Reframing Misconceptions

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.

standards of happiness {i}

From depths I could not fathom a voice inside me roared, “I AM ALREADY GOOD ENOUGH.”

And the tiniest of voices replied, “Okay. Now get better.”

In which the author scolds herself

Why is it so much easier for me to slog through medical school than it is for me to sit down and pen an entry?

Since when has medicine been easier than writing? Well, easier than writing well at least. Usually my procrastination habits work the other way around, and I put off everything that resembles work-and-study for a few hours’ bliss of just typing out whatever comes into my head. I think, somehow, I have made writing a lot more like . . . work.

That’s not necessarily a bad thing – getting better at something takes dedicated practice – but when it’s coupled with my habit of avoiding everything that I have to do, well, you get the picture.

The bottom line? I need to pull myself up by the britches and get some work done, instead of just lazing about. This clerkship is such a golden opportunity for writing (and, more importantly, writing time) and I’m just wasting it.

For shame.

Story time: Fits and starts

If I miss the exit, can I double back?

For those who don’t know, medicine isn’t my first love. That honour will always go to Literature, writing and the editorial arts. Medicine is pretty much just to pay the bills, but that’s not to say I don’t love it (sometimes -_-). I say this as a prelude to a story that took place one night several years ago, and sort of had its sequel a few days ago.

I’d just gone to buy dinner downtown when I happened across a crowd spilling off the sidewalk into the street. Now it is the nature of Jamaicans to move towards a crowd of people, no matter how hostile or downright threatening they appear. So usually when I see a crowd my MO is to move in the opposite direction as fast as possible. But that night I went closer, and it turned out that there was a lady having a seizure, almost in the middle of the road. She lay there on the ground while people were debating what to do with her

“Put one piece a board in her mouth.” “Use her shoes.” etc. etc. But at the end of the day everybody just stood around watching her. (Now, I know that’s pretty much what you’re supposed to do, not move them or interfere with them in anyway until the seizure has passed – unless they’re having trouble breathing and whatnot – but I didn’t know that then).

I wasn’t able to see the outcome, but what I remember most vividly was a burning desire to help her. Not write an article about the underestimation of epilepsy in Jamaican society, not try to educate the mass media about basic first aid. But to be the person who knew exactly what to do in that situation i.e. a doctor. Or something. And for me, that was a defining moment. That ‘would you rather…’ instant of blinding truth when you realize just what you want for yourself, no frills attached.

And then a couple of days ago I almost walked on top of a girl lying on the street, having just had a seizure. She was twelve years old. No one, save one young lady, was paying her attention. People were literally stepping over her on the sidewalk. She was twelve years old. This time I stopped to help. Not as a medical student, just as a human being with some semblance of concern for this girl (I can’t call her little – she was bigger than me) who was clearly in need of help.

It was a check-up, if you will. A little cosmic tap on the shoulder to inquire ‘do you still want this?’.

And strangely enough – despite the tedium, the challenges and the frustrations; despite the unhappiness that sometimes swathes me like a second skin – strangely enough, I do.

Two roads diverged in a wood, and I—
I took the one less traveled by,
And that has made all the difference.

-Robert Frost