Book review – Pragmatic practice

2014-04-20 15:00

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As a medical student from Soweto, Maria Phalime had high expectations for life as a doctor – until the reality of practising hit home. Her book, Postmortem, describes her journey. This is a condensed extract

I was based at a clinic in Site B in Khayelitsha during the second half of my community service.

I saw about 50 patients a day in quick succession.

I processed them as quickly as I could, treating their symptoms with whatever medication was available.

Along with anger, frustration became my constant companion.

I wanted to help, but sometimes I felt that my medical training, with its strong emphasis on the scientific method and the curative approach, was inadequate to give my patients what they really needed.

Often they came to me not with medical problems, but because I was the last resource.

When the man walked into my consulting room, I instinctively straightened up.

He reminded me of someone’s uncle. He had that uprightness that marked him as a respected member of the community.

‘What can I do for you, tata?’ I began when he was seated.

‘Doctor, I’m not working,’ he responded.

‘My children are hungry, doctor,’ he said.

‘I’m sorry to hear that, tata,’ I said, but he didn’t seem to register it.

‘I’m asking you for a grant, doctor,’ he said and produced a carefully folded application form from one of his coat pockets.

‘A disability grant?’ I asked. I’d had this conversation dozens of times in the months I’d been at the clinic.

In desperation, patients came to ask to be declared disabled so they could claim a government grant.

The application required a doctor’s assessment and a declaration that the patient’s condition precluded him or her from performing work in the future.

‘In what way are you disabled, tata?’

He frowned. ‘I beg your pardon?’

‘The only way I can sign for a grant is if I find that you are disabled. In what way are you disabled?’

‘But I’m not working, doctor,’ he said.

‘I understand that, tata.’

I looked through his thin clinic folder. He had no chronic illnesses and had only ever come to the clinic for common minor complaints.

‘There is nothing here that says that you qualify for a grant, tata.’

I could tell he understood what I was saying. His shoulders were starting to sag as resignation crept in. When he spoke again, there was pain in his voice for the first time.

‘The other children tease mine because they don’t have the right uniform,’ he said.

I said nothing, concentrating instead on maintaining my resolve.

He said it in a barely audible whisper. ‘Please, doctor.’

I looked down in shame.

‘I’m sorry, tata,’ I said finally, not daring to look up at him again in case I cracked.

Without saying another word, he stood up and left. I was mortified. I had reduced a respectable family man to begging.

I knew that I could have helped, that my signature on that piece of paper would have put food on his family’s table.

And I also knew that if I had done that, I would have committed fraud.

Phalime is the recipient of the inaugural City Press Tafelberg Nonfiction Award. The award of R60?000 is given annually to assist an author to research and write a work of nonfiction

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