Ten life lessons doctors learn from their patients

It has been said, that in your last moments, your life flashes before you, reenacting the scenes, up to the point where you are ready to move on. As a doctor, I have cared for and watched after many patients and I have found a constant among those plagued by ailments and suffering. Regret. It is the single most important burden many carry to their deathbed. And their burden has taught me how to live my life.

Money is not evil, lack of it is.
Start reading and researching on financial planning early. Invest and keep your finances secure and balanced. Many patients cannot afford the best healthcare when they most need it simply because they did not anticipate and save in advance. If you live in a country where healthcare isn’t free or subsidized, it would help tremendously if you could obtain a health insurance. Plan your expenses judiciously and always save up for retirement. It would be too late to start when you fall ill. The mental anguish of not being able to work and provide for your family can gravely affect your recuperation.

Start taking care of your health now
Health is a precious asset. In most countries, the common causes of mortality and morbidity are due to preventable and modifiable diseases. Heart disease, diabetes, high blood pressure and dyslipidemia are related to your diet and lifestyle. So start eating healthy, go for regular exercise and get proper medical check ups. Reduce the sugar in your diet and count your calorie intake. Start teaching your kids to care for their health and get the whole family involved. It is infinitely far better to cook and eat at home for you will be in control of what you put in your food. A sound health will enable you to lead a more wholesome life.

Travel to new places
It is a constant regret among my patients that they did not travel enough when they were young and healthy. Traveling to new places enriches you in more ways than you know. It creates new bonds, strengthens current relationships and rekindles lost passion and romance. If life is moving too fast and it’s draining your soul away, take a sabbatical and work in a foreign country. Immerse yourself in a new culture with new people and get a fresh start. You may never know how it could change your life.

Don’t hold grudges
It is very difficult for a doctor to watch his patients die. It is worse if you have to watch them die alone. Cherish your friends and loved ones. Don’t allow petty arguments to ruin years of friendship and love. Keep your ego locked up. Sometimes, it’s better to apologize and move on regardless of whose fault it might have been. Forgive generously if you have been hurt. If you think of someone who means a lot to you, call now. Don’t wait. If you love someone, say it now. Don’t let them slip away. Time is cruel to those who keep love and friendship locked within. Look past the imperfections for to be loved is the only perfect thing in the world. And it the only thing that makes sense.

Your family is a gift
Spend time with your family as much as you can. Don’t work too hard. And don’t bring your work home. Find the right balance. Be present when your children are growing up as your presence can influence their formative years. Show up and be there for them when they need you, for one day they will do the same for you. If you have not told them how much they mean to you, say it now. Never hesitate. Go forth. Steal that kiss, hold that hand a while longer or hug them a little bit closer. And always remember; to have a family is a privilege and a gift, not a birthright.

Don’t remain in abusive relationships
I once had a patient with chronic kidney disease who refused dialysis. She finally revealed that she would rather die than to remain married to her husband who has been abusing her for years, and yet she continues to endure. Don’t choose to be unhappy in a relationship. It does not matter how long you have been in it. If someone truly loves you, they will never hurt you in any way. Have the courage to walk away towards a life and a person you truly deserve. And you will be happy.

Don’t settle in life
Fear of the unknown and being relatively comfortable with their current life has forced many people to settle for something very different from what they really set out for. They cast their dreams aside and grow old yearning for something that was always within their reach, but the walls they have built around their psyche, blocks them from attaining it.

Lead a righteous and honest life
Don’t lead a life shackled by deceit and envy. Be genuinely happy for the achievements of others. This is a world of abundance. It is filled with more than you could possibly want. Don’t be lured by the temptation to cheat and manipulate others. Never knowingly or consciously hurt someone especially the ones you love. The guilt will eat you up and stain your conscience for life. And it will never wash away.

Reflect on your life
Take some time off your daily routine to reflect on your life. This is important. Upon reflection we can obtain a sense of direction and conviction, to realign our lives the way we want it. Difficult and unpredictable circumstances can lead us astray and it’s important to have a sound bearing and clear conscience. As John Dewey once said, “We do not learn from experience.. we learn from reflecting on experience.”

Get closer to God
The answers we have all been looking for have always been there. We just didn’t know where to look. Regardless of your religious beliefs, God is a constant and He will embrace you, even in your most shattered form. Ask and He will give you the answers. Surrender and He will show you the way. Fall and He will raise you up.

 

As I write this down I am reminded of each and every patient whose shared experiences made me the person I am today. Some may have passed on and to them I dedicate this quote by Kahlil Gibran,

“For what is it to die but to stand naked in the wind and to melt into the sun?
And what is it to cease breathing but to free the breath from its restless tides, that it may rise and expand and seek God unencumbered?
Only when you drink from the river of silence shall you indeed sing.
And when you have reached the mountaintop,then you shall begin to climb.
And when the earth shall claim your limbs,then shall you truly dance.”

And to all of them, I am eternally grateful. Thank you.

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Dear world, MH 370 is a tragedy, not a definition of my country.

I have been forced to write this to defend my country and its people. Much has been said regarding my people’s lack of empathy in this incident. No country should claim monopoly on grief. We have all suffered and are still enduring.

To accuse my country of ‘lacking transparency’ and ‘withholding truth’ in handling this tragedy is interesting in many ways. More so when the accusation comes from a nation with abysmal human rights record and a highly secretive government. Would you share your military records and expertise if a plane from your nation bound to my country went missing with the exact mix of passengers? Are we entitled to label you ’slow’ and siege your nation with unethical scathing remarks and make public demonstrations in front of your embassy when your own fleet of ships and airplanes are unable to unravel even a string of truth? Do the terms ’murderer’ and ’liar’ sound palatable when your highly advanced satellites produce images of the debris in South China Sea, which are later acknowledged to be false by your own government? This clearly shows there are limits to even your own technology. As such, if you live in a glass house, please learn not to cast stones.

The possibility of the plane being hijacked brought forward a surge of response. One of which was to associate the hijackers to religious extremists. There is no such thing as religious extremism in my opinion. Extremism is a character flaw, not a flaw in the teachings of a religion. Confused people become extremist. I believe there is not a single page, in any holy book, of any religion in this world that promotes killing and slaughtering of its fellow-men. Men are evil. They are flawed. Don’t blame religion.

Were the World Wars started by the very religion you have taken to task for every attack around the globe? Did they kill millions in concentration camps? It’s fascinating when others commit the same sins or worse, they are labelled as ’crime against humanity’ but the term ’religious extremism’ is kept only for a select group of people.

There are those who have expressed their concern regarding the lack of decisiveness on our part. I apologize on behalf of my country for not moving fast enough because I believe we want all our facts in place before making a decision. It’s similar to invading a nation suspected of holding nuclear weapons only to find nothing there, if you get my drift.

Malaysians who have jumped on the bandwagon to criticize the handling of this issue, I find you shameless and disrespectful. Suddenly, everyone’s an expert. Even those who have never flown on a plane or thought ‘Boeing’ was a foreign language prior to this incident. This is the time for us to stand united regardless of our political differences. Don’t use this tragedy to gain political mileage. Have better vision and maturity than that. As Winston Churchill once said, “When there is no enemy within, the enemies outside cannot hurt you.”

I believe the Malaysian government along with the relevant authorities are doing everything within the confines of their power to bring closure to this tragedy. Please don’t make it impossible for them to do their job. We appreciate the help and support we have received from our friends in finding MH 370. As a national daily aptly said ’Countries whom we call friends must now do more to prove their friendship’.

I urge our nation to stand tall, unyielding and resilient. Show up for your nation as it needs you now. This is not a time for petty bickering. Put aside your differences and lend a hand. Or at least your voice.

I leave with a quote by Dalai Lama, “ “Our prime purpose in this life is to help others. And if you can’t help them, at least don’t hurt them.”

Pray for MH 370: Sofuan Ibrahim

 

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I wrote this piece on behalf of my friends, to those who have known Sofuan Ibrahim personally and have been touched by him in many ways. To those who wish they could pen their feelings for him in words. And to those who have kept him in their prayers.

I first met Sofuan when we were seven years of age. We were classmates in primary school for six years and I have not met him since. It has been twenty years.

I will always remember him as a kind hearted and spirited person. Time has stolen most of my memories of him but it has left me the essentials. Even at that very young age he was brilliant and his maturity belied his age. He was one of the best students in my class and a gifted public speaker. Blessed with the ability to lead by example, he was also the head prefect of my school. And we all loved him.

Sofuan contacted me some time ago. I was still working in Sabah and he had visited our home town. He mentioned that he never gets to meet his old friends whenever he is in town. He still remembers all our names and was really looking forward to meeting up. I gave him my word that I would contact him once I am back in town. I never did.

There are very few things in life I truly regret and this is one of them.  We are often swallowed by our commitments and it leaves us drained of everything else. It keeps us away from the things that really matter.

I wrote to remind us never to keep our search for comfort and financial security away from those we care and love. If you think of someone who means a lot to you, call now. Don’t wait. If you have not told someone how much they mean to you, say it now. Never hesitate. Go forth. Steal that kiss, hold that hand a while longer or hug someone a little bit closer for you may never know when you will see them again. Time is cruel to those who keep love and friendship locked within.

Live your life for those who matter. Burn those petty arguments. Cast your ego aside. Mould your life the way you want it to be, rather than conforming to the perceived standards of others. And live in the present for that is your gift to the future and a treasure for your past. Only then will you have truly lived with no regrets.

Please pray for MH 370. Pray for Sofuan Ibrahim. If you cannot pray then hope. If you cannot hope then believe.

I am often reminded of a quote by Albert Camus;

In the midst of hate, I found there was, within me, an invincible love. In the midst of tears, I found there was, within me, an invincible smile. In the midst of chaos, I found there was, within me, an invincible calm. I realized, through it all, that, In the midst of winter, I found there was, within me, an invincible summer. And that makes me happy. For it says that no matter how hard the world pushes against me, within me, there’€™s something stronger, something better, pushing right back.

We are waiting for you, Sofuan. And we will keep praying. I hope to see you soon my friend. God bless MH 370.

It’s the doctor’s fault.

I came to clinic at 9.15 am the other day. I was held up in the wards and was fifteen minutes late. My patient, a 40 year old housewife with poorly controlled diabetes was fidgeting outside my room. She was unhappy. I could tell. She entered my room and started berating me for my seeming lack of consideration for her time. By the time she was done, I had apologized a dozen times. We started with the consultation and to my chagrin, she forgot to bring her home sugar monitoring chart. Her blood sugar control was abysmal and her kidneys were starting to leak protein. She was obese and still gorges on fast food despite being counseled by a dietician. She has defaulted her appointment to the eye doctor because she felt ’her eyes are just fine’. She has not been taking her medication for the past week as she was visiting her sister and forgot to bring it along.

Before walking out of the room she had the temerity to say this: “ If only you could spend more time with me, you could have treated my diabetes better. You just had to be late.”

My years of training in medicine kicked in: “I’m sorry. It’s my fault. It won’t happen again”

She walks out. The next patient walks in. And the cycle repeats itself…

This is a common scenario faced by doctors. We bear the brunt for everything that goes wrong in a patient’s life. The poorly managed disease, the horrid weather, the ungodly waiting hours, the uncomfortable waiting room chairs, the grumpy nurses, the lazy attendants and at times the odious smell that emanates from the person sitting next to them.

We face these frivolous accusations and absorb them, giving our patients an outlet to vent their frustrations and anger. We tell ourselves, “This is part of the job”.

We live by the same mantra regardless of our nationality, color, religion, race or creed… “The patient is ALWAYS right”.

I have listed the following complaints based on my experience and that of my colleagues.

 

The doctors are inconsiderate towards the patient’s time. 

You are probably right. We are inconsiderate. We are inconsiderate for abandoning our health so you could be healthy.

We are inconsiderate for skipping our meals and not giving in to the excruciating pangs of hunger so we could monitor your fluids when you are down with severe dengue.

We are inconsiderate for not returning home to have dinner with our family and loved ones because we are too busy consoling yours.

We are inconsiderate for missing our daughter’s dance recital or our son’s football match because your child was admitted to the intensive care unit and without us being there, will probably never make it through the day.

We are inconsiderate for forgetting our wedding anniversary because our mind was filled with the thoughts of our patients undergoing complications in labour.

We are inconsiderate for placing our patient’s well being above all else, including our own personal time. We should have considered our family and friends before spending so much time at work. We are very inconsiderate indeed.

 

The doctors are selfish and spend very little time during consultation with their patients

An average doctor sees ten to fifteen patients in clinic and this number varies according to hospitals around the world. The larger the pool of doctors, the lesser the number of patients they see, and the amount of quality time they are allowed to spend with their patients increases.

Bearing in mind this simple logic, if the consultation time runs from 9 am to 1 pm, which is exactly four hours, and in a clinic with roughly ten patients per doctor; we are only allowed 24 minutes per patient.

This does not take into account the walk in patients, the forced bookings, the late comers, the ’missed appointments’ who decide to turn up on that day, the ’selective amnesiacs’ who got their appointment dates wrong, and finally the ’self anointed VIPs’ who probably donated a few dialysis machines and built the entire south wing of the hospital.

If you have been to a hospital, have you ever wondered why our clinics don’t finish on time? Have you ever wondered why the doctors are still seeing patients during their lunch hour? Have you asked your doctors if they have had their lunch or at least a bite to eat from morning?

If you do, I guess you will find out how ’selfish’ they really are.

 

The doctors have ’special preference’ over certain patients compared to others

You are absolutely right! We won’t even bother denying this.

Picture this scenario. A patient presents to the emergency department with a massive heart attack. Time is of essence. In case you didn’t know, every second wasted is detrimental to the patient’s life. The doctor knowing this well, rushes to the emergency unit, pushes the patient to the cardiac care unit and performs a life saving procedure called ’angioplasty’. He may have to leave his clinic or the wards, where the stable patients are waiting to see him, who are at present in no danger whatsoever, except probably a bit annoyed of having their discharge from the ward delayed.

We may have to delay your MRI appointment for an hour, as patient may come in with a spinal cord injury requiring urgent radiological diagnosis and surgical intervention.

A pediatrician may take an hour of her time to review a child in an acute cubicle but may only spend minutes with your child who is well and awaiting discharge.

We recognize the ‘frequent visitors’ to our emergency department. And we know the ‘funny feeling’ you have around your fingertips at 3 a.m can wait while we attend to a patient brought in unconscious after an accident.

There are times the operating theaters are fully booked, that we need to postpone elective surgeries to accommodate urgent life threatening cases. We can’t proceed with removal of a lipoma from your hairy back if a mother with fetal distress arrives in labour. If an emergency Caesarean Section is not performed in time, we could lose both the mother and her baby.

You can’t imagine our trepidations when we approach your bed, as we prepare ourselves mentally for the verbal abuse that is about to follow, knowing in full knowledge that you have fasted the whole night prior to surgery.

You will inadvertently be mad. We know. And we can’t help it. We do have ’special preferences’. But what you don’t realize is this; it’s best not to be one of our ’special preferences’.

 

The doctors are supposed to know everything about us and don’t have to keep looking at their notes

Patients have accused me of showing little interest in them if I can’t recall every detail of their symptoms, admissions history and medications, especially if I have to keep referring to my notes.

I am often left embarrassed by the cynical looks some patients give me when I am unable to answer all the questions. Even when I say with all honesty , ’I will look into it and get back to you’, the disparaging remarks can be quite hurtful.

I have often wondered if a lawyer is able to recall with exact precision every case he has tried? Can a teacher recall at will the details of every one of his students examination results? Will a bank manager remember every single detail of his client’s account?

 

The doctors are responsible for our health and it’s their fault if we don’t get better.

We are responsible for our patient’s well being. Only a fool would say otherwise.

We can continue to admonish obese diabetic patients to lose weight and control their diabetes but they don’t heed our advice. They return time and time again for more medication and continue deteriorating and get upset with the doctor when they develop complications from the disease. They assume it’s our responsibility to fix things as they pay taxes.

We can only counsel a patient with scarred lungs to stop smoking and to be more compliant to their medication, but if they choose to continue smoking and disregard our advice, are the doctors to be faulted when they have done nothing to help themselves?

It’s still difficult for us to comprehend the unrealistic responsibilities placed on doctors.

 

There is a quote by Rumi, “Out beyond ideas of wrongdoing and rightdoing there is a field. I’ll meet you there. When the soul lies down in that grass the world is too full to talk about.”

We are not perfect. We are not trying to be. But our patients often forget as they tend only to look at the ’thorns’ in their lives, that we, the doctors, are ’patients’ too.

And it is not always our fault.

I am, because of you

A recent encounter with a concerned father, an excited mother and a clueless child prompted me to write this. We have all been through this. Sycophantic parents doing their best to place their sweet lips on your rear end, while making their own children look like lepers. An abomination when done in the company of many.

The conversation was meaningless to say the least but something they said hit a nerve. In between the father’s mind numbing droning, the mother yelps and interjects like an agitated puppy with this: “ Can you tell my son the secret of your success. He is a great disappointment to us. He is finishing high school soon and he has no idea as to what to do with his life.”

The father turned toward his son, jowls shuddering and bellows, “ Look at him (he gestures towards me). See how far he has come in life. Aren’t you at least a little bit ashamed of yourself.”

“Please doctor. What is your secret?” the mother repeated as she cast her eyes on me, batting her multicolored eyelids like a schoolgirl meeting her first crush. It was very disconcerting to say the least.

The room fell silent. All eyes were on that boy. If the ground could open up and swallow him whole, I’m sure he would have no regrets. The other teenagers were shifting uncomfortably in their seats. Target practice. They knew. And I did too.

I took a deep breath and said as calmly as I could, “ The secret…. Very simple. I have better parents.”

A collective gasp went around the room sucking the air within. The mother nearly fainted. The father stopped talking to me. And the boy volunteered to reformat my desktop. All was well with the world once more.

I am no expert at parenting but I will never treat my child that way.

This incident underlines the most glaring failure of our education system. The abject inability to recognize a person’s worth and judging them based on the myopic views of others.

This reminds me of a conversation I had with my late dad. He was never one to yield to unnecessary expectations and pressures placed on his children. I remember his analogy of our education system and values; “The fish is judged by how well it can climb a tree and a squirrel on how fast it can swim.”

Let me first define what I mean by the term ’education’ for fear of being misquoted or worse still, misinterpreted. I am not only referring to what is being taught in our national schools, international schools and universities, within or abroad but the core values and practices that should be embedded in a child by the parents.

A child should first be given a sense of comfort and orderliness. They should be encouraged to make mistakes and learn from them. Never be afraid of making mistakes. The parents should learn to become the safety net; to catch them when they fall. Through mistakes they grow and develop an identity, preventing them from remaining an empty and hollow shell of themselves.

A parent’s love must be unconditional. Don’t blame them when they do not communicate with you. If you judge their every action, invariably they will shut you out.

Encourage your children to try and learn new things. Get them to learn new skills and meet new people. Let them travel and immerse themselves in different cultures. Never be afraid of going beyond established boundaries.

Invest your time and money on your kids. If you are never around during their formative years, don’t blame their friends or the internet if anything goes wrong. You reap what you sow. If you have conveniently forgotten that, it’s time you remembered.

If judging them is bad, it is a crime to compare. Comparing a child with another individual is detrimental to their growth. No child is alike and each has a different set of talent and ability. The onus therefore lies on the parents to nurture and guide them and provide a suitable and stable environment to harnesses a child’s untapped potential. It is imperative to treat a child as an individual, devoid of comparison with others.

I leave with a quote by Mitch Albom, “All parents damage their children. It cannot be helped. Youth, like pristine glass, absorbs the prints of its handlers. Some parents smudge, others crack, a few shatter childhoods completely into jagged little pieces, beyond repair.

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I AM A DOCTOR: The myth buster

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It is the time of the year again, where the old ends and the new begins. Where we seek reassurance from the baffling resolutions we never meant to keep.

It is also a season for young students to decide the course of their career. Fresh faced and bright-eyed, full of hyped up myths and legends, they will inadvertently have one ambition in mind. A dream they have kept repeating from childhood or rather a mantra that was repeated to them : GROW UP AND BECOME A DOCTOR.

I am here to tell you what your parents conveniently forgot. There are things to consider before foolishly embarking on a journey not meant for you. In short, I am a myth buster. But in reality, I AM A DOCTOR.

 

Myth number one: The hard part is getting into medical school.

This is not the hard part at all. The real challenge is remaining in medical school till you graduate. The numerous exams and assessments will leave most of you gasping for reprieve.

My advice to you is to go to the nearest book store and browse through the medical books. Have you seen them? Do they look shiny and thick? Good. Now imagine spending your weekends with them. For the next five years!

Clinical exams on the other hand are unique to medical schools. Two examiners will observe your every move as you attempt to demonstrate the multiple clinical signs taught only once during your ward rounds. Mass production of doctors by a single medical school is a myth. A significant number would have dropped out by the time you graduate.

 

Myth number two: Internship training is not as difficult as it sounds.

You are absolutely right. It is infinitely much harder. Every decision you make will be scrutinized and criticized. Some senior doctors will humiliate you for simple errors.

There may be times your ignorance might be detrimental to a patient and you may lose a patient during the course of your internship. Recovering from the loss is hard, especially if there is a chance you could have prevented it. The guilt will eat you up, forcing you to drop out of clinical work. And this guilt will stain your conscience for life. It will never wash off.

 

Myth number three: Doctors are highly respected in the society

This may have been the case in the previous centuries but as our society becomes more affluent and educated, they invariably become more demanding.

Walk through the corridors of any hospital in major cities, wearing your white lab coat and stethoscope, you would be hard pressed to find any layman who greets you with a smile or a respectful nod to say the least. Forget about “good mornings” and “good days”.

Since the lawyers are fast becoming the bane of our existence, our daily work consists of evasion tactics to prevent lawsuits. A new form of medicine is being practiced now and it has superseded the “clinical medicine” that was taught to us. It’s called “defensive medicine” and it is being practiced throughout the world.

Unnecessary investigations and treatments are administered, which bleeds our health resources dry, just to protect ourselves from legal attacks. An example would have to be the fast emergence of resistance to most antibiotics due to injudicious use, which if seen from another perspective, stems from the practice of defensive medicine.

 

Myth number four: Patients will always be grateful to the doctors

Before you start filling up the forms to enter medical school, you need to get one thing embedded in your mind.

Most patients will never say “thank you” or “you did your best doctor” if they get better. They will assume it’s their birthright to get better once they see you and it is your duty to make them well as they pay taxes.

I have been in this service for seven years and out of the thousands of patients I have discharged home safely, I can say less than a hundred have expressed their gratitude. Most would be complaining about the time it took for the doctors to prepare their discharge notes and plan subsequent follow-up appointments.

Then when they come back to see us in clinics, they will complain about the waiting time, not knowing you would have been starving the whole morning, just to start the clinics early to reduce the waiting time of the patients. After the consultation, you would be the one thanking them, and they will be rushing for the door to get the next cab home, so that they can be back in time for lunch with their family. And before I forget, lunch is a luxury you don’t often get.

 

Myth number five: Patients always place their full trust in doctors

If I have not deterred your interest in medicine up to now, I guess this will do it.

You are no savior. Remember this, and remember it well.

You don’t walk into a ward with the authority of a royalty and tell your patients you are going to start some form of treatment for them regardless of how they feel about it because they should just trust you. You had better find another job because their lawyers will sue the pants off you.

There is something called “patient autonomy”. It is they who decide to pursue any course of treatment and this is based on the quality of communication between both parties.

You can’t force a Jehovah Witness to receive blood transfusion even if she is bleeding away after delivery and would rather die that see a drop of blood enter her veins. In a bustling labor room, you might get a few requests at the same time for a female doctor to attend to patients with specific religious beliefs when there are no female doctors around. I have had patients who insist on seeing only a particular doctor knowing well he is on leave, while the infection eats away their foot, vehemently refusing other doctors and medical interns to come near them.

Official complaints to the administrators will follow suit if we don’t comply to their every wants and needs. Media bashing and Facebook groups with ridiculous demands are only a tip of the iceberg. The internet age has created many pseudo-doctors who assume they can challenge your treatment plan and knowledge based on a few articles they have read online. They will quote everyone and if possible even their neighbor’s cat which according to them recovered from appendicitis without any surgical intervention (True story!) .Go figure.

 

Myth number six: Sleep deprivation is a thing of the past

Sleep deprivation will remain in your present, brought forward from your past and linger on in your future. Medical interns will suffer the most. Depending on the sub specialty you choose, sleep deprivation will follow you like a shadow. No amount of adjustments to working hours will prevent this because the diseases don’t come with an appointment. As you climb higher up the ladder, responsibility increases exponentially and sleep quality reduces dramatically. Sounds poetic but it’s true.

 

Myth number seven: Doctors are guaranteed a job for life

Get this idea out of your head. Due to the blossoming of medical schools in most countries the supply is fast overcoming the demand. Some countries can’t cope with the number of doctors being churned out every year, that stringent entrance exams are enforced prior to permanent placement for internship. Requirements for specialty and sub specialty trainings are stricter now than they used to be.

Legal ramifications and higher costs in setting up private hospitals and clinics are fast reducing the number of experienced doctors who tend to live on their pensions and lead a relatively stress free life. The only thing you are guaranteed is the title in front of your name, which after a while numbs you and loses its sense of appeal.

 

Myth number eight: Doctors make lots of money

Doctors make a decent living. We don’t mint money if that’s what you’re after. If you are motivated by money I suggest you find another way to earn it. You will never be happy in this field. It’s just not for you. And it’s not your fault if you are motivated by financial riches. Just don’t use the pain and suffering of others for your own gains. There are other ways. Please find it.

 

Myth number nine: Life is easy for doctors in some countries compared to others

I don’t have to travel around the world and speak to every doctor, living or dead alike to tell you this. Life of a doctor is never easy, regardless of which corner of the world you work in. If it’s easy, then you’re not doing your job right.

Each country has its own challenges and any reasonable clinician with a sound insight will tell you the same thing. Perhaps they will venture to add-on some that I have missed out. You can try running but you will eventually end up where you started.

Living conditions and pay structures may change but human nature remains a constant throughout the world. Since our profession deals with human ailments and diseases, handling their behaviors and concerns conjointly falls on our shoulders. This is where the interminable difficulties lie, not in the diseases, but in the unpredictability of human responses.

If you do find or hear of a country where the doctors there have it easy, do let me know. I will swim there or drown trying. 

 

Myth number ten: Doctors are busy but they still have time for their family

Finally, if you have been reading patiently up to now, courageous and steadfast in refuting most of the myths, telling yourself “I know what I am getting into”, then this is the last weapon in my arsenal.

If you love spending most of your time at home with your family, if you see yourself being around your children when they grow up, if you want to be there for your wife when she is pregnant with your children, hold her hands while she delivers your baby, if you yearn to witness the first few steps your child takes, then this unfortunately is not your path.

Medicine will take up most of your time and very little will be left for your family. Many marriages have broken down for this reason alone. Children have grown up blaming their parents for not being there for them during their formative years. You will miss the important anniversaries, dance recitals and football games. Do you think a mere job is worth all this?

For now, this is all I have. I have painted a bleak picture. You have just seen it. And all of it is true.

 

So do you still want to become a doctor?

If your answer is still a resounding “yes” then I will let you in a secret. The important piece of information withheld up to now, meant only for those who truly deserve it. I have no regrets as well. Do you know why? Because we are the select few chosen to ease pain and end suffering. It’s a selfish act of being selfless. For one good day in this profession, I am willing to weather a hundred bad days. For a single smile of gratitude, I will brave a wave of indifference. For a person to be returned to their family, I am content if I only get to kiss my child goodnight.

I wake up every morning with a reason to live. It is profoundly better than those who wander aimlessly in a life of wealth and comfort. There will always be dark clouds. Even if I can’t see the sun, I know it’s there. And this sun is invincible. I hope you see it too someday.

 

The forgotten doctors

Paucity of attention is a serious crime. Lavishing undivided and undeserved attention is a mental handicap. I find it fascinating that there is intense scrutiny over superficial ripples on the languishing plights of a certain group of caregivers but then fails to even scratch the surface of a plight far worse than theirs.

I am a young physician working in the district hospital of Lahad Datu. I don’t blame you if you don’t know where it is. I didn’t too when I received my transfer letter. It’s located near the east coast of Sabah, but I am not here for a geography lesson. Neither am I here for cheap publicity. I am here solely to testify to the working challenges faced by doctors in remote districts of our country. 

District hospitals face the most arduous of challenges daily. Increasing patient load in district clinics and hospitals is just a paltry issue. Population increases exponentially based on the quality of health care. It is the lack of trained doctors manning these centers that should be addressed. The ministry of health took significant steps in addressing this. Medical officers, graduating specialists and senior consultants are transferred from major cities to ease the burden and uplift the services in these remote districts. But the lack of manpower still prevails. Where did we go wrong?

Most doctors have associated district hospitals to career suicide. Slim chance of a transfer back to the main hospitals in bigger towns have also been cited as a reason. Lack of basic amenities to quench their thirst for entertainment is a prevalent criteria. Families, spouses, multiple breeding children are among the reasons quoted in almost all the appeal letters cluttering the desks of the administrators in the ministry. Some have refused and have even resorted to selective memory loss when it comes to reporting for duty. Given the amount of latitude afforded they go unpunished and even obtain cancelation of their transfer on ridiculous grounds. I don’t deny there are genuine reasons for refusal to serve the districts but I am often left puzzled by the difficultly in being away from home for half a year compared to two or even four years of speciality training. The logic baffles me.

The ministry should make its stand clear. All medical officers, graduating specialists and consultants are given a finite time frame to serve the districts. They should be transferred immediately to any hospital of their choice once they have ’done their time’. No pun intended. If it’s their choice to continue serving the districts then so be it. Do not allow them to hold you ransom for promotions later for their conscious choices. If the velvet glove does not work then it’s time to reveal the iron fist.

It must be made compulsory for all new specialists to serve the districts during their period of gazettment. It should be made as one of the criterion for gazettment. A revision on a reduction in the period of gazettment for specialists serving the district hospitals should also be seriously considered. Moreover, these doctors should be given a significant precedence for subspecialty training over their peers who have refused to serve these hospitals, barring of course the consideration towards special reasons and requests. I believe it is a fair deal. With these efforts in place, graduating specialists will be queuing up to serve not only the interiors of Sabah and Sarawak but the deep bowels of our rainforests as well!

Medical officers in the district should be prioritized for speciality training. It is heartbreaking to digest if medical officers in districts have to compete on equal grounds with their colleagues in bigger centers for a place in speciality training. We should give them a reason to believe that their time serving the poor and needy is appreciated.

Why serve the district you may ask? You serve for the very reason of our existence. We exist to serve, to give a sense of orderliness to the chaos of diseases and to bring forth a sense of security to our patients. It is our duty to sweat blood and grind our sinew for this purpose alone. Don’t the people living in the interiors deserve better healthcare? Can you avert your eyes from these humble folks ravaged by poverty when all they ask is to be given fair and safe treatment? What is the use of our government pouring funds for state of the art facilities in these hospitals without anyone to man them? Good clinical practice and safe medicine starts and ends with the clinicians.

Finally, I will bring to your attention an often disregarded fact. In order to produce competent and safe doctors to empower our districts, we need to continue or improve our current training of young doctors. This should best be left to the practicing clinicians without the interference of the compassionate public and concerned politicians. Please don’t make it impossible for us to do our jobs.

I leave with a quote by George Bernard Shaw,  “ I am of the opinion that my life belongs to the whole community, and as long as I live it is my privilege to do for it whatever I can. I want to be thoroughly used up when I die, for the harder I work the more I live. I rejoice in life for its own sake. Life is no “brief candle” for me. It is a sort of splendid torch which I have got hold of for the moment, and I want to make it burn as brightly as possible before handing it on to future generations.”