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Danica Grujičić, Minister of Health of Serbia

Dedicated to the Majesty of the Brain

Renowned and reputed as a top neurosurgeon, the feeling that comes with saving a life is the victory of her own lifetime, and a priceless accolade. And that’s something she doesn’t change for any post or function. For her, the human brain is a miniature cosmos. There’s probably no one who’s been more successful in operating on the brain for decades, and no one who would be better able to author an essay on the brain in the local language. Trusted and loved by her patients, she also enjoys great respect among her colleagues

Danica Grujičić (64) owes her greatest debt of gratitude for having made the right life choices to her parents: her father Milo, an economist, and mother Cveta, a teacher of literature, who gave her unlimited support. She says that she’s grateful to her father for her self-confidence, which is one of her core qualities. Her parents gave her a basic upbringing in the home, which implied:

“You must work hard; you must achieve everything through your own efforts and not count on anyone else. You must respect the family, immediate and extended; you must respect your elders and help those who are younger. I was an only child, but my first cousin was born seven days before me, so I was lucky that we grew up together like twins.”

With father Milo

What remains today of that value system in which CorD’s amiable interlocutor was raised and grew up?

“My natural surroundings are such that I stick to the principles on which I was raised. Here I’m referring to the environment of my family and friends, and the older professors who taught me. When I was in the infirmary, I would stand up when an elderly person entered for me to examine. That’s remained from the way I was raised and is normal for me. And when I happen to enter a room and a younger colleague remains sitting with their feet on the desk, they receive a lecture on good manners from me.”

Born in Užice, she lived in that city on the river Đetinja for 11 years and today recalls her teacher Nadežda Petronijević and her schoolfriends. She remained in the same department for the first four years of school, only for her mother to later transfer her to one in which English was taught. She enjoyed excursions in the area around Užice, trips to the Old Town, to Zlatibor mountain.

“That was a carefree childhood without any kind of turmoil, alongside a strict mother who ran a tight ship and knew how to administer punishment, but also how to reward. Dad was often away. I was his sweetie and he was more of a pal and friend to me. Mum was the one who had to be respected, who was always slightly stricter, but always fair. She was much gentler to me once I grew up, and explained that she’d had to be strict to keep me under control because I’d been a very over-exuberant child. And I thank her for making me, primarily, a good person.”

Danica started playing the accordion as a child. She had a wonderful teacher, Dragan Vasiljević, who developed within her a desire to constantly improve, to be increasingly better. She practiced for three or four hours daily, playing Bach concertos. Later, while at university, her accordion proved indispensable at social gatherings. Wherever they went, her colleagues would carry an accordion to be able to sing along with Dana.

I was raised to work hard, to achieve everything through my own efforts, to respect the family, respect my elders and help those who are younger

Danica’s father worked in Russia when she was 15 years old. She was then in the first year of the 5th Belgrade Gymnasium High School, and it was her that proved decisive in them all moving to Moscow.

“In those years, I didn’t have idols among singers, actors or artists, which perhaps wasn’t a good thing, but rather my idol was my dad, who was always right. Dad proposed that we move, mum was hesitant, while I was clever enough to realise that it was a chance to get acquainted with another culture, that I would learn to speak a new language, as I already spoke English. All that could be a genuine wealth of experience and tipped the scales in favour of us going.”

And so it was that Danica went from the 5th Belgrade Gymnasium High School to the 28th Secondary School of the October Okrug of the City of Moscow. Her mother once stated during a television show that she’d completed the tenth grade of that school as valedictorian. Danica herself didn’t like to boast about that, because she’d considered it would have been shameful to brag in front of the other kids.

With parents Milo and Cveta

“We spent two and a half years in Moscow. I graduated from high school at the age of 17 and enrolled in university. The Russians accepted me really wonderfully, and apart for my first and last names, I didn’t differ from them at all. I sat my high school diploma in both a Russian and a Yugoslav school, got up at three in the morning to study, played the accordion. I was especially delighted that there were primary schools teaching in 198 languages in the then USSR. That was a powerful show of respect for minorities.”

When asked why she opted for medicine, which she enrolled in while in Moscow and continued and completed in Belgrade, Danica provides an interesting answer.

“I had always been fascinated by that which is infinite. I’d wanted to be a designer of rockets and aircraft, but I wasn’t able to enrol to do so because back then only Soviet citizens could study at that particular university. My next choice was medicine, in the knowledge that I would deal with neurosurgery, because your human brain is actually like a miniature universe. The brain remains unfathomable to this day, and the possibilities of the human brain are probably infinite. The fact that we don’t know how to exploit all these possibilities in the best way is another problem. I became fully self-realised in my work.”

The brain remains unfathomable to this day, and the possibilities of the human brain are probably infinite. We just don’t know how to exploit all those possibilities in the best way

The continuation of her medical studies in Belgrade showed how eager for knowledge she really was. She began volunteering in the Neurosurgery department during her final year studies. She was employed a year and a half after passing the professional examination, and doing so with a GPA of 9.6. One has to believe her when she says today that she would have gone a very different way if she hadn’t ended up on the path she took.

“It seems to me that, if I hadn’t completed neurosurgery studies, I would have enrolled to study history or something else, completed that, and dealt with that professionally. And I feel sorry for the children who have an idea about where they could give the most, but don’t get the opportunity to do so. Not everyone can get what they want. I think that non-medical courses at the Faculty of Medicine need to address ethics much more. Perhaps a psychological test for medical school should be introduced. You must meet certain ethical standards and possess a certain level of empathy to be a good doctor. It’s worthless being a top surgeon if the patient can’t place their trust in you.”

When someone so loves her job as a neurosurgeon and is so into the brain, it’s interesting to hear about her first ever encounter with a brain.

“When I first saw that it pulsates with life, I was of course delighted. I observed several surgeries that weren’t technically complicated. And then I observed a very ugly operation. And that’s when you have to remove part of a brain that’s in trauma in order to save someone. This was done by my senior colleague, profeswho performed it with perfect technique. His every move made sense. I watched and complained about how I’d never learn to work like that. But I learned that, regardless of the urgency of an operation, order must always exist. Because if you lose that order, you lose the patient. That was a great school for me. By the way, I used to say to my general surgeon colleagues who are convinced that only their surgery is proper surgery: When I open the skull and see the brain, I say ‘good day, your majesty’.

With professors Nikola Sekulović and Eduard Kandelj

“You’d be surprised what the brain can take, what size of tumour it can contain while you think that the person is completely normal. It all depends on whether the process develops very rapidly, in which case the patient quickly falls into a coma, or very slowly. Some benign tumours can grow for 25 years. The brain slowly adapts, and it’s usually at that moment when all possibilities for adaptation have been exhausted that the patient contacts us.”

She recognised early on that, as a woman, she would have to work harder than her male colleagues, and to know more than them, in order for patients to want her to perform surgery on them. That huge work and effort, but also her exceptional talent in the vocation that she devoted herself to, led to her becoming renowned as an excellent surgeon by the age of 35, and by 40 she was a big name in the world of neurosurgery. She doesn’t forget to express personal gratitude to all the professors and colleagues with whom she’s worked and from whom she learned. And she never accepts that she deserves the credit for the procurement of the gamma knife, but rather insists that it was procured by the state.

Dana was 25 when she gained employment at the Institute of Neurosurgery of the Clinical Centre of Serbia. She later became head of the Neuro-oncology Department of the CCS Neurosurgery Clinic, then director of the Institute of Oncology and Radiology of Serbia, while she has been serving as the Minister of Health of Serbia for the last year. And we should also add to this impressive list her work as a professor at the Faculty of Medicine and the other responsibilities that she hasn’t shied away from. Her motto is that she must be available to her patients at every moment, and that this is the duty of every top doctor. She considers the establishing of the daily hospital of the Neurosurgery Clinic as being her great success.

It seems to me that, if I hadn’t completed neurosurgery studies, I would have enrolled to study history or something else, completed that, and dealt with that professionally

Wherever she has worked, her working days have always begun with her rising at six in the morning. She would already start with an operation by half past seven, and if she had two surgeries to do that day, and if they were harder and longer, she would only finish at seven in the evening. In the case that they were simpler procedures, she would do three operations per day, but if there were any complications, she would remain at the Clinic until ten o’clock at night. She always succeeded in forming a good team to work with.

“It’s very important that you also have good associates for an area that you don’t understand. I learned to ask those who know what I don’t. When you administer an institution, the most important thing is to consult good scholars.”

With her proposals, and their implementation with the help of the team with which she worked, she managed to improve the work of the Institute significantly in an organisational sense. And all those who’ve continued to work for the welfare of patients are aware of this.

“The older generations inherited from their elder teachers this cold attitude towards patients, and a desire to avoid a dying patient. That’s unacceptable.”

Student days

Since being appointed Serbian health minister a year ago, she has found all the meetings the toughest aspect, given that she sometimes has six or seven per day. Although she attempts to complete everything by six or half past six, and then devote herself to her father, her meetings often go on until late into the evenings. Her main objective is to work in cooperation with the Ministry of Finance to provide as much money as possible for healthcare, to launch initiatives for changes to working practises and conduct that should improve the functioning of the Serbian healthcare system. And all her reasoning has demonstrated that she cares greatly for patients, but also for medical workers preserving their dignity in their work. Given that not everything is progressing easily, we asked her what she is finding the toughest.

“As someone who comes from the operating theatre and the most demanding area of healthcare, I need time to grow accustomed to “non-surgical procedures” in the functioning of state bodies. We surgeons are used to making split second decisions and “cutting”. This often isn’t possible in the functioning of the state, which in certain cases isn’t actually a bad thing, because it gives you time to overview all aspects of a problem and make the right decisions. Frankly, the slowness of the system sometimes irritates me, but that’s also a problem in many other countries. We are getting used to one another – the system to me and I to the system.

“On the other hand, we have to work to improve and amend the Law on Healthcare. I tour the whole of Serbia, conversing with my colleagues and with patient associations, and I try to look over all the proposals in order for us to pass the best possible law. For me, Serbia extends from Subotica to Prizren, and as the country’s health minister I will strive, together with my colleagues, to secure equally good healthcare for all citizens of Serbia. In this area there must be no differences regardless of where our citizens live: in Vojvodina, Kosovo or Belgrade.”

You must meet certain ethical standards and possess a certain level of empathy to be a good doctor. It’s worthless being a top surgeon if the patient has no trust in you

She considers the fact that the Clinical Centre of Serbia is slowly entering the Second A phase as being her greatest success in this position, with works advancing quickly on the capital and perhaps biggest project that is the new building of the Institute of Oncology and Radiology of Serbia, and she hopes that part of the new Clinical Centre of Vojvodina will be opened by this time next year.

“We succeeded in resolving the years-long, not to say multidecade, problems over the issues of the identity of the investor and that of the founder. After several years of stagnation, design work is underway for the Clinical Centre in Kragujevac, while the reconstruction of hospitals needs to be completed in Smederevska Palanka, Valjevo and other cities… However, wherever I go, I’m impressed first and foremost by the self-sacrifice of my colleagues.

“I’m satisfied that, after 30 years, we’ve adopted the Rulebook on increasing the availability of medicines (so-called off-label). This is a major step for Serbian healthcare that will provide a significant relief for our patients. Until now, a medicine that was registered for one purpose couldn’t be used for another even if it was effective, just because it wasn’t on the list. I expect great assistance from the RFZO [National Health Insurance Fund] on the practical implementation of this rulebook.”

The minister is also satisfied by the fact that the Rulebook on unregistered medicines has been adopted, because it means that, in the case that shortages emerge, medicines can be imported from Russia, China, India or South Korea. She says that announcements are coming from Western Europe on possible restrictions on the delivery of medicines, so she doesn’t want to wait until the moment when we won’t have anywhere to import medicines from. “This is a great shift that we have taken together with the Government of the Republic of Serbia and I’m convinced that it will ensure the safety of all our citizens.” She is equally satisfied that the Torlak Institute of Virology, Vaccines and Sera is being renovated and believes that we will produce all our own vaccines in five to six years, and that the Health Insurance Act has been amended in the area of sick leave.

“We were the only country of the region in which a general practitioner could prescribe 60 days of sick leave. That has now been reduced to 30 days, as is the case everywhere else in the region. We are working to remedy a great injustice towards our war veterans, towards people who defended this country and could have died for it, many of whom suffer from post-traumatic stress disorder and lacked health insurance. I was very pleased to be able to propose an amendment to the part of the law that allows them to now use their veteran’s ID card to receive complete health insurance, but also for their family members if they have no other basis.”

Extremely important work has also been carried out and agreed thanks to negotiations with the World Bank on the approving of a 75-million-dollar loan for the project ‘100 clinics around the villages’.

“We will procure all the necessary equipment, while we will also have mobile clinics that will tour villages where it isn’t viable umestu doesn’t pay off off to have a permanent clinic, with a doctor from the nearest health centre visiting regularly.”

An agile doctor whose empathy is the stuff of patients’ fairy tales, it is also tough for Minister Grujičić to see young doctors leaving the country to work abroad. And she is doing everything she can to ensure that as many of them as possible remain in Serbia, considering everyone that she retains as her greatest success.

Danica isn’t a member of any political party, but she has given her support to SNS because of all the good that the party in power has done in the field of healthcare.

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