Real Medicine

A Point for the Cold of Heart

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.

Lowest possible mortality and morbidity rate.

Highest possible success rate.

And the Hippocratic Oath that prevents your emotions getting in the way.

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4 thoughts on “A Point for the Cold of Heart”

  1. Clicked on here from another writing blog and was pleasantly surprised to see someone else had chosen the same theme I have on my blog!
    It would be hard to help people who do not help themselves. At least in medicine there is a strong ethical obligation to carry you through. The important part is that just before falling asleep at night you’ll be able to close your eyes and know you did your part. Maybe some of these people will eventually “get it” and turn around.

  2. Thank you for stopping by and dropping a line 🙂
    I do agree with your viewpoint.
    Also, the current theme is my favourite at the moment – simplistic, easy. Like you, I am bound to get bored with it some time or another, though!

  3. But who are we to judge who is deserving & who is not. Who are we to tell if the amount of suffering a patient had had contributed to his misjudgement or even apathy. Plus is he aware -fully comprehened- the consequence of his decision. I have witnessed bad counselings and poor explanationd to patients. And the doc is convinced he did a good counseling. And is mad at the px.
    Unless you can crack open people head & experience their thinking process you are unsafe in your judgement. I truly believe labeling someone as bad ( even alcoholic pregnant) is a form of racism. We are social creatures. So what have we done to stop a harm. Not only in medial aspect but what have we done to improve our community -economy etcs. The cold heart approach is not cold after all.

    I am really enjoying your blog & the way you think. If it was a book I will make it the the Christmas gift to everyone- O but we don’t celebrate Christmas here hehe-

    1. You’re very right. We shouldn’t judge – but sometimes, if we think only with our hearts and not our heads, we can let others’ behaviour affect us too much.
      Thanks for your encouragement!

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