But What If You Change Your Mind?

Dear readers,

This might be my last piece of rambling as a house officer in this weblog of mine. The word ‘Nostalgic’ does not even begin to describe the torrent of turbulent emotion stored up in my chest.

Were I to enumerate all the joy or the heartaches that I have gone through as a house officer in Malaysia, I will be left quite breathless with the effort. All I can say is ‘Alhamdulillah’ for being able to pass these 2 years without being extended.

I really have no idea how I would take to an extension. If it was justly given, I would humbly accept it as my due. If I had been negligent, had caused death to my patients, had caused severe disability to my patients due to an act of stupidity…I myself would resign to wallow in my remorse and sorrow; an extension would be redundant at that point.

But if it wasn’t justly and fairly given, knowing me, I would fume in my dissatisfaction, I would fight with the higher authority and it would get really ugly. And if I lost the fight with the higher authority, I would resign as a protest and then of course I would write torrents of complaints to the ministry, in the blog, in the public forum… it would get really repulsively hideous.

Perhaps, Allah – my Creator, my Lord – knows I am not the sort who can bear extension, thus He made the way easy for me, Alhamdulillah. Extension – justly or unjustly – would destroy me. I would either feel remorse for the act of negligence that I had committed and thus I would resign; or I would cause ugly scenes that would destroy my future in medicine, and thus I would resign as a matter of principle.

All thanks and gratitude belongs to the Almighty for making the way easy for me.

***

Dear Colleague,

The way ahead is not trouble-free. To house officers, remember to slap me in the face (ehem, gently) if I ever become rude and obnoxious enough to say “During my time…” in a condescending way.

The word here is ‘condescending’.

To senior doctors, you can say ‘during my time’ conversationally…in a nostalgic way. No need to say ‘during my time…’ with a smirk on your face towards the house officers who are now working in shifts… like they would never be at par with you in the future. Like they are never going to be as competent as you are now. Like they are never going to be a specialist or a consultant someday too.

Don’t talk as though all competent doctors around the world work in on-calls instead of in shifts. Travel around and see the world. Not everybody on this face of the earth end up becoming a good competent specialist by doing things your way. Some of them are smarter; they become a good and competent specialist the easier way. And we still ‘cedok’ our CPG from them, the lazy bums who work only in shifts in the West.

Irony, MUCH? I certainly think so.

House officers are a tough lot. I belong in the batch of house officers who have done 1 year of on-calls and 1 year of shifts. I am not going to deny that I love the shifts. I love my work more when I am not tired.

When I was a house officer, I tend to champion their cause. Sometimes too much.

One of my friend had said, “Afiza, mungkin bila kita jadi MO nanti, we will change our minds too. We will behave just like them. Sebab tu aku malas sangat nak cakap banyak sebab kita tak tau, in the future maybe we will change our minds.”

True. I have been known to change my mind too.

But what is so surprising about having a change of mind? Being alive is, after all, a dynamic process. A change of mind is inevitable in the course of our lives.

But does that mean we have to suppress our thoughts and our opinions simply out of fear that we might change our mind someday? That would be too…repressive, to my nature.

What matters is, during that time, with the information that you have at that time, you honestly and truly feel that you are saying the right thing. If it’s not the right thing, then in the future you will find that out, and you have the prerogative of changing your mind then. When that time comes, don’t be obstinately stubborn to adhere to your old thoughts simply because you had spoken out loud those thoughts in your previous life.

That, darling, would be stupidity incarnate.

Revise your opinion and acknowledge the fact that when you were younger, you had thought differently. If we never want to find out whether or not we might be wrong in the future, then we shouldn’t have any thoughts at all in the present. Just stop thinking altogether. That way, we will always be forever right.

One of the things I had said in my FB status when I was a house officer, as a response to a provocative remark by a friend, was this:

“Ada orang cakap pada saya, awak nak buat apa pun, tunggu sampai awak jadi MO dulu. Tapi, bila kita dah jadi MO, orang akan cakap : kalau kau nak buat apa pun, kau tunggu sampai kau dah jadi specialist la. Bila kita dah jadi specialist, we then found out that we still have to answer to the HOD. Bila kita dah jadi HOD, we then found out that we have to answer to the Pengarah. Bila kita dah jadi pengarah, we then have to answer to the DG. Bila dah jadi DG, kena answer to menteri. Bila dah jadi menteri, kena answer to PM. I bet you, when you finally become a PM, you will find out that your hands are still tied because there will always be someone higher than you that you have to answer to. And then you will look back at your life and realize that you end up not doing anything at all because you are used to just passively wait. Why don’t we just cut the hierarchy of the authority short by saying ‘I answer to Allah first. Period.’ “

 

Do we have to wait until we become a ‘somebody’ in order to express ourselves…just in case we might be wrong and feel differently in the future?

Isn’t it better to invest your time and energy defending your honestly-felt thoughts now…so that when you have become wiser by experience, you will know what to say to your juniors who might be having the same (mistaken) thoughts that you had had when you were younger? You would be in the position to say “I know where you are coming from. When I was younger I had also thought bla bla bla…..but now I can explain to you what has happened to have caused me to change my mind”

When you bother to emotionally engage yourself with a thought, later you can map out the process of how the thought had changed and convey them – convincingly – to your juniors.

But if you never want to bother investing your time defending your opinions and thoughts when you were a nobody… by the time you are a ‘somebody’ and have to deal with your rebellious juniors, you will have no idea what they actually want from you. You will have no idea what to say to appease their minds. What you say will not gratify their hearts because you have failed to understand where they are coming from. Since you never bothered to get emotional with your thoughts when you were younger, it will be hard for you to remember how it had been. Thus, you will end up trivializing their point of view.

That brings me to another thing I had written when I was a house officer (with some modification), in response to an anonymous specialist commenting in this blog:

“Nak tunggu dah jadi orang besar, baru nak cakap pasal isu HO? Well, think about it honestly! Adakah bila kita dah jadi MO, kita masih akan peduli tentang isu-isu kebajikan HO? Betul ke?

I don’t think so. Bila kita jadi MO, kita ada isu kita sendiri. We have other MO issues that we would like to fight for, kan? When we become a specialist, we also have our own issues as specialists, of course!! Maybe by the time we become MOs or specialists, we will not understand AT ALL what our subordinates are so unhappy about, right? Just like what is going on at the moment! I might turn out to be like the specialist who would say “ Wow! Banyak masa kamu nak kompelin dalam blog ni! Zaman saya dulu….”

Be honest. If you never bothered to defend yourself as a HO; if you never bothered to defend your fellow HO colleagues when you were a HO, what makes you think you will bother to defend your HOs when you have become an MO? Naturally, our attitude would be… “Oh,I’ve been treated even worse. During my time…”

And the cycle goes on. 

So, the right person to talk about HO issues is the HO. The right person to talk about MO issues is the MO. And the right person to talk about specialists issues is the specialist. Don’t take away those rights. “

***

Oh my dear house officers,

In the future, I might become like these MOs who will not understand your issues. Because I will be more concerned about my MO issues. That’s normal and that’s human. I cannot promise you that we will always see eye-to-eye. But I will never deny you your rights to defend YOUR issues. It’s YOUR issues, and you should talk about it. We will talk and debate it out. It will be fun…irritating, yes…but it will be mentally stimulating, too. It will be a challenge to see who can get the other to agree to whose opinion. Isn’t that fun? Or am I the only one mentally-warped? Hahah.

So don’t be afraid to defend yourself when you are right. But don’t bother to defend yourself when you are wrong; it is not only stupid but sinful…so don’t do it. When you have done something wrong, just pray that it won’t result in any serious complication to your patient. But don’t lie and defend yourself when you are wrong. These things have a way of being found out and people won’t believe you anymore. Even worse, when you have done something wrong, please don’t point your finger of blame towards others or your juniors. Please don’t accuse your first posters and don’t accuse your subordinates for something that you should be taking responsibility for with the words ‘Oh, HO tak inform’ walaupun sebenarnya dia dah inform tapi kau yang ambil mudah.

In certain department, HOs are known to take the blame when something goes wrong …the last HO to have seen the patient is usually the easiest scapegoat. It’s just wrong. So wrong it makes me alternately explode and implode when I hear such stories, even though it didn’t happen to me. If it were to happen to me, I would have wanted for someone among my friends to stand up and defend me. But that would be a futile hope when they won’t even defend themselves.

Once, I had offered someone my support. My support was small, but it was what I could offer her at that time. I told her, “What happened to you was unfair. If you want me to accompany you to report this to the specialist-in-charge of HO, I will go with you. But you have to be willing to defend yourself first. Takkan aku pulak nak lebih-lebih sedangkan aku tak ada kat situ when it happened. But if you want to take the step to defend yourself and you are willing to confront issues, I will go with you. We can practice what to say. I can make arguments sound forceful and eloquent, that has always been my specialty. Hahah.”

But she didn’t take my offer nor my ‘legal advice’. I was not given the opportunity to play the lawyer.

And I know as a HO, I will only be deluding myself to think that anyone will jump to my defense should I need it. If HOs do not even want to defend themselves, what motivation do they have to defend others? Therefore, if a HO is to defend herself, she is all alone in it. Your fellow HOs will only say, “Hang buat lah. Aku akan support hang SENYAP-SENYAP daripada belakang. May God be with you.”

Hahah.

Isn’t that funny?

Surprisingly, most HOs were willing to take the blame. I wouldn’t have. If it wasn’t my fault, I would fight to be heard or I would resign after causing lots of scenes. I don’t stand up to every little bullying that I receive, but when I finally do, I’ll make sure that my life won’t be the only life in the mess…the bully will get some share of the mess too. After all, sharing is caring and I was told that one should love one’s enemy.

But then I am speaking as someone who is free of any responsibility. I don’t have to feed the mouth of anyone else other than myself. In fact, I am still fed by my supportive, loving parents, for whom I thank Allah to have been blessed with.

Look in another 2-3 years …I might have to change my mind and feel like I have to feed my children before I feed my ego.

You see, that’s how change of mind happens. The truth doesn’t change. But the circumstances surrounding the truth do. And so, we distort the truth to accommodate our circumstances.

Because sometimes, we are not powerful enough to change the circumstances to accommodate the truth.

Isn’t it sad for the truth?