INVITED EDITORIAL
Psychiatry in Rio Grande do Sul in the 40s and 50s: personal report
Sérgio Paulo Annes
Psychiatrist and psychoanalyst
Having been invited by the editors of Revista de Psiquiatria do Rio Grande do Sul, I will report some of my experience of general medical formation, especially in my specialty concerning clinical practice and psychiatric hospitalizations in the late 1940's or 1950's. I graduated in Medical School from Universidade Federal do Rio Grande do Sul (UFRGS) in 1947.
At that time, there were no courses of psychiatric formation. We could become psychiatrists with the aid of a professor who accepted us as an apprentice. I use to say it was "a homemade formation," different from the current "assembly line," so to speak, in courses with teaching programs, several masters and years of formation. That is the reality of current courses of psychiatric formation. The first course in our country was founded by Dr. Paulo Guedes and Dr. David Zimmermann in 1957, at UFRGS Medical School.
My first contact with psychiatry was through Professor Celestino Moura Prunes, who referred us to psychiatry in his course of Forensic Medicine at Instituto Médico Forense. He undoubtedly was the best professor I have ever had in my psychiatric medical formation.
I expressed my desire to study psychiatry to Prof. Dr. Décio Soares de Souza, who then asked Dr. Jacinto Godoy, director at that time, permission to let me attend Hospital Psiquiátrico São Pedro (HPSP) regularly. I was taken to the presence of Dr. Godoy, who opposed to that idea at first, claiming he did not want strange people attending HPSP. Dr. Souza insisted and managed to obtain Dr. Godoy's approval, seeking Dr. Victor de Brito Velho at HPSP, so that he could gradually put me in contact with inpatients. Since Dr. Brito Velho was not found, I was taken to Dr. Mario Martins, who provided care for women at HPSP. Dr. Martins sheltered me, and my work in psychiatry was then started. I was allowed to follow him, I used to watch him treating patients, and I was then increasing contact with them. He advised me some readings, such as Semiologia (propedêutica psiquiátrica) (Semiology:psychiatric work-up), by Prof. Nobre de Mello, Manual de psiquiatria (Manual of psychiatry), by Prof. Dr. Mira y Lopes, Propedêutica clínica psiquiátrica (Psychiatric clinical work-up) and Tratado de psiquiatria (Treaty on psychiatry), by Prof. Dr. A. Vallejo Nágera. In addition, he encouraged me to interview patients, making notes in their respective charts.
HPSP started being and it still should be a teaching hospital, since at that time, practical lessons of psychiatry were held at the hospital by Dr. Paulo Guedes and Ernesto La Porta. They both shared groups; I was assigned to have practical lessons with Prof. Paulo Guedes. Theoretical lessons were held at Santa Casa's amphitheater by Professor Décio Soares de Souza.
The main hospital treatments used after clinical review were electric convulsive therapy (convulsive therapy using cardiazol was already being discarded) associated with insulin coma therapy (Sakel), besides acetylcholine-induced vascular relaxation (which I watched at Hospital Espírita, applied by Dr. Pedro Rosa, although I have never applied it). In the treatment of neurosyphilis, before introduction of penicilline in the 1940's, malariotherapy was still used in association with injections of arsenic, bismuth and mercury. Chemical antipsychotics were introduced in our country at that time.
Dr. Martins had recently arrived from Buenos Aires, where he had his psychoanalytical formation with Prof. Dr. Angel Garma. Later, Dr. José Jaime Lemmertz, Dr. Cyro Martins and Dr. Celestino Prunes came to Porto Alegre. The latter came from Rio de Janeiro, and the others from Buenos Aires. These four analysts founded the Center of Psychotherapeutic Formation of Porto Alegre, which would later give origin to Sociedade Psicanalítica de Porto Alegre.
HPSP nursing was comprised by nuns, charity sisters of the Order of Notre Dame. HPSP was always crowded, and facilities were precarious. It was common to use one bed for two patients in wards. I witnessed that situation in women's ward.
There was the promise of a public contest for psychiatry at HPSP, to which I looked forward. Since that contest was taking too long, Prof. Décio de Souza took me to the Government House to plead my nomination for Governor Walter Jobim. The Governor did not receive us, and this was another frustrated waiting. Later, three psychiatrists were nominated, all of them very skilled. And the much waited contest was not held.
I then went to the countryside, to the town of Iraí, due to economic problems, since I did not get the job at HPSP. There, after interference by the mayor, Israel Farrapo Machado, I was nominated pediatrician at the local Health Care Facility.
The local main politician, Congressman Dr. Tarso Dutra, had promised the mayor a pediatrician for the Health Care Facility, and I was indicated for that position. Later, I was transferred to Porto Alegre, to the HPSP. Still as "monthly supernumerary," I remained there until I took a contest to psychiatry at a federal autarchy. I was approved and left the state job, since at that time it was not allowed to have two public jobs - "job accumulation." I do not know whether that criterion is still in effect.
To perform my specialty, I provided care at the Outpatient Clinic in the morning - located at Edifício Santa Marta, across from Edifício da Alfândega - and inpatients at three hospitals: HPSP, Hospital Espírita and São José. Afterward, other physicians were included in the autarchy, but criterion was political, through indications. Psychiatry was considered a "simple" specialty by colleagues from other specialties. I have a picturesque recollection about it: one day, a pediatrician, who worked as psychiatrist at the same institution I was working, told me that, when he joined the institution, he was given the possibility of choosing between two specialties: either as ophthalmologist or as a psychiatrist. He chose psychiatry, which, in his own words, was "just talking;" otherwise, working as an ophthalmologist he would be a risk for patients' eyes.
Some years later, besides accumulation of patients and difficulties to manage them, there was also the possibility of retiring, based on an act created by President Costa e Silva, who made retirement optional for those who had 30 years of public service during the II World War and who had served in the so-called "war zones," which, in Rio Grande do Sul, reached the shore and the frontier. I then retired from the Autarchy Service in 1968. To calculate years of service, military service was considered, besides the contest at Hospital de Pronto-Socorro, where I worked throughout 1947, and internship time, for approximately 3 years, from 1945 to 1947, at Hospital da Brigada Militar, in Cristal District. In the latter, I initially helped Dr. Leone Scalco, and later Dr. Gilberto Netto Velho. Since my graduation, I have had a private office.
In 1954, I started my analysis with Dr. Mário Martins and, since then, I have been working with analytical psychotherapy and psychoanalysis. Formation of analysts was established with recognition of the International Psychoanalytical Association, and the Group of Psychoanalytical Studies we were creating here was recognized as Sociedade Psicanalítica de Porto Alegre in 1963.
I have been working as a psychoanalyst since I concluded my analytical formation in 1963.
Publication Dates
-
Publication in this collection
13 Dec 2007 -
Date of issue
Aug 2007
