Tuesday, February 28, 2006

El Baquine de Puerto Rico se muda a Toronto


American Psychiatric Association's 159th Annual Meeting in Toronto, Canada,
May 20-25, 2006.

Puerto Rico Psychiatric Soc
Baquine Reception
Tuesday, May 23, 2006
6:00 PM - 10:00 P
Delta Chelsea Hotel
Stevenson Room - Second Floor South


* El Baquiné se trata de una fiesta a un niño muerto. Esta tradición ya está desaparecida en Puerto Rico. Ponían al niño en una mesa, lo rodeaban de flores. Los invitados ponían sillas a su alrededor donde jugaban juegos, cantaban, comían y bebían. Celebraban que el niño era un ángel que volaba y regresaba de nuevo al cielo en plena pureza.




http://www.prdream.com/galeria/sanchez/baquine.html

ideas

Sunday, February 26, 2006

Que piensan los candidatos a la Presidencia del Colegio de Medicos-cirujanos hoy

Domingo 26 de febrero del 2006

A mi pregunta abierta durante un dia de trabajo del Colegio de Medicos-Cirujanos en Hato Rey:

"Hableme de la salud mental en Puerto Rico"

los candidatos a la Presidencia del Colegio de Medicos-Cirujanos de Puerto Rico contestaron, en el orden que aparecen sus nombres, enfatizando estos puntos:

Dr. Torres Santo Domingo:
1. la depresion entre los ninos es un problema grande
2. llevo a cabo actividades con el Hospital Panamericano
3. Las areas mas olvidadas son las adicciones y el alcoholismo
4. hay que tomar la batuta para bregar con estos problemas
5. Es necesario orientar a la poblacion del pais

Dra. Marisel Velazquez:
1. La reforma de salud hizo un impacto
2. El Colegio estudio las plataformas de los partidos
3. El Colegio ha hecho alianzas con otras organizaciones, con 69 de ellas
4. Hay que hacer justicia a los psiquiatras en los pagos de planes y Medicare Advantage
5. Importante que se enmiende la Ley de salud mental de PR la 408
6. El Colegio ha trabajado en la capacitacion de medicos para el tratamiento de las adicciones
7. Es necesario finaciar para bregar con el perfil de violencia en Puerto Rico
8. El Colegio de Medicos-Cirujanos colabora con ASSMCA

Dr. Ramos Yordan:
1. Conoce al Dr. Galarza Arbona de una reunion en Utuado
2. Recorta paginas de periodicos sobre la salud mental desde que lo conocio en Utuado
3. Hay que atender el asunto del suicidio en la isla.
4. Trabajo con rosa Miranda, quien interesa tener un linea de auxilio en toda la isla.
5. Rosa le pidio ayuda
6. Como presidente impulsaria estos asunto sobre la salud mental.

Dr. Rivera Soler
1. Ha trabajado en Puerto Rico desde la epoca del Dr. Guillermo Arbona
2. La secretaria de salud deberia fomentar la evaluacion mental en las escuelas
3. El Colegio de Medicos-Cirujanos debe exigir leyes de salud mental claras y concisas
4. Se deben poner dineros para las evaluaciones de salud mental en vez de para los celulares de los legisladores.

Saturday, February 25, 2006

Los psiquiatras se siguen organizando y colaborando

American Psychiatric Association
Arlington, Virginia

2006 Election Results


On 22 February 2006 James Scully, Medical Director informed the following;
The Committee of Tellers met on February 22, 2006 and reviewed the results of the 2006 election. The Committee reported that 9,819 paper and online ballots, representing the votes of 32.4% of the eligible voting members, were returned. Of these, 2,774 or 28.3% voted online. The candidates elected (with the percentage of votes) were as follows:
President-Elect: Carolyn B. Robinowitz, M.D. (76.1%)
Secretary-Treasurer: Donna M. Norris, M.D. (51.4%)
ECP Trustee-at-Large: Amy M. Ursano, M.D. (67.4%)
Member-in-Training
Trustee-Elect: Abigail L. Donovan, M.D. (50.3%)
Area 1 Trustee: Jeffrey L. Geller, M.D., MPH (59.6%)
Area 4 Trustee: Sidney H. Weissman, M.D. (52.0%)
Area 7 Trustee: William M. Womack, M.D. (69.7%)

I have notified the candidates that these are the results the Tellers will recommend to the Board for approval. These results are considered public, but not official, until the Board acts to accept the report of the Tellers Committee on Sunday, March 5, 2006.



Resultados de las elecciones del
Capitulo de Psiquiatria del
Colegio de Medicos y Cirujanos de Puerto Rico

San Juan, Puerto Rico

25 de febrero del 2006

Presidente------------------------------------Edgardo Prieto, MD
Vicepresidente------------------------------- Rafael Cabrera, MD
Secretario------------------------------------Nestor J Galarza, MD
Subsecretaria--------------------------------Camille Perocier, MD
Tesorera-------------------------------------Nilda Garcia, MD
Subtesorero----------------------------------Alfonso Madrid, MD
Delegado a Disciplinas Medica----------------Norberto Pellot, MD
Delegado alterno-----------------------------Ramses Normandia, MD
Senador--------------------------------------Ramses Normandia, MD
Senador Alterno------------------------------Hector Torres, MD
Psiquiatria forense----------------------------Raul Lopez, MD
Psiquiatria e Hipnosis------------------------Jesús Saavedra, MD
Psiquiatria Geriatrica----------------------- Carmen Rodríguez, MD
Psiquiatria de Adicciones----------------- ---Nestor J Galarza
Neuropsicofarmacologia----------------------Barbara Diaz, MD
Psiquiatria general---------------------------Erika Rivera, MD
Psiquiatria de Ninos y Adolescentes----------Richard Camino, MD
Contacto con la Comunidad------------------Jose Juan Rodriguez, MD
Arbitraje------------------------------------Dr. Jose Vazquez Sotomayor, MD




ideas

Thursday, February 23, 2006

More opinions on the DEATH PENALTY

This is an important issue for members of the Puerto Rico Psychiatric Society. I have discussed this social issue with Dr. Kenneth Geil who is preparing to help us present an Action Paper at the APA Assembly sometime in the future.
psych@puertoricopsychiatricsociety.org


See Dr. Halpern’s and Dr. Freedman’s and Dr. Ray's recent opinions below.
===================================================================
Abraham L. Halpern, M.D.
Wednesday, February 22, 2006
Re: First Do No Harm

The neurologist's opinion comes as no surprise. The fact is that studies done a few short years ago revealed that the vast majority of physicians were unaware of the actions prohibited by the AMA Code of Medical Ethics. It is absolutely essential that CEJA continue to be directly involved whenever a death penalty jurisdiction seeks physician participation in the planned execution.
Abe Halpern
==============================================================

Many thanks to Dr. Abraham Halpern for bringing to our attention the courageous and ethical stand that the two anesthesiologists took in refusing to participate in an execution. This is in contrsdt to the"widespread,but carefully kept under wraps, involvement of physicians" in executions as pointed out by Dr. H. Professor Gunn of the Institute of Psychiatry in London has predicted that if the death penalty were returned to Western European democracies all the doctors would refuse to participate and thus, the program would fail. Whether or not such a resolve would be possible it indicates the potential if all physicians refused to participate in executions.

In the Maturana case in Arizona, Claude Maturana, an inmate on death row became psychotic and was transferred to an adjacent state hospital with orders from high authorities to treat Maturana with drugs so he could be declared competent and executed. The psychiatrist in charge refused to comply on ethical grounds. Rather, he elected to treat Maturana with a minimal dose that decreased his delusions but did not render him competent and resisted pressure from above to increase the dose.
One hopes that physicians in the USA will take heart from the refusal of the two anesthesiologists and the psychiatrist to never take part in legal executions.

Alfred M. Freedman, M.D.
Chair and Professor of Psychiatry, Emeritus
New York Medical College
1148 Fifth Ave
New York, NY 10128


On Feb 21, 2006 Abraham L. Halpern, M.D. wrote:
Kudos to psychiatrist Priscilla Ray and her fellow members of the AMA Council on Ethical and Judicial Affairs for issuing the statement that resulted in the refusal of two anesthesiologists to participate in the execution of Michael Morales in California. Given the publicity in this case, the statement, not heretofore issued prior to other executions in death-penalty jurisdictions (including federal) will surely alert physicians (and nurses, who have a similar ethics code relating to participation in executions) of their ethical obligations. Up to now the AMA has remained strangely silent in the widespread, but carefully kept under wraps, involvement of physicians.
With the reiteration of Opinion 2.06, CEJA should withdraw its support of the APA Council on Psychiatry and Law position that it is ethical to treat an incompetent death row inmate to render him competent to be executed when that inmate, at a time when he was competent, had made out an advance directive that he be treated should he become incompetent, so that his wish to be executed can be honored. It is the opinion of CEJA that "adhering to a prisoner's wishes and restoring competency may be consistent with the principle of respect for a patient's autonomy." As medical ethicist Edmund Pellegrino points out, not only does this carry autonomy beyond its legitimate interests, but to comply in such a request the physician is cooperating formally with an act that is intrinsically wrong. It constitutes an active, direct cooperation by a physician in the act of execution and clearly violates the code of medical ethics.
Abraham Halpern

On Feb 21, 2006

AMA opposes physician involvement in executions
For immediate releaseFebruary 17, 2006
Statement attributable to:Priscilla Ray, Chair, AMA Council on Ethical and Judicial Affairs

"The American Medical Association (AMA) is alarmed that Judge Jeremy Fogel has disregarded physicians' ethical obligations when he ordered procedures for physician participation in executions of California inmates by lethal injection.
"The AMA Code of Medical Ethics addresses physician participation in executions involving lethal injection. These ethical obligations are set out in detail in ethical opinion 2.06 authored by the AMA Council on Ethical and Judicial Affairs. In part, it states:
An individual's opinion on capital punishment is the personal moral decision of the individual. A physician, as a member of a profession dedicated to preserving life when there is hope of doing so, should not be a participant in a legally authorized execution. Physician participation in execution is defined generally as actions which would fall into one or more of the following categories:
(1) an action which would directly cause the death of the condemned; (2) an action which would assist, supervise, or contribute to the ability of another individual to directly cause the death of the condemned; (3) an action which could automatically cause an execution to be carried out on a condemned prisoner.
Physician participation in an execution includes, but is not limited to, the following actions: prescribing or administering tranquilizers and other psychotropic agents and medications that are part of the execution procedure; monitoring vital signs on site or remotely (including monitoring electrocardiograms); attending or observing an execution as a physician; and rendering of technical advice regarding execution.
In the case where the method of execution is lethal injection, the following actions by the physician would also constitute physician participation in execution: selecting injection sites; starting intravenous lines as a port for a lethal injection device; prescribing, preparing, administering, or supervising injection drugs or their doses or types; inspecting, testing, or maintaining lethal injection devices; and consulting with or supervising lethal injection personnel.
"The use of a physician's clinical skill and judgment for purposes other than promoting an individual's health and welfare undermines a basic ethical foundation of medicine — first, do no harm. Therefore, requiring physicians to be involved in executions violates their oath to protect lives and erodes public confidence in the medical profession.
"As the voice of American medicine, the AMA urges all physicians to remain dedicated to our ethical obligations which prohibit involvement in capital punishment."
###
Editor's Note: For a full text of the AMA ethical opinion, E-2.06, Capital Punishment, please visit the Web site.
For more information, please contact:
Robert J. MillsAMA Media Relations(312) 464-5970






ideas

Saturday, February 18, 2006

Quien dice que los estudiantes de medicina no escriben?

Medicina o Política

Esta es una exhortación a la meditación que dirijo a mis compañeros de la clase de medicina.

Presumiblemente cada una de las personas que formamos esta clase tenemos un mismo propósito, prepararnos genuinamente para la practica fiel y eficiente de la medicina. Sin embargo, creo que con el paso del tiempo, desde que emprendimos esta carrera en agosto del año pasado hasta la fecha actual, ha habido un cambio casi radial en el modo de pensar, en las actitudes y en el propósito de muchos de nosotros ‘ por lo menos en un numero significativo de nosotros.

Aun en sus comienzos, la
clase se vio en una situación critica de compatibilidad de sus miembros. Trabajo nos costo lograr un rapport con nuestros compañeros y alcanzar una identidad de clase como la tenemos ahora. Desafortunadamente, en este momento creo ver una nueva crisis en el panorama futuro inmediato. Me explico.

Personalmente condeno la apatía por los sucesos diarios. Esta puede ser, junto al escapismo, una de las causas de que se postergue la solución a los problemas pequeños, postergación que pare problemas grandes. Últimamente, algunos compañeros en la carrera han expresado en el Escalpelo y por otros medios, la necesidad de atacar la apatía del estudiante de medicina. Bien hecho. Pero también, en esto, como en otras situaciones, debemos buscar un termino medio, evitando los extremismos. Podemos llegar a odiar tanto la apatía como los problemas sociopolíticos de nuestra isla, que en un frenesí por darle solución activa, releguemos la solución de los problemas que nos atañen inmediatamente.

Nosotros nos enfrentamos día a día con dificultades de nuestra educación en la escuela. Unos son de genero colectivo, otras son dificultades personales, pero todas están relacionadas con nuestra educación medica. Y la seriedad con que tratamos los problemas políticos, debe ser la misma que apliquemos al estudio responsable de nuestra carrera. Que no sea la carrera de medicina solamente un trampolín para conseguir ideales políticos, que puedan ser buenos o malos per se, pero que no deben tener prioridad del esfuerzo y la energía del estudiante de medicina. No se puede hacer una separación de la persona y el profesional, pero los ideales personales deben solucionarse como tales y no usar la profesión para conseguirlos en tanto que menoscaben el logro y la calidad de esta profesión.

Nuestra profesión es nuestro deber inmediato y colectivo como clase, la solución del problema político, nuestro deber mediato y particular como personas.
Néstor José Galarza Díaz, MS II


Otro pensamiento.

Dilema de ahora o de antes

Uno de los muchos dilemas que se nos pueden presentar a los estudiantes de medicina es el de si, ya titulados doctores en medicina, damos mejor servicio y cumplimos con el juramento de Hipocrático a mayor cabalidad, especializándonos en una rama especifica de la profesión o limitándonos con exclusividad a la administración del servicio medico general. Creo que este es un motivo serio para lograr una decisión que resulta, sin embargo, difícil y crucial.

Una mirada global a todas las profesiones vigentes en nuestra sociedad, produce el reconocimiento de la profesión medica como la mas dinámica de todas, es una ciencia en movimiento perpetuo. El medico que no esta enterado de los nuevos adelantos de su profesión, no progresa a la par con la ciencia medica y no da el mejor servicio a la comunidad. Lo mismo en medicina general como en las especialidades se puede lograr un dinamismo educativo que mantenga al medico al tanto de los avances científicos en su profesión.

Con estas alternativas en mente debe uno preguntarse cual de ser el propósito de la medicina. O mejor, cual es mi propósito al estudiar medicina. ¿Fama solamente? ¿Dinero solamente? ¿Fama y dinero? ¿Caridad? ¿Satisfacción personal? Y cuando hallemos la respuesta quizá podamos decidir entre especialidad y medicina general.

Néstor José Galarza Díaz MS II.
Clase de Medicina del 1972.
Publicado en El Escalpelo, 1969

Friday, February 17, 2006

My favorite publishable dream

I am lying in bed by my wife, at night.
This is the home in Rio Piedras where we lived in with our three year old daugter before we moved to the USA.
For some reason I wake up in the middle of the night and walk to the window.
There, slowly moving up I saw these three lighted objects, drifting up in silence like saucers...

That is the dream. I keep my associations to myself.

My favorite publishable dream

I am lying in bed by my wife, at night.
This is the home in Rio Piedras where we lived in with our three year old daugter before we moved to the USA.
For some reason I wake up in the middle of the night and walk to the window.
There, slowly moving up I saw these three lighted objects, drifting up in silence like saucers...

That is the dream. I keep my associations to myself.

Thursday, February 16, 2006

"El cuadro esta lleno"

Como pocos programas nuestros en la radio, el lunes pasado en Con tu salud en mente finalmente sentí un inmenso orgullo en decir como Luis Francisco Ojeda ....."el cuadro está lleno."

Las llamadas dirigidas a la Dra. Vilma McCarthy y al Dr. Arnaldo Cruz Igartúa llovían. Había premura por terminar la conversación con una persona para darle oportunidad a la otras. El tema: las adicciones, el discrimen contra las personas que padecen estas enfermedades mayores, casos de personas de edad geriátrica que padecen de multiples trastornos mentales incluyendo el alcoholismo o drogodependencia.

Una persona llamó con angustia diciendo que sentía que no valia la pena vivir, otra persona llamo diciendo que nos felicitaba y que siempre nos escuchaba, otra persona nos llamó para quejarse que después de una hospitalización de personas con adicción no habia tratamiento efectivo de seguimiento, etcétera...

Gracias otra vez a los profesores del Departamento de Psiquiatríaa de la Escuela de Medicina de la Universidad de Puerto Rico que nos acompañaron y se arriesgaron a que les hiciera preguntas como Rubén Sanchez....difíciles de contestar.

Just kidding.

moderador de Con tu salud en mente
por WKVM 810AM a las 7:30 PM lunes

Néstor J Galarza

Wednesday, February 15, 2006

A thank you note

ideas

This is a sample letter to past speakers in our weekly radio program.


Puerto Rico Psychiatric Society
A Chapter of the American Psychiatric Association
POB 33113
San Juan, Puerto Rico 00933
http://www.puertoricopsychiatricsociety.org/


15 February 2006


Dear Dr:
The Puerto Rico Psychiatric Society wants to show our appreciation for your excellent participation in our radio program Con tu salud en mente.on WKVM. This weekly broadcast provides the widest range of influence on public opinion and a tool to accomplish our goal to promote education in Psychiatry and related mental health areas.

Your participation on his radio program has advanced our goals and we expect that it also met your particular goals in the profession of Psychiatry.


Néstor J Galarza, MD President Jorge Gonzalez, MD Vice president
Carlos Caban, MD Presidente Electo
Brenda Matos, MD Secretary Vilma McCarthy, MD Treasurer Luis E Canepa, MD Rep to APA AssemblyVictor Sierra, MD Deputy Rep to APA Assembly Officers and Consultants: Ingrid Alicea, MD, Diana Diaz, MD, Rafael Garcia Barcenas, MD, Kenneth Geil, MD, Arlene Rivera Mas, MD, Rafael Garcia Barcenas, MD, Ernesto Frontera, MD

Con tu salud en mente 1, 2, 3

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Los primeros tres programas de esta temporada Con tu salud en mente contaron con los mèdicos psiquiatras Brenda Matos, Maria Rodriguez, Lelis Nazario, Ingrid Casas, Vìctor Lladò y el Sr. Jaime Gonzalez, motivador. Muy motivados estamos todavìa con el programa que se trasmite los lunes a las 7:30PM por WKVM impulsados por 50 mil vatios de potencia.

El trastorno oposicional desafiante, el trastorno de atenciòn en ninos, el autismo, dos libros importantes y educativos sobre la salud mental y uno sobre como evitar la mediocridad y conquistar al mundo....temas que a su vez incitaron a los radioescuchas a llamar al 787 751-1018.

Este programa es el conversatorio semanal del Capìtulo de Puerto Rico de la Asociaciòn Psiquiatrica Americana con los ciudadanos en Puerto Rico.

Mantèngase en sintonìa los lunes en la frecuencia radial 810 AM para aprender. Ayùdenos a complir con nuestro deber social de orientar.

Saturday, February 11, 2006

Psiquiatria y Cultura #1 Otto Kernberg

Sociedad Psiquiatrica de Puerto Rico
http://www.puertoricopsychiatricsociety.org/

psiquiatria y cultura
#1

Otto F. Kernberg


Otto F. Kernberg, was born in Vienna in 1928 and in 1939 his family left Germany to escape the Nazi regime and emigrated to Chile where he later studied biology and medicine and afterwards psychiatry and psychoanalysis with the Chilean Psychoanalytic Society. He first went to the US in 1959 on a Rockefeller Foundation fellowship to study research in psychotherapy with Jerome Frank at the Johns Hopkins Hospital. In 1961 he emigrated to the US and joined, and later became director of, the C.F. Menninger Memorial Hospital. He was the Supervising and Training Analyst of the Topeka Institute for Psychoanalysis, and Director of the Psychotherapy Research Project of the Menninger Foundation. In 1973 he moved to New York where he was Directory of the General Clinical Service of the New York State Psychiatric Institute and in 1974 was appointed Professor of Clinical Psychiatry at the College of Physicians and Surgeons of Columbia University. In 1976 he was appointed as Professor of Psychiatry at Cornell University and Director of the Institute for Personality Disorders Institute of the New York Hospital-Cornell Medical Center. In 1995 he became President of the International Psychoanalytic Association.
His principal contributions have been in the fields of narcissism, object relations and personality disorders.
He was awarded the 1972 Heinz Hartmann Award of the New Your Psychoanalytic Institute and Society, the 1975 Edward A. Strecker Award from the Institute of Pennsylvania Hospital, the 1981 George E. Daniels Merit Award of the Association for Psychoanalytic Medicine.

External links
A bibliography of his works
Kernberg, Otto F.