The Hour of the Star That Never Comes: Macabéa as a cartography of care for women made invisible in the Family Health Strategy

Abstract

Introduction: Macabéa, the protagonist of The Hour of the Star, portrays the invisibility of women in public health. Like Clarice Lispector’s character, many women remain silenced in their suffering, neglected by ineffective state policies, and exposed to multiple forms of violence: symbolic, institutional, and structural. Objective: This study aimed to reflect, through the figure of Macabéa, on the care provided to invisible women and their expressions of suffering within the Family Health Strategy. Methods: This is a theoretical-documentary study. Based on care cartography, person-centered medicine, and expanded clinic, narrative blocks were built using field diaries, team meetings, and home visits, forming affective and ethical territories that emerge from daily clinical practice. Results: The narratives reveal seemingly banal complaints — such as vague pains, insomnia, and “accumulated fatigue” — that conceal stories of structural violence, care overload, and historical silencing. Although public policies have expanded the scope of women’s health over the years, many of these experiences remain at the margins of traditional clinical care. Listening, in these cases, cannot be limited to symptoms; it demands presence, patience, and willingness to recognize what has yet to be named. Conclusions: The essay proposes a clinic that embraces absences, waits without haste, and trains physicians capable of sustaining complexity without reducing it to a diagnosis. It suggests that even when the “hour of the star” never comes, care is reinvented through radical listening and the gesture of staying.