Excerpt #50: Issue With Trainees

Excerpt #50:  Issues With Trainees

         I had minimal problems with my trainees in JB. Minimal did not mean none. One of my interns, a product of an Indian medical school, took time off right after graduation and deferred her internship to have a baby, an unusual practice at the time and perhaps even now. Women, still a minority then and often not welcomed at medical schools, were expected to defer their pregnancies till after their internship.  She was also much older than her colleagues and thus had minimal rapport or social connection with them.

         She had difficulty keeping up with the fast pace. Despite my frequent encouragement and reminders, she was still behind in her work. One day I called her to my office for some pep talk. I was still in the encouraging and supportive mode.

         She had prepared herself well, fresh lipstick, well perfumed, and her jet-black hair well coiffured in a tight shiny bun. I told her right away that her performance was sub-par. She had her ready excuses and rattled them off; her husband seeing other women, problems with her maids, and demanding in-laws. She pleaded for me to be forgiving and that she was doing her very best. She did not raise any issues with the ward. I was expecting her to blame her colleagues for not being supportive and the nurses, unsympathetic. None of those. It was all about domestic issues for which I could do nothing for her.

         I was trying hard to regain control of the conversation as she was now hogging it. I had to interrupt her to warn her that if she did not improve I would have to make her repeat the rotation.

         That jerked her into reality. “No!” she pleaded, “The whole world will know I have failed!” She started to cry, which made me even madder. Then in between sobs, her eyes looking straight to meet mine, like a whining poodle waiting for a treat, “Please, Mr. Bakri, please! I’ll do anything, I mean anything, for you not to do that!”

         Perhaps I was mistaking the twinkle in her eyes; it was to rub away the tears and not what I thought she meant. I was furious that she considered me a lecher and not her teacher. To her I was just another male to entice into her trap. That thought made me even angrier.

         I pretended not to read her signals and went ahead dispassionately instructing what specific areas she needed to improve. The history and physical examination must be more complete, her differential diagnoses more thorough, diagnostic work-up more appropriate. Most of all she must be on time.

         My listing the criteria snapped her out of her coquettishness, and I repeated them for emphasis. As I was opening the door for her to leave, she burst into crying such that I had to shut the door quickly lest my secretary would hear her.

         I could not make her stop. Now it was my turn to panic. She was so helpless and I felt sorry for her. It was not so much pity as fear. I feared that she would go home that evening and kill herself. I wondered whether her lackluster performance was but a manifestation of her postpartum depression.

         My God, what if she were to commit suicide and in her note she blamed me and the pressure of work? I recovered myself. “Let’s begin with your coming to work on time,” I assured her. “We can work on the rest later!”

         The next day, and on subsequent days, she was punctual. As for the quality of her work, I would give her an A for effort, but C for results.

         The other problem I had was with a medical officer who was a graduate of an Indonesian medical school, a fellow Minangkabau to boot. We were about the same age. “We have lots in common, brother!” he assured me at our first encounter with his exuberant, fraternal long-lost brother hug. He said he had heard many good things about me and my program, and would like to join it. He too wanted to be a surgeon. I asked him to tag us along for a few days or so to be sure of what he was getting into. After one session, he could not contain his enthusiasm. On the next scheduled rotation change, he was in my unit.

         Medical officers ran the out-patient clinic and supervised the interns, under my direction of course. At the first clinic he was scheduled, I had a call from the nurse that he was missing, and the crowd was getting restless.

         Over thirty minutes later came this medical officer huffing and puffing, making a big fuss of hurrying up the nurses and interns. I ignored him and continued on supervising the interns. When he came in to check on the interns, I quizzed him too, treating him like one of them. Later he apologized for being late as he was “at the palace.” When the clinic was over I asked him to come to my office. He had missed or misread my body language, or if he did read it right, he figured he could sweet talk his way out for on the way he was making small talk but I ignored him.

         By the time we got to my office he realized that he was being taken to the woodshed. Before he could apologize again, I told him never to be late again, not for the out-patient clinic, not for rounds, and certainly not for surgery. When he again attempted to use the palace as an excuse, I cut him off. I could not care less whether he was with the sultan, he (my trainee) had to be punctual.

         He was startled by my dismissing the sultan. To him that was downright un-Malay and biadab(uncouth). After he assured me that he had understood me, I let him go. The next day he came to see me, wanting to be released. I did; he joined the medical unit. Its head, who was also a regular visitor to the palace, welcomed him.

         The medical unit was two floors above and GHJB was not a huge hospital. Nonetheless we never set face on each other again.

Next: Excerpt # 51:  Twin Tragedies

Excerpted from the author’s second memoir, The Son Has Not Returned. A Surgeon In His Native Malaysia, 2018.