Monday, January 02, 2006

MEDICINA: ¿VOCACIÓN O BUROCRACIA?

Por Sergio Granillo
(Publicado en El Correo Canadiense)

Ser medico, enfermera o tener una profesión relacionada con la medicina implica algo más que un empleo, es una vocación, o debiera serlo.

Canadá enfrenta el reto de decidir sobre el sistema de salud, ¿debiera existir medicina privada? ¿Debe el gobierno administrar en su totalidad el sistema de salud?

Quizá el problema no deba ser de dónde viene el dinero que sostiene los servicios de salud -uno de los sistemas más complejos y sensibles para una sociedad-, sino en la vocación que quienes ejercen tales profesiones debieran mostrar en su ejercicio cotidiano.

Atender un paciente no es vender refrigeradores, construir casas, litigar o hacer comerciales; es poner al servicio de un ser humano en dolor los avances tecnológicos y siglos de conocimientos, entendiendo que ese “objeto” del trabajo –aunque sea cotidiano-, pasa por un momento crucial y decisivo en su vida, un momento que le puede costar la vida…

Hace dos años, Bárbara –una ciudadana canadiense- notó irregularidades en su cuerpo y consciente de los riesgos del cáncer de seno decidió acudir a su médico familiar para que le practicaran los exámenes pertinentes, y descartar la posibilidad de una enfermedad que, diagnosticada a tiempo, es cien por ciento curable.

Finalmente, el médico accedió, pero al ver los resultados, por ignorancia, descuido o indolencia, pasó por alto la advertencia de un posible tumor cancerígeno y, en lugar de proceder a una biopsia (extracción de una porción del tejido en cuestión para su análisis), le dijo que no era nada…

Bárbara seguía sintiendo crecer en su organismo esta formación extraña. Ante su preocupación, volvió con el médico sólo para ratificar la existencia de un tumor canceroso, que ha aumentado en tamaño y peligrosidad.

El médico le dice que es urgente operarla y extirparle un seno, con el riesgo de que la enfermedad se haya extendido a otras partes de su cuerpo. El día de la operación, los médicos y enfermeras llegan a “cumplir con su trabajo”, una cirugía rutinaria; sólo una enfermera y el anestesiólogo se comportaron amables y sensibles al temor intrínseco que enfrenta Bárbara.

Al terminar, algunas horas después, Bárbara saliendo del sopor de la anestesia, pasó al estupor de tener que vestirse sola, caminar hacia su silla de ruedas, abordar el auto de su esposo e irse a casa a seguir su recuperación; el personal había terminado turno y era hora de salida, ni modo “ya cumplieron su trabajo”…

No hubo manera de hacer un reclamo, pedir una explicación o buscar una segunda opinión, ni siquiera pagar por un servicio privado. Esto hace sentir a cualquiera en un callejón sin salida, impotente, sumido en una burocracia pero que kafkiana.

En este caso, no basta la perfección de la técnica médica, las “softskills” son totalmente pasadas por alto. Y no es sólo materia del gobierno, es cultura, sensibilidad humana; todos podríamos pasar por eso, ¿o no?

MEDICINE: CALLING OR BEAUROCRATIC JOB?


To be a physician, nurse or practicing any career in Medicine takes much more than “doing a job”, actually it is a calling, or should be…

Canada faces the challenge of making a decision regarding its Health System, how good it would be to allow private institutions and professionals to operate, or shall the Government keep running all of it?

It is a very sensitive issue for any society; it is one of the main responsibilities that the State (Government) owes to people (voters). But medical practice should not change whether the system is private or public, but the drive to perform such careers shall be the human calling to serve others.

Taking care of a patient is not equivalent to sell merchandises, doing business, typing letters, producing serial objects or even litigating; medicine is essentially putting into practice centuries of technological developments and scientific research, in order to save lives, heal people and beat the pain. A patient is a human being in pain, facing sometimes the last minutes of his/her life…

Two years ago, Barbara –a Canadian citizen- noticed some irregular formations within her body, aware of the risk of breast cancer, she went to her family doctor -here in Toronto, asking to get the proper medical tests in order to dismiss any possibility of that illness, and in such case start as soon as possible the due treatment.

The doctor accepted to do so, she went trough some tests, but when he received the results, he said nothing to her. Either by incompetence, misunderstanding or indolence, he didn’t warn Barbara about the suspect of a cancerous tumor in her body.

For two years, she kept feeling that uncomfortable mass in her body. Along with the enlargement of the tumor, her scares grew too. Unable to get a “second opinion”, the way is done in a private open market of medicine; she went back to the same doctor, begging for further medical analysis.

At last, he ordered a biopsy and found out that the tumor, now larger and even more dangerous, was cancer; and immediately he order to remove the whole breast, within few days after her last interview.

The day of the surgery, Barbara arrived early in the morning, got ready to enter into the O. R., where surgeons were ready to help their “next patient”, no talk at all, cold as rocks; but fortunately, a Russian nurse and the anesthesiologist “saved the day” being kind to Barbara, at least talking and comforting her, making easier the painful and dramatic experience that she was going trough.


The surgery was expected to last 1 hour, it lasted 3, Barbara’s husband was not able to receive any information about her. When she woke up after her successful surgery, alone in her room, she was asked to dress up all by herself and leave the hospital, the shifts were over, it looked like if they were waiting the precise moment to close “the office”.

By no mean, Barbara or her husband could express any complaint, getting a second medical opinion or even pay for a private service, it’s Canada!

This experience makes anyone feel as in a nightmare, lost in a close ended street, helpless, captive in a bureaucracy in the most insane style described by Franz Kafka.

Barbara’s story is just a sample of the way that a Canadian Experience career should be… if anyone, let’s say a physician, has good enough technical skills, his “softskills” are useless, he is efficient enough for the Health System.

Offering free public health services to everybody is not good enough, private medicine is not either the best solution, it’s matter of commitment, a human way to practice one of the oldest, most respected and best paid careers ever, Medicine.

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