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National Institute for Neoplastic Diseases
Universidad Peruana Cayetano Heredia
Lima, Peru

Courtesy of Eben Yep

I am honored to be asked to contribute to the Legends in Urology Section of the Canadian Journal of Urology. Although I was taken completely by surprise by the invitation, I am nonetheless honored by the invitation and accept it as recognition of the contribution that many people in addition to me have made to urology in South America and the entire world. My story parallels the beginnings and growth of urology as a specialty in my native country of Peru.

First, let me tell you a little bit about Peru. While my country is usually identified with the legacy of the Inca civilization, its background is actually quite a bit more complex. Our culture is a blend of native Peruvian, European, African and Oriental (especially Chinese) influences. Those who travel to the major cities in Peru (Lima, Arequipa or Trujillo) usually encounter people of various ethnic backgrounds. You will see the “mestizo” type of person who will be happy to join you for a nice meal any time of the week - a meal which is likely to include ceviche combined with innumerable typical Peruvian dishes and surrounded by Peruvian music.

I was born in Lima, the capital of Peru, and raised in Ica, a town 300 km South of Lima. Ica is situated in a valley in the middle of a narrow desert flanked by the Pacific Ocean to the West and the Andes mountains to the East. It is the land of Pisco, a traditional Peruvian liqueur from which the world-famous Pisco Sour is made. The region has also produced authors of popular Latin-American short stories including “Lord Carmelo”, “The little Princess with the Green Eyes” and “The Witches of Cahiche”. Equally important titles include “The Legend of Huacachina”, the green-watered lagoon where it is believed that a mermaid lives, and “The Witches of Cachiche”, a story of benevolent sorcerers who rule a small remote community in a remote valley.

I entered medical school after graduation from the University with honors in both music and science. I then found that I had to make a choice. Should I pursue a goal of violinist, composer and conductor or should I fulfill my vocation as a physician? My music teacher, Panchito Perez, (who wrote one of the most popular Peruvian Polkas of all times, “La Huacachina”) persuaded me to stay with medicine. I am eternally grateful to him for this advice.

I received my M.D. Degree from la Universidad Mayor de San Marcos in 1953. I then completed a surgery-urology residency at the Hospital Obrero in Ica, under Dr. Augusto Hernandez, one of the first urologists in Peru. My professors during that period included Drs. Ricardo Angulo, Enrique Blondet, Augusto Hernández, Alejandro Higginson, Enrique Navarrete, Marcos Niccolini and Ricardo Pazos-Varela. They were true legends in the early
1950s when the specialty of urology in Peru was in its infancy. These remarkable and dedicated physicians brought their recently acquired knowledge from Europe, adapted it to the financial and technological limitations of Latin America, and provided state of the art urologic care to the people of Peru while starting to train the new generation of contemporary Peruvian and Latin American urologists.

Following my training, I was offered the opportunity to go to the United States to pursue a formal residency in urology at the Baylor College of Medicine in Houston, Texas. There I learned the latest surgical techniques in adult and pediatric urology, under professors Abel Leader and Michael O’Heeron.

Following my training in Houston I returned to Peru and was soon appointed Chief of Urology at the Children’s Hospital in Lima. Two years later I was appointed Assistant Urologist at the “Instituto Nacional de Enfermedades Neoplasicas” (National Institute for Neoplastic Diseases or I.N.E.N). In 1964 I was appointed Chief of the Department of Urology. I had the privilege of serving in this capacity until 1997. I.N.E.N is affiliated with the Cayetano Heredia School of Medicine in Lima, Peru. Because of this association and my Department Chairmanship I was able to establish the first accredited 4 year urology residency program in Peru.

During my professional career I have had the good fortune to develop sincere and lasting personal and professional relationships with many outstanding urologists around the world. They have always willingly shared with me their tremendous experience and their desire to achieve nothing short of excellence in urology. I have had many such mentors over the years and could not possibly name them all. Those whom I think deserve special mention include Jean Marie Brisset, John Donahue, Ian Thompson II, Willet Whitmore, Gerald Murphy and Victor Politano. Dr. Kash Mostofi, of the Armed Forces Institute of Pathology was also a dear friend and advisor.

I had the privilege to contribute to our specialty by training residents who now work at hospitals around the world and by publishing original manuscripts and book chapters that hopefully have advanced the understanding of urological conditions including Wilm’s tumor, testicular cancer and penile cancer. The latter was endemic in Peru before the turn of the century and challenged me to develop surgical techniques to achieve cancer control while preserving quality of life. I am very proud that my trainees included my oldest son, Julio, who practices urologic oncology at the Moffitt Cancer Center in Tampa, Florida; my son Henry, a general urologist at the Montefiori Clinic in Lima; my daughter, Mariela, a urologic oncologist at the INEN also in Lima; and my son in law, Bruce Robertson, a general urologist in Bozeman, Montana!

At age 86, I still have a small urology office practice in Lima and try to attend many of the major specialty meetings around the world. Looking back over the last six decades I am both humbled by and proud of the accomplishments that we have made in Urology. Just think, when I started in urology we performed rigid cystoscopy peeking through its small lens with an incandescent light attached at the other end! Now we have fiberoptics, high resolution monitors and ways to better diagnose and treat almost all urologic malignancies and other genitourinary conditions. I feel privileged to have been part of this progress. I am mostly blessed to have my wife of 60 years, Graciela, my eternal source of inspiration and strength by my side having supported my career. We both enjoy the frequent visits to our 10 children, 18 grandchildren and 4 great grandchildren.

Julio E. Pow-Sang, MD Professor Emeritus

National Institute for Neoplastic Diseases Universidad Peruana Cayetano Heredia Lima, Peru


© The Canadian Journal of Urology™; 21(1); February 2014