Dr. Geraldo Victoria and Dr. Francisco Sanchez, cardiothoracic surgeons

I am currently writing another article about Dr. Geraldo Victoria for Examiner.com but I wanted to tell readers a bit about these two very nice, and charming surgeons. (I will also be re-posting this article at a sister site). Dr. Victoria graciously invited me to spend even more time with them, but I had a minor injury yesterday and had to defer.

Dr. Geraldo Victoria and Dr. Francisco Sanchez, cardiothoracic surgeons

Dr. Geraldo Victoria and Dr. Francisco Sanchez, cardiothoracic surgeons

It’s always a bit nerve-wracking to meet and talk to surgeons but Dr. Victoria was very welcoming, and friendly.  He readily answered my questions and told me about his practice.

Dr. Victoria is primarily Spanish-speaking but does speak some English.

He showed me around his offices at both Hospital San Tomas and Punto Pacifico while talking about his work.  He is a Professor of Surgery at Hospital Santo Tomas – which is the primary teaching facility in Panama City.  He also operates as a general surgeon there.

His practice is a mix of cardiac, thoracic, vascular, endovascular and general surgery.  He attended medical school and completed the majority of his training in Caracas, Venezuela at the Luis Razetti School of Medicine  – University of Central Venezuela.  He completed his general surgery and specialty fellowship training at the University Hospital of Caracas (Hospital Universidad de Caracas) before completing additional training sessions in cardiac (Texas Heart) and endovascular surgery in New Orléans, La.

He reports that prior to 1992, the majority of patients in Panama travelled to the United States and other countries for cardiac surgery.  Since then cardiac surgery volumes have increased.  Since rheumatic fever remains problematic in Panama, he has a large volume of patients with rheumatic heart disease.

His thoracic practice largely consists of trauma surgery – from penetrating trauma (guns, knives) and hemothoraces as is typical of many surgical practices in large urban areas.   He also sees cases of empyema (infected pleural space around the lung) with several cases involving multi-drug resistant strains of Klebsiella.

Contrary to many vascular surgery practices I have encountered in Latin America, Dr. Victoria has a thriving peripheral arterial disease (PAD) practice. In fact, I was able to see him in action in the cath lab as he performed arteriography on a patient with persistent intermitten claudication (despite medical management).


Since this post is becoming quite lengthy – I will talk about Dr. Sanchez in the next post.

Introduction to Panama City and Panama

Had some internet difficulties the last few days, so I will be posting several posts to ‘catch-up’ as it were.

downtown Panama City

downtown Panama City


The nation of Panama is a nation of contrasts; at once old and young, rich in wealth with grinding poverty, Americanized yet foreign. Rainforests, and lush jungles teem with steamy heat, in comparison with the cooler mountainous regions.  These contrasts extend to the general attitudes of local residents as well, similar to that of “big city versus friendly hometown” with Panama city residents often exemplifying the attitudes of their northern neighbors (New York City).

Daily rainstorms pound the capital city during the rainy season (May – December) but offer little respite from the heat, which can be oppressive. However, despite urbanization along with an impressive array of skyscrapers, the city remains just steps from the rainforest, and a bountiful variety of birds, plants and other animals.


Reluctant or nervous travelers will appreciate Panama’s shared history with the United States. As the USA encouraged the Central American nation towards independence (as part of American efforts to control the canal zone and thwart the Colombian government), these close ties have resulted in a degree of Americanization that is surprising to some first time travelers.

While Panama boasts of a national currency featuring ‘Balboas’ or ‘Martinellis’ by the nations’ satirists, only coins exist as evidence of this. The remainder of trade and economic barter is done using American currency. English is commonly spoken by Panamanians, and the North American presence has grown exponentially in the last decade. Several exclusive communities of United States and Canadian residents dot the Panamanian landscape, particularly in more desirable areas such as the more temperate areas surrounding David.

the 'Balboa', the official currency of Panama

the ‘Balboa’, the official currency of Panama

The shared history of Panama and ‘the gringo’ has existed for well over a century – since the Americans financed and engineered their way in – to complete that Canal project after a spectacular French failure twenty-five years earlier*.

Of course, this influx of gringos, and influence/ interference in Panamanian life comes with mixed feelings.  Some of the local publications are quite critical of  the American economy, and current government policies as being responsible for increased inflation in Panama due to their reliance on American currency due to American currency devaluation.

The large number of US ex-pats and other North Americans has a more appreciable downside to today’s tourists – in that Gringos are a frequent target for scams and rip-offs but that’s no different from several other tourist destinations, (and is more noticeable in the city itself.)

Victoria 009

International flavor

However, the local mix is much more than Panamanians and Gringos, which gives the capital city a more interesting cultural mix..  There are groups of Venezuelan immigrants both quite recent and more remote, Chinese neighborhoods as well as barrios of Colombians, Salvadorans, and other Latin American neighbors..  Germans and Russians also have a presence in the city – making it quite cosmopolitan despite the relatively small population in Panama overall with a total population of just under four million.

* Canal history is pretty interesting, so I have included some links for readers interesting in additional information.

History of the Panama Canal – wikipedia standard

Panama canal

Canal museum 

Smithsonian Collection blogs

Looks like Panama may bite off more than they can chew..

In a recently published story, the government of Panama is now offering medical  insurance for all tourists to Panama for free.  This insurance is not  ‘Complication Insurance’ which is offered by private surgeons in Colombia and other countries for patients traveling specifically for medical tourism.  Complication insurance covers all possible medical complications resulting from medical procedures at the designated clinic or destination..

No – Panama is taking the European and socialized medicine approach and is offering general medical coverage for ALL short-term travelers to Panama.  (The long-term exclusion is a wise move given the numbers of Americans and other overseas residents who make Panama their retirement home.)  This insurance resembles typical travel policies in that it covers injuries, accidents and other medical situations that may occur while on vacation..  I just hope the Panamanian government hasn’t underestimated its tourists and their injury/ illness potential.

Now readers – don’t get any wild ideas.. This is not the time to stress that ‘trick knee’ while hiking to visit the Naso-Teribes..

Meanwhile, Costa Rica is making a pitch for more corporate clients such as Pepsi-Cola.  These multi-national corporations can potentially bring hundreds of millions of healthcare dollars by diverting their employees to medical tourism destination such as Costa Rica.  (Like Colombia – Costa Rica is an ideal destination for North Americans due to proximity, quality and diversity of services available.)