Just months ago, in April, I was quite determined to pursue my career in Public Health. I thought I'd enjoy it because given my utilitarian/outcome-based work ethic, to work on patients one-at-a-time would be too inefficient. By the time I retire, how many patients will I see? Not that many...There must be a more efficient way to change more number of lives with efficient use of money. So I went on an internship with the Minister of Health and observed how the Ministry of Health in Malaysia works. I saw Public Health in action...but disappointingly, there was not much in action. In a perfect world, you'd plan, strategize, execute the plan and achieve the outcome. But in the real world, there's simply too much red tapes and restriction to carry out a plan that will save money and benefit everyone! For example, the MoH would be able to do much better than it does now if the ministry is allocated more money in the annual budget, instead of spending the money in preparing for warfare or on lavish banquets that will only benefit certain groups of people. I can see how our Minister himself is working hard every day trying to reform our health system, but there's only so much he can do. To truly execute your policy in Malaysia, you have to first change deeply rooted the 'anything also can lah' culture to cultivate the spirit of excellence. When your whole organisation and community are on the same page of reform as you do, only will your reform be carried out. When your subordinates go for 'breakfast' during work hours from 8am to 10am, then have 4 hours long lunch break, you will never get anywhere.
There is so much talk in the world of Public Health. So many policies and ideals. But how many of them actually make it to the real world? I am sure many of them do, and many of them are actually changing lives in this world, but I am not sure about my own country. What I witnessed over my internship just made me so cynical about being about to make any difference in healthcare at all.
Being in the hospital has made me love the clinical work so much. Instead of enduring the frustrations of not being able to implement your policies maybe for your whole life, these doctors are actually make changes to people's lives. Doctors, nurses and the staffs on the ground are the ones that actually do the work, make the changes that will have direct impacts on people around. There's something so fulfilling about this that I began to forgo my aspirations in Public Health, and focus on the clinical works.
I am, at the end of the day, a utilitarian.
'What specialty do you want to go into?' That's the question I am being asked daily. At the beginning, I was quite inclined towards surgery. I like doing things, and sitting in the clinic and talk to people the whole day seems a bit dull to me. However, I had no ideas/knowledge to base my decision on. I have been on the hospital for 7 weeks. It's terribly short, I know, but I realized the more surgeries I observe, the more bored I become. Clinics seem so cool. Doctors can just sit there and talk to people, and even before touching the patients (and without the need to cut 'em up), they can reach the diagnosis and treat the patients accurately. Isn't it cool?
I also find myself to be elated when I get to talk to patients and take their histories. Many of them are actually quite funny and lovely people, even thought they are quite sick. Just the other day, I was performing a cranial nerve examination on an old chap with stroke. 'Now, I am going to test your hearing,?' I said. He immediately replied, 'Pardon?' *gigglitis attack*
I also find myself to be elated when I get to talk to patients and take their histories. Many of them are actually quite funny and lovely people, even thought they are quite sick. Just the other day, I was performing a cranial nerve examination on an old chap with stroke. 'Now, I am going to test your hearing,?' I said. He immediately replied, 'Pardon?' *gigglitis attack*
But then again, what do I know? Watching a surgery is different from doing one. Till the day I actually get to scrub in and do something dramatically life-changing, don't take my decisions seriously.
There are so many decisions to make. Before I pre-maturely dive myself in something, perhaps the best thing to do now is to keep an open-mind, to be curious and interested in everything around me. I do realise the change in my attitude towards learning. For my whole life, I have been learning to score in exams. My ultimate objective in any part of my learning to get that distinction in my results. It seems pretty retarded, but that's how it was. Recently, I find myself to not care so much about exams anymore. Rather, I am working very hard because I want to be competent as soon as possible so I can do something to help the patients while learning on the wards. I want to be as skillful as possible so as to minimise the mistakes I will make and to give people the best care they deserve. And if I am ever good enough to help my fellow peers, I am glad that I may be able to play a part in their journey of becoming good doctors, who will eventually help many more people in the future.
I am, at the end of the day, a utilitarian. One which is constantly swayed by the outcomes I desire to achieve.
Till then.
Whatever you do, work at it with all your heart, as working for the Lord, not for human masters.
- Colossians 3:23
Whatever you do, do well.
- Ecclesiastes 9:10
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