About me

I'm Alfonso Aguarón and I welcome you to my blog. Inspired by my own diagnosis of a Hodgkin's Lymphoma in 2008 I decided to get involved in patient advocacy.
A few years later, I keep commited to my desire of help and support patients. There's still a lot to do so, do we look for change in healthcare together? Let's go!

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Saturday, August 23, 2014

Our future doctors

First of all, I'd like to apologize I didn't write any entry for a long while. My mother has been sick and we have spent most of the time between the hospital and the doctor's practice. Fortunately, everything has come back to normality. In a sense, this post is inspired in everything that happened in the last few weeks. It's a topic I had in mind to talk about but, due to the circumstances, I'll do it before I thought.

I state my position clearly: I think there's a great gap that is not being covered in medical faculties that train our future doctors. Every single student will have to pass subjects such as anatomy, physiology, inmunology, pathology... Then everyone of them will have to choose their specialty so they will develope a in-depth knowledge on the heart, the endocrine system or the blood and the circulatory system. When they become interins in a hospital, they'll learn how to perform a precise diagnosis, how to handle symptoms and how to prescribe medications to cure the disease. Maybe, when they're ready to start working in a hospital, that young man who decided to become a doctor by vocation, may forget that a human being is in front of him while he's so busy dealing with a disease instead of a person. Is it his fault? Well, social and interpersonal skills are not required to go to University. But, what I'm almost 100% sure, is that nobody tought him how to comunicate with a patient, how to comunicate bad news or just how to stare at the eyes of a patient when he goes into the practice, leave the computer apart for a while and ask him: "How do you do?".

Last year, I had the inmense forturne to facilitate a seminar on paliative care in oncology on the occasion of the 8th Spanish Congress for Cancer Patients. Dr. Álvaro Gándara, president of SECPAL (Spanish Society of Paliative Care) was very clear: "Medical faculties are training healers, not carers". All the speakers, who were members of the Paliative Care Unit of the Fundación Instituto San José de Madrid, agreed that even the long-term outcome of the disease may be death, the doctor will consider this as a failure, because the treatment did not cure the patient. Alfredo Dominguez, nurse, summed it up well: "When a doctor says there's nothing left to do for a patient, everything still remains to be done". Also Maribel Carreras, psychologist, and María del Puerto Gómez, social worker, laid down the keys to make the change happen when treating a patient. They reinforced for me all the ideas that I had, not only as advocate, but as a patient and caregiver of a patient with a serious disease.

I've remembered a conversation that has taught me much as patient advocate. During lunch time, I was talking with my great friend and professional Fátima Castaño, psycho-oncologist, whom I was lucky to work side by side during 2 wonderful years. I was kidding about a movie in which a recent graduate psychologist extended her hand over the patient's arm to comfort him (in a very clumsy way, I have to say). I asked her: "Why psychologists use that compulsive habit of touching patients and relatives?". She explained me that in some cases this gesture can comfort the person and convey trust and complicity. So then the patient feels relaxed and shows his fears and concerns and doesn't keep them for himself. I have to say that I've remember this conversation every single day during the last weeks while I was accompanying my mother to the doctor, taking care of her at home, watching how she was nervous during various diagnosis tests and when I was waiting in the hall while she was in the operating room. And I have to say I was lucky to have that compassionate hand next to me. Sadly it never was a doctor's hand. Not because doctors were more or less sympathetic. Maybe, it was only because nobody taught them.

However, to be fair, I've the feeling that things are going to change. I am lucky to know medicine students who are members of the CEEM (Spanish Council of Medicine Students) and some others who organises the COE (Oncology Congress for Medicine Students). They are our future doctors. And they worry about patients. They want us to talk to them, to explain them our experience and concerns. When we talk to them, they express a critical point of view. This shows to me that they are treating us like equals and that they really want to confront the patients' speech with the healthcare professionals. On this relationship will depend that their training will change to be really focused on the patient and not only on the disease. There's still a long way to walk, but the seeds of change are already planted. Now it's time to watering them.


  1. Aún queda mucho camino por recorrer pero por suerte las cosas están cambiando. Los pacientes también tenemos mucho que aprender y mucho que enseñar a los médicos de hoy y a los que lo serán mañana. Buen post querido Alfonso. Nos vemos en el camino ;-))

    1. Vamos por buen camino, médicos y pacientes. Seguro que nos encontramos por el camino, no tengo dudas ;-)

  2. we are in the good path but they have to continue working. Are there diferences between the comunicational behavior between doctors of different countries?

    1. As far as I know it seems to be more a cultural issue. It is usually said that the relationship between patient and doctor in North America is more peer-to-peer based, as in Europe and specially in some southern countries there's still a perception of the doctor as an authority from many patients. However, this is just a generalisation and every single case may vary from one doctor to another and also from one patient to another.

      But there are good news: things seem to be changing, but there's a long way to walk yet.

  3. Yo también considero que las cosas están cambiando y que poco a poco vamos por el camino adecuado .Fui a una conferencia hace unos meses en la que la Dra.García Estevez hacia una reflexión acerca de lo que comentas "en la facultad no nos enseñan a comunicar a empalizar eso a mi me lo han enseñado los pacientes" explicaba que para ella muchas situaciones se le hacían duras y era increíble como muchos de sus pacientes le ayudaban a ella cuando debería ser al revés . Estamos todos en el mismo barco ,el médico debe aprender a comunicar empatizar ,como bien dices a tendernos la mano..y nosotros los pacientes como yo digo deberíamos aprender a ser parte del equipo multidisciplinar pero no a través del Dr.Google ;) si no cogiendo nuestra responsabilidad, aprendiendo a preguntar,saber nuestros derechos y también obligaciones.¡Qué trabajo nos queda! .Un abrazo enorme