Author’s note: I’m publishing this article online now, since the newspaper editor to whom I submitted this article seemed to be uninterested in publishing it and did not reply to my email.
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Not too long ago, I wrote an article entitled, “M.D.’s on Strike: Why Doctors are Leaving and Why They Should Be Leaving”. I posted it on my multiply blog and a mailing list I’m subscribed to. Some received it positively, appreciating the risk to bring out an unpopular idea in the open (the only thing that perhaps hindered its offline publication is that I published it online first. Also I have a sneaking suspicion that the newspaper opinion editor does not like bloggers). I also got not so few violent reactions and was accused of neglect of my duties as citizen and abandoning my fellowmen.
I have a hunch that those who emailed or left me accusatory comments on my blogs meant to make me feel guilty of my “selfishness”.
But let me see, why do I need to be guilty thinking about myself? It is in our nature to strive for self-preservation. We are happy when we fulfill our basic needs and have work in keeping of our interests and joys. By striving to work in another place which can provide for the needs of my family and I, I work for our survival. By working on such place where my contributions to health care provision is better understood and appreciated, I work for my own happiness and personal growth. Are these things evil? Of course not. And yet, people see my resolve to work abroad and to encourage others to do, too, if they can, as an indicator of selfishness.
According to these people who call me selfish, there’s already a dwindling number of health care professionals in the country so I should not be adding to the numbers who are already leaving. They say I OUGHT to stay because it is my duty to my fellowmen to serve them. They say I shouldn’t complain about being dirt poor because every doctor goes through that stage of being “dirt poor” anyway. Note, however that those who told me to stay poor are those who are already on the other side of the globe, chilling in their parkas in the perpetual cold but can afford themselves laptops and a decent car to drive.
So, does it mean that I need to sacrifice myself for my fellowmen (when others clearly do not see the need to do the same and yet commanding others to do so) who do not seem to understand the value of such sacrifice and are not worthy of it? Do I kill myself and my family to serve others who continually mistrust me despite obvious indications to the contrary because of their prejudice that all doctors are only out for their money? Did they mean that I should just accept that I am poor and to do nothing about it when I can?
Do I need to feel guilty if I have referred to a patient as “miss” and not “madame” by mistake but just accept meekly if an ill-tempered patient or relative shouts at me in the emergency room in front of other people and the emergency room staff, calling me names that one may only hear from an uncivilized person pretending to be rich and sophisticated, just because they are “emotional”? Do I need to feel guilty if I ask for the appropriate fee for my services but not to be offended if patients/relatives rudely scrutinize my treatment strategy and prescription? Do I need to feel guilty if I have plans of working abroad?
When nurses, teachers, engineers, or domestic helpers leave, they are called heroes or martyrs. But why is it when doctors leave, they are called selfish and unpatriotic? It is because people do not see doctors as human too. It is hard to remove from the minds of those with narrow viewpoints the image of the rich and comfortable doctor, driving in luxury cars and dining in fine restaurants.
What perhaps they fail (or refuse) to see is that doctors can get hungry, too, and have bills to pay. Doctors are humans too who have to fulfill basic needs and want career satisfaction. But unfortunately, it’s difficult to attain those in this country nowadays because of the growing mistrust of patients in their doctors brought about by the media hype on malpracticing doctors and hospitals (when most of these coverages by the media are blown-out-of-proportion versions of the story in an effort to sensationalize an otherwise benign incident) and the government’s apathy for the plight of the health care professionals because its focus rest on those who bring in the dollars that keep the economy afloat. So, you want the dollars to come in? We will leave.
Sorry, folks, there’s no guilt for selfishness in me. I choose to live my life the way I deem it right for me and my family, not the way others say I OUGHT to.
June 28th, 2007 at 11:32
[...] Continue reading this entry [...]
June 28th, 2007 at 11:33
As with my previous comment: If it will make you happy, if it will make you better, by all means, go!
Goodluck
June 28th, 2007 at 14:14
[...] Prudence writes a great article, called “No Guilt For Selfishness”. Read it and think. [...]
June 29th, 2007 at 15:39
I think we kind of discussed this issue in our PolSci subject, although it’s not that in-depth.
We actually came to a point where, I think, we were all lost. It’s like this, people leave the country for personal reasons which are the same as yours. For that, we cannot blame them, right? It is their personal choice, therefore, whatever result it may bring them, it is their responsibilty. But then, this kind of thing affects the nation in general, so this is where the people calling you selfish comes in. This is where we talk about brain drain and our responsibilities towards the nation, etc. So we see a fine line now between the personal and public interest. The question then, would be, where is this fine line and where would we draw it? The want to leave the country is your personal choice and can be concluded as a part of your private life…then these people barge in and tell you to think of the public interest.
(Did I make sense? I don’t think I did. LOL)
June 29th, 2007 at 16:15
Yna,
I used to believe in the same concept (national responsibility) until I realized that most of the people preaching these are a) people who have already left and b) people who have no means to leave.
Likewise there are many ways “national responsibility” is fulfilled by leaving: OFW remittances is the most prevalent form, and then there are individuals who, in one way or another, are contributing on their own by giving out scholarships or setting up businesses or what not. I believe that if the latter activities (which will reverse the brain drain into a brain gain) reaches critical mass, the country’s situation will improve significantly.
My only qualm are with people who define “the Philippines” as “that depressing, futile place with its terrible government” as most people tend to do. One must never forget that the most important aspect of a nation — any nation, is its people. Even if many of us are able to leave there will be millions upon millions who are hopelessly left behind.
Thus the “national responsibility” should not be equivocated as “duty to the Philippine government” but rather, “social responsibility to the rest of the Filipino people”, many of whom are related to us by blood or affinity anyways.
June 29th, 2007 at 23:43
Jon Limyap,
Yes, I think I’d have to agree with that point. But then, it is quite obvious that most of us find it hard to fulfill that responsibilty because of, ironic as it may seem, our other responsibilities. I think that’s the point here, that somebody had chosen to fulfill her/his responsibilities to her/his family and chose to speak about it and defend that choice, but that doesn’t mean that somebody who opted to do so had neglected that so-called “social responsibility”, right? It goes the same for all of us, Filipinos, not just doctors.
Yes, of course, there are other ways. I just hope that the people who ridiculed Doc Tess for this would realize these things.
June 29th, 2007 at 23:48
It is not selfish to work abroad because there are several factors why these people are striving overseas. If it is selfishness to achieve personal goals then why should all else persevere to their road to success.
It’s unfair to be judgmental—call them selfish and unpatriotic—to those people who strive their best in other country no matter what profession they may be. They are also doing their best there.
The selfish in this issue is not the people being accused but the ones who are judging.
June 30th, 2007 at 0:11
to Yna: I think the nice topic for discussion would be, “Who is the public?”. Think of it. Who is the public, really? By living in the human society, does it mean that, if an individual’s sacrifice will lighten the burden of the whole society where he belongs to, he is obligated to make that sacrifice?
A curious little example would be the plot of the novel by Paulo Coelho’s “The Devil and Miss Prym”. In a poor village comes a stranger carrying 11 bars of gold. He challenges Miss Prym and the entire village with a strange test. He will give the gold bars to her and the rest of the village, if they will commit one murder within seven days. The gold bars would be a big help in such a deteriorating small town. Everybody’s lives will be enriched and they don’t need to be too poor anymore. All except for that one unfortunate person who will be the “sacrifice”. And then the village argues that the sacrifice is for the “common good” and wouldn’t be so bad. And of course they contemplated the murder of one old woman, whom they think is worthless to the village anyway.
Sounds fantastic, right? It is, because it came from a novel. But just replace the key words and it will reveal to you that this is how most people think in the society. “It is for the common good”. Haven’t we heard these words so often? But what does it really mean? That the value of the whole society is greater than the value of one lone individual?
June 30th, 2007 at 0:20
to Jon Limjap: I may be encouraging those who think they’ll be able to fulfill their dreams somewhere else to go but I’m also afraid of the kind of people who’ll be left here, when all the good and rational people have gone. I’m not generalizing everybody. But there really are people who seem to be narrow-minded on things. What would become of this country? How would it progress? However, if all the good and rational stayed behind, the narrow-minded ones will continue to depend on the rational and independent for their survival. I think it would be good if they learn how to value the worth of those who’ve been gone and work on how to make the country better themselves, so that they may learn to be independent. Perhaps then, the current deterioration will stop and we can rebuild the country. I think we can do this by putting more emphasis on individuals, instead on the whole society. There comes a point when the emphasis shifts to the society, the individual loses his self-worth and just becomes a commodity. That’s where deterioration begins because the individual will not work for his betterment and will become a disadvantage to himself and to those he work with.
June 30th, 2007 at 0:27
to Agent Grey: There comes a point when, even those with the best intentions, run out of something to give. I think that’s what’s happening here. We have a lot of dedicated professionals who want to be of service to this country. And yet, some of our countrymen do not see the worth of what they’ve given. Rather, they see these “sacrifices” as something that they have a right to and not something to be thankful for.
June 30th, 2007 at 5:54
YNA,
If it were not difficult, it wouldn’t have been an issue worth talking about.
Prudence,
I believe that some of the examples I cited above, e.g., giving out of scholarships, or setting up of businesses, do exactly that : encourage individual excellence in the face of a mediocre society. Give scholarships only to deserving students; let only qualified, responsible persons to be employed in the business you set up. Of course it is easier said than done but, you get the drift.
The point you raised (individual worth) is another point that is quite crucial. To state the obvious, any society is the sum of its individuals. The problem lies wherein the illogical, narrow-minded, band-wagon jumping “cows” (if you’d excuse the term) composes the majority of that society, which is obviously true of our case. While rational, responsible individuals are two or three times more powerful than these cows, you can’t find one in three people that are both rational and responsible in this country. To be able to herd the cows effectively we must be able to train a lot more “cowboys” and “cowgirls” who will take the risks and instigate change in the society.
Secretly I wish I could export all those cows abroad, never to come back. Not only will that fulfill *their* individual dreams (as most cows think that migrating to a western country is the be-all and and-all of a fulfilling life), but it will allow the cowboys and the cowgirls to take back control of the chaotic bullpen that we call the Philippines.
June 30th, 2007 at 10:17
to Jon Limjap: I think we don’t need to have anyone herd the cows, if only the cows would realize that they aren’t really cows that need herding.
I do agree that the society is the sum of its individuals. However, some individuals would rather lose their individuality just to be a member of a certain “society” and would put that society in a pedestal. They themselves are proud to be called members of that said society and would rant on about others who’re leaving that society as traitors to it. And yet they themselves do not do anything to better individuals, and thus in the long-run becomes a liability to their “society”. These are people who have a fallacious concept of altruism: their need is greater so they should be prioritized and those who are more able should give in to their needs first. But society would further deteriorate if we follow this rule. How about those who are more able and would be more of a contributor to the betterment of the society? How about their needs? Do they get neglected because majority of that society assumes that they’ll be able to think of something to fulfill their needs since they’re the more able ones? Is it right to assume that they ought to make sacrifices for those who refuse to be capable? I think it is evil to assume like so. Who would want to work in a society like that? When you work so hard and yet, you do not get the proper return for your investment because the society deemed that somebody else is more worthy of that ROI, be it that he didn’t work hard for it? If that’s the case, then everybody would just aspire to be idiots and feed of from those who are able.
July 1st, 2007 at 15:53
Hi Prudence. I’m a doctor too and I’ve chosen to stay. I have no problems with colleagues who’ve chosen otherwise. I believe it is our right to live our dream. I remember a radio ad which goes this way “Ang nanay ko, nurse sa Saudi…bayani. Ang tatay ko, engineer sa Singapore…bayani.” The ad never mentioned doctors and we are always questioned for our motives. Are we less than heroes if we practice elsewhere? At the end of the day, doctors have families to feed, children to send to school, etc. I don’t think doctors who leave are selfish, they’re just being truthful an chasing after their dreams. There are other ways to serve and that does not necessarily mean staying.
July 2nd, 2007 at 11:53
to Em Dy: I do not have problems with those who chose to stay. Rather, the problem lies in those who think others OUGHT to stay and sacrifice their lives for others. It’s the fallacy in our current concept of altruism. Others’ needs come first? If we will honestly believe in that, nobody’s going to work hard anymore. If nobody will strive to work hard anymore, then this society will fall on itself.
July 2nd, 2007 at 12:05
Hi Prudence. I totally agree with you. Let’s make our own choices and respect other’s choices too. It’s sad that there are others who want to make choices for other people, impose what they think is right and fail to respect those who think otherwise.
July 25th, 2007 at 16:36
Service it is & no questions regarding our purpose but then not everyone appreciates what we do. We even get blamed when some things turn out wrong even if we have no control over it. Aside from that, we need to live too (some people forget that we need to survive… we’re not Gods u know)… things would have been better if we’re well compensated(or with humane duty hours at least). At this point in time, all our non-med high school and pre-med batchmates have settled. For us, we’re just about to start. What we’ll earn won’t even be enough to really support ourselves. Sad to say but most of us still asks money from mum & dad. Would that be so difficult to understand?
No wonder why a lot of doctors would prefer to leave the country… & most of the time, not as doctors anymore. Too much responsibility, too little compensation. Service is service but I still believe we deserve at least a little more.
July 25th, 2007 at 20:52
to rogue: Well, some of our fellowmen and even our colleagues are asking that we sacrifice our lives so that this country might have a chance to improve its healthcare aspect. The problem with this reasoning is that these people are assuming that the exodus of doctors is the cause of our deteriorating healthcare. What they refuse to understand is that the exodus is merely a symptom and merely trying to stop the exodus by hindering doctors from leaving the country will not solve the problem. Rather, it will only trample upon doctors’ rights (we do have rights, too!) to live their lives as they see fit.
November 2nd, 2008 at 8:33
Test message
Sorry me noob…