THE CALLING...

As the doctor's strike bites across Kenya, we are all anxious for various reasons. A three week strike notice did nothing to avert this ugly eventuality and today we are at the point where the doctors union and the government of Kenya are standing face to face, waiting to see who will blink first.
 

This is going on amidst intense pain among the citizens of this country, whose options have been severely limited and the threat of death is real. It therefore follows that everywhere I turn, the question everyone asks me is, 'Medicine is a calling, how can you stand by and watch patients die?'  

Today, I would like us to unbundle this myth.
 

Medicine is a profession, and yes, that profession is a calling. For one to answer to a calling, one must make massive sacrifices. In this profession, the sacrifices are clear. The hard work in medical school, the long grueling work hours, the loss of family ties and friends at large, you name it. We haven't even began to discuss the emotional turmoil one lives with. We maintain a tight upper lip when things are falling apart around us and come to the realization that this part of the curriculum didn't exist in medical school.
 

Do doctors take a Hippocratic Oath? Yes! Do we abide by it? Yes, yes and yes again! So you ask again, how can I stand by and watch patients die?
 

There is a world of difference between a profession and a career. The two words are not synonymous. According to the Oxford English dictionary, a profession is a paid occupation that involves prolonged training and formal qualification. On the other hand, a career is an occupation undertaken for a significant period of a person's life with opportunities for progress.
 

As a professional who chose the path of medicine, it is my responsibility to train adequately to achieve the requisite qualifications. This profession is clearly stipulated that it should pay.  

Every professional has a choice of what career to pursue. So, with my qualifications, I can choose to treat patients. If I so do make this choice, then by all means, I must do so to the best of my ability with utmost dedication in line with my calling.
 

On the other hand,  if an employer then chooses to engage my skill set to see patients that he has promised to deliver health services to, then my signing up with the employer is a career choice. I am in it for a defined period of time, with clearly defined expectations on remuneration and career progression. The employer is solely responsible for his patient while I am responsible for application of my skill with dedication befitting of the calling. Where we disagree on the rules of our engagement, I walk away and the employer's patients are left with the employer.
 

Despite my profession, I can choose a career in marketing or in the arts. This does not change my profession. Choice of profession does not mean you are chained to it or that you are chained to the employer.
 

So in that case, how does the Hippocratic oath fit in? When I sit in front of my patient, the Hippocratic oath is between me and my patient. When I leave the room having given my all,  I leave it up to those responsible for managing the health system to fix it. There is no doctor in this world who takes their patient home with them at the end of the day. This is despite the fact that we take our emotions home with us every day; the pain of losing a patient, the anxiety of waiting for the patient's condition to turn around, the sorrow of knowing a patient is dying a horrible painful death, the disbelief of losing a newborn baby and the bitter realization that we could have done better of only we had the resources.
 

Simply put, my profession is a calling, yes. My career on the other hand, is how I make a living!!
 

Any doctor working in the public sector is a career civil servant. They are not demanding payment because of the profession. They insist that their pay must be commensurate to the skill set they offer. This is because they would like to remain in the public service career for a while. The public sector doctor is fighting to improve career terms. At no point has this doctor compromised professionalism!  

So, how can I stand by and watch a patient die? Together, let us direct this question to the right entity!