Medical Record | Translation

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The following English translation was generated with the assistance of artificial intelligence

[Daniel Alarcón]: Hello, ambulantes.

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Here’s the episode.

The following English translation was generated with the assistance of artificial intelligence 

[Daniel Alarcón]: This is Radio Ambulante. I’m Daniel Alarcón.

On the night of March 28, 2005, Argentine doctor Marcos Hourmann was in charge of the emergency department at Mora D’Ebre Hospital in Tarragona, an hour from Barcelona, Spain.

Marcos had been working there for a few years, a small health center with limited resources and doctors younger than him, who by that time already had more than 20 years of experience as a surgeon and emergency physician.

He liked the job. The adrenaline of urgent situations had never stressed him; quite the opposite. And that night was turning out to be quiet, just like any other. Until the emergency room doors opened and an 82-year-old woman named Carmen arrived, accompanied by her daughter.

[Marcos Hourmann]: Critical. Very critical. With a heart attack… myocardial infarction. A gastrointestinal hemorrhage, diabetes, and a huge colon cancer.

[Daniel]: She had been diagnosed three months earlier. As soon as she arrived, Marcos noticed she wanted to tell him something.

[Marcos H.]: And she asks me to let her die right away… and I ignore her.

[Daniel]: She asked him to let her die, but Marcos didn’t even consider the request. So he began with the routine procedures for cases like this.

[Marcos H.]: I try to pull her through. And with the heart attack, that is what I know how to do. I manage her, manage her, manage her, manage her, as much as I can, as much as I can. And we give her everything after almost two or three—I don’t know—many hours working to pull her through, until there comes a point when the medical situation is irreversible… and there’s nothing more to be done.

[Daniel]: There was nothing he could do to save her.

[Marcos H.]: I explain it to the daughter, that there’s nothing to be done, that the heart is no longer viable. And that if she agrees, we’re going to sedate her.

[Daniel]: He explained that sedation is a standard procedure for patients like Carmen when medicine runs out of options. In this case, he could inject a cocktail of morphine derivatives and other sedatives to decrease her consciousness and relieve her suffering at the end.

The daughter agreed. So Marcos sedated Carmen and went to rest in one of the free rooms in the hospital. It was already almost four in the morning. He was sleeping when a nurse told him that the patient’s daughter was looking for him because she wanted to talk.

[Marcos H.]: And the daughter tells me she couldn’t watch her mother suffer like that anymore. And right there. Then another human being returns. There, it’s Marcos now. Not the doctor. The doctor had done everything up to that point, everything. 

[Daniel]: And that Marcos, no longer in his role as a doctor but as a human being, began to see Carmen’s daughter not as just another family member of the many he had seen in his career, but differently: as a woman defeated by exhaustion and anguish. And then he remembered what Carmen had asked him when she arrived.

[Marcos H.]: I said: I’m going to help you because there’s no need to see your mother suffer one more second. Because that’s the key word in this story: “Suffering.” And I tell her, if she wants it to be now, she says yes.

[Daniel]: To be now… to die now. So he entered the room, loaded potassium chloride into a syringe, and administered it intravenously.

[Marcos H.]: That causes cardiorespiratory arrest. I left the room and looked at her and said, “It’s done.”

[Daniel]: It’s done. Carmen had died. For her and her family, the potassium chloride injection was the end of perhaps an already too-long pain. For Marcos, however, it was the beginning of a nightmare that at that moment he had no way of measuring.

[Daniel]: Our producer Emilia Erbetta continues with the story.

[Emilia Erbetta]: That early morning in 2005, when Marcos administered the potassium chloride injection to Carmen, he had already been out of Argentina for 15 years.

He wasn’t the only doctor in his family. His older brother studied the same thing. But that didn’t mean he was a family of doctors, not at all. His mother Esther was a merchant and pianist, and his father Luis worked with precious stones and also played the violin with perfect pitch. An Argentine middle-class working family like many others.

Marcos doesn’t remember how the medical vocation revealed itself to him. Somehow, it’s as if it had always been there.

[Marcos H.]: When I was a kid, seven, eight years old, I always talked about wanting to be a doctor. After so many years—I’ve been a doctor for 40 years—I feel like it was what I had to do.

[Emilia E.]: So when he finished high school in the late ’70s, he enrolled in the Faculty of Medicine at the University of Buenos Aires, from which he graduated in 1985, at age 24. First, he thought about specializing in anesthesiology. During his internships he had met an anesthesiologist who had impressed him a bit, earning his admiration. So one day he went to watch him work directly in the operating room.

[Marcos H.]: And I realized it was going to be more fun to be with the surgery team. And there I said, “Mmmm, anesthesia is going to be too routine. I’ll do better in surgery.”

[Emilia E.]: He decided to specialize in general surgery and was in full training when his mother died in 1987. Esther had been on dialysis for some years due to a kidney condition and was doing very well, until a very aggressive bacteria entered through her navel.

[Marcos H.]: My mother’s death was quick. In 24 hours she developed a systemic infection and we couldn’t do anything. We intubated her, and in the last minutes we disconnected her. There was nothing more to be done.

[Emilia E.]: Esther’s death was a hard blow for the whole family—for Marcos, his sister, his brother. But especially for his father, Luis.

[Marcos H.]: My mother’s death was a before and after for my father. His life had no meaning; he loved her so much. I remember my father was another human being. No, he couldn’t believe Esther wasn’t there.

[Emilia E.]: Three months later, Luis had a cerebrovascular stroke, and his health collapsed. Marcos and his siblings watched him become another person: lose control of his body and mind until he was completely bedridden.

It was two years of agony in which, somehow, Marcos and his siblings also absorbed some of all that pain. And it was so much and so deep that he felt it could drive him mad.

[Marcos H.]: Seeing my father bedridden is a pain that has been very hard in my life and has marked me deeply. That helplessness, you know? Of not being able to help, to say enough. I did feel that, but through other behaviors, not directly acting to end the pain, but rather I took on that pain myself.

[Emilia E.]: Perhaps that’s why in early 1990, when he was offered a job in Barcelona, he accepted. From the outside, it could be seen as a professional facing an offer too good to pass up. But Marcos experienced it differently: as an opportunity to get away from all that suffering.

So he traveled there with his wife and his two young daughters. Before leaving, he said goodbye to his father in the hospital. A month later, Luis died in Buenos Aires.

[Marcos H.]: My father’s death drove me to the madness of the injustice that he also had to suffer until the end of his life. How did it impact me? I’m telling you, toward absolute sadness.

[Emilia E.]: But at that moment, it never crossed his mind that he could have done something to end that agony sooner.

What came after were years that Marcos defines as “a lot of self-destruction,” although he didn’t want to give me many details.

Nevertheless, he kept working. He specialized in cardiovascular surgery and emergency medicine. He spent time with his family working in Tel Aviv, then got divorced, and in 2002 met a Spanish nurse named Yolanda and fell in love. They married sometime later, and in 2005 they had a son.

After several difficult years, it was finally a good time. He worked a lot and in different hospitals. And although he never had problems getting work in Spain, he did experience firsthand what many other immigrants like him feel: the sensation of always being a bit out of place, not being from here or there, and of speaking another language, even though Spain and Argentina use the same language.

[Marcos H.]: When you leave your home, which is your border, you’re naked. You have to prove everything 100 times more. You have to be 100 times more careful, fight for papers, fight for ID. When I go to Buenos Aires they say I’m Spanish; when I’m here they say I’m a sudaca.

[Emilia E.]: But he still liked them: Spain and the work. He had always felt that the emergency room was that place where he knew exactly what he had to do, where he moved confidently, precisely, with the right amount of knowledge and intuition.

[Marcos H.]: I function in medical emergencies. In the cold, in decision-making, I feel like I’m in my element,both in the operating room and in serious medical emergencies. I know what I’m doing. I like that feeling.

[Emilia E.]: Among the various jobs he had, one was as head of the night emergency department at Morra d’Ebre hospital. It was there that Carmen and her daughter arrived on March 28, 2005.

The people who came to the emergency room, in general, always wanted to live. For Marcos to cure them, to pull them through. So he had never before been in that position, facing pain that asked for another kind of remedy. Not to continue, but to stop. Not to live, but to die.

And it was precisely at that moment that his own story and the two years his father spent suffering came crashing down on him.

[Marcos H.]: What happened with Carmen has to do with this, right? Saying I couldn’t help my father. I’m going to help you with this unnecessary agony when there’s nothing more to be done.

[Emilia E.]: This feeling was also new for him: identifying so closely with the patient. It was a feeling he had always protected himself from in order to cope with the work. In a way, it was a survival strategy.

[Marcos H.]: We doctors distance ourselves from others’ pain. You can’t take everything home. This is very common. What happened to me with Carmen was such empathy with that patient and with the daughter that I became another son. The medical part had been fulfilled in the first phase. And when all this ends and Marco comes—the human being—it’s the first time I truly identify in almost… I had 30 years as a doctor, 35.

[Emilia E.]: That early morning, before administering the potassium chloride injection to Carmen and declaring her death, Marcos recorded the procedure in the medical record.

Marcos knew well that what he was doing was not legal. There was no medical protocol that indicated a potassium chloride injection in such circumstances. The only thing authorized in terminal cases like Carmen’s was palliative sedation. But at that point, he didn’t care. To make his decision, he relied on the only thing he had in front of him: a mother and daughter who were suffering and asking to end it.

[Marcos H.]: I could have left her sedated, but no. It wasn’t the intention. That is to say, I’m going to help you end this agony that makes no sense when medicine no longer reaches. This is very important. When there’s an irreversible medical situation, which means therapeutic chances are exhausted. Why prolong it?

[Emilia E.]: After administering the injection to Carmen, Marcos returned to one of the hospital’s free rooms to rest, as he had done many other times. The next morning, he waited for two hours for the other internists who would relieve him on duty. He was going to tell them about the case, but they were in a meeting and he didn’t get to see them. On the next shift he told the Head of Emergency, but Marcos doesn’t remember her having any particular reaction.

Two months passed without him talking about the subject with his colleagues again. Until one Friday afternoon, while preparing to operate on a patient in a Barcelona hospital, he received a phone call from Morra D’Ebre.

[Marcos H.]: The medical director of the hospital calls me, telling me not to report for Sunday’s shift because of Carmen’s case. I was shocked.

[Emilia E.]: They didn’t tell him anything more. But Marcos needed to know what was happening, so he canceled the surgery at the Barcelona hospital and decided to drive the almost two hours to the Tarragona hospital. When he arrived, he met with the director and the Head of Human Resources. There, in the meeting, they asked him to tell them what had happened that early morning.

[Marcos H.]: He asks me, “Why did you give her potassium?” I will explain. And then they tell me they’re going to fire me. And that they’re going to report me to the police station in the area.

[Emilia E.]: Marcos listened to them, surprised.

[Marcos H.]: They want to ruin my life? We’re coming for you. Directly. And so it was. I left that meeting destroyed. I didn’t know how. I mean, I stopped three times from the shock of what was coming. I couldn’t believe it.

[Emilia E.]: Perhaps what shocked him most was that the complaint didn’t come from Carmen’s family but from his bosses, from the same people he had worked with all that time—the ones who could understand why he had done it.

[Emilia E.]: He spent the weekend at home with his wife and young son, trying to take it in. When he thinks about those first days after the complaint, he remembers himself as… lost, in a state of complete disbelief.

[Marcos H.]: I’m in my house’s garden saying: it can’t be… I think I smoked like four packs of cigarettes. It was like saying, is this true? Is this real? It seems like a movie. I couldn’t believe it.

[Emilia E.]: Right away, he contacted a criminal lawyer to defend him in the process that had just begun.

The lawyer warned him that he should be prepared for the worst: it wasn’t certain, but they could come to arrest him in the following hours. Every time the doorbell rang, he thought it was the police.

[Marcos H.]: Your life enters unknown territory. And the unknown territory is the judicial system. When you enter there, you don’t know what’s going to happen.

[Emilia E.]: Or how long it might last.

[Daniel]: A break, and we’ll be back.

[Daniel]: We’re back on Radio Ambulante. Emilia continues telling us.

[Emilia E.]: In 2005, when Marcos was reported, euthanasia in Spain was illegal. About three years earlier, in 2002, the Netherlands had become the first European nation to legalize the practice. Shortly after, Belgium would do the same.

But in Spain, a country of Catholic tradition, the resistance from the Church, part of the medical community, and a political sector was still strong. Some cases had moved public opinion, such as that of Ramón Sampedro, who became quadriplegic in 1968, at age 25, in a beach accident. His entire body was immobile, except his head.

He was the first Spaniard to request from the State the right to euthanasia or assisted suicide, but Justice denied him on several occasions. Thirty years later, in 1998, with the help of 11 friends to whom he assigned different tasks so that no one could be blamed for his death, he committed suicide by taking cyanide in front of a video camera. The impact of his story was so great that it even made it to cinema: Javier Bardem portrayed him in the film The Sea Inside, by director Alejandro Amenábar.

But it wasn’t just Ramón. In 1984 the Right to Die with Dignity association was founded in Spain, which still works today to promote freedom when choosing how and when to die, especially in the case of terminally ill patients. So activism for the right to euthanasia already had more than 20 years when Marcos gave the potassium chloride to Carmen.

In that year, 2005, Dr. Fernando Marín, who today is vice president of the association, was already a member. And he still remembers how he learned about Marcos’ case. This is Fernando:

[Fernando M.]: Well, it was very curious. We saw a little note in the newspaper, a hospital. A doctor gave potassium chloride injection… and we were a bit stunned. Like saying: but this guy, who is he? He wasn’t from the DMD association. He hadn’t contacted DMD.

[Emilia E.]: It completely baffled them.

[Fernando M.]: It seemed to us: But what’s this guy about? This is a lone wolf going rogue. What guts he’s shown. Because the logical thing is to seek a bit of shelter from those who think like you and seek the shelter of the Right to Die with Dignity association. We would have given it to him totally, and we would have paid for the lawyers and such, but no, no, he went with his face uncovered. Here, I put my body, I put my life, and forward.

[Emilia E.]: Marcos wasn’t the only doctor facing a trial at that time. In March 2005, a few weeks before he administered the injection to Carmen, emergency doctor Luis Montes was anonymously reported for causing the death of 400 terminally ill patients with irregular sedations at a hospital in Madrid called Severo Ochoa. That case put the issue of euthanasia back in the spotlight.

[Fernando M.]: It was a time when speaking out in favor of euthanasia put a mark on you as an extremist, not from this crazy person. Because there was a lot of hypocrisy, and I remember many times being in a colloquium, finishing, some colleagues, some female doctor colleagues approaching me and telling me: Fernando, we all do that, but we don’t say it.

[Emilia E.]: But Marcos didn’t contact Right to Die with Dignity. He managed on his own, as he could, as he had always done. After the complaint, one by one he lost all his jobs as a doctor in Barcelona and nearby cities. And when he applied for a new one, they immediately rejected him. His reputation preceded him: he was the doctor with the injection.

None of his colleagues supported him. He had some doctor friends, but few. During his years in Spain, his personality had never worked in his favor. And he knows it.

[Marcos H.]: I was a complicated doctor. I was a guy who didn’t keep quiet about anything. I told you everything. If someone was useless I told them. If someone was good, I told them. I tried to train them. And so everyone thought I was a son of a bitch. But yes, I made many enemies…

[Emilia E.]: I asked Fernando how this sounded to him—what Marcos was saying—if he knew of other cases where such complaints were motivated by personal grudges, work squabbles, or even political problems. And he told me yes, that it wasn’t rare.

[Fernando M.]: Look, Marcos has character, right? So of course, if he had told the medical director, the manager, to go to hell seven times, well, there won’t be an eighth time. Now I’m going to report you because you’re a jerk and I don’t like you. It’s all very petty. But that’s how we are.

[Emilia E.]: Fernando also told me that the case of Luis Montes, the doctor accused of the sedations, had been mixed with political issues.

[Fernando M.]: The Community of Madrid used him as a scapegoat to go after that hospital, which was the progressive hospital, of people a bit rebellious with the right-wing party that still continues governing in the Community of Madrid.

[Emilia E.]: But there was a clear difference between the two cases: the complaint against Montes turned out to be false, and two years later, the judicial case ended up dismissed and archived. On the other hand, Marcos had administered the injection. He had never denied it and even, as we know, recorded it in the medical record. And that left him much more exposed.

[Emilia E.]: In the months after the complaint, Marcos and his wife Yolanda watched their life fall apart. His son was barely a baby. With Marcos without work and lawyers being so expensive, they finally lost the house they had just bought because they couldn’t pay the mortgage.

So in February 2006 they decided to leave Spain. They traveled to the United Kingdom, where he had already worked a few years before, and settled in Wales. That’s why, when Fernando and his colleagues from Right to Die with Dignity tried to contact him, they couldn’t. He had already left Spain.

In Wales, they began to lay the foundations of a new life. They rented a house, and Marcos registered with the General Medical Council, the system that regulates Health in the United Kingdom, and began working as an emergency doctor at a hospital in Cardiff. He lived there but always kept one eye on Catalonia, closely following every development in his case—if there was any change in the proceedings, if any new witness came forward who complicated things for him or helped him. He also traveled every time they asked him from the Court.

He always lived with the feeling that the life they were leading was fragile, that everything could collapse in a second. That feeling became stronger one day in 2007.

[Marcos H.]: One afternoon the lawyer called me, telling me that the prosecutor changed and that they were asking for ten years in prison.

[Emilia E.]: Ten years in prison, he told him, and without many more explanations he ended the call. “And there he left me, on the phone hanging.”

[Emilia E.]: There he left him, 10,000 kilometers from the country where he was born and practically exiled from the place he later chose to live, receiving the worst news of his life: the new prosecutor had requested a change in the case. It was no longer for euthanasia, a crime not codified in the Spanish Penal Code, but for homicide, a much more serious crime.

He felt a strong pain in his chest. It was his blood pressure rising non-stop, and Marcos thought he was about to have a heart attack. It didn’t get to that point, but that was the first time in his life he couldn’t go to work.

Of all the possible scenarios he had imagined during that time, this was without doubt the worst. From the beginning, the idea of going to prison had terrified him.

[Marcos H.]: Panic. If I had to sum up all the fears: having freedom curtailed. More than losing everything.

[Emilia E.]: It was fear, yes, but also something more.

[Marcos H.]: The helplessness of not being able to do anything because nothing is in your hands. I’m at the mercy of a lawyer, a prosecutor, and a judge.

[Emilia E.]: And there was another thing that terrified him: not being able to practice medicine.

[Marcos H.]: It was like they told Messi he can’t play football. No, man, not that. Look, I’m not Messi as a doctor, but the feeling is more or less “Don’t take away from me what I do know how to do. I don’t know how to do many things, but medicine I do know how to do.”

[Emilia E.]: From that call in 2007 until they summoned him for trial, two more years passed. Marcos remembers them as a time when they were always on edge.

[Marcos H.]: We lived our life thinking that I could be ten years in prison.

[Emilia E.]: In all that time, no colleague supported him or offered his help. But Marcos didn’t seek it either.

[Marcos H.]: I never expected solidarity because I understand others’ fear of becoming stigmatized. “I know Marcos” or “I’m Marcos’ friend. The euthanasia doctor?” No, away, far away.

[Emilia E.]: The date for the trial was set for March 2009. It had already been almost four years of proceedings.

Marcos traveled to Spain to appear before the Judge. It would be a trial for homicide that would be held with a popular jury. Upon arriving, he met with his lawyers, who were waiting for him with unexpected news: the Prosecutor’s Office was offering him a deal. Marcos listened to the conditions: they would sentence him to one year of conditional imprisonment and a fine of 1,600 euros.

It was a good offer: since he had no record and the sentence was conditional, he wouldn’t go to prison, and he could also continue working as a doctor in Spain. But in exchange, he had to do something he really didn’t believe in: plead guilty to reckless homicide, that is, homicide by negligence. As if, let’s say, he had killed Carmen by mistake, by having misunderstood her request.

[Marcos H.]: But I don’t consider myself guilty. No, not at all. I mean, I never felt it. If not, I would be destroyed. If I had felt guilty of homicide—I mean, I can’t live.

[Emilia E.]: Accepting that guilt was the price he had to pay for his freedom. But after four years of uncertainty, anguish, and economic ruin, he was willing to do it.

[Marcos H.]: Let’s say that what I wasn’t going to do is risk my life or risk my freedom for a matter of principles. It may be, let’s say, paradoxical. If I have to continue with my convictions and die under… and no… I’ll be weak, I’ll be whatever they want to call me, but the street is better than bars.

[Emilia E.]: The complaint against Marcos was made by the hospital authorities, and then the lawsuit was carried out by the Public Prosecutor’s Office, because Carmen’s family never wanted to join as plaintiffs or testify against him.

Although Carmen’s last name has been leaked in some journalistic notes, her children’s names have always been kept private. Marcos doesn’t maintain contact with them; he saw them for the last time on the day of the sentencing. They haven’t given interviews, except for a few statements to the newspaper El País in November 2009, a few months after the trial. At that time, Carmen’s son said, and I quote: “The hospital reported him, but we don’t know why they wanted to go after him. He acted professionally and fulfilled what we agreed. He only did what we asked him. Our mother was suffering and we only wanted her not to suffer.”

[Emilia E.]: I tried to contact the current authorities of Morra D’Ebre hospital to request an interview, but I got no response. I only found traces of the hospital’s official position in the same 2009 article I just mentioned. There, someone whose name or position is not cited said about Marcos: “The procedure he used is not included in any protocol. He acted outside the law and we were obliged to report him. We did not act under any ideological doctrine.”

After receiving the sentence for reckless homicide, Marcos left the Court accompanied by his wife. He was also carrying a new feeling—a lightness he hadn’t felt in a long time. As if something inside him, suddenly, had come loose. It was the fear that, little by little, was leaving his body.

[Marcos H.]: And there I tell you that freedom smiled at us again because we felt what it was. After almost six years of torture, we sat down to have a little coffee next to the courthouse, and it was the best coffee of my life that I’ve had in my entire life, feeling the weight that I can drink it calmly, that I know this has ended.

[Emilia E.]: But it wasn’t true. It hadn’t ended. He found out more than a year later, in October 2010, when an unknown man knocked on his door in Wales.

[Daniel]: A break, and we’ll be back.

[Daniel]: We’re back on Radio Ambulante. Emilia continues telling us.

[Emilia E.]: When Marcos heard the knock on the door, it was a little after eight in the morning. He was changing, taking off his work clothes after spending the whole night on duty at the Cardiff hospital. He walked to the entrance and, without opening…

[Marcos H.]: I ask who it is. And he says to me, “Are you Doctor Marcos Hourmann? Are you the Argentine doctor who killed a patient in Spain?”

[Emilia E.]: Those words made him open the door immediately. Standing in front of him, the man introduced himself as a journalist from The Sun, an English newspaper known for its sensationalist coverage.

He was there because they would soon publish a story about him, and he needed to corroborate his identity.

He told him that someone had sold them the story. It’s a common practice in that type of press, which at that time offered rewards of up to 10,000 pounds, about 15,000 dollars, for juicy stories. And Marcos had all the ingredients.

Before leaving, the journalist gave him some advice—a warning.

[Marcos H.]: “To simply start looking for a lawyer.”

[Emilia E.]: Marcos didn’t have much time to react. A few days later, his face was in the printed version of the newspaper, next to an article that called him “Killer Doc”—Doctor Killer. And a photo that had been taken from afar and without his consent.

The article produced a chain reaction: again, like five years before, Marcos lost one by one all the jobs as a doctor he had in Wales.

He didn’t have much way to defend himself. When leaving Spain and registering in the United Kingdom to work, he had omitted in the forms the information about his judicial process in Spain.

[Marcos H.]: What happens there? In all English jobs you take, they ask you, uh, for criminal records. And if you have any legal problems.

[Emilia E.]: In that part of the application, Marcos marked the only answer that seemed viable to him: no.

[Marcos H.]: I lied, yes, yes, I lied, obviously I lied, because if I put yes, where do I go, what do I do? If I say that I have a judicial process, who’s going to hire me from the hospitals? No one. So I lie, obviously I lie.

[Emilia E.]: And the lie, now, had finally caught up with him. He knew that was something that could happen eventually, but he never imagined they would expose him with a newspaper. For Marcos it was devastating.

[Marcos H.]: We were already without strength. It was like, “What else is going to happen to us?” We were very, very, very affected. We’ve had fucking miserable years, very sad. I broke the law. Know that. I’m not saying no, but the treatment, the way, those who did it… how that hospital treated me. The whole cadence of the process was totally destructive.

[Emilia E.]: I asked him if he knew who had sold his story to The Sun—who could want to do him that harm. Because Carmen’s family wasn’t…

[Marcos H.]: No, nor will I know. For many years it was an obsession. I was a bit unhinged trying to know who it was.

[Emilia E.]: He has some suspicions, but he could never prove them. What he does believe is that it was someone from there, from Cardiff. Not from Spain.

[Marcos H.]: No, Spain doesn’t act like that. It’s something very British, you know? Doing that is something very British, someone who knows the system.

[Emilia E.]: Someone who knows what these newspapers pay for stories like his. The article about the Killer Doc transcended The Sun’s coverage. Other newspapers picked up the story, and Marcos’ name appeared in the BBC, in The Times, and other English media…

The notes talked about the judicial case in Spain but also about the legal repercussions in the United Kingdom. They focused mainly on the fact that Marcos lied to the General Medical Council, which finally accused him of dishonest attitude and improper conduct and banned him from practicing there.

So he had no choice but to pack his bags again and return with Yolanda and his son to Spain. This time he did contact the Right to Die with Dignity association. Perhaps he was beginning to understand that he didn’t need to face everything so alone.

Fernando Marín, the doctor we spoke with before, remembers that when he met Marcos in person, the first thing he asked him was why he had written down the injection in Carmen’s medical record.

He couldn’t understand it.

[Fernando M.]: I don’t understand why he wrote it down. Because this happens every day in all the hospitals in the world. Clandestine euthanasia exists. And professionals, depending on the context, run no risk. But he said: “Well, I’m going to write it down, I’m going to put it here, that I’ve given her a lethal injection.”

[Emilia E.]: I also asked him.

[Marcos H.]: I wrote it because I don’t need to hide anything. There’s no application of potassium chloride without signature. It doesn’t enter my head. I was clear that if I did that, I would write it.

[Emilia E.]: That reaction from Marcos still baffles Fernando. Especially because if he hadn’t written it down in the medical record, it’s possible that nothing that came after—the public shaming, the judicial case, the country moves—would have happened. 

[Emilia E.]: Back in Catalonia, Marcos and Yolanda tried, again, to remake their lives. But it wasn’t going to be easy: Marcos was burdened by his bad reputation, and every time he got a new job he lost it when the judicial case came to light.

So he bounced from job to job for a while, until he finally resigned himself to working doing home visits for private medical insurance.

[Marcos H.]: I work six years, almost 24 hours straight, as a house-call doctor. Not all the time, but 2 in the morning, 7 in the morning, 3 in the afternoon. Six years without stopping.

[Emilia E.]: A lesser job for a surgeon and emergency specialist with more than 30 years of experience. He would never have expected to end his career like this.

[Marcos H.]: Medicine has been the backbone of my life. My whole life is what has given me survival and continues to give it to me. But medicine has moved to a point, purely after… I gave everything. And now I give just enough to help my family stay alive. Yes, it’s true that I thought I was going to reach heaven and it wasn’t like that; that also has to be accepted. My fault. Fate’s fault. Mistakes made, decisions taken. I know I’m a good doctor—I know this—but I am where I am. And sometimes I tell Yolanda I’ve failed as a doctor. But well, let’s say, maybe the expectations were very high. And things went this way, right?

[Emilia E.]: Mistakes, decisions… I then asked him if he regretted having given the potassium chloride injection to Carmen.

[Marcos H.]: No, I don’t regret it. But I wouldn’t do it again. Of course I wouldn’t do it again… no, man… 

[Emilia E.]: It’s that he has to be honest: if at that moment he could have glimpsed what came after…

[Marcos H.]: No, no, don’t ask me that because I’m not a kamikaze. They can call me whatever they want, but I wouldn’t do it again seeing the consequences. But this doesn’t mean I regret having done it. No, it’s different, because sometimes it gets confused.

[Emilia E.]: He’s very clear about why he doesn’t regret it. 

[Marcos H.]: It was the most wonderful human act I did in my life. And the most expensive. 

[Deputies]: …Consequently, the organic law bill for the regulation of euthanasia is approved. 

[Journalist]: Spain becomes the sixth country in the world to legalize active euthanasia. The Congress of Deputies has approved it this morning definitively after a year of parliamentary processing due to the pandemic.

[Emilia E.]: On March 18, 2021, the Congress of Deputies approved by absolute majority the Organic Law for the Regulation of Euthanasia, which decriminalized assisted death in some circumstances. Only those who have intolerable suffering from a serious and incurable illness or a chronic and disabling condition can request it. And it’s a commission that decides whether or not to grant permission. 

[Emilia E.]: For Marcos, the news of legalization generated a mixture of happiness and relief. 

[Marcos H.]: The feeling was it’s a wonderful first step. I believe that this law makes countries better. I mean, ever since there’s a euthanasia law I’m happy because I know I’m going to die when I want, the way I want. And that gives me a lot of peace. First for myself and second for the people who love me. I don’t want them to suffer anything more than what’s necessary, but nothing more. 

[Emilia E.]: Because for him it was always about that: not suffering more than what’s necessary.

[Marcos H.]: We human beings suffer too much. It’s not necessary. We have to suffer when it’s time to suffer, yes, but not one second more than what’s appropriate.

[Emilia E.]: And he feels that in that, he made his small contribution. He lost a lot along the way, yes, but the day he helped Carmen die, he removed some unnecessary suffering from the world.

And that, for him, is not insignificant.

[Daniel]: In 2016, the Spanish television program Salvados invited Marcos to participate in an episode about the “good death,” in favor of euthanasia. After that, he received a proposal to turn his story into a theater play. He accepted, and there he tells his version and at the end, a jury made up of the audience issues its verdict. The play was called I Will Celebrate My Death and premiered in January 2019.

Emilia Erbetta is a producer at Radio Ambulante and lives in Buenos Aires. This episode was edited by Camila Segura. Bruno Scelza did the fact-checking. Sound design and music are by Andrés Azpiri.

The rest of the Radio Ambulante team includes Paola Alean, Adriana Bernal, Aneris Casassus, Diego Corzo, Camilo Jiménez Santofimio, Sara Selva Ortiz, Natalia Ramírez,, Juan Pablo Santos, David Trujillo, Elsa Liliana Ulloa, Luis Fernando Vargas, Franklin Villavicencio y Mariana Zuñiga.

Carolina Guerrero is the CEO.

Radio Ambulante is a podcast from Radio Ambulante Estudios; it’s produced and mixed in Hindenburg PRO.

If you liked this episode and want us to keep doing independent journalism about Latin America, support us through Deambulantes, our membership program. Visit radioambulante.org/donar and help us continue narrating the region.

Radio Ambulante tells the stories of Latin America. I’m Daniel Alarcón. Thanks for listening.