House-Hunting: the Mobay Edition

Finding somewhere to live is hard, whether you’re in university, freshly graduated or bouncing around with three kids and a stable career. Fortunately or unfortunately house hunting is something I love to do (is that weird? It’s probably weird), and I’ve picked up a few lessons over the years that I think can be useful to my fellow 20-something Montegonians (all five of you who read this blog, if so much).

I only hope that this two-part series will make wading into the waters of independent living a little less scary, and that it will be a guidepost along a path that can be confusing and muddled. If it’s not time for you to leave the nest for one reason or another, that’s okay. Work hard and save. Living with parents is by far the cheapest option – no rent, free food and your mom will probably do your laundry too. But if you absolutely have to get out there on your own, then maybe this little blog will help you do it.

General rules:
  • Be prepared to pay at least two month’s worth of rent up front (sometimes three). This is the rent for your first month plus a security deposit in case you ruin the place and don’t pay bills.
  • Take everything with a grain of salt. I’ve been told an apartment was on Brandon Hill and after following the directions ended up, disgruntled, in the middle of Farm Heights.
  • If it sounds too good to be true, it definitely is. Look for the catch.
  • Read that rental agreement cover to cover. Get any promises to fix things in writing before you sign. Document any pre-existing damage and make sure the landlord knows about it.

Once you’re ready with that rent money and a healthy dose of skepticism, it’s time to plot your game plan.

Pick an area and know your budget

The first step is to know how much money you can feasibly spend on rent. Be realistic here not ambitious. One of the awesome things about Montego Bay is that you can find a home for any budget, especially if you’re flexible. If you’ve only got $10,000 to spare you can still find a place to live. It will probably be a shoe-box but it will be your shoe-box.

A good rule of thumb is that your budget for rent and household expenses shouldn’t exceed 30% of your total income. Like the pirate code, this is more of a guideline. To find a more exact number, once you’ve figured out 30% of your monthly salary go ahead and subtract an estimate for your utility bills (if not included in the rent) and any associated costs of the rental home like maintenance fees and such.

Once you know what your budget looks like, go ahead and pick an area (or a few) where you’d like to live. Bear in mind that location is everything in real estate and nice areas usually come with really nice price tags. There are ways around this, like smaller homes in uptown areas, or sharing common spaces. Which brings me to my next piece of advice. . .

Be cautious about sharing utilities and common spaces

The first rule will help you in weeding out your prospects. Once you have an amount and a location in mind, you’ll quickly skip those listings that don’t match your specifications. But even though you might want to compromise on that one bedroom apartment in Westgate Hills where you ‘only share a kitchen and the light bill’ take a minute to think about what sharing a kitchen means: dirty dishes in the sink all the time, and people eating your food from the refrigerator. Sharing the electricity bill means constantly arguing over who burns more current. And if you’re anything like me 2AM on a weekday morning will find you angrily trying to calculate the estimated energy consumption of your toaster oven vs her microwave.

Just don’t give yourself the headache.

Be cautious about living with a landlord

People can be . . . sensitive about their homes. Which is understandable. But as a tenant it can be frustrating to have someone constantly looking over your shoulder. This might be okay if you’re a fledgling graduate just starting out in the world of independent living (almost like having a surrogate parental figure – if you have a good relationship!) but gets much more tedious once the independence really settles in. Their ‘friendly advice’ turns into nagging, and all of a sudden you’re desperate to move. My advice would be to avoid living with the landlord altogether.

In the same vein, try to find landlords that are reliable and respectful. Avoid the ones who flake on fixing infrastructural problems, or go into your home when you’re not around. Ask other tenants (if you can) what their experience is like, and when you meet the landlord make sure their temperament is one you can work with.

Make a list of your preferences/needs

This helps to refine your search, and comes in handy when you’ve viewed a prospective home. After you’ve done your ooh’s and aah’s on the walk-through it’s important to drill the landlord with some hard-hitting questions. How stable are utilities? Is there parking available? How do you feel about extra guests or loud noise? Pets? Smoking? The list is endless and subjective. Knowing what’s important to you comes with time and sadly a little trial and error. The awesome thing about moving is if you absolutely hated something about your last apartment you can make it a definite deal-breaker with your next one. Hurrah for starting over!

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That’s it for part one! The second installation, where I talk about how to find these elusive apartments, will be posted tomorrow. Stay tuned, and feel free to share your strategies for house hunting. Do you agree with me on the shared spaces? What was your worst landlord experience? Let me know in the comments!

 

“Senior” House Officer: Doc, where’s my steth?

Firmly in the category of Things No One Asked For (wedged between merchandising coffee mugs and your annual pelvic exam) this one is all about how I spent my Senior House Officer year. If anyone is still reading this to get some idea about medical life in Jamaica, you’re in luck. Everyone else, bear with me.

For my SHO year (the second year of relative supervision, coming after internship and before postgraduate study), I spent four months at the hospital in Internal Medicine and eight months in primary care bouncing around the clinics of St. James and Hanover. I had wanted an even six month split but the powers-that-be changed the schedule from two six-month rotations to three rotations of four months each, likely as an incentive for doctors to spend at least some of their time in primary care (which is woefully understaffed).

While I enjoy solving the diagnostic mysteries of Internal Medicine and relish the mental challenges of our limited resource setting, I did not particularly like my time at the hospital. One of the reasons is the aforementioned limited resources, which made it exponentially harder to get the job done (the job being getting the patient better and out of the hospital) but another more important reason was the unhealthy and sometimes toxic working atmosphere.

Doctors in hospitals across the world have to battle against so many barriers to effective patient care. Sure there are administrative and technical hurdles, but one of the most damaging and pervasive problems doctors face is other doctors. We can be unkind and unsympathetic toward our colleagues, we can be harsh and critical where kindness and compassion are needed. We can be overly competitive, deliberately misleading, and frankly aggressive. Specialties often argue instead of cooperating, departmental heads are sometimes overbearing and the support staff is at times less than supportive.

I frequently left work feeling like I spent the last 8-36 hours running a hamster wheel, exhausting myself and getting nowhere. For all my efforts I was yet to see any noticeable improvement in the quality of care being offered, and in fact quality of care was on the decline as Cornwall Regional was on the brink of a crisis by the time I had moved to my next rotation.

Unlike its older brother, primary care has no pretensions about the level of care it is able to offer. Clinics don’t promise CAT scans and then tell you the machine isn’t working; or promise urgent lab results that take hours to be processed. Primary care understands that its role is to prevent and screen, to catch the life-threatening emergencies before they become life-threatening. And that pace is so far suiting me just fine.

Hanover is the smallest parish in Jamaica, splitting its geography between enchanting sea vistas and rolling hills of green green bamboo. I spent my four months here really sharpening my clinical skills and patient interactions. I honed my management of chronic illnesses and developed some much-needed confidence (from all the time spent in clinic by myself because there weren’t enough senior doctors available). Hanover’s narrow, winding roads are where I learnt to drive and the country clinics reinforced all the stories I hear about the generosity of rural folk. I was sad to leave it behind.

(Spoiler alert: I’m stationed back in Hanover for the foreseeable future)

The camaraderie and team spirit were like a breath of fresh air after Cornwall’s sometimes hostile overtones. I felt more comfortable offering care at a less urgent pace (even though we had our fair share of emergencies!) and I appreciated the opportunity to effect behaviour change before it got to the stage where tertiary or secondary care was needed.

Despite challenges with patients’ educational level and access to care I still believe that primary care is where our efforts need to be concentrated if we are ever going to make our country truly healthy.

But enough about me. SHO year is all about testing the waters and seeing where your passion lies. It’s about picking up skills you think are important and spending time with physicians or surgeons or anesthetists who you think can teach you a thing or two. Internship is merely meant to be survived; SHO is where you thrive. Attack the smorgasbord of hospital specialties like an all-you-can-eat buffet, or settle down to dine at one specialty for the whole time – it’s up to you. Just remember that along the way you’re molding yourself into the medical officer or resident who will be the ‘senior’ by the start of the next year.

What kind of senior do you want to be?

Oops, (UW)I Did it Again

Despite claiming in February that the refurbished halls will not priced out of the range of a student budget, the UWI has implemented a 30% increase in hall fees on the recently remodeled Irvine Hall, a traditional hall of residence at UWI, Mona.

Earlier this year, Principal Archibald McDonald asserted that the cost of the new fees would first be approved by the UWI council. But in July a group of students started a petition to protest the unfair price hike of 30% for the new buildings. Deputy Principal Ishenkumba Kahwa argued that the fee increase only affected the minority of students who would be assigned to these new accommodations, mostly those in their final year. He added that subsidies would be considered on a case by case basis, saying (unwisely) that there are student who can afford the new cost.

I have noticed over the last few years or so that UWI has developed the habit of using financial means as an unofficial matriculation requirement. I first noticed it with medical school where students who didn’t make the cut for the government subsidy would be offered a place at the full-fee tuition (meaning if you can afford it, you’re in). Then lately, their costs of accommodation have steadily been increasing, with the addition of several new (and therefore expensive) halls. The traditional halls like Mary Seacole, Irvine, Chancellor and Taylor were substantially less expensive, less well-maintained and had obvious limitations on number but they provided an option for students who needed on-campus lodgings.

While it is high time these older halls were refurbished, I do think more could have been done to offset the cost of refurbishing so that the student wouldn’t have to absorb such a significant increase in price. The cost of accommodations on campus increases annually anyway, but I can imagine that many students didn’t budget for this level of inflation. And it is unfair that final year students who should be concentrating on completing their degree are now forced to find extra funds to pay the raised price or risk being barred from their exams for owing money to the university.

It is unfair, but unsurprising. University is a business, after all, and the bottom line is profit. Those who can afford it will always pay, and it makes no never mind that we are once again headed in the direction of elitist education that is limited to foreigners and the upper class.

 

 

Sources: here, here and here.

Should you go to Med School? Probably not.

Medicine has long enjoyed its reputation as a distinguished and well-respected profession with an assortment of perks. Not just in Jamaica but worldwide, doctors rank up there with lawyers and politicians in the hierarchy of  ‘jobs you want your kids to have’. Children with even a mediocre aptitude for science get pushed into medicine and often for the wrong reasons. If you want to be a doctor because you “like helping people” or just so you can put that “Dr” in front of your name you probably shouldn’t go to medical school.

If you like helping people that’s awesome, but you have to be realistic about what exactly you’re working toward and what that work involves. (If you just want the fancy title, get out now). I’m not trying to discourage anyone from becoming a doctor but I do think it needs to be said that being a doctor isn’t for everyone. Similarly, being a garbage collector or plumber isn’t for everyone. And yet someone has to do it. You can appreciate this comparison once you understand that the way we ascribe meaning to jobs is totally arbitrary and ultimately pointless.

People who create immense joy and inspiration like musicians or writers are not revered or compensated equivalent to the value of the work they produce. Conversely our government leaders who exist to serve the tax-payers who elected them are revered and compensated entirely out of proportion to the work they don’t produce.

The bottom line is this: If you could be guaranteed the same amount of wealth and respect by working as a grass cutter (or any other underpaid job), would you still want to be a doctor?

If you said yes, be prepared for a lifetime of hard fucking work. Getting accepted to medical school is only the first hurdle, and it’s a pretty big one. You need the right grades and a decent collection of co-curricular activities. In today’s society it helps if you know the right people. The sheer number of applicants to medical schools annually is staggering; competition is fierce and it will be like this for most of your career.

Aside: If you don’t get into medical school it isn’t the end of the world. If after reading this article and doing your research you decide that you 110% want to do medicine there are ways and means. And you’re young, you have so much time. If after the soul-searching and the research you decide it isn’t for you then congratulations! Go do something that makes your heart sing.

Let’s say you get accepted to medical school here at the University of the West Indies. If your parents can’t afford to, you now have to figure out how to finance all five years of your education. A part-time job is out of the question because you won’t have the time, scholarships are hard to come by and student loans are expensive to repay. Where do you turn then?

Let’s say you decide to take out a student loan. Now you have to hit the ground running with your studies. Medical school is essentially a brain dump of information, most of which has to be memorized until you can understand it enough to apply it. There is constant competition among your peers in tutorials and exams and a stifling atmosphere of one-upmanship. The pressure to continuously outperform your colleagues rarely lets up. Starting here and continuing for a good half of your career, sleep will become a hypothetical concept.

Once you graduate, you’re staring down the barrel of what will probably be the worst year of your life. Internship is a grueling marathon of stamina and skill with the added weight of being responsible for people’s lives. And halfway through the year, if you took out loans, the Student Loan Bureau will come knocking.

If you decide to pursue postgraduate studies, you’re looking at another 3-5 years of school, loans and now trying to balance your family life (probably) with your career and education. If you don’t pursue postgraduate studies, your marketability plummets and your pay grade stagnates. Either way you will probably go prematurely gray from the stress of it all.

If you’re still not re-considering, you’re likely thinking one of the following thoughts:

But doctors are rich!

Unless they inherited wealth (which admittedly, a good many doctors do) doctors aren’t rich. For an average Joe from a lower to middle income family, it takes several hours of overtime to maintain the lifestyle the public usually associates with doctors, especially in the early years of a career. In the grand scheme of income rates, Jamaican doctors get paid very poorly compared to our international counterparts (even South African doctors get more money than we do). But there a lot of different factors influencing how much money you make, most importantly post-graduate study.

But doctors are well-liked/respected!

This is true to some extent. Certainly doctors have special privileges: people smile at you more (people smile at puppies a lot too), you can stand as a character reference (so can ministers of religion) and banks tend to want to lend you money (it’s a trap, Jim). But like Uncle Ben said, with great power comes great responsibility. And if you slip up even once it’s a long way down.

But doctors are _______!

It doesn’t make sense to generalize. The experience of the doctors you have so far been in contact with will not be your experience. The field of medicine is constantly changing and rapidly evolving. It isn’t now what it was fifty or even ten years ago. Technology makes things easier and harder, popularity and accessibility make competition a hundred times fiercer, and regulatory bodies have turned medicine into a business, always looking at the bottom line.

The volatile landscape of the medical profession demands a special kind of adventurous spirit who does their research beforehand. Map your territory. Talk to a medical student, talk to a young doctor, talk to an older doctor, shadow them at work, flip through a medical journal, visit a hospital. Get a feel for the shoes you’ll be walking in.

And after you’ve done all that, talk to yourself. If you have a keen interest in helping people, if you love challenges and relish hard work (and care very little for sleep), if you’re naturally competitive and have a good head for business with a passable understanding of the human body then medicine might be the career for you. Otherwise, set your sights elsewhere. Preferably something in line with your natural inclinations.

Might I suggest Banking and Finance?

Jamaicans Dream, Just Not the Way You Think

Recently the Gleaner ran an article reporting the results of their own self-commissioned poll on ‘the Jamaican dream’ at 55 years post-Independence. The entire (horribly subjective, barely factual) piece can be found here; what follows is my summary.

The results of the poll were quickly dispensed – 51% of respondents had “no real Jamaican dream” – and the rest of the article focused on dissecting the results in great detail. The Gleaner seems to be taking itself way too seriously. Writer Syranno Baines pulled quotes from pollster Bill Johnson (never heard of him) and psychologist Dr Leachim Semaj (of whom I remain decidedly skeptical) who gave their strangely misdirected opinions on the outcome. The piece raised more questions than answers, leaving itself open for criticism and ridicule.

To start with, the article is poorly written (Syranno, this isn’t completely your fault; you’re also a victim here. Our journalistic training is sorely lacking). There are unnecessary and frankly lazy repetitions, and it suffers from biased reporting (both sources essentially said the same thing. Also reporting on your own poll just seems uninspired).

For the opening statement Baines makes an example of the American dream, but the choice of words leaves the reader feeling like Jamaicans are deficient for not sharing those aspirations. Why use the adjective ‘real’ when you describe the Jamaican dream, is there a fake one? Why say “Not so for Jamaicans” after detailing the American dream? Last I checked, we aren’t Americans.

Still in the introduction, the article relays some sample dreams from the 49% of respondents whose dreams counted: variations on a theme of national development and personal security. Why use the American dream (marriage, two children, a house and a dog) as the gold standard (which is what the Gleaner seems to be doing) if you’re only interested in dreams about the country? The American dream isn’t about America, it’s about Americans. A better quote would have been Martin Luther King Jr’s infamous speech during the March on Washington. You know, the one that goes “I have a dream…”

I think it’s a shame that more than 50 per cent of Jamaicans are dreamless in terms of the nation’s dream
–Bill Johnson

The timing and purpose of the poll suggest the Gleaner was trying to elicit Jamaican opinions on national affairs since independence. Both Johnson and Semaj seem to be discussing a national dream – the Vision 2030 goal, for instance. But Johnson’s tone suggests that the average Jamaican should literally be sitting down and meditating on this goal of national development. Who does that?

Social Science Isn’t an Art

Objectively speaking, a poll isn’t any kind of valid scientific report. It is highly subjective, often deliberately leading and results are usually poorly representative of the wider society. There’s no way of guaranteeing that everyone interprets the question the same way, and that greatly confounds the results. Not to mention the paltry sample size of 1500 people. The results should be taken with a grain of salt, not treated like some peer-reviewed randomized controlled trial. Certainly, it shouldn’t be touted in a national newspaper with the implication that Jamaicans lack direction.

In his commentary pollster Bill Johnson (is this his only qualification?) suggested that Jamaicans have “no time to dream” because they are “too busy working hard to put food on the table”. He was eager to point out that the upper and middle class (people with “‘high-level education”) were better at “dreaming”.

For his part, Dr. Semaj blamed the media for reporting too much crime and violence and not enough national development. His contention is that Vision 2030 is the Jamaican dream but Jamaicans are too depressed by the news to notice the development that is already underway.

I might be paraphrasing.

We are not dreamless

I am disappointed in the Gleaner for perpetuating the class divide by publishing these bogus statistics. I am disappointed in Mr. Johnson for trying to back up his bogus statistics with illegitimate claims about the lives of lower class. I am doubly and triply disappointed in Dr. Semaj for trying to deflect attention from the national crisis of rampant violence and terror to talk more about ‘development’. The print and digital media are bedecked with stories of national development, but that trickle of good news is outmatched by the flood of social unrest. I appreciate Dr. Semaj’s concern for the awareness of the average Jamaican but I doubt the media is conspiring to block all mention of Vision 2030.

But what I am most disappointed in and irked by is the idea that even our dreams are owned, dictated and rented out by the (not so) great U. S. of A. If it doesn’t look like the whitewashed Hollywood-packaged caricature we’ve been force-fed our whole lives then it can’t possibly be right.

There is no way Jamaicans could survive our day to day existence without dreams, without believing and hoping that one day things will be different, will be better. We are a nation of dreamers, ambitious survivors, and rising fucking stars.

This may come as news to you Syranno Baines, Bill Johnson and Leachim Semaj, but Jamaicans are not dreamless.

We dream about stepping/clawing/digging our way out of the poverty being reinforced by a corruption so entrenched it strips us down to our bones.
We dream about honest politicians and come-unities that don’t have a murder every two days.
We dream about having children and grandchildren and building a legacy that time and death cannot erase.
We dream about putting food on the table and sending our children to ‘high-level education’.
Our dream is a better life for our children than the life we had and all now that dream caan bloodclaat come tru.
We dream about safety, we dream about love and we dream about stability.
And we have had that dream about marriage and two kids and that goddamn house with the white picket fence and the dog. But wedding expensive, people love plenty pickney and some ah wi fraid ah dog.

Don’t tell the people they’re wrong just because they aren’t white.

Lessons in Womanhood

As a black girl child uncertainty was bred into my bones. I was taught to doubt my every thought and decision. Taught to believe someone else’s version of the truth. Taught that my feelings were irrelevant to the task at hand, which was to pave the way for someone else’s vague notions of success. It isn’t that my family deliberately set out to rob me of self-confidence, but these were the lessons I imbibed as a child who was sensitive to the ways of the world.

As an educated black woman I marvel at how much these lessons continue to affect me, particularly in my academic and professional spheres. I note with envy how easily my male colleagues assume roles of leadership. How confidently they navigate their realms, without second guessing, without deferring to another person’s judgment.

I’m acutely aware of the influence that social class must necessarily have on these gendered upbringings. The poor have always been subjugated and have coped with that subjugation by adopting a deferential attitude. This is as much a survival tactic as anything else – the poor frequently have no options for economic mobility other than servitude. And a good servant is docile.

But I don’t want to be a good servant.

I want to be a strong black woman. Strong black women (history says) are rarely ever liked, but they are respected.

If there is one truth I must give the daughter I may never have, it is that her self-worth should never be called into question. That she does not have to shrink to make way for others to grow. That she must go out and make her mark on this wretched, wonderful Earth without fear or hesitation. That she must do this with as much poise and compassion as she can muster because the world will not be kind (though kindness is needed).

This is the lesson I hope society will one day teach: that our black girls are not pawns, no. They have been Queens all along.

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Credit for the image (as well as my blog avatar) to Zigbone.

Dear Patients: Please Stop Asking Me for Sick Leave

Dear Patients,

Please stop asking me to write you sick leave and then getting disgruntled when I say no. If I don’t think you’re sick enough to stay home then that is the medical opinion you have paid/waited in line for. If you don’t like it you can go and pay/wait in line somewhere else. Please stop asking us (doctors) to compromise our ethical standards (and potentially risk losing our license to practice) for your benefit. It’s considered fraud. I wouldn’t show up to your place of work asking you to break the rules; I only want you to extend the same courtesy to us.

Sincerely,

‘Doc’

P.S.

While we’re at it, please stop asking me to write your prescription in someone else’s name. It’s not just that your boyfriend clearly has no medical use for the vaginal inserts I’ve prescribed for you, it’s also insurance fraud. Thank you.

 

Prison Ablaze: A Symptom, not the Disease

Yesterday the Tower Street Adult Correctional Facility caught on fire.

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Photo from the Jamaica Gleaner

Predictably, the government is scrambling to conduct an ‘urgent upgrade‘. The article is peppered with buzzwords like ‘relevant stakeholders’ and ‘infrastructural development’. Interestingly there is no mention of whether any of the inmates were injured, just that they have been relocated.

It’s also worth pointing out that the fire affected the part of the prison that houses the mentally ill inmates. What is the level of supervision for these inmates, and what are their living conditions like? Were these facilities particularly susceptible to fire hazards? Was the fire an accident of poor maintenance, or the intentional act of unsupervised inmates, or something else entirely?

The article is keen to remind us that ‘high-profile’ criminals like Vybz Kartel are also housed at this prison. Is this supposed to garner public sympathy, or expedite government intervention? I’m not sure why the popularity of certain inmates is relevant to the reporting.

But it all goes to highlight the reactive way we deal with crises in this country. Institutions and resources struggle along for years carrying water with baskets until something catastrophic happens. Whereupon every Jack man jumps up to point fingers and fling on a hasty fix, only to have the system break down again because nothing long-term was put in place. For all the government’s talk about cutting costs (and it is mainly talk), you would think they would learn that prevention better than cure.

Doctors and Mental Health

The lives of medical professionals (at least the part of our lives that we choose to share with the public) are a lot like Instagram posts: lots of happy, successful moments to build the image of being competent and caring. But just like Instagram, real life is never as perfect as that carefully curated snapshot.

If you remember my last post about the things we don’t talk about, there was one really important topic I left off that list:  mental health. Just like physical health, our psychological well-being is integral to the way we function. But while we won’t hesitate to get ourselves checked at the first sign of illness, we balk at the idea of talking about our feelings or worse, spending time in therapy.

Sometimes we don’t talk about it because we feel our patients need to believe that their doctor is operating at peak performance. Discussing our mental health issues openly, or even acknowledging them can have a detrimental impact on the physician-patient relationship. Patients tend to think of doctors as superhuman, somehow immune to the struggles that plague the average person. In reality, doctors have the same problems as everyone else. But we don’t like to be reminded of that. We buy into the con, believing that we are somehow capable of feats no one else can do.

Sometimes that’s allowed, even expected – not everyone can perform brain surgery or resuscitate newborn babies – but other times we overreach. Doctors frequently pull stunts like trying to function normally after 36-48 hours with no sleep. We sweep treatable issues like depression under the rug because of course we can handle it, self-medicating with substance use or else ignoring the problem entirely until it can no longer be contained.

The medical profession carries one of the highest rates of suicide (1.4-2.3 times the rate of the general population). But discussing an issue that can call into question your fitness to practice is absolutely off-limits. In the most ideal and ethical situation, doctors would put the patient’s interest ahead of their own security, but we are human first, driven by the same fears and needs as everyone else. And there is a very real fear that any perceived disability will end or permanently blight our careers.

On top of this is the associated stigma of mental illness that is so very rampant in Jamaica and the Caribbean. No patient wants to see the “mad” doctor who “tried to kill himself”. But if any progress is to be made in erasing this stigma we physicians have to be the pioneers. And since this stigma persists even among doctors, we are the first hurdle we have to clear. After that, education and sensitization of the wider society.

Even though no one seems ready to talk about it* (Megz over at Barefoot Medz is one of the few, doing a really great job) mental health is a discussion we need to have. In such an emotionally draining and psychologically demanding profession it isn’t fair to anyone to have doctors fumbling to look after their mental health alone.

We need to catch mental health issues among physicians from early, as early as medical school even. Mandatory psychological screening for depression, anxiety and PTSD among others should be instituted for all the high risk professions: doctors, police officers, firefighters. We shouldn’t have to wait until a doctor commits suicide or a policeman kills his spouse before doing something. Prevention or at least early detection is paramount.

There’s a lot of work to be done. Efforts have started but they’re halfhearted at best and the government offers little in the way of support. We must be our own advocates and work with other key players to remind the public that there is no good health without good mental health.

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Further reading: a pediatrician’s experience with psychosis, and a GP’s experience with depression.

*After writing this post, I discovered Dr. Eric Levi an ENT surgeon who is also making strides in the discussion on mental health in doctors. 

Nepotism, hamster wheels and career-sized roadblocks

This career we call medicine has so many taboos, so many topics everyone seems to avoid talking about.

Like how much we’re really making. Or how to move up the career ladder. Like private practice, emphasis on the private. Or pension schemes and permanent appointments. Like opportunities for postgraduate study. Or the nepotism this country wears like a second skin.

When we get together as a group we’re always talking about wacky patients, the dire lack of resources, horrible bosses or survival stories. Advice is limited to clinical discussions, and a lot of the mid-career medical professionals seem too busy trying to further their careers to steer a junior down the right path.

In the ‘glory days’, medicine was an apprenticeship. Younger doctors worked closely with their older counterparts, learning everything they had to teach about the human condition (medical and social). At the same time, medicine was a lot more paternalistic with physicians adopting an almost godlike role in society. So some change is for the better. But now most doctors play their cards close to the vest, for some reason reluctant to share their hard-earned wisdom.

It’s true that the world of medicine is significantly more competitive now than it was fifty years ago. You can’t throw a stone in Montego Bay without hitting a doctor’s office (some charging a measly $1000 (USD$7) for visits). While medical schools continue to graduate hundreds of hungry indebted interns every year. In Jamaica where everybody haffi eat a food the stiff competition breeds contempt and secrecy, jealousy and sabotage.

But to what end?

The crab in a barrel mentality of stepping on a brother just so you can move up a scant centimetre on the socioeconomic scale is not going to work in the long run. Resources and opportunities shouldn’t be so scarce that we have to fight to the death for them. Information ought to be shared equally, not bottled up and parceled out to a privileged few. Younger doctors should not be forced to reinvent the wheel when there is a wealth of experience available for tapping in to.

We’re told, work hard and you will be rewarded. We’re told, if you want good yu nose haffi run. We’re told, I went through the struggle now it’s your turn. No support, very little encouragement, and everyone more tight-lipped about career advice than a gang of Sicilian mobsters.

Maybe I’m too young, too idealistic, too millennial to simply fit right in as another cog in the nepotistic hamster wheel of capitalism that Jamaica seems stuck on. Either I’ll find a way to make the system work for me, or get flung violently off the ride like the broken ill-fitting piece of machinery I really am.

Only time will tell.