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An Open Letter to New HOs

Dr. Imama Zainab Sattar

"An open letter to all the juniors starting their house job “

The day is finally here when you’re actually in Doctor feels! Kudos to you and congratulations to your parents and loved ones!

I have kept everything in my heart up till now but today I will share my experience so that may be, just may be even if a single one of you is influenced by this post my heart would be at peace. 

On my very first day before leaving for hospital my nano stopped me and said:
 "Remember one thing, always be nice to the patients no matter what. No excuses; always be kind to them"
And to this day I have never even raised my voice with any of the patients or their attendants. 
Yes it is possible. Yes it takes courage and patience. Yes patients drive you crazy, yes the duty hours are hectic! Yes you are sleep deprived, yes you are hungry, yes the patients don’t understand things even the tenth time, yes they lose their X-ray forms, yes they use their phones while you’re standing there, yes they delay the tests you have asked them to do, yes they don’t arrange blood in time. A million YES here.
But always remember you are the doctor not them, you are trained for this not them, you are the healer not them.
My first day in emergency and I had an anxiety attack followed by a 2 week depression phase. Why? 
It wasn’t because of the blood of the patients or broken bones or dead bodies. It was because of how us the doctors treated them. How we behaved with them. How everyone shouts at everyone all the time. On all the attendants on all the patients. I saw my fellow beings become a part of the system. And it broke my heart. 
Gynae is famous for misbehaving with the patients and yet after 2 weeks I saw my own fellows becoming the same people.

I understand that a person breaks under pressure but I will never accept that you misbehave with the patients of the attendants.

Imagine yourself at their position. Imagine your dad or mom bleeding in front of you would you be in your senses? Would you have the brain to work at that time? No. Please understand this. If a patient doesn’t know where the X-ray department is and you don’t have time to answer don’t shout at them, just politely ask them to go ask the guard and carry on with your work. 

If someone calls you sister please don’t be offended ladies. Don’t shout at them and say I’m a Doctor mein koi sister nahi hu. 
1. There is no shame in being a sister/ nurse; they work their ass off. 
2. It’s cultural here to call lady doctors sister here so please don’t be offended.

When you walk in that hospital please don’t be proud. Greet everyone first. The guards, the nurses, the gate keepers , the janitors. I’ve seen people expecting everyone to greet them first, oh because now I’m a Doctor I should better be respected and I’m at a higher place so they better greet me first. And yes this mentality exists. And it’s way more common than one can imagine. To all of you remember you are humans first. The hospital guard at admin gate (morning shift) he is an amazing soul and on my first day I greeted him first and he was in shock. He looked behind himself and there was no one there and he then asked me did you greet me? And I said yes; to which he responded I have been here a long time and no one has ever greeted me first. :’) and to this day I don’t have the words to explain what I saw in his eyes. Respect everyone. Please not just your seniors or class fellows. Everyone. 

I’ve seen people making fun of the patient's accent. Please realise that they might never have been to school or even seen the face on one. Don’t laugh at them. Don’t laugh at their silly questions. Don’t mock them for asking baji juice thanda peena garam , doodh wala peena ya Saada pena, kailay ka peena ya Saib ka, understand that they trust you with their patient's life. Even the little details. That is how sacred you are for them and you sit there and laugh at them and their innocence. Please don’t. Just don’t.

If you see someone bullying someone, calling them names. Please stop them. Be vocal; stand up for them.

If you happen to come across transgenders - (most of them come in surgical emergency after being abused or beaten up), I have had 3 such encounters. Please please please be kind to them. Treat them as humans. When they say they have been abused believe them! Comfort them. Tell them you’re sorry on part of this world who treats you poorly. Try to spend more time with them, counsel them. Don’t let the junior staff belittle them or make fun of them. Sadly I attended a patient who was abused by 11 men, had broken arms and a torn lip and a cut at his forehead and while I was in MOT doing his stitches everyone around me, the doctor, the staff there, the janitor there, everyone single person there was mocking him and making underlying sexual comments. To which I responded by telling everyone to leave the room and stayed with him until everything was done. Counselled him and told him to visit Psychiatry department in the morning. (Still didn’t yell at anyone but made sure he was safe).

For all those dealing with Psychiatric patients please don’t mock them. Psychiatry is one of the finest department I’ve been in, in terms of dealing with patients. Everyone must learn communication skills from them. It’s a different world. And I’m so glad to have been a part of that department. To the rest please stop asking “Psychiatry mein to suna insan pagalo mein reh k khud pagal hojata “ you are a Doctor for God's sake! Have you ever heard oncology mein reh k insan ko khud cancer hojata? Please just please don’t ridicule mental illnesses.

Its the little things that make us better people. It’s the little deeds. For all my juniors I have but 1 advice 
“Kindness first, always first, no matter how tired or over worked are you, kindness first” 
Please don’t become the system. 
It’s a fight that you have to fight with yourself stay strong and you’ll make it! 

Have courage and be kind 💖

Have a great year guys!

(Dr. Imama Zainab is a graduate of Allama Iqbal Medical College class of 2016; an artist and a social activist at heart, and an aspiring psychiatrist. She counsels students and also runs 2 support groups for people struggling with mental health issues. She has also lately organised 2 workshops for communication skills and personality assessment. She has just finished her HJ from Jinnah Hospital.)


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