In memory of Joan Cordoba.

Abstract

Joan Cordoba, a staff member of the Hepatology Unit of the University Hospital Vall d'Hebron (Universitat Autònoma de Barcelona), sadly passed away on January 27, 2014 at the age of 49, after almost 3 years fighting against a cerebral tumour. He leaves a wife, May, a psychologist at the Alcohol Unit at the Hospital Clinic, Barcelona and two sons, Joan and Valentina. He also leaves many friends, colleagues and disciples in the field of Hepatology in Europe and the rest of the world. Joan belonged to the type of hepatologist that unfortunately is disappearing in Spain. He specialized in General Internal Medicine (1989–1994) at the University Hospital Vall d'Hebron. His Head of Department, Professor Jaime Guardia, had a special interest in liver diseases and succeeded in transmitting this interest to a group of colleagues who constituted the second Liver Unit in Spain. Joan, therefore, became a hepatologist from Internal Medicine and not from Gastroenterology, which probably led him from the beginning to be interested in extra-hepatic consequences of cirrhosis and particularly encephalopathy. In 1995, Joan joined Andy Blei at the Northwestern University in Chicago where, after completing a Master's Degree in neurophysiology, he worked on clinical and experimental projects related to liver encephalopathy for two additional years. Andy Blei, who sadly also passed away, often told me that Joan was the best fellow he had ever had in his career. In Andy's opinion, Joan was an excellent clinician and investigator, modern, prudent, honest, hard worker, loyal to his mentors, respectful of his peers and always generous. The fruits of his labour in Chicago include 10 clinical and experimental publications in leading journals on the mechanisms and treatment of cerebral oedema in cirrhosis. On his return to Barcelona, Joan coordinated a successful multidisciplinary research group (physicians, biologists, psychologists, biochemists and radiologists) on hepatic encephalopathy at the Hospital Vall d'Hebron. His work in Barcelona yielded studies on new technologies for the monitoring of patients with hepatic encephalopathy, the impact of minimal hepatic encephalopathy on the quality of life of cirrhotic patients, psychological disorders before and after liver transplantation and, particularly, several randomized studies on the prevention and treatment of hepatic encephalopathy. One notable study showed that low protein diet, a solidly established paradigm in the management of hepatic encephalopathy, offered no benefit for patients with an acute episode of encephalopathy. Joan remained upbeat throughout his illness. He continued to see patients, draw up projects, write articles and lead his research group until 4 weeks before he died. He only surrendered to the onset of incapacitating neurological deficits. In the last year, I had the opportunity to work alone with him many afternoons on common projects and articles. We often talked about his illness and I never noticed any sign of downheartedness or despair. He had wisely assumed that the hand life had dealt him and how to play it. It is very sad to lose a friend so young. Although my relationship with Joan began being basically professional, it quickly overcame these limits and became personal. Joan's physical appearance, form of dress and manner made him seem to be a northern European. However, Joan was deeply Mediterranean and, as such, very sensitive, educated, a family man and a lover of tradition. He loved Barcelona and spent his summers in Minorca where he sailed and enjoyed his large family in beautiful surroundings. Joan was a cornerstone of the development of the EASL-CLIF Consortium, the leading European organization in cirrhosis research. There he leaves many friends and it is in their name that I have written this obituary. Conflict of interest: The author has no conflict of interest to disclose.