Enric Benito (Mallorca, 75 years old) has accompanied 5,000 people on the journey to death. He began his professional career as a successful oncologist, but depression made him see that his true interest and vocation was to accompany those who were leaving, although in that process he did not cure anyone. This Friday he presented the film at CaixaForum in Madrid ‘There’s a door there’a documentary sponsored by the Pía Aguirreche Foundation, dedicated to the promotion of palliative care and founded by José Galíndez. The film, which portrays the birth of a friendship between an ALS patient and Benito, has been chosen this year as best Uruguayan film at the Oscars.
–You were an oncologist until you discovered that you were called to do other things.
–I am a doctor, I became an oncologist and then I realized that what really interested me was not giving chemotherapy or treating tumors, but rather treating people throughout that process. I realized that I was not prepared for it, because Medical School doesn’t teach you anything in that sense. That’s why I explored what dying was about.
–How did you discover that interest?
–At 44 or 45 years old I had an existential crisis, I was not happy. He had managed to publish in American journals, when there was practically no oncology in Spain. He had a house by the sea, a wonderful family, he earned money, he ran a private practice. But I was very sad, they discharged me due to depression. The psychiatrist prescribed me Prozac, but I didn’t really know what was happening to me. To the surprise of my friends and everyone, I left oncology and tried to understand what dying is like. Since that moment I have accompanied hundreds of people in the process of death.
–And what have you learned?
–Death does not exist as such. Just as there is birth, there is ‘death’, there are two processes. And dying is as well organized as being born. You just need to know how to see it. But for this you don’t have to be afraid. When you approach to accompany without fear or put your little fear in parentheses to take care of the patient, what you take away is an impressive gift.
Advice to family members
–What do you advise family members who are on the verge of losing a loved one?
– Please do not run away. There are people who say: “I don’t want to go see my father because I want to have a good memory of him.” Whoever proclaims that is missing the most beautiful part of the film. What a pity!
–Palliative care is often presented as an alternative to euthanasia. Do you agree with that vision?
–Of the 5,000 patients I have treated in my entire career, only five requested euthanasia. I have worked with them and their perspective has changed. I do not have a moral or religious position against euthanasia. But it does seem absurd to me that we have a euthanasia law, which affects very few cases, and we do not have a palliative care law, which concerns hundreds of thousands. Euthanasia is a cheap photo for politicians. It is more elegant, more humane and more professional to end suffering than to end life. We doctors have not been taught to work with suffering.
–Can pain be eliminated in all cases of terminal illness?
–Bodies hurt; people suffer. Pain is physical, organic, somatic, and goes away with morphine, fentanyl, methadone… Suffering, on the other hand, is nothing more than the rejection of reality. When someone gets older they discover that life flows and that the best thing they can do is accept what they cannot change. That’s when you stop suffering.
–There are times when treatment stops making sense. What to do then?
–Sometimes doctors become obsessed with the disease, they prescribe chemotherapy over and over again. But instead we must ensure that a person has a single room, space to be with their loved ones, good symptom control, honest information about what is happening, and emotional support. There is nothing else to do.
–How widespread is palliative care in Spain?
–At this moment in Spain there are more than 80,000 people who die without having access to palliative care. In a developed country, two palliative care units are needed – one hospital and one home – per 100,000 inhabitants. Spain has an average of 0.6.
–What are the emotions that accompany death like?
–People reach this end as they have lived. If they have done it generously, they also leave that way, but if they have lived in fear, in the end they leave in the same way. Death is accepting reality in order to transcend it. If you fight against what you cannot change, you will end up suffering.
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