One of Spain's foremost leaders in the modern fight against tuberculosis died in Madrid on April 30 of this year. Dr Rafael Rey Durán was a tenacious laborer in the effort to remedy defects in the Spanish campaign's organization and its repeated errors.
Rafael Rey Durán was born in Cala, Huelva, on January 21, 1941 but completed his university studies in Seville, where he received his degree in 1965. He spent time in Philadelphia, possibly in an effort to find his place in life, but upon returning to Spain he set out firmly to do his life's work of combating tuberculosis. As part of his training, he visited the sanatorium in Terrassa, near Barcelona, once for a month-long stay between 1968 and 1970. There he learned to use a bronchoscope, which was then a rigid tube, and was probably able to observe a variety of modern therapeutic approaches. Obliged to teach himself, as was the rule in those days, he complemented his study of the problem by choosing what he considered the most modern and appropriate approaches to treating the disease.
After completing an assistantship, Dr Rey Durán joined the staff at the Sanatorio Victoria-Eugenia in Madrid in April 1972. The director of the sanatorium at that time was also secretary general of the National Antituberculosis Board (Patronato Nacional Antituberculoso) and was therefore in charge of the national campaign. Thanks to Dr Rey Durán's knowledge of current scientific developments and his affable nature, he enjoyed a good working relationship with the director and was able to make subtle changes in the rigid, traditional system of fresh air cures and strict bed rest. His greatest victory in the battle against the disease, however, was in establishing the need for the sanatorium to have a reliable bacteriology laboratory as a critical, indispensable element in modern treatment approaches. That victory brought with it the collaboration of Dr Arturo Ortega, with whom he was always able to speak the same scientific idiom.
Already a member of the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR), Dr Rey Durán was elected president of SEPAR's Tuberculosis Assembly in 1976 and from that position he was kind enough to invite me in 1979 to organize a membership survey to be carried out at the society's national meeting. The survey concerned tuberculosis in Spain at the time, and its results revealed the gravity of the situation and the seriously mistaken approaches being followed. My personal relationship with Dr Rey Durán was uninterrupted from that moment until his death. We were part of a then very small group of specialists who shared our dedication to the problems of tuberculosis in our communities, who used the same scientific language, and who conceptualized the disease in the same way.
Dr Rey Durán was an important participant at that time at all meetings on tuberculosis inside and outside Spain, attending workshops of the International Union against Tuberculosis and Lung Disease (IUATLD) and the World Health Organization (WHO). He was an official member of several IUATLD committees and represented Spain at WHO meetings on tuberculosis until illness overtook him. An accomplished and passionate speaker whose knowledge was always up to date, he provided meetings, conferences, and training courses with a rigorous scientific foundation. Although his publications were few, one merits special attention--his important profiling of resistant strains of tuberculosis, published in Archivos de Bronconeumología in 1979 (15:88-91), in which he gives a clear, accurate exposition of regulatory guidelines that continue to be in force today as shown by an examination of recent recommendations from the United States published by the American Thoracic Society, the Center for Disease Control, and the Infectious Diseases Society of America (Am J Respir Crit Care Med 2003;167:603-62). Another important publication came in 1995, when, faced with the unpromising epidemiological situation of tuberculosis in Spain, he assembled and supervised a group of specialists who prepared a document published in Medicina Clínica in which they exposed the public health problem presented by tuberculosis and proposed urgent, coordinated solutions involving several levels of the health care system.
Dr Rey Durán was among the organizers of the National Consensus Conference for the Control of Tuberculosis in Spain, held in Madrid in 1991, and he also participated actively in the preparation of other consensus reports arising from the workshops of the Tuberculosis Investigation Unit of Barcelona (Unidad de Investigación en Tuberculosis de Barcelona).
His was a warm, magnetic personality that has left its mark on whoever enjoyed his friendship. He was extraordinarily generous in sharing his knowledge and ideas, which he presented modestly and pleasantly, though his convictions were strong and he could be critical as well. It was a pleasure to engage Dr Rey Durán in conversation and even in debate.
I could never have foreseen that I would be called upon to write in Rafael Rey Durán's memory, for the laws of nature would have led me to expect that he might have been the one to write in fond memory of me a few lines of tribute to be read by the friends with whom we fought against tuberculosis.
Note. These lines have been written with the invaluable collaboration of Drs José Batista, Joan Caylà, Arsenio Espinar, Victorino Farga, and Arturo Ortega.
