José Joaquín Norberto, pionero en trasplantes cardíacos y director de cirugía en OhioHealth Mansfield, autor de Vivencias de un Cirujano Cardíaco, explica por qué la cirugía coronaria sigue siendo la más estudiada para su perfeccionamiento.
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00:00The Telematutino 11 has started, as always, we are grateful that such an intelligent audience allows us to enter your homes.
00:11Have a happy Thursday. Good morning to all. Good morning, Jacqueline Morel.
00:15Good morning, Ramón. Good morning, Dominican Republic. The Telematutino 11 begins on Thursday, March 20.
00:21As always, it is a pleasure that you are with us at this time of the morning.
00:24We are going to talk about some of the current topics. Today we also have the participation of Dr. José Joaquín Norberto Vargas,
00:31former director of cardiac surgery at Ohio Health Mansfield,
00:36author of Physical Death and Resurrection and Experiences of a Cardiologist Surgeon.
00:42You already know the things that this great professional of medicine has to tell us,
00:48who honors us with his participation in the program.
00:51Ramón, they say, which is the most powerful organ, the brain or the heart?
00:56With what do you make the decisions, with the heart or with the brain?
00:59With the brain.
01:00However, you know that the heart is 3.7 more powerful in emotions than the brain.
01:08Yes, besides, everyone dies when the heart stops.
01:14Well, we welcome you.
01:16Dr. Norberto was the first Dominican doctor to carry out a cardiac transplant.
01:23You know, with the doctor we are going to talk about medicine, but we are going to talk about those books,
01:30one of which was a bestseller in 2015, and the other will circulate tonight.
01:36Well, welcome and stay with us this morning.
01:40Gentlemen, in this country, anyone who puts something on the net, or takes any action,
01:50acquires an extraordinary reputation.
01:53Today, one of the main headlines is that the Constitutional Court was seized by a resource
02:02for the issue of the transitory of the Constitution, which prohibits Luis Abinadés from re-electing.
02:11But it turns out that there is a similar transitory for Danilo Medina.
02:15But even if that transitory is declared unconstitutional, he cannot re-elect.
02:20He cannot, because there is an article, which is the real padlock, which is Article 124.
02:27I don't know if it varies in number, it varies in the Constitution,
02:30which says that the president and the vice president are elected for a period of four years.
02:36They can be re-elected once and never again.
02:40After that, they cannot be re-elected.
02:42That padlock already exists.
02:44So, one does not understand the objective of this man, who is very well known.
02:51He is a very active man on the net.
02:53He is the person who puts anything on the net.
02:56Anything.
02:58What you can't imagine, he puts it on the net.
03:02Well, it will be in the hands of the members of the Constitutional Court
03:08and the Dominican jurists to give their opinion on this matter.
03:12The Constitution prohibits, the Constitution before the reform that President Luis Abinadés
03:20made regarding the re-election, which has been the common denominator of the almost 38 modifications
03:28that our Constitution has had.
03:30And President Abinadés wanted to get ahead and say in time
03:35that he was not going to change the Constitution for another electoral period.
03:40Some understand that this is the brightest point and the contribution to democracy
03:45made by President Abinadés with making that announcement,
03:48although many have criticized it, others have praised it,
03:52at a local and international level.
03:55Let's see the course that this instance of unconstitutionality that was deposited before the Constitutional Court takes.
04:03But the Constitution already prohibited a third re-election.
04:06What the President added was, first, that no constitutional modification
04:13could be made on modifying that article.
04:19That is, he turned it into what the lawyers say, a Petra clause.
04:23But he added that neither could the Constitution be modified
04:26to benefit a presidential official who had,
04:30plus the transitory that was identical to the one that Danilo put,
04:35which specifies that he cannot be a candidate.
04:38That is, the thing is tied everywhere.
04:41Even when the court, I imagine that the court is going to declare irreceivable.
04:44And that was a gain, that's what the jurists and the class understood,
04:51that it gave guarantees and democracy,
04:54and that it gave certainty that the President of the Republic
04:58was going to be respectful of the Constitution
05:00and was not going to do what his predecessors had done,
05:03legislate in his own favor.
05:06And that was the gain.
05:07And also, in the future, it will be put in China.
05:11That is, whoever tries to look for a third period is impossible,
05:15because there are too many articles in the Constitution
05:18that make it impossible.
05:19There are already two periods, and another one is coming, alternability.
05:24On the other hand, yesterday Alfredo Pacheco gave good information,
05:29because there are a number of pending projects to be approved.
05:34He mentioned the penal code,
05:36and he says that they are going to be submerged,
05:38and he urged the deputies,
05:41he talked about that project,
05:44he talked about the solid waste project,
05:48and others that have too much time.
05:53In the case of the penal code, we have talked about it many times.
05:56I feel very optimistic because,
05:58as other winds blow from the United States,
06:02the issue of causality is not going to be a problem.
06:06Most legislators have voted for the penal code without causality,
06:13and it has been vetoed by the executive power.
06:16Now, look, we got that question on Tuesday,
06:21because Genao submitted a project,
06:24and there are like three projects,
06:26and then what was decided was to make a bicameral commission
06:31of deputies and senators
06:34so that they join the efforts, discuss all the projects,
06:37and finally submit a project that is finally approved,
06:42and that we have a penal code according to our times,
06:45and that the causality goes to another place,
06:48to another law, or to another discussion.
06:51Look, Ramón, there are several projects that are pending
06:54in the Dominican legislative chambers,
06:57and that sleep the eternal dream.
06:59And it is a great responsibility that these legislators have,
07:02many of them were ratified,
07:04but there is also new blood in the National Congress,
07:07and they have the opportunity to give way to these projects.
07:11But we are satisfied for now
07:14that the project of the penal code,
07:15which is so important, is known,
07:18and that we have a new penal code.
07:22Look, and regarding the previous comment, Ramón,
07:25a friend of mine who is a TV viewer,
07:27who has experience on the subject, writes,
07:30Good morning.
07:31That instance of unconstitutionality is a farce.
07:35That action cannot take place
07:37because the constitution of any of its provisions
07:40cannot be declared unconstitutional.
07:42The constitutional court is the greatest interpreter
07:45of the constitution,
07:46but it cannot declare it unconstitutional.
07:50The TC has no competence
07:52to declare the constitution unconstitutional,
07:54it can only interpret it.
07:56That action is a farce.
08:00And there it continues,
08:01that's what a friend of mine who is a TV viewer,
08:04a lawyer with experience on the subject, says.
08:06The common sense says,
08:08you cannot declare an unconstitutional constitution.
08:11You declare unconstitutional laws, decrees, resolutions,
08:17administrative provisions, etc.
08:20Although here it has happened,
08:21notice that the constitutional court does not legislate,
08:26and yet the constitutional court legislated
08:29in the case of the independent candidates.
08:32They were subjected to a resource
08:34for a case of a person who was not a candidate
08:38on the subject of an alliance,
08:40and then they shot each other
08:42and legislated because they created the figure
08:44of the independent candidates
08:46that does not exist in the constitution,
08:48nor does it exist in the...
08:50Do you think it was a legislation that they did?
08:52That's what most of the guests
08:54who have paraded around here,
08:56lawyers, politicians,
08:58and it's true,
08:59they created a figure that is not in the constitution
09:02nor is it in the electoral law,
09:03the independent candidate,
09:05which exists in other countries,
09:07but hey, we have to see what the constitution says
09:11in those countries.
09:12This is unacceptable.
09:14It's the least the constitutional court will say.
09:18We'll see.
09:19On the other hand, in the economic field,
09:20there is the Federal Reserve of the United States,
09:24which is the equivalent of the central banks.
09:27It met, and for the second time in a row,
09:30it maintained a fixed monetary policy rate,
09:35but also, of course, in a very conservative way,
09:40it predicted that inflation would be
09:43at the end of the year greater than estimated,
09:47and that the growth of the North American economy
09:50would be less than projected.
09:54All this because of the uncertainty
09:56and the policies of Aranceles,
09:58of President Trump, of course.
10:00The Federal Reserve took great care of its statement,
10:03and did not mention at all
10:06the part that all of this obeys uncertainty,
10:10and the loss of confidence of consumers,
10:13and the paralysis of investment
10:15that has caused the threats of Trump,
10:18of Aranceles, and the imposition of Aranceles,
10:21because there is 25% to all imports of aluminum and steel.
10:27But that's the situation,
10:28and that's not good news for the Dominican Republic,
10:31because that keeps the interest rates high
10:35in the United States,
10:36and it forces us to keep the rates high,
10:41because if our rates are very low,
10:44there could be capital outflows
10:47of sophisticated players
10:49who invest in treasure instruments
10:53or bank instruments in the United States.
10:57The outlook is not easy.
11:00There are even worse forecasts
11:04than those of the Federal Reserve.
11:06For example, Blanchard,
11:10an economist and professor
11:12at the Massachusetts Institute of Technology,
11:15who was the main economist of the Monetary Fund,
11:18says that there is a 50% probability
11:21of a recession in the North American economy.
11:24If there is a recession in the North American economy,
11:27there will be fewer tourists,
11:29there will be fewer remittances,
11:31and all of that will have an impact.
11:32But if there is inflation in the United States,
11:35practically most of our imports
11:39are from the United States,
11:40and then the things we import from the United States
11:43will have an impact.
11:45Ramón, although things were not named
11:47exactly by their name,
11:48the interpretations made by experts on the matter
11:51all point to the fact that this decision
11:53of the Federal Reserve
11:54obeys the imprint of President Donald Trump,
11:57and the policies he has taken,
11:59the decisions, the administrative measures
12:01that keep the population,
12:04the economic agents, the stocks,
12:06and no one has been indifferent.
12:08Not a single economy in the world
12:10has been indifferent.
12:11There are some that have not changed,
12:12because they are being very cautious
12:14when it comes to making decisions.
12:17And the Central Bank maintains the peaks
12:20and foresees two cuts this year,
12:21but it lowers them
12:22from its growth forecasts.
12:24It lowers growth forecasts
12:29and raises inflation.
12:31This, and the headlines say it,
12:33from such important newspapers,
12:35from the media, like the United States,
12:37and also from Europe, like the country.
12:40The chaotic economic policy
12:42of President Donald Trump
12:44increases uncertainty, they say,
12:46about the economy of the United States,
12:48and the Federal Reserve makes that warning.
12:51With what? With the decisions it has taken,
12:53although it does not say it with its name.
12:55So, wait and see.
12:56The Reserve prefers not to move,
12:58as expected.
13:00The Central Bank
13:02maintained interest rates
13:04in a range of 4.25 to 4.50.
13:08In the midst of a fog,
13:09of the direction of where the economy
13:13of the United States is going
13:14after the return of Donald Trump
13:16to the White House.
13:17So, what happened, Ramón?
13:19Now, you said it,
13:23that growth will be lower,
13:24that inflation will be high.
13:27And in the midst of this panorama,
13:28the President of the Central Bank,
13:30Jeremy Powell,
13:31said a word
13:32that some consider cursed,
13:34because he used it in the pandemic
13:36and created a catastrophe.
13:38It was the word transitory.
13:40And then, in the midst of the transitory situation
13:44that the United States is experiencing there,
13:45then, it is interpreted
13:47that ghosts of the past are coming
13:50about the North American economy
13:52and that this can put it in trouble.
13:54And therefore,
13:55it can put the world in trouble.
13:57The Federal Reserve still projects
13:59two cuts of 0.25
14:01in the official interest rates
14:03until leaving it between 75% and 4%
14:06at the end of 2025.
14:08Every day, Ramón, that can change.
14:10But that is if inflation does not increase.
14:13If inflation increases,
14:15the recipe will be to increase interest rates.
14:19Yes.
14:20Because that is one of the instruments
14:22that banks have.
14:23For you to face inflation,
14:25you increase the interest rate.
14:26For example, here,
14:27we came to have an interest rate of 8.5
14:30in the year 2022.
14:32We already have it at 5.75.
14:35So, the central banks
14:36use the policy rate
14:38to stop inflation.
14:41And when they lower it,
14:43it is to lower credit
14:44and to stimulate the economy.
14:46If, for example, the United States
14:47increases interest rates,
14:49what does that mean for the Dominican Republic?
14:52That here, interest rates will increase more
14:53because they are already high.
14:55The average rate is above 15.
14:59In addition, the cost of getting into debt
15:01increases.
15:02Exactly.
15:03That is, loans.
15:04That is, loans, because
15:05mainly the part of,
15:07and that is normal management,
15:10you take, here you take a loan
15:12to cover the fiscal deficit,
15:14but you take a loan to change
15:17old debt for new debt.
15:18That is, you change,
15:20amortize a loan
15:22and take another loan,
15:23but that loan you have to take
15:24at a higher interest rate.
15:26So, your cost of getting into debt
15:29is much higher
15:30and that puts the budget
15:31even more tight.
15:34Ramón, and if that is added,
15:35look, you know that projections
15:37of growth are made,
15:38not only of the year in progress,
15:40but it is predicted how it would grow
15:42with the variables that exist,
15:442025, 2026 and 2027.
15:47In the case of 2025,
15:49growth forecasts indicated
15:52in the North American GDP
15:542.1%.
15:55Now, in March,
15:57they only expect 1.7%.
15:59So, growth forecasts
16:01for 2026 and 2027
16:04also worsen,
16:05and they do it in a wide range
16:08that denotes the great uncertainty
16:10that the United States is experiencing.
16:12And when that little word is mentioned,
16:14Ramón, uncertainty,
16:16listen, you have to start thinking
16:18and having strategic plans.
16:20Yes, applying the tariffs
16:23to Canada, Mexico and Europe.
16:27There is already a trade war with China
16:31and that affects international trade
16:33and will cause a global recession.
16:35My article this week
16:37is very directed in this direction.
16:39It is called
16:40Seasonal Factors and Uncertainty
16:42in the Type of Exchange.
16:43That is a phrase that the governor said.
16:45From the Central Bank,
16:46I put all the data,
16:48because the president said
16:49that 2024 was the year
16:50that there was more appreciation
16:52and that the currency depreciated less.
16:53No, I put in the article
16:56how the depreciation was
16:58in the governments of Leonel Fernández,
17:00in the government of Danilo Medina,
17:02and what has happened
17:03from September to now
17:05and especially from December to now.
17:08For example, on the 18th,
17:10I will give you the article on Wednesday,
17:13in December the exchange rate increased
17:18from 61.32 to 63.20 on the 18th.
17:23But yesterday, on the 19th,
17:25it was at 63.26.
17:27Today it will be a little higher.
17:30Despite the fact that the Central Bank
17:32injected 2.8 billion dollars
17:35into the exchange market last year
17:37and in January and February
17:38400 million dollars.
17:40So all those optimistic forecasts
17:43have to be moderate.
17:45As Fabricio Gomez-Mazara said yesterday,
17:49optimistic but cautious.
17:51It is not true that an economy is armored.
17:54We depend on the United States.
17:56And it is a shame that the government
17:58does not have mattresses
18:00to cushion any external impact.
18:07For example, I ask you, Jacqueline,
18:09with this increase in the minimum wage,
18:12it has already increased by 12%.
18:14Can you imagine that the Dominican economy
18:16falls and that it decreases
18:18the sales of companies
18:19and in January they have to increase by 8%?
18:23What does that mean?
18:24Oh no, I tell you what that means, Ramón.
18:27Many companies cannot do that.
18:29They are going to close.
18:30Obviously, no one is forced to do that.
18:35And taking into account all these
18:38international variables that affect
18:41the economy and the way of doing business,
18:44in the projections that are made
18:46of country growth,
18:48the environment influences a lot.
18:51A lot.
18:52The international environment
18:53obviously has local consequences.
18:56And also internal policies
18:58that are taken, the measures.
19:00So we will have to see
19:02what the result of all this is, Ramón.
19:05Because no one is forced to do the impossible.
19:08If you can't, you can't.
19:10And some companies that can't
19:12with that burden,
19:12are simply going to leave their operations.
19:16There is a saying that when the United States
19:18gets the flu, Latin America gets pneumonia.
19:21And it is true.
19:22The so-called lost decade,
19:24which here is attributed to the PRD governments,
19:27was that in the United States
19:28the oil crisis caused in the 1970s
19:31a two-digit inflation.
19:33And as the then governor, Paul Volcker,
19:36solved it, he raised the rate of politics
19:38to 15%.
19:40Today it is high, between 4% and 25%.
19:42So that caused a debacle in Latin America.
19:46And the cessation of payments.
19:48And it caused...
19:49Well, there was a settlement
19:51because the fund's receipts were terrible
19:54at that time.
19:55But well, let's hope that none of this
19:57happens and that the matter is moderated
20:00and that Trump understands
20:02that things can't be a shock.
20:05We will have to take him to therapy.
20:08The experience, because inflation
20:11is one of the most terrible things
20:12for the presidents of the United States.
20:14People's pockets.
20:16That's right.
20:16Don't miss the interview
20:17with Dr. José Joaquín Norberto Vargas.
20:20He is Director of Cardiac Surgery
20:23at OhioHealth Maxfield.
20:25But he is also the author of interesting books.
20:28As I said, he is the first Dominican doctor
20:32who did a transplant.
20:32So we are going to talk to the doctor
20:34and also to the author of interesting books.
21:21The interview with Dr. José Joaquín Norberto Vargas
21:24is an important subject.
21:27We are joined by Dr. José Joaquín Norberto Vargas.
21:33He is Director of Cardiac Surgery
21:36at OhioHealth Maxfield.
21:38And he is also the author of books
21:40that we are going to see.
21:41And he is a doctor who has
21:43important milestones in his career.
21:46Good morning, doctor.
21:47Thank you for the invitation.
21:49Good morning. Welcome to Telematutino.
21:52And the people who served us as contacts.
21:54Doctor, you graduated from the Dominican Republic.
21:57You are from San Cristóbal.
21:59I read some of your books,
22:01of your origin.
22:02Your parents were of a humble origin,
22:04but they did university degrees.
22:07How do you decide and achieve,
22:10because it is not easy,
22:12you have to go through a series of exams,
22:14to be able to go to the United States
22:16and prepare and also reach
22:18such an important position as Surgery Director.
22:21Yes, well, thank you very much for the opportunity.
22:23And really, that's what the book is about,
22:26that trajectory, that journey.
22:28And even the cover,
22:30which I am very happy with our graphic designer,
22:33Adita, who really...
22:36That is Anita Vilez, my sister's daughter.
22:38Yes, she really did an exceptional job
22:41because she tells you what the book is about
22:43immediately, if you read it.
22:45And it all begins in San Cristóbal,
22:47in a very simple home,
22:49a home of a very respected family.
22:52I am the son of Reyito and Gradya,
22:55so you know them from San Cristóbal.
22:57And my father was a leader of the Catholic Church,
23:00a very prestigious person.
23:02And also both were teachers
23:04of the normal school,
23:07but they came from humble backgrounds,
23:10they were poor.
23:12They worked hard to get
23:15a university education.
23:17For example, my mother is from Mao.
23:20At that time, in the town of Mao...
23:23Conterránea de Yaquelín.
23:25Yes, I am from Laguna Salada.
23:27Well, well, at that time,
23:29you only got to the eighth grade,
23:31I think it was.
23:32You had to move, if you wanted to continue studying,
23:34you had to move to Santo Domingo
23:36or a neighboring town, the capital.
23:38She moved to San Cristóbal,
23:40with her well-known family.
23:42And there she went to university,
23:45I mean, sorry, to finish high school,
23:48and then to university,
23:50where she graduated as a lawyer,
23:52and then she continued studying
23:54to become a teacher.
23:57Then she became a teacher
23:59of Dominican history.
24:01My father had already graduated
24:03as an odontologist,
24:04but he was from San Cristóbal,
24:06and also very poor.
24:08He told me that for him,
24:10a normal day was
24:12a piece of bread with coffee.
24:14And with that, he had to go to university
24:16and stay the whole day.
24:18And when he came home again,
24:20the food,
24:21other people had already eaten it,
24:23who had arrived before him.
24:25And my grandmother was one of those people
24:27who gave food to anyone.
24:29My father sometimes stayed with bread
24:31and coffee, that was the whole day.
24:33That's how they graduated.
24:36That's how they obtained their
24:38university degrees.
24:40I remember when I heard those stories,
24:42it gave me something,
24:44because I was already in the middle class.
24:46I said, I have this privilege,
24:48I mean, I didn't have those problems.
24:50And then I realized
24:52that I had a commitment,
24:54because I said, if they did it,
24:56with those limitations,
24:58I have no excuses.
25:00That was what began to create in me
25:02that anxiety,
25:04that desire for improvement.
25:06I said, I have no excuses.
25:08What I'm going to do, I have to do it well.
25:10And that's how my journey
25:12to what would be
25:14the search for academic excellence
25:16began.
25:18And after that, several things happened.
25:20For example,
25:22the holidays between
25:24sixth and seventh grade.
25:26Several things happened there.
25:28Two important things.
25:30One day, like any other day,
25:32I went to church, to Mass,
25:34on Sundays, we went as a family,
25:36a Catholic family,
25:38and I heard the sermon of the gold bags.
25:40Basically, the priest
25:42who gave that sermon that day,
25:44Father José María Aguirre,
25:46a priest who, for that community
25:48at that time,
25:50was a great leader.
25:52And he explained that
25:54the gold coin,
25:56I mean, the gold coin bags,
25:58meant the talents
26:00of every human being.
26:02And then he explained
26:04that it was our responsibility
26:06to develop those talents to the maximum.
26:08And he said things like,
26:10the one who sings,
26:12to practice his singing,
26:14to elevate his singing.
26:16Basically, he encouraged excellence.
26:18And I wondered, what am I?
26:20Because I don't even sing.
26:22What is my talent?
26:24I don't sing.
26:26I play sports,
26:28but I'm not great at it.
26:30And that's when I said,
26:32no, I know what I have.
26:34I have willpower,
26:36and I like to study.
26:38That's going to be my talent.
26:40That's what I'm going to polish.
26:42And then, on those same
26:44holidays,
26:46I went to the program of Don Horacio de la Madrid.
26:48The program was called
26:50Saturday of my city.
26:52Something like that.
26:54And they presented
26:56an open-heart surgery.
26:58Dr. Ángel Chanaquino
27:00did the surgery.
27:02A very well done surgery.
27:04A very tremendous technique.
27:06A replacement of the mitral valve.
27:08I was sitting on the floor
27:10watching television.
27:12How old were you when that happened?
27:14Thirteen.
27:16And my father was sitting next to me.
27:18He wasn't watching television.
27:20He was drinking his afternoon juice.
27:22And I told him,
27:24look, look, look,
27:26that's what I'm going to do.
27:28That's what I'm going to do.
27:30And he, seeing
27:32the enthusiasm I had,
27:34started watching television
27:36with me.
27:38And he said,
27:40that Chanaquino is tremendous.
27:42You're going to have to polish yourself, Kiko.
27:44But I already had the issue
27:46of talent.
27:48And he said, don't worry about that.
27:50You're going to have to learn English.
27:52Don't worry about that.
27:54And that's when my search for
27:56open-heart surgery began.
27:58At that time, at 13 years old.
28:00You studied at the Autonomous University
28:02of Santo Domingo, Medellín.
28:04And how did that happen?
28:06You knew you wanted to go to the United States.
28:08How did you learn that language?
28:10Exactly.
28:12At 13 years old, I had a plan.
28:14If Dr. Chanaquino goes to the United States,
28:16I have to go to the United States.
28:18No, I have to go to the United States.
28:20And that's when I started
28:22learning English,
28:24since I was little.
28:26We had a group of kids
28:28from San Cristóbal
28:30to the Dominican Republic.
28:32I also went to PEC.
28:34And I learned it.
28:36And all the opportunities I had
28:38to practice it,
28:40tourists,
28:42going to the movies,
28:44trying not to read the subtitles.
28:46But one thing is to learn English
28:48in that way.
28:50And another thing is the practice
28:52when you are in the place.
28:54Exactly, because one thing is to see a movie
28:56and understand it well.
28:58But when you depend on the language
29:00for a job, especially a job
29:02as delicate as taking care of patients
29:04in a very fast system,
29:06because the issue
29:08of our adaptation
29:10to the American system
29:12is that the pace,
29:14the speed of the American system is very fast.
29:16In the hospitals,
29:18it's a huge job.
29:20So I remember
29:22when I got there, I think I speak a lot of English.
29:24And that you speak well.
29:26And I realize that, wait, there is a situation.
29:28I have to make an extraordinary effort
29:30to concentrate a lot,
29:32to understand everything
29:34and to be understood.
29:36And that exhausted me.
29:38At three in the afternoon,
29:40I had to talk to someone in Spanish.
29:42I had to find someone to speak Spanish.
29:44Or call the Dominican Republic.
29:46No, that phone from that hospital
29:48I had to call my mom.
29:52Colette Cole.
29:54But she succeeded in her revalidation.
29:56Yes, of course.
29:58And the book talks a lot about that.
30:00Because for me,
30:02it's an obligation of mine.
30:04I feel obliged to try
30:06to carry a message
30:08of optimism, because I see
30:10a contamination in the networks
30:12where there is so much negativity
30:14and so much
30:16mediocrity and pessimism.
30:18And I remember...
30:20This is more or less to chase
30:22your dreams.
30:24To dream and have a plan, obviously,
30:26to achieve that which you long for so much.
30:28Yes, because I remember
30:30that when I said,
30:32when people found out
30:34that I was going to take the exam called Foreign,
30:36which is the exam for the United States,
30:38it's a man-eater.
30:40People started to say,
30:42but what do you think,
30:44Kiko, because that's my nickname.
30:46Yes, Kiko.
30:48What do you think?
30:50Nobody takes that exam.
30:52Everyone gets burned.
30:54Everyone breaks up.
30:56Yes, exactly.
30:58And if it happens,
31:00they won't give you a general
31:02surgery position
31:04because they are very competitive.
31:06Latinos, Dominicans.
31:08And if you get a general surgery,
31:10it's not true that you'll get a cardiac surgery.
31:12I got it.
31:14I got a general surgery
31:16and I got a cardiac surgery.
31:18So,
31:20it caught my attention
31:22because at that time
31:24there was no internet.
31:26There were no cell phones
31:28like there are now, none of that.
31:30No, no GPT.
31:32So, what happens is that
31:34it affected me so much
31:36to the point that I had to block.
31:38I didn't go anywhere
31:40where I knew there were people like that.
31:42I locked myself in my room, in my house.
31:44There were people like what?
31:46Pessimistic people.
31:48Pessimistic people like that.
31:50I isolated myself
31:52because I couldn't with that.
31:54Because I know that the fear,
31:56if I let myself be intimidated,
31:58the fear could make me fail that exam.
32:00Yes.
32:02There are many recommendations
32:04that great gurus make
32:06on how to succeed in life.
32:08Yes, yes.
32:10Stay away from pessimistic people,
32:12from fear, and really dream big
32:14and go for it.
32:16So, if that was the effect
32:18at that time,
32:20where we didn't have WhatsApp,
32:22we didn't have Instagram,
32:24we didn't have Facebook,
32:26imagine what's happening
32:28now in the networks.
32:30See another type of message.
32:32And that book,
32:34that result of years
32:36of writing on Facebook,
32:38many anecdotes, many anecdotes,
32:40many anecdotes,
32:42and people started asking me,
32:44Doctor, keep writing,
32:46because people have
32:48their own time.
32:50Doctor, keep writing.
32:52You have to write something weekly.
32:54They put me at that height,
32:56and then they told me,
32:58Doctor, what surgeries
33:00do you most often perform
33:02in the hospital and under your direction?
33:04Right now, what we do
33:06are the so-called conventional
33:08cardiac surgeries,
33:10that is, coronary surgeries,
33:12valvular surgeries,
33:14ultrasound surgeries,
33:16that's what we do.
33:18The transplant, at the time of my transplant,
33:20was when I was in Ohio State,
33:22which was part of the university system,
33:24because to be a transplant,
33:26you have to be in a university system.
33:30So now you don't do transplants anymore.
33:32No, not anymore.
33:34But you were the first Dominican doctor
33:36who did a transplant.
33:38Yes, because at the end, in 1999,
33:40when I was finishing
33:42the specialty,
33:44I had already helped so much
33:46the two transplants with Dr. Robert Michele,
33:48who was my boss,
33:50that I already knew the technique.
33:52So one day,
33:54when I brought the organ
33:56that we were doing a transplant,
33:58he was doing another transplant,
34:00when I brought the organ,
34:02I told him, doctor, look, this is fine,
34:04everything is fine, his heart is very well,
34:06he tells me, do you want to do it?
34:08And I said, of course.
34:10So I turned around,
34:12and I did it,
34:14and it was an extraordinary moment
34:16for me,
34:18it marked my career,
34:20in the sense that at that time
34:22I didn't think I was going to be a transplant,
34:24I thought I was going to be a surgeon,
34:26a conventional heart surgeon,
34:28but he gave me the opportunity
34:30and we did it.
34:32Doctor, have you ever felt,
34:34in addition to that pessimism that they say
34:36in the country of origin and in the people
34:38until they know you, you are not going to achieve it,
34:40it is difficult, you are not going to be able to,
34:42it is very complicated, everyone burns,
34:44everyone breaks, there, well,
34:46that filter passed, but once there,
34:48did you feel discriminated
34:50because of your origin, because of what you were?
34:52Yes,
34:54I also talk about that in the book,
34:56what is called sophisticated discrimination,
34:58which is the most dangerous,
35:00which is the discrimination
35:02where people
35:04supposedly cults,
35:06well-educated,
35:08pretend a friendship to you,
35:10but they expect any
35:12detail
35:14to attack you.
35:16For example,
35:18I have realized that for me
35:20to have been able to survive
35:22in the United States, I have had to be
35:24always trying to be
35:26A1,
35:28A plus,
35:30because when I am A-
35:32less, when I go down a little bit,
35:34there they start to look for things,
35:36and that has been my life.
35:38For example, for me to go
35:40from second
35:42to third year of general surgery,
35:44for me, the director of the
35:46Surgery Program in Washington
35:48Hospital Center,
35:50asked me to get
35:52more than 90%
35:54in the annual
35:56exam of
35:58surgery residents.
36:00And what was the normal percentage?
36:0250%.
36:04And you had to get 90%?
36:0690%.
36:08But I have to admit that I went,
36:10they gave me
36:12a two-year contract,
36:14and I needed five,
36:16so to pass,
36:18they said, I give you the other three years,
36:20if you do that.
36:22And I said, are you sure?
36:24You guarantee me that if I get more than 90%,
36:26you will give me the position?
36:28He said yes.
36:30What happens? People have to understand
36:32that in a program,
36:34in the residence,
36:36the name is residence,
36:38the doctor lives there in the hospital,
36:40literally, working, training,
36:42and there is no time,
36:44there is not much time to study,
36:46you learn by the voices, as they say,
36:48what is going on, and you study
36:50as much as you can.
36:52And I lowered
36:54the,
36:56what is it called, the hours of sleep,
36:58I lowered it as much as possible,
37:00to allow me to function.
37:02And
37:04I got a 98%
37:06Wow.
37:08I did not know that,
37:10what did that mean?
37:12I remember that he called me to the office
37:14to tell me,
37:16do you know how much you got?
37:18I told him, I know I got above 90%.
37:20He said, how do you know?
37:22Because I studied the book
37:24where they took that test,
37:26I read it almost whole,
37:28they tell me, you got a 98%
37:32Do you know what that means?
37:34I said no.
37:36That of every 100 surgeons,
37:38you were above
37:4098 of them,
37:42only 12 were above you.
37:44That's what it meant,
37:46that form,
37:48that note.
37:50Let's take a short break,
37:52because we still have a lot to know
37:54about Dr. Norberto,
37:56and also of course about his two works,
37:58because there are some religious
38:00that are worth having
38:02a few minutes of his first work.
38:08Music
38:12Music
38:16Music
38:20Music
38:24Music
38:28Music
38:32Music
38:36Music
38:40Music
38:44Music
38:48Music
38:52Music
38:56We continue this morning on Telematutino 11,
38:58we are talking with Dr. Jose Joaquin Norberto Vargas.
39:02He is the director of cardiac surgery
39:04at Ohio Health Mansfield,
39:06and author of the works
39:08Death, Physics, Resurrection and
39:10Experiences of a Cardiologist Surgeon.
39:12Doctor,
39:14since you saw the first video
39:16where Dr. Chanaquino appeared,
39:18may he rest in peace,
39:20we had the opportunity to share
39:22many opportunities with him,
39:24but today, how much has changed
39:26that surgery that seemed almost impossible,
39:28that was for few people
39:30to perform it,
39:32and few to receive it,
39:34how much has it advanced,
39:36how much has it modernized
39:38since that time until now?
39:40Yes, it has advanced a lot,
39:42and I have to say that
39:44coronary surgery is the one
39:46that has been studied the most
39:48in terms of prognosis,
39:50in terms of survival,
39:52in terms of longevity,
39:54it is the surgery
39:56that has been studied the most
39:58to always perfect it.
40:00So,
40:02I have to say that
40:04cardiac surgery
40:06is a routine surgery,
40:08and that we can
40:10expect
40:12a mortality
40:14depending on
40:16the risk factors
40:18of the patient itself.
40:20Do we always have to open the chest,
40:22doctor, or not always?
40:24No, not always.
40:26There is what is called
40:28minimally invasive surgery,
40:30with small incisions
40:32on the sides,
40:34but the one that is used
40:36the most
40:38is in the middle,
40:40what we call a medium sternotomy.
40:42So, what has advanced
40:44so much is
40:46survival.
40:48I remember
40:50my case,
40:52for example,
40:54I had 10 years,
40:562,000 cases,
40:58without a death
41:00in the operating room.
41:02Those are 2,000 cases.
41:04Impressive.
41:062,000 cases in a row.
41:08Of course, we have to understand
41:10that one thing is death
41:12in the operating room,
41:14and another thing is patients
41:16who deteriorate
41:18in intensive care.
41:20That's another thing.
41:22But even so,
41:24I was doing emergency surgery,
41:26elective surgery,
41:28high-risk surgery,
41:30and I had
41:32forgotten what it was
41:34to die in
41:36the operating room,
41:38until it happened to me later,
41:40and that makes me
41:42think again
41:44and understand that one is also human,
41:46because that was a performance
41:48that, after I think about it,
41:50I think it's almost a Guinness record,
41:52because 2,000 cases
41:54of surgery,
41:56and we're talking about all kinds,
41:58high-risk,
42:00that's a lot so that I don't die
42:02in 10 years,
42:04I didn't lose a patient
42:06in the operating room.
42:08Doctor, robotics has not yet reached
42:10that type of surgery.
42:12What you know about robotics
42:14is that you need,
42:16to do it well, you need
42:18a very high volume.
42:20I know that there is a group
42:22in North Carolina,
42:24Cleveland Clinic,
42:26that is doing a lot of robotics,
42:28mainly for the mitral valve,
42:30because they go on both sides,
42:32so they can see better
42:34the mitral valve,
42:36which is sometimes difficult
42:38to expose in the center.
42:40I don't do robotics,
42:42I am, in that sense,
42:44more conventional,
42:46because after all,
42:48what interests me is the patient's survival.
42:50With my technique,
42:52I have a very good survival.
42:54Doctor, you published a book
42:56in 2015,
42:58it was a web-saler on Amazon,
43:00Death, Physics and Resurrection,
43:02Vision of a Surgeon,
43:04but it's the death, physics and resurrection
43:06of Jesus Christ.
43:08Scientists, doctors,
43:10don't believe in God,
43:12they don't believe in Jesus Christ.
43:14However, in this book,
43:16what you propose is
43:18the death and resurrection
43:20of our Lord Jesus Christ.
43:22So, how does a doctor
43:24harmonize science
43:26with faith?
43:28Well, you know that
43:30that's a myth,
43:32that scientists
43:34are not people of faith,
43:36that doctors are not people of faith.
43:38What happens is,
43:40you have to be careful
43:42and put things in their right place.
43:44I say,
43:46God is what God is,
43:48and science is what science is.
43:50And so I manage
43:52to stay well focused
43:54on that.
43:56But it's not true that scientists
43:58are people of faith,
44:00I can prove it,
44:02even with statistics that have been done.
44:04The Association
44:06for the Advancement of American
44:08Sciences
44:10did
44:12a survey
44:14among scientists
44:16and, to our surprise,
44:1851%
44:20are believers,
44:22but of the total.
44:24But when you go to evaluate
44:26among young people,
44:28young scientists and older
44:30scientists, young scientists,
44:32less than 40 years old,
44:34and we're talking about laboratory science,
44:36people who are
44:38looking at cells, doing experiments,
44:40that kind of thing,
44:4266%
44:44of young scientists
44:46are believers.
44:4866%.
44:50So the atheists
44:52are the oldest.
44:54But why?
44:56Because what happens is that
44:58the advances of science in the last 50 years
45:00question
45:02many things
45:04about creation.
45:06For example,
45:08the origin
45:10of the universe,
45:12all the laws.
45:14When you say laws,
45:16you imply that someone
45:18made those laws. For example, the laws of gravity.
45:20The laws of gravity.
45:22The speed of light.
45:24Those are constants that are there
45:26and that scientists know
45:28a little.
45:30For example, equations destroy everything.
45:34Mathematics itself is an example
45:36of a superior mind.
45:40And biology.
45:42Today we talk about
45:44bioinformatics.
45:46Bioinformatics. Why?
45:48Because what's in the cell nucleus,
45:50in the genes,
45:52in DNA,
45:54is information.
45:56I put that information there.
45:58So,
46:00that scientists
46:02don't believe in God,
46:04that's totally false.
46:06That's false.
46:08And there are 73% of doctors
46:10in the United States
46:12who believe in God.
46:14Let's put it differently.
46:16In a transcendent being.
46:1873%.
46:2074% believe in miracles.
46:22So what happens is that...
46:24Yes.
46:26Have you seen many cases
46:28that you consider miracles in medical practice?
46:30No, I've seen rare cases.
46:32I can't...
46:34It's hard for me to speak,
46:36but I've seen and heard and read
46:38interesting cases.
46:40I know a case.
46:42A friend, a psychiatrist
46:44of Dominican origin,
46:46who lives in the area of Orlando,
46:48had advanced lung cancer.
46:50She had advanced lung cancer.
46:52She was discharged.
46:54And one day,
46:56she prayed.
46:58She wasn't a believer.
47:00She had her doubts.
47:02But she said,
47:04if there's a God,
47:06please.
47:08The next day,
47:10the cancer disappeared.
47:12And there's my friend.
47:14So, things happen
47:16that you can't explain.
47:18You can't explain.
47:20So you don't have to be humble enough
47:22to say, I don't understand
47:24what happened there.
47:26And I am.
47:28I try to say that there are things
47:30that I don't understand,
47:32and that I open the possibility
47:34that there is a creator.
47:36How do you see medicine in the Dominican Republic,
47:38and if it stays in contact with the country?
47:40Yes, I stay in contact with the country.
47:42Not as much as before,
47:44because there came a time
47:46in my career,
47:48after I left,
47:50after I trained in cardiology,
47:52that I received patients from here,
47:54in the United States,
47:56at Ohio State University.
47:58And I also did several
48:00sessions for people with limited resources.
48:02Here?
48:04Here, in 2006, 2007, 2008.
48:06And those sessions were supported
48:08by Ms. Elena Villella,
48:10who gave us resources
48:12to be able to do those sessions
48:14for poor people.
48:16And I have also participated
48:18in many conferences here.
48:20Yes, they have kept me very close.
48:22Many advances have been made
48:24in global medicine
48:26in the Dominican Republic.
48:28I know a lot
48:30about what is done in cardiology,
48:32cardiac surgery.
48:34It has advanced tremendously.
48:36What I do believe
48:38is that there is a situation,
48:40what I call
48:42a management and administrative situation.
48:44And what I mean by that
48:46is that it has nothing to do
48:48with the quality of the service.
48:50I know
48:52cardiac surgeons and cardiologists here.
48:54The problem here is
48:56that the resources,
48:58we do not have
49:00enough resources to be able
49:02to face epidemiologically
49:04the number
49:06of patients that need to be operated.
49:08For example,
49:10the population of 11 million
49:12inhabitants
49:14generates approximately
49:161,000 cases
49:18per million.
49:20So here, in theory,
49:22we should operate
49:2411,000 people
49:26per year.
49:30And here, I don't think
49:32more than 1,000 cases are done
49:34per year.
49:36Doctor, is the heart the most
49:38lethal organ?
49:40I don't think so.
49:42I think it's difficult
49:44to know which is the most
49:46lethal organ.
49:48But what about the death rate?
49:50How many die for what?
49:52No, no, no.
49:54The death rate
49:56has to do with cardiovascular disease.
49:58So this is the most lethal organ?
50:00No. I have skin problems.
50:02I have skin problems.
50:04Things that don't kill you.
50:06The most lethal organ?
50:08Yes, the most lethal.
50:10For example, the flu.
50:12Everyone gets the flu
50:14every now and then.
50:16But when it comes to mortality,
50:18that's another thing.
50:20Cardiovascular disease
50:22includes the heart
50:24and obviously
50:26cardiovascular accidents.
50:28And why is it so hard?
50:30Why is it so hard that people
50:32have to die?
50:34The heart fails
50:36to pump
50:38the oxygenated blood.
50:40What makes you sick, doctor?
50:42According to your experience
50:44and so many studies, I know you're a surgeon.
50:46But obviously, to become a surgeon,
50:48you've had to go a long way.
50:50You've had to hear a lot of stories
50:52about why the patient
50:54gets to this stage of surgery.
50:56What are your conclusions?
50:58Well, it's what's called multifactorial.
51:00In the United States,
51:02obesity is a problem.
51:04Obesity, smoking,
51:06hypertension,
51:08high levels of cholesterol,
51:10stress,
51:12sedentary lifestyle.
51:14All of these are factors that are a time bomb
51:16for our bodies
51:18and our hearts.
51:20But we're only seeing it here.
51:22There's already a level of obesity
51:24in the Dominican Republic.
51:26And all of the factors you're pointing out
51:28are stress.
51:30I only drove a vehicle here
51:32in the city.
51:34I don't drive here anymore.
51:36I haven't driven in a long time.
51:38I haven't driven in the city in a long time.
51:40Doctor, in addition,
51:42I saw in your life story that you play clarinet
51:44and saxophone and play merengue
51:46in your free time.
51:48Yes.
51:50I belong to a generation in San Cristobal
51:52that...
51:54I thank society
51:56at that time,
51:58the leaders.
52:00Because in San Cristobal
52:02there were many music schools.
52:04There was everything.
52:06There were many cultural clubs.
52:08So I took advantage of my people.
52:10And then there was a fever,
52:12a fever of music.
52:14I'm from that generation
52:16that there were some guys
52:18that today
52:20are great musicians
52:22here in the Dominican Republic.
52:24I'm talking about Luisín del Rosario,
52:26who was a saxophonist
52:28of Juan Luis Guerra
52:30and did the production of Ban Reservas.
52:32The brothers of La Cruz,
52:34who live in the United States.
52:36All those guys.
52:38So I studied, but I knew
52:40it was a hobby for me.
52:42For me it was a hobby.
52:44For them they became great musicians,
52:46but for me it was a hobby.
52:48In your free time you play instruments.
52:50Yes.
52:52And you play merengue.
52:54For example,
52:56on my birthday,
52:58two years ago,
53:00I played with the orchestra
53:02of Pablito Martínez.
53:04I played merengue with them.
53:06How interesting, doctor.
53:08We have really felt very honored
53:10and even impressed
53:12by your simplicity,
53:14despite all the achievements
53:16you have had.
53:18And how good that you are also a believer
53:20and that at the book fair
53:22the book about physical death
53:24and resurrection will be published again.
53:26So we thank you very much
53:28and we hope to have you back
53:30in the program.
53:34Thank you very much, doctor.
53:36And we congratulate you for the achievements you have achieved.
53:40You can always do it.
53:42When you dream big
53:44and you go down a path,
53:46you do it well.