Absence is the enemy of love – Traditional proverb
It seems I just turn around, and my previous life has dissolved. This confessional blog lies dormant, and my life here in Bendigo is now established. However, the return to first world medicine has not stopped me questioning and discussing, examining and exposing my experiences as a surgeon.
I have been amazed by the differences in medicine and surgery in this place. Where Nepal felt frantic and desperate, Australia feels strident, and competitive and defensive. There is no value here on efficiency with equipment or consumables, on reducing waste and expense. But there is a huge value on outcomes, at whatever cost. There is a general assumption that every patient wants the same thing – the highest possible standard of invasive care, so much so that the withdrawal of that care, or any problem or stutter is a major event, requiring either extra compassion, or extra explanation.
With that level of care comes extra possibilities, though. Many options for nutrition. Cool devices. Extra support and a choice of skilled assistants and anaesthetists. Equally, more fear – fear of failure, fear of mistakes, and fear of being unable to justify your mistakes. And perhaps also lack of appreciation – we do so much, achieve so much, and focus much more on the stumbles than the success stories.
I hope to return to discuss, dissect and revel in these surgical conflicts, and with your permission, I hope to share them with you.