Wednesday, November 12, 2008

to comfort always

one of the complaints that people have about healthcare professionals these days is that there is no empathy, or even sympathy, no passion in the way they work. doctors and nurses see patients as liabilities, diseases that need to be treated and discharged. the more successful cures there are, the bigger pat on the back for those responsible for taking the illness away.

a lecturer of mine posed the following question to us: why do we think that is so? most of our answers were along the lines of...there are more patients than ever these days, we're short on staff, the infrastructure is insufficient to support an ever-growing need for good health facilities, our country doesn't have the budget, and so on.

i'm not sure if it was a case of "the-good-old-days-itis" or "in-my-day-aemia", common diseases that strike anyone older than you are regardless of your age, but she brought to our attention that when she was a house officer, things weren't any less busy than they are now. the difference is that while the number of women giving birth have not changed much, there were fewer housemen, less equipment, fewer wards and hence greater congestion...yet the doctors then were more human than they are now.

she proposed that the real reason the workforce lacks empathy is that these days, being a doctor is no longer about passion for the job or a sincere desire to help people and, here comes those sarcastic words again, save the world. now, every spm top scorer screams for a scholarship to study medicine and every stpm 4-pointer demands a spot for medical training. why? for the glory? so all that intelligence isn't wasted? no space for genuine interest and naive altruism then?

all my altruism crashed down when i started medical school, but then no one said that saving the world was going to be easy. i mean, it's been 3 seasons and hiro nakamura is still at it! but that's a different story. sorry for the digression.

anyway, that lecturer then told us a story of how she got off her high horse after a particularly moving encounter with a patient who lost a child not long after giving birth. it was a moment that stirred the humanity in her and she never looked at patients the same way again. she was a proud, brand new specialist who prided herself on her qualifications, but it took a tragic story to get her feet back firmly on the ground.

i'm just wondering if all of us in this field really need to have a tragic story of our own in order to be reminded that medicine isn't about the disease and technology. even in the earliest days of mankind, when there were no tools, books and fancy equipment, people were practicing medicine. none of the scholars and medical philosophers of old mention anything about drugs in the care of patients.

dr. edward trudeau, founder of a tuberculosis sanatorium, said this, "to cure sometimes, to relieve often, to comfort always". it is a favourite phrase among some of my lecturers who seem to make it their personal mission to drive into us the message that medicine is always, always about what makes us human - our feelings, thoughts, desires and needs. there is no greater need than to be cared for and loved and those basic ingredients are what we need to inject in ourselves to be continually reminded about who we are as people and physicians.

it is a less than pleasant realisation, but i guess it's true that we need tragic stories in our lives to push the button within us and reactivate what it means to be beings with higher cognitive function and also greater emotional sensitivity. if there is a high horse we're on right now, i just hope the event that shakes us off won't be a devastating one, but i'll pray for God's mercy that it'd be just sufficient to get the message through.

lishun at 6:40 AM