If one believed in such things, one would say that adopting the surname Alegría and discovering an early vocation for medicine were signs that were difficult to ignore. Because the doctor, who has now been working as an emergency doctor for three decades, soon felt that the way she dealt with patients influenced both their healing process and herself; Things that all his career and specialization years hadn’t been able to cover. In search of answers, he began to travel and became interested in other cultures to see firsthand how patients improved when treated with empathy and love. But talking about the connection between emotions and pathologies of any kind wasn’t always easy: when he talked to his colleagues 30 years ago about the possibility that, for example, fear was behind back pain, they laughed and didn’t take it seriously.
What has changed since then? Sánchez Alegría is now convinced that “despite the fact that there are still very pale colleagues”, aspects such as empathy, humane treatment of patients or emotional intelligence are already part of medical practice. Some factors addressed with ease, closeness, and scientific rigor in Love is the Best Medicine (Vergara Editorial), on the pages of which he reflects, among many others, on the healing power of meditation and forgiveness. EL PAÍS speaks to her via video conference.
Questions. It is very nice to say that love heals, but what is the scientific basis for this?
Answer. Just think of a moment when you felt loved: it doesn’t matter whether it was your first love, your mother’s hugs or when you touched the stars with your hand while making love. By connecting with that emotion for just a few seconds, your body will automatically start acting differently, as that memory has set in motion a cascade of hormones, neurotransmitters, and biochemical changes that occur in the bloodstream cell, ranging from the cerebral cortex to the tip of the toe next lies. When you experience this emotion, your body begins to produce what I like to call loving substances that heal: oxytocin, endorphins, serotonin, dopamine… It’s like the cells that collect that loving sensation expand .
From my early days, I had intuitively felt that my patients gave me something to take with them for every emergency action; something that was not in the books and that seemed to have no scientific, biochemical, or anatomical explanation: and it is that in emergencies I became less tired when I approached them, my best teachers, with love. So I started searching and I met many people who, regardless of culture or geography, based their medical practice on loving listening, loving laying on of hands, or loving preparing herbs. And that resulted in the people who came into his office or cabin coming out better physically, mentally, and emotionally.
Q They note in the book that the same drug can have different effects depending on how the doctor treated the patient. Can you explain it to me?
R A patient does not understand pharmacology or radiology, but understands how they are being cared for at that moment. And when he realizes that the doctor is paying attention to him, he automatically improves. Think of the placebo effect, drugs that are pure flour or starch and still work. Because? Let’s not fool ourselves: when we take them, our body starts to produce healing substances because we think we are taking a drug. A doctor is able to produce this effect, and even vice versa: he can make a patient worse just by giving a frightened look at a diagnostic test. Because although the patient has no criteria to know what he sees, he pays great attention to the doctor’s face.
Q How is medicine practiced with love?
R It’s easy to give treatment after listening with empathy, putting myself in the patient’s shoes and calling them by name, after realizing the importance of a gesture of affection, a “Hello, Juan. Good morning, sit down. How can I help?”. I begin all my inquiries like this. Even unconscious patients are receptive: I remember one who had an arrhythmia so severe that I had to transfer him to another referral hospital because they had more resources there. I took him out unconscious and he didn’t seem to know anything, but he woke up 100 kilometers from our destination and he said to me: “Oh Doctor, how nice that I’m going here with you, how calm. Because this doctor in the screamed so much in the hospital, he was so scared…”
Q Do emotions really have such a different impact on the healing process?
R Almost all diseases are psychosomatic, that is, they have a psychological basis. For example, many dermatological diseases are related to stress, low self-esteem, worry or the desire for perfectionism. If I insist on something and I can’t improve it from within, no matter how effective the dermatologist is, no matter how much he listens to me with empathy and prescribes the best medication, I will make the disease chronic, no matter the fact that the symptoms change sometimes improve.
On the other hand, a distinction must be made between healing and healing. That’s something external: that I put on a bandage when I’m bleeding or that I take antibiotics when I have an infection. But healing is an inner process that involves connecting with my true essence, love. If I don’t change the way I look at life; if I don’t change my thoughts or my feelings; If I remain anchored in the complaint, in the victimization, or in “it’s not worth living,” no matter how hard the doctor insists on healing me, I won’t be completely healed.
Cover of the book “Love is the Best Medicine” by Carmen Sánchez Alegría.
Q Isn’t any of this taught in medical schools or hospitals anymore?
R I think they’re getting closer to the humanistic vision because there have even been universities that have called me to give a talk or share my perspective on death. More and more colleagues are realizing that medicine is something more than performing diagnostic tests and offering differential treatments. Just like in school, teachers are already beginning to realize that if you treat a child carefully, they will learn to read faster and have more self-esteem and confidence. So it’s good that faculty are recognizing the importance of a bit of empathy, of listening to the patient, so that they are that and not just the client.
I remember certain instances where I would walk into the ER and hear them say, “Ah, Dr. Zen”, sometimes with affection and sometimes with a certain contempt. But then they found that patients who showed up with a severe panic attack got better within minutes without having to be given an intravenous Molotov cocktail of drugs (which reduced their anxiety but later kept them asleep all afternoon let). And if a colleague had a moment of great stress, they would come into my office, they would close the door and they would say to me: “Quick, do something for me, but don’t let these people know about it…” But the situation has changed . When I first wanted to learn complementary medicine, meditation or other things, they were surprised that I was a doctor. Now I see with joyful surprise that there are many colleagues who are aware of this and use it in their practice.
Q A good test of the relationship between emotions and physical health is to see how emotional and physical pain activate the same areas of the brain.
R It’s very interesting. I was able to verify this a few years ago with the advent of neuroimaging, a wonderful way to see the inside of the brain. Thirty-two years ago, such diagnostic techniques did not exist, and learning about the brain required performing an autopsy or undergoing surgery by a neurosurgeon. And that’s how we learned anatomy. But now, with neuroimaging, it’s great to check the areas of the brain that are activated by certain emotions or when you’re paying attention to one thing or another. So the imaging experts found that when you’re sad, when you’re in emotional pain, or when you’re told something you don’t like, you activate the parts of your brain that correspond to pain, the same ones that are activated when You fall off your motorcycle or down a ladder. The pain area does not distinguish whether this pain comes from the soul or from the body.
Q In the prologue of his book it says that death is not taught in the universities. How should it be addressed?
R I remember that when I first started working as a doctor, for me and my colleagues, death was understood as a therapeutic failure: if a patient died, it was because we didn’t do well. Little did we know that this patient had simply reached the end of his life and that the best thing you can do there is to accept death, help him, accept it and live this process as a lesson. I learned the best lessons of my life there, accompanying the patients who are leaving.
Q What are the benefits of meditation?
R There are many diseases that get better through meditation. Of course, if you have to undergo appendicitis surgery, no matter how much you meditate, you will have to undergo surgery. And if you break a bone, no matter how much you meditate, you need to put a splint on it to heal. But meditation also helps with these processes. I realized many years ago that it does me a lot of good to close my eyes for a while and be aware of myself, my space, my breathing and my emotions. It’s the easiest way to connect and calm our mind a little; It is not for nothing that we have an estimated 75,000 to 100,000 thoughts every day.
It has been proven that meditation lowers heart rate, fixes blood sugar levels, lowers blood pressure, improves head-to-toe circulation, improves the responsiveness of all organs and systems, lowers hydrochloric acid levels in the stomach, for example… Meditation improves absolutely everything. The good thing about meditation is that it helps each person feel good about what they need to feel good about. Those who have neck contractures meditate to remove them; for the one who is a bad sleeper, for the one who has knee pain and also for the one who has an angry ability to react to absolutely anything.
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