EPISODE Twenty one｜The World's Great Doctors with Prof. Massberg

In the newest episode of the World’s Great Doctors, Gloryren is so honored to invite an internationally renowned cardiology expert, Prof. Massberg, Director of Medical Clinic and Polyclinic l (Cardiology), LMU Klinikum, Founder of Munich Heart Alliance for interview. With his passion and dedication to his career, Prof. Massberg has become a successful Cardiology expert. He has led significant Cardiological projects across various platforms in Europe. The Munich Heart Alliance, which was founded by him, has advanced Cardiology research, fostered collaboration on Cardiology research among German cities, and elevated the level of Cardiology research in this country to new stage.

1. First, could you please tell us a little bit more about yourself and please share with us of how did you find the path to your medical career？

So, myself, I'm 53 years old and I'm now working at the University Hospital of LMU, which is the Ludwig Maximilian University of Munich. How I found my way into medical discipline is, actually, I come from a family with a lot of doctors and I always was fascinated by their jobs. So, the different aspects that they had to cover, the close interaction with other humans, I found very interesting. And also, I loved to, this may sound strange, but I like to handle stressful situations in emergency care. I had contact very early in my life and found this very exciting and that's probably the major reason why I got interested in Medicine.

2. At what point did you start seeing Cardiology as something you could be really great at?

Actually, originally, I wanted to become a surgeon and I was starting my career actually also in Surgery, in General Surgery. And during that time, I started with my doctoral thesis, actually also I started already doing my medical training. During the university time I spent, I started in an Experimental Department of Surgery, so I did my early training in Surgery and doctoral thesis, also in an Experimental Department of Surgery. And my doctoral thesis was on ischemia/reperfusion of the small bowel and, and that, when I did my project, I did a lot of histology and I found that during ischemia/reperfusion, platelet activation is a very important phenomenon and actually that caught my interest and of course, in Surgery, platelet research is not probably the most important thing. That was the reason why I thought about other subjects in Medicine that are interested in platelet research, and of course Cardiology as you're aware of, is discipline that has a lot of disease aspects that were, were, platelet activation and complex complications due to plated activation are of relevance and that's why I became interested in Cardiovascular research. Also, of course, when I went over the papers for my doctoral thesis, many of them came from the Cardiovascular feed and that's why I became first interested and that was already doing my doctoral thesis, and the final decision I actually made when I applied to the Department of Surgery and there was no open position. And then I said, well then, I tried to go into Cardiology first and when I did that after one year, I was fascinated by the subject of Cardiology and I did not regret that I was not taken Surgery in the first place.

3. Is there any person(s) who inspired you to pursue your career in Medicine, to be specific, in your specialties?

I had, yes, I had a mentor that was sort of mentoring my doctoral thesis who was, recommending me also the subject of Cardiology. During my doctor thesis, I also had contact with some cardiologists that also worked in the lab and of course we communicated and there I saw that the subject of Cardiology could be of interest to myself also. And then I came across several publications that were published by scientists that turned out to be also physicians that were active in Cardiology even from Munich. And I Met them at meetings and that sort of was the major driver of my decision to become a cardiologist.

Appen Q. Yes, and it turned out that it was a very wise choice for you to turn to Cardiology.

I'm very happy, still very happy with the subject because it's, it's a beautiful combination. It's a very scientific subject, because most of the things we do are research-driven. Our decision making is evidence based, so there's a huge space for doing research both at the basic research level, translational research level and also the clinical research and that the consequences that not only we can go into academic careers and there's several facets that you can focus on. You have heart failure, you have coronary artery disease, you have arrhythmia. So whatever your interest is, you will find a place where you can do research of your specific interest.

The other other side of this research activity of course is that we know what we do, so it's if we treat a patient, typically there's evidence or we treat the patient in the context of a trial and I think this is what we should achieve and this is something which I think is very specific to Cardiology.

And working wise, I personally love to do research and I love to do research that is somehow related to patient care, either translational research or clinical research. And I love Cardiology because it allows me to do research on the one side.

On the other side, it's a subject that allows me to do internal medicine, while also to work with your hands. And this combination where you can do interventional procedures such as TAVI or Mitral interventions or whatever you want, coronary stenting on the one inside. Then you have strong Intensive Care and Emergency Medicine, some situations where you have to make acute decisions and you have to keep your temper in stressful situations, I find very interesting.

And then you have the Internal Medicine, the more conservative aspect. So the different aspects of the subject are making it a very exciting, very interesting subject. And so I'm really happy that destiny made a decision for me and I did not go into another subject. I wouldn't say that Surgery is not interesting, but for me Cardiology was the best subject to take, as far as I think.

4. What advice would you give to the young clinicians?

So indeed, Cardiology is very fascinating for the young people as well. So, what would be your advice to those young people who would like to start their career in cardiology or to the young cardiologists?

So, I think, as I said, that one very exciting aspect of Cardiology is doing research. So, I would recommend to get involved in research at a very early stage of the career in Cardiology, because of course that allows you to, to pursue an academic career, which I think is one aspect that is attractive to many, because you can of course then go through all the academic levels. On the other hand, as a physician, of course you are at an optimal position to combine your experience with patients care and translate the ideas that you develop during patient care into research projects and I think this is something that you need to use also for your development. So make sure that your, the projects that you are following are using the advantages that you have in your specific position, meaning you are at the interface of clinical application and you can use your knowledge and your experience with patient care to develop your research and this makes your own research, I think, also exciting and you gain the most enthusiasm by this sort of type of interaction between the two aspects of your working daily working business. The other things I think you need to involve in the research of course of others also to be informed to know what areas are coming up. So, for example, if you see that there your interest is in structural heart disease, of course you should read a lot, inform yourself, know about the ongoing developments, maybe even beyond what is already published, in order to develop a fundamental where you can then build your own research career on. And I would recommend at an early stage to also get in contact with as many research groups as possible to see what they do, to see whether this is of interest and even to see whether they have open projects that you could involve in.

5. Also we are curious about one thing, how could you be able to manage to fulfil the obligations in your hospital, in teaching in the university and in holding major projects in a variety of European Platforms all at once？

So, the key for my success was not myself, actually was (credited to) the excellent people that I met during my development and that joined the group. So that's, I think what made our group so successful, it was not my personal, but rather, I was very lucky to recruit really excellent minds and they came up with their own ideas; they developed their own research projects; they kept on involving me but that I also probably gave them responsibilities at an early stage, which allowed them to develop their creativity, even independence for myself. And that turned out at least for from my perspective to be a very successful concept, because people came up with really exciting ideas, together with myself, we developed projects that in the end turn out to be a successful and so, that allows me to pursue research at a level, which I think is what I would have hoped for, to be able to achieve. When I started my career, it would not have been possible without these people in the group, in my institution. The other thing that was really important to me was a time which I spent out of the hospital. So, I have been spending three years, approximately three to four years in the United States. And really very motivating situation in a research group over in Harvard, Boston, which gave me new input. I collected a lot of new information, I met exciting people there, particularly the head of the research lab I was working in was really a, yeah, a role model for me and still is. And that sort of, again triggered my enthusiasm for research and gave me new also ideas for research projects and I led and boost in my methodological development. So, I learned new techniques that allowed me to also develop areas of research at the beginning and we started we learned techniques in the states that we develop further then here in Munich that were sort of characteristic for our lab, that was not performed in other labs. And that allowed us to do research that was a little bit different from what other research labs did.

6. What motivated you to get involved in founding Munich Heart Alliance？

Yeah, so the, the history of the Munich Heart Alliance is that there was the German government decided to announce the ability to apply for German centers of health research including German Center of Cardiovascular Research. And the application was designed in a way or was planned in a way that there were partner sites that could, with a research program apply for funding, was considered to be a funding not only for a year or two years but for long term institutional funding. So, in Munich, of course, it's not only our group, but it's actually huge number of groups that have very complimentary expertise, and on the other hand, common interest in nature join forces to set up and found the Munich Heart Alliance. And the Munich Heart Alliance we applied to be at the German government, the Ministry of Research and Science to get funding of the Munich Heart Alliance in this in the context of the German Center of Cardiovascular Research. So we are one of the seven partner sites of the German Center of Cardiovascular Research and receive funding to conduct our project locally, but the German Heart Center of German Center of Cardiovascular research also in particular supports interaction between the partners side and that actually boosted also our research because now we are not only working locally with the partners that we have here, with the different methods that are available, but we also join forces on the nation national level with other groups in Hamburg, in Berlin, in Frankfurt, and in Heidelberg, to conduct joint projects, which of course has put our projects at a new level. So that was a major boost to our research of the research of our group.

7. The field of Cardiology has a wide spectrum and many of the heart disorders involve treatments with other specialties. And we would like to know how is multidisciplinary collaboration organized in your department when it comes to treatment of heart disorders?

So, that touches a very important aspect, that was is getting more and more into the focus of interest. And in our hospital we have a very close collaboration with the other disciplines and I would say this is happening on all levels of, all career level.

So there's mutual exchange to between the chiefs of the department. So we meet regularly to exchange our problems. We have close contact if there are problems in the organization of our departments, we have exchange programs so that education particularly in Internal Medicine but also in other disciplines of course includes, or requires you to go during the medication to, not only work in Cardiology for our exam but also in other internal disciplines like Gastrology or Hemato-oncology or Pneumology, so there is exchange on the education level, but also of course, on the organization level.

So organization of emergency program, so the emergency board that we have is organized in an interdisciplinary way and then of course we offer our services, so there is a platform where you can ask for an echo, you can ask for an ECG or you can ask for being seen or patient or your department if you work for some in Surgery and you want a patient to be seen by a cardiologist, there is a software system in the hospital in place, where you can sort of handle the information and then this patient will be seen by oncologist and the next to ours.

Appen Q, So, as always, it's always a power of team. No matter it's inter-departmentally or inter university or internationally.

So, and also for the outside view, I mean for the Cardiology, of course the most, not most important but very important in the action is with Cardiac Surgery. And I think huge part of our success is that we have a very good exchange with our Cardiac surgeons. So we meet with them once a week to discuss patients. But we also, I would say in reality we read every day to discuss unplanned questions. So if we have a patient where there are two options, surgical and non surgical, of course we discuss this patient together with our surgeons. We help them if they have complications and vice versa if we have complications that have to be treated surgically, they are available and supported. So it's our Cardiovascular program is strong here at our hospital because our surgeons are strong and the cooperation between surgery and Cardiology is strong.

8. So as the Chairperson of the department, another important aspect of your work will be the education to the young generation. This is the only way of how to have a good team within the department. So, what would be your advice to the Chinese chiefs on how to train the young generation?

You have to be innovative in how you train, so you have to adjust to the needs and that I think China, I would assume is much more advanced in Germany, sort of the education of course we look back to a very long history, but we have to adjust to changes. Digital applications that are already used in other scenarios have to also find their way to education. I think the COVID pandemic as well as it was of course has some, has led to some also positive aspects because it changed our way of thinking how education has to take place. So, we have implemented a lot of things that were necessary during the COVID pandemic like teaching via ZOOM, digital training, also training in digital technologies. We have taken these achievements that we had to implement during the COVID pandemic and introduced it also now in our education as a long-term project beyond the COVID pandemic. So, we have to be modern in our education in order to educate, to get the interest of the young next generation. We have to also try to, to excite them, for what we are doing, so that I think is requiring the, the, the content of the education. So, what you want to deliver to be interactive. So, interaction during education and practical examples are very important. If I look at what I remember for my education, most of the things I remember are related to some patient case. So, patients I saw or a patient that was presented during a lecture, those are the things that easier to remember and that will have a major impact, or larger impact on your education to have the education not so some not purely theoretical, but to combine information with examples and to, to have close communication, why is this relevant to what patient group is this relevant and why is this mechanism important that you learn in Biochemistry and how can it be applied to patient treatment. So, to always cross between theoretical knowledge and the potential relevance for patient care that is at least something I find very important to be implemented at this very early stage of education. And then also I think it's important for the lecturers to provide some insight in what they do personally as a research portrait because you don't only want to educate the next generation in being a good medical doctor, but you also want them to, at least some of them should be interested in academic careers. So, for that they need to know what potential projects are what, how can we do research, why some area of research interesting and what could it mean for patient care in the future, so not only focusing on the medical training but also to provide some insight into the research aspect of education and working as a doctor.

9. Is there any trick you would like to share with us on work-life balance?

A.So I think it has changed, at least in Germany has changed. In the beginning it was of course, the balance was very much on the side of the work and not so much on the life, and I think it's good that it has changed because for particular, for being creative person to come up with ideas for research projects and you you need to have also some some life outside of the work. So to find a balance there is good and it's something that probably the chiefs have to learn from the younger generation. We have to come up with new models of working new plans of working that allow having a life, having a family, but still be a good doctor and successful academic Cardiologist. I think it possible, and that's something that we will have to develop, not probably the chiefs on their own, but the chiefs together with the next generation to really account for the needs of this generation.

10. What are your hobbies during your leisure time?

Oh, I love to do about water sports, which is, I mean, we have a lot of lakes around here in Munich, so swimming is one of my favorite things to do, but I love to do particularly like sports that are related to water and wind. So wind surfing, kite surfing, which is a little bit more difficult to do in Munich. So, but that's my major, my favorite hobby, doing kite surfing. Actually, there's one funny thing. I had an accident while kite surfing, which did not allow me to work as a cardiologist for six weeks, and during that time I applied for funding for a research project I got funded. So even sometimes hobbies allow you to improve your efficacy in research just as a side remark.

Thanks for the interesting anecdote and that's the end of our interview today. Thank you very much.