Confidences de Salon: Thierry Troosters

Thierry Troosters is the ERS President Elect. He is a professor in Rehabilitation Sciences at KU Leuven, where he heads the Research Group for Rehabilitation in Internal Disorders. His research focuses on physical activity and non-respiratory consequences of lung diseases (e.g. muscle weakness and exercise capacity) as well as pulmonary rehabilitation.

Did you always dream of being involved in medical research/healthcare?

The earliest career dream I can remember (beyond becoming a firefighter or soccer player) was an idea to set-up a chocolate shop in the USA in the mid-1980s. According to the US embassy it required a vast investment, which I could in “no way” afford (I was 16 years-old!). Later I discovered that beyond my passion for sweets, I was also passionate about helping other people. I started studying physical therapy at the University of Leuven, an education that trained me to be critical and evidence based, but where I soon discovered that many of the therapies offered to patients were not yet solidly grounded in evidence and mechanisms. This triggered my interest in research and when I was given the opportunity to start a clinical research career, I took it with both hands.

What is the best advice you had when you were starting your professional career?

Perhaps the best advice that I've been given was by my mother. When I told her that I had decided study physiotherapy in Leuven, she was a bit disappointed. She was aware the healthcare market in those days was “flooded” with physiotherapists. My parents did not try to talk me out of my idea (they probably knew me well enough to know this would be pointless). Rather, my mother advised me that if I was to pursue a career as a physiotherapist, I had to try to become very good in at least one small aspect of the profession (her literal words were “even if it is the mobilisation of the left pinky finger”). I took that advice and tried to become good at pulmonary rehabilitation. An important field (perhaps more important than the pinky finger?), but it does not cover the very broad spectrum of what physical therapy has to offer. Luckily, later in my career, I was blessed to receive much more professional advice from my mentors: Prof. Rik Gosselink, Prof. Marc Decramer and later Prof. Joseph Roca. However, I might have ended up as a happy general physiotherapist without the advice of my mother…

What advice would you give someone at the beginning of their professional career?

Do not shy away from opportunities that cross your path and play in a team!

What has been the greatest change to make a difference in your field in your lifetime?

The proper reimbursement of pulmonary rehabilitation in our centre. The Belgian government realised that rehabilitation would potentially be a cost-effective therapy towards the end of the 1990s. In Belgium, we have chest physicians dedicated to and trained in pulmonary rehabilitation. Prof. Decramer was able to convince the Ministry of Health in Belgium to organise an experimental reimbursement system in a very transparent way in four centres across Belgium. That allowed the government to investigate the effectiveness and the cost of multidisciplinary pulmonary rehabilitation when embedded in clinical care. It proved to be effective and the patients reported huge benefits. The reimbursement became more permanent in 2003. This allowed us to step up our clinical care programme and also continued to allow us to do research and help shape the rehabilitation of the future. I realize that without the proper reimbursement, our field (both clinically and in terms of research) would not have advanced so much. Patients engaging in our programme, and similar programmes worldwide experience the benefits on a day-to-day basis. Our pulmonary rehabilitation team is currently under the clinical directorship of Prof. Janssens, with whom I share a passion for clinical research in a top-notch clinical environment.

What do you foresee being the next great thing and what do you foresee as being the biggest challenge in your field in the next 10 years?

It would be great if lung damage could be repaired or reversed. Many excellent researchers present work at ERS events that make me hopeful this may become a possibility, but we're not yet there. I also see important advances in lung cancer care, another major burden to patients. Early detection of lung cancer is nowadays possible and at this stage patients can be taken care of much more effectively. As a physiotherapist/researcher, I realise that when the respiratory problem is alleviated, further multidisciplinary care will be needed to rehabilitate “the patient beyond the lungs”. Progress in basic lung science, surgical and intensive care procedures, and transplantation and other techniques therefore go hand in hand with multidisciplinary care, whenever patients are involved.

What is your favourite scientific breakthrough from any field?

I don't have one in particular, but a thing like a microwave oven combines the implementation of physics and electromechanics and brings that into my kitchen on a daily basis. Sometimes when I take my microwaved carrots with honey from the microwave, I mumble “well done guys”. Obviously, this does not compare with major breakthroughs in medical science that saved millions of lives, like vaccines, antibiotics, or more recently immunotherapy.

How do you see the future of the ERS?

I see the ERS as a place where people can meet without pressure in a friendly and politically neutral atmosphere. It should be a society that offers opportunities to its members, young and old. In my function as President Elect, I can see first-hand how the ERS staff is truly dedicated to the society and its members. It is amazing to see how staff really care about individual members. I'm convinced that in 5 years the ERS will have further evolved into a society where it will be even easier to find the content and the people that are of interest to your personal career. The Society has a lot to offer, but sometimes it is hard to find. This will improve, and easy navigation through science, education and career opportunities will be possible. Otherwise, I hope that ERS can stay as it is: a friendly family of people that meet around the common goal of “promoting lung health throughout the life span and alleviating suffering from respiratory diseases”. The Congress will remain an important beacon to facilitate the meeting of all stakeholders, but I also see a future for smaller face-to-face or virtual meetings to allow dissemination of science and to contribute to the education of as many respiratory healthcare workers and scientists as possible.

When are or were you happiest?

I'm happy in my professional and personal life when I see happy people around me. If gives me even greater joy if I could contribute to that happiness.

What do you dislike most?

I have difficulty coping with people that are only fighting for their own profits. I'm deliberately not saying people fighting for their own ideals, as in that case there may be value in listening to them.

Who has been your greatest inspiration?

I was blessed to have to have two great role models as mentors: Prof. Gosselink and Prof. Decramer.

Whom would you most like to thank?

It is a bit of a “soft” answer, but my partner Fabienne, who is herself a busy behavioural scientist and professor at our university, and my son Arne cannot be thanked enough. They provide me with a smile on a daily basis and make sure that in busy periods I can fully engage professionally.

What do you consider your greatest achievement?

I think I'm too young to have a “greatest achievement”. The best is yet to come!

Who are your heroes in real life?

Dedicated healthcare professionals. I truly mean it. Now that my parents are getting older, I see how much they appreciate somebody that truly takes care of them in moments where they have doubts about something that is very dear to them: their health. I have utmost respect for those people that take care of people they often don't know day in, day out. Scientists might be advancing things, but my real heroes are those who implement this on a day-to-day basis, who stay up-to-date and focus on treating individual patients and who provide these patients with a sense of security: “I'm taken good care of”. Keep up the good work!

Where would you most like to live?

I enjoy very much living in Leuven. I don't think I would trade it for another place. I can work at one of the best (I'm admittedly slightly biased) respiratory centres, where the sky is the limit, and with colleagues such as Prof. Janssens, Prof. Gosselink, Prof. Langer, Prof. Gayan-Ramirez and many others in our clinical and research teams. I live in a safe city with friendly people, great food and an easy connection to a central airport in Europe. What else can you wish for?

What qualities do you appreciate most in your friends?

I very much appreciate them “staying tuned”, even when I'm out of tune or off the radar…

What qualities do you appreciate most in your colleagues?

I truly appreciate the team spirit among my colleagues and the fact everybody in our multidisciplinary teams (clinical and scientific) respects the competences of one another. This is crucial to success.

What do you consider to be your strengths and weaknesses?

Feel free to let me know. A friend once told me that you are not who you think you are, but rather how others perceive you. So, even if I think I have strengths and weaknesses, they do not matter if you did not see those in me…