Carme Valls’s father (Barcelona, 1945) was a cardiovascular surgeon and from a very young age, she accompanied him to the emergency room. Once, he told her about a patient: “See? If we had diagnosed him earlier we would not have had to cut off his leg. ” That made two things very clear to the young Valls: that she wanted to dedicate herself to medicine and that a patient who complains should never be ignored. Later, making a specialty in endocrinology, she understood that menstruation was a pain that was constantly ignored and ignored, and that was how she devoted her life to studying medicine with a gender perspective. After 40 years on the front lines of the war in the scientific NGO CAPS, his book Invisible women for medicine (2006), reissued by Captain Swing last year, has brought back to the public arena a problem that affects half the population.
Question. Her book has now been reissued because there is a renewed interest in what happens to women in general. Are you optimistic or pessimistic about gender-sensitive medicine?
Answer. Moderately optimistic. Women have not been present in the research groups, but they have also not been investigated and that has led to incredible biases. There are a thousand aspects of daily life that differentiate us and that have not been taken into account in medicine. For example, we metabolize drugs differently from men and that must be taken into account: we do not need the same doses as men. A general review of the science would have to be done in this regard. In 1993, cardiologist Bernadine Healy, while running the National Center for Health, discovered that the leading cause of death among women in the United States was cardiovascular disease. Until then it was thought that we did not suffer from these types of ailments, simply because no one had included us in the study samples!
P. What is the main difference in how women and men cope with medical problems?
R. The woman has more chronic problems and the man, acute. The woman seeks help, but sometimes she finds that the system tells her: “What you have is nerves.” She sees that it is not like that and it generates frustration because she thinks: of course I am tired. But the patriarchy has not helped man either. He has said: do not complain. And precisely for that reason many come to the hospital straight with a bleeding ulcer, pneumonia or heart attack: because they have not complained or looked at each other.
P. Is that why far fewer psychoactive drugs are prescribed for men?
R. For sure YES. A suitable psychological work at the precise moment would have prevented a heart attack for many. That is to say: gender reflection in medicine also includes assessing what it is that we are doing wrong with men.
P. In his university years he participated in the Capuchinada, which led to the creation of the first democratic student union in Spain. You are a contestant, do you continue to argue a lot?
R. I am a contestant, but I am also very democratic. I have been looking for ways that allow me to grow without having to constantly argue with those who said no. Where I have had the most answer perhaps has been in the hospital of San Pablo because there were doctors who when investigating they told me: “We do not have to go into so many details, if one in four women has a thyroid problem, it is not a trouble”. And I said: “Sorry, it is a problem. That generates fatigue, mental limitations to many. Of course we have to try to diagnose everyone well. If it was a men’s problem, wouldn’t you deal with it? Let’s search”.
P. How do you not lose your temper when after so long you can’t get some colleagues to understand your perspective?
R. There is a problem in medicine and in other sciences which is that the researcher does not see patients. I have never stopped having contact with patients several times a week and listening to them talk about their pain, their fatigue; Seeing that I could apply what I was studying to them has helped me maintain hope.
P. Do we know why women are the most frequent sufferers of persistent covid?
R. Look, there is so much talk that we are the weaker sex and although we are less muscularly strong, our immune system is much stronger than that of men; However, this immunity is a double-edged sword because so much defense of the system attacks some parts of the body.
P. How is it possible that we did not realize until after applying the vaccine that it could cause problems with menstruation?
R. Well, because menstruation is considered as an outgrowth of the body, that is, as if it did not exist in the woman’s body. In the research papers that were published on the cured cases, there were samples of 50,000 people, half men and half women, but the questions asked about how they had responded to the treatment did not include any specific questions about that. Patients were studied as if they were male or non-male, but nothing more. The woman with her whole body and her way of being different is never taken into account.
P. After the deaths in nursing homes and the protocols of the Community of Madrid during the beginning of the pandemic, do you think that the ethical responsibility of doctors is taken very lightly?
R. I have been very concerned about what you are aiming for. Nobody can say that due to age you do not attend to a person or that you send them to a health care provider to die because you have no other option … For me, this has been a bioethical setback and a bad example for our future professionals that requires reflection on the part of the profession and the administrations.
P. What did you think about Isabel Díaz Ayuso saying that some women are going to have an abortion like someone who goes to a party?
R. It is a very serious statement that shows a total ignorance about the circumstances of the women who have had to abort. Society does not help us at all in the experience of motherhood, so for many, abortion has always been a total suffering. Such a statement can only indicate that you do not know anyone thoroughly who has had to have an abortion. It would be much better if these statements were not made by a public person with such lightness and superficiality.
P. What female victim of patriarchal medicine do you especially admire?
R. There are many women who were put into asylums so that a man could easily get a divorce. But if we talk about scientists, Rosalind Franklin, whose colleagues took credit for their discoveries about the structure of DNA and never mentioned it. That robbery affected him a lot emotionally and they won a Nobel.
P. And have you ever been copied?
R. I have to say no, and I would have liked to. That would mean that there are more people researching the differences between men and women and the more people researching, the more right I am. [risas].
P. Do you think that now that there are so many women in medical schools, the gender approach will change?
R. It depends on the will they have to look for alternative reasons to what they have before them. I didn’t buy it that if a woman told me she was tired and in pain, she only had nerves. She must be nervous, because living in an androcentric society makes us nervous. But that does not mean that all our problems come from there. They have another solution and you have to find it.