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The series of interviews Experts as Disciples collects the experiences of outstanding personalities during their learning processes, both in the academic field and in everyday life. It has a double objective (in addition to natural entertainment): to serve as a vocational guidance tool for students, teachers, and the general public and to highlight what, in my opinion, is the most common trait of human beings: always to be learning.
Interview by Andrés García Barrios
Dr. Tapia-Conyer, General Director of the Carlos Slim Foundation and twice Undersecretary of Prevention and Health Promotion in Mexico, begins this interview by telling us part of his childhood: what he learned from two admirable parents (undoubtedly extraordinary), the singular environment in which he grew up, and the schools and teachers that provided his first academic foundations. I will only add here that he completed his master’s degree at Harvard University and received his doctorate with honors from UNAM; he is a professor at this university and in California and a member of three national academies in Mexico and numerous epidemiology organizations worldwide.
Roberto, how were your childhood and young adult education? What do you remember about those times and your first experiences in school?
In Guanajuato, I was born and raised in the province on a farm between Apaseo el Grande and Celaya. My parents had agricultural properties, so I lived there until adolescence, always surrounded by farmworkers. I spent my holidays with them, working, living closely together, beginning in the early mornings. During those years, I received primary and secondary education in a private school in Celaya, Guanajuato. I had an exceptional teacher who taught me philosophy and biology in high school! This unusual combination allowed me to understand the relevance of biology and the work done on the farm. I became interested in animal health and its benefit to people. I decided to study veterinary medicine. “That’s all very well,” my dad told me, “we have a lot of work here for that, but … don’t you think you can study human medicine?” “No, no, no, what I like are animals, no, no, no!” I said. He accepted respectfully.
The thing is that one day, after a failed attempt at the University of Guanajuato, I came to Mexico City and directly proceeded to complete my application to UNAM. I was at the head of a long line of students registering for Health Sciences and Humanities (I remember all this very well; you will see why) when the employee asked me what career I wanted to study. “A medicine career,” I replied, unintentionally omitting the veterinary part. Then he asked me: “Human or animal medicine?” At that moment, an avalanche of reflections accumulated since that conversation with my dad came crashing upon me. “Human,” I replied. In that second, I decided that would define my entire life in some way. Such things often mark us. When I returned to the village, and my father asked me how things had gone, I replied, “Well, the exam is such and such a day… I just want to let you know that I’m going to study human medicine.” Tears came to his eyes, and he hugged me.
You had trusted him.
That’s right. I can tell you that, rather than learning from formal schooling and its curricula, I learned from contacts with people, the farmworkers, the chats with my teachers, and, above all, my parents.
Do you remember what your parents thought about education?
My dad was self-taught. He had been born in the early years of the 20th century, and at the age of sixteen, when his mother died, he migrated to the United States to start a new life. He worked hard and had extraordinary success. He was a great innovator and promoter in the hotel industry. He worked with the Hilton family and for a long time was manager of the Waldorf Astoria, one of the great hotels in New York, actually, the world. He also opened the first Mexican restaurant in that city. In his first marriage, my older sister Ana was born. After he divorced, he met my mother, a young public accountant, who years previously had had an extraordinary job – she had been an equestrian acrobat in the most prestigious circus in the United States, the Ringling Brothers Circus!
That’s extraordinary! Enough to motivate a child forever! Like your father did.
You will see that it does not end there. My dad’s dream was to have a ranch, so one day (daring as they were), my parents decided to use their savings to buy a pickup truck and a tractor and start on the road to Mexico. And well, the dream worked, oh yes! My dad was the inventor of hydroponics and made multiple contributions to cultivating onions and garlic. (He was the first to export garlic to the United States.) However, he never cared about economic success. Money never attracted him, and he told us, “The important thing is how we act.” Of course, when he died, we were in debt and had nothing to pay with, ha-ha! I learned to forge an education with dedication and effort from my dad.
Moreover, in part, thanks to him, instead of going into veterinary medicine, you entered the UNAM School of Medicine one day.
Yes, as you say, in part.
Do you remember that day?
The first day of school? I will never forget it. It was the last year that the notorious hazing was allowed. Those who had become sophomores grabbed the new entrants and shaved their hair. Knowing that I went to the barber the day before to have it shaved. So, when I arrived at school the next day, a guy grabbed me and said, “Why are you already shaved?” “Because yesterday they grabbed me.” “Ah, sure, no way, man! Then we’re going to paint all over you.” “No, no, no…,” I said, “I was grabbed by…” and I made up a name, anyone. So, he let go of me. That is why they did not paint me. Some hazing was so violent that there were injuries, so they ended up banning them. Mine was the largest generation of entrants that the School of Medicine ever had. There were thousands of us. The classes were filled with a hundred, one hundred, and twenty students. Imagine that! It was 1972.
Your parents’ stories raise many questions for me. You brought to my mind the image of the circus, and it makes me think of a subject that has become central in education: gamification, play as a way of learning. Is there play in the training of health professionals?
Well, one element used a lot in the training of health professionals is the case study. There is some play involved, especially now because the rise of online education has become an extraordinary didactic application. You see, the program gives you a person’s health condition and adds all kinds of information about them. Then it takes you through decision trees with several questions that, due to its algorithm, become more complicated as you answer. If you make a mistake, it teaches you why – just like when you get it right. It is a kind of game increasingly used in real-life scenarios. Underlying the game is a great deal of responsibility.
The memory of your father as an inventor takes me to another topic of interest in education: creativity. There is a common idea that talent is reduced to knowledge and technique in medicine. Is that true, or does a spontaneous element that we call “creativity” also enter?
It depends a lot on the discipline. A radiologist, for example, has the task of studying and seeing, perfectly measuring what is happening inside the body, mastering spectrography, magnetic resolutions, ultrasounds…observing. In that case, creativity does not apply, nor in many aspects of medicine, generally. In the first place, medicine is a discipline and teaches you just that, to be disciplined, to follow methods: interrogation, physical examination, integrating symptoms into syndromes, comparing a pathology with others, designing a treatment plan. However, undoubtedly, intuition is essential as well. What is this? When you face a problem, you have all the possible analytical elements, but you only conclude by relying on your experience what you have lived. You bring this to the present; you involve it in decision-making. You become increasingly clear about the factors at stake, how they are determinants of the events occurring, where they are headed, and where they will go. Then you sense that the solution may be right here! Intuition always comes wrapped in experience and the ability to integrate. That is what you need: the ability to incorporate a lot of data, information, and analytical elements to bring your thinking to a decision, to an action.
That is what distinguishes a creative finding from an occurrence.
Absolutely.
“Public health is a generally misunderstood discipline.”
Intuition leads to a kind of happy ending, which closes a process. Now, speaking of this, one goes to school with the idea that they will learn to put strategies in order but ends up realizing that reality always imposes some disorder, unexpected things. Clutter is part of life. To some extent, we go to school to learn to live with the unforeseen. How does your profession deal with “disorder?” At school, were you taught anything about it?
Serendipity frequently occurs in scientific knowledge: discovering something when looking for something else. Some drugs have been successful against conditions for which they were not originally intended. However, that is not ordinary. In medicine, what we learn most is order and systematization: The life of a human being requires a strict follow-up of processes and protocols. The same goes for public health policy aimed at impacting thousands of people. In the field of health, we are guided, as you say, by processes: exploration, interrogations, laboratory studies, data interpretation. However, being rigorous does not free you from the unforeseen. In any clinical scenario, when processing a diagnosis or a treatment in the framework of a population intervention, there come times when you have to face elements that you did not expect. It happens to the surgeon when something becomes complicated in the middle of the operation. It is essential to know that you will have to make decisions on the fly in vocational training. So, there is also training for that, exercises that help put some order within that unexpected “disorder.” It is similar to aviation pilots’ training, which simulates unforeseen scenarios.
Only recently, especially since the COVID-19 pandemic, has the work of epidemiologists as medical professionals become widely known and recognized. Before, they were almost unknown, kind of heroes who saved lives without anyone knowing them. They always seemed more concerned about the health of others than about their own protagonism. Do you remember what you thought of this when you were a student? Did your teachers discuss it?
Public health is a generally misunderstood discipline. Historically, it was seen only as administering health services, but it has been strengthened with countless tools that allow it a greater analytical capacity in recent decades. Still, we are health professionals working behind the scenes. It is true that as an epidemiologist, you are not in front of a patient. However, it does not matter because you know that your actions can help control a pandemic and benefit tens, hundreds, and thousands of individuals if done well. As an epidemiologist, you even aspire to create theoretical models on “things that could happen,” predicting phenomena and reducing future adverse effects. You take the knowledge of the experts in viruses, including virus evolution; you nurture it with genetic and genomic analysis, you add all the possible “omics:” proteomics, metabolomics; you add the information that a multitude of researchers worldwide have placed on the table; you apply the mathematical capacity of cognitive computing (and the computation that learns, which we have called artificial intelligence)…and, suddenly, you are on the wave, one of the privileged who can anticipate how an epidemic will behave and act with preventive opportunity! That being the case, what do you care about your protagonism? You care about people; being close to them. You are not removed from pain and suffering. I think many people do not value and comprehend the privilege of being able to help.
That mystique – is it taught?
It is something you learn along the way, not based on your training but human values. Sure, you have exemplary teachers. I had them: Dr. Kumate or Dr. Soberon, for example. However, you also find examples among anonymous people who live in the health trenches; colleagues you see in the field who work under the sun’s rays to bring a vaccine to someone.
The English philosopher Bertrand Russel said that higher education emphasized specialization and too little on expanding the mind and heart.
When in school, you have to concentrate on specific knowledge, assimilate it, and make it your own. You focus on finding your reasoning structures to put that new knowledge into practice. The truth is that you need time to pass to strengthen communication with particular professors and mentors to understand the importance of making decisions with the human being in mind. By expanding mind and heart, as Bertrand Russell says, each patient, each individual becomes important to you, each becomes a source of knowledge. You become interested, for example, in the social conditions that are unique to him, if he has a family and social support network, whether he has resources. You delve deeper into a vocation of understanding and empathy. I understand vocation as the desire to be in the heart of the other. In the case of public health, you can be in the heart of millions.
Finally, I want to delve into one of your main current activities, CEO of a philanthropic institution. I understand that there are a lot of technical aspects behind helping others. What do you think of promoting philanthropy in academic studies? In your view, what would be some of the main points to be addressed?
Today the word philanthropy should be described as social investment. What does this mean? It means that the support generated – financial, innovation, access to particular products and services, for example – must strengthen the beneficiaries without developing dependence, allowing the person to improve while simultaneously acquiring sustainable capacity. Doing this has to be learned. It is necessary to train professionals in this regard. In our society, knowledge about this subject is limited. You ask me what elements need to be taught. First, be very clear about the benefit of the social investment action and perfectly identify the problem to be addressed. Here is something fundamental: it must be a real problem, a problem truly felt by the person who will receive the benefit, not just by the one who will grant it! Secondly, the intervention must be accessible and manageable by the beneficiary, not something pretentious that the beneficiary does not understand. Also, as I mentioned before, “sustainable” means that you do not have to give it in perpetuity. Sustainability is built into the initial aid and facilitates the final exit because the last thing you want is to generate dependence.
Social investment is providing support with a vision of social return. For example, you create an educational platform for technical careers. In the end, one of the participants specializes in beauty care and manages to set up her own aesthetics. She comes out of unemployment, generates a service, can take care of one or two children, accepts them, and picks them up from school. That is social return, a real benefit, which you can measure and know how to do it. The third point is to assess the benefits’ impact, so we must teach information techniques that measure results and their significance. The fourth and final point is to train people in accountability: where was the money used, for what purpose, what benefits did it bring? Some topics must be addressed along with others in sociology, psychology, financial structure, and even politics. I am convinced that organizations with social programs are essential contributors to the se
arch for greater global equity nowadays.
Translation by Daniel Wetta.
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This article from Observatory of the Institute for the Future of Education may be shared under the terms of the license CC BY-NC-SA 4.0 
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