All is well that ends well

Interview with Armando Baez, specialist in psychiatry

Theme: Lost in translation

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Armando Baez is a Mexican born psychiatrist who left a fine position in Mexico City to follow his Danish wife. After having had to rewind his education and start all over he is now well established as a psychiatrist in the Copenhagen area with his own clinic.

Marianne Kastrup: Tell me briefly about your professional career in Mexico.

Armando Baez: I graduated as an MD in 1986 and got my psychiatric specialization in 1992. From 1992 I worked at the newly established and largest psychiatric department in the main medical center in Mexico City, focusing on liaison psychiatry.

Why did you leave Mexico?

My wife is Danish, and we took a personal decision in 1999 to settle in Denmark not fully recognizing that the road to become a Danish specialist would be so long.

Could you briefly take us through your journey?

I started immediately to learn Danish and after about 7 months I got an unclassified job at a psychiatric department in a Copenhagen suburb; after having been there a year I got a similar job in another psychiatric department for about 6 months followed by a job in a community mental health center. While working as a psychiatric resident I passed the required exams to receive my authorization as a medical doctor in 2001. I tried - with little luck - to negotiate with the National Board of Health to avoid having to repeat an obligatory internship. My wife who is a political scientist then wrote a personal letter to the prime minister questioning the rationality to prevent a qualified psychiatrist from working in his field of expertise. And mirabile dictu the result was that if I could demonstrate that my Mexican internship fulfilled the Danish standards, I did not have to repeat it. So, I returned to Mexico, procured the documents and finally in 2006-07 I got my Danish specialization as a psychiatrist, after completing a series of obligatory courses in psychiatry.

Was it then smooth sailing?

Well, I was offered a nice consultant position in the Copenhagen region. I have learned many different aspects of the specialty being part of the anxiety department in Rigshospitalet, an outpatient clinic afterwards, a clinic for the treatment of eating disorders, and finally an outpatient department for patients with personality disorders and depression. I went along, becoming responsible for the postgraduate training as well as training junior colleagues in psychotherapy. I worked there for some years but to cut a long story short administrative, non-medical decisions changed my working conditions in a way that made me seriously consider my future.

Consequently, I decided to settle down as a psychiatrist with my own clinic and here I am 10 years later.

Could you elaborate on obstacles you have been facing at the Danish system?

Let me emphasize that when it comes to my relations with the leaders of psychiatry in Denmark, I have experienced nothing but openness and good will. A willingness to welcome me and acknowledge my background. It is my impression that these contacts have facilitated my way and kept me optimistic also when things were tedious.

When it comes to the bureaucratic aspects, I have felt that the system is slow, with little flexibility which seems contradictory in the light of the fact that in many areas there is a shortage of specialists.

Armando Baez: “Let me emphasize that when it comes to my relations with the leaders of psychiatry in Denmark, I have experienced nothing but openness and good will.” Image by Unsplash.

Have you experienced any discrimination during your work and stay in Denmark?

Once you start to focus on such aspects you see them in many ways – sometimes subtle, sometimes more brutal.

Years ago, I frequently made jokes about my background but became aware that it backfired and could be used against me, so I stopped.

Let me tell you a small anecdote. I recently took the subway home, entered a compartment and sat vis-à-vis an elegant lady with a Louis Vuitton handbag. She scrutinized me and subsequently took the handbag and clutched it tightly in her arms. I responded by clutching my Fjällräven rucksack tightly in my arms while looking at her. She became embarrassed and left the compartment.

One of my patients originating in Latin America told me how people generally see her as a cleaning lady or some uneducated person and get surprised when informed that she is a university researcher. So unfortunately, despite increasing globalization and interaction the conceptualization of how foreigners are seen has not changed much and as a migrant you have to find ways to cope with it.

What are your coping strategies?

Humor is always a fine way of sublimation and so to speak place a mirror in front of the person. I have also become increasingly aware that when people approach you with prejudice it is in general less due to your background or appearance but rather something in their past that works as a trigger.

I think that it is important to navigate trying to understand the background of the other. That facilitates your own coping.

Do you see any advantage in having insight into different cultures in your clinical work?

I recall years ago meeting Norman Sartorius in Mexico and watching him so smoothly change from one language to another. Similarly, I think that it is an advantage that a consultation with me may take place in Danish, English, Spanish, Portuguese or Norwegian, and I express an interest in the linguistic as well as cultural background of my patients. About 12-15% of my consultations take place in another language and I know that patients specifically get referred to me for that reason. I also have the reputation of being “LGBT+ friendly”.

Do you have any advice to foreign doctors settling in Denmark?

My first and foremost advice is to learn the language not just to make yourself understood, but to get an insight and knowledge of the nuances to grasp subtleties.

Secondly, I think that you should approach the challenges with curiosity trying to get behind what seems odd or not understandable. It is important always to stay respectful and decent in your contact.

Try to get in contact with medical authorities, get involved in academic discussions or work and learn from them but also to be part of the social events despite having a feeling to be left out not understanding the unwritten rules.

Is your present work situation satisfactory?

Yes, I have a very satisfactory life. Here in Denmark, it is possible to have a fine work/life balance. I find Denmark an excellent country to live in and bring up my children. So, all is well that ends well. □