7.27.2013

I MET YOU

Hi.

I will try to write this post as honest, as genuine, as I could. Because sometimes I get biased, by random main characters' feelings written in novels, or lyrics made by Taylor Swift.

I've been meaning to write about what I'm about to write. But I had to wait, see for how long it will linger, dominating my mind. It's been months now... and it's still there, on my mind. But it's not dominating like it was; uncontrollably. I learned to let it take over me only when I allow it. Even though I haven't mastered it yet.

So, I met a guy. He's dark (not black, but dark). But that's not the only thing that makes him special.

We met in a place, but we weren't total strangers, because he knew who I was before I knew who he was. That's another story.

I'm already aware that I've fallen for him. Heck, he isn't even my type but this is happening in me. The feelings, they just come uninvited. I'm in a phase where I'm doubting whether I should let him know about it or not. Somehow, imagining admitting what I'm feeling to him make me feel fragile... in a way. But also happy. But that's not the point. I really don't know what the point is. I don't.. I'm tired of hoping. I'm tired of words being said as promises, confessions and imaginative plans and not see any of them really happening. I can now only believe in those words when they are proven through actions.

What is really difficult is, waiting for the actions to take place. I know patience is really necessary in this. It's better to know that they will happen in a certain moment, than knowing that it will never take place. Shiz, Karina, this is hoping already.

I've realized it. I'm serious with this guy. I have to tell my dad.

7.21.2013

Ethical Dilemma


“A girl with Down syndrome was diagnosed with renal failure and requiring kidney transplantation. Suitable kidney donor for the girl is her birth mother, but the mother quietly asked the doctor to tell her family the her kidney is not suitable because she did not want to donate one of her kidney to her daughter, saying what if one day her first daughter (who doesn’t suffer from Down syndrome) required a kidney. She did not want her family to know the truth so she asked the doctor to lie.”

If I were the doctor handling the case written above, I’d feel very disappointed in the mother of the patient and feel deeply concerned towards the young girl with the Down syndrome. It feels like wanting badly to instinctively deliver a moral message to the mother, yell to her telling what a terrible mother she is and force her to understand how crucial this matter is to her daughter’s life. Then again, if I think over it thoroughly, I do not really have the slightest idea about how it feels like to be in her shoes. And as a doctor, I know well that I must take professional actions and not be too involved emotionally, especially if doing so will bring no benefits for the patient, and to actually scold the mother is merely an action of defending my principles of life.

One of the ethical dilemmas obviously witnessed here is having to lie to the patient and the family of the patient. One of the reasons why physicians are obliged to tell the truth is to aid them in selecting the most fitting and effective therapy for their condition. Although the patient suffers from Down syndrome and is probably mentally disturbed and hence incapable of making a decision, must we determine this case as an exceptional one, lie to the patient’s face and her family that the mother’s kidney isn’t suitable to be transplanted and that they should find another kidney donator? To answer this, I had to look through another reasons of telling the truth, regardless of the patient’s mental status.

 Telling the truth is defined as “the practice and attitude of being open and forthright with patients”, and the patient in this case is the girl with the Down syndrome. Telling a lie to the patient signifies our belief that dishonesty is a better option for the sake of the patient’s condition; that telling the mother’s kidney isn’t appropriate for transplantation is better than telling otherwise. In this situation, telling the lie does not really benefit the patient, because it means that they would have to push more effort to find another person who is willing to donate their kidney and make sure that this another donator’s kidney is appropriate for transplantation or not. Lying, in this condition, delays the patient’s therapy.

Another important, yet, a simple reason on why the truth is worth telling is the respect owing to them as persons. Down syndrome patients may be mentally retarded, but they are still persons, and persons are entitled to know whatever that is going on with them. And if somehow, this patient is treated and continually receives psychological therapy that later improve her mental condition, she would demand the facts. Apart from being mentally disabled, as a person, she would have needed this information because she’s the one who needs a new kidney for the sake of the continuity of her life.

Another ethical issue involved in this case is discrimination. The mother of the patient declares that she disagrees to perform kidney transplantation considering her healthy daughter might need it one day. This reveals that the mother somehow prioritizes her other healthy daughter over the disabled one, and it indicates discrimination. By agreeing to lie, physician is viewed to agree, or at least, encourage the act of discrimination. And the act of this is prohibited by law, and is ethically improper. The fact that the mother seems to discriminate between her healthy and disabled children may imply that she probably wasn’t well-informed about her child’s condition.

Being the doctor handling this case, I would initially speak out my concerns to the mother by expressing my appreciation on how it must have been a major struggle for her to take care of her genetically-defected daughter, because in growing up a Down syndrome child requires deep patience and great effort. I later on clarify the benefits of donating her kidney to her daughter, in the hope of her compliance on how necessary it is to disclose it, for it may largely influence her daughter with the Down syndrome’s health condition and how it will affect her emotionally for now and possibly in her later years.

Indonesian law prohibits any form of deception and discrimination. This is clearly proven during when medical students themselves during the period where they are inducted in becoming a doctor are obligated to swear/make a promise/an oath to perform their jobs holding strongly to the values of honesty and non-discrimination.

Below is one of the promises being declared related to the values mentioned:


“Saya bersumpah/berjanji bahwa saya senantiasa akan menjalankan tugas dan wewenang saya ini dengan sungguh-sungguh saksama, obyektif, jujur, berani, adil, tidak membeda-bedakan jabatan, suku, agama, ras, jender, dan golongan tertentu dan akan melaksanakan kewajiban saya dengan sebaik-baiknya, serta bertanggung jawab sepenuhnya kepada Tuhan Yang Maha Esa, masyarakat, bangsa dan negara.”

***
I reckon the hardest task when being a doctor is facing such ethical dilemmas. I was once engaged in an intriguing conversation with a friend and he mentioned his thoughts about the most difficult thing about working as a psychologist is to stay neutral and even-handed after listening to a client's stories. I believe that even though it's difficult, it should still be accomplished. Under the circumstance written above, the mother of the patient obviously seems to defy the value of honesty, which means there are other values that she highly regards, higher than valuing the truth, even though I, the doctor, hold dearly to that moral standard. The truth is, people will always value different things. And that explains the difference between us all on earth, and is the reason why this world will never be monotonous. Tolerance is born when each of us respects the other one's value, and that should be included in doctors' job. 

Maybe, the way to get past through it is to explain the consequences related to the treatment and therapy if we choose to have it the patient's way (and, ideally, we always have it their way), with regards to the values they respect.

7.11.2013

I've never been as sleep-deprived as I am right now. I'm exhausted to the point of not even being able to describe my exhaustion.

7.08.2013

THE DAY I UPLOADED EMPATHY

It hurts to love, sometimes. But I guess, I'd just have to be courageous enough to open my heart, so to feel its' bliss.