I really love my job – I consider it such a privilege to be able to use my hands to transform lives. It’s a job that I’ve been steadily working towards since my 5th year of medical school. Nights being on call, exams every year, many extra courses and workshops around the world to gain specialised skills, lots of sleepless nights, stiff necks and missed family dinners. All worth it when I am able to tell a parent that their child’s hearing has been restored, that we got all the cancer out, or that they can speak again.
Of course, it’s not always happy endings. Sometimes the hearing impairment cannot be fixed. Sometimes my surgery is for the diagnosis of cancer, and with that the beginning of a difficult and painful journey for my patient and their family. And other times, all too often, it’s just too late. These are the ones that hurt the most. Where I know that had the patient made it to my rooms just a little sooner we would have had options. Sometimes the journey to our door does start early but barriers in the public health system mean the patient still doesn’t get care in time. There are situations where diagnostic equipment is not available, or staff so strained that waiting periods are too long. Within three months of starting at my last position the waiting list for ear surgery alone grew to over 100 patients and based on our workload that was a wait of over 7 months: for ear surgery for treatable hearing loss,. Some of these patients are unable to get work because they failed a hearing screening test – a failure that gets carried by their families. Some of these are children who are struggling in school because they just can’t hear the teacher well enough. These children may find themselves be ostracised because of the hearing impairment – it’s difficult to play soccer with someone who doesn’t hear their teammates calls for a pass. As a frustrated but committed public servant, I knew I needed to try to find a way to help this system that services some 80% of our population. The system in which I work, like so many other public-sector social services around the world, needed me, the practitioner, to gain some insight into its inner workings.
This is what drove me here to Oxford. I packed up my life and dove head first into this foreign world of business school. I sat in classes where google was my first friend in unravelling the lingo and acronyms – everyone nodding when the lecturer talks about EPOS and my confusion because, in my world, EPOS is the pivotal European Position paper on Sinusitis, not Electronic Point of Sale (thank you Google). Where the assignment brief says write like a management consultant – but I’ve never worked with management consultants. Where my classmates had job titles that puzzled me – in medicine its virtually impossible to be a consultant without specialising, and what on earth is an associate?
So every now and then I had to regroup – remind myself why I came here, and take stock of what I’d learned. I am quite confident that I can now sit with the CFO and have a balanced discussion about financial projections and budgetary considerations. I have a good idea of how I can formulate strategies for growth, for innovation and for change. I’ve gained insights into the global economic and political factors at play in my world.
Can I get my patients to see me sooner? Maybe not tomorrow, but I know that in the circles of influence I can now have conversations that move that wheel forward. Conversations that go beyond the medical lingo and incorporate a broader perspective. I am so grateful to my fantastic classmates who had to sit through my learning process, and many times ran “for-dummies” review sessions with amazing selflessness. I am thankful for those lecturers who had such a love for their subject that they were able to teach with passion and patience.
I am grateful to the ENT Department at the John Radcliffe Hospital who let me do a Clinical Observership with them – which meant I could spend time in the operating theatre and clinics, keeping the surgeon inside me happy, and have conversations with colleagues that felt like coming home. It was also somewhat comforting to realise that some public health system problems are universal – and those of us in the developing world are not as behind as we may sometimes feel.
As I start to pack my bags to return home I have been asked – has this year been worth it? Without a doubt – YES.
“Education is the most powerful weapon which you can use to change the world.”