Elena—Dr Benegas

Elena’s relationship with Dr Benegas is shaped by a stark imbalance: he can name and assess her illness, but she experiences it as the daily loss of movement, independence, and bodily command. He is her specialist and a source of practical instruction, yet medical explanations do not always reach her in terms she can use. As her condition advances, his clinical knowledge becomes both necessary and insufficient: it helps Elena navigate her body, while leaving her and Rita to confront a prognosis for which there is no cure. After Rita’s death, the doctor’s undisclosed meeting with her daughter adds a further uncertainty to a relationship built on Elena’s trust in his care.

Medical Care and the Limits of Explanation

Dr Benegas explains to Elena and Rita that Parkinson’s disease involves the degradation or alteration of nerve cells that stop producing dopamine. Elena dislikes the word degradation, and the technical account remains difficult for her to understand, even after he explains it several times. She can grasp the illness through its effects inside her body: when the brain sends an instruction to move, dopamine must carry the message to the feet. She turns that explanation into an image of a messenger, while her increasingly unresponsive feet make the abstract account bodily and immediate. Her understanding is not simply a lesser version of the doctor’s terminology; it is grounded in the movements she can no longer command.

Medication forms part of this everyday exchange between clinical knowledge and lived experience. Elena knows that Levodopa must dissolve and circulate before her feet respond, and she waits for its effect rather than being able to make herself walk by will alone. Dr Benegas has also taught her how to stand from a chair: place her feet together, position her knees at right angles, cross her hands to her shoulders, and rock forward to gain momentum. Elena practises the method because she wants to demonstrate at her next check-up that she can still perform it. The exercise shows how his care extends beyond diagnosis into specific techniques, but also how much of her independence depends on learning to work around bodily limits.

Examination, Diagnosis, and Prognosis

Two weeks before Rita is found dead, Dr Benegas arranges for Elena to be admitted to a hospital for two days of tests. She brings two new nightgowns, prepared in case she must suddenly go into hospital, but uses only one. The team takes blood, performs an MRI, tests her reflexes, examines her eyes, and observes her walking, raising and lowering her arms, sitting, and standing. A specialist in Parkinson’s disease, Dr Benegas brings a group of ten residents, who repeat questions, check her blood pressure, and sometimes confuse her with other patients. Elena remains accommodating because she hopes the doctors can help, even as the misidentifications make the examination feel impersonal and uncertain.

Dr Benegas explains that Parkinson’s disease and its progression must be assessed clinically; no single test can definitively establish its presence or extent. After the team reviews its observations, he tells Elena and Rita that her condition is Parkinson-Plus syndrome. The word plus immediately becomes a source of distress. Rita demands to know what more can be added to the drooling, incontinence, difficulty walking, swallowing, breathing, dressing, and other losses already shaping her mother’s life. Elena tries to interrupt, but Rita directs her anger at the doctor, challenging whether he understands what the diagnosis means in practice. His clinical label describes a disease category; Rita’s list supplies the accumulating work and indignities that the category contains.

Dr Benegas warns that the disease will advance more quickly than previously expected. Elena may soon be unable to get out of bed, feed herself, or use the bathroom without help; her food may need to be liquid or semi-liquid, her speech may become difficult to understand, and she may experience memory loss or dementia. He advises Rita to consider hiring someone to care for her mother while she is at work. When Rita asks whether Elena is going to die soon, he shifts the issue from length of life to quality of life and says there is no cure or solution. His answer is clinically direct, but it leaves the practical and moral burden with the two women.

Caregiving and the Doctor’s Advice

The prognosis brings the limits of Dr Benegas’s role into focus. He tells Rita that she will have to give back what her parents gave her and become her mother’s mother, because Elena will become like a baby. Rita rejects the comparison: the changes she anticipates are the reverse of a child’s development, as Elena loses control of bodily functions and movement rather than acquiring them. She says she does not think she can become the caregiver the doctor is asking her to be. Her resistance is not abstract: she has described the daily work of helping Elena out of bed, managing meals and dentures, taking her to the bathroom, and responding when she calls at night.

Dr Benegas offers help and support for both women and holds out pamphlets. Rita wipes away her tears but does not take them; Elena reaches out her hands and accepts the papers herself. The contrast captures the different positions of mother and daughter in the consultation: Rita voices the burden the prognosis places on her, while Elena receives the written materials about the illness and its management. At home, she reads the pamphlets alone while Rita is in the shower and does not answer her calls. Their silence follows them from the hospital, and the doctor’s advice has not resolved the conflict over what care will require or whether Rita can provide it.

Trust, Practical Dependence, and Unanswered Questions

Elena continues to measure herself against Dr Benegas’s instruction. On the train, she recalls an earlier Parkinson’s support-group visit with Rita at Hospital de Clínicas, where the sight of other patients made the disease’s possible future newly visible. At that time, Rita helped her put on the sleeve of her jacket; the memory contrasts with Elena’s present effort to manage movement and appearance with diminished help. The support group did not make Rita feel better, and they never returned, but the visit altered what both women understood about the illness. Dr Benegas’s care thus belongs to a wider medical setting that can offer information without making the future easier to bear.

After Rita’s death, Elena learns from Inspector Benito Avellaneda that Rita visited Dr Benegas two days before she was found hanging in the church belfry. Elena had not known about the appointment, and Dr Benegas had not told her; she now wishes she had asked what they discussed, but believes she is too far away to get answers. She adds the doctor’s office to her own handwritten list of places Rita went before her death and insists that the inspector include it. This does not establish what Rita and Dr Benegas discussed, or imply that he was involved in her death. It does, however, change the meaning of Elena’s relationship with him: the doctor who had treated her and delivered her prognosis also possessed a final piece of her daughter’s history that Elena had not known to ask about. Her dependence on his expertise remains, but so does the gap between what he knows and what he has shared with her.