Carles Güell de Sentmenat…
My father.
Industrial, Catalan high bourgeoisie.
The man who, as a child, taught me to write well.
And his mother?
He knew about Basque cooking. I miss her so much!
As was his childhood?
I do not forget the summers in Comillas, the spectacular breakfast table, my grandparents in the room of the Gaudinian palace…
And you came out a doctor.
And I write: I will be a better doctor if I write.
Write to heal?
I went through my crisis, I felt distanced from the patient.
And literature brings you closer?
Writing trains empathy. Oliver Sacks says: the human in the clinic is crucial. In his work The Man Who Mistook His Woman for a Hat he recounts rare cases.
What did the patient of that title have?
Prosopagnosia: You don’t know what you see.
A serious neural dysfunction?
One among hundreds in our brain, which builds what we call memory.
Are all memories 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. So imaginative.
And that diminishes with old age.
That’s normal, although I will never equate aging with dementia.
What is dementia?
A broad and progressive cognitive decline in memory, behaviors and language.
What about Alzheimer’s?
Due to the accumulation of abnormal neuronal proteins, from the age of 85 Alzheimer’s is registered in 40% of people.
My mother is there, what do I do?
Routines: instill calm. And some activity. And some encouragement. And family support.
Tell me something about depression.
The mood falls, there is anxiety, insomnia: you see everything black. We already have drugs that alleviate anxiety without damaging neurons.
Does the psychiatric pharmacopoeia defend?
I go patient by patient: if a drug works for him, I keep it; if not, I change it or delete it. I am pragmatic.
Do the drugs refine more every day?
Neuroscience advances, the arsenal of psychiatric drugs grows, indeed. For delusions, for example.
What is a delusion?
Your brain creates a hallucinatory reality that you literally believe yourself. That makes you agitated… And it’s alleviated with neuroleptics.
Neuroleptics, what are they?
Antipsychotic drugs: they manage to improve your quality of life.
What is the latest we know about our brain?
Michael Gazzaniga’s findings: the brain has made its decisions before we are aware and act.
So… my brain and my consciousness circulate separately?
Your brain dialogues with your environment: this inside-outside dialogue is what ends up being you, your awareness of yourself.
And my brain, what is it based on to make decisions?
In experiences, in experiences, in stored data.
The conclusion is that I do not paint anything?
We’re free. And we receive little pushes, yes. But stay with Schopenhauer: “It is difficult to find happiness within oneself, but outside one it is impossible.”
To what extent are we born knowing?
Due to our evolutionary inheritance as a species, we are born with a disposition to language.
Equally the male brain and the female brain?
The female brain has more facility for language, and greater emotional capacity. The male brain is better prepared for aggressive reactions.
Is personality innate or is it carved out?
It is innate and changeable: if you suffer from a lesion in the left hemisphere, you dramatize; if it is on the right, you will have anosognosia (you ignore your sudden deficit).
Will artificial intelligence help the mentally ill?
It is useless in the face of emotions: the subtlety of a good psychiatrist is irreplaceable.
The soul is in the brain?
The right temporal lobe indulges 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? Because?
You will prevent brain damage from ischemic accident: you will avoid hemiplegia, aphasia, blindness, loss of strength or sensitivity… and other misfortunes. Do it!
