I recently finished reading your book Věřil jsem, že to může jít lepší cestou (I Believed There Was a Better Way), , and one idea kept resonating with me: Can one truly passionate person change the world?
You know, I didn’t just fall out of the sky. I built on the work of my teachers and predecessors, and I worked as part of a team. The medicine we practice is the medicine of a larger team of people, which kept growing as more doctors, nurses, and other professionals joined us. Each individual plays a greater or smaller role, but it is crucial to have colleagues who believe that what they do truly matters. Our goal was simple: to keep striving to treat seriously ill children more effectively and better. The world that opened up to us after 1989 made this possible. Without that, it wouldn’t have happened—and today, it probably couldn’t even be replicated.
Did Europe welcome you back into the scientific community with open arms?
Very warmly. They invited us to conferences, waived or reduced fees because we simply didn’t have the money for travel. We were able to go on internships, which we gladly did –that’s the nature of the academic world. Our colleagues abroad knew we had come through a difficult time and needed to absorb their knowledge. And last but not least: Prague is beautiful! They were happy to have the chance to visit as well. We made excellent use of those opportunities. Fortune favours the prepared, and I was prepared then – I was 37 and knew exactly what I wanted to achieve. So I spread my wings and set out into the world.
Fortune favours the prepared, and I was prepared then – I was 37 and knew exactly what I wanted to achieve. So I spread my wings and set out into the world.
Were you the driving force behind this way of thinking for your colleagues as well?
In my view, every change needs a point person – someone who brings energy to it and keeps their eyes open to the world. I always tried to bring back ideas from abroad on how to care for our patients better. We started from relatively very modest conditions. Today, we can hardly imagine that anymore.
Recommended
Open Day 2026
17 January 2026
9:30 a.m.—3:00 p.m.
lecture halls, Second Faculty of Medicine and Motol University Hospital headquarters
Prof. Jiřina Bartůňková a prof. Jan Starý obdrželi medaili Za zásluhy
U příležitosti udílení státních vyznamenání 28. října převzaly medaile Za zásluhy z rukou prezidenta Petra Pavla také dvě významné osobnosti spojené s 2. lékařskou fakultou Univerzity Karlovy.
Věřil jsem, že to musí jít lepší cestou: Profesor Jan Starý v knižním rozhovoru bilancuje svou dráhu
„Skvělá kniha o tom, jak může jedinec obrovsky ovlivnit celý obor v celé zemi a zachránit obrovské množství životů," napsal pregnantně na LinkedInu Jaroslav Kuboš.
I have a faculty-related question. What do you think the role of an emeritus head should be?
I believe it’s quite a complex stage of life. You’re moving at a certain pace, and suddenly the situation changes – you find yourself on the sidelines of the main action. Everyone experiences it differently. It’s like a mosaic: how you shaped things is how they turn out… how you prepared your successor, and what role your followers assign you in the process. Some of us are so exhausted that we’re happy to close the door and only appear at the clinic occasionally. Others are thrilled to keep going – like me, joining ward rounds and speaking up when there’s something to say about patients, even if we no longer do daily rounds and our outpatient work is limited. And we teach students when we want to and when there’s demand.
An emeritus head does make sense for a clinic. It’s about continuity and experience, which can sometimes be a real advantage. But it’s only right that every new head and leadership team follows their own path. They don’t usually come to the emeritus head for advice – why would they? It’s their turn now, and it’s up to them. Even so, an emeritus head should know how to tread carefully and offer advice sensitively. Both sides need to make an effort, and this relationship – while I wouldn’t call it fragile – needs to be handled thoughtfully. My predecessor, Professor Koutecký, worked at the clinic until he was 88, and Professor Hrodek, another of my teachers, stopped lecturing and coming to the clinic at 90. That’s not to say I’ll be here until I’m 90 too.
Can someone still deliver top‑quality lectures at the age of 90?
You still possess a wealth of knowledge and talent, even if age takes a slight toll. Your name carries weight, just like Professor Koutecký or Professor Hrodek. I was glad to have them at the clinic – two legends who always had something valuable to say during ward rounds. Students enjoyed seeing them because their names were well remembered. Over time, however, every famous name gradually fades into the background, and it is up to each individual to decide whether to live off their reputation or strive to keep pace with the latest trends in medicine – and to choose what role they wish to play within the clinic. Some people genuinely want to step back because they feel they have given enough over the course of a long professional life.
Over time, however, every famous name gradually fades into the background, and it is up to each individual to decide whether to live off their reputation or strive to keep pace with the latest trends in medicine.
It must be extremely difficult to lay down your sceptre and hand it over smoothly to someone else.
For some people, certainly. It is a change, but it does not happen overnight. You know when your term is coming to an end. Personally, I had enjoyed the role long enough – I stepped down as head of department at the age of 69. That is how academia works, and rightly so. Younger colleagues also have the right to start changing things, and they should be given the opportunity to take on that “shaping role” at the right time.
Professor Jan Starý was born on 18 May 1952 in České Budějovice. He graduated from the Faculty of Paediatric Medicine at Charles University — today the Second Faculty of Medicine — habilitated in 1993, and has been a Professor of Paediatrics since 2003. He specialises in paediatric haematology and oncology. From 2004 to 2021, he headed the Department of Paediatric Haematology and Oncology at the Second Faculty of Medicine of Charles University and Motol and Homolka University Hospitals. He was instrumental in introducing bone marrow transplantation in children in Czechoslovakia and took part in international clinical trials. For his lifetime contribution to science, he received the Neuron Award (2022) and the Medal of Merit (2025).
I recently came across a very nice quote in a podcast produced by the Vlček Family Foundation, from Associate Professor Jarmila Kruseová of the Department of Paediatric Haematology and Oncology. She spoke about a generation of cured forty‑somethings and mentioned some impressive figures: “We currently have information on 2,000 healthy children born to our patients. The incidence of cancer in these children is exactly the same as in the general population. In further research, we evaluated 900 women who collectively gave birth to more than 400 children. We found no evidence that pregnancy increased the risk of secondary tumours.” She added that she wished this positive message could reach as many current and former patients as possible.
It is certainly encouraging news. In many cases – across a range of diseases and treatments – fertility is preserved, and the children born to our patients are healthy. There is no reason to assume that women who have undergone chemotherapy, yet remain fertile and able to conceive, should give birth to children with malformations. At the same time, we know that certain types of tumours and some forms of treatment do reduce fertility – and in some instances this may affect boys even more than girls. It is a very sensitive subject. We can usually identify in advance who is at risk and what those risks are. If boys are already in puberty, we can collect and freeze their sperm; for girls, the situation is more complicated. So, returning to your opening point – yes, it is true, and it is good news. But it does not apply to everyone. There is still a journey ahead of us before all children can be cured and go on to live full and healthy adult lives.
Is it important not only to treat, but to treat well?
To treat well… Our patients have their entire lives ahead of them, and we must strive to ensure that life is as free and as uncomplicated as possible. We have to weigh every step carefully, and interventions that we know carry late consequences should be used only when clearly indicated. Yet sometimes the scales tip between a life – even one lived with a disability – and death. These are the decisions we face throughout our professional lives on the clinic. We will continue to face them for some time, and I cannot foresee when the good news will apply to everyone.
How do you clear your mind so that you can keep going? Do you meditate, for example?
No, I don’t meditate. Even at a time when my life – between 1985 and 2020 – felt like one big ride, there was no time for any kind of “head clearing”. Sometimes I would get up and go on a trip, but I could count those on the fingers of one hand each year. I would meet up with my friends from university or from my primary‑school days in České Budějovice… but I do not want to paint myself as a workaholic who knew nothing but work. I went to football matches, to the cinema, to the theatre – but I never managed to become one of those people who consciously and regularly relax. Somehow, I always found my own balance, and burnout passed me by. Even though there were moments when I thought to myself: “Goodness! How am I going to manage all this?” Things were often complicated for a whole host of reasons. But there was nowhere to run.
Where do you see the future of treating leukaemia in young children? There is talk, for example, of outpatient care.
In the most common cases – in preschoolers and toddlers – we will very likely reach the point of outpatient treatment quite soon. Next year, we are launching an international controlled study for a selected group of children with the best prognosis (those whose chance of cure exceeds 95%), which accounts for roughly one third of patients. Our aim is to reduce their treatment to such an extent that the entire two‑year course can be delivered on an outpatient basis – so that the treatment is tolerable and hospital admissions are needed only in exceptional situations. Whether we will fully succeed remains to be seen. We must remain cautious. As one of the colleagues who taught me the most – a brilliant German professor who transformed childhood leukaemia treatment – once said: “Don’t take risks with these children, because they will all die.” We cannot reduce treatment to the point where it slips out of our control. Medicine must be careful.
We are also seeing progress in treating other types of leukaemia. Just before Christmas, we received wonderful news about a study we completed two years ago involving children at high risk of an unfavourable course. We replaced part of the chemotherapy with a monoclonal antibody, and it appears that not only is this approach less toxic, it is also more effective and results in fewer relapses. Over time, we will be able to replace intensive chemotherapy with new methods. For some forms of leukaemia, this is already a reality – the amount of chemotherapy required is very small, or almost none. Within the next ten years, this type of treatment will certainly be used for a significant proportion of patients.
In the most common cases – in preschoolers and toddlers – we will very likely reach the point of outpatient treatment quite soon. Next year, we are launching an international controlled study for a selected group of children with the best prognosis.
There is a lot of talk about the trend towards personalised treatment. Do you see this as the future of medicine? Could every patient really have tailor‑made therapy?
Completely individualised treatment for every single patient is not possible – and probably never will be. Specific diagnoses share common features; not everyone experiences their illness in a wholly unique way. Most cases can be grouped into various subtypes with similar characteristics, and it is within these subgroups that we are able to individualise therapy. It is not about treating each patient however we please, but rather that we can already tailor treatment for these defined subgroups.
Sometimes, however, standard treatment fails or complications arise that force us to improvise and find solutions tailored to the specific patient. This is not an ideal situation, and we do not always succeed. We are successful with most children, but when we fail, we need to have other options at our disposal. In such cases, it is essential to have a strong laboratory background and a team of experts who can respond quickly and propose alternative procedures. Treatment lags somewhat behind diagnosis. In recent years, we have seen significant improvements in the results for some types of leukemia, but others have stagnated, and the chances of cure for some childhood cancers remain very low.
Is there anything else you would like to experience during your practice? Are you expecting a revolutionary method in the coming years, for example in diagnoses that you describe above as being like drawing the short straw?
I don't think there will be a miraculous new discovery that will fundamentally change the treatment of childhood leukaemia. Progress in medicine is always gradual and takes time. Some new treatments are already in development and are in the clinical trial phase, where it remains to be seen whether they are truly effective and safe. I am optimistic that some of them will have positive results and will eventually be included in the standard treatment options, but it is unlikely that something revolutionary will suddenly appear. In our field, every new drug or procedure needs to be tested and monitored to see if it is effective and safe. All of this takes years.
What do you think are the limits of current Czech medicine? What prevents us from becoming a leader in a particular field, such as your own?
The world of paediatric haematology and oncology is relatively small. If we leave aside the United States where this type of medicine is at the very highest level thanks to enormous financial and human resources – the key players in Europe are the large countries: Germany, Italy, Scandinavia, Britain, and France. They have greater potential, tradition, manpower and funding. Those of us from the former Eastern Bloc joined international collaboration later, and although individuals can succeed and become equal partners, it will never be a matter of large numbers.
Nevertheless, I believe we are very well established and active within international communities. For example, my colleagues Professors Jan Trka, Jan Zuna and Tomáš Kalina have served, or still serve, as chairs of international societies or working groups. Professor Zuna described a new subtype of acute leukaemia that has been incorporated into the current international classification of leukaemias. Professor Hrušák initiated and led an international retrospective study on diagnostic and therapeutic approaches to a rare type of leukaemia. Based on its results, American paediatric oncologists designed a treatment protocol in which they repeatedly cite this study as part of the rationale. If we keep going as we are, more individuals will emerge who will join the world’s competitive elite. But it is important to recognise that even in the large countries, outstanding figures do not appear on a conveyor belt – often, only a handful emerge in each generation.
What do you think about the concept of “chairs”, that is, sponsored scientific positions? Could this be a way to attract top scientists from around the world to the Czech Republic? Are such dreams – for instance, of bringing a Nobel laureate into our our rather small scientific scene – realistic?
To je otázka, která má několik rovin. V Německu nebo Itálii, alespoň na pracovištích, která znám, to není běžné. Ani ve Španělsku to není standard. Výjimkou je Holandsko: soustředili všechny dětské onkologické pacienty do jednoho centra pro celou zemi, což jim umožnilo koncentrovat i špičkové lékaře a vypsat konkurzy na vedoucí pozice, které obsadili i renomovaní vědci i klinici ze zahraničí. Ale to je zlatá loď, mají peníze a možnosti, které my nemáme. Ale že bychom do Česka lákali světové hvězdy, třeba nobelistu, na to zatím nejsou finanční prostředky. U nás bychom měli spíše motivovat mladší talentované kolegy, kteří působí venku a mají už dobré jméno a nabídnout jim zajímavý výzkumný projekt, který s nimi budeme cizelovat.
That is a question with several layers. In Germany or Italy – at least in the institutions I know – this is not common practice. Nor is it standard in Spain. The Netherlands is an exception: they centralised all paediatric oncology patients into a single national centre, which enabled them to concentrate top specialists and to advertise competitive calls for senior posts, some of which were filled by renowned scientists and clinicians from abroad. But they’re sailing on a golden ship: they have resources and possibilities that we simply do not. As for attracting global stars, a Nobel laureate for example – we do not currently have the financial capacity to do that. In our situation, we should rather focus on motivating younger talented colleagues who are already working abroad, have made a good name for themselves, and could be tempted back by an interesting research project that we would develop together.
In our situation, we should rather focus on motivating younger talented colleagues who are already working abroad, have made a good name for themselves, and could be tempted back by an interesting research project that we would develop together.
For example, scientists‑clinicians such as your colleague at the clinic, Michal Svatoň?
Michal Svatoň is a perfect example of a young, talented scientist who has gained experience abroad. However, it is essential to offer people like him not only competitive salaries, but above all a guarantee that they will have the opportunity to secure grants and develop their own research projects. They should be able to access European funding, because our domestic grants are not sufficiently motivating for top researchers – the success rate is low and the amounts often do not match their ambitions. Ideally, they should be able to support their work precisely through European grants. There is no reason to be pessimistic; we need to think about this actively and look for ways to motivate young scientists to return. Speaking again about my own field: people such as Tomáš Kalina, Jan Trka and Jan Zuna have both the experience and the authority to consider new possibilities, identify promising Czech talent and bring them back.
For the last three questions, I turned to your colleagues – scientists – for inspiration. Associate Professor Markéta Bloomfield would like to know what you consider the most important qualities for the doctors of the future.
It will always remain essential to master medicine: to know how to make a differential diagnosis and to be empathetic – that is the foundation. Artificial intelligence will not replace everything, but we must know how to work with it, just as we must know how to use other modern tools that speed up and facilitate diagnosis. But above all, you must still be a good clinician if you want to focus on clinical practice, and a good scientist if you want to pursue research. It is important to be careful and caring with your patients, to communicate with them, and to show empathy. That will always be true, regardless of the era.
Can soft skills such as communication or empathy be learned? Or do you have to be born with them?
No one taught us anything of that sort; we learned through practice and from our older colleagues. We often behaved the way they did. But it is still true that a person needs to have something extra – empathy and a certain instinct for communicating with people. That cannot really be taught; it has to come from within. Today’s medical students hear about these things much earlier than we ever did. Times have changed, and they are certainly more sensitive and more open. For most of them, topics such as empathy and communication are important – and that is undoubtedly a good thing. But it still holds that each of us brings our own personality into the work, and that plays a major role.
Prof. Trka would like to know whether you have ever regretted not going to work abroad, where you might have been able to use your skills within a well‑functioning infrastructure.
In 2001, I received an offer to go to Montreal, in Canada. It was a very concrete and very good offer: I could simply pack my bags and start immediately at the McGill University hospital, in paediatric haematology‑oncology. It was a senior position, and I would not even have had to undergo qualification recognition – that was part of the package. To my surprise, my wife and son said, “Let’s go!” But after careful consideration, I said, “We’re not going.” I have never regretted that decision. I believe I did the right thing by staying here.
I have never regretted that decision. I believe I did the right thing by staying here.
If you could attend a concert by a single band in its best line‑up, which band would it be? The question comes again from Prof Trka.
Unfortunately, most of my favourite “old‑timers” no longer exist or perform – time simply cannot be turned back. But if it were possible, I would undoubtedly choose the Beatles. Even though I’ve seen Paul McCartney and Ringo Starr perform separately, I have never seen them play together
Prof. Tomáš Kalina asks what you think are the pitfalls of intergenerational knowledge transfer.
Pro mě byl mezigenerační přenos znalostí v době, kdy jsem nastoupil na kliniku do Motola, naprosto zásadní. První roky na klinice jsem v roli nejmladšího sekundáře nasával informace od svých učitelů. Učil jsem se od lidí, kteří mi byli blízcí a o kterých jsem věděl, že se něco naučit mohu. Na tom se podle mě ani za 50 let nic nezměnilo. Mezigenerační přenos zkušeností je k nezaplacení: mít otevřené oči, uši a ochotu naslouchat a vnímat. Pokud na vás nebudou mít čas, učte se za pochodu, vnímejte, jak mluví s pacienty, jaké předepisují léky, jak uvažují při vizitách, o diferenciální diagnóze.
For me, intergenerational knowledge transfer was absolutely crucial when I joined the clinic in Motol. During my first years there, as the youngest junior doctor, I absorbed everything I could from my teachers. I learned from people I trusted and from whom I knew I had something to learn. In my view, nothing has changed in this respect over the past fifty years. The transfer of experience between generations is priceless: keeping your eyes and ears open, being willing to listen and to observe. And if no one has time for you, then learn on the go: watch how they speak to patients, what medication they prescribe, how they think during ward rounds, how they approach differential diagnosis.
Learn on the go: watch how they speak to patients, what medication they prescribe, how they think during ward rounds, how they approach differential diagnosis.
Prof. Kalina also wants to know whether you think a passion for travel is linked to curiosity.
I'd say definitely yes. I think they're connected. I was curious in medicine, and planning trips is a kind of complementary sport for me. I enjoy it and I keep doing it – I'm already planning the next ones.
You have a Pacific Trail calendar ready for 2026. Is that perhaps an unfulfilled dream?
The Pacific Trail… maybe if I were younger and had the time – which I would never really have. Walking the Pacific Trail requires at least three months of vacation. But it would attract me enormously. I’ve had the chance to walk a few shorter routes, for example on the Appalachian Trail.
What is the longest trek you have recorded in your travel diary?
I am not a record holder. When I was young, we used to go on 14-day backpacking trips and sleep in the open air on hilltops. We hiked through the Tatra Mountains and the Malá and Veľká Fatra ranges... Today, since I have less work, I go on one-day trips for five or six days a year. I take a vacation and systematically walk through the Czech border mountains. I started in the Ore Mountains, continued through Bohemian Switzerland, and this year I finished the Lusatian Mountains. I do a 25–30 kilometer loop on my own and then drive home. My routes are connected, and in the spring it will be the Jizera Mountains. And why do I walk alone? At that moment, nature is part of me and I am part of it. When I walk with someone else, nature becomes just a backdrop. The journey itself is the destination.
This leads to a final, slightly more philosophical question which comes also from Prof. Kalina. Does true freedom arrive after the age of 65? Ideally, you no longer need work or money… Is stepping out of the spotlight a form of liberation?
For me, that freedom came a little later, because I remained the head of the clinic until the age of 69. At that point you have nothing to lose; you gain time, the administrative burden drops, and you can plan what you want – and don’t want – more than before. Life becomes freer, yes. It becomes easier to say no than it used to be. There is something to look forward to, colleagues!