Reflections from CSFC week 1

It's been a really tiring week, mostly self-inflicted I would say. But I suppose at the end of this week, I've seen much more than I have over the past 2 years, and learnt much more than I would have over the course of 10 PBP sessions. Practical really puts more perspective and more purpose than dry text. I gave some thought about the past week though... and so I've reached the conclusion that...

Awesome as it has been, it has also been a tad depressing... somewhat. I'll use three patients that I clerked as examples...

I clerked Mr A. on Tuesday. One of the standard cases - obstructive jaundice. Went back to see him on Weds, his pain and cough was gone, he was feeling better. Then I went back today to see him again, found out he had diarrhea, with the case notes suggesting sepsis and hepatic encephalopathy

I saw Mr B. for the first time on Thursday. An elderly man, with children who wouldn't support him. Monthly income of <$1000; government rejected his multiple applications for a HDB flat.

Ms C. had SLE. She was really cheerful, really helpful. I was probably the countless medical student who approached her to ask for a history. One question and the entire history came out, filled with medical terms and information that taught us much. On that day, she was awaiting results - which came out the following day. Her previously controlled condition had progressed to cerebral lupus. A very poor prognosis indeed

I think about such cases and then I think back on my goal of striving to be a doctor. Much as medical science can do, it cannot solve chronic conditions, it cannot solve end stage diseases and all the more, it cannot solve social problems.

People talk about how great doctors are, how they have the 'ability' to heal and how they are able to change lives. But really, what can doctors do for these things? Nothing I would say. Simply nothing. While all these glorious talk is going on, what people don't talk about is how helpless the healthcare profession is when faced with these problems. Paliative care doesn't heal, it relieves. Financial aid has its flaws, as evident from the elderly man's case. Medical science right now tells you that you have a chronic/end-stage disease and it leaves you there - no cure.

So what really is the purpose of health care workers? With much thought, the best answer I can find is that, we treat those that we can. For those whom we can't, we'll have to support them emotionally, if possible, financially. Thing is, there's always a limit. How much time can you actually spend with one patient when there are hundreds and thousands more out there who need someone to speak to, but don't? How much aid can we give to one person, how much do we help each one of them?

I think back to the story of a boy and the beach of starfishes...

~~~
Once upon a time, there was a wise man who used to go to the ocean to do his writing. He had a habit of walking on the beach before he began his work.

One day, as he was walking along the shore, he looked down the beach and saw a human figure moving like a dancer. He smiled to himself at the thought of someone who would dance to the day, and so, he walked faster to catch up.

As he got closer, he noticed that the figure was that of a young man, and that what he was doing was not dancing at all. The young man was reaching down to the shore, picking up small objects, and throwing them into the ocean.

He came closer still and called out "Good morning! May I ask what it is that you are doing?"

The young man paused, looked up, and replied "Throwing starfish into the ocean."

"I must ask, then, why are you throwing starfish into the ocean?" asked the somewhat startled wise man.

To this, the young man replied, "The sun is up and the tide is going out. If I don't throw them in, they'll die."

Upon hearing this, the wise man commented, "But, young man, do you not realize that there are miles and miles of beach and there are starfish all along every mile? You can't possibly make a difference!"

At this, the young man bent down, picked up yet another starfish, and threw it into
the ocean. As it met the water, he said, "It made a difference for that one."
~~~

I suppose, that'll be a good way to end this post. It's a long journey ahead. And it'll a journey guided by God. LORD, may You guide my steps, my speech and my heart.