DR Claudio Jiménez is a neurologist and neurophysiologist at Bogotá’s Simón Bolívar Hospital and director of the stroke centre for the city’s northern subnetwork. Just over four years have passed since he first stepped inside the public hospital that lies sandwiched between a busy main road and one of Bogotá’s largest favelas. Completed in 1982 and named in honour of the liberation hero whose statue dominates Bogotá’s central square, Simón Bolívar Hospital has over several years undergone a process of renovation and expansion while in its neurology department a quiet revolution was underway.
The leader of this revolution was drawn to his profession by passion and by the “philosophical intrigue and physical mystery hidden inside the mind” – so Dr Jiménez wrote in a post on the Instagram page @neuro_filos where he shares developments in neurology with his nearly 50,000 followers.
“When we save brain tissue, we save social fabric,” the same page announced, offering a glimpse of something else that drives Dr Jiménez, namely the duty to build a resource that belongs to and serves the interests of everyone.
Moved by these twin passions, he joined Simón Bolívar Hospital in August 2019 and embarked on a series of interventions that began with building a team to manage stroke. “From that moment on my life changed radically,” he told the Colombian Medical Association in an interview in 2021 by which time the hospital’s stroke care programme had already earned the second of its three WSO Angels Diamond Awards.
What had begun as curiosity about how the brain creates our perception of reality, and a desire to alleviate suffering, had evolved into a vision of public healthcare reform in a caring society. It’s Dr Jiménez’s dream that everyone who makes Bogotá their home should, if they went to hospital, be cared for with quality and humanity.
Big problems and a hopeful future
“When I started working at the Simón Bolívar Hospital,” Dr Jiménez says, “I discovered that there were several small problems, but one serious and urgent one, which was creating a stroke protocol and standardising care. This led us to create the first stroke network in the country and the first stroke centre in the Colombian public network that was certified by the WSO.
“We now attend 450 to 500 patients with ischemic stroke per year, and treat more than 110 with thrombolysis, but there is still a profound deficit in access to thrombectomy. We are working with our health secretary to create a district stroke network that seeks to eliminate access barriers to mechanical thrombectomy.
“It must be considered that in Bogotá’s public network alone, there are more than 2,000 stroke cases per year and currently ours is the only public facility that can offer this procedure.
“But although the current outlook is still dark, I see a very hopeful future. The most important advance is that the population is increasingly aware of the symptoms of a stroke, they are learning to consult emergency units on time.
“Now we want to treat the stroke before the stroke. That is, we are working on a programme that allows us to identify and evaluate patients with risk factors and treat them to prevent stroke.”
At Simón Bolívar the stroke programme now resides within a comprehensive neurology programme that includes a neurorehabilitation centre, and a neuroimmunology group lead by Johns Hopkins-trained Dr. Maria Isabel Reyes that attends to patients with neuroinfections including HIV. There are also clinics for headache and botulinum toxin to treat spasticity and motor disorders and, in the offing, an emergency neurology service that will treat acute neurological conditions besides stroke.
Dr Jiménez says, “We increasingly understand that neurological diseases are a public health problem. There is still a lack of resources, financing and access to certain fundamental diagnostic aids, but I must say that we are improving.”
Poetic justice
A campaigner for social justice in healthcare, Dr Jiménez’s imaginative style of expression also marks him as something of a poet-philosopher.
He says, “I have learned to use medicine and my medical practice as a tool for reflection on life itself, on what should matter and what should not, on the search for the meaning if there is one, of being here in this place on this huge green and blue rock, experiencing something like consciousness.
“The earth is full of life, from plants to innumerable forms of animal life, and although there is a cognitive and emotional experience in everyone, we humans are the only ones who question ourselves, identify ourselves and also transform the environment as to avoid adapting ourselves to it.
“So you see all this suffering, you see someone who loses their language. Minutes ago you could say ‘I love you’, minutes ago you could write a line turning ethereal thoughts into letters. Moments ago you had the freedom to hug, run, make an expression of joy or sadness, then suddenly it is lost. Suddenly you cannot hug, you cannot say ‘I love you’.
“Stroke is like a predator that stalks us all, at any age, and as if it were an ambush it snatches our humanity, or something essential to it.
“I see hundreds of people per year suffer from the bite of that animal, and I must see what is left, and then we make every effort to take care of them, to repair the damage, as if we were treating a bite from an invisible animal.
“Well, the story is summed up in that I decided I would invest my lifetime in treating stroke, so that no-one stops saying ‘I love you’. I summarize it in one sentence, ‘When we save brain tissue, we save social fabric’. But we could also say, ‘When we save brain tissue, the world keeps saying I love you’.”
