It is evident from his short speech accepting an ESO Spirit of Excellence Award in Basel, that Dr Apostolos Safouris is a very entertaining, very warm and a very serious man.
“You cannot make a Greek shut up,” he warns before announcing that he wants to talk about stories. He leads with a favourite quote: “What makes us different from the animal kingdom is that we believe in stories.” There are many great stories, he continues, and one of these is that the Angels Initiative is building a community around stroke care.
After drawing laughs with a riff on finding himself (and fellow nominees) on the dinner menu back to back with pineapple carpaccio, he closes on a solemn note: He predicts that integrating the work of Angels and the ESO Stroke Unit Committee (which he chairs) will result in more being done for stroke patients in Europe.
A couple of days later he doubles down on the community of stories.
The efforts of doctors at remote or rural hospitals are seldom acknowledged, Dr Safouris says, but Angels recognizes hospitals that, although they are not well funded or well staffed, nevertheless provide an excellent level of care. The wide embrace of the Angels community means that even on an island as remote as Rhodos the general hospital has twice been recognized with an Angels Award.
The ESO has evolved into an influential body capable of taking science forward, Dr Safouris says, but stories, with their ability to journey across vast distances and reach into the tightest corners, can carry the science outward.
He explains: “Science is for the progress of society, but many parts of the EU have had no benefit from the progress of science. It is heartwarming, the stories that spread scientific knowledge to people and communities. Europe is after all an assembly of communities; the entire stroke network is part of a greater project.
“That is why the stories told by Angels are important.”
Young people have to make mistakes
Dr Safouris’s own story begins in the rural Macedonian town of Serres, another small city a long way from Athens whose general hospital has been recognized for excellent stroke care. In one sense the six gold awards that adorn these hospital walls may be even more important than the twelve times his own hospital in Piraeus has been recognized for stroke care. Having lost his grandmother to stroke, Dr Safouris’ fears for another strike against his family are allayed by the dedication of his colleagues. He says, “I can sleep easier at night, knowing there is a group of motivated people who are working for my family should something happen.”
“Young people have to make mistakes,” he says of the 18-year-old from Serres who opted out of Thessaloniki’s vibrant student life by combining his medical studies at the Aristotle University with training in the Hellenic Military Academy.
At 24 he began his training in neurology at Thessaloniki’s then brand-new Papageorgiou General Hospital. With claims to be the most modern hospital in Greece, it was at the time the only facility that offered training in thrombolysis for stroke, thanks to a German neurologist, Dr Rudolf Jobst, who had followed his neurosurgeon wife to Greece.
It was, Dr Safouris says, “an opportunity to see what it meant to change the progress of the disease.”
In 2010, newly married after a whirlwind courtship, he continued his training at Brugmann University Hospital in Brussels, where their eldest daughter, Barbara, was born. It was here that he was “infected with the virus of stroke neurology”, he says. After completing his training at AHEPA Hospital in Thessaloniki, the Safouris returned to Brussels where they saw Barbara start kindergarten and welcomed a second daughter, Kalliniki.
Their cue to return to Greece in 2015 was the establishment of the stroke unit at Athens Metropolitan Hospital in Piraeus where Dr Safouris is the supervising neurologist. In 2018 it became the first hospital in Europe to receive ESO stroke centre accreditation under a programme to benchmark, standardize and improve stroke treatment in Europe.
“We applied as soon as the platform went live,” Dr Safouris says, emphasizing Prof. Georgios Tsivgoulis’s role as “the scientific heart of the project”.
Prof. Tsivgoulis, until recently ESO vice-president and a past Spirit of Excellence nominee, is neurology professor and chairman at the University of Athens where he and Dr Safouris collaborate on stroke research and best practice implementation.
The newly accredited Metropolitan Hospital set new standards for stroke care in Greece, Dr Safouris says. “Many look up to us, but now we also have competition from many centres. There are other stroke units in private and public hospitals that also work very well.”
I came to it late in life
It was effortless, says Angels consultant Eleni Panoutsopoulou who nominated Dr Safouris for the Spirit of Excellence Award. The words just flowed as she described his role in creating a community of stroke doctors that meet once a month, his work with the University of Ionnaina to develop a mobile app for mapping thrombolysis and thrombectomy centres in Greece to reduce emergency transport delays, and his advocacy of certification as a means to change patient outcomes.
She wrote: “Apostolos is behind several actions to improve stroke care that do not have a direct impact on his hospital. His selflessness and support inspire me. He understands the quality and potential of Greek healthcare professionals and tries to find ways to make their lives easier, thus giving not only his patients but the whole country a chance at life.”
Eleni ended the task with a flourish: “Name me a better nominee . . . I’ll wait!”
Two days after accepting the award and charming the audience, Dr Safouris has settled on the honour being about future rather than past work, describing it as “recognition from people who are betting on me that I will do better”.
“The appreciation of people who recognize that you are trying is a great push forward,” he says.
Forward into his role as chair of the stroke unit certification committee because more certified stroke units are an indicator of more optimized stroke care. Forward with creating a community of like-minded colleagues, changing views, translating established science into implementation.
He says, “I have seen people struggle with the aftermath of lost opportunities, and little by little I have understood that helping them did not require deeper scientific knowledge. That every day without optimizing stroke care was a day lost and that it was fine to invest effort and time in providing the best possible acute care to as many stroke patients as possible.”
Having witnessed how stroke tears at the family fabric, he has become “a physician to the families of stroke patients” as well as a driver for change.
Advocacy was something that grew in him, Dr Safouris says. “I was a typical student; I thought only about improving myself and giving the best of myself to my personal projects. In reality there are many impactful things to do through projects that cross these narrow limits. I came to it late in life. I will try to catch up.”
How to be human
Greek culture is a storytelling culture, and though his forum may be Facebook rather than the courts of the Bronze Age kings, Dr Apostolos Safouris clearly enjoys telling stories about the exploits of gods and men.
A trip to Paris last November, for example, brings to mind Marcel Proust’s essay, “Fillial Feelings of a Parricide”, written after a Parisian bourgeois killed his mother before taking his own life. It is shorter, Dr Safouris reassures his friends, than the description of afternoon tea being served in In Search of Lost Time.
Elsewhere he recommends a new English translation of Homer’s Iliad “even to Greeks, as most Greek translations struggle over form and often fail to convey the universal wisdom of the classics”.
A meal with friends on a summer’s day elicits a quote from the poet Walt Whitman: “I have perceiv’d that to be with those I like is enough.”
And his birthday at the end of June is an occasion for reflecting on the Temple of Hephaestus located in the Ancient Agora of Athens: “My opinion is that this temple brings together all the elements that shape the modern state of Greece and in general the modern state of man: constructions made of materials from different traditions that form a unity and withstand time and brutality inside and outside the walls . . .”
He loves to read, Dr Safouris confirms. At the suggestion of a colleague he has adopted the practice of augmenting presentations with references to great works of literature, history and thought. This has allowed “stories” to enrich his work in quite a deliberate way. He says, “The great texts from the history of humanity help place my work in the broader context of human experience.”
