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The making of a doctor under pressure

By Dr KIZITO LUBANO

My first Caesarean section, by default, in March 1993, just 20 days into my internship was humbling, illuminating and terrifying.

My seniors could not be traced. So I was encouraged and assisted by the midwives to successfully carry out the operation. I could not believe what I had just done.

I remained awake almost all night. For some reason, I wasn’t fatigued. Medical school and a six-year boot camp for doctors had trained me to transcend sleep deprivation. I kept going to see the mother and baby every two hours to make sure they were okay. After review the following day by my seniors, I was congratulated and welcomed formally to the profession. Later that day I went home and cried myself to sleep. I couldn’t help but congratulate myself on my own achievement.

Somehow, every doctor knows upon entering the profession that the job is never an eight-to-five one; health services and medical treatment have to be provided 24/7.

In comparison, while lawyers invariably gird themselves against a worst-case scenario, doctors are different creatures. We survive on hope and optimism that we can do the best for our patients; heal them; cure them; and make them happy.

Medical interns traditionally have brutal introductions to their respective fields of profession. Everyone is expected to know what they are getting into. The punishing training and taxing schedules are thought essential to teach rookies how to operate under pressure and achieve quality.

Fact is, this pressure can be destructive. I am not aware of a Kenyan study on experiences of young doctors, but a study in Malaysia – A Being Frank enquiry – showed dozens of primary care doctors, mostly interns, had been assessed for mental health issues in the preceding six months. The most common mental illnesses included anxiety, emotional exhaustion, clinical depression, sleep deprivation and substance misuse.

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