… and this is in no way a TFIOS reference.
Premise 1:-
As part of our General Practice (GP) block, we had a day visit to a hospice in the Bro Morgannwg (Vale of Glamorgan) area. The aim was to get us acquainted with palliative care and see how a real life hospice works. The hospice itself was as lovely as one could wish a hospice to be with excellent services and top notch staff. The services would make you highly consider end-of-life in a hospice with aromatherapy and massage to alleviate pain, calming view of the sea and 24 hour staff. Basically, it’s like a hospital ward only much homier. Patients in the hospice are terminal and are usually on an end-of-life care pathway which is centered on pain and symptom relief.
After a tour of the hospice, I got assigned a patient who was diagnosed with gastric cancer in July, with extensive metastasis (spread), and was told she would only make it to September. The diagnosis was really the worst case scenario with the elements of : Sudden, Poor prognosis and Cancer. After 15 minutes I realized just how difficult it is to ask questions that might make a patient who is dying dwell on the circumstances of her death.
Later on, we had a session with the Oncology registrar. We had a discussion on career paths post medical school. There are basically 4 main paths: Academic, GP, Med/Surgical training or run-through programs (ObGyn, Paeds, radiology etc). The discussion took a turn for the serious and the soalan cepumas “How much does a doc in each speciality make?” came out pretty early. GP’s could make up to 250K pounds per annum while hospital doctors could make up to 60-70K if they trudge slowly up the career ladder and depending on how much responsibility they take on. The GP job was looking very attractive throughout the discussion with the fact that they can earn the highest pay and have the best work-life balance, so it was no wonder that most of the group were opting for it. Then we learnt about the competitiveness of each specialities with bottlenecks in training settled with the amount of research, effort, conference posters and interest shown from early on in medical school. The reg made it clear that there were not many spots per speciality and competition was tough with the rising number of graduates (heh masalah lambakan doktor ni bukan masalah kat Malaysia je rupanya)
Everyone left the room with the intention of working harder, determined to making it into the speciality of choice, nailing the high salary and living the good life befitting the hard years of toil and competition that is the medical career.
Premise 2:-
“Being pregnant is like having 1 foot in the grave.”
“Women say farewell to their children before they go into labour.”
“In UK, 1 in 5100 mums die in labour, while in Chad, it’s 1 in 11.”
In a global health talk on Maternal Mortality, we were served with some heart-wrenching facts about how mothers in countries like Chad, Liberia and Nigeria die on a daily basis while giving birth. The saddest part is, most of them die from hypertensive complications of haemorrhage post-partum, both which are very preventable with drugs that cost less than 1 pound.
The woman giving the talk was a Angela Gorman, a nurse who worked in the Neonatal ICU in UHW. She saw a documentary on BBC’s Panorama called “Dead Mums Don’t Cry”, which showcased the work of Dr Grace Kodindo’s efforts to save women in childbirth and their babies.
She was so horrified by what she saw in Chad, that she started a charity called Life for African Mothers and is committed to raising funds to help buy medication and improve the hospitals in Sub-Saharan Africa.
“Is giving birth the most dangerous thing an African woman can do? Without a doubt. If you add the fatalities from the Haitian earthquake in 2010 to those of the Asian tsunami in 2004, you still don’t reach the number of women who die as the result of pregnancy every year”
In Malaysia or the UK, being pregnant is a cause for celebration. Thinking about pregnancy makes me envision a baby’s gurgle, little fingers and toes, and a lot of love. No one really considers that the outcome after 9 months could be death.
What really made me ashamed of myself was the fact that:
1. I am a Muslim. The suffering of fellow Muslims or people anywhere should be something that I help with or at the very least spare a thought to.
2. I am a medical student. I learn about diseases, and maybe because I live in a country where the healthcare is really advanced that I’ve lost touch at what it’s like for people who don’t have the privilege of modern medicine that I learn about every day. It’s like I’m studying medicine in a parallel dimension, where I think about getting into a job that pays a ton and a great speciality that lets me roll in the dope, spend quality time with my family and live the life, when across the world there are actual doctors who are facing life and death scenarios and spend their time thinking about how to overcome odds like not enough money to buy meds or equipment.
Premise 1 & 2 sparked a few questions about the distinction between being realistic and being idealistic, and if the distinction between the two is the difference between a persons’ life.
Both women in premise 1 & premise 2 are dying. One on a hospital bed, at a good old age, with plenty of painkillers to numb the aches, surrounded by her loving family and every possible comfort. The other is probably still young, bleeding to death or fitting from eclampsia, leaving behind a baby who’s life will hang in the balance with her absence, and her death is probably the pinnacle of her life that is possibly full of hardships from poverty.
Like if I was just to be realistic and focus on the present circumstances in my life, if I just work to get a good paying job, I’d still be practicing Medicine, I’d still be making a difference in someone’s life, no?
Is it idealism to want to go somewhere where medical help is really needed, like Africa? In the back of my head, I can hear a voice that says, you have to get a good job, be financially stable, follow the conventional path of getting married and start a family, then donate to charitable causes, or perhaps do a stint of charity work somewhere, but don’t make that your life, because you’ll make no money from it. But if everyone did that, Medecins Sans Frontieres (Doctors Without Borders) and Amnesty International wouldn’t exist.
This post isn’t going to end with a summary on the decisions and answers, because I don’t have them. I actually feel a bit unsure about how to address the mismatch between the 2 premises above. I want to do something about it with my life, but at the same time, I don’t know how to go about it. I feel a little shallow, especially when Angela mentioned some of the doctors she was working with to expand her work in Liberia, had recently died of Ebola.
Merawat masyarakat yg ramainya menghidapi penyakit kesan dari perbuatan sendiri eg pemakanan & merokok VS doktor yg menolong orang yg, rata-ratanya dalam kemiskinan dan begitu terdesak?
Hmm. Well this is just an outburst from the bowels of my brain. I shall ponder on this again, soon and return to my coursework now so that I can pass 3rd year and graduate and actually become a doctor.
Ps: Spare a prayer for all the mothers out there, because they literally, almost die trying to bring you into this life and figuratively, almost die trying to raise you in it.
Solace 