East Timor Medical Elective - Week 4 (Part 5 / 6)

BPC'S 15TH ANNIVERSARY

Friday afternoon was BPC's 15^th Anniversary. It was amusing that Dr. Dan's Birthday was quite close to BPC's “Birthday”, and I asked a staff member if both have ever been celebrated together, in which she said “Yes, in fact most of the time!”

Cake for BPC's 15th Anniversary. The icing design is based on BPC's logo. Middle symbol is supposed to be a Crocodile, from the traditional East Timorese Legend of "La Faek".

The front door to the main building was covered with cloth / curtains, and a clothed table set up for the ceremony. The arrangement was simple yet pretty. I sat at the side of the main waiting benches. I felt like something big was going to happen.

A girl lights up the Candles before the Sermon starts.

The crowds gathered, and eventually the Padre/Priest showed up in his gown, starting his sermon. I was unable to understand all of it, but clearly he was quoting from the Bible and at some point discussing the “Catholic values” of love etc, and linking it with Dr. Dan's charity work. There was a bit I disagreed with however, when he followed the discussion of medical work by stating “La iha sakrifisiu, la iha hadomi.” ( “[If] there's no sacrifice, there's no love.”)

***WARNING – RANT, NOT DIRECTLY RELATED TO THE ANNIVERSARY***

For about a minute, I got really annoyed when he said that, because he somehow implied that Medicine as a Career was a “Calling”, that one must give it their all-in to their work as a Dr. At the time it felt extremely “traditional”. My observations are that as the Medical Profession in Australia (and several other Western countries, especially the Anglophone ones) has become significantly devalued and disrespected compared to the “good old days” (30+ years ago). It's gotten to the point that the notion of introducing a $7 co-payment for visiting a GP (in spite of the 9+ years of study/training to be an independent GP) is seen by the voting majority as so “unaffordable” (in spite of the copious social welfare relative to other countries), even though they happily fork out (much) more for Hairdressers and Restaurant Meals.

These days in Australia at least, being a Dr is for the most part just a job rather than some “G-dly pursuit/passion” that “should” take over your entire life for the sake of saving humanity, irregardless of the pay. Even in the face of increasingly onerous (and possibly unjust) Medico-Legal Pressure/Stress, Public Hospital salaries for Drs continue to decline in real terms every few years through an apparently fractured Dr' Union, in addition to exploitation by State Governments. This is in contrast to the Nurses who in practice hold more clout despite their graduate and junior nurse oversupply being far far worse.

We're human as well, and have our own personal, financial needs etc. I resent it when a lot of people (Australian or not) think that just because we're working as Doctors, that money should never be an issue. They expect Doctors to work and behave like Saints/Monks, yet for the most part in Australia they're not treated as such (as opposed to Developing Countries). Interestingly, a lot of these people have far more sympathetic views towards Nurses. Medicine is a highly trained profession, with a lot of responsibilities, impacting on Patient's lives every day. One mistake can kill a Patient. My opinion is that the remuneration should reflect that, otherwise at the very least the working conditions should be conducive for focusing on Clinical Work. 

Drs in Developing Countries have much lower pay, but at least they don't have to worry about getting sued or notified regularly. They can just focus on Clinical Work and try their best to treat Patients with the limited resources available, ie “Classical Medicine”. With Medico-Legal repercussions being so strong in Australia (closely following America), I think it's gotten to the point where if Drs' real pay continues to fall, retention within the Public System will decrease as more Drs feel the pay isn't worth the responsibilities and stress of covering their “Professional Asses” for half the day, lest they miss something and get penalized over some dubious technicality by some judge who happens to have negligible Clinical Insight by comparison (and just follows the fine print created by other similarly clueless politicians/senior bureaucrats etc). 

Some people try to dismiss the issue of (Public) Drs' pay, purely attributing it as a product of Supply vs Demand, but the fact that the vast majority of Junior Doctors and (Non-GP) Registrars are stuck within the Public System means that State Governments can exploit their Monopsony (as much as possible) on such highly-skilled labour, undermining these Drs' true value compared to a genuinely free market (hypothetical). How else could you make an Intern “only” earn ~$32/hr after studying for 5-7+ years at Uni, when a School-Leaver can already earn ~$24/hr as a Waitress in a suburban Cafe, even though for the latter job the entry requirements are vastly lower, and labour supply vastly greater?

These Nay-Sayers can try to dismiss the issue of Australian Drs' pay/conditions in light of the current climate, but at the end of the day, Drs can and will vote with their feet if needed (as demonstrated by the Queensland Health debacle earlier this year)...

***RANT OVER***

After the sermon, the choir started singing songs. Again I only understood part of it, but I started feeling a lump in my throat. Some of the choir people, and audience started shedding tears and sniffled during the singing. 

Choir singing in the Mass with Keyboard Accompaniment.

I started feeling strange. Initially I felt a tingling sensation in my skin, with my “hairs standing straight”, as I absorbed the magnanimous blend of melody and harmonies. By the time they reached the Portuguese Hymn “Ao Amor que te Arrasta”, my throat became tight, and I felt like I was about to cry, and had to restrain myself from doing so. I stopped looking at the Choir singing, and just stared at the lyrics, and intermittently closing my eyes, but it didn't help much.

I couldn't understand why I started having such a strong automatic reaction, like I was being possessed by an unknown being. I felt like I was subconsciously being commanded to remove my Flat Affect, and cry. It was only a few minutes after I got annoyed at that specific sentence from the Padre/Priest, and I was surprised at how quickly my feelings changed. I didn't like how my body was being pushed to do something that I intellectually thought was irrational, and didn't want to give into “Emotional Conformity”, yet another part of me felt that to cry was the correct emotion to display during this period. I previously never entered into my “Social Database” to cry during Hymn singing, especially when we sang Hymns routinely at Assembly in High School. Back then, we had Assemblies 3 times / week, so it would've been ridiculous for me to cry that frequently. I felt like I was being overwhelmed emotionally, to the point of being nauseous.

I wanted to leave the place coz I felt overloaded, but thought it would be rude if I left early on such a large occasion. I just sat and decided to let the music “penetrate” me, hoping that my body would quickly down-regulate the seemingly visceral response. Eventually it did, but only near the end.

I didn't cry at the end, but as the nausea disappeared, I could “observe” the warmth and passion shown by the Choir, in fact the East Timorese people at the ceremony. I personally hated conformity in its own right, but I could now see how pleasing it was to have people gathered at a place for celebration. Some of the piety was visible; Patients with TB or suspected TB sat in the audience and took off their face-masks as a sign of respect. Everybody's presence at the time just felt “beautiful”, but I was unable to quantify it. Some of the Patients who complained of Pain earlier in the day, looked much livelier and in less visible pain as well. The arrangement just “felt right”.

Priest/Padre is feeding round wafers to a long line of people.

As my emotions were under better control, I was pondering again as the ceremony progressed to the audience lining up to eat the circular Wafers representing the Body of Christ, followed by Dr. Dan giving a gratitude speech. The singing, it's part of the Catholic Culture, but also the East Timorese Culture. The Unison of people doing the same thing together looked wonderful but was an example of conformity. I lamented about how Australia lacked an obvious “Culture” (not including Property Investment/Speculation, “Tall Poppy Syndrome”, Political Correctness, and AFL), but realized that in order to have a “Culture”, there has to be conformity. If everybody does something different, then you're statistically much less likely to have a Culture, let alone a prominent one like that of the East Timorese, whose population is superficially more homogenous. 

Ever since migrating to Australia, I had an “inside feeling” that in spite of its relative wealth, there was something missing that other poorer countries (or even America) had. I had access to food, clean tap water, and a home connected to electricity, adequate sanitation, in addition to my direct Family. Yet when I went out in Melbourne, I frequently felt the outer environment was rather “Bland” and “Soul-less”, especially the suburbs. I thought that there was something “off” or “Artificial”. I thought I was being spoiled or ungrateful for having such sentiments in a Developed Country. Yet in Dili, a City of ~200,000 people (as opposed to Melbourne's ~4 Million), with far less public amenities, I felt much more stimulated outside of home, and not in the anxious sense.

It must be the people and their collective behaviour, I thought. Their population is less Multicultural (in spite of the other Tribal languages in the Districts) than Australia, and the people have far less opportunities Education and Vocation-wise. The weather is becoming hotter, but the people on the whole behave quite “warmly” in spite of the Language Barrier. I don't feel Euphoric here, but have been appreciating the more “visible” homogeneity in behaviour from the locals – their responses, questions, opinions, gratitude (is gratitude more from being poor, or Catholic influence?), “warmth”. Nearly all the locals I speak to are eager to learn new things and/or help develop the country, even if they are unable to think of specific solutions. National development is an obvious goal that unites people. Their word for development, “Dezenvolvimentu” is used copiously in TV and Newspapers. Many people are poor, and Youth Unemployment is high, but they just keep moving on, day by day.

The conformity was easier for me to process thanks to my fondness for repetition, and I felt great joy at being able to understand East Timorese people as a whole a lot quicker than Australians, without being considered “superficial”, “naive”, or “lacking insight”. It pleased me to be able to rapidly understand the psyche of NT people from another country despite my initial deficits secondary to the AS. The paradoxical stimulation from the East Timorese people's superficial simplicity/purity still baffled me (at the time of this writing).

However at the very end of the day I wouldn't want “Mass” conformity to happen in Australia. I think I was in the position to be able to be fussy over the presence of an obvious “Culture” or not. In the long-term, I value my freedom to be un-chained to an overarching Religion (Catholicism), or Collectivistic Society (as per traditional East Timorese Culture) where there is pressure to get married and have children, along with much more influence from relatives (non-parents) in various issues. The taxes are much higher in Australia and there are a lot more lazy/ungrateful Bogans and Politicians, but in spite of the over-regulation and bureaucracy, I still have many more opportunities to pursue what I want vocationally and academically here than in East Timor, in addition to access to a far more robust Healthcare System (Public and Private).

It's probably unfair to compare with a Developing Country, but many things aren't set in stone. In the future, if my values change, and if I manage to save up enough money, I always have the option to explore/move to other countries (even East Timor?!) if I get fed up with life in Australia later on. Australia seems to lack an overarching “Culture” and is geographically isolated, but the price for this relative Individualism (along with wealth) is that you have to put in much more effort to find others with similar interests, beliefs and goals, eg Subcultures or Hobby Groups. Otherwise you can just resort to the internet. You can't have your cake and eat it. 1^st World Problems indeed. At least I don't have to truly worry about starving to death, or despair at a hospital being short of a common Antibiotic, any time of the year.