Forty-five years ago, while I was in Prague – in the then Czechoslovak Republic (CSR) – for my doctoral studies at the Carol University between 1962 and 1965, I received, full of excitement, the visit of a Romanian colleague, Head of the Pediatric Neuropsychiatry (PNP) Section from Cluj, as it was then called, who was on an exchange of experience tour in CSR, GDR (East Germany) and RSP (Socialist Republic of Poland), in order to find an answer to problems he was facing professionally and to see how the specific support network in these countries was organized.
Not only was he the Head of the PNP Section from Cluj, but also he had the responsibility of organizing the first PNP hospital in Romania at Păclişa – Hateg, in the Hunedoara county, as requested by the Ministry of Health, for which Dr. V. Ilea had drawn up the plan of a hospital unit with 400 beds for assistance and recovery.
At the time, I used to be part o a team whose mission was to organize the PNP network in socialist countries. This team had been set up in Prague, under the leadership of prof. Dr. Jan Fischer, head of my PhD, and included professors Dr. Bilichievici from Poland, Dr. Gölnitz and Dr. Müller from the GDR, Dr. Suhareva from the USSR, etc. Due to my participation in this group, I was familiar with the organization models and the achievements in these countries, as well as with some information on the state-of-the-art in Western countries, which were also at the beginning of the road in the psychiatry and neurology of the developmental age. (developmental neuropsychiatry)
To give my visitor a more accurate picture of the subject he was interested in, I accompanied him to hospitals and specific sections from Prague, I introduced him to Prof. J. Fischer, who was Head of the Child Psychiatry Clinic Department, to Prof. Dr. Lesný, Head of Child Neurology Department, and to other sections profiled on both directions, but only for the preschool age, such as those directed by Dr. Čepičca and Dr. Kucera.
Dr. Ilea’s greatest concern was to discern the right direction to follow in organizing the PNP in our country and to conceive methods of completing the project started at Păclişa. From Prague, his journey continued to the GDR, to Prof. Dr. Gölnitz and prof. Müller and we resumed our conversation after 1966, when I returned from studies to my old job in Cluj.
Today, when time had decanted and checked the validity of our ideas formulated in the ‘60s and of his aspirations and endeavors, it is a pleasure for me to evoke the memory of Dr. Vasile Ilea Jr., from whom we sadly we parted in 1967, and to point out his merits in the development of PNP in our country.
The beginning of this medical branch, its split from the common trunk of adult neuropsychiatry, in our country, as well as in the rest of Eastern Europe, can be traced after World War II and was determined by two significant events:
1. Emergence, in 1947, of the World Health Organization (WHO) which, a year after its establishment, and considering the ill health of people in the specific circumstances after the war, set up the first program concerning mental health, focusing on the two fundamental principles that WHO experts recommended: firstly, to promote the responsibility of all medical and social factors both for mental health care and for somatic health care; secondly, to focus on problems of psychic therapy and prevention in the developmental age of the child.
2. The 1948 Education Reform, which led to the establishment in Romania of the Institutes of Medicine and Pharmacy which included Faculties of Pediatrics, as a consequence of poor health care, high morbidity and lack of health professionals in the field of the developmental age.
While the situation was common in all Eastern countries, the ways to tackle the problems, the material resources and the commitment to implement national programs meant to accomplish the above mentioned desiderata were different. Dr. V. Ilea had realized the necessity of taking that effort and he engaged himself in the necessary work with enthusiasm, determination and perseverance, but he lacked experience and practical models.
However, what he did accomplish during a short sequence of his life, the trace he left in our memory, are the expression of a vigorous, multilateral personality, whose enthusiasm had burned at unusual temperatures.
Ever since his early childhood, Dr. V. Ilea’s dynamic personality has been foreshadowed, bringing enjoyment, fulfillment and hope to his parents. He was born on January 14, 1923, in the city of Sighet, where his father was director of the Psychiatric Hospital.
He was lucky to be born and to receive an outstanding education in a well reputed family, in the environment of famous personalities of Romanian culture and medicine, such as Julius Hatieganu, Iuliu Moldovan, Victor Papilian, Balifi in Cluj, etc., who, like his father, have shaped the future direction of his professional creed.
His talents and potential had been validated ever since his childhood but especially during his adolescence, as a student at “Dragoş-Vodă” High School in Sighet, where he proved to be keen not only on learning but also on sports, violin, hiking and on people for whom he wanted a better and more optimistic life.
When his family was forced to change jobs and address, he finished the 8th grade in Lugoj and took his Baccalaureate examination at the “Coriolan Brediceanu” High School, in 1941. The same year, he went to the Medicine Faculty in Sibiu, which he graduated in Cluj, in 1947, where the Faculty moved back from Sibiu. Being an eminent student, with an arduous interest in research, he was quickly noticed and, in 1945, was recruited as an extern clinician at the Department of Clinical Neurology, for which he had a particular attraction, and as a junior in the same department, in 1946.
He graduated in 1947, but remained at the same clinic, where he became assistant professor in 1949 and part time standard specialist consultant in the network until 1952, when the moved for two years as a physician to the Adult Psychiatry Clinic to complete his professional profile as he felt the urge.
In the two years of psychiatry, he was particularly impressed by the mental confusions that often ended with death in those years and by the protrahate insulin comas, and, as a consequence he decided to start research in histopathology of the Central Nervous System in the research laboratory of the clinic, thus widening his knowledge in this area. With such thorough training in neurology, psychiatry and laboratory histopathology research, Dr. Ilea took the lead of the Child Neuropsychiatry Section (CNP).
That department had been established on October 1, 1949 under the leadership of docent dr. Maximilian Müller, helped by his assistant, dr. Margaret Drăgoi (both from the Section of Adult Psychiatry), but it was partially disorganised and, after 1954, it remained without leadership.
The reason for this disruption was due to the fact that the Child Neuropsychiatry (CNP) Section was founded, organized and designed as a clinical base for students from the Faculty of Paediatrics. At the beginning, its staff was made up of 10 university teachers (see SNPCAR Journal No. 3, vol II, 1999), but after 1952, not being included in the curriculum approved by the ministry, it was dissolved while docent Müller left the academic life, dr. Margaret Drăgoi went to Bucharest after her marriage, taking the name of Margaret Ştefan, and the remaining staff was transferred either to Adult Psychiatry Clinic, to Neurosurgery or to Paediatrics.
Thus, Dr. V. Ilea became Head of the Section, assuming full responsibility not only for its reorganization, but also for establishing the CNP local network. Other objectives were: to structure a plan of ambulatory health-care with polyclinic surgery and to design an in-service training programme for professional and support staff, as a complex team in the field. Aware of the tasks implied by his new position, he engaged in a thorough study of the neuropsychic pathology in the developmental age, managing to pass his MD examination in CNP in 1959 and to become well known on both local and central levels due to his remarkable achievements obtained in a short period of time.
He sought primarily to improve the health-care quality in the section that he took over, managing to structure and to form a complex CNP team, made up of a speech therapist, a psychologist, a nursery teacher and a teacher of physical education and to improve their activity continuously. He also managed to improve the patients’ living conditions, the atmosphere in the Section, the required parameters of its activity as well as of the means of investigation and treatment.
As manager, he had inherited his father’s the rigorous organizing spirit which had made the latter a remarkable personality in all the hospitals where he had been director: in Sighet, Lugoj, Oradea, Mocrea.
From his mother, Dr. Ilea had inherited the restlessness, dynamism and continuous urge for perfection and for being a good manager. He was a good doctor, indeed, willing to follow the example set by his father, but also aspiring to have a wider area of breath and understanding. From the outset, he understood the need for interdisciplinary relationship with the clinics of paediatrics, physio-paediatrics and of contagious diseases, which he helped with consultations in exchange of receiving their mutual services when necessary.
He understood that his work could not be limited to the activity in his Section, that he should extend the area of ambulatory activity in order to detect sick children and supply them with adequate medical aid, especially those children with particular diagnostic categories, so as to provide them with prophylactic treatment. In this regard, he organized:
- a surgery room within his section, which he served in person;
- a medical consultation cabinet at the paediatric polyclinic;
- a medico – pedagogic cabinet at the local
- staff training department, where he himself used to participate;
- the first Regional Council of Children with deviate behaviour problems in Cluj and Dej;
- a “Parents’ School” with help from retired academics in order to help parents understand the psychic suffering of childhood.
In parallel with his health care work, he understood the need for linking it to scientific research; thus, he collaborated in interdisciplinary teams composed of valuable and rigorous academics such as professors Desiderius Duma, Victor Papilian, Popa Rubin Capusan, Julius Alexander Vaida, Mircea Serban, Stephen Lakatos and Iacob, the Chief of Neurosurgery.
Together, they published and communicated papers on various important topics such as: vascular secondary epilepsy in children, brain tumours in children, brain tumours and pseudo – tumour syndromes, phakomatoses in children, clinical study of uncompensated hydrocephalus and others. He used to be a constant presence in scientific debates at local and national levels, and at the National CNP Conference from Iasi in 1958 (the first one of national scope) he contributed with four papers which were highly praised by the audience.
As a researcher, although being involved in this type of activity for only a short period and failing to enjoy the fruits of his organizational preamble, he produced a total of 30 works, which revealed in him the glitter of the true scientist. He was convinced of the value of research in specialist training and of the need for active participation in academic confrontations, both nationally and internationally. He sought to instil these principles to his later collaborators at Păclişa Hospital. In spite of his good results in the medical and research fields, dr. Ilea felt the urge to get involved and to participate in health education, as well as in other social and cultural activities like musical events, conferences on music and literature, trips and sports.
Recognizing his achievements and merits at local level, in Cluj, the Health Ministry asked him to organize a republican regional hospital, for the developmental age, at Păclişa near Hateg, where Greek children had been temporarily housed after the political events in Greece. He was asked to devise the project for a unit with 400 beds and a personal model to implement it which Dr. Vasile Ilea submitted for approval by the Ministry of Health. Both the project and the implementation plan were accepted and, between 1960 and 1963, we find him dealing exclusively with the implementation of the project, while temporarily retaining his position as the chief of the CNP Section from Cluj.
Within the limitations set by the available buildings and spaces at Păclişa, dr. Ilea designed and accomplished – a modern and complex medical unit with healthcare and living conditions that went beyond the “asylum” nature originally envisaged. The unit was endowed with a medical library which, at that time, was better equipped with specialist books and magazines than the IMF from Cluj. Here are some other characteristics of the hospital from Paclişa:
- a sports centre with sports grounds and an outdoor swimming pool for doctors, hospital staff and patients,
- opportunities for occupational therapy for patients, either vegetable growing or taking care of pets,
- an operating room for neurosurgery,
- electric-physiotherapy laboratories,
- Psychology consultation rooms, etc.
He recruited eight graduates, well-trained in the medical profession, whom he transmitted his inspired love and enthusiasm for the chosen profession. He asked them not only to perform their daily duties at high standards but also to devote their time to study permanently in the library, in order to present their findings and discuss the new ideas at their weekly meetings. Among them, two doctors subsequently became eminent academics: prof. Mircea Lazarescu and Secareanu Alexandru, and while others became distinguished practitioners in the field, or unit leaders, like Ştefan Kecskemet.
When, in 1963, he became Head of Department, in order to maintain an active atmosphere in the hospital, a good working atmosphere, a climate of scientific activity, he gave up his home in Cluj and moved to Păclişa. Unfortunately, he was deprived of the enjoyment of hopes and investment made for the future development of the unit, because he passed away at the age of only 44 years, in 1967, suffering from leukaemia.
That was, historically speaking, the road from 1923 to 1967 where his work was exemplary, his whole personality can be viewed from different angles, appreciated for its complexity and multi-purpose character, his exemplary dedication being a model that can be followed by our younger colleagues in the CNP branch.
But speaking only of his work, without mentioning his love for children in general, that had guided him to his chosen specialty which he faithfully served, as well as his love for music and literature, sports and excursions, would be to deprive him of what brought prominence to the “human being” called Vasile Ilea Jr., with his distinguished culture and intellectual stance which imposed him as a worthy representative of the Romanian CNP who left an indelible trace on its beginnings.