Mal yatrógeno

Mal yatrógeno names a pathological dependence on the hospital, accompanied by a phobia of leaving it. Explained to Alice Gould by César Arellano, the concept gives a name to a condition that can persist even when a patient is no longer physically inside the institution—and can be registered through a change in the body as well as in the mind.

Definition and Scope

Arellano identifies the condition as the mysterious mal yatrógeno and explains that the term derives from the Greek Yatros, meaning physician. The novel associates it with both fear of distance from the hospital and pathological dependence on it. Cosme el Hortelano and el Albaricoque are named among those who suffer from this pattern, placing Alice’s experience within a wider group rather than presenting it as unique to her.

Alice’s Physical Response

Alice’s symptoms shift as the journey changes direction. Once the party turns away from the hospital, she begins to feel relief from the burden tormenting her; her nausea does not return, and her fever subsides until it disappears. The sequence makes the concept tangible: the turn in the road coincides with a marked bodily easing. The account does not reduce the condition to those symptoms, but uses their change to show how closely Alice’s distress is bound to leaving the institution.

The Hospital as a Place of Both Freedom and Dependence

The surrounding hospital regime complicates the idea of dependence as a simple consequence of confinement. Under its relatively open system, patients can move around the building and grounds, take part in activities, and, in some cases, leave for nearby towns. Yet the novel also identifies patients for whom distance from the hospital itself is feared. Freedom of movement and the capacity to leave are therefore not the same as feeling able to go.

Narrative Significance

Mal yatrógeno gives the departure from the hospital a double meaning. Leaving is a change of place, but it is also a moment in which Alice’s physical state begins to alter. By connecting her relief with the journey turning away from the institution, the novel presents hospital dependence not as an abstract label alone, but as a pattern with observable consequences. Its inclusion alongside the experiences of Cosme el Hortelano and el Albaricoque also broadens the hospital’s portrait beyond Alice’s individual case.