. : Summers you resulting from a family of doctors?

J.C.P. : Not whole. But the name is widespread. I remember that a long ago, a decent sort who dealt with our children at the house returned from one consultation to the Private clinic of the Gate of and known as with my wife: “Your husband is very famous, I even saw his office over there”. I did not work there any more and I had there even less office but there makes some was a wall cupboard in which one arranged the splints of with this name writes above! I come from a very poor family, of a very humble social environment and I unfortunately lost my father in 1944. He was teacher. My mother did not have a trade and it had three wire; she was obliged to work to enable us to make our studies. In fact I am at the same time a son of “black hussar”, i.e. a son of teacher radical socialist and a son of the Republic since it is the aforementioned which paid us our studies to all the three as war orphans. Have regard to our origins, we had much chance of us to fire some like that.

 

. : Where did you pass your childhood?

: I lived my childhood in the ruins since one was in Normandy close to the Mount Saint-Michel in the small town of which, the 6 then on June 7th, 44, was completely destroyed. I was 6 years old, but I remember it well. I have members of my family who died under the debris. My youth occurred close to the holes in which we fished frogs. Actually, I do not see how we made studies, because nothing pushed us behind. We made our secondary in Normandy. My chance, it is probably to have an older brother as Yves who fired his two brothers, i.e. Jacques and me, upwards. Jacques is a , a large mathematician of a higher intelligence, which left its name in sciences. There are the laws of . Me, a little with the drag, I tried to catch up with the others with much difficulty.

. : And the FAC?

: In Paris. Our Yves older brother had preceded us and wished that we study beside him. Me I would have agreed to make mathematics like Jacques but because of my level, my desire did not last very a long time and I made medicine like my older brother.

 

. : How does your boarding school occur?

: I believe that a first strong moment ago, it is my passage to the Ill children. I am in second year and I meet Pierre . This person with her clear thinking, her kindness, starts to make me work much, it helps me much. It makes me do small work, makes me forward them. It is my key meeting. It will never leave me.

 

. : You had already chosen surgery?

: When I was appointed with the boarding school, I did not know yet that I was going to make surgery. I remember that I was at Mr. with the Hospital which occupied much diabetes, renal pathology, etc… and appointed to the boarding school, I were practically sure to want to make nephrology. But when I have lived life of these doctors which turned all the day around the bed of the patients, which in fact did nothing but discourse and write, I told itself that I was probably going to annoy me. I returned to the house and I told to my wife: “I will make surgery”.

 

. : What did it have of so attractive ?

: There is a thing essential to say it is that at the time no university position had, he was attached, it had some vacations with the Ill children and it is all. It came there every morning, and it dealt with its private customers the afternoon. What it had attaching of very, it is its heat whereas one always regarded it as somebody of cold, rigid. In fact of rigidity it was quite simply of the rigor. It had an extraordinary heat to accommodate us the morning with always a nice short note. It expressed an immense knowledge and a phenomenal experiment which immediately conquered me. was very close to the young people and much was occupied some.

 

. : What was not the case in the other departments of surgery?

: Indeed, I had not met that front. The other surgeons whom I had met before were rather masterly and probably were interested more in themselves that with the young people.

 

. : And after ?

: I then made plastic surgeon at Mr in which was also an extraordinary figure and which had rained me much. I would have liked, a time, being plastics technician. From there, I left for a training course except boarding school to the Gate of at Emile whereas it was not appointed yet with aggregation. Then I went to Robert in .

 

. : How was it at ?

: it was an extraordinary surgical mechanics with charged operational programs and which started very early. I was probably the first intern of Emile who makes with him all the consultations and which helps it for all. Emotional as was Emile, he had immediately for me a sympathy which he kept, I believe, until the end. When I finished my , Emile began again to me with the Gate of . It is probably my second key meeting. Emile with all that one knew of him, i.e. his perfectionism, his excesses, his faults from time to time also, but which made an enormous character of it of which one found very small. I was struck by his yells. I even believe that I was afraid as soon as it raised the voting right. But most of the time it was a charming and extraordinary type.

 

. : Does prepare you with going in ?

: It prepares me so much although when I arrive at , Robert tells me: “You know, I cannot tell you though is because Emile told me that you were the best”. It had prepared me the ground so that I immediately found at Robert a heat, a kindness. I had a small specific place in the service thanks to Emile.

 

. : With the passing, how do you perceive now Robert ?

: The shift that there was between a young intern and this universally known man made that one did not even dare to put forth a judgment. All in him was admired. At the same time its way of being, its courtesy, its kindness, its humor, its surgical qualities completely out of the commun run, so that actually, for us, it was an alive god. Today, thirty years after, I understand it a little differently. However, it was a man whom one always saw in his trade but whose personal life was extremely rich. It read much, it knew very well the music, it sang sometimes operas during an intervention. It was very with the current of all that appeared in bookstore, it went to the cinema, with the theater, in short it was a man of a great intelligence and which one could not wedge on anything.

 

. : It maintained its will have?

: It tended to simplicity in its vocabulary and its remarks in a general way, but actually, it liked to have the high-speed motorboat. It had this taste of the theater which made that when it re-entered in a part all people looked at it, listened to it.

 

. : Was that due to what?

: An immense personality. There are people as that who release a respect, which releases an attractivity; and even when they say a silly thing, that passes, one does not even realize any or one forgives them. All that with a species of facundity, a safety of oneself. That joined all these big bosses of the time, Merle of was similar; when it re-entered some share, nobody dared speech.

. : How react did when he was not content with the course of an operation?

: It had a tic, it was to lean the head on a side and to blow by its nose. One intended it to do that; he did not speak any more, until the moment when he had taken again the things in hand. Never it made somebody responsible for a failure and when an assistant had not operated a patient well, with a joke, it told him that probably it would be necessary that it learns, but that with kindness. Robert and Robert Blackbird of , they was both Robert of csotcina.comedy. Both “”, it was a pun which readily Robert made. It was often very funny.

 

. : For example?

: I liked to follow his consultations. At the time, people arrived very stripped in the consultation. There is splendid a 25 year old girl who returns, small slipway, small bra. Robert asks him: “Dear Madam why you in consultation come?”. She says “It is for my hallux valgus”, and she adds “I came to see you because it is to be better addressed to the good god that with its Saints.” And Robert who was not insensitive to this semi-nudity answers in aside: “Dear Madam, me I would prefer to address to me rather to your breasts than with the good god!” It was that also, Robert .

 

. : How were day's works organized?

: It should be recalled that the activity was shared between the hospital and the private clinic. It was necessary to arrive at 7 o'clock in the morning and to make the inspection of 60 patients. Three times per week, the owner came early to the hospital and it was of use that all the assistants present will see it. There was Jean , Raymond who was then his only aggregated, Emile , Gerard Lord… The interns did much thing, but always operated with the aid of a senior. There was no staff strictly speaking and one showed the files in the office of the assistants where everyone was stripped… In fact, there was full with free electrons in the service. People who had already good experience and who traced their furrow without being concerned with what the others thought and in particular, without referring to the owner about it. He, trusted them great in general and let start from new ideas like that.

 

. : From where the Days of which gave a description of the activity…

: The days of were theatrical days which I connect in environment with the “festivals of May” of the Middle Ages; it was the anthem with the glory of the Master. They were the occasion to re-examine files and to give a progress report on works in progress, but there were not many figures, even less statistical studies. When one reads again
the books of the csotcina.comedic Current events of Raymond , one realizes that there was then an expansion of ideas but without scientific rigor.

 

. : And you were in the middle of this expansion of ideas…

: Yes. When RJ discovered a new thing, either during an inspection, or at the time of one of its many voyages, that made “” in its spirit. He did not speak about it. He reflected. If it had hardware requirement, it convened a manufacturer, it explained to him what it wanted and it found a name. For example, the famous : I remember a morning very well when it had put what remained of an upper end of femur in a and where it wondered how to call this operation; it returned the following day and it told: one will call it “”. One day when I was at his sides during the inspection, he sees a confined to bed girl which had a fantastic foot equine and for which Emile had placed a pin of traction in the and a pin of in the to rectify. The correction was progressive. Fifteen days afterwards, RJ had drawn the articular . I always connected the two things. He did not like at all to keep the confined to bed patients, and this situation gave him the idea of the articular who allowed a progressive traction while keeping joint mobility. Every three months, there was an innovation, good or bad, which remained or not. It had to develop 6 or dels of total prostheses in ten year. What wants to say that he always sought something again. Advised more or less well by its entourage, it made errors of course, nevertheless it was somebody who always sought to better do, which wants to probably say that it was never completely satisfied with what it did.

 

. : And the private clinic?

: One was going to help it in private clinic for the operational programs and the consultations. I more often went with Jean because I was rather on the pediatric slope. They was very formative meetings since there were many patients and much excellent surgery. After, there was a heavy meal with a small always delicious beaujolais wine, so that one had a sometimes little evil to leave, I want to say evil to pass the gate of the private clinic. It was an extraordinary environment of simplicity, heat and work. One was well.

 

. : Later, how did he live his troubles?

: I was very close to him at the time when it had all its troubles. He thought that it was a political revenge coming from very a top-level. He found very unjust what one did to him and wrong did not have since the judgment was re-examined a few years later. He wanted some much with the political world as a whole. He entrusted forever to me only one name, he me forever known as of the evil of somebody. It was its secrecy. He assumed it, but he forgotten forever. In 1976 thus, it leaves the hospital, it continues its private with the private clinic which went very well. On the purely professional level, I believe that it was not very affected of the situation. It had kept many contacts with all its pupils and the international csotcina.comedic world. One was going always much to see it. He liked that one comes to lunch with him. Perhaps also this is the occasion not to forget the famous beaujolais wine.

 

. : At were the time of your boarding school with , you already directed towards pediatry?

: Yes because after my passage to the Ill children, under the influence of , I had kept my interest for the surgery of the children. As there were many children with , one often asked me to be occupied some. Then, I was senior registrar during one year with the Ill children and very regularly took me along to with him. When I returned to make a second year of at Robert , he asked me to create a department of pediatric csotcina.comaedics in his service. Therefore, during my , I started to create this department. I still went in and besides I went there during more than 15 years. My finished, I worked during two years, part-time, with the Private clinic of the Gate of where I made adult surgery with . I helped it much to make a little difficult patients because I wanted to keep a good experiment of the adult csotcina.comedy if I would not find a channel hospital.

 

. : Do these two guidelines, child-adult, appear distant to you?

: Not with regard to the technical epic but certainly moved away by the reasoning. In fact when pediatric csotcina.comedics is made, like says it Henri , one is initially pediatrist, and then possibly surgeon. The vision is different, the follow-up is different, the contact is different, the hospitalization is different. There is only one thing which is not very different, it is the operational gesture. If one takes an csotcina.comedic surgeon having made only of the adult and that one him teaches the three or four characteristics from the surgery in the child, it will be able to operate them very well. But technically, the adult csotcina.comedic surgery is generally more difficult than the pediatric surgery as I think as it is completely necessary that the csotcina.comedists pediatrists have a solid adult formation of csotcina.comedic surgery.

 

. : After your , you do a foot keep with ?

: I am attached to , I am time-partial assistant with the Gate of and I go regularly in where I make only pediatric csotcina.comedics. I share my time between these three places. Actually that lasts only two years since Emile is appointed with but share very quickly with the Gate of . It thus releases a post and the owner proposes this post to me. I am appointed into 74.

 

. : And then?

: I find myself aggregate into 74 with an activity primarily of pediatry. Unfortunately in 76, ! , the owner must leave and me I find myself with Alain as department head. The situation was a little difficult since I was under his commands and that to each time I said something, he said the opposite. I am thus obliged to go to see the Chief executive officer of the Public assistance, to ask for my independence. In 78, the service of infantile is individualized and thus I am free with my own assistants. But I am in an unimaginable poverty. One had made me like office a shelter out of wooden with a small and it was necessary me to wait several years to recover means. It is thus only very slowly that this service could turn correctly and thanks to my faithful collaborators whose Jacques , one could lead to a service adhered to within the French pediatric csotcina.comaedics.

 

. : Which were your “hobby-horses”?

: I always had two poles of interest, the scoliosis and the inequalities length. At the beginning, for the inequalities, I made only follow what did . They had started at the same time as Wagner the lengthening of the femur and the tibia by means of their external fixer. Where they were precursory, it is that they said that the bone must consolidate all alone, whereas Wagner lengthened then grafted with an osteosynthesis by plate.

 

. : How could they lengthen with the fixer “rail”?

: There was a threaded rod which . Therefore, in fact, they had already invented the consolidation in distraction which will be published later by then De .

 

. : They had already foreseen the consolidation in distraction?

: The brothers did not turn over on the chamber of lengthening; for them the bone was to consolidate all alone, because the periosteum was adhered to and because they had peeled. Moreover at the time, they had understood that it was absolutely necessary to cut the fibula and to fix the fibular malleolus so that it does not go up. It is an element which the Italians did not admit that 20 years later. had conceived a universal technique which could be implemented to all the segments of bone, grace it is necessary well to tell, with collaborators like Pierre and Jacques which had made some improvements. It is a technique which one used during about 12-13 years. One lengthened meters of tibia and femur, always with this until the moment when one discovered the fixer.

 

. : A period ago of meanwhile

: If, me I played the game. I tried to make some , notwithstanding the fact that with my usual awkwardness I machined myself the hands much. I found that it was very uncomfortable for the patients and I did not see there real advantages apart from some difficult rare instances. Thus I quickly gave up. It is at this time that I went in where I met De and all his team with which I wove very major links.

 

. : What did you see in ?

: A better hardware than ours and easier to put. It was roughly speaking same philosophy as ours with this close nevertheless that had invented dynamization. The team of that I like much had brought of small more on the material plan and the so conceptual level. This hardware was thus used, and a day one concentrated oneself on the problem of the tibiae and it is there that one drew T known as of and who is used now in the whole world. Why, it is firstly that it was found that for lengthenings of tibia, it was not logical to make lengthening in diaphyseal area which does not consolidate very easily. It was preferable to do it in metaphyseal area where the bone consolidates very well. Secondly, when one makes a lengthening of tibia, the first complication, that which one usually has, it is the valgus. When you made a lengthening of tibia in diaphyseal area, if you have a valgus, it will be diaphyseal and if you must correct it, it will be necessary to make a diaphyseal osteotomy what is not good in the field of the consolidation. Therefore, one told oneself that we needed a metaphyseal osteotomy with an aircraft which enables us to catch up with the deviation in valgus each time. Thus one arrived at the fixer in T.T has a metaphyseal and diaphyseal implantation, and has a system of axial correction. That makes it possible to correct without stop the valgus, that also makes it possible to leave on tibial a or , then to correct while lengthening.

 

. : What thought the team of of it?

: The Italians had not seen it and they were a little critical at the beginning. Then, gradually, they adhered to the thing and now they use it constantly, and one disseminated it in the whole world or almost. The most usual use is not the lengthening of tibia, but the of the knee at the old subject to be able to make support immediately. I did not do it for that, but it is used thus in much country, in particular in Spain and in the Nordiques countries.

 

. : You still made many lengthenings?

: Rather less than front. The morbidity of lengthenings is extremely important, and it is thus necessary to select the subjects at which one can hope for a real benefit. Among certain patients who have not very important shortenings, I prefer to make a at the appropriate time other side and they are better and take less risk. Among patients who have very great shortenings, I think sometimes that the programs of lengthening would be risky either for the hip, or for the knee and that the solutions of equipment are perhaps preferable. Let us say that with the age the doubt comes and that gradually one eliminates the indications until - ; careful being is preferred. But if the quantity of lengthenings decreased, one does not make any yet badly because people come to see us of rather far for that because our techniques are quite elaborate.

 

. : You always use T?

: Yes, of course; for the lengthening of tibia, it is T about 9 times out of 10, and if there is a correction to make in the three plans of space, one can have to use . For the femur, one uses practically only of with, for certain difficult cases, the hybrid of Mike . However, I am not opposed at all to the nail of lengthening. In addition Christophe who works with me used in the service. It is a good technique, but reserved for a whole small number of case. It is necessary that the growth is finished or almost; it is necessary that the femur is not deformed too much, and it is necessary that there is a sufficient medullary canal. That done much of if. When certain mechanical problems are solved, I believe that it will be a valid technique, but one yet very did not solve.

 

. : And scoliosis?

: The question which one can put it is: of significant progresses have been made for 20 years? Yes and not. The great innovation of this period it is which makes it possible to very quickly give the patients upright and who allows to stabilize the with less nonunions than before. It is one more especially for the neurological scolioses but it is not a great progress for the final reduction, nor for the esthetic aspect of the idiopathic scolioses.

 

. : Previously one made how?

: One made of plus a plaster. The plaster modelled very well and I can ensure you that I with satisfaction re-examine patients operated 25 years ago with of . These patients, generally, do not have badly. They were confined without too much difficulty of small children that they lead me to detect a scoliosis. And in the final analysis, they in vain have a flat back, an inversion of curvatures etc… they go nevertheless very well. Thus I believe perhaps that one should not too push with the sophistication. The great wrong at present is to want to make a beautiful radio and actually the problem of the scoliosis is not to have a beautiful radio, it is to have a scoliosis which does not worsen any more with one foot of arthrodesis which is quite horizontal so that it does not make badly.

 

. : Why not push with the sophistication?

: Because it is a surgery which remains dangerous. The greatest catastrophe which one can have in his life is to operate lively 13 years and half, which has a scoliosis with which she would have lived completely correctly and to cause a paraplegia to him. It is a terrible drama. I believe that one is not surgeon of the scoliosis, one is a doctor who sees a child in the course of growth and which has a scoliosis. It is necessary to integrate the scoliosis and its to become in this child and his family, and her other concerns. Now, I leave much girls finish their growth with dorsal scolioses of 40°, S curves of 50-50, in their saying that if one day, they are unhappy, it will be always time to operate them. It is necessary simply that they are well supervised.

 

. : You think that one went too far in the instrumentation?

: I would not like to formalize the things too much, but it is necessary that we are eminently criticize and to tell us that after all, since the adult csotcina.comedists make remarkable scoliosis of way, we are not obliged all to regulate in childhood. Can't one leave their chance to a certain number of individuals who can pass 10 or 15 years quiet, and after all, later, one perhaps will have another thing. There is all this medical side in the scoliosis which impassions me almost more than the hardware. What frightens me always a little, it is the creation of these “” where all will be based on the hardware. One will forget the human side completely. It is necessary that we remain pediatrists. It is necessary that one thinks that one is not obliged to regulate all the problems before the end of growth.

 

. : What would you think of a great csotcina.comedic center which would go from the infant to the old man?

: If you include there all the other specialities of pediatry, I do not see a disadvantage. I am not at all against a collaboration with the adult csotcina.comedic surgeons, but one should not lose the concept of hospital of child. The hospital of children, it is initially an address 24 hours a day for the young people, it is then the place where one finds about all the specialities which the child in distress can need. Let us take an example. In my service, there is a large recruitment of diseases of the child. There are thus children who must have hip prosthese, knees… He is not question only one discusses these patients without the help of colleagues who put these prostheses daily. Collaboration with the adult csotcina.comedists is essential there. But they are children who are very fragile. It is very difficult of the . They have medical care, cortisone, etc… They are in general of a small weight and it is essential to leave them in a pediatric medium with a reanimation and pediatrists who can occupy themselves some. Thus the problem is before a whole environmental problems. A department of pediatric surgery needs a whole pediatric environment and it is a daily requirement. One can always invite an adult specialist to carry out an act for which one considers not to have the total control, but it is a specific problem.

. : Why did you leave ?

: Initially, the community of the surgeons pediatrists of Paris had wished a reduction in the number of departments of pediatric surgery in Paris, whereas I was at the time the company secretary. Then, the hospital of took the route of the handicap and moved away from current pediatry. Lastly, from went away and the Public assistance required of me to take its place. With this occasion, I proposed to transfer all the pediatric sector of hospitalization from towards the Ill children, which avoided leaving in place a structure in difficulty. That was done a little more quickly than provided for by the unhappy disappearance of Philippe who precipitated my departure. It is not easy to arrive in a service where one is to some extent the usurper. I had many contacts with a certain number of collaborators of Pierre who had ensured me that all would occur well, that I would be well accommodated but actually that was a little more difficult than I thought.

 

. : Why?

: In I had a practically new service and the service of the Ill children had not been renovated for a very long time. One thus proposed to me to go there while me ensuring that there would be work. This work was made partially and with a delay of two years and half. It was necessary that I reorganize all the service so that it marries a little our way of working which is very collective. One can say that with Christophe , one could remake with something close what one had in and one has, at present, an extremely welded team, with people for whom I have a very great admiration like Jean Paul , Georges and Jean .

 

. : You do not regret?

: I only lost in the passing of the posts whereas it had indeed been agreed that I will not lose any. But, considering the hugeness of the task, I do not despair to recover some. The pediatric csotcina.comaedics do not nourish its man and it would be necessary only one trains practically saints. There are not many people who agree to be and at mercy without having a minimum of certainty for their future. When you train with pediatry an csotcina.comedist of which you think that it could become pH or pH and that you do not reach that point, that it will become? It perhaps will try to settle, but you know like me that to have patients to operate, it is necessary that it works in four different places. It will pass a life of dog. The result it is that there are very few people who engage in this discipline and whom one has an hard time to recruit them and to form them.

 

. : Perhaps the system would have to be amended?

: It is completely necessary to reconsider the hierarchy of the hospital posts and much think on it of the instigation of Henri mainly. The current system cannot last. It is necessary that the pH becomes a pH with a university contract for a certain number of years. Moreover it appears absolutely necessary to me to create a system of emulation. The pH could reach according to their motivations various grades: 1st, 2nd or 3rd grade. That would avoid great injustices at the time of the selection of the hospital surgeons, while making it possible those which want it, to take an university orientation then.