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Original Neurosciences and History 2014; 2(4):140-148

Neuropsychiatry and politics: the clash between Gonzalo R. Laforaand José María Villaverde

S. Giménez-Roldán Former head of the Department of Neurology. Hospital General Universitario Gregorio Marañón, Madrid, Spain

ABSTRACT

Introduction. In 1933, shortly aer the proclamation of the Second Spanish Republic, Madrid’s Hospital Provincialannounced that it would hold a competitive examination to fill the position of the head of its neurology andpsychiatry department. Lafora and Villaverde, the sole contenders, had a history of vehement professional disa-greements, and even their ideologies were diametrically opposed. For reasons that have not yet been fully explained,the outcome of the examination was a department divided between the two doctors, in clear violation of the law.Methods. We searched government archives for official documents having to do with the competitive examination.We also located any comments in the general and medical press clarifying the ideological stances of the contenders.Results.e names on the board of examiners, and the struggle among those examiners in order to present examtopics that would benefit one candidate over the other, draw a clear picture of political tension. As had beenexpected, Lafora carried the most votes and the board awarded him the position. e surprise came a few dayslater when the examiners changed their verdict: by splitting the department into men’s and women’s units, theywere able to assign one to Villaverde and the other to Lafora. However, contemporary medical newspapers and aletter written by Lafora himself both suggest that the decision had more to do with Lafora’s famously poor oratorythan with politics. Conclusions. Although the political backdrop did influence the constitution of Spain’s first neurology andpsychiatry department to select staff by means of a competitive exam, it is also clear that memorisation and polishedoratory were rated higher than other professional qualities. Lafora, faithful to his reputation as a staunch defenderof the truth, graciously accepted the partition of the department.

KEYWORDSGonzalo R. Lafora, José María Villaverde, competitive examination, neurology, psychiatry, Hospital Provincial deMadrid

earlier generation of French alienists had come to becalled psychiatrists3; Spain was now also spearheadingchanges, and not just in nomenclature. In fact, thiscompetitive exam represented a totally new concept incare: patients with nervous system disorders would, fromthis time on, be studied in a general hospital, usingmodern diagnostic methods and updated scientificcriteria.4,5 This was a ground-breaking decision; in Italy,for example, neurological patients were still attended inpsychiatric hospitals (clinica delle malattie nervose ementali) until well into the 1950s.6

Corresponding author: Santiago Giménez-RoldánE-mail: [email protected]

Recibido: 30 April 2014 / Accepted: 4 June 2014© 2014 Sociedad Española de Neurología

Introduction

On 13 October 1932, the Official Gazette of the Provinceof Madrid announced that a competitive examinationwould be held to hire the head of the Neurology andPsychiatry Department at Hospital Provincial (Figure 1).This news was unquestionably historic; ever since the19th century, the department had been known as the“Mental Patient Observation Department”, a short-stayin-patient unit from which most patients were later trans-ferred to asylums after being diagnosed with ‘mentalderangement’.1,2 Many years had already passed since the

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Neuropsychiatry and politics

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This new position, which came with a salary of 4500pesetas a year, was an attractive proposition and one thatawakened considerable interest among neuropsychiatristsin Madrid. While a professorship at Hospital Provincialwas intrinsically prestigious, it could also be used as aspringboard for attaining the chair of psychiatry thatwould soon be created in the nearby Faculty of Medicine.7It might also position the candidate for the directorshipof the new psychiatric hospital being built in Alcalá deHenares (although that building was converted into abarracks in the end).

Gonzalo R. Lafora and José María Villaverde, the onlyaspirants to take the exams, had a history of bitter profes-sional disputes and were also known for their profoundideological differences. As it was feared, the examinationprocess took place in a climate of political strife, and theresult was the illegal decision to divide the departmentbetween the two candidates. Shortly thereafter, bothdoctors would suffer the harsh consequences of Spain’s

deep political rift, and so would many members of theboard of examiners. Since this delicate affair has onlybeen mentioned in passing in the biographies of Lafora8,9

and Villaverde,10 we believe that it is time to present ananalysis of the events based on original sources.

Methods

We consulted a copy of the hospital’s candidate selectiondossier (Expediente de selección de personal para laprovisión de una plaza de Médico de neurología y psiquiatríaen el Hospital Provincial de Madrid). That dossier is keptin sheaf 545/5 of the document collection at the MadridRegional Archive. Any mentions made of that hiringprocess were then investigated in newspapers with an anti-liberal, monarchic slant (La Época, La Nación, AcciónEspañola) and those with liberal or republican views (ElSol, Diario de Madrid) in the digital periodical collectionat the National Library of Spain. We also searched for anynews about the competitive exams in the 1933 and 1934issues of Archivos de Neurobiología (Lafora was a member

Figure 1. First page of the bulletin issued by the Regional Council ofMadrid announcing the competitive exams to fill the position of neuro-logical and psychiatric specialist.

Figure 2.Gonzalo Rodríguez Lafora (1886-1971) at the time of the compe-titive exam.


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of the journal’s editorial board), as well as El Siglo Médico,La Medicina Íbera and Archivo de Medicina, Cirugía y Espe-cialidades (of which Villaverde was a board member).

Results

The candidates

Truth be told, Gonzalo Rodríguez Lafora (1886-1971)(Figure 2) and José María Villaverde y Larraz (1888-1936)(Figure 3) had many things in common. Nearly the sameage and both well-regarded neuropsychiatrists in Madrid,they had received their initial training in Cajal’s school ofneurohistology (Figure 4). It is also true that they exhib-ited marked differences in personality: Lafora wasbrusque and stiff, although warmhearted11; Villaverdewas the charming extrovert who entertained Cajal after

the summer holidays with his gossip of amours amongaristocrats,12 but he was also said to have “an odd person-ality that limited his private practice”.8(p80) At the venerableage of 79, Lafora indiscreetly let slip that when Villaverdewas a student, he had journeyed to Madrid “to be treatedby Simarro for a psychiatric syndrome”.13

Another point to ponder is that Hospital Provincial wasnot an attractive assignment at that time; G. Marañóncalled it “a storeroom of invalids with no sign of scientificorganisation”.14 Lafora had already been branded as unpa-triotic for having published criticism of the cold, poorly litconditions in the Mental Patient Observation Department(Kraepelin had requested photographs of those facilitiesfor his museum of asylum history). In contrast, the Neuro-pathic Sanatorium that Lafora had founded in 1923 inCarabanchel, and which he often advertised in the news-paper El Sol, was financially successful. Furthermore, itsorganisation and staff was such that “no similar institutionever surpassed it, whether during its time or after it”.8(p69)

Villaverde was working in a neuropsychiatry departmentin the now-vanished Hospital del Buen Suceso, a lesserinstitution located in Calle de la Princesa.17

As stated above, the candidates’ political views could nothave been more divergent. Lafora was a progressiveliberal and staunch republican who voted for the coalitionknown as the Popular Front. He also became a signatorymember of the Alliance of Antifascist Intellectuals in July1936.8 Villaverde’s emblematic green hat (green = verde,

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Figure 3. Jose María Villaverde y Larraz (1888-1936), wearing his charac-teristic green hat to show his support for the restoration of the Spanishmonarchy.

Figure 4. Very faded photograph taken on the terrace of the NationalMuseum of Anthropology (then known as the Institute of Biological Rese-arch). Shown from left to right: José María Villaverde (1), Santiago Ramóny Cajal (2), Fernando De Castro (3), and the secretary Enriqueta LewyRodríguez (4). Some sources identify the seated woman on the far left asCarmen Sanz, another secretary.



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used here as an acronym for Viva el Rey de España, longlive the King of Spain) very likely means he was a memberof Renovación Española, a far-right monarchist party.

The scientific disputes

The two candidates had already clashed professionallyand exchanged caustic words by means of medicalnewsletters. Lafora staunchly but tersely defended sodiumnucleinate as treatment for schizophrenia. Villaverde, onthe other hand, argued that improvements after treat-ment, if any, reflected only the well-known fluctuationsthat were typical of the disease. When Villaverdedescribed Lafora’s drug-induced sleep cures as “inappro-priate and dangerous”,18 Lafora rebuked the former’s“profoundly unscientific attitude explained only by defi-cient understanding; the doctor could well deserve areprimand for toying with the trust of private patients”.Lafora dogmatically defended empirical treatment:“Would it then be preferable to do nothing?”A surprised Lafora described the discordant finding thatsome tabes dorsalis patients with marked clinical ataxiaalso demonstrated relatively preserved “deep sensi-tivity”,19,20 meaning periosteal sensitivity. It was Villaverdewho offered an ingenious explanation: the initial stagesof tabes dorsalis result in selective damage to the cornu-commissural fibres, which are collateral to afferent fibresof the posterior root ganglion. This would elicit patellarareflexia and hypotonia, but not ataxia.21 Both doctorswere up-to-date in the literature, but periosteal sensitivityis no longer thought to be exclusively conveyed by poste-rior fibres.22 To this day, the mechanism by which tabesdorsalis selectively damages fibres in the Redlich-Ober-steiner zone (dorsal root entry zone), or in the radicularnerve of Nageotte, has not been clarified.23

What was perhaps their bitterest dispute revolved aroundintrathecal treatment for neurosyphilis. Lafora was anunwavering supporter,24 despite the risks shown in experi-mental models25 and the questionable long-term benefitsassociated with that treatment.26 His unwary patients at theNeuropathic Sanatorium must have witnessed an intimi-dating tableau: Don Gonzalo, a dry and distant presencearmed with an impressive trocar, flanked by Mouriz, whowould perform the Wassermann test in CSF, and Escudé,entrusted with preparing the salvarsanised serum. Like anew version of medieval theriac, a barrage of salvarsan,neosalvarsan, and mercury salt injections were adminis-tered to the patient intrathecally and intravenously, and theentire procedure had to be repeated every 15 days. Laforamight have anticipated our current understanding of the

blood-brain barrier with his belief that it would be theoret-ically difficult for these drugs to “pass through the choroidplexus if delivered by the oral or parenteral routes”.20

Villaverde countered that if this were the case, the methodwould only act as a topical treatment, and therefore fail totreat parenchymatous lesions.27,28 While on the subject, helet drop an ironic comment about the diagnosis of Lafora’sfirst case, a young man aged 20 with a negative Wassermanntest, who had experienced “flu-related” weakness in his legsthe previous year and was now afflicted with multifocalsymptoms. This patient had supposedly been cured by thesecond injection.

Historical background The pretext for holding a competitive exam was the deathof José Sanchís Banús on 22 July 1932 in Ibi, his home-town in the province of Alicante.29 Dr Sanchís Banús’spoorly-defined position in the Mental Patient Observa-tion Department is best explained by the documents keptby the Madrid Regional Archive in sheaf 545/5. Thedirector of that department was in fact Francisco Huertas,who had been given the unfortunate nickname of“Paquito” because of his lack of leadership. Suffice to saythat his father, Francisco Huertas y Barrero (1845-1934),doctor to the prominent politicians of his time,30 had usedhis influence to bring about his son’s appointment.

Announcing the vacancy and publishing the exam condi-tions provided proof that there would be a new approachto nervous system disorders within the framework of aNeurology and Psychiatry Department. There was someresistance by those who attempted to derail the hiringprocess. The panel recognised that there had been “aperiod of cooperation between Sanchís and Huertas”,during which “Sanchís was assigned to Ward 1, a wardessentially reserved for neurological patients and whichin fact had been relinquished by Huertas, the departmenthead” (emphasis in the original). With the death ofSanchís Banús, “the temporary transfer of half of thedepartment would revert to the previous situation. It istherefore impossible to recognise a vacancy”. Accordingto this logic, there could be no call for an exam, but thatobjection was overruled and the exam was held. The candidates were well-qualified. Gregorio Marañón,who openly campaigned for Lafora, hastily published a flat-tering biography in Archivos de Neurobiología that includedthe impressive list of Lafora’s published works.31 Villaverde’scontributions were also numerous: 32 histological studiesas a co-author with Cajal, and a total of 111 publications.10

This was a far cry from the “three studies on lead


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neuropathy” that Lafora recalled in his old age, when hismemory tended to exhibit curiously biased gaps.13

The dean of the corps of doctors and pharmacists atMadrid’s regional healthcare authority proposed selectingthe examiners from among the doctors at that hospital.Mindful of the growing climate of political tension inwhich the exam would take place, he attempted toprovide an ideologically equitable solution, but a countof the expected votes shows that the board only gave theappearance of being balanced. On the one hand, itsmembers included Gregorio Marañón Posadillo (1887-1960), a known republican and liberal; José MiguelSacristán Gutiérrez (1887-1957), branded a ‘leftistliberal’32; and Agustín del Cañizo García (1876-1956), allof whom were members of Lafora’s camp. The board’schair, pharmacologist José Mouriz Riesgo (1884-1934),was a member of the Socialist Party and probably hadsimilar leanings. In the opposite camp, we find FernandoEnríquez de Salamanca (1890-1966), a prestigious doctorof internal medicine,30 and Francisco Huertas, the currenthead of the department, who seems to have beenamenable to relinquishing his position.

It was common knowledge that Lafora preferredneurology as a specialty, whereas Villaverde showed moreinterest in psychoanalysis and psychology, at least in hisearlier years. Choosing the subject matter must havecome down to a tug-of-war between Enríquez de Sala-manca, professor of medicine, and José Miguel Sacristán,secretary of the board and a prestigious psychiatrist.Enriquez de Salamanca proposed a list of purely psycho-logical topics: ‘sensory emotions’, perception of space andtime, tendencies and volition, psychotic disposition, andpsychopaths in society were just a few examples. In turn,Sacristán fought to include neurological subjectsincluding CSF analysis; extrapyramidal disorders; sensorydisorders; cortical cytoarchitectonics; aphasia, apraxia,and agnosia; Wilson disease; and the aetiology, diagnosis,and treatment of general paresis. After a heated debate,they reached a consensus to present a total of 35 topics,including only 12 ‘purely’ neurological or neuropsychi-atric topics. This placed Lafora at a clear disadvantage.

Completion of the exercises The test consisted of four exercises, and a single low scorewould result in elimination. 1) Presentation of the candi-date’s educational experience and accolades, with thecandidate also delivering a presentation on the conceptof psychiatric care (neurological care was not mentioned);2) Elaborating on a topic chosen at random, to becompleted within a maximum of four hours; 3) Exam-ining a patient selected at random (patient names weredrawn from a pool of twice the number of candidates);4) Preparing a forensic psychiatric report on one of thepatients selected from the same pool.The exam was scheduled for 10.00 on 14 October 1933 inthe assembly room at Hospital Provincial. The atmospherewas strained. Villaverde’s followers could be identified bytheir green hats; their number included Carlos GonzálezBueno (1898-1984), who would be the one to spearheadthe construction of Madrid’s Francisco Franco medicalcentre in the 1960s. Lafora’s followers were also numerousand no less enthusiastic. We were unable to recover a copyof the written exam. In the practical section, however,Lafora was given the task of determining the legal capacityof a patient drawn from a pool, and Villaverde had toaddress criminal responsibility in the case assigned to him.

A surprising verdictOnce the candidates had finished, the board of examinersmet on 23 October at 9.00 to deliberate, but it would notreach a decision for another two weeks. At last, the boardformally named Lafora for the position on 8 December

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Figure 5. Signatures of the examiners ratifying the decision to divide thedepartment into a men’s ward (Villaverde) and a women’s ward (Lafora). Wecan make out the signatures of Mouriz (1), Sacristán (2), Del Cañizo (3),Goyanes (4), Huertas (5), Enríquez de Salamanca, (6) and Marañón (7).



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(Figure 5). Strange as it might seem, just four days later on12 December 1933, the board modified its decision. WhileLafora’s victory was not contested, the examiners “decidedto declare an additional vacancy in the same departmentfor reasons of imperative necessity, designating the candi-date Dr José María de Villaverde y Larrar [sic] for that posi-tion in light of the exceptional circumstances surroundingthe event, which the board cites as providing due justifica-tion”. The board had met on 12 occasions and the entirehiring process lasted 16 months (Table 1).

Valenciano Gayá’s magnificent biography of Lafora onlydedicated a line or two to this unexpected decision.8

Gonzalo Moya9(p85) discovered two conflicting versions ofthe story, one of which was told by Lafora’s own son.According to this version, while Lafora emerged victo-rious from the contest, he did not object to the proposal todivide the department down the middle (emphasis added).The other version states that Lafora was betrayed by hispoor speaking skills, whereas Villaverde’s delivery was soimpressive that he was offered half of the departmentdespite having scored lower on the test. Two of Lafora’sstudents (Dionisio Nieto Gómez and Ángel DomínguezBorreguero) contested that decision on the grounds thatVillaverde’s appointment violated the Provincial Statuteof 2 March 1920, according to which “the selection of agreater number of candidates than the stated number ofvacant positions is invalid”. Another complaint, signed by

Figure 6. Front cover of El Siglo Médico, a popular medical journal of thetime. José María Villaverde was a member of its editorial board. Biased infavour of Dr Villaverde, the journal published a description of the exerciseson the exam.

Table 1. Documents from the dossier for the competitive exams held to fill an opening for a neurologist and psychiatrist at HospitalProvincial de Madrid (Madrid Regional Archive, sheaf 545/5).

13 October 1932 Announcement that selection would take place by means of a competitive exam, at the request of Dr Mouriz.19 October 1932 The regional healthcare committee sends its report to the corps of doctors.19 November 1932 The report by the corps of doctors does not support the proposal put forth by Dr Mouriz.29 November 1932 The regional healthcare committee agrees to postpone the process.6 December 1932 The regional healthcare committee decides to hold competitive exams to fill the position of Director of the

Psychiatric Institute of Alcalá de Henares. The successful candidate would be responsible for caring for mentalpatients as soon as the facilities were ready.

15 December 1932 The regional healthcare committee decides to create a position for a psychiatrist and fill it by means of a compe-titive exam.

11 March 1933 The hospital publishes the guidelines for the competitive exam (modified on 15 July) to fill the vacancy left byDr Sanchís Banús. The process would be supervised by the dean of the corps of doctors.

26 May 1933 The dean appoints the examiners on the board and names Dr Mouriz as the chair.22 June 1933 The board determines the time, venue, rules, and subject matter for the examination.14 October 1933 Candidates are summoned to complete the first exercise.2

12 December 1933 The panel announces the appointment of Dr Lafora and the creation of an additional position for Dr Villaverde.Dionisio Nieto Gómez and Ángel Domínguez Borreguero launch an appeal against the appointment of Dr Villa-verde.

27 January 1934 The Board of Examiners denies the appeal.


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numerous followers of Lafora and dated 22 October 1933,highlighted that the candidates’ respective scores had notyet been made public.9 Neither of these complaints wastaken under advisement.

The partisan response by El Siglo MédicoLafora was conscious of his limitations in the arena: hisexasperating long-windedness, his sudden memory lapsesthat left him speechless, and his unusual ‘chronologicalimpairment’ that left him unable to gauge time. The timehe devoted to preparing for the test was pure torture; hespent an entire summer shut away in his house in Camor-ritos, 57 km from Madrid.8 As for Villaverde, the popularmedical journal El Siglo Médico sang the praises of hissupposedly dazzling performance (Figure 6). Villaverdewas a member of the journal’s editorial board.33

In an attempt to appear impartial, El Siglo Médicoexpressed “admiration for the merits of both contenders”,although “from the first exercise, those attending becameaware that Villaverde’s skill surpassed Lafora’s” (emphasisin the original). “As for the second...Lafora’s presentationwas frankly deficient. During the third exercise, publicopinion and that of the board seemed to favourVillaverde....In the fourth, we regret having to say thatLafora’s answer was very poor and he displayed a totallack of technique” (referring to the forensic report). “Thepanel awarded the position to Lafora, (with Mouriz,Marañón, Cañizo, and Goyanes voting in favour);Enríquez de Salamanca and Huertas voted for Villaverde”. A note signed ‘Decio Carlán’, the pseudonym adopted bythe journal’s editor-in-chief Carlos María Cortezo,announced an event in honour of Villaverde, “a significantand appropriate gesture...reflecting the well-known meritsof this illustrious Spanish psychiatrist and neurologist...anda glorious name in Spanish neurological research”. He tolda bold-faced lie in declaring “let the reader take note thatthe appointment made by the board of examiners was infact UNANIMOUS” (capitals in the original text). “Whilethis proposal may have clashed with trifling bureaucraticbarriers, it obeyed the strictest principles of justice”.34 By“trifling bureaucratic barriers” he was actually referring toa flagrant violation of applicable law.More surprising still was the lukewarm response fromLafora, who had always been more pugnacious: “it is anunfortunate fact that this merely ‘technical’ matter has beengiven a political spin from the very beginning”. Lafora alsocriticised the omission of any comments by Sacristán; “asthe only one possessing ample knowledge of the technicalaspects, he held a decisive vote”. Above all, he let drop ironic

references to “the class of attendee to become aware ofVillaverde’s superior skill”, referring to his rival’s green-hatted supporters. The director of El Siglo Médico answeredthat the journal “had dispatched qualified staff...to cover theexercises and had presented its findings in a completely fairand objective way”.35 In other words, El Siglo Médico hadsent an inside tribunal as part of a crowd of boisterousonlookers, and then published its own anonymous verdict.

The aftermath

Only a few years later, the events that rocked the nationtook a terrible toll on those who had been involved in thecompetitive exam. José María Villaverde disappeared inSeptember 1936 as Madrid was swept up by the militaryrebellion. His body was never found; some believe thathe may have fallen in the Paracuellos massacres, but proofis lacking (Figure 7).36 His sister María reported his disap-pearance on 29 May 1939 before a judge of the FrancoistCausa General. She pointed a finger at the “leftistemployees at Hospital General, who must have been theones to denounce him”.10

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Figure 7. Obituary notice sponsored by the Cajal Institute in memory of JoséMaría Villaverde (reproduced with permission from Villasante et al.).10



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This vague implication of Lafora, who went into exile inMexico City in September 1938, had no factual basis what-soever but was to cause him a great deal of trouble whenhe returned to Spain in late 1947 and had to be ‘politicallysanitised’.8(p161) Lafora’s republican convictions made himno friends at the Neuropathic Sanatorium, and itsemployees threatened him; since the local revolutionarycommittee suspected that some of his income had been‘appropriated’ from right-wing sources, his very life was atrisk.8(p131) Valenciano relates that after Lafora’s return, “therewas a hidden and self-serving hand that slowed his politicalsanitisation process”, 8(p164) which was a cryptic reference toDr López Ibor. Lafora’s department was only returned tohim when he was 64 years old and soon to retire.José Miguel Sacristán “remained to the end of his days ina peculiar state of internal exile”32; he faced ostracism andhad to eke out a living as a translator of German texts.Gregorio Marañón exiled himself to Paris in 1937. Hisposition as professor and department head at HospitalProvincial was not restored until 1944.37 An inquiry wasalso launched against Agustín del Cañizo, accused ofbeing a “leftist whose friends...including Miguel deUnamuno...were preparing a Marxist revolution”. He wasdeclared ineligible to hold a leadership position.38

Lafora’s situation in the post-war years contrasted cruellywith that of F. Enríquez de Salamanca, who had played acrucial role in the atypical ruling handed down by theexaminers at Hospital Provincial. After that incident,Enríquez also managed to select Villaverde to fill Cajal’sseat in the Academy of Medicine, this time by vetoing thecandidacy of Pío del Río-Hortega.39 Following theSpanish Civil War, he was made the Examining Magis-trate of the Political Decontamination Tribunal at theUniversity of Madrid, or as some called him, “theInquisitor of San Carlos”.38 Enríquez, branded by hisfellow professors as an “obsolescent right-winger”38(p39)

and “strict and almost fanatical Catholic,”38(p45) had beenphysician to Alfonso XIII.30 His approval sealed thefortunes of future aspiring department chairs, and hisverdicts also resulted in the expulsion of hundreds ofuniversity professors, some of whom were imprisoned.38

Conclusions

The political tensions surrounding Lafora and Villaverde’sinfamous examination during the 16 months that passedbetween publication of the announcement and publicationof the decision were the product of that time in Spanishhistory. Whereas “an overjoyed and hopeful crowd cele-brated the unexpected collapse of the monarchy and the

inauguration of the Second Republic in the plaza of Puertadel Sol in Madrid...another crowd [of royalists], perhaps alittle less numerous, gathered before the Royal Palace,where the Queen and her children had spent a sleeplessnight”.40 The atmosphere was even more volatile by the dateof the exam, which coincided with the announcement oflegislative elections on 17 November 1933. Under therallying cry of “order and religion”, a coalition of right-wingparties,40 including Villaverde’s monarchist RenovaciónEspañola, finally carried the day.41

This article reveals that the competitive exams took placein a profoundly politicised atmosphere, as evidenced by thecomposition of the board of examiners, which leanedtoward Lafora. Further proof was the struggle betweenSacristán and Enríquez to choose topics that would besuited for one candidate or the other. If we examine onlythe vote count, it seems that Lafora was the clear winner.This cannot begin to explain the board’s unprecedenteddecision to overrule its own initial ruling and split thedepartment in two. We could not say which strings were moved and what argu-ments might have swayed Sacristán, backed by Enríquez deSalamanca, to propose the King Solomon-style depart-mental split (Gonzalo Moya’s version of the story based onaccounts from Lafora’s son). Nothing ever came of the peti-tion signed by Lafora’s students (Germain, Valenciano,Nieto, Prados Such, Fernando de Castro, and others) andsubmitted on 22 October 1933. The students alleged that“Dr Villaverde’s result on the third exercise was not onlyinferior, but also demonstrated his considerable lack of skillin clinical examination”.9

The key to understanding what happened can be found inthe letter published in El Siglo Médico that its director,‘Decio Carlán’, had received from Lafora himself.7 The latterlaments the political tone that soured the exams and evenmentions the unruly crowd that cheered for Villaverde. Hesays nothing at all about the atypical decision, which heseems to take in his stride.

Gonzalo Rodríguez Lafora was without a doubt highlyinfluenced by his “almost visceral urge to tell the truth,no matter the consequences” and “his impassioneddefence of fair play”.11 This trait was even evident on occa-sions like this one in which the facts ran counter to hisown interests, and he always followed through on hisconvictions. To cite just one example, he was the onlyscholar ever to have resigned from Spain’s NationalAcademy of Medicine because of his quixotic world-view.42 The surgeon Bastos Ansart, a member of Lafora’s


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extended family,43 refers to these events in his commentabout the “personal rivalries that have fed the conceit ofan insignificant man [once again, Villaverde] and soevidently snubbed the one who by all rights deserved theposition so unfairly awarded to the other”. Be that as it may, Gonzalo Moya suggested two alternativeexplanations: political intrigue, or Lafora’s poor oratoryability in the exam. This article provides documentaryevidence suggesting that both of these factors werepresent and had an impact on the outcome.

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S. Giménez-Roldán
