Unintended by Muse : An Interpretation

I haven’t written poetries in a long time.

Nor have I had the time nor the inclincation to ponder on songs (and their lyrics interpretation). I have missed writing literature analysis (not the scientific journal kind). I haven’t had the mood to do book reviews in ages. (I am not that functional in the BookClub Whatsapp, I am afraid). I continue to read books without having the energy to write and rave about it as I used to during my teenage years, pre-med school.

I guess, it must be because I don’t get to hang out with the same crowd as I used to, growing up. My adult crowd consists of doctors, mostly. Some of them don’t read anything else other than scientific journals. They appreciate good songs too but I don’t think they are the sort who would like to discuss the song the way I liked to do with my then best friend/roommate in MRSM Langkawi. (I miss her whenever I came across good books and great songs.) My teenage crowd consists of dreamy, easy-going artsy type but who is also intense and serious about books (non-academic ones), history, philosophy and culture.

Those were the days….

But today, my writer’s block seems to vanish simply because I came across this particular song in my newly bought Asus Zenfone 2 smartphone (a worthy budget phone to buy when you are desperate and broke)

Some background story: I lost my Note 3 a few weeks ago. And when I bought the new phone, the guy at the counter had kindly transferred many stupid rock/hip-hop songs that I detested upon the first note. Most of the songs he gave me sounded more like noise than music. I could not differentiate one from the other. So, I was merrily going through all of them and deleting one by one of the songs he put in, all the while regretting my decision of allowing him to put those songs in the first place. Judging from his hip dressing and flirtatious overfamiliarity, I should have known that my taste in music and arts cannot possibly have the slightest resemblance to his.

I was about to delete the song ‘Unintended” by Muse when the melody of the song caused me to pause.

And I paused long. To the end of the song.

And my finger hit ‘repeat’.

Again and again. 

I see. So, this is how it feels to have stumbled upon a diamond among worthless rocks and rubbles. Now I know.

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Oh dear readers, the song is beautiful. It reverberates in my soul deep within. I couldn’t get over how such simple words in the lyrics can have so many layers of meanings. And the singer’s falsetto voice at the chorus communicates the kind of poignant, eerie pain that can make you weep. The pain haunts the person. I could sense that the person is struggling with his past, wants to move on but he is stuck, wrapped in a long chain that is so powerful even as it is invisible.

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I feel terrible for him. I want him to break away from the chain. But I have a feeling that he will feel naked and vulnerable without the chain. The chain is bad for him. But it is also the comfort zone he has always known. It is also his armour against the world.

The saddest part is, I know by the end of the song that he will NEVER want to leave the chain. If I were to come and rescue him, and unwind the chain layer by layer from around his body, he will only gather the chain in his arms and lump the whole lot by his side and sleep with it throughout the night and never wants to wake up.

*heavy sigh*

But some people may have a different interpretation altogether. Some would probably interpret this song as a story about a guy who is asking his current lover to wait patiently until he sorts out how he feels about his dead girlfriend who he used to love deeply. They think he will succeed in throwing away the chain and move on. They think that when he says “I’ll be there as soon as I can” it really was a promise rather than a mere hopeful wish that will never come true. They think that when he says “she could never be as good as you”, he was praising her current lover sincerely rather than it was him being in a state of denial. He intellectually knows that the current lover is better in many ways than his previous past, but his feeling is stuck. Maybe forever. 

Oh well…

Talk about simple words with deep layers, huh?

Judging by the music, the tone, the falsetto voice at the chorus…he is not ready to give up his past. Not anytime soon. And the current girl should leave him and move on. That would be my advice as a therapist. Hahah.

But that’s what fun about arts/literature/songs, you see. It doesn’t matter whether your interpretation is right or wrong. The only way you can solve the mystery is by asking the writer himself.

But then if I were the writer, I will never tell.

Because I know that when you lose the mystery, you also lose what makes the whole piece beautiful and poignant in the first place.

Just be content that you are not the person in the song.

***

The song also tells me the same thing I have always known.

That it is kinder to everyone involved if you just win someone’s mind than someone’s heart. It is much easier to get over. It is fairer, less complicated, and more honourable in the long run that you engage someone’s mind than someone’s heart. 

The writer of the song knows intellectually what he should do. Who he could love and should love. But knowing something is not enough for him to act on it and to do what is best for him. He will choose his emotion over his intellect.

Knowing is just not enough.

That’s the dilemma of life.

That’s the dilemma in PSY too. That my patients knew what’s right to do. I knew they knew. But most of them will never do it. (and I become frustrated)

I like to think that if I were ever in the songwriter’s place, I will choose what I SHOULD and COULD do. However, judging by how I feel about the song, I am not 100% confident that I will succeed.

Readers, you should know that feelings are messy. They can make you get stuck. They can make you stupid. But at the same time, not stupid too, because you actually know, but you just can’t choose. You are not stupid, but your action is stupid.

So, you should protect your heart and guard it well.

Your heart should have several outer and inner layers and filters. Logic, reasoning, facts, truths, moral and ethical principles….These are all the filters that anyone or anything should pass through before you allow them the key into your heart. Examine a person, an idea, a principle, a worldview…examine them carefully through the filters, before deciding to let them into the sanctum sanctorum of your heart and soul.

Because once they get there, you will be stuck with them. For almost forever.  

***

I am not going to say whether it is better to choose the mind over the heart. I think it takes courage to choose either one. To ignore one and choose the other.

I think you can be happy just as well if you choose to go with your mind rather than your heart. But deep inside, you will always feel a certain unspeakable, indescribable lost, that only you will know. So you learn to suppress that lost and walk on, only occasionally looking back.

I had chosen my mind when I took medicine instead of law. I had chosen my mind when I decided to be formally educated in science rather than arts. And it still turned out not too bad. I like my life the way it is. It’s meant to be. But I have always wondered about the other option. My heart crave for something else all the time.

And you learn to live with your choice. And you can live happy choosing your mind.

That’s something the person in the song may not know yet. I hope, he will make the leap of faith soon.

***

I also searched for the cover version of the song and here’s are the two I love best.  Enjoy!

Ramadhan Mubarak 2015!

This is my fifth Ramadhan as a doctor.

My fifth Ramadhan since coming back to Malaysia. Still, I miss my fasting days in Australia.

This year, the Australian Muslims only get to fast for about 10 hours a day. Haha. Lucky them. Fasting when it’s autumn to winter time.

When I was there, Ramadhan was during Spring to Summer. Love the local Newcastle Mosque. The pot luck food was crazy good. Everybody contributed with the food, even me. I basically brought french fries and cucur kodok, most of the time. But hey, people still ate and polished them off the plate. The cute arab little kids LOVED my fries, okay!

Goes to show that simplicity is the way to go. Even with food.

And the terawih was very long, we get to burn all the calories we took.

Hahah! What do you know??
Hahah! What do you know??

But I digress, folks.  What I really wanted to say is a reminder for myself and for everyone of my readers.

The point of Ramadhan is not for the crazy good food I mentioned. But it is for the sake of attaining piety and takwa. And for the purpose of attaining that taqwa, Allah helps us by getting rid of the devils for us.

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You see? That’s the scary part of Ramadhan. This time, YOU KNOW FOR SURE, it’s you and not the Satan.

So, I have to prove to myself, that’s it’s the Satan, not me. When I could not control my temper, it was the Satan. When I could not control my tongue, it was the Satan. When I was lazy and performed my prayer at the last minute, it was all the Satan’s fault.

Hahha. So in the month of Ramadhan, you will see the tamer, nicer side of Afiza Azmee. (God…you may not even recognize me. ROFL)

Tough to do, too.

So, allow me to take this opportunity to wish Ramadhan Mubarak to all my readers.

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And here it is, my favourite English song for Ramadhan.Enjoy.

Ethics And Justice: What Can We Do When Ethics Don’t Produce Justice As Its Final Outcome?

I am emotional. But I am emotional about principles and facts. I know,  I cannot always behave like “it’s either my way or the highway.” But some things are so obviously wrong and when people defend it, I go ballistic. 

But I flip out when people don’t get their priorities and their facts right. In that sense, I might be a bit autistic. It feels like my world come tumbling down when things don’t go according to the principles I know to be correct and facts I know to be true. It irritates me. In that sense, I can also be a bit offensively manic in my irritation.

If someone says that the world is flat, and since it is his opinion that the world is flat and I should respect it, I will totally go insane with anger. 

***

I attended a course one day. One of the speaker works in the management side of the MOH. He talked about documentation and medicolegal issues. 

At the end of his talk, I asked him (I have forgotten the exact words I used, but the gist of it were as such) “What can MOH do to help clearing up the reputation of a doctor in the case where a patient goes to the social media with wrong accusation against the doctor? For example,  there was a case where a patient who had an allergic reaction to a medication went to tabloids and viral it in the social media that the doctor had given him the wrong prescription? The patient had already broken his own confidentiality, so can the doctor correct the facts in the same social media to regain his reputation?”

He basically said that obviously, the doctor cannot correct the facts in the social media because the doctor is bound by the ethics of confidentiality. Basically in his own words “we can only stay silent. Malaysians are forgetful, anyway. The hype will go away”

“So, KKM won’t help to clear up the doctor’s name?” I was getting warmed up, hahah. (See? I can be really annoying)

“What can we do? What’s your suggestion?” the speaker asked.

“Well, we can do health promotion. We can issue a statement that in the case of such and such, investigation has been done and we have since found out that the allegation towards the doctor is false. We have to viral the statement that we issued to the same extent that the accusation was viralled against us.  Otherwise, the public will never learn the truth of the matter and there will be more unfair accusations being viralled.”

The speaker said “But when you respond to such accusations, sometimes you are giving more weight to the matter. Silence is golden in this case.”

(The word “silence is golden” grates my nerve endings)

“If the doctor wants to counter-sue the patient, will KKM help?” I asked

Again, the answer is disappointing.

I ended my interrogation with “So, there’s no solution.” Then I passed back the microphone to other audience.

I don’t blame the speaker. It was not his fault. He was only representing our own mindset in MOH and our general conduct in our passive culture. I am sure, he himself would be frustrated if he were in other doctors’ shoes. But sometimes it’s hard not to blame the messenger.

***

I am grieved by injustice. Not just against me, but against anyone. 

We Muslims, used to have better standards in how we expect other people to conduct themselves.

I hate it when people said things like “We have to look at the management point of view. Even though your point of view is correct, the management also has their own take on this matter. They have to do a lot of damage control, money that can be spent elsewhere have to be spent for legal fees etc etc. ”

Okay, let’s look at EVERYBODY freaking point of view. And then what?? 

What is the bottom line?

The bottom line for MOST people is “We have to look at the management point of view. And since we have now looked and understood the management point of view, we can follow what THEY decide.”

Sure sounds diplomatic. Management love people like this. Kudos! 

People like this want to please everybody. They will say everybody’s point of view is correct, but then they will give MORE WEIGHT to the management point of view and follow whatever unfair decision made by the management. They think they are being less rigid, more holistic just by saying ‘everybody is right’ but at the end of the day, they will go with the management. 

If that’s how you want to think, then next time, just cut the diplomatic act short, by just saying the management is right.

That’s why I get irritated with diplomatic people. The only diplomacy I display is with my depressed patients because it is therapeutic and that diplomacy serve a good purpose. (unless the patient is like me and can tell bullshits apart) But in my day-to-day dealings with people, I am direct and some people have interpreted that to be rude. Because in my day-to-day dealing with people, diplomacy does not serve any better than simple straightforward talk does.

And in my experience, diplomacy can sometimes be another form of dishonesty. Some management people are good at that. 

Quotation-Patrick-E-Mclean-mankind-knowledge-Meetville-Quotes-145451

***

The point of ethics is to serve justice. You shouldn’t stick to ethics just for the sake of ethics, without serving the real purpose of justice.

Not just for patients, but also for doctors!

If a patient has spread in the social media about his/her own disease and then wrongly accuse the doctor of not treating her well, then the doctor should no longer be bound by the ‘confidentiality’ clause. Why? Because, justice will fail to be served. That’s why. And therefore, the ethic lost its purpose of being adhered to, in the first place. 

The confidentiality clause was made with ‘protection of patient’s rights’ in mind. But when the patient himself/herself breaks it (in the social media where it spread like bushfire), then the purpose of the confidentiality clause is already gone. There is no confidentiality anymore!  Therefore, the doctor should no longer be bound to it when he has to defend himself. 

But see, some doctors don’t think that way. They think conventionally and cannot analyse beyond the point of what they have already known.  There are so many others who cannot think flexibly and still said “Patient can break his own confidentiality but the doctor still can’t.” (and ironically, I was the one being accused of inflexibility. I am flexible. Believe me I am SO flexible, that I can be a rule breaker when I don’t agree with the rule. Just because I stick with my principles for justice doesn’t mean I am inflexible. People who cannot change their ethical reasoning when presented with different scenarios…they are THE ONES WHO ARE INFLEXIBLE!)

Yes, in general, patient can go around telling anyone about her own disease and the doctor cannot tell others about the patient’s disease. “Suka hati aku laa aku nak habaq kat sapa pun aku sakit apa. Doctor yang  tak boleh pi habaq kat orang lain”.

Okay, setuju!

But when you ADD IN another factor where the patient ACCUSES the doctor of misconduct in the freaking social media, the purpose of ethics to serve justice cannot be realised if the doctor is STILL BOUND by confidentiality. This sort of ethic is an ethic that has lost its soul (justice)

And if you CANNOT think this way, then there’s something wrong with your justice reasoning.

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***

I am all for justice. Not just for the patient but also for the doctor.

My suggestion is:

-Investigate each accusation in the social media that has been viralled.

-Come up with a fair conclusion after that investigation

-And viral the outcome of the investigation in the social media, regardless of whether the accusation was true or false.

If the accusations is true, issue a statement saying, “With regards to the case of A accusing Dr. B of so and so, our investigation showed that, Dr. B was guilty of so and so. We have asked Dr. B to apologise and compensation will be awarded to patient A.”

If the accusation is false, issue the statement, “With regards to the case of A accusing Dr. B of so and so, our investigation showed that A had an allergic reaction which could not have reasonably been expected for Dr. B to know that A would develop such reaction. We hope, patient A will apologise to Dr. B and correct the impression he has given against Dr. B in  the social media.We in MOH fully support Dr. B should he decide to pursue legal action against patient A if patient A fail to extend his apology.”

The statement, especially if the accusation is false, should be viralled SO THAT the reputation of Dr. B can be regained which is only the fair thing to happen. 

But what usually transpires is, the accusation was viralled throughout Malaysia. But the outcome of the investigation that clears up the doctor’s name was not viralled to the same extent as those of the accusation. So the public will still be under the misapprehension that the doctor is wrong. In this case, AGAIN justice is not served. What is the point of investigating an accusation if people don’t know the outcome of it? 

Viralling the outcome of the investigation is also good for these purposes:

-For public education and health promotion about diseases, in general

-serve as a lesson for the public not to viral the things that they don’t know before they clarify with their doctor or complain to the right channel. 

-serve as a lesson to doctors not to repeat the mistakes of other doctors.

So, I am not suggesting this just to ‘hentam pesakit’ because I am fully aware that I might be a patient too one day. I want justice to be served for everybody; doctors and patients both. Because I also believe that we should not hide misconduct done by doctors.

Fair is fair, is fair, is fair.

Fighting for justice is human instinct. But we have dulled our instinct when we douse our instinct in diplomacy and fear of hierarchy.

diplomacy-and-virtue-do-not-make-easy-companions

***

“O you who believe!  Stand out firmly for justice, as witnesses to Allah, even if it be against yourselves, your parents, and your relatives, or whether it is against the rich or the poor…” (Quran 4:135)

“God commands justice and fair dealing…” (Quran 16:90)

“O you who believe, be upright for God, and (be) bearers of witness with justice!…” (Quran 5:8)

“…If you judge, judge between them with justice…” (Quran 5:42)

Why Doctors Are Losing In The Social Media Game

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I welcome the statement made by our esteemed DG regarding the use of social media by health professionals.

I agree in parts. Disagree in others. Neutral in some.

I agree that ethics and professionalism need to be maintained in the use of social media when it comes to certain aspects of our work. When it comes to confidentiality, there is USUALLY no compromise to it, I agree.  (there is a reason why I CAPSLOCK the word ‘usually’. Read on and I will elaborate)

But I am more interested in this particular paragraph written by our DG:

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I would like to elaborate on this, in particular. Because I know the older generation has NO IDEA how social media can be used effectively. We cannot blame them. We are the ones who grow up with social media. They (the politicians and leaders) took up social media as part of the evil necessity in this current age, but they don’t know how to effectively use it.

We do.

They need help. But they have to help us to help them.

***

Before I elaborate further, I would like to tell you that any game cannot be fairly played when there is no level playing field.

One side will always lose when there are different rules for one team, and another set of rules for the opposite team, when they are playing THE SAME GAME.

In chess, my king can move the exact same minuscule step as your king. My queen is as powerful as your queen. My cavalry and my pawns have equal strengths as your cavalry and your pawns. See? Chess is the fairest game in the world. They eliminate all biases and all other factors that could influence the outcome of the game. Discounting luck, takdir’ or ‘qada and qadar’, the winner MUST be the most strategic, and the most brilliant. No biased referees, no other judge. (not even courts can be THIS fair). I was never a sporty person, and the only game I could play were chess and carrom when I was in school. (And I was not even that good but I like it because it’s fair. I lose fairly. And I win fairly).

In any other sports, you cannot guarantee that each player in one team has his EXACT equivalent in the other team. So they have to buy players into their team.

Social media is not like chess.

Social media is a sport. And to make it worse, it is a sport with different rules for different people. And someone will always be at the losing end.

At the moment, the doctors are at the losing end. ALWAYS!

1) Confidentiality

The patient with allergic reaction can breach her/his own confidentiality when they go to the newspaper and claimed “doktor salah bagi ubat”. Can the doctor go to the same media and breach the patient’s confidentiality to clear up his name? He can’t. He has to abide by different rules. His hands are tied. He suffers by the unfairness and the indignity of it all. And what can we say to him. “Tough luck, mate!”

Is that it?

It happened to my own colleague! Someone snapped her picture and accused her of nonsense. It was viral in the social media. The whole Malaysia talked and commented about her. Inquiries were made by the Pengarah and the DG. But when all facts have been laid out, and accusations against her have been cleared, who in Malaysia knew about it except her colleagues and her superiors? The facts were not even published in the social media. So the whole Malaysia STILL THINKS she was wrong. If you are a decent human being, the injustice of it all would grieve you. I can never tolerate injustice against others without commenting scathingly, let alone against myself!

Are patients the only one who have the rights to be treated ethically? That is NOT the ethics that I learn in medical school. Ethic is a guide. In general, you can’t commit murder; But you can in self-defense. In general, you can’t breach confidentiality, but if it were to happen to me, I will breach confidentiality to defend myself and my honour. I will sue the media and the patient! And I WILL viral it to the same extent the accusation was viralled against me. It’s not a threat, it’s a promise. I am very protective of my good name. And I think, everyone should too.

The problem is, MOST health professionals don’t like to GO ALL THE WAY when they are fighting against these sort of injustice. They rather take the attitude of “malas nak panjang-panjang”.

See? We are too kind. Our inherent goodness is also ANOTHER reason we are always losing.

2)Intellectual Capacity

Another reason why we are always at the losing end.

Doctors are generally brilliant people in their own field (non-doctors are brilliant in their own field; have to clear that up just in case some people think I am being arrogant. Been accused of that too many times). We can explain things brilliantly because some of us were also elocutionists and debaters and public speakers when we were at school.

Unfortunately talking and debating about diseases is not the same thing as debating about “whether or not school uniforms should be abolished in public school” in a school-level debate competition.

It’s not that we are not brilliant speakers in our own rights. It’s just because whatever brilliant explanation we can give will always be lost to translation. Medical terms are most accurate in its Latin form and English form. And informed consent is only as good as the patient’s level of understanding.

3) Unequal ethical rules between doctors and the ‘natural healers’

For this point, I think my esteemed colleague (now, already a psychiatrist) has nailed it in the head with this part of his facebook status. Below is the print-screen of his brilliant elaboration of something I could not explain as clearly. His facebook status has got many shares and I took it for granted that he wouldn’t mind  one more share in this humble blog of mine.

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Dear doctors in any generation,

-We are losing!

-You are no longer practicing medicine in the golden age of 50 years ago, or even 10 years ago.

-We have to revise how we use the social media.

-We have to learn the ropes. We have to adapt. And we have to do it quick.

-Even medical ethics need revision. At least some of them. Not merely the clinical guidelines that need revision.  (Don’t be so scandalised. Ethics and laws are revised according to the passage of time, provided it does not go against the law of God. This is nothing new)

Let the younger generation help you understand the social media, a little bit more.

***

We Need To Understand The Social Media Format

I will give you a simple analogy. Hopefully it will help demonstrate where I am coming from.

In our schooling days, we learned how to do essays, no? We learned how to write formal letters and informal letters. Language used in the informal letters (overt expression of tender feelings, peribahasa bagai, flowery words) will not give you high marks when they are used in the formal letters. Formal letters have to be succinct, precise and to-the-point.

On the other hand, if your task were to write an informal letter to your girlfriend…. using dry, unadorned, uninspired style of language will NOT give you an A. In real life, your girlfriend will say “you are a dry, stick-in-the-mud bore. Our relationship is finito!”

Writing a case report is the equivalent of writing a formal letter. The scientific, dry and to-the-point style is best used when we are speaking among health professionals and doctors.

In the social media, the general public who does not have the slightest idea about medicine will NOT read what you write if your facebook status is as dry and yawn-inducing as all that.

So when the DG wrote : “Inappropriate, emotional and irrelevant uses of words are not welcomed” when it comes to posting in the social media, we need to properly qualify what does ‘inappropriate, emotional and irrelevant’ means.

If it means we have to use the case-report style of language when posting in the social media, with all due respect, I have to disagree. (Read on, and I will elaborate)

We Need To Understand The Purpose Of Using The social Media

The point of using the social media is not to educate. It is to advocate. There is a fine line between ‘educate’ and ‘advocate’. The line is thin, but it’s there.

To simplify the matter, I will say that to educate is what the teachers are for. The textbooks, the case studies, the journal articles are all the tools being employed to educate. They belong in the class room. Not in facebook. Teachers are great people, but students don’t always listen to them.

To advocate, is what the celebrities and the artists are for. The celebrities and the artists are attractive, beautiful, appealing! Underneath all the make up, they have their flaws. But they magnify  their strength and downplay their weaknesses.

We all do it in our own way. When I go for a holiday, I don’t show people the pictures of me being tired and grumpy and hungry. I show them only the fun things I do, the good food I eat, the beautiful sceneries I have seen.

Do you understand?

Doctors have to know how to coach their facebook status in a manner that is attractive and appealing for it to go viral enough to be read by the public and the target audience (not just by their fellow colleagues).

Sarcasm has its uses. Emotion has A LOT of uses (take it from the psychiatry MO).

Sarcasm has been (mistakenly) thought to be a sign of intelligence. It’s not always so, I know (sometimes, it only means you are rude, ill-mannered and uncouth). But the majority of people ARE entertained by sarcasm and they DO THINK sarcastic people are intelligent. In the battle of the social media, we need to be perceived as intelligent for our words to attract attention, and in turn, having the power to influence.

It’s all about perception. 

Being dry will not even cause anyone to READ your status, let alone influence them to think favourable of you. Perception is everything. Some people manipulate perception for a bad purpose. At least we are manipulating it for a good purpose.

I say, where appropriate, use sarcasm!

I say, where appropriate, use emotion! Most people don’t decide based on reason, they decide based on emotion. This is true! The evidence of this is rampant in the psychiatric clinic when it comes to relationship and marital conflicts.

Now, when I say ‘where appropriate’ what do I mean? (read on!)

We Need To Understand The Power Of Context And Words In Our Argument

Absolute truth can only be known by God.

In real life, truth is very relative. In real life, logic is only patterns that have nothing to do with the truth.

Premise 1:  A is B

Premise 2:  B is C

Logic: A is C

That’s logic. It is ONLY true if Premise 1 and Premise 2 are REALLY true (if A REALLY is B, and if B REALLY is C). In life, premises are not as simple as ABC. Sometimes, you will never know whether the premises are ACTUALLY true in the first place.

The premises surrounding the (possible) truth is complex! So, let’s not try to explain it, if we don’t have to. (if we have to, we will do it. If we were asked, we should do it. Until then, simplify your explanation).

Just work with context and sharpen your vocab in any language you know. Learn human emotion and motivation.

The public claims they want to know the facts. But sometimes, the facts don’t MOVE them. The facts don’t affect their decision.

I make use of emotion when I want my patients to be compliant to medication. Yes, I make use of it. I, who always claim that I don’t like to be manipulative, actually manipulate emotion when it comes to dealing with my patients.

I started with a smile. In various subtle words, I showed that I care. I demonstrated the fact that I have no conflict of interest. “Gaji saya tiap-tiap bulan sama jer samada awak makan ubat ke tak. Saya tak dapat untung macam bomoh-bomoh tu. Kalau awak tak makan ubat pun saya tak rugi. Awak rasa kenapa la saya berleter panjang-panjang kat awak? Tu kat luar tu, banyak lagi pesakit dok tunggu.”

They will take the meds if they believe you genuinely feel a level of care towards them (why do you think doula is so populour?)

That’s emotion.

On the other hand, I have used sarcasm towards rude, demanding patients. And magically, they become less rude when I am more firm. They are more receptive to accurate information when we show who is the authority, here.  I cannot show inferiority with these sort of patients. Bullies will trample the weak among them. If I look intimidated, I will no longer be effective as their therapist. I know this! And I change myself and my demeanor, accordingly.

In fact, it is my principle not to kowtow to anyone who acts superior towards me without no other basis other than their social position. It is irksome, and I show my polite poker face to them. No more and no less. (In general, I don’t prefer dealing with VIP patients. Sometimes, when there is no specialist around, MOs will have to see these VIP patients. Some VIPs are polite and never try to impose. Some like to subtly show they are someone important by certain words and certain attitude that I deal by simply pretending that I don’t understand and don’t care to know).

That’s context.

In psychiatry clinic, we have depressed patients, manic patients, psychotic patients, kids with learning disabilities, adults with dementia, drug addicts, personality disorders (psychopaths, sociopaths and the likes). Context is so important. Versatile ways of wording your emotion are very important to influence different type of people.

To quote a fellow PSY colleague, “our words are our tool of trade”. And now, this is also true for other doctors wanting to use the social media.

****

Doctors are brilliant at scientific biological facts. Doctors are brilliant life-long learners. We know what we know. We know, what we don’t know. What we don’t know, we know where to find out (if we want to find out). Indeed, where I graduate from, we made jokes about the term ‘self-directed learning’.

Tutorials and lectures were given to inspire curiosities and questions which we will have to find out the answers to on our own. We will then discuss it in the next tutorial session. That’s why tutorials are so stressful, folks. Australian mates right and left spoke on top of each other’s voices wanting to show off what they had found out from their own research. The dumbfounded Malaysians were waiting patiently for these mat sallehs to stop talking so that we could share what we have found out too. But they never stopped talking. They sounded brilliant. The timid Malaysians went home feeling dejected and stupid for not contributing in the discussion. The tutor made a remark “The Malaysians are passive and not participating”.

Oh….memories!

Like everyone else with problems, the Malaysians gradually learned to solve them. We self-directed-ly learned to interject, interfere and cut other people in the middle of their speech. We stopped waiting. We self-taught ourselves to be ruthless to survive, even though by the mat salleh standard, we were still very timid and passive.

See? Doctors are brilliant at solving problems. In life, we do what we have to do. In work, we do what we have to do for the sake of our patients. No sleep? No worries. No time to eat? We will simply starve. Got scolded publicly by specialist? We will simply develop a thicker skin.

No sweat!

We do what we have to do.

If you are not resilient, if you refuse to evolve, if you don’t know how to be like the adaptable chameleon, you cannot survive as a doctor.

May I suggest, that we start being self-taught on how to be effective in the social media too?

In the long run, it can only benefit us if we can use the weapon of social media to our advantage. Remember, social media is a sport with different rules for different people. But like any other game, practice can only make perfect.

If you don’t know, you can learn. But learn it, you must.

That is, if you want to survive and stay relevant.

In Support Of The Doctor Who Speaks Up For All Of Us

Screenshot 2015-06-09 22.19.40

The above was the Facebook status of a very bright, young doctor relating about one aspect of the many ironies in life that a doctor experiences in the course of her work in the society.

I read her status, and it cheered my day. I felt vindicated and validated on behalf of many doctors working in O&G in specific, and on behalf of all doctors fighting against medical misinformation in general.

I shared her status. Many doctors did. Go and check up my FB wall. I have nothing to hide.

And then, THIS NEWS came up in my facebook newsfeed!!

Screenshot 2015-06-09 22.18.01

Dear doctors in the higher up,

Act like a leader, and support your subordinates who are saying the right thing.

So what is the big deal if the doctor had been slightly sarcastic in her FB post? I would have done exactly the same thing! Her facebook status hit the nail on the head. It drives the point against irresponsible practice of homebirth right home!

If I had the opportunity (of being on-called while that particular case had materialized) I would say what she said. It was the best example of the consequence of shunning modern hospital intervention and that example happened to be current.

OF COURSE I WOULD GRAB THE OPPORTUNITY TO EDUCATE THE SOCIETY WITH THIS EXAMPLE!!

Has confidentiality been breached? On what ground(s) was she punished?

Many doctors had shared the FB status of the brave doctor when she was being so-called sarcastic in her FB status. Myself included. Yups, I shared her status in my FB wall too. Many of my friends did. Why is she the only one being punished?

Is there anyone being made responsible to track every single doctor who has shared her status in FB and then punish all of them? Is there anyone being made responsible to track every single FB status THAT SUPPORTS the doctor’s FB status and then punish them too?

Is she the only one being punished for representing what we all believe in?

Be fair, that’s the least you can do!

All doctors should rally in support for the brave doctor! All doctors who have liked and shared the status of the doctor when she first posted it should support her against the unfair punishment. She said exactly what we would have been thinking had we been in her place.

***

It must be the generation gap.

Our generation is not politically correct. And we don’t want to change that part of our personality. We knew it, and we don’t care. We revel in it. Proud of it.

We know you shake your heads at us. We forgive you. Because at the moment, I am shaking my head at your children (who is one generation below us) who you mollycoddled and pampered far more than we ever were when we were growing up. (During my time, most kids were not chauffered by parents to school, we went to and from school by bus or by bike, we didn’t have smartphones or tablets. We went out, playing and roughing it around the neighbourhood with no fear of being kidnapped, abducted or raped. We fought our own battles without involving adults and my parents blamed me whenever teachers scolded me).

So let’s forgive each other’s generation snobbery. We all think we knew better. You did (and still do), I do, and the generation below me will do.

The truth is, we are not at all disrespectful of protocol. It’s just that my generation is easily disgusted by two-faced ingratiating butt-kissers of our generation (or in any generation). We don’t respect authority just because they are authority. No…there is more to respect than merely your position. Most of us prefer to say exactly what we think, preferably at the very moment we think it. If the moment doesn’t allow us the luxury of saying what we think stat (because the higher authority is not receptive to feedback and simply does not appreciate original ideas when they are given), we will postpone the saying later.

But it will get said (or written). It will be discussed among our friends and colleagues. Discussion and argument back and forth will ensue. We are exhilarated by the intellectual exercise of defending what we believe, when we believe it.

That’s us being expressive. Can’t blame us. We were brought up in the age where learning was supposed to be INTERACTIVE. Where feedback was encouraged. No courses is complete without feedback forms being distributed nowadays.

Yes, I know. During your time, you were not pressured to be interactive. You learned in the type of school where teachers could scold you and cane you and your parents would say the teachers were right. “You must have been naughty”, your parents concluded straightaway. Your side of the story would be ignored, not worthy of being listened to, let alone of being considered.  Being expressive and opinionated was not encouraged back then. It wasn’t the way you had to learn, DURING YOUR TIME.

Now, our time is the more interesting time of learning (but I might be sprouting generation-biased nonsense here, but then this is my blog.) Even when we have no idea what to say, we are asked to participate. Even when we don’t have that much of an original opinion, we are asked to speak up. You cannot attend a talk where the speaker won’t say “Saya tak mahu saya sorang yang bercakap di depan. Kita mahu sesi yang interaktif yadda yadda yadda.”

Ugh! ( One tip: if you are interesting to listen to, people won’t fall asleep even if the session is not interactive. Trust me! They will want to listen to you talking non-stop. They don’t need any other stimulation in the form of interaction, because you on your own is stimulating enough.)

When I went to Australia, I felt pressured to participate in the tutorial, to offer an opinion …when all I really wanted was just for the lecturer to tell me what I need to know and for me to just go back, learn it, rehearse it,  swallow it up and spit it out in the exam. (Yes, I was more traditional than what some people might think).

I had to rack my brain finding something to say to fill up my speak-up quota of the day. I felt embarrassed whenever anyone had commented “The Malaysian students are not participating in the lecture nor in the tutorials. Too passive. Too silent.” Because stupid me, I felt a responsibility towards my country that I should be making my country proud by my performance, however superficial it might be. I had to learn to be more extrovert and to be more forthcoming because in Australia, people are encouraged to speak up. It is tacitly being thought as the most superficial measure of intelligence. And I cared about Malaysia too much to let them think that Malaysians were simply passive, non-opinionated fools.

We come back to Malaysia not knowing how to suppress our thoughts to ourselves when we believe we are right. If we are wrong, we expect you to tell us point by point how are we wrong, and how you are more right than us. REGARDLESS OF WHO YOU ARE IN THE GOVERNMENT!

Because that’s how you wanted us to be, remember? Otherwise, WHY DID YOU GROOM US THAT WAY FROM THE VERY BEGINNING OF OUR SCHOOLING DAYS?

Don’t get me wrong. We know how to be polite. We can be diplomatic to those who deserve our kindness. We return smiles. We say our thank-yous and our apologies when they are required.

However, we don’t like to be false and pretentious.

We are ultra-sensitive to false information that belittle the effort of our fellow doctors in any department, and will fight those openly, without shame. And by fighting openly, I include the social media.

Social media was used to denigrate and libel the reputation of our healthcare workers, and therefore social media must also be used to defend our honours. Because the higher authority is hardly effective at defending the various issues that have cropped up against doctors for the past few years! For doing our parts in defending the doctors rights, we don’t expect your thanks. Just help us by not making it harder.

You see, social media started in our generation. We know how to use and manipulate it more effectively than the older generation does. Social media IS the modern and latest medium of advocacy. What the young doctor wrote on her facebook wall was a non-issue, in my opinion.

***

Another peculiarity of our generation is that, we always try to mean what we say.

I am not going to say sorry if I am not sorry.

I AM NOT SORRY FOR SUPPORTING THE DOCTOR WHO HAD SHARED HER TOUNGE-IN-CHEEK COMMENT IN HER FACEBOOK WALL ABOUT THE PATIENT WHO CAME TO THE HOSPITAL WITH THIRD DEGREE TEAR AFTER HAVING REFUSED HOSPITAL INTERVENTION AND OPTED FOR HOMEBIRTH.

I AM NOT SORRY FOR SUPPORTING THE OTHER DOCTORS WHO HAD SUPPORTED THE  DOCTOR. I AM NOT SORRY FOR WRITING THIS IN SUPPORT OF HER EVEN WHEN I NEVER KNEW HER.

AND I AM NOT SORRY THAT I AM NOT SORRY.

There are MANY, MANY of us who had either liked or shared her status. There are hundreds of us who had shared the status of others who had supported her.

Do all of us deserve similar punishment to her?

WHAT IS YOUR STAND?

Perhaps, the more accurate question is, DO YOU EVEN HAVE A STAND?

And if you do have a stand, do you have the correct one?