dr Stephane Bermon

An interview with Dr Stephane Bermon

by Kay Hare

Late one Thursday evening I visited Bermon who is a sports Doctor at his office in Im2S Monte Carlo, bumping into the last patient leaving his practice on my way in. It had been a long and a busy day. Stephane was not perturbed by the late appointment and seemed delighted to see me as I was greeted with a friendly introduction to his practice.

Doctor Stephane Bermon is a Sports Medicine and Traumatology Specialist based in the heart of Monte Carlo. He set up his practice 12 years ago and has never looked back. Currently, he sees on average 20 clients per day however sometimes the number increases due to sheer volume of clients. He is over prescribed with patients which is reflected in his character, he is the kind of person who will always give more than is expected and has a genuine interest and patience with people. I believe there is now a waiting list to see him, so I set out with a list of questions to find out why:

Why did you want to become a sports Doctor?
I have always practised sports since the age of 5. At the beginning of my career as a medical student, I was a ski instructor and a professional snowboarder. So, associating sports and medicine appeared very natural and logic to me at that time. So far, I have never regretted this choice.

What is the safest form of sport for the average person and how much should someone exercise to feel good?
It would probably take dozens of pages to explain which sport is the safest. It is up to your sports physician to help you address this question. While choosing your physical activity or sports practice, you should, as a priority, consider your musculoskeletal status (arthritis, unstable joints, weight or non-weight bearing activity etc) and your cardiorespiratory status (undiagnosed or pre-existing cardiorespiratory condition, asthma, medicine intake etc).

The World Health Organisation recommends for adults aged 18–64, that their physical activity should include leisure time physical activity (for example: walking, dancing, gardening, hiking, swimming), transportation (e.g. walking or cycling), occupational (i.e. work), household chores, play, games, sports or planned exercise, in the context of daily, family, and community activities. This all helps to improve cardiorespiratory and muscular fitness, bone health and reduces the risk of non-communicable diseases and depression.

Adults aged 18–64 should do at least 150 minutes of moderate-intensity aerobic physical activity or at least 75 minutes of vigorous-intensity aerobic physical activity throughout the week or an equivalent combination of moderate- and vigorous-intensity activity. Aerobic activity should be performed in bouts of at least 10 minutes duration.

For additional health benefits per week, adults should increase their moderate-intensity aerobic physical activity to 300 minutes, or engage in 150 minutes of vigorous-intensity aerobic physical activity, or an equivalent combination of moderate- and vigorous-intensity activity. Muscle-strengthening activities are encouraged to strengthen major muscle groups two or more days a week.

Does medicine inspire you or is it the interest of helping the patient recover?
The whole process (should we name it like that) is fascinating. As a physician, I concentrate on the diagnosis process. Linking the aggregated results obtained from both the patient and the clinical and preclinical investigations, with their previous history is interesting. As Nietzsche quoted “Devil is in the detail”; 80% of diagnoses can be reached without really looking at these details but, you have to be really cautious should you aim at diagnosing part of the remaining 20%. The treatment-related aspects rely more on psychology and help you to build a (sometimes) long-term relationship with the patient.

What is the most common sports injury you deal with?
These are micro traumatisms related to misuse or overuse. Tendonitis is probably the most frequent. The knee is the most frequently affected joint.

Do you think sometimes people injure themselves self-consciously in order to slow down in life and take a rest?
It may happen but this conscious process is very rare in my opinion. However, I very often see overuse injuries or infections which are the result of an excessive and inappropriate training load. This leads to injury or illness which in turn forces the athlete to rest.

Do you think many sports injuries can be prevented?
Yes indeed. There are numerous research groups around the world conducting efficient research on injury prevention. Basically, and as far as sport is concerned, this can be achieved through three different axes:
The evolution of sports materials. The improvement of preventive methods, training and recovery sciences. The rules of the sport.

Do you always prescribe medicine or sometimes can the patient heal themselves either by resting or carrying on with a lighter form of sport?
When it comes to sports medicine and traumatology, rest and recovery are essential components of the healing process. Surprisingly, it is very difficult to convince many athletes to take time out and rest. Medicines and physical rehabilitation are also helpful. However, I believe that the Hippocratic precepts “Primum non nocere” are still valid in 2018. In some cases, the patient will heal spontaneously; our treatment, if properly conducted, only speeds up the process.

What is your belief in mind over matter? Do you think people can heal their bodies through a positive mindset?
Again, answering such a question deserves several symposia. I am convinced that some patients with a positive mindset are less prone to injury or illnesses. Should they experience a medical condition, this positive mindset is a powerful ally. One should, however, be cautious not to turn this into a dogma which will then prevent some patients to receive appropriate medical care in due time.

Are you as a Doctor still learning and seeing the body as a tool, as a subject to learn from. Does the human body still surprise you from the point of view of healing?
Indeed, the more experience one gains in medicine, the more tempting it is to take shortcuts for diagnosis and treatment. Shortcuts are dangerous in medicine. Taking shortcuts, you’ll succeed nine times, but you and your patient will fail the tenth time. I learn every day from my patient, and the more experienced I become, the more I doubt.

As our lives get busier and we are living longer, do you feel medicine is progressing fast enough that keeps up with our evolution?
There are two ways to answer this question. The optimist would say that our life expectancy significantly improved during the last century and this is a result of the progress made in Medicine. The pessimistic would argue that in spite of a significant reduction of infectious disease during this last century we are still facing serious and alarming issues with non-communicable diseases such as cancers, cardiovascular diseases, metabolic and pollution-related diseases. Like Daedalus and Icarus, many of us are convinced that technology will always help us to find a solution to escape from above. I am not sure of that and believe that we should more focus on the human behavioural changes as possible levers.

What field of medicine do you think has advanced and expanded the most in your career?
Medical Imaging, as far as my own speciality is concerned.

Do all your patients fully recover or do you have to refer some patients to specialists?
No, many of my patients do not fully recover. For instance, you cannot actually recover from a degenerative disease (arthritis is a degenerative disease). It is of utmost importance to work with a network of colleagues. In sports medicine, like in many other specialities, even a skilled doctor cannot achieve good results alone.

You regularly write scientific articles and give lectures at Oxford University (Green Templeton College). What inspires these papers? And, where can we read them? Are they published or can we find them online?
Yes, most of my scientific work is published in English peer-reviewed journals (https://www.ncbi.nlm.nih.gov/pubmed/?term=Bermon+S). However, they often deal with complicated sports medicine and exercise physiology topics which are academics papers.


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