2023-06-27 09:43:50
He decided on General Medicine as it is a broad specialty with a strong social imprint. He thinks that the practice should not lose humanism.
Invisible: Value and fame do not always coincide; Not even the most dedicated doctors are the most visible. They value the gratitude of those who need them more than a few minutes on television. They are part of their communities and are committed to them. They have nothing to sell; rather they share what they have, what they know. They care for humble families in remote locations, they do not want to leave any disease orphaned. They heal when they can and always take care. They are those who with their feet in the mud give meaning to an ancient profession. IntraMed wants to honor them with this cycle of interviews that aims to give visibility to the “Invisibles”.
The doctor Julio Cacchiarelli He had not known since he was a child that he wanted to be a doctor. “I was interested in science, such as biology, but towards the end of high school I thought that medicine could match my interests with a socially attractive profession,” said the professional, who today works as an intensive care physician in Córdoba Capital.
It was only towards the end of his career that he decided on General Medicine, under the influence of a friend, who informed him that this branch was broad. “I always saw the specialties as too limited and I was interested in the more horizontal ones, including intensive care, which is like a generalist for critical illness,” he said.
Fate brought him closer to his task and also to rurality. After finishing his degree, he had to do Compulsory Military Service. In that year, he contacted a friend who was going to do a General Medicine residency in Zapala, Neuquén. “General medicine there is very different from what is known in larger cities, something more similar to family medicine. In those settings, it is more like rural medicine. I had never imagined being a general practitioner until they began to tell me what it was about, ”he said in an interview with IntraMed.
Already decided, he worked in the hospitals of Zapala, El Huecú and Plottier, Neuquén, before returning to Córdoba. Today, if asked “who is your example of a doctor?”, Cacchiarelli would answer “the fellow friends who are still in the trenches of a rural hospital”, because he learned something from all of them. Here, his words.
Trajectory until practicing as a rural doctor. Before considering becoming a general practitioner, my idea was to do a residency in a Medical Clinic and something else. When I came back from the Military Service I gave up and it went well, but I had to make a decision to see if I would resign and go and give up in Neuquén. I did that and it went well. I started my residency in Zapala and when I finished, I accepted a position in the town of El Huecú, with 4,500 inhabitants. After four years there I returned to Zapala where I worked as a generalist and helped residents with teaching tasks. And I dedicated myself to Palliative Care, which was a necessity in the community. We formed and created a team that had many achievements, such as raising awareness about the importance of this care in terms of quality of life of patients in their last stage. After getting married and having two children. I went to Plottier, where I stayed for 8 years and in 2013 for family reasons I returned to Córdoba. There I dedicated myself to Intensive Therapy, an activity that I carry out to this day and that I went through during the entire pandemic. Although Intensive Care is in some aspects the opposite of Palliative Care, it is not so when you are clear about the objectives and that satisfaction can be obtained from both specialties.
Difficulties or challenges of attending in small communities or far from urban centers. Many times there were geographical barriers, due to distance or because there are nomadic livestock there. This means that in winter the shepherds live close to where we serve, but in summer they climb higher up the mountain range, since new grass appears due to the thaw. The health system adapts to that and makes summer visits. We visit mountain range posts from early morning until late at night. And when you have to refer emergencies it is stressful due to the complexity of the roads, the transfers are mostly by land and the distances are long.
Anecdotes. I have many and I am not proud of some, because it would be difficult for me to repeat them today. Luckily, in both cases, everything went well, but today I would not have risked following the will of two patients, who did not want to be referred from their town. The first was a first-time pregnant woman with sequelae of childhood rickets who she wanted to give birth in her town where there were no facilities for caesarean sections. Her pelvis had not been tested. It went well because we were able to get the baby out with forceps, but today, from a distance, I see that in Córdoba all labor is derived, but not in Neuquén, due to the difficulties of the roads. The other case was that of a grandmother who had a dislocated fracture of the elbow and I had to reduce her because she did not want to be transferred.
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