it is, wherever you are, but be useful. To me, this is fundamental, we have to get out of ourselves, even with all of our problems, and get together if we have lots of problems, but I think that to be useful is important. To be useful, we need to know all of the coordinates. I think that we have spoken about education, etc., that you can choose and be useful with your
talent, with what you know, etc. I think that, for me, this is the most interesting topic, if you can get out of yourself and be useful in your society. If you can't get out of yourself, try to meet people that you can have a relationship with, of any type, and with a lot of communication. I think if you can reach this point, the next one is easy, but for me... I think that... Well, there are people in society who have been lucky, I have been very lucky, therefore when I talk about this, I say it
because I have been a very lucky person, so I can give more than I receive, because I have received throughout my life. The advice that I would give you is a state in two points. If you are already prepared, you are confident, you know what you want, where you are going, I think it is the right time to be as useful as possible to society, I think you will find great satisfaction in that. If you can't reach that point due to personal problems or whatever, above all, remember that there are other people in the world
that can be very helpful to you. This is state number one. I think that this message is a little superficial, you might think, but it's what I would say as a final summary of the contact we have had. Good luck.
