Mini Review
Austin Med Sci. 2016; 1(2): 1010.
The Current Medical Practice: The Case of a Medical Act of Kidnapped
Donovan Casas Patino* and Alejandra Rodriguez Torres
Departament Sociology Health, Universidad Autonoma del Estado de México-Centro Universitario Amecameca, Mexico
*Corresponding author: Donovan Casas Patino, Department Sociology Health, Universidad Autonoma del Estado de México-Centro Universitario Amecameca, Mexico
Received: August 03, 2016; Accepted: September 02, 2016; Published: September 07, 2016
Abstract
Submit reflection, it is part of a time when medical act and the medical practice, which is exercised in a corner of contemporary Mexico, where the approach to medical science invites oblivion patient, dogamticas structures domesticate the medical act coast the neglect of this science, here is a moment of reflection for the few who dare to look oblivion of our profession.
Keywords: Medical practice; Medical act; Medical ethics
Introduction
Unhappiness occupies my mind, my mind occupies the time, time occupied my life, life occupies fate, fate succumbed my past. Where past used to smile and ruled with pleasure, pleasure that was neglected, in the tragic moment of my absence. The absence that was stolen, stolen for losing with the fate. That fate that collapsed my mind, where unhappiness lighted my way up.
That slow and occupied way, where my mind is occupied, contorting my own truth, a while ago, my mind has abandoned me. In the eternal time it became entangled, in order to remain orbiting. In the weakening of my being, in this infinite space, my mind travelled, moved, transmuted, into a space lacking of end in this way, my mind succumbed, into endless memories of my past, where unhappiness lulled my being.
Reflection and work in medical practice
This reflection of health is located in México, but who can claim that this reality doesn’t perpetuate in another beautiful place of the world? The medical act is the same in a repetitive precept of acting, thus the identical trace of acting is presented incessantly, where the greed of mortifications moves you to a consciousness of the endure of fellows, I mean –patient-, such as emotions, memories and changes originate a provisional confinement, so that, it is proclaimed the arrival of a sparkle life with a confinement in four walls, which are white and full of infinite propaganda, actions and protocols in respect to health! In this emptiness a profession is revealed. Besides that, this place is completely illuminated in a white perennial trickster. In this way, getting to this infamous place, an
Incomprehensible scientific authoritarianism is proclaimed and rigid in its act. At this point, the most important thing is to understand how pain and discomfort are combined between different faces and opposite parts in a body immersed between degradation and suffering, where transmutation of medical act creates a maelstrom of control and submission of the same scientific moment of thinking.
Here, a marginalized act of abandonment prevails without reason. Our own position in a passage of flash has changed over the few years of medical practice. That litmus sensation turned into an opaque color, full of waiting, listening and earthly dismissal. The feeling sometimes makes its presence to get over and over that distrustful relief [I bring to this text distrustful relief like that suffering that can be cured momentarily, but with immediate regression or subsequent to the medical visit] which makes manifest but hidden to the other]. It should be said that people fight against a talent or capacity that a person feels losing or wasting over elapse the time in a medical office. In this way, that talent is being easing between your hands and eyes. That talent which is being forgotten among multiple avatars of a kidnapped medicine by the hegemonic capitalist power bloc [understanding now as a theory of transnational consumption] –according to Marx or Gadamer: “the structure that shapes our social act”. This malevolent Leviathan -structures health services, with guidelines and executors “called by myself Policemen Doctors”- [1-3] This leviathan is outlined and moves between records, prescriptions, halls of clinics or hospitals, bleeding, death, absences and pain, according to the circumstance. This keeps a voracious appetite, so the malicious Leviathan regulates us, standardizes, kidnaps, torments, tortures, submits and steals the best years of the actor -doctor- and patient –suffers-, submitting them to eternal pleasure of consumption of health.
Implicitly and explicitly, to our being, it has gone even shaping our own movements: hands must include kidnapping reflection towards using the keyboard, mouse and printing. Likewise, it is ordered, not by written policy but by infinite act of absences, a minimal gesture that is directed toward the facial muscles, where the ordinance on managerial policy shore health to keep turning towards what indicates concern or discomfort, even disdain to the system that forgets other and dominates the professional, in a final order to transit in a nirvanic state: -imagine sitting in a doctor’s office, where you are the main actor in this play, is dressed in a bright white coat and a suffering patient is delivered to your knowledge waiting for something, which many times will never come, but never loses faith the act itself between the two actors-, mention that to directing the words in the medical discourse, are adjusted. On the one hand, by medical technicalities learned in School, Schools or Hospitals or Scientific or Informal Meetings. On the other hand, institutional policies or managerial medical policies that pontificating through coming national systems from outside the discourse fashion health policy at the time of social development - now called Universality Health, with the slogan: for a country with health for all their citizens, and finally, foolishness learned through the same medical practice forcing forget about the real situation of patients, repeating a stilted speech and dominated by the real situation of health services - no, and that’s not up to me, complain to another person. So, without realizing we fall to empty unheard of these speeches that evoke the act of a medical practice that is running out for the same act of cultural learning of our science fashion. Thus, through the medical discourse are sorted and reported thousands of words intended to convey what is to misinform and shirk in a medical act that forgets its own essence, within a structure in health that kills and maims everywhere (Figure 1) [1-4]. In this place, there are no days that invite the doctor to the reflection of his acting, his passing is volatile with certain skills in conflict management and indifference.
Figure 1: Realities of Health Sector: consultation rejection, indifference and ridicule in the medical act, arrogance with features of social rejection suffering.
In this area there is no longer a space to find differences between a new patient or one ignored, this is no longer allowed, is no longer one option among such a range of processes and lack of inputs. Being into a health system, whatever one may think or build, will end many times for giving the immortal and pernicious to the illness existence, and is not that in the past century is I established this worldview, this has been building for thousands of years. Now the illness has virtues of ephemeral, acute and chronic patient’s life, to which he always throws a last name, scientific name or nickname clinic or hospital proclamation. Now what is folded and concluded is that the illness in its maximum destructive and continuous expression cannot exist in an entity in the eyes of medical science and not suffering from the absence of the Illness. Everything happens between Normality Statistics and the thin line, which is corrupt and sends individuals outside the Normality, forcing them to unprecedented resource of scientific medicine; the prescription. There are many examples: medical treatment for children with hyperactivity, desestresores1 with vitamins for this fleeting world, medicines for controlling overweight and obesity, anxiety, depression or banishment treated with anxiolytics, in the pusuit of perfection of the body, the pursuit of perfection of the body, because of fashion stereotypes, they give plastic surgery, etc. In this way it exists in a nirvanic epic and unequaled state, where hours pass between prescriptions and diagnostic hypotheses, which generate part of their selves. In this live where the services provided are given by a Company, which makes you forget the solitude of our being, establishing us as a raw material of a health system that leads to a short scientific sigh controlled all its slopes.
Myths and reality in medical practice
Long lines and clusters of people, can be seen throughout the Health System (Figure 2), it should be noted that patient waiting is not the only condition seen, there are other relationships that exist for granted and to be unfolding over the years into the system; we refer to the condition deed between the two actors [patient/doctor]. This becomes discontent from both fleetingness and apathy. On the one hand, we must understand give it time in an area where everything is urgent and shore every person to desperation for lack of immediate attention, although service protocols prioritize the actions of this care. This lead us to think this situation again from the moment you want, in a certain way a medical care for a family member, friend, parent, child or for yourself, the situation may change direction. This whole situation is in agony, insolvency and aggression, but there are other patients, aware of their severity or status, are giving priority attention on a set of scales and sensations [Very bad, bad, bad mildly, a number of states of feeling, better than a Triage2] “… you pass first, Sir…”, “…You should be checked first; I can wait…”, “…It’s better to go away, I thought… He came pretty bad…” “…I am not so bad…”, “…I just bring this, it’s not urgent…”. Thus it is built in the area of medical attention a culture of submission and ignominy to the lack of attention early and mediate, on the other hand, try to imagine a feeling of breathlessness, anxiety and haste generated to get to work on the structure State Health [since in the private medicine that would be the opposite]. Glimpse the looks of breathlessness and indifference with its huge burden of rabies, which cause long queues, where the endless row of suffering will never end. They condition the irremediable sense of job anxiety, where everything is urgent and no one expects, on the contrary, are stacked against each other to fight with sagacity and bestiality for getting more time for doctor’s appointment and agility in the promptness of their attention, as well as to find what they had always wanted, a consolation of suffering in this cold, arrogant and unfair structure. Here, has been built in this system the wonderful phrase often medical domain: “if I do not heal them, why I distracted them?” [1-3]. This provides for structural health side, out of the situation that the character’s health - doctor- in an area that has been built to practice hard and scientific humility. Now, survives in a health structure with a heavy workload. The health structure is no longer functional and therefore known as actors or managerially servers health, tend to peaceful, orderly, methodical and systematic exhumation that offer the same failed health system.
Figure 2: Realities Health Sector: long waiting lines, refusal of medical attention, saturated rooms, no waiting areas, inaccuracy in reporting protocols to the patient
and no response capacity.
There is no time and place to start the parade of problems, these have been caused by this medicine aforesaid has been co-opted by the unhappy system which life an unprecedented chain of subjects and prisoners’ health, that the minimum flash of light answer punishment turns to asylum m media dungeon of infamy. Thus it appears to any punishment the fleeting provocative act of his medical practice “…If you can´t, there are people who want your position…” [2,3] causing in people submission in the factual structure. Thus, medicine common benefit has been in fantastic recreation of the magnificent scenery of our minds, that which we proclaimed to flourish in all those inert fields of our society where the comptroller of these tasks was the health professional. That doctor in training or initiation that vigorously and perseverance, filled with youth to hospital white monster, and that this white youth insult him back with scorn and insults the boldness of its approach. In this way, our avid presence in hospitals conditioned us study late hours and practices that were accumulated experience and mental dexterity, prolonged fasting and physical punishment on penalty duty hours. They were establishing a rigor brought from the same dungeons of Traditional Educational System “las letras con sangre entran” [3] [to pleasure of a note of great painting of Goya -Pintura I-] (Figure 3), so between domestication and illogical scientific rigor, we build for an In-terminable end and nobody caused us to waver, however the internal forces of will, courage and humanism were combined with science and patience cure an endless reason. Being built with passion and awareness doctor offering his knowledge gained in the pursuit of flowering medicine common benefit [4,5].
Figure 3: La letra con sangre entra or Escena de escuela. Fuente: Autor Francisco de Goya. La letra con sangre entra o Escena de escuela. 19,7 x 38,7 cm. Óleo
sobre lienzo. Museo de Zaragoza (adquirido por el Gobierno de Aragón en 2008 a la Galería Caylus).
Times have changed; they are no longer what they pretend to be. It had been those days that spoke with passion, without trying to fall into nostalgia fantasy, although it is true that apparently spoke of another world, another reality that explained with facts and smiles; the vast majority lived the transition from the twentieth century to the decorated twenty-first, we have believed that this has been marked with multiple gestures of transformation: [for example: Mass media –catching all the senses- that has catapulted globalization and put in new generations grounds interconnected by the network, but disconnected with reality, except the Arab Spring of 2010], with respect to the medical profession, it is said generational voice to voice that this was lived with a certain social prestige that was exceptional, unique, respected and even necessary, but the reality is different. Since 1942, at the time of the construction of epic Mexican Health System [Mexican Social Security Institute - IMSS-, Institute for Social Security and Services for State Workers -ISSSTE- Secretary of Health and -SSA-, mainly], there are already reports of: lack of medicines, no doctors for medical attention, no effective registration system of workers, lack of medical facilities, neglect, very low salaries for Health staff, etc. [3-7]. Now the National Health reality is not far from those epic moments, currently the system consists of multiple complaints on poor service, provided by public hospitals. These complaints range from: drug shortages, long lines and hours of waiting, dirty hospitals, lack of staff, even give birth in the street or in bathrooms of any establishment, which it has been so much lied or has forgotten the origin of being.
Apparently the fanciful reality which spoke at a particular time does not exist. The reality that concerns us, is currently composed of a permanent, chronic and perpetual chapter pathologies: theft, looting, eternal hegemony of managerial positions, authoritarianism, complicity, corruption, agony with loss of direction and lack of selfcriticism [2,5,7]. Thus, it is claimed as the perfect act of a magnificent play “Y se los siguen chingando a placer”. This work includes stage a unique distribution; the characters, politicians’ area of health, maintain a complex dialogue and sometimes unprecedented monologues. Where the “revelation, suspense, action and coercion”, determine the future of the event, where all together, presents the conflict to be discussed, to consecrate an outcome where political actors rise to a dispute between blocs and so, to focus our attention and seize our interest, while the astonishment always maintained. Here a limited social plot develops, since the conflict is lived by political actors and the problem is lived or breathed by the public. In the final by social democratic representation –the payment of an entry ticket–, political actors resolved the conflict to try in a favorably or unfavorably way many times. As well the play leaves staging questionings, abstractions and is difficult to understand for the audience, this magnificent play has been played for more than 80 years in the Teatro México de los Olvidados; mentions and says that once, in a remote Mexico, there was a medical practice called old guard, is trying to express, where we stand?, what have we done?, Who has conditioned our actions?, Who Stole the same story?, why we need this damn story?, what we have?, we become who we serve and why?, why persist in this existence full of absences?
One day I could ask to the time, I asked for a quiet moment in my working life. The Time inexplicably, can afford me a moment. At that moment, Radiographic way, I could see the reality of my actions. I could see how I treated and I tried to take control of my profession, and likewise, I reflected in my actions and those people I met; as patients, people and life friends. They put in me the full confidence of their body [functional medical body organ, systems and devices; functional sense that we refer to in this quote] and I could never look beyond the healing biomedical functionalism to those individuals who sought only the realization that something actually exists. Beyond our biocontrol world, finished full of social injustices that impacted directly or indirectly in the patient, but my stubbornness dominated this uncontrolled emotion of social reaction. So, shame completely flooded the office itself, the unprecedented and terrible cowardice. To my mind, had taken pity on my act, it had continued abduction of our being, existed for conspiracy of a system and a science of fashion, where membership of this event was imposed in an authoritarian manner, at the expense of non-compliance and losing your job or be censured by the Academies or medical advice, I have noticed:
Is there no freedom in medical practice?
There is no redemption for the doctor?
Someone or some people stole what was left in pure medicine?
That all medical practice is now disposable? Purchase the highest bidder, the best payment system.
That the medical act is an act of play with fatal outcome?
That my life became a static painting without social scientific thinking?
That medical practice has disappeared as some say? We are all part of a System - public, private, state, tripartite system, whatever we want to call it-, this captured us, subdued, tortured, strangled and finally is slowly and gently wiping us a full infernal rhythm of pain.
Who captured our huge dream? Who cornered us? Who?...
Conclusion
To conclude, I want to mention that the foregoing considerations are part of our lives, which are dedicated to this tech scientific work with supposedly humanistic dyes. They were marked by a single condition in life, the eternal pursuit of development of humanity [that is sold as “American lifestyle”]. Thus he confirmed through this humble reflection avatar and gave me time. We have only sought shelter in medical practice of a social and economic status, we seek that vocation lie invented, because it never has existed, this was just a media invention and eternal –will arrive humbler sheep domestication, at the end of useful life of the person who leaves the office, operating room or emergency room, so several times this evil assembly, which is not permitted social scientific reflection, will be repeated–.
So I shout to the infinite Universe, to that place where its stars lie between implosions and explosions of stardust, because we have been simple workers of a science that brings in finding more customers, more pharmaceutical discoveries, more devices imaging, more technology and more practitioners. That total sum is added to the chaotic conditions of a working life of scientific submission in combat illness, where the only enemy is this entity based senior. So where time becomes confinement, is completely erased the image of your being and your well-being, white coat culminates by suffocate in the last breath of his absent vocation in medicine of destruction and infamy...
Acknowledgements: To all family doctors, general practitioners and primary care, to them who want an alternate reality of the world in which we live.
References
- Casas D, Jarillo E. Tesis para Obtener el Grado en Doctor en Ciencias de Salud Colectiva. “Significados de la práctica de la medicina familiar, en México: el caso del IMSS”. UAM-Xochimilco. 2013.
- Casas D, Rodríguez T, Casas I. “Medicina basada en existencias: la espera del paciente en un acto medico agotado”. MEDWAVE Chile. 2015; 15.
- Casas D, Rodríguez A, Oliveira C, Poschi A. “Enfermedad médica: una mirada hacia el bien mercantil en salud”, Revista WAXAPA. 2015; 7: 11-19.
- Casas D, Rodríguez A, Oliveira C, Contreras G, Martínez A. “La práctica médica en la hipermodernidad: caso Médicos de instituciones en salud del Estado de México”. Ciencia desde el Occidente. Marzo-Septiembre del. 2015.
- Casas D, Rodríguez A. La caída de la Seguridad Social en México; Caso IMSS. Revista de Archivos de Investigación Materno Infantil. 2014; 2: 84-94.
- Casas D, Rodríguez A. Infame medicina. Ciencia desde el Occidente. 2014; 1: 53-68.
- Casas A, Jarillo E, Rodríguez A. Significado de la Practica de la Medicina Familiar en México. Medwave. 2014; 14: 5975.
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