When friends, colleagues and family members were asked about Dr. Juan Canoso, the joy in their voices is palpable. Clearly, they did not want to overlook any detail of his career, nor of who he is as a person. Most of them requested some time to remember stories and encounters, time to spare no words –or choose them precisely and carefully– to describe one of the masters of rheumatology and winner of the Aníbal Ruiz Moreno Medal at the recent PANLAR 2020 Congress.
Dr. Juan Canoso is a Mexico-based Argentinian physician. A chief of rheumatology at the Boston Veterans Administration Medical Center from 1974 to 1985, he also worked as professor of medicine and director of clinical rheumatology at the same institution from 1985 to 1994. In addition, Dr. Canoso has been an associate professor of medicine at Tufts Medical School, since 1994. To date, he has authored 80 PubMed-indexed papers, 53 book chapters in Internal Medicine and Rheumatology, and two chapters in Up to Date.
To discuss his achievements as a review of his resumé would fail to do justice to the person everyone agrees to call a teacher. His life’s work reaches way beyond those numbers and awards, on to stores, dedication, passion and teachings, richly described and fondly remembered by his wife, Dr. Mary Carmen Amigo.
“Talking about Juan Canoso’s professional and academic achievements is quite easy. One could review his long and well-earned curriculum vitae to understand why he is a master of rheumatology. It’s a lot more difficult to talk about Juan, the man, so here I will talk about Juan, the man-master”, she said.
In PANLAR, as in other instances, Dr. Canoso is a reference. He served as treasurer from 1990 to 1994. “Juan’s biggest concern about PANLAR were the excessive expenses it would incur, due to the few resources it had at the time. His way of thinking about the healthy and ethical relationship that should exist with the pharmaceutical industry”, recalled Dr. Amigo.
He has joined numerous PANLAR congresses both as an attendee and as a speaker. “I remember at least four congresses in which, together with his clinical anatomy group, their seminars were always successful. This seminar has been presented in virtually all over Latin America and also in the congresses of the American College of Rheumatology”, she stated.
In spite of all of this, his wife said, “Juan does not understand why he was awarded the Anibal Ruiz Moreno Medal. To me, it is perfectly clear”.
“Juan says he did not know what he wanted to study when he finished high school. He even considered law, like his father, but finally he decided on medicine. He received his degree as a surgeon from the Universidad Nacional del Litoral, in Rosario, Argentina (1963)”, recalled Dr. Amigo.
Since then, he has been fascinated by anatomy and histology and he was an instructor and professor in pathological anatomy, performing over 140 autopsies.
After graduating as medical surgeon he relocated to Montevideo, Uruguay, where he spent five years at the Hospital de Clínicas as a resident of Internal Medicine under his great teacher, Dr. Pablo Purriel. His great love for Uruguay stems from those days, and today he holds a Uruguayan passport. Due to administrative schedules, he could not pursue the academic career and “together with a dear friend, he decided to transfer to the United States, to the Framingham Union Hospital, for an internship”, according Dr. Amigo.
From 1968 to 1973 he was a resident in internal medicine and later in rheumatology at Boston University Medical Center.
When asked why he chose rheumatology, he returned to an anecdote, which his wife recalled as “having been accepted to study epidemiology, he changed his mind and opted for infectious diseases. However, the senior resident told him, ‘you’re wrong, you have to study rheumatology under Dr. Alan Cohen. And so he did”.
What followed was a love story. “During the Mexican Congress of Rheumatology in Acapulco in 1991, I met the great Dr. Juan Canoso. I was accompanied by Mary, my daughter, since I always liked to invite my children (Mary and Luis) to academic events. Believe me, that first meeting was one hundred percent academic until the closing dinner on the beach”, says Dr. Amigo.
When he approached her to say goodbye, a moment she recalls with particular fondness, she stood up from her chair and heard the following: “I wanted to say goodbye to you and tell you that you have impressed me as a doctor, as a woman and as a mother”. “At this point”, she said, “I was stunned”.
“I thanked him, said goodbye and sat down next to Mary, who asked me, “What did the doctor say to you, Mom?” and I replied, “Nothing, he was just saying goodbye”. A week later, she received the first of “many poetic and sincere letters”.
They became acquainted then, for months, through correspondence and later, in expensive phone calls. “Juan took advantage of an academic trip to Guadalajara, Mexico, to come to my house and meet my children. Soon after, I went to Boston to meet Adrian, his youngest son, and his close friends, and later I met Diego, his oldest son. All this was not easy, however, we had certainty and love on our side and today Juan and I have a total of four children and five grandchildren that fill our lives with happiness", she emphasized.
In 1993, after two years of a “beautiful and loving long-distance relationship” they married, and Mexico City is their current place of residence. “Everyone was aware of the profound change in Juan's life. From Boston to Mexico City…Every day I thank and appreciate his generous decision”, said his wife, colleague and life partner, Dr. Amigo, with deep love.
Another part of this love story was told by his friend, Dr. Luis Catoggio. “For some of us, that an Argentinean held the position that Juan had in Boston seemed almost like touching the sky with his hands. Leaving that seemed crazy to many of us. However, he left that position and had to fulfill all the necessary requirements to practice in Mexico, which took quite some time. This act was, for many of us who knew him, an incredible life lesson and the person responsible for it was Dr. Mary Carmen Amigo, whom he married at that time”, he says.
In Mexico, after several immigration and professional procedures, including the test of the Mexican Rheumatology Council he began working as a rheumatologist at the ABC Medical Center. “He retired from medical practice in 2019, but not so from teaching and clinical research”, he tells.
Meanwhile, Dr. Bernardo Pons-Estel described him as a quiet man, always listening carefully, with a smile, raised eyebrows and a wrinkled frown. A warm, unhurried, real, touchable human being, full of life, anecdotes, principles, ideas, and projects. “But beware, he is not the only one, there is another Juan. The one who goes all out to defend difficult situations and pulls out all the stops when indifference would have been more comfortable, but there he was, giving his opinion, the one that no one fails to listen to. Luckily, in this story I had to be on the side of the defendant, and believe me, I would never have wanted to be in the crosshairs of his questioning”, he said.
He was a founding member of the Mexican Group for the Advancement of Musculoskeletal Clinical Anatomy (2009). He has received many distinctions, among those, he was awarded the title of Master of Mexican Rheumatology, Master of Rheumatology PANLAR, Master of the American College of Rheumatology (ACR), he is also an Honorary Member of the Rheumatology Society of Central America and of the Rheumatology Societies of Chile, Costa Rica, Cuba, Panama, and Uruguay.
In 2015 he received the award for Medical Excellence from the ABC Medical Center in Mexico. The most recent recognition took place during the PANLAR virtual Congress in 2020, when he received the PANLAR Anibal Ruiz Moreno Medal.
IN HIS WORK
He corresponded with Dr. Catoggio -since that time- and in 1990, when he traveled to Argentina to visit his mother, he spoke at the Hospital Italiano de Buenos Aires.
“He was an enthusiastic supporter of my idea of creating a foundation with the name of my father, who had been one of the founders of modern Argentine Rheumatology, so to speak, and he donated the value of the ticket and his honorarium to the foundation when he gave the second Pedro M. Catoggio Conference in Buenos Aires in 1992. That donation made it possible to raise the fund required by the authorities to set the foundation up…Among so many other things I have to thank him for, is this", Dr. Catoggio recalled with nostalgia.
Hard work has always been part of his life, as everyone agrees. From student, resident or head of service, Dr. Amigo said, “the hours could go by and he would never take a rest. Even now, retired from the practice of rheumatology, he does not stop working on research projects, reviewing articles, publishing original articles”.
Teaching fascinates him, his wife mentioned, and then added that it must have something to do with the fact that her mother was a great teacher. “He likes to teach small groups and at floor level. The podium is not his thing. Do you remember him in shorts and flip-flops to show off the ‘anatomical qualms’ as he calls them?”.
Over the years, Dr. Catoggio describes, they shared his apartment in Boston and then several visits to Argentina that he made to visit his family from time to time.
“In Mexico, besides his clinical skills in general rheumatology, he developed an interest in anatomy -which he transmitted intensely to a group of young people- to strengthen the knowledge that we rheumatologists have or should have. In the last decade he has traveled the world giving practical workshops on what is called clinical anatomy”, he emphasized.
Kindness, said Dr. Amigo, is a substantial part of his personality, he is always trying to help. “Something wonderful Juan has is his ability to ask for forgiveness, to say ‘I'm sorry’. For me, that virtue is an essential part of his greatness. Those who know him know that he has a very particular sense of humor and that he likes simplicity as a way of life. And sure, he also has a touch of obsession. He checks “n times” a paragraph, presses his collaborators to finish a manuscript or checks his e-mail every ten minutes to see if the long-awaited response of acceptance of an article has arrived", she observed.
Meanwhile, Dr. Catoggio, has a particular way of remembering their first encounter and, incidentally, the “lost time” between then and when they became great friends.
“I first heard about Juan Canoso in December 1979. While I was in Boston visiting the Arthritis Unit at Massachusetts General Hospital, for a couple of months I attended a monthly meeting held in the hospitals of that city. That month was Tuft’s turn and Juan Canoso was the head of the clinic. I went to that meeting, but I did not greet him due to a certain shyness towards an Argentinian who held a high position in American rheumatology. So, I lost 6 years of enjoying his friendship!", he said gracefully.
He finally met him in 1985 during a congress of the now American College in Los Angeles, “and since then I could enjoy a growing appreciation, in addition to the respect he deserves for his trajectory and his qualities as a person”.
“I am not going to mention here his countless academic merits, nor about his trajectory which are already well known to most people. Rather, I would like to relate my personal relationship through the years and aspects that make a human being”, and thus another wave of memories reaches these paragraphs.
Dr. Bernardo A. Pons-Estel, began by saying "it would be difficult, if not impossible, to find another person in life like Juan Jorge Canoso Ardigó".
“I met Juan as an unreachable person, as a world reference. Initially through third parties. Third parties that I admired and followed as example of knowledge, behavior, capabilities, and life, among them Carlos Battagliotti, my soul teacher (Argentina), and the Latin Americanists Donato Alarcón-Segovia, from Mexico, and Antonio Reginato, from Chile/USA. All of them, contemporaries of Juan, who spoke highly of him. I say this in past tense because they are three admirable figures who have passed away, but they left an immense legacy to our generation. All of them admired Juan...and as it always happens, from the multiplication of so many idealized images, the figures become bigger, stronger and idolized, while they move away from the earthly landscape, becoming illusions", according to Dr. Pons-Estel.
Fortunately, he added, the roads he traveled gave him “the great opportunity to meet and get to know Juan more closely”.
"We crossed paths many times, in academic, social, gastronomic and even cultural events. In San Salvador, we went together to see the work of Archbishop Oscar Arnulfo Romero (Monsignor Romero) and the place where he lived and was assassinated on March 24, 1980. We shared long talks on philosophical, ethical, and ideological topics, where we almost always coincided”, he added.
“As time went by, when we met, our conversations stopped being about medicine and became more about family life, our working groups, our specialty, and the respect he has always had for the basic values a good person should have. Exchanging e-mails is always a pleasure, especially this last year”, Dr. Catoggio emphasized.
When you are with him, explains Dr. Bernardo Pons-Estel, he catches you with his comments, without you realizing it, “and you can even feel that you are his equal, or even more, that he recognizes your virtues. I do not know how he does it, but he manages to invert the situation and turn you from an admired to admired, a situation I have never experience with another person”.
To that, Catoggio added: “as for many of our generation, to me Juan has been and is a mentor in every sense, not only for what he taught as a physician, but more so, for the life lessons, behavior, and how to be a great man while keeping a low profile. Hard to beat”.
“So, in this brief biography I have tried to show you why Juan is a master. But for me as his wife, there is another side of the master. I have to thank Juan who has been a true master of life and has given me the opportunity to know myself better as a person and a partner”, concluded Dr. Amigo after speaking and remembering the person who shares the path of life by her hand.
Photo 1. Dr. Juan Canoso with his wife, Dr. Mary Carmen Amigo.
Photo 2. Meeting in Mexico City with the Latin Americanists in Dr. Donato Alarcón Sagovia’s house. With his friends Bernardo Pons-Estel and Luis Catoggio together with other GLADEL members at the launching of the Lupus Study Group, 1997
Photos courtesy of Dr. Catoggio.