I believe that human beings being different from one another is a blessing bestowed by the Almighty to all of us that are wandering the face of this glorious earth. Allah said so himself.
“O mankind! We created you from a single (pair) of a male and a female,
And made you into nations and tribes, that ye may know each other
(Not that ye despise each other). Verily the most honoured of you in the sight
of Allah is (he who is) the most righteous of you. And Allah has full knowledge and is well-acquainted (with all things).”
(Quran – 49:13)
I have been told some time ago “Afiza, not everyone is like you. Some people care about other things and those things are just as important to them. Those things that are important to them influence their feelings and their actions too. Just like what you care about influence your feelings and your thinking and your actions. If things that we care about don’t influence our actions, well, we never really care about it in the first place, isn’t it? But people are different. Embrace the diversity.”
Well, I actually have embraced the diversity for a long time. But I manage the diversity by putting people into categories of whether they can fit in my table or they should sit in other tables. Whether they can be close friends or casual friends or just acquaintances.
I actually think that it is a good thing that people are different. That’s how we learn from each other and that’s how we grow… when we come to understand that other people’s way of doing things are much better than ours in this particular context, (but not necessarily better in another context) we can adopt and adapt or fit and match our methods accordingly. It gave us certain nuance and flare that wisdom is so characterised by.
So far, I have had fun finding out that sometimes I could be wrong. (ok, it wasn’t fun, but it was educational… and education is kind of fun. So yeah, it can be fun in a convoluted roundabout way, if you know what I mean. haha)
But some things are objective. Some things are factual. Some things are not subject to your opinion or your preferences. Some things are carved in stones because they are universal ethics that surpass any consideration of individual culture and local customs. And most importantly, some things have legal consequences. (ALTHOUGH, some things that are legal are not always the most fair or just, anyway. People in the parliament who MAKE the law are not infallible individuals. Sometimes, they overlook certain things. Sometimes, they have their own agendas and interest too. So bear in mind, that laws can have weaknesses and loopholes. And when the laws contradict universal principles of justice or ethics, they are BAD laws)
One particular issue that came up up in the (social) media had really pushed my brain into overdrive. Especially after I have read so many comments about it in our private doctors’ forum on Facebook. Nothing so polarize the medical fraternity more than the issue of the treatment of house officers, don’t you think?
I have talked about the issue of housemen in so many of my postings. But I never get tired of discussing it. It is like my pet issue, I think. In the same manner that I never get tired of talking about the rights of Muslim women, the rights of mentally-ill patients, the importance of practicing the Islamic religion fairly and correctly (rather than culturally and convolutedly), the quality of Malaysian education system or the importance of reading fiction and improving your language…haha. Those are my favourite topics. If you talk to me about those things… about books, psychiatry, women’s rights, education, bullying of house officers, the kind of weird rulings given by misguided so-called ustaz (giving people a bad impression that our religion doesn’t make sense when actually the religion should not be practiced in the manner they have jumud-ly described)…. I can talk about those issues all day long. (If ever I become a member of parliament, those will definitely be the issues I want to champion.)
Everyone knows my stand on houseman issues. I have written about it ever since I myself was a house officer. And I have been consistent in my stand about them.
While I do think that HOs should stand up for themselves and fight their own battles without relying on their parents (because we are all adults here) while at the same time having excellent work ethics (do your work, no MIAs, continue to improve), I DO NOT and NEVER will I condone bullying, public humiliation, histrionic file-flying tantrums or any form of vulgar verbal abuse in the name of ‘tough training’. Never!
Those are childish behaviours and reflect poor anger management and pathetic emotional regulation. Say what you want to say to your HOs firmly, give warning letters, terminate the HOs, go through the channel…. but mind your manners in front of your staff and your patients.
“Even in a declaration of war, one observes the rule of politeness.”
“Manners maketh man” 😉
I admit that I have disagreed and crossed heated words with many people within my own department or inter-departmentally… but only when I feel they have crossed my sense of rightness and fair treatment (towards my patients, my colleagues or my department). I hate it when people make unfair or stupid decision and force me to abide by that decision simply because of their rank or position. But even then, I have NEVER shouted or sprouted profanities. People generally know Afiza is upset, but Afiza has enough self-control and enough vocabulary to make her displeasure known without using vulgar profanities that reflects poor breeding.
When I talk about politeness, I don’t mean you have to pretend you are not upset when you are. But there is no need to shout psychotically, and there is no call to broadcast to the whole ward of your displeasure in a histrionic attention-seeking high tone, with patients as witnesses to your childish public tantrums. Please…. pull yourself together! Say your piece assertively and move on.
It is easy, isn’t it… to display your displeasure to a subordinate who you think is dumb! But how many people have dared to shout at their bosses who they also think as dumb? If you are upset at your bosses and you NEVER shout at them, how can you freely shout at your subordinates when you are upset with them? That’s preferential treatment based on rank, isn’t it? Aren’t you ashamed of yourself? Or perhaps, more accurately, that is preferential treatment resulting from your own inner cowardice. Shame on you! At least, strive to treat people equally based on the merits that they deserve. If you treat your bosses nicely even when they are being dumb, then you should do the same to the subordinates as well. If you are the short-tempered type who cannot hold your temper with your subordinates, then I dare you to equally be short-tempered with your bosses. So that even as I cannot approve how you treat your subordinates, but at least, I am more likely to respect the CONSISTENCY of your conduct. Otherwise, I will go away thinking what a pretentious unprincipled cowards you are!
I tend to treat my subordinates in a similar manner I treat my bosses… sometimes, even better. With my subordinates, I feel like I owe them a duty of care and a duty of protection. I am in friendlier terms with them than I could ever be with my bosses. I am in friendlier terms with my nurses and my HOs and my fellow MOs than with my bosses. My HOs are helping me with MY work… by rights, I am in-charge of my patients. Not them. They are only helping me while they are learning and training.
Similarly, that’s how specialists should think of MOs too. The specialists are the attending physicians. All the patients in the ward and the Klinik Pakar are the patients of the specialists… the MOs and the HOs are helping them. But the specialists are in-charge! That’s what attending physician means! The specialist MUST know in and out about the patient.
Of course we all want competent helpers. MOs want competent HOs. And specialists want competent MOs. But at the end of the day, the patients in the ward belong to the specialists. FACTS! So, specialists should not pull a long face or make your subordinates feel like they have bothered you when they wanted to consult cases with you! They are YOUR cases!
“An attending physician typically supervises fellows, residents, medical students and other practitioners. Attending physicians have final responsibility, legally and otherwise, for patient care, even when many of the minute-to-minute decisions are being made by house officers/residents.”
The moment you become a specialist, all the MOs/HOs under you are automatically your responsibility and patients seen by them are YOUR patients.
Frankly speaking, I would rather be the kind of specialist who is very approachable so that they won’t be afraid to let me know every single detail of my patient… easier for me to do some damage control should anything go wrong. If you are unapproachable, your subordinates might hide things from you or do not feel like some things are important enough to bother you with (because you always make them feel like they have bothered you whenever they approach you) and by the time the shit hits the fan, it’s too late, ok! Your reputation goes down the drain. Scary isn’t it?
So, how do you train your helpers? How do you help them to help you?! Teach them la! And teach them humanely. Because at the end of the day, they are helping you. Help to look after your patients for you. They help you… and this is how you treat them? By bullying them? And cursing at them?
Teach them how to best serve you and adapt to your style of management. And you are not going to be able to do that with your childish (bordering on criminal) behaviour.
Another doctor in our doctor’s forum had pointed out that insulting someone’s modesty is also a criminal act! He highlighted Section 509 of the Penal Code to educate doctors in the forum who were bashing “housemen these days”. In him, I find some hope in the future of our medical culture.
Shall we see what Section 509 of the Penal Code said, hmmm?
Section 509: Word or gesture intended to insult the modesty of a person
Whoever, intending to insult the modesty of any person, utters any word, makes any sound or gesture, or exhibits any object, intending that such word or sound shall be heard, or that such gesture or object shall be seen by such person, or intrudes upon the privacy of such person, shall be punished with imprisonment for a term which may extend to five years or with fine or with both.
It is not even necessary to talk about legal sections on assault (Section 351 of the Penal Code deals with assault). Because insulting someone’s modesty is already a criminal act!
Do you want to be a criminal MO or a criminal specialist? Hahah. Just because you want to “tunjuk lagak” you might end up having your practicing license revoked when you end up becoming a criminal. So, be warned!
This is the law! No one can argue with what the law has clearly stated! (You see, I am doing forensic psychiatry now… So I am at the ‘look at the law’ phase of training. Haha)
So my take home message to housemen and all doctors: Do not ever tolerate abuse by anyone in the medical fraternity. Of course people cannot always go along with each other because, yes… we have different personalities with different drive, different goals, different (conflict of) interests…. BUT! be mindful of the Section 509 of the Penal Code.
After all said and done, some things are objective and not subject to your own biased opinion. When it comes to the law, we don’t give a fig about what happened “during your time” or whether “You came from a tough generation who became oh-so-great via gangster-like training“ or whether “The HOs who lodged a report against you was weak and manja” . The law doesn’t care about those irrelevant non-issues! When you insult someone’s modesty with a word or a gesture… doesn’t matter whether he is manja or otherwise, competent or otherwise, responsible or otherwise….you have committed a crime under the Section 509 Penal Code. (Because you could have dealt with incompetent HOs by giving them warning letters and terminate them through the right channel. There was NO NEED to insult or threaten them. So, when you did that, you have become a criminal! Got it?) If the HO decided to sue your ass…. you are doomed!
Wouldn’t it be easier for you to simply remain polite, give the HO a warning letter and then proceed to terminate the HO…all done in a pleasant and civilised manner through the channel? Why expend all that energy scolding and harassing people only to get sued in the end, risking your career and your livelihood in the process?
Think about it.