I admit that much of my decision to study medicine – and not to drop out – hinges on the humanitarian aspect of this field. As a high school student, I wanted to study everything and to be quite honest I think I would have done quite well at most of it. So the decision had to be made based on what I would enjoy most. And my happiness depends largely upon a sense of purpose, of doing good.
So although the medical field is vast and constantly renewing and stimulating, my passion for it is renewed by this idea that I am helping people, saving people, making the world a better place. Because at some point I have convinced myself that somebody needs to save those who deserve saving.
The fundamental error with this thinking is that, logically, there must be a converse. For example, a lawyer may appeal someone’s death sentence based upon rehabilitation and remorse. By that principle, he will not defend anyone sentenced to death. He is a bad lawyer, an emotional lawyer, when compared to the lawyer who “specialises” in appealing the death penalty because that is what he does well. Note that this is not a reflection of their respective characters.
What happens when a doctor has spent his working life saving needy patients because he believes that they are deserving, and he is suddenly faced by a rapist that needs healthcare?
If our work is fired by emotions, what happens when those emotions are negative towards our patients?
During my obstetrics rotation, I saw pregnant women who had defaulted their ARV-treatment and brought into life children who, essentially, will be battling infections their entire lives. I saw women who drank straight through their pregnancies; despite previous miscarriages and children born with Foetal Alcohol Syndrome. I saw a woman who refused sterilisation even though she was told that another pregnancy would kill her.
I have seen mothers who do not bring their children to hospital in time because they are stone drunk.
A friend of mine was recently brought a six month old patient who had been suffering diarrhoea for six days. It was the first time that the mother was seeking medical attention. When he examined the baby, he found that it was stone cold and had been dead for six to eight hours.
The cold hard truth is that, faced by patients such as these… I do not have that desire to help them. They do not want help for themselves. They do not want help for each other. How am I to save people who take no responsibility for themselves?
The only solution is the academic approach. An approach I myself have called cold-hearted. But perhaps it is the only way to ensure that you provide the same standard of healthcare to all patients.