Laser Surgery 1987: Croatian Healthcare as Dr. Jekyll and Mr. Hyde

On September 25, 1987, Zagreb neurosurgeons performed a procedure that was presented as the first of its kind in the world. At the Department of Neurosurgery of the then Clinical Hospital ‘Dr. Mladen Stojanović’, today’s KBC Sestre milosrdnice, in collaboration with American neurosurgeon and peripheral nerve surgery expert David G. Kline, a nerve was cut for the first time using a CO2 laser. The operation attracted the attention of the international professional community as an important step in the development of microsurgery of peripheral nerves.

From Štampar to Transplants

Croatian medical history is full of successes. Andrija Štampar was among the founders of the World Health Organization and its first president. Zagreb doctors developed one of the most successful transplantation programs in Europe, while Croatian surgical and cardiology centers have introduced methods that were soon adopted by other European healthcare systems, and Croatia has been among the leading countries in the world for years in terms of the number of organ donors and transplants relative to its population. Numerous Croatian surgeons, cardiologists, neurosurgeons, and scientists have achieved results comparable to the most prestigious European and American centers.

The Other Side of the Coin

Croatian doctors often present the latest achievements and procedures in the media that represent the pinnacle of world medicine, which opens hope for all current and potential patients. This is precisely why Croatian healthcare represents a kind of paradox. While certain doctors and medical teams achieve world-class results, patients often wait for months, even years, for examinations, diagnostics, and specific procedures. The system faces a shortage of doctors and nurses, an aging population, chronic financial problems, and organizational weaknesses that repeat from term to term.

Croatia does not have a dramatically low number of doctors in international comparison. The problem is that this workforce is unevenly utilized, there is a lack of specialists in certain branches of medicine, and the organization of the system often does not match the level of expertise of its best doctors.

Public Health is Declining, Private is Growing

Despite all this, the healthcare system is divided into public and private sectors. While public health is increasingly declining, private entities are doing better. Twenty years ago, there was not a single private healthcare institution on Lider’s list of the 1000 largest creators of new value, ten years ago there were five, and on the current list, there are 12. The additional absurdity is that in these hospitals, doctors who are supposedly overburdened in the public system often work in their free time.

Public trust has been further undermined by corruption scandals that begin in offices buried under ‘tokens of appreciation’ from patients and end at the very top of healthcare administration. Thus, alongside stories of medical achievements, investigations, arrests, and court proceedings involving individuals who led the healthcare system are often mentioned.

Permanent Duality in Croatian Medicine

Therefore, the story of the laser nerve connection from September 1987 is not just a reminder of a medical success. It symbolizes the permanent duality of Croatian medicine, reminiscent of R. L. Stevenson’s legendary work about the esteemed doctor Dr. Jekyll and his dark alter ego Mr. Hyde. On one side are top knowledge, innovation, and experts capable of world-class procedures, and on the other is a system that often fails to ensure an equal level of quality and accessibility for all patients.

In other words, Croatian medicine has been proving for decades that it can be among the best in the world. At the same time, Croatian healthcare shows how difficult it is to turn that excellence into a system that will serve every citizen equally.