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05/19/2021 | Unmasking the surgeon

Stefaan Bergé

Stefaan Bergé infront of his house

1. You are Belgian, living in Germany and working in the Netherlands. How did it come to this? Do you live “The Convinced European”?

After my studies in dentistry and later medicine in Belgium back in the 80’s, there were two main factors that brought me to Germany. The first one is, that German-speaking countries are the cradle of OMF surgery from my point of view. The second reason why I was drawn to Germany is my love for classical music, that I already had as a child. 
When it comes to my workplace, I did not decide for the Netherlands, but rather for a clinic that has an outstanding reputation and is one of the big European centers for OMF surgery - Nijmegen. Thinking of my great predecessors there, like Merz, Freihofer and Stoelinga and what they achieved in the past, I was not hesitating a minute, when I received the call to go there. 

2. Do you get along with all these national mentalities and where are the main differences from your perspective?

There are a lot of existing clichés, but I think they are overrated. I prefer to look on the positive aspects rather than the possibly negative ones. For me, there are nice things in all of these countries. Living in Germany for me means to have huge green spaces and very caring neighbors. It almost feels a bit like vacation. When you look to the Netherlands, you have a more vibrant and busy life. When you combine these aspects with Belgian cuisine, you almost have the perfect life. 

3. What would you say is the principal aspect of your personality? 

In my yearly feedback rounds with my team I often hear, that I am able to transfer my passion for OMF surgery and my project to others. This aspect is also really important for me personally, since my projects are often of a visionary and future-driven nature. I love to think about what will be in 2030 rather than tomorrow and this way make a difference. For those projects it is important to break them down into smaller steps to win others for your ideas – and this strategy seems to work.

4. When and how did you decide to become an OMF surgeon?

Right after I graduated from school, I started my studies in dentistry. Everything went smoothly and I was about to finish my studies before the age of 23. Back then, I could not imagine working within the same profession for the next 45 years. At the same time, I met Prof. Eric Fossion, which was really good fortune for me. With his incredible charisma, great sense of humour and impressive skills within the OMF speciality, he really was an idol for me. These two factors brought me to OMF surgery.

5. What is it that fascinates you about your surgical discipline the most? 

For me it is the great diversity in patients, the team collaboration and the delicate work. We really see patients of all different ages, starting from babies up to the cancer patients in their terminal status. Apart from this, I appreciate the cross-discipline cooperation with students, assistants, scientific collaborators and surgeons to only name a few. Another important point is the high precision we work with. For example, when closing a cleft lip, 0.5 mm mean a lot. In our discipline you really have the chance to work close to the limit of perfection – and that is what I love.

Stefaan Bergé in his music room

6. Which profession would you have chosen, if you had not become an OMF surgeon? 

Besides OMF surgery, I have a great passion for classical music, that already started early in my life. That is why, I also could have imagined to become a conductor of an orchestra – both opera or classical music. 
 

7. If you had the opportunity to look over the shoulder of a colleague, who would it be and why?

I thought a long time about this question. Although there are some senior surgeons, that I really admire, I would always choose to look over the shoulder of a young talented colleague, who is willing to learn and do the next step. That is also part of my general attitude, where I ask myself what I can do to support others in their individual development. 
When it comes to senior colleagues, I really admire Prof. Klaus Wolff from Munich, Prof. Gosla Reddy from Hyderabad and Prof. Fossion and would love standing at the OR table with them - not for their outstanding surgical skills, that they certainly have, but because you can learn a lot from them in terms of social skills, philosophy and friendship. That is what it is all about in the end.

8. What was the most eye-opening event in your career and what did you learn from it?

A very special moment was at the beginning of my career in Saarbrücken, together with Prof. Dumbach and Dr. Rodemer. We received a complex panfacial trauma but Prof. Dumbach was not there and Dr. Rodemer was already kept within an oncological case. I was alone and there was no supervision or assistance in order to instruct me. Dr. Rodemer then said to me: “You will do this; you are capable of this.” Following his words, I started the operation being certain, that I would not be able to finish it successfully. In the middle of the surgery, I noticed that I can do it. This moment where I realized, that I can do it and that I am indeed an OMF surgeon meant mental liberation to me. 

Another nice episode during my studies was, when I found a book on cleft lip and palate in a second hand shop. I was completely fascinated by this book and kept on reading it again and again. That was the beginning of my love for cleft lip and palate repair, that changed my future perspective. 

9. If you look back on your career, is there anything you would like to change and if yes - why?

The steps in my career Saarbrücken, Bonn, Nijmegen were great – I would not want to change anything there. However, I spent far too much time with administration and in meetings. I would really act differently today. It is a pity, how much time you can waste there. 

10. Do you think that young surgeons are too much protected nowadays? Should they be more exposed to the challenges of the specialty?

That depends on the country you look at. In the Netherlands you have fixed, organized blocks and learning aims of what you are supposed to learn at which moment in your career. The student will be nicely guided through his/her career. Such blocks are completely missing in Germany. That has two sides: If you are good, strong and ambitious and you take the initiative you can do a lot more in Germany than you could do in the Netherlands. You can really fly there! The other side is, and I have noticed that myself in Bonn, that a lot of people go overboard. If you are not courageous and you are not willing to do a lot more extra work than you are supposed to do, then you will not get a good training.

11. You have shown your visionary streak by founding one of the first OMF 3D labs in Europe. What was your motivation for doing so?

I am convinced of the holy triade in OMF consisting of soft tissue, hard tissue and dental tissue. For all three of them there are great imaging techniques available, but the challenge is to bring them all together – and this is what we wanted to achieve and the motivation behind it. I think we managed it and it was a great milestone for OMF surgery.

The detailed answer to this question goes back to my times of study. There was a moment where I was struggling to choose between radiology and OMF. So, what I want to express with this anecdote is, that imaging techniques were always fascinating to me. During my time in Bonn I had the chance to experiment a lot with fascinating things like 3D-imaging thanks to the close cooperation between the university and the Cesar Institute for six years. As I then received the call to Nijmegen, I was already obsessed with those techniques and wanted to bring them to Nijmegen as well. I insisted on things like a Cone Beam CT, which was not at all available in the Netherlands at that time and stereophotogrammetry. This inventory then built a good base for the 3D lab.

In addition to this technical things, I also was lucky with my first fellow workers, like Thomas Maal, who was only 23 years old and still a student when he started with us. Today he is the first 3D professor in the Netherlands and has close to 200 own publications. 

12. How will the surgical future look like in a growing digital and big data environment? 

I am fully convinced, that artificial intelligence (AI) will take over a large part of our responsibility. We currently have around five to six PhD theses running on this topic. We believe, that a lot of the decision-making will be covered by AI - whether it will be on removal of wisdom teeth or on orthodontic rehabilitation, implantology or oncology. Besides AI, augmented reality will also play an important role. We already do nice things in craniofacial surgery, implantology or TMJ surgery - orthodontic work will follow. Robotic navigation and data acquisition will as well have a place. 

We also believe in dynamic medical networks. The idea, that a clinic will offer a certain service and the patient will come and visit is no longer economic. The clinic needs to establish a network in which the patient will receive the optimal care, depending on his/her individual pathology. The patient will travel less, but the institution will orientate itself more towards the patient. 

And a final point: Genetics will also have an incredible impact in the near future. For example, when I think of cleft lip and palate patients: It is not so certain that we will see babies who are born with this pathology in 2050. Or prevention: I cannot imagine, that the numbers in oral cancer will be the same in 2050 as we see them today. 

13. Do you have a ritual before performing surgery or a lucky charm?

Maybe one thing, that I would not necessarily call a ritual, but rather a way of working: I tend to operate barefoot without my clogs. I learned that in Nigeria, where it is very hot. The doctors there take off their shoes and place their feet in a bucket with cold water which cools their body temperature down considerably. We tried that as well and it felt nice to operate without clogs. It forces you to operate in a clean way without a mess lying under the table. 

14. Which kind of music supports your work in the OR? 

I am a fanatic opponent of music in the OR. We know, that pop music is negative for your concentration and bad for the general mood. In my opinion it should be forbidden in the OR. 

The sound I most enjoy in the OR is in fact silence. We currently have a project to build up the silent operation. If there is one thing which I would like to bring to a big success in the next ten years, it is this project. Hundreds and thousands of surgeons are being mistreated by anesthesia and further equipment which only creates noise. We hear the heartbeat of our patients all day long. We constantly hear false alerts coming from the anesthesia unit. If you listened to a recording of 30 minutes of an average operation day, you would go crazy. 

So we are trying to build up an OR environment which brings us silence. Anesthesia, head nurse or surgeon: Everybody is wearing a knob in the ear and only hears what he or she is supposed to hear. Everything is on a professional level: I raise a question, you answer – just like in a cockpit of an airplane. I do not need talks about private vacation or soccer in the OR. I know that I am special in this sense, but it is really ridiculous what you are confronted within an OR. Sometimes we practice and try to be silent whenever possible and in the end everybody is amazed by the beauty and the concentration a silent OR can offer.

15. What is something only few people know about you?

It is maybe a well-kept secret, but for things I care about, I can have a huge amount of patience. Usually I have the reputation to be impatient and pushy, if things are not moving. For example, when I am doing grocery shopping and have to wait three minutes in line, I already go crazy. However, when it comes to a complex operation, accompanying a young surgeon to one of his/her first operations or building harpsichords at home, the contrary holds true … but only if the result is good.
 

Stefaan Bergé infront of a harpsichord

16. What do you enjoy most in your free-time? 

I most enjoy building harpsichords at home and take it as a moment of silence and rest in order to concentrate myself. Apart from building them, I also love playing music instruments. I try to play a bit of the piano every day and compose some music on my own on the weekends.

Another hobby I really love is playing snooker billiard. When I come home from work, this is the first thing I do with my kids. I have six of them – so finding someone to play with is not that hard. The only thing to be suspicious about is, when I come home and one of my children asks me, if I want to play. Then I already know, that they had a bad school report or stress in general. I also take this as an opportunity to have good conversations with my family. 

17. Which deceased person would you have liked to meet and why?

My top two names would be Georg Friedrich Händel and Giacomo Rossini. Two composers who were real popstars at their time. Both had an extremely nice life. Händel was the first rockstar ever. He never married but had several affairs and an incredible passion for food, drinks, music, opera as well as festivals. If you listen to his music, you will understand that immediately. He must have been an extremely funny character as well. Another fun fact is that we both share the same date of birth: February 23. When I think of Rossini, who is a genius as well, he might even be funnier and more charming. The special thing about Händel or Rossini is, that you only have to listen to one minute of their music and you can tell this is Händel and that is Rossini. That only is true for very few composers. They are grand masters in perfection, but still very social people, genius to the bone and I really believe one could learn a lot from them. 

18. If you could tell three things to your younger-self, what would you tell him?

There is one thing I know for certain: If I had the chance to start again, I would be a much more professional student. My years of dentistry in Leuven were one single party. I do not regret that, because it also offers you a lot in terms of leadership or social components, but looking back, there was little perspective in all that. Today I see what my children do. For example, my two elder sons are also studying medicine, but still they realize their own music career as well. That is something I really have missed, that I would go for, if I had another chance.

The second point is maybe an open door: From 18 to 28 I practiced a lot of sports. In recent years that declined, which is a pity. I would do that differently now. I admire people who still have a very good fitness level at the age of 55 or 60 - but I am lacking a bit of discipline there.

19. If you could witness any event past, present or future, what would it be?

I would like to be present at my own funeral, which ideally-speaking should happen at a very high age, satisfied with a fulfilled life surrounded by all my children who are grateful and happy on that day. If I had the chance to sign for that, I would do that straight away. The reason, why I chose this event is simply because I would then know, that my children are doing fine. That is by far more important than anything else in the world.

20. If a plane flew you to any destination you like right in this moment, where would you go and what would you do there?

I strongly believe we are already flying far too much. So I would prefer to stay here with my team and with my family and I would build upon the here and now. 

And if it was by bicycle?

That is a good one. I hope that I will one day be in the physical condition to complete a Tour de France stage in the Alpes. The big cols of the Tour de France like Alpe d’Huez, Galibier or the Mont Ventoux and so on. I would be very proud of that.

21. What are the top three things on your bucket list?

A very ambitious dream would be to play a century break at Snooker. That means a hundred points in one game in a row. The maximum a player can achieve is 147, but this is impossible for non-professionals - but a century break, if I keep practicing for another ten years, who knows? Not very realistic to be honest. I am only telling you that, because it gives me a good opportunity to play again, which for me is very social, interactive, nice and relaxing.

Maybe due to the Corona pandemic short ski trips with my kids would be high on my list as well. We used to do that several times in the past and it was always a highlight throughout the year. You cannot do that often enough. 

My third point would be playing the “Concerto for four harpsichords and orchestra” from Johann Sebastian Bach. I am now about to build my fourth harpsichord. I would love to finish that and to play it in the concerto. That is a project from which I am not sure, if it is realistic but I will try hard for that. 
Specific questions:

22. How did classical music come into your life?

My dad used to be a conductor of a church choir in Antwerp and I myself was already member of the children choir there at a very young age. That dominated most of my youth up to the age of 15. Two to three times every week we found ourselves in the opera, either practicing or performing. Apart from that, I went to music school at a very young age and learned how to play the harpsichord. Since playing alone spoils all the fun, we have always played in the group of four, five or six musicians, which for me was very fascinating. I really became addicted to music by doing that.

Bergé orchestra

23. Your family are all music lovers resulting in the Bergé string ensemble mainly formed by your kids. Please describe how you made that happen. 

All the credits for that go to my wife. She is in medicine as well, but additionally studied violin and has great passion for music. She brought our children and music together at the age of three years. If you start music at three, you can already play very well at the age of seven and then it is already fun. That is the big problem: If you only start at seven or eight you will soon turn into puberty, where playing an instrument becomes uncool – and this is usually the end of the story. In contrary, when you have already played the four seasons from Vivaldi with orchestra at the age of ten you only want to do one thing – to play that again! And the kids have success, they support each other and they thoroughly enjoy that. It is all without stress and builds up on its own. 

I firmly believe that all kids have fun and talent for music, if they are brought in the right environment and are trained adequately. We should as a society pay far more attention to this. Music can build up bridges and create peace. Two children who play in an orchestra can have different opinions, but they will always find a more harmonic way to deal with different ideas compared to kids who e.g. play in a soccer team. Music is a very good school for social behavior and functioning in groups.

24. How was it possible to keep up the motivation for all of your family members for such a unique project? 

You have to approach them and you need to play their music as well. I really do not mind what we play as long as we just keep on playing together every now and then. This is what counts. Recently, my son came home and said: “I looked through the notes of “Love of my life” and “Bohemian Rhapsody” and I think, I could also play it on a bass guitar”. I said: “But we don’t have a bass guitar.” – but I am fully convinced, if he will manage to organize a bass guitar, he will start his own project and he will stick to it. So you see, it is all about fun and motivating people.

25. Where does your love for harpsichords come from and how did you become a harpsichord builder yourself? 

I had a harpsichord teacher when I was 14 or 15 who built his own harpsichord. It was back then that I knew I want to do this as well. I collected all kinds of books and plans about it. Apart from the knowledge, you also need a special room or even a house for such projects, which is why I could only start at the age of 40. Space is actually the most important thing. The components for the instruments you can find on the internet or on a special store or a bazar in Paris.
One day, I would love to build up a harpsichord only with components which everyone can buy in a hardware store - but I believe

I can only do that once I am retired. Actually I would like to build up six harpsichords: One for every child!
At the moment I have two harpsichords and one piano in the making, that I also paint myself.

26. Building up an acoustic natural instrument needs a lot of patience, passion and love for detail. Do these characteristics also describe the person Stefaan Bergé?

I would say yes, but again I would prefer other people to judge on this. Love for detail is certainly true and I already mentioned that various times. Sometimes it can really become neurotic and painful. Last year we were renovating a barn house here and we also built a small pub in it together with the kids. Sometimes they really got mad at me saying: “Daddy it is fine now!” And I just answered: ”No, let’s sand-polish the whole wall again and repaint it and then it will be fine!”

That also holds true for cleft surgery, where I believe it is the most rewarding field in our specialty. Unfortunately, not too many are interested in that. I used to operate a lot of tumor patients, but in the end that is always a destroying surgery. In clefts you have the opposite. It can be a very rewarding surgery, even though you cannot always lead it to absolute perfection. It all lies in your hands how well you will perform. 

27. How do you manage your work-life-balance to have enough time for your family and your work?

If people think that they bring their life into balance, that means, that they do not have it under balance right now. This thought is from a different time, when you had to work ten to twelve hours in a factory and needed to recharge your batteries afterwards. Today, our professional and private lives are completely tangled. We need to stop to tell each other, that we need a work-life balance. We need to arrange our lives in that way that private and professional life coexist in a good harmony. Let me give you an example: If my son has an exam tomorrow at 11:00 a.m., I will certainly write him a WhatsApp at 10:45 a.m. wishing him good luck. If I have a patient in severe circumstances and I want to know how the patient is doing I do not care at all if I am not on duty on that day - I will call or I will be called. 

You need to make the best out of the time you have. If you live that way and if you try to introduce your fellow workers into that philosophy you will gather a large group of happy people around you. 

28. Can you give any tips to young colleagues for their career path which could be helpful? 

Try to mobilize the strength in you not to follow the path of least resistance. Follow your own path and your heart. Try to find out what makes you happy and do not accept a position simply because it is vacant. I see that in many application talks. I always ask the people: “Why do you want to work here; you have never been here before? Who tells you, that we are all not arrogant idiots?” That is often already the end of the conversation. “But I heard that ….” – “OK, fine but that is completely insufficient!” Try to introduce yourself into an institution where you really think: “This could be my thing!” and then go for it. A good career will partly be formed by luck: You need to encounter the right people, the right talks and so on - that is the luck factor, but the steady factor is yourself. You are the blacksmith of your own career and sometimes the iron needs some days longer to be heated until you can work on it. So take your time and be elective before you take a decision. I think that is very important.

Another advice, that I also often tell my fellow workers (and you realize you get old once you talk like this): “Believe the seniors, when they tell you, that something they did was a mistake in retrospective and do not try to verify it on your own. I say that, because I made the same mistake.” I know that surgeons below the age of 40 to 45 need to operate their own list of complications as well, but it would be nice, if we can find a way to prevent that. 

29. What helps you to relax after a long or exhausting working day? 

Although my life is in balance, I also experience tiring days. That is usually the case when I have a lot of meetings and talks. That leads to headaches and does not make me happy. That happens to everybody and is related to the job - so I am fully fine with that. Here again, you are the designer of your own fortune. You also have the possibility to say “no” and give up some of your part-time activities. My career is over and I am completely happy with what I have achieved. That also offers me freedom with myself. It is good when you notice that you reached a position, where the people who surround you are glad you are there. If you have achieved this feeling, you should stop and not do another step. 

30. What were the reasons for you to join SORG?

In my case, I was just dropped in. When I moved to Nijmegen, my predecessor there was Prof. Stoelinga, who was a very prominent SORG member. One morning he just mentioned, that from now on I would be SORG member, too. That is the reason why I entered, but by far more important is the question why I have remained within SORG until today. For me the best about SORG is the teaching aspect as well as creating a network with young, talented and ambitious colleagues and the great spirit.

31. What was your favourite experience with SORG so far?

That definitely was the international band we created in Hong Kong on behalf of SORG. The band comprised OMF surgeons from all over the world playing musical instruments or singing together during an evening event of the world congress ICOMS 2017. That is my SORG experience number one. That was really outstanding and I am always thankful for that. Especially Oliver Scheunemann, SORG Secretary General, and myself were taking the lead and could show to the world, that OMF can be far more than just operating. There are humans behind the professionals. It is great that this worked out. 

30. What were the reasons for you to join SORG?

In my case, I was just dropped in. When I moved to Nijmegen, my predecessor there was Prof. Stoelinga, who was a very prominent SORG member. One morning he just mentioned, that from now on I would be SORG member, too. That is the reason why I entered, but by far more important is the question why I have remained within SORG until today. For me the best about SORG is the teaching aspect as well as creating a network with young, talented and ambitious colleagues and the great spirit.

31. What was your favourite experience with SORG so far?

That definitely was the international band we created in Hong Kong on behalf of SORG. The band comprised OMF surgeons from all over the world playing musical instruments or singing together during an evening event of the world congress ICOMS 2017. That is my SORG experience number one. That was really outstanding and I am always thankful for that. Especially Oliver Scheunemann, SORG Secretary General, and myself were taking the lead and could show to the world, that OMF can be far more than just operating. There are humans behind the professionals. It is great that this worked out. 

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