Saturday, 23 October 2010

Doctors and Others Work Ethics and Happiness

I was extraordinarily lucky to have had my medical education divided between three countries:
London in England, a medical model still paying attention to the great masters of the past while trying to provide equitable care to all
Australia, where the average person started the conversation with the holidays they just had or the holidays they were planning or dinner parties. I enjoyed the medical model of this country where they very cleverly used the young doctors as pawns, rewarding those who wagged their tails to the drools of the senior doctors, dark skinned doctors assigned jobs that no one wanted and the mediocre white doctors (the grand majority) of them guaranteed a cushy life of suburban life with no great expectations of life, except holidays in Noosa or an occasional medical conference in the USA or Europe. They were a bunch of imitators of American ideals, but without knowledge that American ideals were heading nowhere, and still clinging on to a system assuaged on its colonial origins.
United States of America (there are United States of Mexico, United States of Brasil, America is the name of the continent, and usurped name really on the back of economic might. Their revolution was one of the oldest in the world, their democracy certainly very old, older than France where the revolution arrived a couple of decades later)
Go West, Young Man, said Benjamin Rush, considered the father of the Limitless Western Medicine practiced in the USA with its boundless optimism and endless possibilities that leaves 50 million people without care and another 50 odd million afraid to get sick because of bills and people like Dick Cheney getting extraordinarily good medical care! One cannot help enthused by the eternal determination of the Americans and as such reflected in their medical system as well.
The first week I was at the Washington University School of Medicine to begin my career as an Endocrinologist; I realized that a communication barrier existed: None of the world famous doctors knew anything outside their very limited field; one even asked what Belize is? Not where is Belize? And I had no great interest in the finer aspects of the calcium metabolism of the trabecular bone. This lack of communication was to plague me for the next four years, until the American Indians, Jamaican Rum and Cuban migrants to Miami saved me...I can communicate well to the spirit world of the Indians, I liked the ambience created by the mindless bourgeoisie of Jamaica who had created an incredibly narrow cage for themselves made of Gold and thanks to the streaks of Cuban ness still surviving in the soul of the cuban immigrants, I became interested in the real thing, the island of Cuba, which became my home.
This balance between Knowledge, Dedication to Service and Solidarity and counsel of Ancient People brought a sense of balance, approaching something close to what one could call Harmony in life...
It was evident to me, I was not destined to be a doctor with a plush office full of waiting patients, No one would be willing to pay large sums of money to a doctor who specialized in talking about the society and the sicknesses it creates, no drug company would pay a first class ticket to Paris with a hotel room at George V to a doctor preaching Natural remedies, Ayurveda and meditation and Yoga whenever possible, in ADDITION to the limited mechanism and aetiology oriented medications supplied by the drug companies. I once asked my good Friend Daniel A, who is the President of the Diabetes Association in his country, Tell me Daniel, why are they treating you to Paris (first class tickets for two and a week at George V), his answer was frank enough: I prescribe more Vytorin (a drug not shown to be that superior to cheaper version to combat high cholesterol levels) than anyone else in my country. Go in peace, Daniel, you are my Family but can’t say that of another leech of the society, who manage to sneak into the private practice world of Medicine in Miami from an impoverished south American country, after a suitable absence of years and presence of accoutrements of superficiality, I met him at an Endocrine Society meeting, his first question was: what happened to our dreams? I am still living it, my dear friend; it is you who has given up. Then and there I made a point of never getting in touch with him again, a usurper of morality and leech on his own country where he was educated and sucking the innocent in Miami dry. He seemed very angry and disappointed at his friends, but he told me he had a plush office.
Because I have travelled, more than my share, I always maintain Frequent Flier status that brings smiles to the Airlines, and I am faithful to just one airline, so often rewarded with upgrades on transcontinental flights. Once sitting next to me on a flight from Madrid to New York was a young American man, of African descent, who couldn’t wait to open his computer as the flight took off. To be polite, I asked him, where were you in Spain? Valencia, he answered, but quickly added hoping to sore bonus points, but had no time to see anything and I only ate American type food at the hotel. I watched this pitiful specimen of the powerful nation on earth, seeing him work, for the six hours, while I drank champagne and delightful wines from around the world, danced in my head to music from Cabo Verde and reading Alvaro Mutis once again extolling the virtues of Maqroll el Gaviero. As we were disembarking, as a departing gesture to this most hospitable country I told him, why don’t you buy a plot in the cemetery and lie down and wait for death to arrive...
I don’t think he who prides in his hard work appreciated this comment from a champagne drinking, music listening book worm from the other side of the world.
No one could write more elegantly about the Pleasures and Sorrows of Work than the philosopher of everyday life, Alain de Boton. I am quoting the last page of his book in its entirety. He brings to light my own thoughts lying dormant, which I would have liked to have said to a good friend in New York, Istanbul born, and London Educated, an accountant, working for a prestigious accountancy firm which is rather a household name around the world, along with its competitors. In fact, one of the chapters on Alain de Boton’s book is about Accountants, this time he was given the opportunity to spend time with accountants at Ernest and Young, at their Head Quarters, and had a chance to interview the CEO, but Alain de Boton is a literary anthropologist who does participant observation and translates them into brilliant language, English, which we all love.
His words on Work follow, dedicated to those who take their slot in life far too seriously, a state of mind not congruous with good health.

Work does not by its nature permit us to do anything other than take it too seriously. It must destroy our sense of perspective, and we should be grateful to it for precisely that reason, for allowing us to mingle ourselves promiscuously with events, for letting us wear thoughts of our own death and the destruction of our enterprises with beautiful lightness, as mere intellectual propositions, while we travel to Paris to sell engine oil. We function on the basis of a necessary myopia. Therein is the sheer energy of existence, a blind will no less impressive than that which we find in a moth arduously crossing a window ledge, stepping around a dollop of paint left by a too-hasty brush, refusing to contemplate the broader scheme in which he will be dead by nightfall.
The arguments for our triviality and vulnerability are too obvious, too well known and too tedious to rehearse. What is interesting is that we may take it upon ourselves to approach tasks with utter determination and gravity even when their wider non-sense is clear. The impulse to exaggerate the significance of what we are doing, far from being an intellectual error, is really life itself coursing through us. Good Health encourages us to identify with all human experiences in all lands, to sigh at a murder in a faraway country, to hope for economic growth and technological progress far beyond the limits of our own lifespan, forgetting that we are never more than a few rogue cells away from the end.
To see ourselves as the centre of the universe and the present time as the summit of history, to view our upcoming meetings as being of overwhelming significance, to neglect the lessons of cemeteries, to read only sparingly, to feel the pressures of deadlines, to snap at colleagues, to make our way through conference agendas marked “11:00 am to 11:15 a.m.: Coffee break” , to behave heedlessly and greedily and then to combust in battle-may be all of this, in the end, is working wisdom. It is paying death to much respect to prepare for it with sage prescriptions. Let is surprise us while we are shipping wood pulp across the Baltic Sea, removing the heads of tuna, developing a nauseating variety of biscuit, advising a client on a change in career, firing a satellite with which to beguile a generation of Japanese school girls, painting an oak tree in a field, laying an electricity line, doing the accounts, inventing a deodorant dispenser or making an extended-strength coiled tube for an airliner. Let Death find us as we are building up our matchstick protests against its waves.
If we could witness the eventual fate of every one of our projects, we would have no choice but to succumb to immediate paralysis. Would anyone who watched the departure of Xerxes’ army on its way to conquer the Greeks or Taj Chan Ahk giving orders for the construction of the golden temples of Cancuen or the British colonial administrators inaugurating the Indian postal system, have had it in their hearts to fill their passionate actors in on the eventual fare of their efforts?
Our work will at least have distracted us, it will have provided a perfect bubble in which to invest our hopes for perfection, it will have focused our immeasurable anxieties on a few relatively small scale and achievable goals, it will have given us a a sense of mastery, it will have made us respectably tired, it will have put food on the table. It will have kept us out of greater trouble.

Finished writing in Paris 17 22
August 14, 2009
From memory I think on this day Paquistan became independent and on the 15th august, India became independent form the British rule in 1947..
Happy Independence Day!