Last February, Alfonso Castro Beiras died in A Coruña, Galicia, in northwestern Spain. Born in 1944 in Santiago de Compostela, the capital of Galicia, he studied medicine in the university of his native city with brilliant results. He received his training in cardiology, at that time an incipient specialty, at Clínica Puerta de Hierro, in Madrid. In those years, it was the leading medical center in Spain in terms of public health care and technological resources. This enabled Dr. Castro Beiras to acquire a solid clinical basis, which he preserved and built on the rest of his life. However, in Madrid, he learned more than “the trade”; he became aware of the fact that, as physicians, we not only had to cure (or relieve) patients, but should also become involved in the creation of health structures that would ensure universal, equitable, high-quality medical care. In 1977, on arriving in A Coruña as Head of the Cardiology Department at Hospital Juan Canalejo, he came face to face with the reality of Galician medicine, which consisted of moderate patient volume and scientific activity, concentrated in Santiago, exactly the opposite of his concept of what public health should be.

This circumstance marked his entire professional career from then on. It is impossible to understand his curriculum vitae unless this idea is kept in mind. The great love of his life, aside from the persons dearest to him, was Galicia. I remember perfectly that once, following a political change, he told me, “Now I’ll be able to do something more for Galicia”. And, sure enough, he was faithful to that idea to the end. His first effort in Hospital Juan Canalejo was to organize the nonexistent cardiology department, with the main focus on high-quality care and a characteristic that was unconventional (and visionary at the time) consisting of involving public outpatient cardiology clinics in the patient care and teaching activities of the hospital. In 1991, he gave a boost to the heart transplant program in Galicia, with excellent results that remain today. In 2005, he organized a program for the care of acute myocardial infarction involving the 4 provinces of the autonomous community of Galicia, a first in Spain, that is still functioning at the present time. Aware that the management of ischemic heart disease in Spain was not homogeneous and could be improved, he became involved, through the Spanish ministry of health, in the coordination and drafting of a document based on a consensus of all of the Spanish autonomous communities, published in 2006, which led to the “Ischemic Heart Disease Strategy” program of the Spanish public health system.

Teaching was another area to which he devoted a great deal of energy. The residency program in his department had a novel feature: in their last year, resident physicians should spend 6 months abroad in a highly-reputed center to broaden their medical and human horizons. His determination to achieve an overall improvement in in the Spanish cardiology scenario led him to the presidency of the Spanish Society of Cardiology (1997-1999); his lasting legacy from that period is the Casa del Corazón, in Madrid, the magnificent fruits of which are known to all Spanish-speaking cardiologists.

Throughout his life, he received many awards, medals, honors and tributes. Evidently he was pleased by this, but he told me once that the most important thing about this recognition was not its magnificence, but its implications. For him, praise meant that the outcome of his efforts had benefited society, and that gave him strength (and ideas) to continue to work for a better health system. He maintained this attitude to the last day of his life.

Carmen, loving wife, faithful companion up to the final battle, the demon of cruelty, envious of your happiness, wanted to take revenge, but did not achieve it; now, in the realm of light, Alfonso rests in the heart of emerald-colored seas like the waters of the ria of A Coruña that he so loved. Here, in the realm of darkness, you, your daughters, your granddaughters, and the rest of the family will continue to weep over his absence and premature departure; we, his life-long group of friends, will miss his affectionate friendship, the Spanish Society of Cardiology will never be able to forget his efforts to improve it, but, above all, the invisible presence of Dr. Castro Beiras will accompany thousands of fellow citizens who have not had to leave their native Galicia, and will never have to, to receive cardiac care of the highest quality. Adiós, amigo.