Book review – The truth isn’t pretty

2014-06-01 15:00

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Postmortem: The Doctor Who Walked Away by Maria Phalime


208 pages

R185 at

After nine years of study and four years practising, Soweto-born doctor Maria Phalime hung up her stethoscope.

Postmortem, her first book, which won the inaugural City Press Nonfiction Award, is a story of one doctor’s experience of working in South Africa’s healthcare system, and a glimpse into the state of the system itself.

Phalime recounts her experience of living in what she calls an “emotionally unstable” home from which studies in medicine at UCT provide some kind of escape. She loses her brother at the age of 14 in 1986, and her father dies shortly thereafter in 1989.

After the six years of rigorous study, her eventual departure from medicine is foretold by a professor who, at her valedictory, says only 75% of Phalime’s graduating class will be practising medicine in 10 years.

The writer weaves a tight, lucid story of her experiences as a junior doctor doing more than what is actually meant to be done by newly qualified doctors because of limited capacity in state hospitals.

“Every day we engaged in endless haggling with medics; surgeons; gynaes; psychiatrists; and, in moments of desperation, social workers, to justify why they needed to take over the care of these patients. No one wanted the additional burden on their already overflowing workloads,” she says of her community service at GF Jooste Hospital on the Cape Flats.

This situation would only worsen.

Phalime witnesses the upward spike of the HIV/Aids pandemic, made worse by a government unwilling to roll out antiretroviral drugs until it satisfied itself with the link between HIV and Aids. She details the manner in which the impact of HIV was compounded by other socioeconomic factors that were a legacy of apartheid.

Her experience of working in Cape Town’s townships paints a picture of a healthcare system burdened with severe staffing issues and huge demand.

There are stories of how medical practitioners collude with pharmacists who rip off medical aid schemes for their own benefit, as well as stories of how members of the public come in for bogus sick notes and disability grant forms.

These forms of fraud and corruption add to her ethical and moral crisis.

At times, Postmortem’s tone borders on being whiny as Phalime attempts to understand why and when she suffered this great disconnect from a vocation she once believed in.

She writes: “Before the start of a shift, I would promise myself to be nice to my patients, to enjoy my job more. But it only took one patient calling me ‘nursie’ or a drunken gangster yelling ‘fokken dokter’ and I’d plunge right back into that dark space. I didn’t like the person I was turning into. I felt disconnected from the very people I was meant to be serving.”

Ultimately, Phalime presents a frank and critical look at the health sector while attempting to deal with the unfinished personal business of walking away.

» This article was corrected after first published. It incorrectly stated that the author had lost both her parents.

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