Criticism
Sunday, September 28th, 2008
“Worried mum” as she identified herself, had thanked my employers and written very complimentary things about how I attended to her daughter – who was 37 weeks pregnant – and allayed their worries about the prognosis of her unborn grand-daughter. A Community midwife, who felt that the baby was rather small and lagging behind its expected growth velocity (“small-for-dates” or “intra-uterine fetal growth retardation)” had referred them to the hospital. Two weeks earlier I had received a “Thank you” card from a patient I did not remember. The delivery records showed she was one of three women whose babies I delivered by an operation on night duty in May 2008.
The two expressions of gratitude contrast with the commonplace culture of complaints, criticism and disaffection that is prevalent in our society today. The doctor, especially the Gynaecologist is the most-affected. The reasons are legion but some include:
Gynaecology “patients” are normally healthy women who come to have a baby or who have a menstrual problem. Unlike other patients with severe abdominal pains from appendicitis or chest pains from a heart attack, they are not exactly ill. It follows that their treatment must be perfect. Perfection however belongs only to God. If and when things go wrong our women feel aggrieved and if an apology is not swift and satisfactory, the solicitor’s letter follows as light follows darkness;
Obstetrics is one of, if not the most, high-pressure clinical speciality. It is the only speciality where the doctor is confronted with treating two individuals in one – the one inside the other. The mother’s needs must be balanced against the baby’s hence the timing of intervention requires lots of experience. If a woman of 32 weeks’ pregnancy has severe abdominal pains due solely to her pregnancy, we can relieve it by performing a caesarean. That however creates another problem – a premature baby who could become brain-damaged, blind, deaf, disabled or even die. In trying his/her best, the doctor may cop an earful from patients and their spouses and relatives. Added to this is that the resident doctor usually has more than one client to attend to simultaneously. He or she prioritises but that would not satisfy the last in the queue;
Previous press reports of doctors’ misdemeanours and successful litigations have fuelled the belief that every complaint needs to be aired and pursued to its logical conclusion. There are always genuine complaints as well as doctors’ blunders that need to be addressed. I personally believe that victims of medical errors, who have been incapacitated should be compensated but frivolous complaints about trivialities not only undermine the confidence of these doctors, they also slow down their work as they need to take time out to study case notes, write reports and on occasions attend hearings or even courts. In practice only a tiny proportion of complaints succeed because there are always extenuating circumstances and peer reviews along the lines of Bolam and Bolitho.
With these in mind, every doctor is uplifted when a patient returns to say “thank you.” On the other hand, victims of insinuations, presumptions, assumptions and innuendoes usually despair if their character is not strong enough. Some can shrug off such misinterpretations but others are not so strong emotionally. When Tiger Woods was wincing in agony in the fourth round of the 2008 US Open golf competition, Retief Goosen, a fellow pro, was quoted as saying that Woods was exaggerating an injury. It turned out after tests that Woods had indeed been very courageous to play through a serious injury when most mortal men would have cried off. Michael Stich, the German former tennis player whilst commentating on Wimbledon 2007 thought that Serena Williams was making too much of an alleged injury. After the Beijing Olympics, there were doubts from newspaper sports writers on the genuineness of the feats achieved by Usain Bolt, Michael Phelps and Christine Ohuruogu. It is true that certain athletes have cheated in the past – some were caught, others escaped – but every human endeavour, no matter how incredible must be given the benefit of the doubt. Until I have walked in some else’s shoes, it ill behoves me to criticise them for limping. Until I know somebody’s genetics and how oxygen-deprived his/her brain was at birth, I would be wrong to criticise their stutter.
Let us give credit to whom it is due and be considerate when criticising any errant person. The best criticism I have ever come across was that in the letters written to seven churches in (today’s) Turkey. Five of the seven were failing. The writer first outlined what they were doing well before suggesting what he would have done differently. That is constructive, improvement-oriented, desirable and life-changing criticism (Revelations. 3 & 4).
And who makes us a judge over others anyway? It was well said by ………………. that there is so much good in the worst of us and so much evil in the best of us that it hardly behoves any of us to talk about the rest of us.
Johnson Folorunso Ajayi, September 24, 2008
