¿Quo Vadis, Hospital Vargas?

Hospital Vargas

On August 16th, 1888 president Juan Pablo Rojas Paúl signed the act that disposed of national funding for the creation of the José María Vargas Hospital in Caracas.
What was once the beacon of medical studies in Venezuela and the south american continent, nowadays lies in ruins.

The José María Vargas Hospital in Caracas, home to Venezuela’s first medical school, signed into law by Simón Bolívar in 1827 is was an institution amongst the finest medical studies in Latin America.
With its french-inspired nineteenth century architecture, el Vargas has been the home to most of the greatest medical minds in Venezuela.
But after decades of the most corrupt, decadent, money squandering and careless administrations, both from the ancien régime and the chavista revolución, the hospital lies in ruins.

Whenever you put your hand on something there’s dust, and there’s dirt.

Everything is decrepit and broken down, communal showers for patients are filthy, with human hair blocking the sinks, full of dirty water. The unsanitary details of conformism, are everywhere you look.
There’s propaganda everywhere pumping out ideology about the glory of socialism and the coming struggle of the masses.
Patients are treated as degraded beasts of burden, attending physicians just complain, and residents are frustrated about the fact that they’re losing the best years of their lives practicing medicine under scarcity, and they oftentimes wonder if the way they practice medicine actually benefits their patients or rather does them harm.
-Yes,
residents at el Vargas wonder whether or not it’s actually a good idea to get a diploma if you’re honouring the Hippocratic Oath.

A few days ago, right in front of the main gate of the Hospital, doctors, nurses and patients alike were surprised with the dantesque show that was displayed for the community: A meat and produce market.

Poultry and beef were being sold and displayed in vitrines without any refrigeration, covered in those big flies that make that horrible buzzing sound.
Rotting cabbages, tiny onions, withered lettuces and runny tomatoes were displayed in the socialista market that was allowed with the complicity of the chavista hospital board.
Not only does this market has the political intent to showcase some sort of food sovereignty to the ever hungered masses that queue endlessly across the country, but it also shows a deep sign of disrespect for the health of the Venezuelan people.

Sanitary permits, which are required to be displayed pursuant to the draconian regulations signed into law by chavista bureaucrats were nowhere to be seen. Proving the fact that these regulations are just another way to harass the private sector with fines.
The same flies that haunted the market, were seen in many places across the hospital, from the lobby, to the kitchen and cafeteria, to the hospital wards.

Residents are blighted by a variation on Hannah Arendt’s banality of evil, for they are also the victims of a very inhuman and cruel healthcare system

A colleague told me about a young patient that had to go into surgery for a gunshot wound to the abdomen, and needed a colostomy. We’ll call him Juan.
The surgeons did a wonderful job performing that colostomy from a technical point-of-view but medicine scarcity in Venezuela rounds at about 90%, according to the Venezuelan Medical Federation (something which steroid-pumped-fitness-aficionado People’s Ombudsman refuses to accept). So Juan’s family needs to procure the pain killer medication, which they couldn’t find right after the surgery.
Juan had to face 18 hours of post-operation status under excruciating pain.
A day later, after doing some social engineering with twitter and other social networks, the pain meds were procured and this man’s pain was allayed.
A couple of days later, doctors start giving Juan liquids and his family buys him a soup, (because the food service in the hospital is under technical shutdown).
Poor Juan developed an acute diarrheic infection: enterocolitis, with more than 60 bowel movements, since he couldn’t stand up, and his family wasn’t let in the hospital because they were out buying him food, his bed was covered in his own feces and the stench, together with hot tropical climate of a Caracas afternoon with no A/C made it a horror.
Nobody helped Juan, not the other patients or family that shared the hospital ward with him (“que asco” they said), nor the nurses(“They don’t pay me enough to do that”), nor the doctors (“Not my job”).
So Juan had to wait covered in his own shit for his mother to come and clean him up while he was in excruciating pain.
Neither Juan, nor his family, nor anyone complained to the doctors.

Residents in such a hellish workplace with a case overload, underpaid, understaffed,  little resources, motivation and a medical system that cares very little both for them and their patients have a lot in their plate.
The attending was angered at them because they did very little to ease this man’s pain, so during medical rounds he reminded them of their Hippocratic Oath. They sighed, and moved onto the next patient.

This sort of numbness to human suffering reminds me of Hannah Arendt’s Banality of Evil book on the Eichmann case, in which she argued that Adolf Eichman wasn’t a fanatic or a sociopath, but an extremely average man who relied on clichéd defences rather than thinking for himself and was motivated by professional promotion rather than ideology.
In that sense, residents and attending physicians are not monsters. The system turns them into individuals that value conformity and narrow self-interest over the value of others.
Residents deny the moral responsibility of not doing anything because they don’t feel any responsibility to do so because they were robbed by the system to do so in the first place, they just want their diploma to leave the hospital and run a private practice. This extraordinary emotional shallowness impoverishes not only their sense of ethics but also their vocabulary and actions in general.

If you cringe at the fact of how they force-feed prisoners in Gitmo, having a man without pain medication after a big abdominal surgery is the sort of institutional aggression, torture and human rights violation that can only be possible in the minds of the most sick, twisted, warped, and deformed people.

This is what real socialism does to your doctors.

NOTE: I did a similar piece for Caracas Chronicles before the Head Editor had ideological differences with me. So I wrote this one here. And I have another one coming. 

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