CC BY-NC-ND 4.0 · Revista Iberoamericana de Cirugía de la Mano 2022; 50(01): e1-e2
DOI: 10.1055/s-0042-1751343

“The one that does not change everything, does not change anything”

Article in several languages: English | español
Marc Garcia-Elias Cos
1   President, International Federation of Societies for Hand Surgery (IFSSH)
› Author Affiliations
Zoom Image
Dr. Fernando Fonseca

Just a few days ago, at the La Granja de San Ildefonso, we wished each other a sincere “see you soon” while we were pulling our suitcases towards our usual chores. We said goodbye after an emotional 25th face-to-face congress of the SECMA, organized by Fernando García de Lucas. After so many masks and solitary isolation, we finally managed to hug each other, like lifelong friends. After the great parenthesis caused by the pandemic, we went to Segovia “with renewed desire”. Hesitantly, we approached each group without knowing whether or not we should ask about the fate of some colleagues. In any case, we thought that, this time, yes, we would see each other again soon, very soon as if this COVID-19 had been a long nightmare from which we would wake up soon, rejuvenated and ready to return to our lives.

Life, as in the song of Pedro Navaja, gives us surprises. Fortunately, most of them are good. We keep them in the department of anecdotes, and gossip, until we forget them, which, on the other hand, is very desirable. It also gives us bad news, tells us about events, reminds us of likes and dislikes that we keep in our personal file, and that over the years becomes nostalgia, a word that, coming from the Greek, has to do with pain (algios) that we feel when we remember something or someone (nostos).

What I would never have suspected would happen the way it did was having the opportunity to show myself as something that many did not know: as a guitarist, composer and singer-songwriter, and that I do not mind doing it in public. The occasion was well worth it: I was able to pay a heartfelt tribute to my friend Fernando Fonseca. It was at the end of my lecture on Friday. I had been asked to give an instruction course on how to rationally guide the diagnosis of ulnar carpal pain. Already in the course of preparing for the conference, I realized that many of the concepts that I proposed coincided essentially with some reflections that Fernando Fonseca made in 1995, and that Fina Sensada, a well-known Catalan filmmaker, Fernando's partner, had recently shown me

Written in the form of a poem, it advised us not to be shy about radically changing our daily practice if something we have repeatedly tried does not work out. In this sense, he spoke in favor of:

  1. Improve training in basic sciences (anatomy and biomechanics) of surgeons, adapting them to the peculiar pathology of each environment, and not to the strategic needs of the industry.

  2. Reduce public resources to those research projects that only benefit a few, favoring those aimed at dealing with the most common problems of the population.

  3. Avoid expensive treatments that we already categorically know will not work, or if they do work, they do so partially and randomly.

  4. Remember that not everything that appears with age is necessarily pathological, that there are asymptomatic osteoarthritis that does not require treatment.

  5. In this sense it is good to be humble, and not think that we know everything. It is worth looking for points of coincidence with the treatments that are being used by other groups, non-surgical, and that empirically, and since ancient times, are proving to be effective. It must always be remembered that “healers” also cure, and they relate through the internet.

Well, from the poem I condensed some verses and put them into music, and the resulting song (“Moments of reflection”) I will always carry with me.

As you will well remember, Dr. Fernando Fonseca Máñez, was an active member of SECMA, organizer of its Congress at the Playa de Aro (1989), and of the potscongress of the FESSH in Girona (2000). Unfortunately, he passed away in 2014 from a brain tumor, after dedicating a good part of his life to treating children with handicapped hands and feet in third world countries.

The scarcity of existing publications on his international cooperation activities prevented Fernando from having the recognition as a “pioneer in hand surgery”, which he deserved so much.

One of the few advantages of being president of the International Federation of Societies for Surgery of the Hand (IFSSH), is having the possibility of proposing what one deems appropriate as a contribution to the congress that we have been developing every three years. In this case, I thought it would be desirable to pay a special tribute to Fernando during the opening ceremony of the London congress, a proposal that was accepted unanimously last March. Those of us who were lucky enough to meet him can attest to the suitability of this decision.

Among the various initiatives that have been proposed is the publication of a tribute book of very few pages in which the reason for Fernando's altruistic attitude is explained. With this we will not only remember that great friend that he was, but we will extend that memory to all those “unknown surgeons” whose premature death and/or altruistic activity went unnoticed, or directly ignored by their peers.

Illustrated by Mr. Nacho Duato, a world-renowned classical dancer and patron of the Fernando Fonseca Foundation, this book-tribute will be presented in English to those who attend the London Congress, with the hope of being able to distribute it worldwide soon.

I hope I have been able to find the right tone and the right volume to make Fernando happy. If he always said that all patients were more than patients, for us Fernando always was, he is and will be a reference, an example to follow.


Publication History

Article published online:
23 June 2022

© 2022. SECMA Foundation. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (

Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil