I don’t know why I’m spending this precious Saturday morning writing this letter to a naive junior colleague who is currently working a few thousand miles away from this hell. Perhaps I feel obliged to tell him, or whoever feels that this is worth reading, what this so-called “system from hell” has made us what we are now.

First I have to say, I may have written this post:

https://mariakamalmilatu.wordpress.com/2013/09/21/what-the-public-doesnt-know/

…which may have sounded like just a bunch of complains to some of the readers, feeling that probably I (and many other doctors around me) have lost our integrity, our honesty, to serve the people.

But then, I also wrote this:

https://mariakamalmilatu.wordpress.com/2014/03/02/a-day-in-a-doctors-life-in-remembrance-of-allah-swt/

…because as Muslims, we have our purpose in life, and we need to remind ourselves about it every once and then. It is with this remembrance that we could get back our spirit and motivation to go through fulfilling our responsibilities as true Muslim doctors.

You see, adik, I am, like, you, an overseas graduate. My name is followed by MB BCh BAO (Ire), and I hope, soon it will be followed by MRCP (UK). Not yet, but striving for it. I took a loan from the government and guess what, I’m still paying for it. I could have worked overseas as I am not totally bounded, but I chose “hell” instead. I am also paying for my exam cost in British pounds, with my own hard-earned ringgit.

Is this truly a hell, though?

Those were our thoughts before we start housemanship. We were scared by our seniors who decided to stay back overseas because they heard it is hell here. They have never worked here, so how would they know?

Of course, it was not entirely wrong, but neither was it entirely true!

Yes, all of us wished for shorter working hours. All of us wished that we could go home the morning after being on call. All of us wished we had shift system. We all know how working overnight affects us, we have experienced it, we have tried to do something about it, and things have improved, you see.

You may have noticed that culturally, Malaysian and British are different. I am sad to say that we are more manipulative and cunning in a lot of ways, hence ANY system at all would not be perfect if we aren’t good INSIDE.

If you are responsible, any system is good.

But if you were born with a silver spoon in your mouth, brought up having had everything you ever wanted given to you at your doorstep, you would probably grow up thinking that the system should change you. You would end up believing that a perfect system is the only way to cater a good healthcare.

That’s where you’re wrong, adik.

I have to admit, we have all felt frustrated before. Those who have worked in university hospitals would feel frustrated with the lack of service they could offer in a district hospital. Those who started working in a first world country would feel deeply frustrated that the system is not as “perfect” as it was back there in those cold (and wet) countries. Even for myself, who have only worked in two specialist hospitals, have felt some frustration about the service that we have.

Now THAT lack of service bred different kinds of doctors we have in this country.

Some stay back passively and just go with the flow.
Some work hard to spark a change and make the world a better place for patients and healthcare workers alike.
Some quit their jobs to look for greener pastures.

Nobody is wrong in this sense, we all have our own lives and problems to think about.

Before I go any further, I would like to remind you that I’m not saying we should not improve. I’m not saying that the system is unchangeable.

I’m talking about what we should do while change is happening.

I don’t know whether you were a student paid by the government to study in the UK. If you were, then you were obliged to come back and serve the people, like your other friends.

Do you know why you were sent overseas to study?

Or let me rephrase that. Do you know why studying overseas is actually good for you?

I’m sure you were blessed with some degree of intelligence, that you were accepted into a scholarship programme. With that intelligence, you were expected to learn from the mat sallehs and BRING BACK all those good things that you have learnt over there.

Studying overseas opens our eyes to a lot of possibilities, experience, discoveries, and teaches us to maturely appraise a system for the benefit of the patients. The British text books even taught us how to deal professionally with the juniors, with the nurses, with our senior colleagues. Have you come across those texts yet?

So instead of loudly wanting to slap the senior doctors over here, why not do it the mat salleh way? Talk it out in a professional manner, discuss the ways to improve working conditions, and help out each other so that better healthcare is delivered.

You see, adik, a good healthcare is not just about better working hours or conditions. It is up to you, deep inside, to serve your people in the best way that you ever could.

We were blessed with good grades in school, and to some, it signifies intelligence. But for me, intelligence does not mean a thing if we expected to be served by a “system from paradise”, rather than trying our best to help the people, with whatever we have in hand.

There are people on the top level who can’t prioritise on which sector needs money the most. There are those who think more of entertainment than the health of their people. Sadly there is not much we could do at this particular moment to change their attitudes. Personally I think our best bet is by educating the younger generation to make decisions wisely and campaign against corruption.

What does that leave us with?

OURSELVES.

You probably have heard this quote before: “BE the change you want to see in this world.”

You have not worked here, so you have not met the various amazing consultants who work in government hospitals. You have not met those who have served decades in this “hell of a system” and made a difference wherever they go. You have not met those soft spoken gentlemen, those hardworking ladies, who lead their departments and made the most out of the little budget given by the government.

You have not met those who actually go out of their way to train themselves overseas with their own hard earned money, and come back to be a better surgeon.

Even the not-so-senior ones like me and my colleagues, we are trying to train our juniors in the best way possible. We are trying to be more patient, despite the poor attitude shown by some of our juniors. We strive to be more professional, unlike those horror stories that you heard from here. Of course there ARE seniors who still speak unkindly to the juniors, letting out rude words, attacking personally rather than correcting someone in a proper way.

A good healthcare is not only provided by giving the best medications and equipments, from the freshest looking doctors who work 60 hours per week. Obviously, that would be really great, I would welcome that with open arms and a happy heart.

There is so much more to job satisfaction than just working hours or conditions. It is also about seeing that smile from them after we have tried our best to improve their health, about sitting and talking to them about what has happened in their lives that made them stop caring for their own health, it’s about empowering the patients to get up and work hard for a better life.

It’s also about talking to the loved ones when the worst is coming, preparing them, getting them to come together, make peace with each other and say their final goodbye, or even encouraging them to write their wills, so that when the end is reached, there is no more guilt.

You could work in any perfect system, but still be unhappy and frustrated, as proven by many horror stories that we could hear from the UK.

Or we could work in a seemingly imperfect place, but still be happy and satisfied because we know that we have done to the best of our abilities to help those in need.

In the end, it all comes from within.

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