Como apresentar a Bruninha?
Difícil, ela é especial. Há um tempo, ela me escreveu este e-mail:
Querida Morgana, Estou preparando o meu currículo para as entrevistas dos concursos de Residência.
Os pontos fortes do currículo são as produções científicas, as atividades extra-curriculares, e também, as cartas de recomendação. Muitos pedem essas cartas aos chefes das disciplinas, ou a alguém do tipo. Mas, já que tenho que ser cara-de-pau para isso, prefiro pedir para você .Acho que uma carta de recomendação sua no meu currículo me deixa muito mais contente e a vontade!
Se vocês assistirem o discurso de formatura da Bruna aqui postado, se vocês lerem com atenção este e-mail vão ver que ela é representante de uma forma de fazer medicina que deseja nascer. Ela fala em nome de uma juventude que esta construindo um novo futuro para o cuidar. Precisa dizer mais? As palavras dela podem ser familiares para alguns mas, mais importante do que o que ela diz é o lugar do qual ela diz: o lugar acadêmico do saber médico. Dar novos contornos a esse lugar, colori-lo, amolecê-lo, afeta-lo com a força das emoções: este tem sido, para mim, o desafio da Bruna e de tantos outros estudantes de medicina que tenho conhecido. É uma honra abrir espaço para as palavras da Bruna.
Por Bruna Silveira
No processo da escolha imatura da profissão, estudantes de segundo grau baseiam-se naquelas matérias que mais lhe agradam, em assuntos que mais lhes interessam, em coisas que gostam de fazer, pensando sempre em um modo prazeroso de entrar no mundo profissional, uma forma mais agradável para produzir (matéria, serviço, tecnologias e/ou conhecimentos) e, principalmente, uma boa maneira de gerar renda. Afinal, “o dinheiro não é só o que importa, é preciso também ser feliz”: a maior prova da sutil presença enraizada do neoliberalismo (aqui não como uma posição política, mas como demonstra Foucault, uma prática de vida). Sem notar, os indivíduos são capturados e se governalizam desde cedo sem conhecer a fundo seus desejos, mas desejando construir seus capitais humanos da forma mais produtiva possível.
Medicina (aqui como representante de toda a saúde): profissão como outras quaisquer, bem reconhecida, com mercados de trabalho razoáveis, baixo desemprego, salários adequados, status elevado, e que, nas simplificadas questões dos tais testes vocacionais, são escolhas ideiais daqueles que assinalam “biologia” e dos que demonstram interesse em “ajudar os outros”.
Mas é neste ponto que ocorre a grande confusão, pois, certamente, pode ser muito mais fácil ajudar alguém a partir de outras áreas e ações. Porém, mesmo aqueles que chegam repletos de convicções, quase que inevitavelmente, rendem-se à pobreza das relações humanas, repartição do ser, à separação do corpo e da alma, à normatização dos organismos, à existência autônoma das doenças, o descaso com o bem estar e à vitória das tecnologias na incompreendida disputa contra a arte de cuidar, à medicação da vida.
Consequências das transformações históricas da saúde. Transformações que ocorreram no sentido de sanar as necessidades de cada momento, guiadas fundamentalmente por interesses burgueses e econômicos. Com a criação da medicina de Estado alemã, permitiu-se catalogar os indivíduos através das medidas antropométricas; a medicina urbana francesa surge no contexto de isolar os doentes e higienizar os meios; a medicina social inglesa tem seu enfoque no tratamento das populações carentes para evitar a progressão de doenças até as classes mais favorecidas. E, por maiores as transformações subseqüentes, por mais distintos que sejam uns dos outros, ocorreu um engessamento generalizado dos sistemas de saúde.
Afinal, o que são os hospitais senão um reservatório para amontoar os doentes e trata-los isoladamente da população saudável? Como diferir daquelas medicinas policiais as atuais práticas de controle e vigilância, as campanhas populacionais, a obrigatoriedade e imposição dos diversos tratamentos (ainda que a céu aberto) que se sobrepõem à autonomia do paciente e ao seus direito de viver, adoecer e morrer como bem desejar? Na doença, foi encontrada a possibilidade de alcançar o progresso.
E então, os profissionais se especializam em bloquear as enfermidades na busca da otimização dos corpos, o biopoder e a biomedicina transitam pelo controle da vida, da morte, dos corpos e das doenças. As ações medicalizadoras, e inclusive as não medicalizadoras (como as dietas, atividades físicas e mudanças no estilo de vida), só são válidas se permitirem a generalização: o que servir para todos. Vivências, percepções, emoções e experiências individuais pouco importam. Importa o resultado numérico final de uma amostra significativamente grande.
A complexidade da vida se reduz frente aos diversos dispositivos de segurança e às regras impostas no modelo de biocentrismo contemporâneo. E práticas como homeopatia, acupuntura, medicina antroposófica e todas as demais formas de manifestação cientifica são esmagadas nessa construção de infalível verdade, de uma ciência inquestionável. Enquanto isso, para fugir desse explícito controle, buscam-se outras estratégias. Surge a prática da humanização que, ao contrário do que se imagina, não é necessariamente a solução de nenhum problema, mas sim o grande diagnóstico de que a saúde encontra-se fria e empobrecida em suas relações humanas.
A sociedade clama pela autonomia do indivíduo que, de tão governamentalizado, já está doutrinado a exigir a causa e origem exatas de seu sofrimento, bem como uma medicalização adequada. Então, não há saídas. Está tudo dominado.
A física indiana Vandana Shiva afirma que “só um paradigma não reducionista pode apreender a complexidade dos sistemas biológicos”. Vinicius de Moraes dizia “a vida é a arte dos encontros”. E Foucault concluiu que há uma alternativa possível ao sutil controle absoluto: retomar da Grécia antiga o governo de si, sem almejar governar o outro.
Ainda há esperança.
Afinal, a saúde talvez seja a área que mais possibilite os encontros. Encontros, inclusive, transdiciplinares. Encontros que podem ser livres do biopoder, que permitam identificar a complexidade da vida e todas as suas vertentes, as alterações orgânicas às angustias do ser, respeitando a existência humana como unidade indissolúvel e indivisível do corpo e da alma.
Encontros que podem ser horizontais, sem o intuito de governar o outro, com total respeito à autonomia do paciente e isentos do sentido de produção, mas com intenções realmente honestas e que tenham o amor ao próximo como caminho. O amor como força política e vital. Assim, a humanização se torna a ferramenta para retornar que, além de ciência, a medicina é uma arte e a arte pode ser perfeita, com tudo aquilo que for possível curar, tratar e cuidar partindo de um criativo intercâmbio humano, e não de uma transação empresarial.
Cuidar apenas pelo sorriso é a força política do amor na saúde, em que todo e qualquer diálogo sincero se fazem necessários. Pois, no fim, mesmo que tudo realmente permaneça dominado, serão os sorrisos e olhares que testemunharão se os encontros deram sua real contribuição à vida.
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