Aspects from the biography of Professor Cornel Tiberiu Opriş. The Beginnings

Abstract

Professor Cornel Tiberiu Opriş was the founder of the clinic for Oral and Maxillofacial Surgery, and also the first to teach this specialty in Cluj-Napoca in the first half of the twentieth century.

Earlier in his profession, Dr. Cornel Opriş went from research into human physiology to practical activity in the field of surgery, to which he was more attracted. He was active both in research and Oral and Maxillofacial plastic surgery, facing unfavorable material and social conditions, exacerbated by the circumstances of war and the relocation of the Faculty of Medicine to Sibiu. This article presents the life and work of Prof. Dr. Cornel Opris, with particular reference to the stage of education, the problems associated with “family, society and school.”

Professor Dr. Cornel Opris Tiberiu was the founder of the clinic and education of Oral and Maxillofacial Surgery in Cluj-Napoca, member of the Academy of Medical Sciences and Honorary Citizen of Cluj-Napoca. (Figure 1)

Figure 1.

Prof. Dr. Cornel Opriş.

The famous physician and scientist was born in Baru Mare, Haţeg County, on October 24, 1908, and his parents were teachers [1].

Ioan Opris, a school teacher and Cornel’s father, was from the town Voila near Fagaras area where, along with Brasov and Sibiu, the spirit of Enlightenment had passed on from the great personalities to the teachers in small towns or in villages. The teachers were meant to bring light and to pull out of ignorance the people of villages and small towns with whom they shared their lives. The Opriş family was part of that category, teachers who have stimulated the spirit of boldness and willingness to change their social condition.

Cornel Tiberiu Opris was born in those times, and despite countless obstacles or adversity, and thanks to his strong personality, he marked the history of Dentistry and Maxillofacial Surgery in Cluj and at national level. He also had a great impact on Romanian Physiology. During timehis name underwent adjustments, caused by historical circumstances: Opriş - Oprişu - and Oprişiu and again Opriş. This explains the fact that in various documents, either administrative or scientific, his name is recorded differently. During the whole journey of his life, Fortuna, the goddess of fate, cast endless obstacles and adversity, but also remarkable achievements, thus structuring his whole personality.

Unfortunately, he was still a student when his father died prematurely, leaving in his care, in addition to his mother, six other brothers and sisters, he being the oldest of the brothers. Therefore, he came at an early age in the position to assume the role of hope and support of his mother and family. In reality, he became responsible for the care and education of his brothers and sisters. This empowered him to a degree that marked him for life fortunately, for the better.

Taking the responsibility of a father, he introduced restrictions and discipline which contributed to an impressive evolution of the family, except his older sister, Lucretia, who died in an epidemic during early childhood. The school evolution of all his brothers and sisters was pursued with vigor by Cornel, ensuring that each one used all their intellectual endowment God had bestowed on them. And God had been generous.

Cornel Opriş did not accept any logic of unfinished business. As his disciple, I recall, not without emotion, that when any of us colleagues went to report that we did not manage to solve the “problem X or Y” he answered with the following question: “I see, do you have a head on your shoulders? You do! Then, use it, do not keep it for decorum!” We were faced with finding solutions to problems, including surgery. His grandchildren, Cornel and Jeni (Eugenia) that he took care of with devotion throughout the schooling, including when they were students, recounted that they were treated the same way, within the family as well as outside it. He just treated them the way he treated his brothers and sisters, whom he cared for after his father’s disappearance. He would not accept complaints, nor admit any lamentations. He put great value on dignity.

This contributed to the fact that under his supervision, all brothers and sisters, including him, had a remarkable evolution, being all outstanding university graduates.

Cornel cared for all his brothers and sisters till their graduation, though he himself was in full effervescence of the school. In order to be a model for them, he was was “platoon leader” throughout the whole school period, from gymnasium to the end of university studies. He was aware that performance is reached only through effort and overcoming social condition was possible only by hard work. He was also aware that he had intellectual resources and, therefore, all he had to do was to mobilize them.

School had begun under bad auspices at the State School of Petrosani, in Hungarian language, which he did not master at all. He went to High School travelling back and forth, between Petroşani, Oraştie Lugoj and Petroşani, that became a high school teacher in Romanian, after Transylvania returned under Romanian administration. With a keen intelligence and a good memory, after finishing high school, he competed for a scholarship at the Ferdinand Medical Faculty of the University of Cluj. Scholarships were few and without success in this selection he could not attend university. After passing the examination, he was, throughout faculty, among the most worthy students, obviously keeping his Scholarship [2].

At that time, graduates of the Faculty of Medicine, were provided by the Ministry of Health with jobs in rural districts. However, many of the graduates were seeking solutions to stay in the city hospitals. They felt the need to take responsibility before time, in the field of healthcare, with the purpose of improving their medical knowledge. Upon graduation, Dr. C. T. Opriş was offered a job as assistant at the Department (Institute) for Physiology, and from there he advanced to be Lecturer. Meanwhile, the possibility has emerged that, in parallel, he could receive training and internships without pay from other disciplines, including clinical ones. This was one advantage that young teachers were offered.

Being attracted to surgical specialties, Dr. Opris was enrolled in training courses in dentistry, and followed them between 11.01.1933 - 10.29.1934, under the leadership of Prof. Dr. John Aleman [3]. At the end of the course he passed the graduation exam and, thus, achieved specialization in the field.

After a thorough preparation, he participated in a physician contest organized by the Ministry of Health, Bucharest. Dr. Opris came first but because there were no longer posts in the big cities, Bucharest, Cluj, Iasi, as originally announced, he gave up and refused to live in a smaller town, and returned again at the Institute of Physiology of Cluj. Here, however, he did not find any professional satisfaction and, as a result, gave up the position of Lecturer. Seven years after graduation, he competed and became assistant of General Surgery. At the new job he encountered colleagues, some of them being his former assistants that became his superiors. From this position, the abuses and restrictions of these colleagues came in sharp contradiction with his personality. And this was disturbing, especially since the colleagues, knowing his potential, saw him as a formidable competitor. However, in this clinic he came to master the basic theory and practice of general surgery, but along the way he was drawn to plastic surgery, an emerging of Surgery in those times.

During this period, Dr. C. Opriş noted that the broad gestures of surgeons of mainstream surgery did not match those of a plastic surgeon, which required mostly finesse and parsimony. Congenital malformations of the face and jaws were an area where such gestures could create uncontrolled surgical errors with significant repercussions. The most concrete example was the problem in the dental buds included in the bone in the jaw or the interventions of the growth cartilage, anatomical details that were not known by the surgeons performing general surgery. Either examples, if they were not respected, could have caused serious disturbances in the growth and morphological and maxillofacial functional symmetry.

For Dr. C. T. Opriş the control of the surgical gestures was not a problem because he had already obtained the necessary dexterity in experimental physiology, where everything had to be conducted accurately, in order to prevent the distortion of scientific results. Experience in this field and his option for plastic surgery, along with the training that he already had in dentistry, during which he became acquainted with the field of a small operator and the particular pathology, oral and maxillofacial led him to focus on the surgical anatomy of these regions.

As he himself confessed, it was a new field of activity in which he could stand out without infringing the field of activity of the general surgeons [4]. Occasion ariso shortly with the political events that preceded the Second World War. At that time they began concentrations and mobilizations on the front. Dr. C.T.Opriş was concentrated on the western front near where he worked at Oradea Health Service of an artillery battalion. From the Western military region, the unit went to Măcicăneşti in Moldova, and from there, after the surrender of Northern Transylvania, he was discharged and took refuge in Sibiu, together with the Faculty of Medicine in Cluj.

In the conditions provided by the refuge, surgical services were reorganized with difficulty. For the surgical specialties the situation became complex and specific to campaign surgery (war), the war wounds with tissue loss, were common and required a large percentage of plastic and reconstructive solutions. In these circumstances, on the recommendation Surgery Clinic (Prof. Dr. Al. Pop), he went to Austria for training in plastic surgery. At the time, Plastic Surgery was most closely related to the needs of oral and maxillofacial surgery.

For this area, Professor Hans Pichler from Kieferstation Hospital in Vienna was one of the best trained doctors in Europe. He went to his clinic where doctor Opriş actually worked for six months. There, among others, he learned the technique in the treatment of oral traumatology and maxillofacial and also has mastered the treatment of congenital anomalies of the face, the treatment of oral and maxillofacial tumors or inflammatory processes of the region.

As the Austrian doctors of that hospital were few, being mobilized to the front, a very large part of the hospital was put in charge of foreign doctors who were there for their specialization. The situation suited doctor Opriş, who wanted to operate as much as possible in order to be able to learn. However, he could only operate as second hand, at the most. But in this position he learned a lot as he was equipped with a sharp sense of observation and great surgical skills.

Ȋn parallel to this stage, he completed a course in dentistry since in Vienna this discipline was developed at a high level. About Prof. H. Pichler, who guided him during his course, he said he was a professional with extensive training in oral and maxillofacial surgery, facial surgery pioneer, author of important works and the author of a treaty of maxillo-facial surgery in which he recorded personal ideas that remained classic.

From Vienna, Dr. C. Opriş went to Berlin Clinic headed by Prof. Rudolf Virchof Krankenhaus Wassmund who was also considered a personality, but who was different from Pichler due to the radical surgery which was different from Pichler’s soft approach.

Upon his return from Germany, with an important expertise, he wanted to implement it as widely as possible and, of course, he wanted to gain the necessary experience to enable him to express his vision on the field. However, historical conditions did not allow him to return to the surgical clinic he had left in search for improvement. He was sent to the front to Sinferopol in an ambulance headed by a military doctor whom he was subordinate to, this doctor being not particularly distinguished by training and sometimes even by morals. This has created grounds for conflict between them. The result was that he was sent to a post on the advanced front in Crimea. There he discovered the first case of typhus, a professional diagnostic who clashed with the one posed by the chief physician of the ambulance, his superior.

The busiest days at the front of war were those after the attack on Sevastopol, an attack followed by a large number of dead and wounded. Then the ambulance was inspected by a general practitioner to whom doctor Opriş reported that he might be more useful to a hospital and not in an ambulance because he was specialized in plastic and maxillofacial surgery. He was sent home to Inner Area Hospital 303 in Craiova. The hospital was owned by Mrs. Maria Antonescu, the Marshal’s wife, and had the best equipment in all hospitals for wounded in the country. Different departments were headed by doctors with excellent training, after the war many of them becoming professors at faculties of medicine. At that hospital, Dr. Lieutenant C. T. Opriş was appointed, for four months, chief of oral and maxillofacial surgery, and the lawful head of the department was posted to Tiraspol, Transnistria.

Inner Area Hospital 303 had to solve many problems of maxillo-facial surgery and plastic and related dental problems. In that hospital were also treated civilians, not only soldiers from the front [4].

In 1945, after demobilization, Dr. Opris returned to Sibiu and then, together with the Faculty of Medicine, to Cluj. Here, he resumed his activity as assistant at Surgical Clinic I. At that time, he had one year of specialization in surgery of congenital abnormalities of the face, obtained in Austria and Germany and enriched with personal experience in Inner Area Hospital 303 [5].

Therefore, when he returned to surgery he had the necessary training to address plastic surgery of the face and especially, congenital malformations related to the oro-maxillo-facial area where other members of the clinic staff were not prepared.

Finding himself in an unfriendly environment, he resigned and came back to the Institute of Physiology. There, the Lecturer position he occupied years ago was vacant, but he could get it back only after a contest. The Professor and Head of Department he had worked with before knew him both in terms of professional knowledge and surgical skills, so he promoted him during the contest. In fact, he needed him to cross the experiment of “isolated head”, maintaining the integrity of the spinal cord, where they had worked together years ago.

The experiment was based on the idea of Heymans, a scientist that was awarded the Nobel Prize in physiology. This was modified and adapted by Benetato, Opriş and Baciu. The experimental model was extremely demanding in terms of surgical preparation, because it required the discovery of spinal cord and spinal ligation of vessels in the spinal canal, which Heymans, author of the idea, did not manage to achieve. That’s because a simple touch of the experimental spinal during preparation might cause a respiratory syncope and the death of the animal. Therefore, the operators of the experimental times were not well placed yet to point to the authors cited. The difficulty had to be overcome, and this task was undertaken by Prof. Dr. Grigore Benetato, future academician, and Dr. C. T. Opriş who worked with ambition, with effort and steel detrmination.

This time, Dr. CT Opriş possessing rich experience of plastic surgery and, moreover, being familiar with using dental drills, managed to discover the bone and ligature vessels within the dura without fracture of the spine of the animal and therefore, preserving the integrity of the bone marrow. He did so by surgical skills to unravel the Gordian knot of the experimental model and realize its morphological basis, something that no one had succeeded the world before him.

With this model, Dr. Grigore Benetato and his collaborators had obtained remarkable results in physiological research. As a result, in 1956 he presented this model at the International Congress of Physiology in Brussels, an event that was taking place under the presdidency of C. Heymans, who predicted the experimental model, but never managed to achieve it in the form imagined by him. Dr. Opris departure for the congress was a real odyssey since communist authorities did not like the idea of his departure to the West. However, because he was only able to perform the surgery experimental model, at the insistence of Academician Benetato, ultimately, he was allowed to go.

At the congress, when the Romanian delegation announced the topic, the Congress president, C. Heymans, did not bother to attend demonstration, arguing that it is practically impossible to accomplish it. In exchange, he sent his assistant to attend the demonstrations and the eventual failure of the experiment. The assistant announced that the experiment proceeds as modified by the Romanian Protocol and doing well. As a result, Heymans came to experiment with the intention to contradict the authors. In the presence of the President of the Congress, all the well known professors in physiology, all the teachers, except the Hungarian teacher, came to see the demonstration and possibly to hear the President’s comments. When Prof. Benetato was assured that all the great physiologists of the world are present, he injected the adrenaline into the vessel and animal transfusion and the effect was demonstrated in the clearest possible way (Figure 2) [6]. The experiment was a success and Heymans was forced to recognize for the first time his missled skepticism. He said that the experiment was a 100% success and congratulated the Romanian team.

Figure 2.

Schematic representation of the “isolated head” experiment [6].

The resounding success of the team was rewarded by the organizers with a week in Paris, where they repeated the demonstration. This technique would be presented in Argentina, in Buenos Aires, but Romanian officials did not allow Dr. C. Opriş to attend the event.

The scientific event was attended including by the famous Professor Bîcov, the greatest celebrity of the Soviet physiology at the time. The experiment had a great importance in the world of science, because the Soviets used the experiment extensively in support of the “nerviste concept” in medicine. Personally, for Dr. Opriş, the event was important because it showed not only his skills as a future professor of plastic and maxillo-facial surgery, but also his tenacity in seeking enhancement of the proven scientific ideas. Scientific probity of his work was never challenged again. He always started from the well and logically formulated hypotheses and working methods that were appropriate to the goal, sparking the correct interpretation of the results, whether positive or negative. For us, his collaborators, they were learning lessons that we have never forgotten.

On the other hand, the success of the experimental model presented in Brussels and Paris played an important role in a difficult moment of his life, which he recounted every time on the occasion of reunions with graduates of the Faculty of Dentistry [2].

Coming back to the professional development of Dr. CT Opriş, it is important to note that in parallel with the Institute of Physiology and continuing to specialize in plastic surgery, he engaged in extensive work to resolve war-wounded patients requiring such treatment. Also, he used to operate maxillofacial malformations in civilians patients of all ages. He did all this in the toughest conditions because he did not have an operating theater and a hospital where the operation and postoperative patients could be observed.

Under the circumstances, he appealed to different hospitals with surgical profile which made those spaces available. He commonly found openness and goodwill from Professor Michail of Ophthalmology and Professor Buzoianu from O.R.L. Moreover, Dr. Opris was invited to address maxillofacial pathology, ophthalmology tangent to the O.R.L. in the respective clinics. And after the war, there were a lot of such cases. Prof. Opriş’s gratitude to the two personalities was emphasized by him repeatedly.

As for surgical instruments, not only in terms of procurement, but also in the preparation for surgery (washing, sterilization, storage, etc.) here too, Dr. Opris encountered many difficulties. But they were all overcome by passion and hope that a moment will come when all will be resolved. The moment came in 1948, with the Education Reform, when the medical education was also reorganized. On this occasion, he was asked to organize the clinic and the teaching in the specialty of Oral and Maxillofacial Surgery. He was among the few in the country who had the right training and abilities for the job. In fact, this proposal meant a recognition of his value and actually a gain for the Romanian education system. Subsequent events have proved this assumption to be the correct one.