Wilson Botelho: The Difference Between Time and Money is That You Know How Much Money You Still Have
Wilson Botelho, Chief Executive Officer at Alpha Iatros Medical Assistance, shared a post on LinkedIn:
“I Lost US$ 320 this Christmas
Unlike what happens in developed countries, many cardiac surgeons in Brazil do not work exclusively in operating rooms. We also serve as general surgeons, emergency physicians, and intensivists—as is my case. The reasons are complex, but in short, cardiac surgery is poorly compensated in Brazil.
In predominantly Catholic countries like Brazil, Christmas is traditionally celebrated on Christmas Eve. Families and friends gather, share a generous meal, relive joyful memories, and celebrate together. It is a sacred night.
After the birth of my second child five years ago, I stopped working night ICU shifts to be more present with my family. Still, I remain on call for emergency cardiac surgeries.
On December 24th, after a 12-hour ICU shift at a large hospital in São Paulo, I was preparing to go home when a friend, also a cardiac surgeon, called me: he needed urgent help. The other on-call surgeon had been in a car accident and would not arrive in time. I paused for a few seconds, weighing the cost of leaving my family on such a special night. But duty spoke louder. I said yes. After a quick shower, a simple sandwich, and handing over my shift, I drove 30 km to a small rural hospital with very limited resources.
The patient was a 52-year-old woman with acute thrombosis of a mechanical aortic prosthesis, biventricular heart failure, and severe mitral valve dysfunction. There were no alternative treatment options. Remember: I’m in Brazil, a developing continental country with continental inequality.
Despite the lack of resources, my colleague and I had experience. We replaced both the aortic and mitral valves with biological prostheses without the support of an in-locus transesophageal echocardiogram and with improvised instruments. The surgery lasted 12 hours, followed by another 6 hours caring for the patient in the ICU. Thankfully, she was extubated on December 26 and is recovering well.
The irony is that the insurance company will pay me about US$320 for this surgery only in March 2026. We fulfilled our duty. We saved a life with minimal resources. We went far beyond what is expected of a cardiac surgeon. And still, the work is profoundly undervalued. I also lost a family celebration and moments that will never return.
It was never about the money. Long, exhausting hours are routine in cardiac surgery. What is unacceptable is the absence of fair recognition. I am at peace because we saved a life. But I cannot accept that our work is valued so poorly. There is a real possibility that I will no longer be a cardiac surgeon in Brazil in 2026.
‘The difference between time and money is that you know how much money you still have.’
‘If it costs you your peace, it’s too expensive.’ ”
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