Health, Medicine and Illness
Health-related practices have a long history in Barcelona. Several places and practices have been developed throughout the centuries in order to improve the quality of life for the city’s inhabitants.
Medical culture was popularized in the Barrio Chino through anatomical museums, known as “Museos Anatómicos”, which helped to bring education to the masses. The museum housed a collection of anatomical mockups of fetuses and embryos. It also had anatomical models that taught visitors how human reproduction and fertilization works. But the museum’s primary goal was focused on educating the masses on sexually transmitted diseases, drugs, alcohol, and other health issues. There were also several hospitals located in the area such as Hospital de Santa Cruz off of Carme Street, the San Antonio Abad, which used to be the Hospital de Ardientes, and another one down Calle de la Cera.
The most notable aspect of Barcelona’s Fifth District, nonetheless, were the ‘healing houses’, in which doctors and nurses provided medical care for the residents. There were two famous medical clinics located on the outskirts of the Barrio Chino (which would later be relocated to the Eixample) – Dr. Salvador Cardenal’s ‘casa de curación’ (‘healing house’) and Dr. Ricard Botey, an ENT specialist’s, healing house.
Dr. Cardenal’s healing house was first built in 1888, and turned a “‘little town house with an almost square ground plan measuring 10 metres each side’ into ‘a building with a façade almost 30 metres long, three habitable floors and a basement for the service facilities, all of it south-facing and abundantly airy and sunny’” (Zarzoso and Martínez-Vidal 2016: 74).The healing house was able to contribute so many advances to the development of both medicine and outside amenities as well.
In 1899, Dr. Cardenal’s healing house was remodeled and renovated. The house grew from one house to Cardenal purchasing and combining the two houses next door as well. The healing houses brought emerging techniques to the laboratories as well as new therapeutic and diagnostic tools. During the remodeling in 1899, the operation rooms were changed in order for them to be used during both the night and the day. At night, incandescent lamps and reflections were used to light the room for the surgeons and helpers to see. This improved efficiency and helped save lives by being able to perform emergency surgery at any time of day.
Besides operating rooms and patient rooms, the healing houses also had annexed laboratories that included areas for patients to get x-rayed. Another big part of the healing houses were the lodging areas for families. These areas had many bedrooms and bathrooms for loved ones of the sick to stay while they were in the hospital. Some of the other conveniences mentioned were operating theaters, annexed laboratories, relaxed dining rooms, and bedrooms that made patients feel like they were in the comfort of their own homes (Zarzoso and Martínez-Vidal 2016: 69). This clinic also had three floors along with a basement to hold the buildings inner facilities. While the extra floors did not allow for easy movement for the patients, the building had an electric elevator. This elevator not only allowed patients to go from floor to floor, it allowed for the healing house’s doctors to transport them from the aseptic theatre to the antiseptic theatre if they wished (Zarzoso and Martínez-Vidal 2016: 69). The use of aseptic conditions was important because the aseptic technique is imperative in preventing the spread of germs in surgery. This method limited dangerous pathogens from infecting and potentially killing patients after surgery (“Healthline”).
Around Dr. Cardenal’s surgical clinic, dozens of other healing houses were being constructed. This transformation solidified the area as the designated ‘health street’ in Barcelona. The laboratory medicine that was being practiced here was extremely influential in bringing more and more medical facilities and doctors specializing in different fields (Zarzoso and Martínez-Vidal 2016: 72). This period of Barcelona’s “hygienic revolution” prompted many surgeons to try and discover new surgical techniques to prevent infections and pain (Zarzoso and Martínez-Vidal 2016: 76).
The Casa de Curación and the new medical technics discovered by Barcelonan doctors created a powerful trend towards the development of more hospitals and clinics in Barcelona. Indeed, the city’s relationship with health does not stop here. The Corporació Sanitària Parc Taulí is an exemplary model of how mental health is addressed in Barcelona. The documentary, Una Cierta Verdad (2008), directed by Abel García Roure, focuses on the struggle between mental health providers and patients and uses the psychiatric ward of the Taulí hospital as its setting. Six psychiatric patients were followed for two years. Javier, one of the six psychiatric patients, has severe sound hallucinations and delirium. Another of the patients kept telling the doctor that he was not sick and was completely fine. A line spoken by Javier in the documentary states that “there are two points of view: The doctor’s and mine” (García Roure 2008). The struggle between the providers and patients is primarily based on the treatment of the patients in regards to medication. Some patients resisted treatment and medication, and claimed that it had negative effects on their cognition and behavior.
Another issue that the Corporació Sanitària Parc Taulí faces with mental health is the degree to which the needs of outpatients are met. The article “Met and Unmet Needs of Schizophrenia Patients in a Spanish Sample” by S. Ochoa et al. (2003) provides a study on the met and unmet needs of 231 schizophrenic outpatients that receive treatment from the Taulí hospital. They used the Camberwell Assessment of Need to measure the needs. The Camberwell Assessment of Need is a test that measures the degree of the met and unmet needs of the outpatients. The Camberwell Assessment of Need showed that most of the patients need a treatment plan that is individually made for them. The study also showed some of the limits of the mental health care system (Ochoa 2003: 206).
A third issue that the Corporació Sanitària Parc Taulí encounters is determining how to give patients the best quality of life with their mental illness. The article “Subjective Quality of Life in Schizophrenia Outpatients in a Catalan Urban Site” addresses mental health in Catalan culture and in Barcelona. This cross-sectional study looked at assessing the subjective quality of life in forty-four schizophrenia patients during a stable time during their illness over the course of a year (Duñó 2001: 685). Overall, the majority of patients claimed that their quality of life was not inhibited by their illness or the presence/absence of medication or treatment. Holistically, the conclusion of the study was that the “Subjective quality of life neither seems to be influenced by the type of antipsychotic agent (conventional/atypical) nor by the presence or absence of medication side effects” (Duñó 2001:689). All of these issues that the Taulí hospital and Barcelona face in regards to mental health are equally prominent in countries across the world. Mental health is a large open-ended question in desperate need of answers.
—Edited by Camille Kresz and Benjamin Fraser with text from Grace Langley, Andrew Lee, Tricia Malcom, Lillie Rhodes and Jayati Vyas