Romance, reality and repulsion

Activaid 2011 was a nice insight of how mission work overseas is really like. It was no longer things like: you should go for missions; the people need your help; why providing aid to neighbouring countries is important; the need in the world. No, the speakers there knew one thing: they want to go on missions, and they have been. No more pep talk on pushing people for missions. The conference was on missions, and how they are realistically. What do you want to achieve? How is it going to be done? What are the short term and long term aims? How is finance going to be settled? Very real questions to very real problems.

The second workshop I attended was termed: Avoiding another 'hit and run accident'. There are instances when people go there with good intentions, do a job halfway and leave. Not only do they not help the people, they left an obstacle: a half built and useless concrete buildi... ruin in the middle of their village. So, yea the talk was how to avoid that or the like

One thing the speaker brought up was the progression of how people who want to go on missions go down the route of romance, reality and finally repulsion.

Romance: Yes, missions are really great! I want to go out and help others, to reach out to those who need my help, to hear the marginalised society and give aid in every way possible. I want to build houses for them to live in, toilets for good sanitation and help them find a stable income to break the poverty cycle!

Reality: Well, I can give this family a meal today, but that helps them for one day. They're hungry again tomorrow. The new system implemented for better sanitation is not being accepted by the villagers due to custom and habit. There aren't enough funds to do what I want to. I cannot stay here forever

Repulsion: Missions are stupid. They're absolutely useless. They waste time and they waste resources. All this effort put in will only come to zilch. I'm never going for missions anymore. I'm going to discourage everyone from doing it.

Sounds harsh, but definitely true in some situations. Not only in missions I would say, but also in the wards, in the calling to do Medicine.

On my side, the 'romance' part started very similarly. The passion for learning, for helping others, to heal them, to cure them, to better their lives. Nothing detered me, not even the doctors' advices which all ranged from: bad choice; 36 hour shifts; *shakes head*

'Reality' has set in. Studying isn't easy. Well to be fair I never loved studying. But still, the field of Medicine is just so big. There's so much to know and probing too much into one area leads to a deficiency in another area. It's just not possible to cover everything however hard one may try. But that's only secondary. Learning is a lifelong thing. Even the consultants are learning. Studying is important, but what about our morals, and this big thing about ethics?

The other day in one of the ward rounds, an MO was asking a consultant regarding medical futility versus the law. The discussion went on to talk about negligence, and quoting the consultant...

"There was this case about a guy who went to the doctor for an acute chest pain. The doctor did an ECG, found it was very fuzzy and could not read much from it and decided that the ECG is normal - he discharged the patient and tore up the ECG because it was of no use. The very same day, the patient died due to an AMI. The doctor got stripped of his license, not because he failed to pick up the AMI, but because he tore up the ECG - he had no prove he did an ECG for the patient. If he did not tear up the ECG, the court would have let him go.

You see, there is a difference between negligence and stupidity. If you do not do an ECG for that patient, you are negligent, your title deserves to be stripped. However, if you did an ECG, and the ECG shows a blatant ST elevation in a few leads but you discharge the patient saying there is a no problem, the court cannot charge you. They will just say, doctor, you can't read ECGs. You need more training. They cannot strip you of your title just because you are stupid. They can only do so if you're negligent"

The entire conversation.... I can't find words to describe my reaction. Shocked wouldn't be too accurate. Enlightened isn't right either. I felt like.... although I wanted to judge that consultant, I couldn't. He was very right because that's how the law is. But at the same time, how can a patient's life be lost simply because a doctor is "stupid" but not "negligent"?

Which brings back the thing about reality. Reality is such that nothing is ideal, nothing always goes as planned. Being skilled for the exams is one thing, being skilled in the important areas of service is another.

The scariest part of reality is, the possibility of it progressing to repulsion. I don't want to reach the point where I find the wards repulsive, find studying useless and worst still, find patients irritating.

Romance, reality, repulsion. Out of these, I'm supposing reality is the most applicable because, well, it's reality. What's most important is, integrating romance into reality and shunning repulsion from day to day. That's the ideal, but it definitely is by no means easy. Not with the environment around being so stressful and demanding in one way or another.

God, be my Guide. Be my everlasting Guide I pray.