Carles Güell de Sentmenat...
My father.
Industrial, Catalan high bourgeoisie.
The man who, as a child, taught me how to write well.
And his mother?
He knew Basque cuisine. I miss him a lot!
What was your childhood like?
I don't forget the summer holidays in Comillas, the spectacular breakfast table, my grandparents in the living room of the Gaudí palace...
And you, doctor, came out.
And I write: I will be a better doctor if I write.
Writing to heal?
I went through my crisis, I felt distant from the patient.
And does literature bring it closer?
Writing trains empathy. Oliver Sacks says: the human in the clinic is crucial. In his work The Man Who Mistook His Wife for a Hat, he recounts rare cases.
What did the patient have with that title?
Prosopagnosia: You don't recognize what you see.
A serious neural dysfunction?
One among hundreds in our brain, which builds what we call memory.
Is every memory unfounded?
Whenever you remember, like me, the Comillas table, you are creating it, you are recreating it with new nuances.
So what is memory?
A system of registration, retention and evocation...selective. Imaginative, therefore.
And that diminishes with old age.
This is normal, although I would never equate aging with dementia.
What is dementia?
Extensive and progressive cognitive impairment in memory, behavior and language.
And Alzheimer's, what?
Due to the accumulation of abnormal neuronal proteins, Alzheimer's is registered in 40% of people over the age of 85.
My mother... What do I do?
Routines: instill calm. And some activity. And some encouragement. And family support.
Tell me something about depression.
The mood drops, there is anxiety, insomnia: you see everything black. We already have drugs that alleviate anxiety without damaging neurons.
Does he defend the psychiatric pharmacopoeia?
I go patient by patient: if a drug works for him, I keep it; if not, I change it or delete it. I'm pragmatic.
Are the drugs getting better every day?
Neuroscience is advancing, the arsenal of psychiatric drugs is indeed growing. For delusions, for example.
What is a delusion?
The brain creates a hallucinatory reality that you literally believe. This gives you agitation... And it is relieved with neuroleptics.
Neuroleptics, what are they?
Antipsychotic drugs: they manage to improve your quality of life.
What is the latest we know about the brain?
Michael Gazzaniga's findings: the brain has made its decisions before we are aware of them and act.
So… are my brain and consciousness running separately?
Your brain dialogues with your environment: this inside-outside dialogue is what you end up being, your self-awareness.
And my brain, what does it rely on to make its decisions?
In experiences, in experiences, in stored data.
The conclusion is that I do not paint anything?
we are free And we get pushes, yes. But stay with Schopenhauer: "It is difficult to find happiness within one, but outside one it is impossible."
To what extent are we born knowing?
Due to our evolutionary heritage as a species, we are born with a disposition to language.
Male and female brain alike?
The female brain has more facility for language, and more emotional capacity as well. The male brain comes better prepared for aggressive reactions.
Is personality innate or cultivated?
It is innate and it is changeable: if you suffer an injury to the left hemisphere, you will dramatize; if it's on the right, you'll have anosognosia (you ignore your past deficit).
Will artificial intelligence help the mentally ill?
It is of no use in the face of emotions: the subtlety of a good psychiatrist is irreplaceable.
Is the soul in the brain?
The right temporal lobe delights in an experience of divinity.
Give me a golden tip.
Ask your cardiologist, once a year, for an ultrasound of your carotid arteries.
The arteries that supply blood to the brain, right? Because?
You will prevent brain damage due to an ischemic accident: you will avoid hemiplegia, aphasia, blindness, loss of strength or sensitivity... and many other misfortunes. Do it!
