In Memoriam

Dr. Virgil Carballo Zárate
(1964-2020)

Dr. Helí Hernández Ayazo: Especialista en Clínica Médica/Medicina Interna, PHD en Ciencias de la Educación-Historia de la Medicina, Profesor Titular de Medicina Universidad de Cartagena, Internista de consulta Hospital Universitario del Caribe. Cartagena (Colombia). E-mail: helihernandezayazo@gmail.com

DOI: https://doi.org/10.36104/amc.2020.2018

- Hey Teach, did you get the lectures?

- No, you sent me the one on cardiac remodeling.
I want the one on heart failure to use some figures for the class I'm giving the sixth semester students, and the other one on dulaglutide to review some data I found interesting...

- Teach, it's just that Sandra hasn't been able to get to it, but don't worry, I'll save them on a flash drive and leave it at your building.

Sunday, August 23

It was the last conversation we had.

On Monday the 24th at 9 PM another one of the many children I have been given through 40 years of teaching in the classroom and hospital wards called me.

- 'Teach! Teach! Virgil doesn't answer me..."

- "Calm down, Angelita, he was discharged today and I'm sure he's enjoying his bed and pillow after a week in the hospital..."

Early the next morning I was to find out that they had taken him to the Medihelp ICU and I knew in an instant that the Fates were coming for him, but as a physician I ultimately refused to accept such an ominous thought and directed my thoughts to mythology and assumed that our colleagues could hold back Atropos' scissors, the cutter of life, and allow Clotho and Lachesis to weave it together again. Soon, pessimism overwhelmed me until last Friday, the 4th, when that evening's Eucharist returned my optimism, which only lasted until the night of Sunday the 6th, when I understood the end.

Virgil Carballo-Zárate was the best student in his graduating class at the Comfenalco school in Cartagena in 1981, and the next year he began at our alma mater, graduating as a medical doctor in 1989, and returning in 1991 to pursue his dream of being an internist. He graduated as an internist in 1994, and began an increasingly commendable professional practice.

I met him in 1983 when he arrived in the department as a physical assessment student, but it was not until a day in 1991 when I began to appreciate him, during his internal medicine residency.

And, shortly after graduating as an internist, we began to get closer until he became my companion and friend through a multitude of hours. But it was last November, when the Sociedad Argentina de Medicina (SAM) [Argentinian Medical Society] granted me the title of 'Mentor" that he, as he presented me with the title, confessed that during his sixth semester (when he was assigned to a rotation with me), he had 'taken me, platonically, as his mentor."

"We made a path as we walked," as Machado says. A path marked by his roguish way of approaching the topics under discussion and a great ability to simplify discussions with the unmistakable stamp of his smile, a combination of spontaneous happiness and abundant humility.

During those days in the 90s, during our national holidays, as executive secretary of the University Professionals of Cartagena Club, I said to him, "Virgil, a pseudo daughter of mine wants me to take her to the gala with the national beauty pageant candidates and she asked me to find her a date, and you are that date."

"Fine, Teach, give me the information and I'll go."

And that is what happened, and this big boy ended up being a bit bad at dancing but good at "chatting, joking and laughing", so his date put up with him until dawn.

Many years later he would understand why.

In fact, at one point I said to him, "Virgil, who said this?":

"The soul dies defeated
Hopeless in pain...

And he continued:

Sacrificed for no reason
Without a love there is no salvation
Do not stop loving me
I beg you.

- "'Without a love', by Los Panchos," he said. He had a great ability to remember the words and melodies of many songs of all different genres, and hum them. He knew the most famous soundtracks very well, along with Enrio Morricone, his favorite. He was a rare case of a high balance between both hemispheres of the brain. He was a swift lefty!

But Virgil lived in a hurry, as though he knew that his time was running out. At the beginning of this year I asked him, "Virgil, on May 6th is the Paraguayan congress and on the 8th is the Dominican.what do we do? You go to one and I to the other?

"No, Teach, we need to honor both of them. Find a way.

And, well, the proposed and accepted solution was: we leave on Monday the 4th, arriving in Asunción early the morning of the 5th, attend the inauguration that day, the lectures on the 6th, and on the 7th we fly directly to Punta Cana, give our lectures on the 8th and return on the 9th. We get home in time for bed, in order to get up early on Monday to work. But the pandemic did not allow it.

He loved this pace, and we really made it fun. If he did not sleep during flights, he would pester me with questions about my professors, my experiences, trying to understand the present in the manner of a historian.

Other times he would raise his concerns and sometimes would make me give my opinion, which he almost always accepted and then applied, if needed. He was a man who knew how to listen and would do so without showing emotion.

His passion for internal medicine was boundless; the outpatient department, emergency room, ICU and hospital rooms were the setting for a wise and prudent practice, framed in ethics and with overwhelming simplicity.

During the last 10 years, he capably taught in the Medical Department of the Universidad de Cartagena, his alma mater. He kept his word scrupulously; on several occasions, upon landing after returning from the innumerable trips we made together, he would say to me while we collected our luggage: ".the students are waiting for me in Zaragocilla, at the other end of the city," (home of the Medical School of the Universidad de Cartagena and the Hospital Universitario).
"What are you saying, Virgil? It's Friday and it's 5 PM."

"Yes, Teach, but that's what the students and I agreed on."

And he would fulfill his task.

During my ACMI presidency, I drafted a bill to regulate our specialty, and he accompanied me, as always, but with guarded enthusiasm; and he was right, little by little it died at the Capitol. He kept up with every failure; liberals, conservatives, the U party, the democratic center, just disappointing. And that led him to increasingly side with the grievances: "I cannot understand how they - the physicians - accept working with payment eight months later, when the light bill, water bill, schools and banks have to be paid every month."

In January of this year, he said to me, "Get ready, because as soon as you finish the presidency we are going to work on the union and legal contracting."

The pandemic made him go ahead and raise his voice to clearly and without exaggeration denounce the tragedy which the practice of medicine in general, and internal medicine in particular, has become.

This was, perhaps, his final and heartfelt concern.

But, why, Virgil?

This is a big question we always ask ourselves when we lose a loved one, and even more when we consider that he is not yet a candidate for dying.

Virgil Carballo Zárate was a highly spiritual human being, but his spirituality was silent, with actions rather than words. Perhaps without knowing it, he had distanced himself from Heidegger and the existentialist's "Being-for-death" to live as a "Being-despite-death", a "Being-for-my-neighbor", like Lévinas.

To Sandra, the pediatrician of the "big boy" Virgil was, we express all our solidarity, wishing her strength and Christian resignation. To Daniel "the naughty one" and Juan José "the artist" I say: carry out everything you talked about and planned with your father.

All colleagues and friends: Ricoeur says, "Death, in a way, incorporates the absent one into history." Virgil is already a part of the history of medicine as well as that of each one of us.

Thank you very much!!

Helí Hernández-Ayazo
Cartagena, 15 de septiembre 2020