It’s been an exhilarating week.
After two years of struggling to germinate under fluorescent tubing amidst piles of notes filled with esoteric names of microbacteria, drug names and biochemical reactions confined within the four walls of a lecture theatre, we’ve finally taken the leap to enter our clinical years.
The difference between a third-year medical student in his clinical years and a second-year one is as huge as the ocean. At once, you’re transplanted from the dull, sterile classroom into the chaotic, heart-thumping pace of the hospital ward, from meeting merely tutors and lecturers to interacting with your greatest teachers- real patients themselves. What you once knew as only theoretical information and pictures in the textbook becomes fleshed out into reality- you see that an illness has a face, family, friends, feelings and a future, real consequences for someone’s life. From the pen-tapping mundane routine of the classroom, you’re thrown into a dynamic, ever-changing storm of the ward, where you scrub and gown and watch surgeries, where there’s so little time, so much to see, hear, feel, learn.
You feel a sense of liberation, like you’ve finally become what a medical student ought to be- part of the drama. At once, you feel like finally, you’ve been given the right conditions to bloom. Everything amazes you, and you can’t wait for the next study period when you can engorge yourself on all that knowledge that fertilises your brain, half-withered from the dry routine of the previous two years. There is adrenalin pulsing through your veins, you’re in a white coat, you’ve got your pen and paper by you all the time, your stethoscope hangs sexily around your neck. In your heady excitement, the fact that you don’t quite know how to detect a simple heart murmur doesn’t quite sink in, just yet.
There are Strangers from all walks of life, all willing to tell you their Stories because of your white coat, people giving you pats on the back congratulating you for coming this far, patients holding your hands thanking you for spending time with them… and then you suddenly realize… you don’t know anything at all.
Your utter helplessness overwhelms you when reality sinks in- that in a sea of vast, vast knowledge, you’re struggling to breathe, you’ve Stories to listen to but little advice to offer, you’ve a stethoscope around your neck, but instead of feeling like a glamorous young know-it-all ripped from a medical drama serial, you feel it’s real weight around you, realise what this all really means- life and death, persistence and stamina, long hours and a upstream struggle for a balanced life.
You’ve reached the first milestone, the first second of momentary euphoria wanes off, and you realise-you’ve still a long, long way to go.
Of late, I’ve had to ask myself the serious question of the implication of This on a vocation such as mine. Two people challenged me about it, and it left me, to say the least, quite unnerved.
I realize, that many people suffer from This illness. Yet, the reason for this extra scrutiny, the reason I was questioned, challenged even, put down for my honesty on this space was simply because of my choice of a vocation that many demand far, far higher requirements of.
It’s been a struggle all this while. And all the time I am receiving mixed signals from two opposing camps- one thanking me for my brave honesty and inspiration, and saying how much they believe my experience will make me a better doctor, the other mocking my stupidity, fearing for my future and suggesting me to take the easy way out- get out now so you don’t regret it later.
It’s not that I particularly fancy the occasional time-bomb thrown at me. But how do I explain my conviction of being honest and unafraid to share about my journey, how do I begin to explain to you that This illness is no respecter of man, that just as how anybody can have it, anybody can triumph it, too- and that one has a choice not to allow it to take you away.
How can I tell my own patients to be brave to acknowledge their conditions and seek help- if I myself fear what others think of me? How can I tell them to take courage to face the world with their heads high in dignity, when I can hardly practice what I preach?
And how do I explain the reality of too many inexorable, slippery slides to suicidal despair, that could have been stopped, avoided, if not for the pathological and unfounded, irrational fear of failure, disclosure, shame, guilt and of being exposed, found out, caught vulnerable in the limelight. How do I explain the sheer un-necessity of lives lost, wasted, flushed down every single day- all this completely preventable if not for our immaturity as a so-called developed nation to be unable to accept these grippingly stark and genuine realities. How do I begin to share with you the emails I receive from people being impacted from this honesty, whose lives have been touched, changed, revived?
Oh how our deceitful, cowardly and unthinkably selfish natures have distorted our perspectives- building and puffing up our own esteems, at the expense of others, lives lost which we’ve heard about, tragedies which we’ve read about, and bright futures bursting with potential which we’ve never even met, known, loved- all completely wasted, thrown away, flushed down and lost, forever, because of our one moment’s folly to accept the greatest lie there ever was- that to win, you must hide.
When in fact, everyone who plays hide-and-seek gets found out in the end. If you don’t, and you find yourself hiding for hours and hours in a dank, musty cupboard full of cobwebs and spiders, with the rest of the gang given up looking for you and moving on to play a different game, you lose anyway.
You lose anyway.
It reminded me of Ed. When we let him go, tell him we don’t need make-up, or a façade, or anything else in the world for that matter, we shock ourselves to find that… people really do like us, far more for who we are for real, than the person we tried so hard to be, and never had feet large enough to fill those over-sized, mouldy shoes.
The medical profession sees more depressed, overworked and burnt out healthcare workers than any other single profession in the world besides pastors and missionaries. These are the people who work their lives to the core, for the single altruistic cause of helping others.
There has been paper after paper after paper published on the high percentages of doctors and medical students diagnosed with depression and other psychological illnesses. You put a group of exceptionally high-achieving individuals with perfectionistic tendencies through a rigorous course with ever-increasing demands, long work hours and scarce sleep, on the frontline with blood, illness and bereavement every single day, and tell me if you do not see the formula for disorders, distress and woe.
Contrary to popular belief, doctors and medical students aren’t infallible, all-knowing superheroes who heal and transform and perform miracles. We aren’t God. At the end of a long day after a 36-hour shift seeing patient after patient after patient, and listening to Story after Story after Story, we have our own homes to return to, family to entertain, and perhaps, spouses who may not be half as understanding, wondering who it was they married years ago.
And all I am trying to do, what I am trying to say is this- that I’ve nothing to hide, and I’m not afraid.
Some have told me I don’t need to do this- that I can go about my own life, avoid these cruel arrows strange people send me once in a while, wrap up and forget about all this talk of being open, of sharing, of helping people through a public space. You put yourself on the line unecessarily, of course you’ll get hurt.
How do I explain this foolish thing called a calling-
-the thing that makes you terrified of giving up what you believe in, and to be unable to bless other people in the way God has blessed you, to be unable to share and to live out the things God has taught you through experience.
We swim upstream, not for nothing, but for a Purpose. The same purpose I started out with- to raise awareness about This, to give it a face, and to testify how there’s nothing to be afraid of, that one ought to get help and help others to do so, that it’s perfectly fine, beautiful even, to be Real, because it’s worth it. A Purpose makes things all worth it, even if you get hurt, even if it faces resistance.
I dedicated Kitesong to the one teacher who impacted and changed my life in the most phenomenal way. He’s the kind of teacher who makes you want to salute him not merely because of his knowledge, but for who he is, and for who you are when you’re around him. He is the reason of a large part of me today. A few days ago, I went to visit him at my previous college, and asked him, “Sir, so you think I’m foolish, too? And maybe, I ought to choose a different vocation?”
He looked at me and said, ” In the Holocaust, Wai Jia, there was this huge oil lamp in the middle of the concentration camp. It was what gave the prisoners heat during winter. It was said that one ought not to go too near it, because even though it was so cold, the heat from the barrel would cause your body to warm up, and paradoxically, you would catch pneumonia more easily.”
” Holocaust survivor Viktor Frankl realised that in order to live, he had to find a purpose greater than his life then, greater than his circumstance. When he found it, he found that he could withstand the chilling temperatures far away from the oil lamp in spite of the suffering. What he observed was that those who lost their calling in life, their sense of purpose, inched nearer to the oil lamp day by day, and eventually died because of pneumonia. When they lost their purpose, they only cared for immediate comforts like warmth but cared not for the long-term. There’s always a price to pay, suffering to bear when you do what you believe in, but the Purpose makes it bearable, worthwhile. After all, Socrates was sentenced to drink the poison hemlock on account of “polluting minds” and Christ was known as the King of Fools and crucified… This story speak to you?”
So I’m afraid, I will not stop wearing my heart on my sleeve on my white coat, not stop telling the truth, not stop doing what I believe I was made to do, a missionary doctor, and not stop living. I will listen and take good advice, constructive criticism, and feedback on my doctor-patient communication skills, study techniques, clinical procedures, but I will stand up to anyone who tries to tell me their opinion that I ought to be doing something else.
I love talking to patients, love listening to their stories, and I can’t take my eyes off a medical book, now. A calling, a Purpose can be so strong that its fire sets you ablaze.
It gets mighty cold sometimes, especially when all you have is a white coat in a cruel blizzard, and it’s not easy, but I suppose- for one’s Purpose, it’s all worthwhile at the end.
