The Oath

An autobiography by oncologist Stephen Brincat

Stephen Brincat starts his narrative with a colourful and at times emotional description of his first trip to Aleppo, in Syria, which he undertook with his brother Mark when still a medical student. And it was love at first sight, because despite the vicissitudes they had to undergo to get there, he kept going there in later years.

The book can be considered as two in one – a travelogue and the professional journey Brincat undertook to become one among the very first fully fledged oncologists in Malta and Gozo, and eventually the person setting up, in later years, a proper Oncology and Radiotherapy Department at Boffa Hospital.

Descriptions of the many places he visited over the years, whether alone, or with his wife, or with his family and friends, come across rich in descriptive details and with an astounding memory of names and historical notes, allowing the reader to visualise these places and feel with the author the wonder of being there.

Whether he was practising medicine in Abu Dhabi or travelling on professional business, Brincat always found time to go and discover new sights and places that are described in the book. These are full of colour and in a style that borders between a serious account of his travels but full of side remarks, tangents  and humorous anecdotes that make for pleasant reading.

But the part that interested me most, having been a patient of Brincat for many years, is the development of what was to become today, in the fullness of time, the Sir Anthony Mamo Oncology Centre, or SAMOC as it is popularly known today.

The story starts with Brincat being left without a medical school to finish his studies because of the infamous strike during the Mintoff government of the 1970s that resulted in all doctors, members of the Medical Association of Malta, being thrown out of hospitals and the eventual closure of the school. Many professionals left the island to seek work abroad, and several students had no alternative but to seek universities abroad to finish their degree there.

After he graduates from King’s College London, Brincat continues his studies in England, and while practising medicine there, in those early years, he feels the call to specialise in an area still new at the time – oncology. In his words, this choice presented a challenge as one needed a double postgraduate degree − first in medicine, that is, one had to become a physician, and next in radiotherapy and oncology.

Difficult as any new branch of medicine could be, Brincat starts oncology training at the London Hospital to eventually graduate in 1986 as fellow of the Royal College of Radiology, the professional body in the UK responsible for the specialties of clinical oncology and clinical radiology.

A testimonial of the fortitude of pioneers like Brincat and his colleagues and collaborators to whom we all owe much gratitude for getting us where we are today

After a stint working in Abu Dhabi, and a change of government in Malta in 1987, Brincat was invited by the government back to Malta as his services were badly needed here.

His description of the state of things at Boffa Hospital in 1987 makes one cringe! Not only was the so-called Oncology Department “under-resourced” and full of “antiquated equipment”, but apart from the services of Dr Victor Muscat (a hero in those dismal circumstances) as senior consultant, there was a complete lack of specialised personnel and no plan to start training of professionals in the expertise that the department badly needed.

And the story continues from one struggle to the next with government red tape and bureaucracy, whether to buy the much-needed new equipment, whether it be the procurement of medicine, whether to stay at Boffa or move elsewhere − processes that, in part, still bedevil government departments today.

But the story also takes readers from one success to the next, as block after block, the department starts taking shape, structures are put in place, people are professionally trained, and this to the satisfaction of patients, not to mention of the doctors and other paramedics working there.

In describing all this, the author introduces personal experiences, recalls anecdotes, mostly in a humorous way, making the reader relax and smile, forgetting for a brief time that one is reading about cancer and cancer patients, and the development of an oncology and radiotherapy department.

And I think that is what struck me most while reading this book. Many people, like me, who have used Brincat’s services, get to know only one side of his character. Direct, at times laconic, very much to the point, without circumlocution. But there are times when the other facets of his character shine through. For those who might have missed these experiences, this book will give them a fuller and much more real picture of Brincat.

The story of the development of the Oncology and Radiotherapy Department is a testimonial of the fortitude of pioneers like Brincat and his colleagues and collaborators to whom we all owe much gratitude for getting us where we are today.

This book is part of Malta’s medical history and the people who made it so.