The last blog post I wrote was a staggering four months ago! I completed medical school, amidst the university strikes, had a brief holiday with my family, and then begun the big world of internship. My past two months as a newly qualified doctor have been a baptism of fire – I have grown immensely as a medical professional, but also as a person psychologically and emotionally. And as much as I am grateful for what this two-year experience will teach me, I am equally frustrated with the healthcare system in which I have to practise, leaving me in a mental torment with the question of “am I really helping anyone?”
I started in paediatrics. For those who are unaware of how the South African medical internship process works, here is a bit of a summary: for two years after graduating as doctors, we have to complete two years of practical training in a hospital where we rotate every four months between disciplines to get a wide range of experience. After this, we complete a year of community service, and only after that are we allowed to practice independently in this country. In reality, due to understaffing and frozen posts, many interns are actually practicing independently from day one, with little to no senior consultation. But back to paediatrics… I was truly thrown in the deep end. I started in the nursery with very tiny sick babies; I was called to five emergency Caesarean sections on my first day in which one baby had to be resuscitated, and my first 27-hour call in nursery was in my first couple of days as an intern. I learnt quickly. With over 100 babies falling under the neonatal team’s care, putting up drips and taking bloods from the most minute veins never seemed to end.
But it did. After a month of nursery time, and ears deaf to cries that I couldn’t relieve, I rotated again to the paediatric outpatients department (i.e. clinics). With no booking system to speak of, patients streamed in every day to get help for eczema, TB, epilepsy, cerebral palsy, behavioural problems, asthma, and other weird dermatological conditions. We see them, make a diagnosis (or a best guess in the case of derm!), and send home with treatment… with the unlikelihood of ever seeing them again. Because next time they come, they will be placed in the queue, and any other doctor will see them… not me.
And so, as I do one more blood, fill out one more admission form, discharge one more patient and tell them when to come back to the clinic to follow up, I am left disappointed. Thousands of patients being failed by the system – not only the healthcare system that prescribes treatment for what are really just symptoms of an underlying issue or biochemical process, but also the bigger socioeconomic context, the environment that they go back to when they leave the hospital, only to return in a couple of weeks with the same issues. And I don’t have the answer to the bigger problem at hand – I don’t know if it works better in other more developed countries, but I have a suspicion that it doesn’t. We live in a society of abuse – alcohol, drugs, food, stress. We have no pride in our health, physically, emotionally, and psychologically. And disease is the manifestation.
I listen to many health podcasts and I am excited about what could be the future of medicine, if the barriers to entry were lowered. What if we could run stool micro biome and urinary organic acid testing on patients? What if we could pick up dysfunctional underlying biochemical processes or unhealthy guts? What if we started giving probiotics to children with eczema, instead of steroids? What are the possibilities? Right now, we don’t know… because the medical fraternity are stuck up and stubborn; they laugh when I challenge the notion of cholesterol and heart disease, or suggest coconut oil as an anti fungal. But I won’t give up. Two months of internship have cemented my desire to study functional medicine, and after two years I hope to start changing what people demand from doctors – not an antibiotic, but a stool test and a probiotic. And if I’m lucky, maybe one day I’ll be working with a population I identify with: athletes.
So here’s to fulfilling dreams and making a difference. Until next time xx