INTRODUCTION

Dear Pathologist Colleague,

On mid May, 2004, the five of us were fortunate enough to participate in the most original, successful and enjoyable pathology meeting any of us had ever attended. It was a pathological pilgrimage that took place not in a single location but along a sacred route, the Camino de Santiago.

The Camino de Santiago – the way to St. James - is the ancient pilgrims’ route to Santiago de Compostela, in Northwest Spain. James Michener, in his book Iberia, describes it as “one of the two or three finest journeys in the world, a two-fold pilgrimage to a long-dead form of art and to a living religious shrine.” During the Middle Ages there were three locations upon which the imagery of the Christian Church depended: Jerusalem, Rome, and Santiago. Those who went to Jerusalem were called palmers and those who went to Rome were romeros, but only those who went to Compostela were entitled to be called pilgrims. The pilgrimage to Santiago began around 900 AD. In medieval times about half-million pilgrims moved along the road each year, despite Erasmus of Rotterdam’s warning that “one has to be crazy to go to Santiago”. They were helped by the first tourist guide ever produced in Europe, the Codex Calixtinus, written by Aimery Picard, a cleric from Poitou, in the 12th Century. Some of those pilgrims were Charlemagne (778 AD), King Alfonso II of Spain (813 AD), El Cid Campeador (1064 AD), King Louis VII of France (1154 AD), St. Francis of Assisi (1214 AD) (“taking quite a few monks along”), King James III of Scotland and England (1719 AD), and – in more recent times – Pope John XXIII, Pope John Paul II, and Shirley McLaine (strange bedfellows). Goethe went as far as stating that the spirit of Europe developed along the way of this pilgrimage. In 1987 the European Council declared the Camino de Santiago the “first European cultural itinerary”. At present, there are about 70,000 people taking the pilgrimage each year, with the number almost doubling on Holy years, which 2010 happens to be.

According to Michener, during the middle ages the pilgrims were divided into seven fairly well distinct groups. First were the devout Christian laymen; second were knights; third were monks, priests, and even a few cardinals; fourth were criminals who had been told by their judges “Five years in jail or a pilgrimage to the tomb of St. James, whichever”; fifth were beggars, forgers, thieves, robbers and other unsavory characters; sixth were merchants, architects, itinerant painters, and weavers; and seventh were Spanish government agents and French clerics keeping a watch on this unquiet land. To this we added in 2004 an eighth group, that of pathologists, and buoyed by the success of the enterprise we will do it again in 2010.

For our previous pilgrimage, we chose El Camino Francés (the French route), the best known of the ten or so routes leading to Santiago. This time we will be taking the second most spectacular and popular route, i.e., El Camino Portugués (the Portuguese route), which started in the high medieval period and intensified following Portugal’s independence in the mid 12th Century. It has the special distinction of being the route most intimately connected with the life, ministry, death and burial of St. James. The route follows the Atlantic coast of Portugal and Spain through stunning and unspoiled countryside. It starts in the medieval heart of Porto in northwest Portugal and continues northwards, crossing the rivers Lima and Minho, where it enters Spain. Still heading North, it crosses the river Ulla at Padrón before arriving to Santiago. The total distance is about 241 Km (150 miles), divided into 126 Km (78 miles) for the Portuguese portion and 115 Km (72 miles) for the Spanish portion.

Day 1 will be the arrival day to Porto for most of the participants, with check-in at the Tiara Park Atlantic Porto Hotel.

On Day 2, participants will attend lectures during the day and the Opening lecture by Dr. Manuel Sobrinho-Simões, a private concert, and a welcoming dinner at the Casa da Música of Porto in the evening.

Starting on Day 3, the Course schedule will consist in alternating days of travel and lecturing. The travel days will be composed of 3 walks about 12 Km/7.4 miles long each, combined with approximately 205 Km/127 miles on bus. The walking stretches have been selected in each instance by taking into account their attractiveness and ease. The motorized portion of the trip will take place on luxury buses rented for the exclusive use of the participants for the entire duration of the Course. In addition, a small van will be on-call to assist Course participants during the walking stretches if needed. Additional facilities will include medical emergency services, local guides, and a photographer who will document on pictures and videos the progress along the route.

Each of the lecture days will take place in the Auditorium of a local institution of a different city (Porto, Viana de Castelo, Baiona and Santiago) under the auspices of a local host pathologist. There will be 7 lectures in the morning (with a coffee break between the third and the fourth) and 6 lectures in the afternoon. The last lecture of the day will end at 5.30 P.M., thus giving the Course participants about 3 hours to visit that particular city with the help of the tour guide or on their own.

During Day 3 (the first walking day) we will tour Porto in the morning and walk from Ponte de Lima to Labruja along the Route Braga-Ponte de Lima-Valença (12 Km/7.4 miles) in the afternoon. This was the way followed by St. Francis of Assisi, the first Portuguese kings, and Queen Santa Isabel in 1325.

During Day 5 (the second walking day) we will go from Âncora to Caminha (at the mouth of the Minho river) following the Porto-Viana do Castelo-Caminha-Valença-Tui route (12 Km/7.4 miles). This route, known as the “maritime way”, was taken by several kings and queens during the 18th and 19th centuries, including King D. Manuel the 1st in 1502. We will cross the Minho river in the city of Caminha using the ferry boat at the end of the Rua Direita (Straight street). On the other side of the river is A Guarda, a quaint harbour village featuring the Jesuit monastery where Manuel Oliveira, the legendary 100-year-old Portuguese film maker, studied as a teenager. A Guarda is located at the feet of the Santa Tecla mountain, a perfectly conical hill, where we will have lunch. At Santa Tecla there is a very interesting Citania (the remains of a fortified dwelling from the Second Iron age) and an Archeological Museum. The accompanying persons will visit Valença and Tui during the lectures’ day in Baiona.

Day 7 (the last walking day) will be the Spanish (Galician) portion of the trip. For this, we will be walking from San Martino to Santiago, following the route along Pontevedra and Padrón, where the corpse of the Saint is said to have been brought by boat.

The interesting sights along the Way are plentiful. A chapel we will visit near Ponte de Lima was the site of a “pious robbery” by the Archbishop of Santiago at the beginning of the XII century. He took the best pieces of the Chapel and brought them to Santiago. Perhaps as a divine compensation, this chapel was enriched in medieval times by the presence of St. Abadao, an Italian Saint who was returning from Santiago and decided to settle there. During his pilgrimage to Santiago, St. Francis of Assisi visited this chapel, since he took the same route we will be following on our first walking day. D. Manuel the 1st, King of Portugal, took in 1502 the same way along the sea we will be following on the second walking day. He went to Santiago to thank the Saint for the discovery of India (1498) and Brazil (1500) by the Portuguese explorers, and donated funds to build the Hostal dos Reyes Catolicos. We will stay for two days in Viana do Castelo. In that city, D. Manuel restored the Fortress of Santiago, which will be the place for the lectures and buffet lunch. In Viana, he provided financial support for the refurbishing of the Hostal of Pilgrims, originally built in 1468 and today known as the old Hospital (Hospital Velho). Along the coast we will pass the Chapel of Saint Isidoro, where St. James is said to have performed several miraculous cures.

References

Course directors

Juan Rosai, M.D.
International Center for Pathology Consulations
Centro Diagnóstico Italiano (C.D.I.)
Milan, ITALY

Genzyme Genetics
New York, NY, USA

Jerónimo Forteza-Vila, M.D.
Department of Pathology
Hospital Clínico Universitario
Santiago de Compostela, SPAIN

Manuel Sobrinho-Simões M.D.
Department of Pathology
Medical Faculty & IPATIMUP
Porto, PORTUGAL

Associate Course directors

Fátima Carneiro M.D.
Department of Pathology
Medical Faculty & IPATIMUP
Porto, PORTUGAL

José Cameselle-Teijeiro M.D.
Department of Pathology
Hospital Clínico Universitario
Santiago de Compostela, SPAIN

Supporting organizations

  • Sociedad Española de Patología
  • Sociedade Portuguesa de Patología
  • European Society of Pathology
  • Facultad de Medicina de Santiago de Compostela
  • Universidade de Santiago de Compostela
  • Universidade de Porto
  • Consellería de Sanidad - SERGAS
  • IDICHUS
  • S.A. de Xestión do Plan Xacobeo
  • Xunta de Galicia
  • Centro diagnóstico Italiano CDI

Faculty

  • Ferrán Algaba, M.D.
  • José Cameselle-Teijeiro, M.D.
  • Fátima Carneiro, M.D.
  • Paula Chaves, M.D.
  • Howard Dorfman, M.D.
  • Jonathan Epstein, M.D.
  • Fabio Facchetti, M.D.
  • Jerónimo Forteza-Vila, M.D.
  • Robert Kurman, M.D.
  • Gregory Lauwers, M.D.
  • María Merino, M.D.
  • Elizabeth Montgomery, M.D.
  • José Luis Rodríguez-Peralto, M.D.
  • Juan Rosai, M.D.
  • Fernando Schmitt, M.D.
  • Stuart Schnitt, M.D.
  • Manuel Sobrinho-Simões, M.D.
  • Fattaneh Tavassoli, M.D.
  • Robert Young, M.D.
Supporting Organizations