"I can give my patients the opinion of a doctor who has experienced death"

    Dr Canessa during the interview in Madrid.
    Dr Canessa during the interview in Madrid. / Alberto Ferreras
    • Roberto Canessa Head was one of the 16 survivors of the the 1972 air crash in the Andes, an accident immortalised in the book and subsequent film 'Viven'.

    On 13 October 1972, flight 571 of the Uruguayan Air Force, which was taking some rugby players and their families to Chile, crashed in the Andes, killing several of those on board. After 72 days, long after the search had been called off, Nando Parrado and Roberto Canessa appeared, after spending ten days climbing through the mountain range. Later, they led teams of rescuers to 14 other survivors who were waiting amid the wreckage of the aircraft.

    Roberto Canessa decided to dedicate his life to his companions on that flight who had not survived. He graduated as a cardiac paediatrician and won the National Prize for Medicine in Uruguay three times. In 2015 he was designated an Honorary Fellow of the American Society of Echocardiography. At present he is the head of Ecocardiography and Cardiology at the Italian Hospital and collaborates with a network of the most prestigious colleagues in the world to help babies and children with congenital heart disorders. "As soon as I listen to a foetus' heart I can tell whether it is complete or broken; if it only has one piece, then it has to be mended" he says.

    He has been featured in the news, documentaries, films and books, mentioned by companions such as Nando Parrado... but now he is telling his own story and how the tragedy inspired his career, in a book called 'Tenía que sobrevivir' (I had to survive).

    What lessons did you learn during those 72 days of brutal survival?

    I learned not to wait for the helicopters! I learned that you don't have to be in a plane crash to realise how lucky you are, that we always hanker for things without realising what we already have, that you shouldn't look ahead to the mountain, just focus on the next step, because anyway you don't know what you are going to need to get up the mountain when you reach it. People think of problems when there aren't any. We knew that if we walked, then at some point we would come to a path or a road. It was a finite distance. We couldn't think about the impossible, we had to just take everything in small stages. Uncertainty makes us less effective.

    As you were studying medicine, you instantly became the emergency doctor. What was that like?

    Awful. Very hard indeed. I suddenly found myself having to make bandages, clean wounds, stitch them, find out how to control infections, which were internal because the freezing cold in that place made it the most aseptic operating theatre in the world... and all with no instruments. The cologne we found in people's luggage became disinfectant, razors became scalpels, rugby shirts were used as bandages... and there wasn't a single doctor among us, only me with the soul of a doctor.

    During those months lost in the Andes, you must have found that the term 'never before' is relative.

    Definitely. That 'never before' led everyone to give us up for dead. And when they saw that we were alive, they didn't say "we were wrong." They said "they have made it after all." They called us heroes, which we never thought we were, there in the fuselage of the plane, because we were just unfortunate enough to be there, far from home... and people said things like "they survived because they ate the people who died." No, we saved ourselves because we left the shelter of the fuselage and set off to find a way out, because we knew they must have stopped searching for us by then. It's incredible how the world sees our story and how we actually experienced it. People still tell us we were lucky - why? Our plane crashed, they didn't find us, they forgot all about us, many of our companions died...."

    It was your idea to eat the dead and as a doctor you knew there was no other option, but it must have been very hard to tell the others that and to actually do it.

    Obviously, it was the only source of calories, fats and proteins we had, but at a personal level there was a philosophical and spiritual problem, because we couldn't ask those people if they would give us permission to use their bodies in order for us to survive. I thought that if I died, I would want my muscles to be used by somebody else, so they could survive. It would be a way of giving life to others. I would want those who lived to tell my mother that I had fought to the end. Sometimes I think that some malignant spirit wanted to experiment on us and that is why it put us in that place and in that situation. We were strong young men, we were part of a rugby team and university students, so we had knowledge to use as a tool. We were religious, so if we believed in God, he would have pity on our souls. Phrases like "where there is life there is hope," came to mind. They may not mean much in our normal lives, but for us at that time they were very valuable, they had a powerful dimension. "I am dead, but tomorrow I could be alive," things like that kept us going.

    Did you lose your fear of death?

    Yes; at least, I believe so. You lose it so you don't give in to that fear in desperation. For 72 days I carried the burden of death on my shoulders. Imminent death was my greatest terror, and when we got out, when we saw a person for the first time, I felt an indescribable happiness. It was like coming back to life.

    Did your experience change the way in which you see and deal with things in medicine?

    Yes. I now know what my patients and their families are feeling. I'm in the same circle, you could say. As I say in the book, I can give them the opinion of a doctor who has also faced death. It also changed the way I see life. After all that, I thought it would be wrong to waste my life and that I should honour my companions who died, so that they would have been proud of me. I wanted to live a good life. I didn't want the parents of those who died to wonder why I had survived instead of their son. I couldn't live a relaxed life. I had a commitment to it, an opportunity which others had not had. And medicine formed part of my plan, it was a commitment to helping others.

    Going back to your patients and your commitment to them, are you in contact with the babies who were born with half a heart and who, thanks to your help, have survived and grown up?

    Yes, of course I am, very much so. They and their mothers and fathers help me on many occasions. One of the boys, Roberto, said: "Mummy, how could I not be in this book? He saved my life." It's as if we were all one. And another of the children I talk about, the lovely Tomás, who sadly died, used to come to see me as a friend, not as his doctor.

    Is his story one of those which has marked you most?

    You never forget the patients who die. You keep asking yourself: "What didn't I do right? What went wrong? What more could I have done for them?" There are always unanswered questions in your conscience.

    Are the children you treat braver than adults, or does everyone feel afraid in the same way?

    I believe people can be born fearful and die brave, and vice versa. There are things which change in life.

    There must be questions that so many parents of these children ask, such as "Should we carry on? If we do, what will things be like?" And the final question, "Is it worth it?" What answers do you give them?

    I can't give them any. These are questions they have to resolve themselves. I can only show them the way, without giving them any guarantees of knowing whether we will be successful or not, none of us know that. But I also show them the light at the end of the tunnel, what they can expect if everything goes well.

    In your case, it was worth carrying on....

    I believe that life is worth the effort, that there are some wonderful situations like that of my patient María Rosario, who was born with half a heart. She loves to run in races and she always come last, and her parents are afraid. They ask me, "Do you think we should let her carry on running?" And I always say, "Ask her". Because she loves it, she loves everyone clapping when she reaches the finishing line, even though she has come last. It's like having an engine with one cylinder, when everyone else has two. She knows that she is always going to come last, but that's life. I believe Rosario has twice as much soul and only half the engine. People with a disability often show others how to live.

    What happens when all the odds are against you?

    For a child who has 90 per cent, the possibilities against it are ten per cent. For many of my patients it is the opposite. But if you're lucky it can be a 100 per cent success, no matter how unlikely that may seem. We are not talking about probabilities, we're talking about people. And that's something that the parents of my patients bear in mind. Where there is an illness, there may well also be a cure.