How significant was Theodor Kocher for the Inselspital during his lifetime, and how important is he today?
The former of Head of the Inselspital, Fritz Leu – himself an outstanding visionary figure and a great asset to the hospital – explored precisely that question in an article published in 1991 in a monograph on Kocher edited by Urs Boschung. That article explains that Theodor Kocher was a prominent promoter of the new University Hospital building in Kreuzmatte (where it still stands today), investing his own funds and raising donations in a campaign organised primarily by his spouse Marie (nee Witschi), and exerting his influence as Rector of the University of Bern. To get his own impression of modern hospital architecture, Kocher travelled halfway across Europe to inspect around a dozen examples in the company of the architect Schneider. Conditions at the old university hospital in the grounds of what is now the Federal Ministery of Interior were intolerable for both patients and staff in terms of infrastructure, space and sanitary facilities. Politicians had long debated how best to deal with the situation. The cheapest option for a new building had been costed at around 2.1 million francs, and this was seen as not politically feasible. Through various financial arrangements, sales of land and a number of other measures in which Kocher was actively involved, a package of 700,000 francs was finally put together and passed with a large majority by both the Grand Council and the voting population in November 1880. To me, there are two significant points here for later generations and for the collective identity of the Inselspital. Firstly, the Inselspital, founded with money bequeathed by wealthy widow Anna Seiler in 1354, was originally established as a hospital for the needy to provide beds "for thirteen bedridden persons, cared for by three honourable persons" and retained this status as a hospital for the poor for some time, even when it moved to Kreuzmatte, where 320 beds were available. Wealthy patients were treated elsewhere, including by Theodor Kocher himself, who had built his own private hospital – operations were even known to have been carried out in the dining room of a fine hotel. The transformation into the University Hospital did not happen until later, although Kocher increasingly used the new building de facto as a university hospital for teaching and research. Secondly, even during Kocher's time, there was a debate on the relationship between healthcare service provision, teaching and research. The statutes of 1898 give prominent mention to the facility for the poor, whose main purpose is treating needy patients. The "facility for the education of doctors in training" is only of secondary importance.

Kocher was without a doubt also key as a scientist, physician and rector in shaping the University Hospital, and he also engaged in philanthropic work. Take for example the 200,000 francs that he donated to science for "research into human processes in the broadest sense" ("Erforschung der Lebensvorgänge im weitesten Sinne") – which according to Tröhler's research correspond to the prize money for the Nobel Prize at the krona to Swiss franc exchange rate at the time. This money was later to lead to the establishment of the Theodor Kocher Institute, and also funds the annual Theodor Kocher Prize.

How did surgery at the University of Bern and Bern University Hospital continue to develop?
The former surgical department in the new University Hospital in Kreuzmatte opened in 1884 was in Haller-Haus, a separate complex built in the pavilion style. Kocher practised what is from today's perspective a huge range of surgical procedures, and brought significant innovations to everyday clinical work in all fields of practice of the time. Here is just a brief selection as an illustration: in limb surgery, he developed new procedures for treating fractured hips, and new methods for reducing dislocated shoulders. In gastrointestinal tract and endocrine surgery, he demonstrated his brilliance with optimised concepts for thyroid operations and new procedures for mobilising the duodenum in stomach operations, improved the technique for tumour operations in the lesser pelvis and conducted tissue transplant experiments. In neurosurgery, he explored the problem of intracranial pressure and searched for solutions – with the help of a young American surgeon, Harvey Cushing, who was there on an extended visit. He is nowadays considered one of the fathers of modern neurosurgery. The ear, nose and throat and the eye department already operated separately from surgery in Kocher's day. The further division of surgery into the many organ-specific specialities that we are familiar with today came much later, and was a gradual process. In 1963, Maurice Müller became Professor of Orthopaedics, and with the retirement of Karl Lenggenhager, who was Professor of Surgery at the University of Bern from 1942 until 1971, greater specialisation was also reflected in the top University staff. Lenggenhager's successor, Rudolf Berchtold, was a GI tract and endocrine specialist in the modern sense of the terms; Ernst Zingg became Professor of Urology and Ulrich Althaus Professor of Heart Surgery, to name just a few examples. Even within the field of GI tract and endocrine surgery, specialisation in individual organs has increased. In my department alone, there are now eight "organ" teams who carry out the most complex surgical procedures on and engage in their own research into the thyroid, pancreas, the liver, the rectum et cetera. With the recent appointment of Guido Beldi as Professor of Hepatobiliary Surgery and Vanessa Banz as Head of Transplant Surgery, the next generation is now also ready to approach the challenges of the future. 

What is the current status of medical and medical technology development in Bern? Is the Bern success story continuing?
Success is defined in terms of the competition and depends not just on individual creativity and excellence, but also – as in Kocher's time too – on location factors. If we study the political environment of the time through quotes and records, we can see that the same issues were dominating discussions then as are now. Kocher was a medical and scientific figure with strong ties to Bernese society; a figure whom administrators and politicians could only treat with respect even when his views appeared absolute and sometimes inconvenient. He was certainly not afraid to rock the boat, unlike certain business-minded hospital managers' ideal chief medical staff today. Kocher brought together an effective combination of creativity, hard work and strong local ties – and these last were perhaps more important in traditional Bern than in cities with greater industrial migration. That combination was a model for success, and laid strong foundations for Bern's lasting renown in the field of medicine.  Kocher was instrumental in creating lasting structures that have also helped later generations succeed – Hans Goldmann in ophthalmology, Maurice Müller in orthopaedics, Fritz de Quervain and Leslie Blumgart in GI tract and endocrine surgery, Ewald Weibel in physiology, Marco Mumenthaler in neurology and Urs Studer in urology, Bernhard Meier in cardiology are just a few figures from Bern's medical faculty who have become world-famous and in turn made significant contributions to Bern's development and links as a center of medicine. 

What do you see as the strengths of and future challenges for medicine in Bern?
Firstly, I firmly believe that one day, on the occasion of a future anniversary and another look back at the faculty's history, we will also be listing the names of female colleagues. Today the current staff at the faculty is welcoming more and more brilliant female doctors and scientists. I have only named a few previous members of staff here. They are simply a representative sample of the many who have contributed to Bern's success in medicine and continue to do so today with energy and commitment day after day. It would, however, be presumptuous to judge the achievements of the current generation. Instead, let me just highlight a few facts: we are on the way to becoming Switzerland's largest medical faculty, and the Inselspital leads the field in many areas, in particular in highly specialised medicine. What is more, the partnership between the University hospital and several district general hospitals is unique in Switzerland and offers opportunities that we will hopefully be able to harness in the future also for academic purposes. It seems to me that the tide has also turned at a political level in favour of strengthening Bern as a center of medicine. Yet political will, sharp brains and a large student intake in medicine are not enough on their own. In this complex environment, we also need greater coordination between the different players in academic medicine – and in addition to current research initiatives (such as ARTORG and sitem-insel), we need more, broad structural projects to further diversify Bern as a center of medicine. Computing at the interface between biology and medicine (big data), digital image processing and smart medical communication systems are just some examples of where we should be investing more in future. In Kocher's era, one leading figure could influence an entire system. In these times of globalised and digitalised cooperations, structural issues, flexibility and investment in the fields of the future are the major overarching challenges. We must also consider the speed at which changes are taking hold and turning entire fields of medicine upside down.