The Argentine Society of Cardiology (SAC) is a pioneering institution that brings together prestigious cardiology centers dedicated to patient care, research, and specialist training. As President of the SAC, I am pleased and proud to write a letter to the young cardiologists who graduate each year from the program offered by our institution. I consider the opportunity to address these cardiologists in this letter a comfort to the spirit, not a boost to the ego—an insatiable creature all physicians must take care not to inflate.

The graduation ceremony of a medical specialty marks a rite of passage into a new chapter of professional life—one that well deserves celebration. They are receiving not only a certificate qualifying them to practice within a cardiology subspecialty, but a human and scientific responsibility toward the needs, vulnerability, and lives of others.

Throughout this journey, the graduates have logged hours on call or during long shifts, taken histories and listened to patients, meticulously reviewed electrocardiographic tracings, interpreted hemodynamic data or imaging, or mastered specific techniques. Yet at the heart of all this technical complexity, the fundamental anthropological question remains unchanged: what does it mean to heal another human being?

In a recent letter, I pointed out that humanism in medicine is the school of thought that holds that medical practice cannot be reduced to a mere application of science and technology but must instead be deeply rooted in empathy, respect for human dignity, and a holistic understanding of the patient. (1)

The rational practice of medicine requires understanding that our object of study is not a malfunctioning machine, but rather a suffering person. Ancient Greek philosophers laid the foundations of our practice by understanding that technical skill (techne) is blind if it lacks practical wisdom (phronesis) and moral character (ethos). The body cannot be cured without attending to the soul. (2) It is vital to resist the temptation to treat the part while disregarding the whole.

In medicine, as in life, knowing how to win with humility is as crucial as knowing how to lose with dignity. The famous maxim “to cure sometimes, to relieve often, to comfort always” summarizes the essence of human care. Although science cannot always defeat disease, human presence and support are indispensable at all times.

In our contemporary world, the master clinician Francisco Maglio bequeathed a fundamental premise for humanistic medicine: “One cannot be a better physician than one is a person.” Maglio taught us to distinguish between disease (the biological entity described in textbooks) and illness (the biography and the subjective, social, and existential experience of the person suffering it). (3) A physician who is hypertrophied in technical skills yet atrophied in human warmth becomes a mere requester of diagnostic tests or prescriber of drugs. To cure is a biological act; to heal, a relational one. The physician–patient relationship is not a service transaction, but rather an encounter of two wills and two vulnerabilities: one seeking help, and the other offering knowledge and empathy.

To honor this profession, the technique must be guided by a robust ethical framework. Values are not theoretical abstractions; they are validated solely through concrete actions that honor them: (4)

• Honesty: honored by communicating complex diagnoses truthfully and with sensitivity, without false promises or concealment.

• Responsibility: honored through the rigorous study of each case, continuous learning, and accepting the consequences of our clinical decisions.

• Respect: honored by recognizing patients' autonomy, beliefs, and dignity, regardless of their social status.

• Gratitude: honored by acknowledging the efforts of the patients who trust us and the lessons we have learned from our peers and masters.

• Humility: honored by acknowledging the limits of our own knowledge and seeking a second opinion when doubt arises.

• Solidarity: honored by ensuring that the best medical care also reaches the most vulnerable.

• Excellence: honored in the unending pursuit of the perfect detail, shunning mediocrity and routine.

• Practical wisdom (Phronesis): the clinician's supreme value. It is honored by weighing the benefits against harm and by knowing not only when to act, but also when to abstain.

Continuing with the cultivation of virtues, it is essential to maintain fortitude when it seems impossible or unattainable, to practice justice by being fair and constructive in both error and success, and to promote reflection and empathy over vertical authority when resolving complex issues.

Immanuel Kant bequeathed to us his categorical imperative, reminding us that we must act in such a way that the maxim of our will can always hold as the principle of a universal law. In cardiology, this means: never treat the patient merely as a means to professional advancement, statistical record-keeping, or financial gain, but always as an end in themselves.

Yet, real-world medical practice confronts us with dilemmas in which principles come into conflict. This is where the principle of the lesser evil and Max Scheler’s hierarchy of values come into play. Scheler teaches us that values are organized hierarchically: agreeable values are subordinate to vital ones, which in turn are subordinate to spiritual ones (the just, the true, the beautiful), and all of these are subordinate to holy and ethical values. When clinical reality corners us, the prudent physician must know how to sacrifice a lesser value to save a higher one, always prioritizing life, dignity, and the relief of pain over comfort or institutional inertia. These aspects are very well developed in the book Sabiduría Artificial, in light of the emergence of artificial intelligence. (4)

The mathematician and physicist Roger Penrose revisits Plato’s classical triad as intertwined pillars of reality and knowledge. These concepts correspond directly to the transcendentals of being: unity (unum), truth (verum), goodness (bonum), and beauty (pulchrum). (4)

• The true: the rigorous adherence to scientific evidence, method, the logic of pathophysiology, and statistics.

• The good: ethical intent and pure benevolence oriented toward the patient's well-being.

• The beauty: harmony in a medical encounter. There is beauty in an elegantly reasoned diagnosis, in a masterfully performed surgery, and in a word of comfort offered at precisely the right moment.

When a physician succeeds in integrating the truth of science, the goodness of intention, and the beauty of execution, medicine ceases to be a mere craft and rises to the status of a sublime art.

None of this is possible without the imperative of the Oracle of Delphi: Nosce te ipsum (know thyself). A physician who is unaware of their own biases, fears, limitations, fatigue, and projections runs the risk of causing unintentional harm. Self-knowledge is the armor against hubris (arrogance) and the only path to managing frustration in professional practice. Far from being a weakness, acknowledging our own intellectual and human frailty is the only path to rigorous discernment. By setting aside the mask of infallibility and the need for constant approval, we rediscover the profound truth of our work, allowing us to learn, connect genuinely with others, and practice with true ethical authority.

Furthermore, we must recall the famous maxim attributed to José de Letamendi and widely popularized in medicine: “He who knows only medicine, does not even know medicine.” Cardiology reduced to myocytes and ion channels is blind. To understand a human being suffering from a heart condition, one must sometimes understand history, sociology, philosophy, and language.

However, this does not mean falling into soft subjectivism. Modern medicine requires mastery of the formal language of science: mathematics and statistics. Probabilistic reasoning, the rigorous interpretation of the p-value, confidence intervals, relative risk, and absolute risk reduction are indispensable tools for rational practice. Statistics is the filter that protects us from self-deception, from elevating personal anecdotes to universal rule, and from quackery. But we must be clear: statistics describe populations; clinical practice deals with individuals. The specialist’s mastery lies in knowing how to apply populationbased evidence to the unique and unrepeatable situation of the patient before them.

Cultivating sensitivity through the arts is no mere pastime; it is a constitutive necessity of the medical mind. Art trains us in observing nuance; poetry teaches us the precision and weight of words; music attunes us to rhythm, pause, and harmony.

If we analyze Maslow’s hierarchy of needs in the context of medical life, we observe a troubling paradox. As physicians, we often strive to reach the top of the pyramid—self-actualization, academic prestige, and mastery of our specialty—by sacrificing the foundational layers: adequate rest, proper nutrition, physical activity, emotional safety, and time with our loved ones. (5)

To achieve true personal and professional fulfillment, we must address the holistic needs of both sides of the health equation:

• What do patients need? They need impeccable technical competence, but also attentive listening, time, direct eye contact, clear explanations, and a serene professional they can trust.

• What do we physicians need? We need dignified working conditions, time for study and reflection, spaces for emotional support, respect for our personal lives, and institutional environments that safeguard our mental health.

Dear young colleagues, cardiology is a highly demanding discipline. Roberto De Vicenzo, the greatest Argentine golfer of all time, used to say: “I’m lucky, but the more I practice, the luckier I get.” You will face situations where your efforts will not immediately translate into a favorable result. Resilience the capacity to maintain one’s integrity in the face of adversity—will be your most valuable asset. Do not jeopardize a successful trajectory by putting the cart before the horse. With clear objectives, a sound methodology, and core values—guided by a rational and patient perspective—you will build the personal culture that makes things happen and delivers results. Do not let the pursuit of immediate gratification cloud your medium- and long-term perspectives. In life, there are things that take time: peace, war, love, and a professional career. The meaning of Hippocrates of Cos’s famous maxim has changed very little: “Art is long, life is short, experience is deceptive, judgment is difficult, and opportunity is fleeting.” (3)

Be leaders in your roles. Deepen team-based learning, propose improvements and innovation, motivate and inspire, celebrate the team’s success, and manage your personal ego —letting it be the group that uplifts you, without ever letting it go to your head. In the face of today’s culture, which sometimes confuses algorithmic validation with merit, hype and excessive self-promotion generate fleeting expectations that erode credibility. Professional humility acts as an ethical brake against this temptation, reminding us that true prestige is not proclaimed through artifice, but validated through consistency and sustained dedication.

When leaders fail today, it is often due to an inability to adapt to change, weak interpersonal bonds, a failure to build and lead teams, or excessive misdirected ambition. Know that the unit of measure is the team—transforming “I” into “we,” or flipping the “M” in “me” to become the “W” in “we.” Know that there is no motivation without connection, no connection without conversation, no conversation without time, and no time without conscious purpose. (6)

Likewise, I urge you to tenaciously seek a balance between your professional life and your family. The medical profession is all-consuming and fascinating, but it must not become a sacrificial altar where our primary affections are burned. Family is the safety net that sustains us when clinical practice exhausts us; home is the harbor where the physician, if only for a time, becomes a person again. Do not postpone the hugs, the celebrations, or your presence in the lives of those you love for the sake of fleeting professional success.

Masters and mentors are the beacon. Caring for and respecting masters is a non-negotiable ethical imperative. A true master in medicine is not the one who knows everything, but the one who teaches how to think, shows how to treat the humble, and demonstrates how to stand firm in the face of complexity.

“If I have seen further, it is by standing on the shoulders of giants.” This quote from Bernard of Chartres was popularized by Isaac Newton. He wrote this in a letter acknowledging that he had reached his conclusions on the properties of light only through the pioneering work of Descartes and Hooke. It is important to remember that, beyond effort alone, we have all received gifts that allowed us to cultivate ourselves, and that no one is truly self-made. Cultivate humility and gratitude. Professional development does not occur solely through personal attitude, but also through the fundamental role of mentors, educators, and the institutions that shelter them. In this sense, if the student surpasses the master, the educator will have more than fulfilled their purpose. At times, as parents or educators, we ask ourselves what kind of country or healthcare system we will leave to the next generation. For some time now, I have changed that view to one that depends more on personal action, asking myself what quality of children and physicians we will offer to the country.

Institutions are not mere concrete structures; they are human ecosystems dedicated to the preservation of life and the passing of knowledge across generations. Forming a specialist requires infrastructure, investment, a culture of safety, and a sustained educational vocation.

Throughout the history of medicine, great figures have reflected on the transmission of knowledge and the cycle of professional life:

Hippocrates, in his Invocation and Oath, placed the master on the same level of respect as one’s own parents, requiring students to share their resources and honor the old age of those who taught them the art. (7)

Sir William Osler insisted on the need for young physicians to recognize the foundations laid by preceding generations, reminding them that cumulative experience is an indelible treasure. (8)

Alberto Agrest, a master of Argentine medicine, taught us the importance of critical thinking, intellectual honesty, and respect for elders, warning us of the dangers of ingratitude and institutional amnesia. (9)

I would like to make a special and heartfelt mention of those physicians who work to foster institutional educational processes and who are now at a mature stage of their professional careers. Do not forget them; take care of them. This aspect shapes the culture and values that sustain institutions, serving as a sign of trust for those who choose to commit to the institution.

You owe part of your present to those pioneers. Their footprints are etched in every hallway, in every case conference, in every service standard that you now apply as a matter of course. Institutions that fail to honor their mentors lose their soul and their historical memory.

Dear graduates, today you step out into the world with a formidable toolkit. You have statistics to analyze evidence, mathematics to understand hemodynamics, technical skill to intervene upon the body, and science to support every decision. But never forget that behind every electrocardiographic tracing there is a life story, eyes seeking hope, and a heart that not only pumps blood but loves, suffers, and dreams.

Be rigorous in science, impeccable in ethics, sensitive to humanity, and grateful to your masters. Seek professional fulfillment without sacrificing family harmony. Honor the memory of those who preceded you and become the safe shelter your future patients will need.

May prudence guide your hands, truth direct your mind, and empathy move your heart.