Sunday, July 29, 2012

Hippocratic Hippocrites

“I solemnly pledge myself to consecrate my life to the service of humanity.”

I still remember my professor reciting this simple line when I was a young medical student. We were following him on his rounds, and at one point approached a patient possibly suffering from meningitis. The patient had thrown up, and the staff hadn’t gotten around to cleaning the floor by his bed. Our professor explained to us that this was not the patient’s fault and nothing about our demeanor should embarrass him. The fact that we were treating the patient was his right and our job. Then, he quoted this line from the Physicians’ Oath.

In the days that doctors all over Punjab decided to take a stand for what they considered to be their right, they went against the very grain of this oath. These doctors allowed their own needs to supercede the service of humanity. There is no going back from this, and no amount of sugar-coating can take away from the egregious wrong that was committed by them. But then we must also look at this event as a failure of society at some level. What led these doctors to go against an oath that is so sacrosanct?

The fact of the matter is that most doctors are not the heartless automatons that society makes them out to be. They are working at a profession drenched with the misery of humanity. They see and experience life at its most wretched on a daily basis. They literally struggle with life and death decisions every day, and don't always come out on the winning side. And then they have to shrug off the weight of their day and go home to deal with the mundane issues of life.

This is not to justify, in any way, the fact that the consequence of this strike was the loss of many lives and the deterioration of even more. This is not to deny the misery caused by this strike, or to ignore the negative impact it’s still having on so many innocents. On the contrary, I am trying to figure out what these demands were -- demands that would cause an entire organization of caregivers to turn their backs on those who need them the most.  And most of all, it is important to evaluate whether this was a selfish, destructive act by a group of professionals, or the complete failure of the government to resolve an issue before it caused loss of life and infinite suffering.

The Young Doctors Association were, in most part, asking for better pay, safer work environments and respect in the workplace.The Government of Punjab ended up accepting these demands after almost two weeks and many deaths. The bureaucrats kept whining about there being no money in the budget, but when you look at the way finances are handled, you wonder whether it is actually a budget deficit or just gross mismanagement.  Paychecks and worse, pension checks, are being withheld for the month of June by the government of Punjab. Why? June marks the end of the fiscal year, which means that it’s time for the government to air its dirty financial laundry for the world (or, at least, the people it “represents”) to see. So, in order to show less of a deficit than there actually is, it decided to withhold this money. As elected, democratic governments are wont to do. The funniest thing (not that anyone is laughing, really) is that everyone already knows this little “secret.” Looks like the cat’s out of the bag.


On the other hand, there is money for distributing laptops, and there is money to take young scholars on a trip to Europe (Which, I’m sure, everyone who’s been waiting indefinitely for a well-earned paycheck or a well-deserved pension check, appreciate fully). But, all these “good deeds” mean nothing when put up against a single life lost because a financial issue was not resolved fast enough.

Then, one starts to wonder if there is something wrong with the people we elect to office. I know that many will chuckle and say that I am stating the obvious, but I don't mean particular personalities. I mean the social status most politicians hail from: the privileged elite. If you belong to a class that flies to Dubai to be treated for the flu, and crosses oceans and continents for anything more serious than that,  then you probably don't know what it’s like in the OPD of a government hospital, or the everyday trials of a doctor on a remote posting.

These are issues with simple solutions. But solutions cannot be rendered if the responsible are oblivious to the nature or, at times, even the existence of these problems.  Rather, we are left at the mercy of fat-cat bureaucrats who cannot be bothered with certain crises, either because they think the problem will fizzle out or because they are busy elsewhere. Or, we have non-politicians, like Imran Khan, who takes every crisis as an opportunity to declare that he has a solution for it. Captain Khan can, apparently, solve any world crisis in 90 days or less -- but needs to be elected before he will actually do anything. Service without political office is not part of his plans.

By allowing the strike to come to a point where lives were lost is a failure on the part of the doctors who defied their oath and the governing authorities who failed to resolve the crisis in time. Maybe it is time for the common man to become  part of the ruling class. If a middle class medical student with first-hand knowledge of the hospital system becomes the health minister, he or she will be better able to resolve an issue before it becomes a full-blown problem. Only someone who has struggled towards success can truly know the struggles of others. We need leaders with a finger on the pulse of the man on the street, not industrialists and millionaires who have no idea what it is like to worry about a roof over your head and two square meals everyday.

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