A week spent resolving issues – communication gaps between us and partner NGOs, miscommunications between staff and patients, problems with the new intensive care unit– all of this takes time, and a lot of talk. Meanwhile you see from the corner of your eye a child who needs help urgently – or perhaps you hear, from a distance, the cries of another mother as her child dies. Yet to run the service you need to distance yourself from these events, to keep focused on the problem you are currently trying to resolve without worrying about what else may be happening around you. How does anyone manage this?
Yesterday I found a child crying in pain from a hugely swollen knee following a fall 5 weeks previously. I had seen him a week before, prescribed painkillers and referred him for an X-ray, but he had not had the X ray and the painkillers had run out. He had now stopped eating, possibly because of the pain. When I saw him, alone, in pain, crying, I felt suddenly guilty at the fact that I – that all of us – had forgotten this child. And then I did what most doctors do in these situations – I got angry with the nearest nurse.
Well, of course, I know I must stay calm at these moments, and examine how this situation has arisen, and think about how we can support a mother like this to ensure that her child is not ignored in the future. But at that moment, I struggled to control my frustration, blind and misplaced as it was. Can I ever develop the equanimity needed to lead a service like this?
We all know that being quick to anger can be a sign of stress. But having no capacity for anger can be less attractive still. I think perhaps it was Martin Luther King who said “You’ll know you have grown old, the day you cease to feel anger in the face of injustice”. In quoting him I am not trying to suggest that anger is healthy, or wise, or even useful – like most of our generation in the west I ascribe to the ideal of cultivating tranquillity and an acceptance of the events that befall us. But whether anger is healthy or not, it is very much an element of our normal emotional experience. I am not sure I will ever master my own anger, and I can’t decide if I want to do so.
I have a friend who says that you need to look at the stars when you feel like this. For the time being, and for when stars are not available, I have another solution – I look at M, my favourite extra-terrestrial, who at last has started to resemble a human being (just compare this to the photos of him in previous entries.) His mother’s joy and his incredible facial expressions are usually enough to resolve any tension!