“Medicine is a state of opinion, what is right today is wrong another day”

Is there little empathy in the consultations?

The problem is that people sometimes dedicate themselves to a job for which they are not prepared or do not like it. I have seen everything, even a bad example. The “I don’t get paid for this” is never a good example. You have to attend to people come as they come, with or without an appointment.

Is that deep calling being lost in a profession like this? Are there doctors who do not have it?

Many. The problem is the base and if you don’t have it, what are you doing there? Most of the time it is due to great insecurity, they do not have confidence in themselves.

What difference is there between the insecurity of current doctors and that of doctors 50 years ago?

It is the same but those doctors had more prestige and were subject to less demands from patients. But the patient never has to overwhelm you, this is an interpersonal relationship, a give and take. If you’re nice to them, they’ll be nice to you. It happens as with teachers and high school students. And in the end, you burn.

Where is the solution?

In oneself. I have had countless patients, I was the one who put in the most hours of consultations. I never had a problem with my colleagues or with the patients. Neither medicate nor low stress. One rules.

The doctor is supposed to be cold-blooded and temperate, but he is a person…

Sure, but you have to make yourself, because one is made.

The profession has been democratized, from being a family trade to being available to everyone… a boom.

And that’s fine, but we find ourselves in a dilemma: one thing is to study everything well and get the degree with the best grades and then apply it. Just like the legal profession. A doctor is much more than a technician. We are what we do every day and it has to do with dedication. I am not in favor of lifetime positions, no one would have to be in Social Security with a fixed position.

I find you very critical…

I have seen a lot. At a certain age you work in a hospital and you are free of guards and then the young people arrive. Who can know more than those with extensive experience? But they are not. Let the young people work. I have never had a problem with my superiors and that I have diverged a lot. When it was necessary to prescribe generics, if they were worth the same, I would prescribe the brand, they inspire me more confidence.

At least the evolution of technology has helped…

But advances in medicine are made by those who are not doctors, that is, chemists, engineers… Pasteur was not a doctor and there is competition with medicine, but now there is a lot of tendency towards machinery and little towards skills.

Especially to address the hypochondriacs, the squeamish…

There are more diseases and therefore there are more fears. And one thing is the person who invents diseases and another is the person who is well and as soon as he has something unbalanced. The latter is not a hypochondriac, who is the one who repeats himself “I have this”.

do we have to look at Google?

I am absolutely in favor of consulting on the internet even for those outside of medicine. What makes us more anxious always depends on who is looking at the screen, how you handle it. If a patient shows me a stain, I consult the internet with them. They tell me, “this is what I have”. And reinforces the diagnosis.

And shouldn’t it be the other way around? Does the doctor reinforce or not what we have seen on the internet?

If the computer reinforces what the doctor tells you, it means that the professional is right.

After the covid, are we a more fearful, scrupulous, apprehensive society?

I think not because we do everything. We have become used to the threat. To change you have to do something different and we are already trained. It is the grace of the protocols, to do the right thing, you always have to have a good habit to follow it. If we always do the same, it is an intelligent practice because it saves energy. If you train yourself to react in a certain way, you will end up doing it.

Also applicable to medical professionals when dealing with illness or death. Are they made of a different material?

There are also apprehensive professionals and that is impossible to handle. And it must be hell. Our profession has a very high rate of suicides, drug addicts or alcoholics. It is because they encounter situations that they do not know how to face and are not prepared to face them. It is not about doing a job for many years, it is necessary to do many things. With 30 years in a profession you can have more experience than one in 50.

So, is resilience in doctors a myth?

Yes, it is a myth. We are just as human as everyone else.

What will be the diseases of the 21st century?

Obviously cancer due to the prolongation of life and because the diseases of the past are not decisively fatal. Then there are factors such as risk, we agree but nobody knows how to assess it…

And mental health? It’s in the top ten?

Anxiety we all have and it is not bad. Without it you wouldn’t pass an exam, but a lot of it annuls you. Of course also the degenerative ones of the nervous system.

We will arrive with strong hearts that keep our framework alive and our memory lost. Will we be dependent beings with good physical health?

Taking care of ourselves is going well but we don’t know to what extent it influences, there is also genetics. There are things that can be corrected, smoking, sedentary lifestyle, blood pressure, diabetes… but there are factors inherent to the person, age of course, sex and genetics, which can greatly influence.

Does that explain why Carrillo died at the age of 97 without putting down the cigarette?

Or Churchill, fat and drunk like a Cossack who died of old age. There is something. It may be because of that or the opposite.

Are we obsessed with lasting? With death? If the important thing is to live!

But it is something elementary. A 20-year-old boy jumps from one balcony to another or rides a motorcycle without thinking about death, here and in Bangladesh, it is a contempt for life. It just so happens that he doesn’t die but he reaches 85, he’s in a wheelchair and he doesn’t want to die even by beatings. And he is the same person, but he sticks to life. When you get old you always say: “a little more”. And in medicine there is still much to discover.

How much?

It is that the more we see the less we know. We do more specialties, subspecialties. We have everything. A general practitioner knows a little about everything, a specialist knows a lot about little, and a superspecialist is a doctor who knows everything about nothing.

Do we care a lot about the neck down and little about the neck up?

And who tells you that someone doesn’t go to the doctor every day because of the neck up? Before there was the priest or friends, the doctor often performs that function.

But psychology professionals are necessary…

Well, it depends on the professional. You find people who tell you “I’m perfect” after being in seven or eight psychologists. And he tells you that the last one is fine. When you ask him what the last psychologist told him, he tells you: “the same as the others but… how did he tell me!” Once again, the important thing is communication and there are specialties that not only require that there be something more, but also what is not there, which are the barriers.

And now there is email. Are you hooked?

I answer every day even if I’m not in the office and I’m on vacation. So they think they bother, why? When I’m away I never say where I am unless they tell me that they are going to show up at the consultation. But then they won’t find me.

In any case, it is positive that these channels are opened with the patient. Does it reinforce trust?

I am, how could it be otherwise, a supporter of face-to-face consultation, but also a firm defender of email because it is written down and thus you avoid confusion or misunderstandings. If you understand yourself, you trust.

A great achievement of health policies was the anti-smoking law. Who was going to tell us 20 years ago?

But as long as tobacco exists, it should not be sold. Sale prohibited. That they put the taxes from another place because the expense in the end goes to the hospitals.

But there was a time when doctors smoked and even received you smoking in the consultation….

I have never smoked, but it is true, there were consultations in which you could not see the amount of smoke, the ashtray full of cigarette butts and listening with the cigarette in your mouth! If we have seen everything.

What do we do with alcohol?

A glass of wine is stimulating and creates well-being. I don’t go into bars but every day I have my drink. Ban alcohol? I have my doubts. Drinking alcohol can be done by anyone, even at home.

There are defenders of alcohol 0,…

Medicine is a state of opinion, what is right today is wrong another day. From the posture of babies, to the consumption of eggs, oily fish or daily orange juice. This is for fashion. The dose is the poison, there is nothing that is not deadly, not even tap water.

STAFF

Name: Santiago Otaduy Bengoa.

Birth: July 25, 1947 (Arrasate-Mondragón).

Trajectory: After finishing high school at the Escuelas Pías school in Bilbao, he entered the Medicine career at the University of Salamanca. After military service, he specialized in Internal Medicine at the Basurto Hospital. He has practiced medicine for 50 years, in the Social Security Emergency Service or as a company doctor at the Lemóniz nuclear power plant, within the Ibemo company for six years and until its closure. Until his retirement in 2013, he was a primary care physician practicing in his practice for three decades since 1983.

If you want to ask Dr. Otaduy a question, write an email to [email protected]. All responses will be posted on the websites from the newspapers of News Group.