«I have walked many tracks,

I have opened up many paths...»

Dr. Manuel Quero, one of Spain's most prestigious cardiologists, died on 22 August 2003 in Collado Mediano, Madrid, Spain.

These simple lines by Antonio Machado make a perfect frame that sets the career of Dr. Manuel Quero, a leader in modern-day pediatric cardiology in Spain, in its true context.

Manolo Quero, as he liked to be known to friends and colleagues, was born 62 years ago in Andújar, Jaén, where his father practiced medicine. He completed high school at the Instituto Ramiro de Maeztu, Madrid, and studied medicine at the Universidad Central, later renamed the Universidad Complutense, de Madrid. He did his internship under Professor José Casas and took his first steps in cardiology with Professor Pedro Zarco, followed by a period at the Children's Hospital, London, where he acquired a sound grounding in pediatric cardiology under Professor Richard E. Bonham-Carter. He continued his studies at Harvard University, Boston, with Alexander S. Nadas and Richard Van Praagh.

The mid-sixties found Quero at the La Paz children's hospital in Madrid where, together with Víctor Pérez Martínez and, later, Felipe Moreno, he set up the first in-hospital pediatric cardiology unit in Spain. With minimal resources (a stethoscope, an old electrocardiograph and the support of the radiography unit) and admirable persistence, he undertook truly productive research that soon received the recognition it deserved. It is no exaggeration to say that this was when the foundations of modern-day pediatric cardiology in Spain were laid. And the flood of enthusiasm that accompanied these beginnings led, in time, to the establishment of other such units, notably in Barcelona (Dr. Juan Roca Llop) and Bilbao (Dr. Alberto Cabrera and Dr. Iñaki Azkuna).

With his tireless capacity for work, Quero attracted young cardiologists and pediatricians who helped him to set up the basic structure of clinical care for children with heart disease. Quero worked long into the night and it was not unusual to find that he had snatched only a few hours´ sleep in an armchair or a bed in the observation ward. Such total dedication to his work was something he would not abandon for many years, and it was a characteristic that he took with him when, in 1977, he moved to the Ramón y Cajal Hospital as head of the Pediatric Cardiology Service. In the mid-eighties, he even had the fortitude to take on additional responsibilities within the management structure of the center.

From the very beginning, Quero believed it was essential to enlist the help of cardiovascular surgeons in order to offer fully integrated medical and surgical care. Spurred on by his support, Dr. Francisco Álvarez Díaz, Dr. José María Brito and Dr. Carlos Lozano also initiated a new approach to surgery for congenital heart disease in collaboration with pediatric cardiologists.

Once the ground rules of clinical care had been established, Quero threw his energy into research. His studies of morphological variations of cardiac malformations and their anatomic and clinical correlation earned him international recognition, which grew considerably over the years to the point when he became a standard reference in medical bibliographies. Quero's doctoral thesis (which was awarded the highest possible distinction) dealt with the univentricular heart and the classification of congenital heart diseases. It formed the starting point for a number of further studies.

In the mid-seventies, Quero set himself the task of obtaining official recognition for his area of cardiology and, in the face of reticence and opposition, he succeeded in creating the Pediatric Cardiology section within the Spanish Society of Cardiology (Sociedad Española de Cardiología), of which he became its first president. He achieved the same objective within the Spanish Society of Pediatrics (Sociedad Española de Pediatría) and, at the end of the decade, convinced the national council for medical specialties (Consejo Nacional de Especialidades Médicas) that they should approve specific accreditation in pediatric cardiology, the first step on the road to the specialty being recognized as such. Sadly, a change in government left this decision on the bureaucratic shelf, and it was some years before final official approval of the specialty was forthcoming.

Quero's enthusiasm for teaching his specialty was exemplary in many ways. He established Spain's first school of pediatric cardiology and continued his tireless work there up to his death. Under him, nearly a hundred specialists have been trained and are now practicing halfway around the world, mainly in Spain and Latin America.

An affable man, Quero shunned the trappings of fame and always dealt in a cordial but straightforward manner with everyone who approached him in search of advice, instruction, or merely to observe his professional clinical manner. Such was his nature, that countless numbers were able to delight in his affection and exuberant friendliness.

Manolo Quero was never affected by the unavoidable traditional jealousies that are a true impediment to coexistence in our part of the scientific world. On the contrary, he responded with great humility; with him it was a watchword that negative criticism might perhaps be justified, making it essential to work even harder to eliminate possible errors. Similarly, he was inclined to turn a deaf ear on the sometimes offensive slander of would-be image breakers who were quick to criticize when he had, of his own volition, stepped down from management positions. Nonetheless, betrayals hurt him deeply and he found it difficult to accept that such meanness could exist within his own scientific family.

In 1973, Quero published what can be considered the first Spanish language manual for the training of pediatric cardiologists. As his international reputation grew, he was invited to join the editorial boards of most of the journals within the field. His nearly 300 publications, many of which broke new ground, are testimony to the incomparable research he carried out throughout his life. We may never encounter another with his spirit: the gap he has left behind cannot, for the moment, be filled. His many friends and colleagues will feel the loss for a long time to come. If we are to meet him again on the lonely moors left behind by his absence, we will need to invest twice as much energy in our daily work simply to be able to follow in his wake and converse with him again from the depths of our painful memories.

«And you, with a shadow no more, sleep and rest,

may your bones enjoy lasting peace...»