Medical dramas

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Friday, August 8, 2014


IN CLINICAL practice, health professionals inevitably touch not only the biophysical aspects but also all the other affairs of their patients that come to the practitioners’ knowledge.

From signs and symptoms to financial constraints and alleged concubinage are the bedside matters that concern the health professional.

And somewhere along line, he or she must cope with the reality that the patient is not merely a ‘dysfunctional’ organism needing healing or repair to regain ‘homeostasis’ or balance but also a social being whose behaviors are mediated, compelled and inhibited by such sociological factors as income, class, education and most importantly, social interactions within and outside social structures.

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Having studied Sociology and Anthropology at graduate school has opened my sociological eye to see how social structures greatly influence health and health behaviors of the population.

As far as the Filipino culture is concerned, among the many social structures that greatly impact health and the patients’ ability to recuperate is the family.

Perhaps that explains why a good number of physicians advocate partnerships with family members of the patient or the so called ‘significant others’ (SOs) to make treatment a success.

And this may well explain the drama associated behind the success or failure of the medical treatments received by the patient.

The last eight years of my nursing practice—hospital, community and academe—have taught me that healthcare providers must have some degree of impenetrability to human emotions especially during the times when the angel of death is just around the corner waiting to claim lives in the most insidious and enigmatic ways figuratively.

But this may be a characteristic or skill, if one must call it as such, that is difficult to build especially when human emotions—stress, separation anxiety, anger, denial, etc.—dominate the clinical areas as death strikes its horrific axe on a patient whose life is dangling by the edge to let him or her fall like a piece of rock falling off the cliff.

Most novice healthcare professionals couldn’t agree more in sharing the piercing experiences of either over the demise of their patients or witnessing the human suffering unfolding before their very eyes.

Human suffering, be it physically, emotionally or psychologically, is as palpable as the beating of the heart that is felt through the pulses.

Yet, ironically, it is one thing that is often neglected, or put in a fair light, something that is reduced to physical manifestations—headache, fever or chills.

The real picture of human suffering encompasses such seemingly surreal variables as unmet material, emotional and psychological needs of the person.

On the other hand, medical dramas may present itself during the active phase of dying of the patient.

For newbies in the health professions, the feeling can be one with ambivalence, of guilt, of dissatisfaction and shame of not being able to save or at least help someone when the reason for the existence of a health profession—medicine, nursing, etc.—is to be such to begin with.

Worst, the sight of the SOs weeping over the demise of their loved one can be heart-wrecking and as traumatic as it can be.

As I count the years that I have been in practice, I occasionally spot this collective feeling among those new in their craft and among students of health professions: they feel sorry for the deplorable situations that the SO of their patients find themselves.

Some books refer to this feeling as empathy. Others label this as sympathy.

But for mental health professionals this is ‘counter transference’: a state wherein the health practitioner develops a sense of concern beyond professional boundaries.

Furthermore, the development of this state varies from the over development of rapport between the professional and the patient to the ignition of personal affairs.

But maybe this is among the price health professionals must pay apart from the long years of schooling and training.

In another vein, those who had been too long in practice had well overcome this state of counter transference.

Instead, they had grown impenetrable to empathy and rather choose to redefine professionalism
by reducing to it to treating patients like a malfunctioning equipment or device and undermining the human element of holistic approach.

These are the likes of health professionals who have become numb to human suffering and are seeing their roles as something customary and a matter of routine.

In fact, they have grown insensitive to the genuine needs of the patients. These are type of doctors or nurses common in our setting today.

This phenomenon is no less than a paradigm shift from focusing on the ‘bedside’ to focusing on charts, papers and medical bills giving less and less face-to-face contact with the patient.

And this kind of culture is slowing corrupting the once hailed Filipino culture of genuine care among health professionals.

Where is this medical drama now? Has the theatre finally closed its curtains to end the show staged by the heroic Filipino nurses and doctors?

[Email: polo.journalist@gmail.com]

Published in the Sun.Star Cagayan de Oro newspaper on August 08, 2014.

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