I make a habit of naivety.
Not always on purpose, but often enough that even my super-oblivious brain has recognized the trend. In his more romantic moments, my current partner says that my optimism is the perfect antithesis to his cynicism. In less romantic moments, he expresses great concern about my intelligence.
Running headlong and heedless from hospital medicine into primary care with the half-baked hopes of “fixing Jamaica’s healthcare problem at the source” will not rank highly in my self estimation. And it was silly of me to think for a second that the only thing broken was the almost universal lack of health education among Jamaican patients.
I will probably never know how wrong I was, because I will probably never fully comprehend the multiplicity of the flaws afflicting the delivery and reception of our healthcare. From patient contact to policy making, I think there are a myriad of ways for either the system or the client to fail each other.
This is where my optimism wanes. I doubt myself. It’s one thing to be exasperated by a health illiterate patient in the emergency department, mentally berating primary care doctors for not taking the time to have proper dialogue with their clients. It is quite another thing to be confronted by climbing physician:patient ratios, dwindling consultation times, and perhaps the most frustrating of all: repeat offenders. The patients who, despite adequate counselling and interventions, persist in their unhealthy behaviours.
Cynicism rolls in like a dark cloud, closely followed by the lightning storm of burnout. The horizon of my imagined clinical nirvana (where patients and physicians work together to help patients live longer, better lives) all but disappears.
And yet.
The dream of an effective and efficient health care system isn’t inherently stupid. Yes, I was foolish to think I could effect change just by wishing for it hard enough, but the bottom line is that change needs to be effected. And the nugget of reality at the core of my fantasy is the desire to be a part of that process.
If I just re-frame my ideas of how exactly health care reform will happen (a lot more meetings and red tape, and a lot less glitter and fairy dust), the cloud of cynicism drifts out of sight. It will be longer, more tedious and may not turn out quite the way I expect (like most adult dreams) but that is okay. I don’t have to throw away the dream, I only have to take it down from that lofty shelf and actually work at it.
It would be easier to be cynical.
well read robin 
“From patient contact to policy making, I think there are a myriad of ways for either the system or the client to fail each other”
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Yes. Funny enough I did some minor research (just because I was curious) on the Jamaican Health care system and I found that the above statement is so frighteningly true. Lack of communication from the patient level like you say, to the board level, the red tape and the elite corruption (politics, nepotism) where people are in the health profession for the wrong reasons or to advance their own agendas is crippling for JA.
Your naivety as you call it is refreshing to me, you offer me hope. Hold out the faith.
You say naivety, I say: looking on the world through younger eyes.
–Blessings
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Thank you for reading! I’m trying to keep the faith, but it is rough.
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It is dreamers who change the world. …I came to that point a year/a year and a half ago, rather unceremoniously–realizing that my heart was not big enough to hold all the cares, and that I alone was not powerful enough to effect change…I was angry and heartbroken for months thinking “how could we let our society sink so far? How could we knowingly tolerate the inequalities and injustices etc.”, so I knoooow, it’s difficult. Every day is a challenge, but nurture your naivety (read idealism) in your heart at night and every day, don the mask of reality and fight like hell, because it is dreamers like us who change the world.
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Thanks Tomekha. That’s good advice!
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