Friday, July 18, 2014

Be ballistic please!

There has been much controversy generated by a single tweet, one by broadcast journo Maki Pulido and her perception of the lack of compassion among health service providers at the Philippine General Hospital (PGH).

We’ve long known that social media easily gets the nerves of people. The problem is in a 21st century world devoid of wit and almost all of satire, these little microblog phrases do more than surgery. They do vivisection and expose the illness and its pathology if we may, and in the process killing the patient. In a more literate age, another physician did a similar thing. Dr Jose Rizal did not pen a tweet, but what made for tweets or blogs in 19th century Spanish Philippines are novels and essays. They killed Doctor Rizal who was essentially a messenger. But unlike Ms Pulido the journo, Dr Rizal had what we now call post-residency training. He was part of the medical fraternity. I never heard of an account that a physician went ballistic over Dr Rizal’s diagnosis. Perhaps it was professional courtesy.

Dr Rizal likens the disease as a cancer, then as much as is now, an incurable disease. He made the only prescription possible given the state of medical science at the time.

Dr Rizal wrote on his prescription pad

“I will do with you as the ancients did with their afflicted: expose them on the steps of the Temple so that each passer by would invoke the Divine and propose a cure”

And so the illness stinks and stinks like a diabetic foot or a carcinoma in which the flesh had started to suppurate.

My work rarely brings me to PGH and in the few times I went there (aside from a medical procedure), it was to give talks about rapid environment changes to physicians. Since some of the doctors were once my students in undergrad courses, they welcomed me and showed me around. Since I am a scientist, I have this insatiable curiosity to learn about the conditions of the hospital. And noting an unpleasant smell, I asked what was that. The resident doc told me it was what they call “diabetic foot”. And so that was my nose-opener. It was not that new. I am no stranger to bad smells. In one post assessment of a disaster, I have known the scent of decomposing human bodies.

I did not extend my visit beyond what was required since the doctors had to attend to their duties. But it was not long enough to comment if the doctors were compassionate enough. But it was long enough to comment about the facilities of PGH and the great lengths the physicians go to provide basic medical care to indigents.

And here is where that issue of compassion goes. The crux of the matter is that compassion to a health provider is different to the compassion, or what is thought to be compassion by the lay observer or by the patient. Western medicine is built upon objectivity in diagnosis and in treatment protocols and in assessing the health outcomes. Here is where compassion of the doctor must be seen. When one of these is awry especially the last, doctors get troubled and in the last they may raise their hands in frustration. Like Doctor Rizal and why?

My curiosity to know more about it made me pick up a copy of Dr Ting Tiongco’s memoirs of PGH life in “Surgeons do not Cry”. If one wants to know the context of compassion in PGH, I would suggest he/she reads Dr Tiongco’s book.

With this, I do not blame the physician for reacting the way she did and whose nerve got nicked by Pulido’s tweet. In frustrated words; she essentially made Rizal’s diagnosis. The question is what the cure should be? Should mere “exposition of the Temple’s steps” be enough?

I am of the opinion that Ms Pulido was just as frustrated enough as the doctor was. Analogous to a doctor’s job, a journalist has certain diagnostic jobs to report what is there, the feel good stories and the stories of corruption that make listeners and readers rise in anger.

And so the doctor and journo did Rizal’s job and exposed the afflicted on the Temple steps. However what kind of cure can netizens propose aside from likes and memes?!?

For starters, the whole Philippines is a PGH, if you keep your eyes, nose and ears open. I am an environmental scientist and has been to this PGH of islands and likewise like the physician, I raise my hands in frustration when I learned that the reason why there were decomposing bodies is because when they were alive, they had no choice but to live in that hazard prone area. Why?

I rage when social media hypes of Laboracay at the beach when at the same time I am on a remote island beach better than Boracay, to assess an environmental problem related to some capitalist environmentally damaging investment, but the welcoming party are smiling but tubercular and obviously protein malnourished kids. Why should they be tubercular in an age of Facebook? My grandmother finished her nursing degree at PGH during the American colonial period and she treated tubercular children in the same hospital. I remember her calling this condition with its ancient Greek name “pthisis”. She caught it at the hospital and she had it until her death. And yet children are dying of the same disease when people complain of slow Internet speed. When I joke of the Laboracay camp when the revolution is triumphant, it’s not just tongue in cheek!

I can give an endless number of examples. But one that makes me extremely ballistic is this. I rage at the middle classes who suggest that poor people deserve the kind of services they get (including PGH) since they don’t pay taxes. And they do pay taxes at every cup noodles they buy while their children fall victim to infectious diseases the rich and middle class need not worry about. And the children should not be subsisting on sodium rich cup noodles for in the future they would need dialysis machines.

And so what’s the cure for the disease? Where is justice? Perhaps only when the government criminals have no choice but to seek hospital arrest in PGH! Whether that be from hypertension, some gynecological condition or mere hysteria. Taking from Dr Rizal, Dr Ting Tiongco gives what I believe is the right prescription

“Drag them screaming to the people’s court to account for the injustices”

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