The break of dawn approaches, bed alarm bells mercilessly scream to alert the masses that the pleasantly confused fall risk ah gong is trying to get out of bed again. The “clickity-clackity” keyboard sounds from nurses documenting overnight events harmonise with them almost symphonically. One can easily resonate with the familiar feeling of arriving in the ward, approaching the ward COW/desktop with a sense of trepidation, collapsing onto a surprisingly sturdy seat on its last legs, and letting their fingers go loose on a Dell keyboard long-defiled by strata of dried chlorhexidine hand rub stuck in the crevices. Some of us are more picky, hunting for the smoothest keyboard with the softest keys, followed by a purification ritual with a Hospicare wipe.

For a writer a pen, a chef a knife, a physician has a unbreakable bond with a keyboard which they probably spend more time with than their own family. Some retreat to the sanctuary of the internet to share about their experiences after a ruthless day at work through different media — some draw comics, some make reels, some write lengthy blog posts. Depending on who and what you’ve chanced upon on your social media feed, you could have experienced a series of emotions ranging from a hearty chuckle to frank haematemesis. Regardless, these artforms have allowed the general public to get a backstage pass into the inner workings of the mythical healthcare system, and catch a glimpse into the medical practitioner’s psyche.

The US Office of Disease Prevention and Health Promotion started the Healthier People initiative around 40 years ago, with digital health, accessibility to information, and health literacy, examples of “social determinants of health”. Digital medicine could refer to a friendly neighbourhood GP spreading the gospel of going for your screening checks on your Instagram feed, to medical students and junior physicians worshiping the divine Indian lecturers on YouTube who possess an inhuman wealth of knowledge.

It is likely that we can get more eyes on a post or advert to raise awareness online compared to slapping a few pamphlets all around the hospital where it fades into the background like elevator music. Some not only use their platform to improve health literacy, but also as a form of peaceful protest — via satirical skits and comedy — about systemic issues such as the exorbitant healthcare costs, how difficult it is to claim your well-deserved coverage from the grubby paws of some insurance companies, and the plight of residents and junior physicians. With their effort, one can only hope that they can make a difference and galvanise others to do so as well, but it is truly a behemoth task to materialise tangible change (which we may again discuss in the future).

In the hustle and bustle of working in medicine, even the best of us have been guilty of prescribing “Lactulose 10mL TDS” for 6 months (this could or could not be an exaggeration) to an ah gong whose only crime was skipping his dietary fibre. We all have met some physicians who manifest some philosophy that even a frail and debilitated patient hanging by a thread should be subjected to the wonders of modern medicine — be it invasive procedures, drugs, et cetera — to wrangle him or her from the talons of death.

Thankfully, most of us possess the inherent ability to reflect about our clinical practice. Being in this line of work, it’s easy to be desensitized to the absurdities — normal two day weekends are “golden”, abuse be it patient-healthcare worker or within the medical fraternity is rampant, the irony of physicians being the ones to promote healthy lifestyles while also having a blatant disregard for their own health. Through these media, one can invoke a sense of self and collective reflection, the latter a privilege we enjoy due to a shared “human condition” of working in this field — be it on topics such as rationalizing medication or end-of-life care.

Pending notes for the next morning till 9pm with your best (trauma-bonded) mates, convincing an obliviously sick patient to not discharge AOR, screaming inside while trying to round patients post-call having been awake for more than 24 hours — we have all been there and done that. What better way to honor this morbid reality than to translate it into memes? Making fun at how absurd things are makes the hard work easier to swallow and the day-to-day easier to handle. Life is a tragedy in close up, but a comedy in long shot (probably said first by Charlie Chaplin).

FINAL REPORT:

Physicians are strange creatures — that platitude about how “Medicine is a lifestyle” will strike a chord in any of us. It is not only a lifestyle, but a brutal sacrifice of time better spent with our loved ones, physical health, and sanity which we lay down to be burnt on an altar as a holocaust to the very idea of our patients.

Without the rose-tinted “Dr” prefix, some can only vaguely remember being filled with fiery aspirations and selflessness; passion pummeled down by empathy fatigue. However, like a warm fire in the dead of night or a iridescent shell we find on a beach, finding the joy and satisfaction in small things makes it easier for us cope. Ordering in bubble tea with your co-HO/MOs for a morale boost, working together and finally getting a makcik home after close to 3 months in hospital, managing to clear the list to single digits are just some examples – these simple wins make the struggle better. In the book Love’s Executioner by Irvin D. Yalom, you will find this quote: “Even though you’re alone in your boat, it’s always comforting to see the lights of the other boats bobbing nearby”.

We are all in this together — and oddly enough, knowing that sends a wave of comfort through our lukewarm hearts.

clickclack