In medicine, there is a saying that the training is onerous but the rewards are many. More often than not, these rewards come coated in a myriad of shapes, including lucrative incentives, personal gratification, warm contentment, and a sated joy among many others. For many physicians, a last wound-closure of the day, a smile on their patients' faces, and warm, heartfelt regards from them carry immense significance. Yet, for many others, lucrative incentives seal their fate, becoming a bane to the integrity of the medical profession as a whole.
Medicine ought to be a profession of compassion, empathy and sincerity, first and foremost. Focus too much on medicine's lucrative decoys, and you reap the worst possible crop: a warped focus. For many physicians in Pakistan--especially those that work in the private sector--this certainly seems to be the case. Delving into the 4 months I spent shadowing a Cardiothoracic surgeon, who I will not name, will delineate a picture of Pakistan's medical care sector that is astoundingly perturbing but simultaneously essential to highlight.
On my first day of shadowing, I entered the OR where a cardiac-bypass procedure was underway. With the surgical tools all lined up neatly on the surgeon's desk, I keenly observed the surgeon deftly make his first incision, focusing and precociously planning his next move, much like a chess player at work. As I watched the process take place seamlessly, a frenetic banging on the OR door rendered me agape--startled. Midway through the procedure, a hospital chief surgeon interrupted, "This patient has not paid all his dues. In addition, there is no guarantee that he will be able to afford the cost later either since his cosigner has now declined to afford the costs of his treatment". With my jaw wide agape, still, I noted the befuddled expression on the surgeon's face. In response, the surgeon exclaimed, "Let me finish the procedure; we can talk about this issue later on." Yet, despite the surgeon's response, which boasted a hint of disappointment, the chief kept arguing, subtracting from the crucial time the patient had left. However, despite the chief's order to stop the surgery midway through due to non-payment, the surgeon carried on, undeterred. There are two types of physicians, I assume. There are physicians that lust solely for lucrative incentives that come entrenched in medicine; yet, at the same time, there are physicians that have an empathic conscience. The chief surgeon indubitably belonged to the first category, and so, midway through the procedure, walked out the OR, ordered the staff, I assume, to turn off the life-support machine for the OR we were in, and then continued with his daily roaster, assured--and proud, no less--of his ostensible boldness.
Within the OR I was in, I promise, a hubbub besieged us. With scalpels clattering, hands a blur, and the surgeon's cacophonous shrieks now omnipresent, I fell into a reverie of brooding, introspection and perusal, feeling a sense of doom which was novel to me. "Why on earth would someone actively do, or even come close to doing something as cold-blooded as what the chief surgeon did? What could be his rationale? Is money more important than a poor man's life? Or was this man's blood, who was now about to evaporate from earth, cheaper than mine, or the chief surgeon's?" But the more potential reasons I came up with to see any sane justification in the chief's doing, the more I despised the chief's repugnant, vile course of action.
In the end, like an autumn tree, bare and dejected--on the verge of collapse--I left the OR with the realization that I had seen a man die in front of myself--not because of his disease, but because of his financial status.
For me, the word medicine thus conjures images of selfishness, apathy and indifference--traits that even every individual should expunge from his/her persona, leave alone a physician. But at the same time, the word medicine also brings a ray of hope, and a realization of the amends that must be made. Maybe if not now, later. If not me, maybe someone else. But such brutality must terminate eventually, for it can not possibly sustain a people of any nation, race or sect.
For me, medicine is a double-edged word; while it hurls such obscure images of cold-bloodedness towards my face, it also motivates me to grow, to observe, and to learn so that I may be able to positively contribute--even if to an infinitesimal extent--toward overcoming this wrongdoing someway, somehow, someday.