The first decade – 1982 – 1992
It was 1948 when a Croat, Mateus Mudrovitsch, and his German wife, Bertha Weinske, built the house at Rua Padre Anchieta, 155, in Curitiba, Brasil. The grandson, Paulo Rogério Mudrovitsch de Bittencourt and his colleague Paulo Roberto Miranda Sandoval, upon arriving from their post-graduations respectively in São Paulo and London, opened a small private consulting suite in 1982. Soon other physicians coming back to their home town from various places around the world used the house and its growing structure, to establish themselves. These included Léo Cardon, Ricardo R. Seixas, Ricardo C. R. Moreira, Júlio C. U. Coelho, Paulo R. F. Rossi, Ruth Graf, Antônio J. S. Dourado. Then came neurologists Ana Marlene Gorz and Ana Cristina Gabardo, physicial therapist Lucymara Silva, in what was called the Centro de Diagnóstico de Curitiba S/C Ltda.
Soon other clinics were set up: Centro-Dia Clínica de Recuperação, Centro de Reabilitação de Curitiba, Unidade de Fisioterapia, Unidade de Psicologia, and finally Unidade de Neurologia Clínica, which was to last. In 1985 the unit was accredited as a Residency in Neurology, and neuropsychological evaluations were started with Mônica Bigarella, Maribel P. Doro and Maria Joana Mader at Hospital Nossa Senhora das Graças, where a small EEG lab was opened in 1987. In 1988 there was a first structural rennovation of the house, when Bittencourt was there with Cleverson M. Garcia, Thereza C. Winckler, Pedro A. Kowacs, Ricardo and Alaídes R. Seixas.
The second decade – 1992 – 2002
The group dissolved and Bittencourt was joined by Paulo J. M. Leite, Marcos C. Sandmann, Milton M. de Bittencourt Jr., Edson R. Piana and Eduardo Hümmelgen. At the same time Unidade de Neurologia Clínica sold its participation in all the previous clinics and concentrated on the neurological sciences. In 1994/95 there was a major expansion into digital clinical neurophysiology, and the first Sleep Lab in Paraná was set up. The extensive library acquired digital support. Speech therapist Rosana Lenzi and psychologist Eliane M. Ferraz began to run neuropsychological evaluations at the clinic, by then fully registered as a clinic, rather than private consulting rooms. By 2001 a practical and modern clinic was installed. At this time we could carry up to 10 simultaneous procedures, and communicate through 7 phone lines.
The 21st century
The constant change in the processes of the health sector with the introduction of new techniques of diagnosis and therapy, often at DIMPNA before anywhere else in the country, or in the continent, more than 250 formal scientific publications, 350 participations in international neurological events, the active participation in more than 50 major scientific events, became a greater challenge as time went on. The chronic financial crisis of the large, state or religious-funded medical institutions that held most training and research in Brasil, became acute at the turn of the century, and hit Unidade de Neurologia Clínica in full force. Many of these hospitals, including Hospital Nossa Senhora das Graças, where we were based, had to downgrade and concentrate on profitable activities, which, in Brazilian Medicine, means procedure-related, related to intensive care and surgery. Unidade de Neurologia Clínica, like many specialties, had to move into smaller installations, designed for their own purposes. Public health care, called SUS in Brasil, has continuously deteriorated, and pricate care has been painfully replaced by medical insurance, paid by private institutions, private citizens, and by a growing involvement of the judicial system in the case of the more complex, expensive cases that fall out of the capacity of the former.
In our case, there was a relatively surprising development. UNINEURO, as we were known, already established at the Padre Anchieta clinic, having already moved out of Hospital Nossa Senhora das Graças, became involved in the international stem cell discussion on the 2003-2008 years, due to a publication in Acta Neurologica Scandinavica in which we reported a case that had recovered from a well established case of chronic paraparesis after she received a high dose of cyclophsphamide, and received treatment that helped her bone marrow recover through the production of stem cells. This had taken place in 1997. The case was published in 2005. Lesions had disappeared from her MRI. She is still very well and in full remission in 2015. Drs Valdir Furtado and Monica Pereira were our partners in this case. Other cases wre published in Multiple Sclerosis.
Overnight we were involved in the stem cell phenomenon internationally, even though we had only used high doses of cyclophosphamide. This brought structural, functional, conceptual, legal and ethical consequences. We needed more specialized licences from the sanitary and even from the fire and garbage departments, to develop a restaurant and all kinds of details, to rapidly become a small hospital. Again, without the help of the hospital where we had developed all the technologies for more than 2 decades. For a while, we used the installations of Hospital Santa Cruz, and had a lot of help from Dr Rodrigo Rigo, Clinical Oncologist, our partner in some of the publications. By 2012 the clinic was established as a small hospital in a very central but at the same time quiet region of the city, with extremely fast access to one residency hotel that has accomodations for people with the psychiatric and neurologic problems we cater for, as well as other accomodations, 3 major hospitals, many diagnostic clinics, and neighbouring supermarket, pharmacy, even a street fair, all within minutes of the clinic by walking or driving distance, in one of the safest regions of the city.
There were 2 anniversaries in 2012: 60 years medical graduation of Paulo Orlando Mader de Bittencourt, deceased in 1975, and 30 years of medical practice in Curitiba, at the same clinic and hospitals, of Paulo Rogério Mudrovitsch de Bittencourt. At this time, we changed the name of the clinic to DIMPNA, established our capacity to offer care, attention, mobility and comfort to those who look for us, those who are the object of the attention of Saint Dymphna, those with paralysis, madness, epilepsy. Following the natural history of the clinic, it has become more and more a copy of the little hospital Paulo Orlando had in Ourizona in the 1950s, ando of the Medical Unit of the Chalfont Centre for Epilepsy, outside London, UK, where I, Paulo Rogério, worked as a Medical Registrar, during the years between 1978 and 1981. Already in Curitiba, I made a first attempt at setting up a clinic like this, called Centro-Dia, in the 1980s, the experience of which is incorporated in DIMPNA.
DIMPNA is a polyclinic, a clinic with the capacity to house for short periods people with difficulties in mobility, who need to undergo diagnostic and and therapeutic procedures in the área of the nervous system, or medical problems that fall in our área of expertise. People that have our trust, and that are sure we will refer them to people that will treat them just like we treat them.