– From a doctor who stayed
The Malaysian Insider
Jun 01, 2011
JUNE 1 — It has been illuminating reading the various stories of the people who left and the people who stayed. I personally feel it is the individual’s choice and I agree largely with the opinions of John Rahman. However, I do want to share a couple of angles from a physician’s perspective.
1. To all those who have migrated whose parents are still alive, please make provisions for them if they are left behind. Most people write about the opportunities they need to give to their children but rarely mention what happens to their parents when they migrate.
As a doctor, I see this every day. There are many elderly patients who are admitted to hospital and their children are all living abroad. It is very sad.
One old man when I asked where his children were, told me that he had no more tears left to cry, they had all dried up. This frail man took two buses and a taxi to get to hospital. Sometimes there are siblings who are left behind who take care of their parents and I hope silently that they are getting all the help they need from those who left.
Very often we get requests from a patient’s relative who is only there as next-of-kin “to talk on the phone to the son/daughter who is in the US/UK/Australia”, always said with a hint of what I feel is misplaced pride. Generally doctors do not like giving news over the phone even to someone within the country.
There is much room for misinterpretation and of course the issue of patient confidentiality. I always insist on giving news in person to avoid such things from happening. When such requests are made I cannot help but feel irritated.
They always want to know if they should come back to Malaysia to see their parent. They tell me, “Doctor, it is so far, inconvenient and expensive.” I believe they should be asking themselves that question, not me.
Sometimes they do come back to visit. Sometimes it is very unpleasant as they assume that we are not competent and they say that “medical care in the US/UK/Australia etc is so much better”, statements that I believe do not even merit a response from me. Sometimes when the patient dies, they come back to Malaysia demanding to see the doctor and they blame the medical team for the patient’s death when there is no reason to. Obviously to us, but not to them, this is out of guilt for their not being there.
I do not blame people for migrating. It is an individual choice. But I plead to all who do to please make provisions for your parents. Make sure you send money regularly to your siblings who are left behind to take care of them. Make sure they have enough for food, medications and transportation to the hospital. Please call them often to see how they are. Please don’t forget that your parents are also still your responsibility, not just your children. If you find it is “inconvenient” please change your mindset. This is part and parcel of your decision to migrate. Accept it.
2. The second angle that I want to share is something that maybe people don’t think about when they migrate and I hope they never have to. I once had a request from a patient’s sibling to see me to discuss organ transplantation.
The patient had organ failure which required transplantation but as he/she was not a citizen in the country in which he/she resided, this was not an option there (unless he/she made a very substantial monetary investment in that country to gain citizenship — an option he/she had already explored).
So the only place where he/she could join the transplant list would be in Malaysia. This patient was “too busy” to come home to discuss it as he/she was an “important person.” So he/she sent his/her siblings instead to ask a list of questions which soon became apparent to me was designed to assess our hospital’s “competence” and if we were worthy of him/her.
It was difficult to hide my irritation but I politely explained our hospital’s protocol for listing someone for transplant. It soon became apparent to them that far from the patient assessing us, it is we who will assess the patient whether he/she is worthy of an organ donation from Malaysian people.
I do not know what happened to this patient but honestly, I think he/she should thank his/her lucky stars that we even have a successful transplant programme in our country. So the learning point is that even though medical facilities may be “far superior in the US/UK/Australia”, there are some treatments that will still not be available to you unless you are a citizen of that country.
In conclusion, I would like to ask those who are planning to migrate to please factor in your parents as well and not just your children. If they are in good health now, they will not always be. Please make plans for that bend in the road.
All this obviously does not apply to everyone who migrates. There are many people who do not behave in such ways but what I have written is based on real-life experiences as a physician and I wanted to participate constructively in this discussion.