Processed.

“You have what?”

“Yeah, I still have 4 bullets inside of me.”

Fungus had asked me to join him and 2 other handcyclists for a night training session- they needed an able-bodied rider to look out for them on the roads and act as safety marshall. As we rode back with our aching limbs, he said, ” Because of the bullets inside of me, I have pain shooting up inside of me all the time.”

Sometimes it gets quite bad. He didn’t show up once on our regular rides because it got too bad.

But just because he has pain shooting through his entire body all the time, doesn’t mean he stops training, stops dreaming of joining the Paraolympics in 2012 in London; Just because we don’t know where our interests may lead to doesn’t mean we leave them to rot, and give up our talents, give up dreaming. I learnt over my attachment to the psychiatric department some months back that just because the relapse rate for alcoholics is sky-high doesn’t mean we give up treating them, or that people should give up seeking help.

I am learning, that just because the present doesn’t give us assurance of the future doesn’t mean we don’t even try. That just because the outcome may be the same, we neglect the lessons to be learned along the way. That it is process which guides us to the end which matters far more than the end itself.

There are many roads to the same end- the longer, less convenient one paved with more suffering inevitably has more treasures along the way.

For what is the point of earning medals, overcoming our vices and achieving our goals if they make us proud and covetous? On the other hand, what does one lose in gaining discipline, focus and perserverence; what does one lose in allowing the suffering of alcoholic rehabilitation to mould one’s character and bring one to yet another milestone in life; what does one lose in pursuing one’s interests, luxuriating in the unique way which God has made each one of us and learning how to bless others with them?

We can get to the same destination, but is it not what we pick up along the way which matters more? We can drive a swanky car, but how do we drive it using money earned from abortions? “For what will it profit a man if he gains the whole world, and loses his own soul?”- Mark 8:36

Some time back, I got into a bit of trouble at the hospital, for standing up for a mentally-ill patient in what appeared to myself at the time a breach of patient’s rights. I could not bear to stand and watch the scene unfold as to do so would be to tacitly support what was done at the moment, which to me, was ethically unacceptable. Yet, I was afraid- afraid of being judged before my classmates, of being embarrassed, of being thought as trying to be a hero. I suffered a terrible struggle within me before finally making myself heard, my tiny petrified voice shivering in the procedure room like a withered leaf in a galestorm, knowing the terrible implications which would follow after overturning The Immutable Laws of the Universe by challenging The Terrible Hierarchy of The Medical Kingdom, especially since I was in the class of The Minions. But I could not do nothing. So I did what I thought was right- to make a stand. The managing team was shocked at my… perhaps audacity would be a fitting word.

The patient received the due treatment but things became sticky after that, and a couple of meetings were needed to clarify, explain and diffuse the situation. I had expected to be dismissed or reprimanded, but the students-affairs doctor was fair and just, listening to both sides. In the end, the misunderstanding was clarified, my concerns and feedback addressed, and we were assured of the patient’s best interests.

My stand was that just because the outcome would be the same does not mean we overlook the process, forgo the basic human compassion or dignity a human being deserves and over-ride the requests of the patient-at that point, the patient expressed the same view too; their stand was that since the outcome would be the same, efficiency would have to be priority, no matter what lay between them and the final destination, for every often, delays in treating mental patients can lead to worse outcomes. It was a very, very intense and difficult situation for all sides.

I have no doubt the managing team had the best interests of the patient at heart, and I have deep respect for the work they do- the conflict lay simply in the tension between the utilitarian/realist/them versus the foundationalist/idealist/me. And it also lay in the fact that I was asking Why in a place where nobody asks why simply.

My question to them was if the manner in which what was done could have been different. The dilemma was that the utilitarian would argue that sometimes an iron rod serves better, more efficiently.

I am learning, that Efficiency is both a powerful and terrifying word because of the kind of people it makes us.

I kept wondering if I should have done what I did, said what I said, after knowing how much hoo-hah and inconvenience this matter had caused among the staff. Fortunately, my peers weren’t affected-most don’t know what ensued. I kept wondering, kept going through the situation in my head over and over…but the same ending played repeatedly, still. Had I not spoken up for the patient, or had chosen to speak up only after what I thought to be unjust had been done, I think a part of my heart would have hardened and died forever. Had the incident been played out a million times, I think I would have done the same thing, because not doing so for whatever reason at the time would have compromised my values, the same values which I brought into the medical interview room when the board interviewed me and which I hope to carry throughout the rest of my medical career, for myself, for my patients and for the people around me. Not doing so would mean I was more comfortable to hide in the crowd than to stick out to be what might seem to others, an alien.

I got myself into a bit of hot soup, but I learnt a lot through the process, things which I will treasure for a long time and which I would not have gleaned had I chosen the easier, more cowardly option of unquestioningly accepting everything going on around me. Perhaps I could have reacted differently, but replaying the situation over and over, I could not quite see any other way which would have been true to what I held on so strongly to- values of respect and humanity.

I must confess, I am an activist, and I am used to bringing myself trouble when making a stand. I would rather make the stand and take the risk than not at all. I remember I once forgo-ed the opportunity to defend a patient because I was afraid of He Who Is Too High to be Named- it saved me a lot of trouble because who knows what would have happened had I challenged His Highness in front of everyone, but I will never forget that incident, never be able to explain my cowardliness to stand up for what I had thought was right. There were other incidents during other attachment postings too, events which left me feeling dead and jaded about the medical profession, times which I wished I would have stood up to say or do something.

Perhaps this foolhardiness will never wear off. And for some silly reason, I hope it does not, either, even though I know I risk getting into greater trouble someday.

Conflict brings opportunity for discussion, for depth, for exploration. I think it is a worthwhile path to take, albeit a less convenient and painful one.

To be truthful, as I walked home from the hospital, I felt really crummy inside after receiving a call that the doctor from the student-affairs department wanted to see me the next day. The word which had gone round among the staff was ” Student tried to stop procedure: First time in History.”

I felt damned, doomed to die in embarrassment the next day. And as I sulked, I suddenly remembered what an author (MP Prof Thio Li-Ann) had shared with me at her book launch some months ago. She didn’t really know me but after a short chat, told me to read the book of Jeremiah of the bible.

Like the prophet Jeremiah, she said she recognised that I, too, like Jeremiah, had the heart of a whiner because of the sense of haven God had placed in my heart and my earnestness to watch that haven being played out in reality. Jeremiah was stoned for standing up for his ideals and for righteousness. He also had a thoroughly miserable life because of it. I remember being very shocked when she said that, because she has been the third person in the last year to tell me that they saw Jeremiah’s life in mine.

Trust me, this isn’t easy to swallow- Jeremiah had a hard life- he was stoned and trodden upon for standing up for what was right, and his life was full of pain, tears and sorrow because of it. The book of Jeremiah speaks to me and stings me in many ways, not least because people have spoken it over my life, but because God had spoken directly to me about it too. A few months back I bought a book called Run with the Horses because ha, I liked the title and cover page, only to realise it was about the life of Jeremiah too.

And now that I’ve discovered my love in Obstetrics and Gynaecology, I am beginning to see how, in trembling and fear, how I may be “stoned” for the rest of my life for making certain stands about abortions and the rampant unethical practices that human beings have come up with to own and discard children like commodities. I even once considered not doing O&G because of what treacherous ground it is, even tried to convince myself I may find something else to pursue, something where I wouldn’t need to stick out like a sore thumb for making a stand.

So that afternoon, in tears for a bit because of fear, I read the first chapter of Jeremiah.

In fear of being stoned, Jeremiah had pleaded with God, “Ah, Lord God! Behold I cannot speak, for I am a youth!” I felt the same way that day, feeling thorougly stupid and worried that I had screwed up big time. Me and my big mouth and my stupid activism.

But God told him, ” Do not say, ‘I am a youth,’ For you shall go to all to whom I send you, And whatever I command you, you shall speak. Do not be afraid of their faces, For I am with you to deliver you.”

So I straightened myself out and chided myself for being such a coward. If I had stood up for what I had thought was right, then what was there to fear? But facing a panel of doctors can be awfully scary, especially when you know you have crossed The Untouchable Line. So I read it, over and over.

Two sessions of talking with the doctor in charge of student affairs. Some glares from staff who had misunderstood my intentions. A couple of email correspondences. And finally, resolution. And through it all, my trusting in God to stay calm enough to explain myself and defend my values because of those few verses I had read.

I learnt a lot from this experience-the challenges and implications of dealing with mentally-ill patients, the dilemma and trauma and physical assault which hospital staff have to deal with, the armor of valor which they continue to wear in spite of such a thankless and difficult job. I learnt that right and wrong is not as clear as black and white (please don’t go away thinking our healthcare staff do not treat our patients right-they do the best they can in the way they know how, and as I said, right and wrong is often in shades of grey.) I learnt that there are many ways to put the patient’s best interests first- and that can vary from person to person, depending on what ideals you hold on to.

But I also learnt that healthcare professionals have feet of clay. That they are human, and therefore imperfect-myself included.

But would I have done things differently? The answer still remains, no.

Because then, I would have betrayed the values which I so claim to live by, shortcircuiting the process which, when worked through, reveals lessons and truth and depth which grows the spirit to explore, question and to better ourselves as a medical community…

… for an outcome which, yes, no doubt would have been the same anyway.

But you see, it’s the Process which counts. Just because the outcome is the same doesn’t mean we can’t choose to do things differently, allow the process to shape and mould us.

After the drama ended, the doctor conveyed to me:

Thanks Wai Jia for your mature email. I have spent some extra sessions to diffuse the situation, things are okay now… Thanks again – you are good student. I can tell you care a lot for patients and that is much to be desired. Have a good career.

-Dr A

Even if I had the chance to, I wouldn’t have changed a thing.

Don’t allow the world’s praise to attract

Or its blame to affright you

From the discharge of the duty

You owe – to God, to yourself

Or the souls of those about you.

God will take care of your reputation

If you make His glory

And your own duty – your sovereign aim.

– William Booth,

founder of The Salvation Army.