When Dr Martin Reincke, in the opening speech of the last European Congress of Endocrinology brought that picture to the screen, the first image of the supermassive black hole at the center of the Milky Way Galaxy (or at least a picture of its shadow), I felt this was really where we had all been these last 2 years. And, from what we knew, no one had ever come back from one to tell how it felt.
Many of us have lost relatives, colleagues and friends during this pandemic, many of us felt on ourselves the destructive power of such a tiny alive entity, in our bodies, in our teams, in our health systems and societies. We could not see it, but we suffered its consequences, like gravity taking over. The hole was deep, and the dark matter was hungry to swallow everything that dared to look inside it.
But there we were, at the Milano Convention Center (MiCo), a sunny warm day of May 2022, looking at this photo, alive and eager to learn, to refine our tools to help our patients, to enjoy life and friends. The region where almost everything started in Europe, the Lombardy, was the driving force where we were starting to come out, by the hand of the President of the European Society of Endocrinology, Dr Reincke. It was impossible not to see the beauty in this closing circle.
However, if black holes are places where gravity is so strong, not even light can escape, how were we able to see a picture of Sagittarius A* (SgA*)? Well, it seems that black holes can not only collect and ingest material orbiting them but also expel it, in a process known as ‘accretion’, and the light comes from the region where it happens. What we see in the picture released on May 12 is the shadow of the black hole against a brighter background. So, my bet is that we had all been close to SgA* but were expelled from it. We were able to come back alive and brought some light with us in the process.
The audience in the MiCo on May 21 was diverse, including basic researchers, professors and fellows, but the vast majority were clinical endocrinologists. Undoubtedly, we have all come back from SgA* wiser, and more aware of how quickly science may advance when needed. Hopefully, our fellows and students at medical schools during COVID-19 pandemic will also have this valuable lesson deeply rooted: nothing is written in stone, always maintain a scientific mind, keep alert and updated. The only constant in life is change.
During our journey towards and backwards SgA*, we have also learned that many of the diseases we handle as endocrinologists, like diabetes and obesity, confer a higher risk for the patients we treat, in the face of new viral infections, and remembered the importance of listening to their individual stories. And finally, although we had been trained to look beyond what is obvious, to find the broken piece and fix it, we generally used to apply this skill in our patients but not in ourselves. Now we know that, as human beings, we need to take care of ourselves too, to expose our wounds so that they can be healed.
So yes, it is possible to come out from a black hole after its gravity plays with us, like stellar material falling inward and pulled toward its doom. Time might be a construct but movement is real. If we crossed the event horizon, or the point of no return, we will disappear from view. But if we get expelled from it, the light will be seen. Let us use it well until we travel again to the heart of another SgA*.
Declaration of interest
The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of this letter.
This work did not receive any specific grant from any funding agency in the public, commercial, or not-for-profit sector.