"Go to Pelhřimov, see the crematorium, so you know what you're getting into." When Rudolf Hrušínský, as Dr. Skružný in the comedy Vesničko má středisková, gave the advice that became one of the most famous lines in Czech cinema, perhaps only Jiří Lír, who played the innkeeper Bedřich, knew that there was no crematorium in his hometown. However, at the time the film was made, in the mid-1980s, there was already a well-equipped hospital in the district town, which MUDr. Karel Kalla Jr. helped to develop from his position as head of the Clinical Biochemistry Department and later as director. The second of the medical family whose indelible Pelhřimov trace comes from Blansko. It left its imprint not only within the hospital walls and in the structures of the Czech Society of Clinical Biochemistry, of which MUDr. Kalla was the chairman, but also on the football field. And expressed in the name of the Pelhřimov FC, the medical marathon of the Kalla family will continue for some time.
All the Kallas - whether with one or two eLs - come from Blansko. When I was a medic on my internship at St. Anne's, I treated a Major Kalla there. He was already a white-haired gentleman and was said to have researched the history of our family. According to him, Kalla was a rebellious serf from East Bohemia who had killed his master and escaped to the forests near Macocha to escape punishment. My parents had to prove their ancestry because of Comrade Hitler, so my dad had it mapped back to sometime in 1830, and my grandfather came from Holštein, where Punkva falls.
But you were born in Pelhřimov, where you spent your whole life. When you went to Brno to study medicine, you were actually returning to your native region?
Yes, my father was a Brno native, from Cejl. He went to the classical grammar school in Kapitán Jaroš and studied medicine at Masaryk University. When exactly, I'm not sure, because he was in the class of 1900, so he came of age during the First World War, and I don't even know if he studied for six years or less. He was still reciting Latin poems in his old age, and when I took Latin in high school he always used to say: "After whom is that child so stupid, that's terrible!" (laughs) "Leave him alone, don't stress him out," his mother would reply...
So I should ask you how your father got from Brno to Pelhřimov...
After graduation, he went to Jihlava, where he was a second in the internal medicine department, I think under Mr. Veselý, and for a change in the surgery department, Dr. (Jaroslav) Pujman, about four years older, worked under Chief Horn. They were all friends at that time, they would meet in the evenings and drink, and when Pujman went to Pelhřimov to become chief of surgery and director of the whole hospital, he approached my father to head the newly established internship there. My father was originally going to Bohumín, but when he got there and went to the station to buy cigarettes, he told the tobacconist that it was strange there. And the tobacconist said, "Sir, we call this place the asshole of the world." So he turned around again, didn't even get to the hospital, got back on the train and went to work in Pelhřimov. (laughs) And actually it turned out to be a good decision, because during the Second World War there was a front there, while here it was quiet.
Were you destined from a young age to follow in your father's footsteps and be a doctor?
Well, yeah, because the Pujmans and the Kuncks used to get together every Saturday. The men played cards, smoked, drank wine, the women talked... I came home from school, I thought I would go to the dance, but Dr. Kuncek said to me: "Colleague, you can't do that to us, we don't have a fourth in taroki!" I was always persuaded like that, so I used to play cards with them, from my youth I listened to the doctor's cases they solved and I found it very interesting...
College entrance exams must have been a piece of cake for you then, right?
Fortunately, I didn't take the entrance exams, because if I did, I'd be kicked out. I had basic ignorance. (smiles) But in those days, if you got straight A's in your A-levels, you were admitted without exams. I remember being in the office of Professor (Ivo) Hrazdira, then still an assistant, where it was so smoky that you could hardly see. And that if they had to take me, they would take me. And then when we were in the third semester, he called me: "Hey, Kalla, show me the index! If we didn't do something stupid to take you that time." He looked and said: "Oh, no, we didn't, you've got a nice one. Keep it up."
And in the end, you graduated with honors, right? Can you think of any educators who have grown close to your heart?
Certainly Professor (Jiří) Štefl in pharmacology. He even wrote books, detective stories, took trips with us, told us stories about important personalities of Brno... Professor Štefl was a very clever and communicative person! But then the Commies fired him and when he went to our graduation ceremony, he teared up... We felt sorry for him...
Were you clear that you would return to Pelhřimov after graduation? Your long-time classmate, friend and colleague, Dr. Leman, mentioned that he was tempted by the invitation of his classmate...
...Mirek Kralert! They were four years older and together we had a group called APIA - the Amateur Beer International of Academics. We used to meet every Friday or fortnightly at the Stoppers. We always knocked back pints and shook until the silicon flew, as we used to say! If one cracked, we'd throw it on the cupboard... That's when everybody got their placements. I still didn't choose, until the bundler from the committee told me that I should, that only Ostrava and Humpolec were available. So I went for Humpolec. At that time it was still the Humpolec OÚNZ - District Institute of National Health, but when I started, from the first of July it was the Pelhřimov OÚNZ, which was the second largest medical facility in the South Bohemia Region after the Budějovice KÚNZ.
So you started your professional career in Humpolec?
Yes, I spent three years with the chief medical officer (Jan) Sedlak, including the war. Originally it was supposed to be only half a year, but because they had just built a wall in Berlin, they left us there "for as long as necessary, indefinitely". We didn't know if we would be there for a month, a year, five years... I was in a tank regiment, it was all full strength, so there were fourteen doctors, I was doing surgery once a fortnight... We were so fed up with it that we went out to drink, what am I going to tell you... A week before Christmas they let us go home. That's how I did my military service in Humpolec, then I was on the surgical round, which I have to tell you a story too...
Tell me...
I got that call one night to come to the birth. So I cut the lady's hair like we were taught, delivered the baby beautifully, and when I was stitching her up, she said, "Doctor, you have golden hands. I had my first birth in Pelhřimov by caesarean section and they told me I would never give birth the normal way. And you did it." She was lucky she told me after the birth, or I would have run away. Because it was my first and last birth. (Smiles) About fifteen years later, a young man came to the hospital to see me, saying he was going to show me that I had delivered him years ago. That was nice. But to go back, I was also in the pulmonary ward. Mostly, though, in internal medicine. Chief Sedlak was a great boss, a smart man. Then - this was in Pelhřimov - where he was the head of the LDN, we even had a fight. Poor guy died of stomach cancer...
“When I became chief of medicine at the age of 26, I'll tell you what, I didn't know shit about it.”
Karel Kalla
So you graduated in the sixtieth year, worked in Humpolec until the sixty-third year and then moved to Pelhřimov?
At that time, a friend of mine, Dr Havlas, who was in charge of the OÚNZ, came to see me and told me that they wanted to set up a central laboratory in Pelhřimov and if I would like to head it. At that time, the laboratory belonged to the internal medicine department and my father used to go there to take microscopic readings of urine... At that time, only a small range of examinations was done in such a laboratory than is done today... I was interested in biochemistry and pathophysiology, so after about a week of thinking, I gave him the nod. Obligatorily, I went to Lukavka for another month to work as an orderly, and on the first of November sixty-three I was appointed head of the central laboratory.
At 26, you must have been the youngest chief of surgery in the country, right?
Yeah, well, what am I gonna tell you, I didn't know shit about it. I had one and a half rooms and four lab techs - two hematology and two biochemistry. So I took after my dad and started doing the urinalysis and preparing the chemicals and solutions. Everything had to be weighed, mixed, it wasn't like today where you buy everything ready-made... In time I knew so many tricks that I put the lab technicians in my pocket! For about two years, I went to Prague, to the Institute of Postgraduate Education in Health Care, to the Department of Clinical Biochemistry, which was headed by Chief (Karel) Mašek from Bulovka, and I was mentored by an assistant - later professor - (Miroslav) Engliš. There I gained a lot of skills and knowledge, which I then used in practice. In the sixty-fourth year I got my certification in internal medicine and in the sixty-sixth year I became the director of the hospital...
So at twenty-six, chief of staff, and not even thirty, director?
Yeah, I was told I was the youngest director... (smiles)
Didn't anyone tell you that you got it from nepotism, if your daddy was a respected doctor in Pelhřimov?
No, no. Jura Tomanů also wanted to be the director, but since he was a surgeon, he eventually realised that it would not be an ideal combination... The director of the OÚNZ called us together on New Year's Eve and said that the only one who could do it was Kalla. I said, "Comrades, I don't dare." They gave me fourteen days to think about it, so I thought about it and then I nodded.
Did Daddy approve of your decision?
Daddy told me "Do whatever you want." I continued as head of biochemistry while I was director. It was two half-employments, but I was at work from morning till night. It was quite time-consuming. I managed to strengthen the laboratory, I got a Pelhřimák, an engineer (Jan) Kalina, with whom I started my studies, and we were in the same group. They wanted to put him in hygiene after the third year, but he didn't want to, so the cadre started going through his papers and said, "Man, you're the son of a kulak!" They had a farm at that time... If he had kept his mouth shut and gone to the hygiene school like the others did, he would have graduated normally, but he had his own head, so they fired him. He went to Uherské Hradiště, studied chemistry in Bratislava, and then one day I offered him to come to our laboratory, that we needed such a smart person. And he agreed.
What was the collective like in Pelhřimov then? Overall, probably quite young, right?
Honza Kalina was about five or six years older. He had problems with his studies because of his kulakship earlier... But the team was good. We had such a group - the Lemans, the chief (Milan) Zajíc from the children's ward, whose wife was the head nurse in the orthopaedics department, the Kalinas and us. My wife was also a doctor.
You're a medical family through and through!
My wife was studying in Prague and when she joined us, we met in the corridor and Jura Tomanů said, "She's a pretty girl, isn't she? She's worth a sin!" - "Yeah, well," I nodded. She originally went to Humpolec, so I visited her there a couple of times, then invited her to a medical ball, and after the ball we went on a trip to Křemešník (a hill and a place to visit near Pelhřimov - author's note). I didn't have a car yet, so I borrowed one from my dad, a thousand Škoda Popular... Well, we started dating, then she moved to Pelhřimov and we got married...
As a hospital director, I assume you must have been in the party. But at the same time, I gather from your choice of words that you were not a fan of the ruling communist regime...
I never sympathised with the regime, but as you say, I had to join the party, otherwise I wouldn't have become a director. When I was recruited by the chief gynaecologist (František) Linhart, he said: 'Look, you idiot, the more decent people there are, the better it will be for us. Otherwise, we'll get some bastards in there who'll wave us around." So I figured he was right...
How was the hospital developing and equipping with new equipment at that time?
In the 1970s, we received foreign exchange funds from the Ministry of Finance, which were used to buy equipment for surgery, internal medicine and OKB. From the Dutch company Vitatron, we acquired flow photometers and a densitometric handpiece for the evaluation of protein electrophoresis. We have thus taken a major step forward in the repertoire of examination methods. At that time, many colleagues from other biochemical laboratories came to see us.
Do you have a story in this regard that is harder to imagine from today's point of view, which would describe the political and social conditions at that time?
Thanks to the party and the government, we got a Hitachi 704 analyser, which was about third in the country at that time. I was promoted to deputy director of the OÚNZ for medical and preventive care under the director of the OÚNZ Havlas. On May Day, the regional party secretary came to us and said, "What do you need?" Havlas cheered the lab and me on, so he tells him that we would need crowns and foreign currency for a Hitachi analyzer. "Well, I'll arrange that for you, you can count on it," said the secretary. For twelve months nothing happened, and a year later on May Day he came again and asked if we had it yet. "Well, we haven't." He got upset, how could that be, and he said that when he got back to the county he would see the hassle he would make there. Within a fortnight we had the money and the foreign exchange and I was able to go shopping in Brno with Engineer Jirků from the technical department of the OÚNZ. So as I said, thanks to the party and the government we got Hitachi. (smiles)
“Professor Štefl was a very smart and communicative person! But then the commies fired him and when he went to our graduation he was tearing up... We felt sorry for him...”
Karel Kalla
Under your leadership, the Pelhřimov Hospital has become a so-called second-type hospital. What did that mean?
There were three types. The basic first type was a hospital with four wards - in our case we had to set up inpatient wards for orthopaedics, neurology, urology and ENT. When we wanted to become a second-type hospital, we had to build more wards, which then meant availability of care for patients that had not been there before, and a greater flow of finances for us. The three were then regional hospitals, i.e. in Budějovice. However, we were the second largest medical facility in the South Bohemia Region. We had three hospitals - Pelhřimov, Humpolec and Počátky - and a number of other facilities. We wanted to close down some departments, so we went to Počátky and Humpolec to explain to our comrades what all this would bring - new equipment, better care - but we failed to convince them. It was only when the revolution came that the two units were finished within two years...
What did the revolution bring to your work?
For financial reasons we had to close the ENT inpatient department, neurology is struggling to hold on... Because there are no doctors! Now they'll have a beautiful new ward, in a newly built pavilion, but the main thing is to have doctors. Sergei Kusov, a Russian from Siberia, is currently in charge. He's a decent man, he says hello and he can....
Can you recall any new developments in your career that have fundamentally changed your work?
When I worked in the lab, I tried to implement new things as soon as possible that I learned about in training sessions or read about in magazines. At that time, the new thing was troponin, which was used in the diagnosis of myocardial infarction. We introduced it relatively early, the internists liked it too, so they worked with it in droves, and about three months later I got a call from the Military Insurance Company in Budejovice asking, "Please, what are you doing with the troponin? Nobody uses it from the Austrian border northwards, except you in Pelhřimov." So I explained to them what it was and told them to wait, that soon they would start using troponin elsewhere! Nowadays it is a common thing, but we were the only ones in the region then!
Why was it that you were such pioneers in Pelhřimov?
They weren't so flexible elsewhere... With Dr. (Josef) Kubik, who was the head of the ARO, extremely dedicated - he even lived there! - we started introducing complete parenteral nutrition into the veins of post-operative patients. I knew it from the training in Prague. We made these cumulative sheets in which we wrote the balances of minerals, glucose, fats and amino acids. Every day I would run with it from the lab to the ARO, where I would break down the infusions. We even held a professional meeting here in Pelhřimov with lectures on nutritional nutrition... Or - also with chief Kubík - we did peritoneal dialysis. There was no haemodialysis centre here then. There were so many bottles of solutions, which we dropped and discharged directly into the abdomen, in the ARU that we had nowhere to go. But we were doing well and we were really improving the kidney function of the patients. Then it shifted, and some people were able to start doing it at home on their own...
What has been the most rewarding thing for you during your career?
Of course, a cured and satisfied patient. But also the fact that the team of medical professionals here in Pelhřimov was excellent. We had no disagreements, everyone was pulling together. I liked that.
You still go to the hospital today, don't you?
Yeah, I'm still on zero point two. But when I got rid of those directorships a while ago, I thought it would be nice to have something new. At that time, Professor (Joseph) Šobra started Lipidology, so we took a course with him, got a leaflet at the end, and I'm still doing it today. Now I was at the Shobra Day in Prague a few days ago, again you learn something new... To go among people, to be interested, that's what you need to train your brain. And I have to boast - in 2017, the district association of the ČLK awarded me the title of Outstanding Doctor of Pelhřimov Region. I was the first, since then it is awarded annually to a selected doctor.
In addition to your work for the Pelhřimov hospital, you have been active in the Czech Society of Clinical Biochemistry for many years. How did you become a member?
You know, I could have ended up in Prague. I have a third certificate, in social medicine and health care organization. Because when I was a director, I had to learn about the construction issues, how hospitals were built, what types and so on. I did that in the year sixty-eight. And two years later, when I was doing my certification in clinical biochemistry, Professor (Jiří) Homolka was there and he offered me the position of director at Kachlíkárna, the polyclinic of the first medical faculty. He said that he would arrange it for me with the understanding that I would work part-time as a chief in his laboratory. Professor Homolka, if he liked somebody, then you had won, and if I had gone there then, I would be a professor today, he would have gotten me there. But I refused with thanks, because at that time we had just moved into a new apartment in Pelhřimov, we already had our first daughter... However, a few years later Professor Homolka chose me to become the scientific secretary of the Czech Society of Clinical Biochemistry.
What did the position entail?
Originally I started to prepare a kind of information magazine - more like a list - and everybody liked it very much, I was arranging professional events. At that time, a number of professional meetings took place in Pelhřimov, such as the 2nd Intercounty Days in Clinical Biochemistry of the Czech Republic and South Bohemia, the national congress of biochemical laboratory technicians and other events. I was the scientific secretary from 1985 to 1998, when I was finally elected chairman. So at the turn of the millennium I was also the chairman of the Czech Society of Clinical Biochemistry for four years until 2002. Then I continued to serve on the committee for a few years, but then I gave it up. But! I wrote something that no other such society has. When it was the 50th anniversary of the Society, I was approached to write its history. So I researched where I could, wrote it, and it was published as a booklet. Yeah, but what else. It would be a shame not to continue. So I decided, as a joke, of course, and proposed to the committee that I would set up the Institute of the History of Clinical Biochemistry in Pelhřimov, of which I would be the director and the only employee, and I would compile its history every year. My colleagues were very enthusiastic about it, and although they forgot about it later, I still do it today. Respectively, last year the history of the Society was taken care of by Chief (Richard) Pikner from Klatovy, the vice-president of the Society, who, when I handed him my minutes, was amazed that we have the entire history of the Czech Society of Clinical Biochemistry from the foundation to the present. I offered him that as long as my head would serve me, I would take care of it.
And to make matters worse, in addition to your medical functions, you also performed one important function in football. How did you manage it all?
Yeah, I was chairman of the football club in Pelhřimov for forty years. I was used to working long hours... I played basketball myself, but I joined football in 1973. My dad was a big fan, he was also the chairman, and even as a boy he took me to every championship game. Pelhřimov used to play in the regional championship and when I joined, we won it and got promoted to the division. We played there for me for at least twenty-five years. Plus two more years in the third football league. When I quit, it got relegated, then I got dragged back to it for another six or seven years, so me and my mates pulled it up to the division again, then we quit and it got relegated again. But this year we won again, so we're going to play division again. To this day I still go to watch the games and I'm still interested in football. Otherwise, I am a Spartan at heart, but I also support Brno. I was sorry to see them relegated this year...
Zbrojovka hasn't been bringing much joy in recent years, so from next season Brno fans will be able to watch the derby with Lišná again...
We used to go to Lišná during our studies at the faculty by carriage to the castle to see the military department. Twice we even went to a military camp in Slovakia. We learned medical things from war surgery or hygiene and we marched in the courtyard of the castle... When I went to the army, the then chief doctor, a captain, wanted to leave, so he threw himself sick with stomach ulcers. And I took his place as Corporal Kalla.
Your eldest daughter is also a doctor, even a biochemist like you. The trace of the Kalla family in the Pelhřimov hospital has not disappeared...
My daughter became head of the Clinical Biochemistry Department after me! And my grandson, who successfully completed his first year of medical school in Motol in Prague this year. I'm a bit sorry he didn't go to Brno, because the Brno medical faculty is the most modern in the Czech Republic, no doubt. You're doing well! But he was admitted to Prague without entrance exams, on the basis of merit. Anyway, this is the fourth generation of doctors in our family and maybe it will be extended by another grandson who is Brno and will apply to your faculty next year. Where else, right? So get him in! (laughs)
MUDr. Vladimír Leman graduated from the Faculty of Medicine of Masaryk University in 1957. Although a native of Brno, he spent his personal and professional life in Pelhřimov. He continues to come to the local hospital to examine patients even at the age of ninety, making him perhaps the oldest serving physician in the Czech Republic.
Dr. Jana Djakow and Associate Professor Martina Kosinová from the Department of Simulation Medicine at Masaryk University Faculty of Medicine were the first women in the Czech Republic to receive degrees from international professional societies in the field of resuscitation and anaesthesiology and intensive care medicine, respectively.
