Feb 2017

Dearest me, Smonday is already upon me!

I've gotta say, since the doctors' strike started, last week had to have been one of the worst weeks I've ever faced. For starters, I pretty much put in 60 hours worth of work during the week (...and none of that comes with any overtime). I think the earliest I actually got home might have been 8.20 pm, which coincidentally happened on Friday, the day most people are like to make their exits before 5.00 pm.

I've been so tired lately that I'm starting to embrace the Kenyan culture of not reading. By the time I'm done with my patients and all such related activity, I just want to get home and de-stress. My mind can't be bothered with fanciful thoughts of reading or even trying to keep up with new advances in the medical field...I'd rather just soak in some sensory deprivation and chill.

Last week, I even had the dubious distinction of being tossed under the bus by my consultant for some shenanigans that went down at the hospital. Of course I can't divulge any of the details, but it has got to be one of the most underhanded things that has happened to me while I've worked as a doctor. People don't understand how much medico-legal detail is involved in dealing with patients, and I think a lot more people would steer clear of the medical profession if the actually found out. We may have come along way scientifically, but there's still a lot that we don't know about medical practice. Sometimes it can actually feel more like practising an Art than a Science.

The patients and their relatives will see things differently though. I think medicine is one of the few careers where people feel like they can question your acumen without having even a basic grasp of the concepts involved. Even a primary school teacher is unlikely to get called out on the pedagogy that they employ to teach their students; but a doctor is fair game to everyone. We have moved away from Paternalistic Medicine to a more shared patient-doctor relationship, which I feel is more ideal; if you can understand the disease process and its respective treatment, then I believe the patient can participate more actively in the treatment. Don't get me wrong, if the situation calls for it and either their patient or caregiver is unable to fathom what needs to be done, it is my duty to go "over their heads" and be paternalistic, for the patient's sake.

There is, however, a third patient-doctor relationship that has developed lately that emphasizes Patient Autonomy. If the patient has the necessary education or understanding of their condition, this may be bearable; however, a lot of times you encounter this from a patient who merely wants to be in-charge without a semblance of a clue as to what they actually require. These are the patients (and relatives) that are likely to haul you court for some good old litigation. Thank God I have an extra card up my sleeve for such patients: I can just "Discharge (them) Against Medical Advice" (DAMA), and let them end up being someone else's problem.

I think I'm just a bit disillusioned by the medical field these days. Job satisfaction is at an all-time low, and I don't have the energy to keep myself afloat. I'm beginning to detest some of my patients and the systematic failure at my workplace is just draining. I hate this government for doing nothing to avert or even alleviate the effects of this strike; I'm annoyed at the general public for not having the guts to even try to keep this government accountable despite the egregious missteps that they have committed.

Lord knows I just need a break. Maybe a change in this 10-month routine will do me some good. Something's got to give.