Professional development
I have had the wish to be a
doctor since I can remember.
I was lucky to have the possibility of being in contact with the practice
of medicine before entering the university, since there were other doctors
in my family.
They let me observe a surgery in the operation room…or I would accompany
my oldest cousin, who was “the” doctor, to see the patients in their homes…sometimes,
sitting next to him, I would listen and observe how he assisted
outpatients at the hospital clinic. It’s worth mentioning that all this
took place in a small town in Buenos Aires province and I was an
adolescent. Therefore, when I started the university I knew quite clearly
what I wanted to do. I have always enjoyed listening in order to get to
know that person in front of me, who suffered most of the times.
The contact with the morgue and corpses I had when I was 17, at the
beginning of my studies, was so dissociated from death itself that barely
impressed me.
I really enjoyed the first years at the university.
I found it really exciting to discover the wonders of the corporal
behaviour throughout physiology and physiopathology later on.
I remember the first time when in the pathologic anatomy course, Dr.
Rapaport let me see through an electronic microscope a cell’s structure.
That was really marvellous and made me think that if all this existed
beyond the human eye, there was for sure something beyond our conscious.
That’s how I got the intuition that the unconscious could also exist.
In the fourth year of the career, we started working in emergency rooms
and on the medicine floor for the first time. The contact with patients
was not as would appear from the books. I still remember the first
feelings I had next to the patient’s bed, such as the encounter with his
anguished look, beyond his physical discomfort.
In those days, some classmates at the university asked me to form a group.
At first, the purpose of the group was not very clear. The only thing we
knew was that something happened to us when in contact with patients. The
group was driven by Marie Langer, a veteran Austrian psychoanalyst who was
also a doctor and came from the surgery field. She would listen to us and
help us unravel what was happening and how our own emotions mixed with our
narrations. Therefore, I learned to accept first and to admit then, that
doctors are emotionally touched by patients and this generates feelings
that either consciously or unconsciously play a role in the relationship
doctor-patient. Later on, I learned this was called counter-transference.
The group lasted until the end of the career, period in which due to the
military coup in Argentina, Marie Langer had to suddenly exile in México.
I still remember her abrupt goodbye, asking us to take care of ourselves
because difficult times were coming. She had gone through the two World
Wars…so she knew what the persecution was like.
When I got my medical degree, I got into the Italian Hospital of Buenos
Aires as a fellow in gynecology. That experience allowed me to learn the
clinic surgical approach to the female body. But of course…I heard the
woman beyond her bleeding uterus or her mammary dysplasia. I heard “more
than what just the operation required”, as my teachers used to tell me. I
had neither theoretical nor formative tools by that time. But I knew how
to discover that there was something deeper in the narration of that
patient. I knew that the anguish behind the corporal symptom wouldn’t calm
down after the hysterectomy, for example, if this was the case.
Discovering psychosomatic medicine was a big help for me. It allowed me to
support academically that there was something beyond the body and the
sight.
The “psy” world started to amaze me.
Years were passing by in the CIMP of Buenos Aires
I reckon that the study of Freud’s work has unquestionably captured me.
For quite a long time I moved away from the clinic medicine and the
gynecology. I was connected to the “psy” world and the work with patients
into this discipline, which I found fascinating.
Psychoanalysis is still my first choice as a therapeutic tool. Although
along the years I got to know other therapeutic dynamics, I consider that
they remain at an imaginary level which, in the best of the cases, can
improve the patients’ situation but not heal in depth.
Nothing heals everything, naturally, but I still find it touching the
change of subjective state a person can experiment through psychoanalysis.
The years of formation and work as a psychoanalyst have undoubtedly given
me a lot of pleasure until these days.
The experience I acquired in Clínicas hospital of Buenos Aires allowed me
to deepen into the medical psychology and the relationship doctor-patient.
My experience in the medical psychosomatic service in San Pablo hospital
of Barcelona was also very useful. However, after some time of listening
“without touching” I started to feel that something was missing again in
my condition as a doctor.
I have always been between the world of the white coat and the analyst
armchair.
I was already living in Barcelona when I discovered the homeopathic
medicine. First as a patient… and it was fantastic.
The first thing I liked was the interview with the doctor: how he listened
to me, the things he asked me, the feedback he gave me before he
prescribed the medicine, etc. And the second thing was that those white
little balls which were a mystery for me could not only solve a problem
which I thought could only be cured with antibiotics, but also make it
disappear for good.
I didn’t dare to discover what homeopathy was about through its study,
until many years later.
I had to defeat two prejudices: first the psychoanalytic one which led me
to reduce the topic to transference and suggestion. And then, I had to
start questioning my own medical thinking system which was, despite its
cracks, what had upheld my ideas since the university.
Homeopathic medicine let me observe the body, the health and the illness
from a different perspective.
In the first place, I liked the respect for the body and its defensive
mechanisms to cure illnesses. Official and technological medicine, however,
has attributed itself the knowledge and the power to heal, being this
quite arrogant.
I also liked the fact that even if the patient suffers from any illness
such as a stomach ache or a glandular disease, the doctor lays emphasis on
the symptoms or the mental characteristics, and the questions are based on
them as well as the follow-up work. This allowed me mainly to listen. That
is to say, to listen with the white coat on and to discover that my
teachers saying “I heard more than what just the operation required” didn’t
fit anymore.
Emotions such as resentment, hatred, badly-assimilated pains, insecurity
and constant dissatisfaction distort the vital functions in the long run,
eventually manifesting themselves in physical illnesses, which is the way
to make emotional suffering more tolerable.
The starting point of any curative change is the confidence in the
existence of another way of life. Without that confidence, all the body
mechanisms necessary to cure don’t set themselves in action. This process
requires (as in psychoanalysis) the patient’s commitment.
In every illness, the person is involved as a whole together with her
background and her present. When the patient comes back and expresses that
she “feels emotionally better” it is when the curative process has started
its way. Homeopathic medicine relieves the psycho-emotional symptoms first
and the physical ones later on.
Discovering homeopathy has been like rescuing an old wish, a role, a way
of doing clinical work which had remained in the background as an illusion
until now since I didn’t know how to link and channel therapeutically,
from the medical point of view (and not through psychoanalysis), what I
heard from the patient.
Nowadays, my first encounter with the patient is under the framework of a
homeopathic interview. By listening, their needs and reasons for coming
become clear.
Many times a gynecologic consultation with the physical examination and
complementary studies are enough.
Some other times a homeopathic treatment is carried out along different
encounters to control the evolution of the illness, which can be either
gynecological or any other physical or emotional pain.
But on some occasions, during the first interviews or in follow-up ones,
the symptom causing the suffering which makes the patient wonder, appears
or is exposed even after a subjective improvement. This is the stage in
which listening to the unconscious will let us move forward to reveal
meanings. That is to say, following the psychoanalytic path if this is the
patient’s wish.
With this narration I try to express as faithfully as possible my
experiences along my professional life, which justify my current position….
Today I thank for all the times I have questioned myself what I was doing.
I also thank the teachers who have showed me the way to constant search,
and my classmates…today colleagues or friends, who have accompanied me
along this way and who, due to destiny or love, are still my most valid
interlocutors.
And to the patients…all of them, who somehow keep making me feel
enthusiastic day after day.