正文
I have just finished four evenings in emergency at Ryde Hospital, part of the North Shore network, with minimal sleep over the long weekend. I am a mere intern, fresh out of medical school, driving with a learner\'s licence, but driving nonetheless.
Recent events at Royal North Shore Hospital and its aftermath have brought tremendous sorrow into my life. Sorrow for the mother who miscarried, sorrow for the hospital and sorrow for our health profession. What is more unfortunate however, is that the event has become a platform for politicians to campaign while the real problem disappears into the background.
There is no doubt that what happened to Jana Horska was a tragedy. Miscarriage at any stage is a harrowing experience and you do not need medical training to appreciate that.
We live in a time of medical miracles. Heart attacks can be prevented and stopped as they are happening, degenerating hips are replaced with synthetic ones, cancers can be beaten into submission through chemicals. But we are helpless in effecting change in the early period of pregnancy. There are no absolute predictors for which pregnancy will proceed and which will terminate. Such is the nature of conception. Mothers are usually fit and healthy. Telling them that something may go wrong is exceedingly difficult.
For better or worse, our emergency departments are designed for emergencies. Patients are categorised by severity and reversibility. It is unfortunate but necessary. Patients who may die from a easily reversible condition are given priority over patients who we are helpless to assist.
In an ideal world, Ms Horska would have been placed into a bed and protected from the ultimate horrors that ensued, but hospitals in their current form cannot provide that. We as health professionals have no control over who receives a bed. Guidelines and codes determine which patients receive a bed.
The attempt to categorise human suffering has led us ultimately to this destination. Having spent all my student years at Royal North Shore Hospital and feeling like I was part of a family, I have watched it degrade over the past five years. It is no secret that many hospitals are underfunded and under-resourced. Budgets are exceeded each year and the response by the bureaucrats is to give less. This will encourage less spending over the next financial year as workers attempt to be more fiscal at a cost to patients. Thus reports of budget blow-outs are often misrepresented because hospitals have less to work with each year. Hospitals are not businesses and yet are managed as such with boards and chief executives. Patients are not profits and yet economic models are applied in attempts to manage them. These are the cards we are dealt everyday.
There is a belief that we practise medicine for financial gain yet, any doctor working in today\'s health system will laugh when this is suggested. I am not implying that doctors are scraping the poverty line and most do live quite comfortably. But the sacrifices made to attain that level of comfort come at the expense of their own families and their own lives. Thus the real reward in medicine lies in the ability to help another even if there are difficulties in expressing this undeniable truth.
I was completing a research masters at Cambridge when my professor discovered I was finishing to pursue medicine. He laughed and tried to dissuade me. What would you rather, Phil? he asked in a typical pompous British accent. To affect the life of one? Or the life of millions ?
I chose the life of one. The doctors, nurses and health workers I have encountered at North Shore and elsewhere have served to confirm my initial decision. I can confidently say that most I have encountered hold the above ideal true.
This ideal is what brings my colleagues and myself into work every day, to face abuse from patients for an article they read that morning, to go through shifts of 14 hours or more without breaks and to find increasingly that we have less to work with. This ideal and its current state forms the basis for my compulsion to write and make an impassioned plea.
As the hype settles and the blame game takes its turn moving around the board, I hope the real issue resurfaces. What happened with Ms Horska is the tip of the iceberg of faults that exist in the health system and not just at Royal North Shore Hospital. Inquiries and articles blaming doctors, nurses and health workers may satisfy the anger of the mob, but it will never effect change.
In a period of prosperity, the resources of hospitals and universities have dwindled. Politicians will debate the foibles of my colleagues and seniors, shifting blame and providing a smokescreen to the truth. I love my job and medicine in spite of the system and I can attest that many of my colleagues feel the same. Yet the current system has drained the passion away from so many, turning them apathetic as they are blamed for actions beyond their control.
The media have tremendous power and effect. Effect that can be directed towards change and empowering individuals. Effect that is lacking in current stories about blame and fear
Recent events at Royal North Shore Hospital and its aftermath have brought tremendous sorrow into my life. Sorrow for the mother who miscarried, sorrow for the hospital and sorrow for our health profession. What is more unfortunate however, is that the event has become a platform for politicians to campaign while the real problem disappears into the background.
There is no doubt that what happened to Jana Horska was a tragedy. Miscarriage at any stage is a harrowing experience and you do not need medical training to appreciate that.
We live in a time of medical miracles. Heart attacks can be prevented and stopped as they are happening, degenerating hips are replaced with synthetic ones, cancers can be beaten into submission through chemicals. But we are helpless in effecting change in the early period of pregnancy. There are no absolute predictors for which pregnancy will proceed and which will terminate. Such is the nature of conception. Mothers are usually fit and healthy. Telling them that something may go wrong is exceedingly difficult.
For better or worse, our emergency departments are designed for emergencies. Patients are categorised by severity and reversibility. It is unfortunate but necessary. Patients who may die from a easily reversible condition are given priority over patients who we are helpless to assist.
In an ideal world, Ms Horska would have been placed into a bed and protected from the ultimate horrors that ensued, but hospitals in their current form cannot provide that. We as health professionals have no control over who receives a bed. Guidelines and codes determine which patients receive a bed.
The attempt to categorise human suffering has led us ultimately to this destination. Having spent all my student years at Royal North Shore Hospital and feeling like I was part of a family, I have watched it degrade over the past five years. It is no secret that many hospitals are underfunded and under-resourced. Budgets are exceeded each year and the response by the bureaucrats is to give less. This will encourage less spending over the next financial year as workers attempt to be more fiscal at a cost to patients. Thus reports of budget blow-outs are often misrepresented because hospitals have less to work with each year. Hospitals are not businesses and yet are managed as such with boards and chief executives. Patients are not profits and yet economic models are applied in attempts to manage them. These are the cards we are dealt everyday.
There is a belief that we practise medicine for financial gain yet, any doctor working in today\'s health system will laugh when this is suggested. I am not implying that doctors are scraping the poverty line and most do live quite comfortably. But the sacrifices made to attain that level of comfort come at the expense of their own families and their own lives. Thus the real reward in medicine lies in the ability to help another even if there are difficulties in expressing this undeniable truth.
I was completing a research masters at Cambridge when my professor discovered I was finishing to pursue medicine. He laughed and tried to dissuade me. What would you rather, Phil? he asked in a typical pompous British accent. To affect the life of one? Or the life of millions ?
I chose the life of one. The doctors, nurses and health workers I have encountered at North Shore and elsewhere have served to confirm my initial decision. I can confidently say that most I have encountered hold the above ideal true.
This ideal is what brings my colleagues and myself into work every day, to face abuse from patients for an article they read that morning, to go through shifts of 14 hours or more without breaks and to find increasingly that we have less to work with. This ideal and its current state forms the basis for my compulsion to write and make an impassioned plea.
As the hype settles and the blame game takes its turn moving around the board, I hope the real issue resurfaces. What happened with Ms Horska is the tip of the iceberg of faults that exist in the health system and not just at Royal North Shore Hospital. Inquiries and articles blaming doctors, nurses and health workers may satisfy the anger of the mob, but it will never effect change.
In a period of prosperity, the resources of hospitals and universities have dwindled. Politicians will debate the foibles of my colleagues and seniors, shifting blame and providing a smokescreen to the truth. I love my job and medicine in spite of the system and I can attest that many of my colleagues feel the same. Yet the current system has drained the passion away from so many, turning them apathetic as they are blamed for actions beyond their control.
The media have tremendous power and effect. Effect that can be directed towards change and empowering individuals. Effect that is lacking in current stories about blame and fear
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