‘Music helps us to understand the brain and to diagnose and treat illnesses’

“We need to do something about the situation because most regional hospitals are in need of more neurologists”

ÁNGEL ESCALERA

Jesús Romero Imbroda was born in Melilla, studied Medicine in Granada and has been living in Malaga for many years. After nearly 20 years in the health service (he works at the Regional hospital), this neurologist requested a sabbatical in April and is currently the head of neurology at the Quirónsalud Hospital in Malaga. On 1 October this year he was appointed as the president of the Andalusian Neurology Society and in this interview he says more neurologists are needed in hospitals because Andalucía is lagging behind other regions in this respect. One of Dr Romero Imbroda’s hobbies is playing the guitar; he was taught by his uncle Javier Imbroda, who is the Junta de Andalucía’s Minister for Education and Sport and has a close association with basketball. He says music helps us to understand how the brain works, and to diagnose and treat illnesses.

–What objectives have you set for yourself as president of the Andalusian neurologists?

–For the past two years, because of the pandemic, we have been in flight mode, unable to carry out any scientific activities unless they were online. So one of my objectives is to make up for that. One of the first things we did was to arrange for fourth year residents in neurology in all the hospitals in Andalucía, whose training has been affected somewhat by Covid, to receive a grant of 1,000 euros so they can gain work experience in a different province or outside Spain. We are also planning to organise a Masters course of our own, in collaboration with the universities.

–How many members are there in your society?

–Around 400.

–What is the neurology situation like in Andalucía?

–Neurology in Andalucía is lagging behind in comparison with the other regions of Spain because most hospitals here do not have their own team of neurologists. We consider that that is a situation which needs to be improved. Even if we tried to provide neurologists to all the regional hospitals, which is something we have been calling for for ages, we would find there were not enough to do so. We need to reflect deeply on how many neurologists will have to be trained, if we are to be able to provide them to large regional hospitals. We need to ensure that there are no differences between a patient who lives in La Axarquía and someone who lives in the centre of Malaga city, for example.

–Is the solution to increase the number of resident posts in neurology?

–I have been on the national committee for this speciality and there are several questions involved. First, the hospitals have to want to receive more neurologists for training. When I trained at the old Carlos Haya hospital, there was one resident in neurology per year, and now there are three. Second, when a decision is made to increase the number of residency places, it takes four years for it to be implemented, while those residents finish studying their speciality. We are going to ask the Andalusian Health Service to let us know how many neurologists are of retirement age and what plans they have to cover those posts.

–At present, as you are on sabbatical from the Andalusian Health Service, you only work in the private sector.

–I prefer to call it non-publicly- managed medicine. I think that is a better term than private medicine.

–What are the most common neurological illnesses?

–On one hand there are pathologies that involve seizures, such as stroke, epilepsy, multiple sclerosis and migraine, and on the other there are neurodegenerative illnesses associated with age, like Parkinsons and Alzheimer’s. The most common reason people are referred for a consultation in neurology is headache, and the most common reason for being admitted to hospital is stroke.

–How does Covid-19 affect patients from a neurological point of view?

–In neurological patients who have Covid their illness gets worse, although they can recover. SARS-Cov-2 is a very neuro-invasive virus.

Cognitive stimulation

–How does music help patients with neurological conditions?

–Music is a top class activity for the brain. I would always recommend playing an instrument to the same level you learn a second language. We learn how the brain works in health by understanding how sound is processed in the mind, and the emotions and aversions it provokes. There are some degenerative illnesses where the patient can’t speak, he or she is aphasic, but they can sing. That helps them to communicate.

–So what you are saying is that listening to music is as beneficial an activity as learning a foreign language?

–From my point of view, yes. At the Quironsalúd Hospital in Malaga we have presented a work to the Andalusian Neurology Society about a short diagnostic test based on music, to explore patients and see how their memory and their apraxia (how skilful they are with their hands) are. Music helps us to understand the brain, to treat some illnesses as a non-pharmacological type of therapy and even as an aid to diagnosis.

–How do you see the current scenario and the future of your speciality in Malaga?

–I believe neuroscience and neurology in Malaga are well represented. The population of Malaga can be proud. We have two fantastic neurology departments in the public health hospitals, and in the non-publicly-managed sector the standard is very high. The standard of my team at the Quirón is amazing; we look after patients from all over the world. The future of neurology is hopeful; great things are coming to treat rare neurological illnesses through gene therapies, and Malaga is going to be at the forefront.