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A bottle of beer
DISSECTING ROOM
LIFELINE Miriam Adhikari Miriam Adhikari is acting head of the Department of Paediatrics, at the Nelson R Mandela School of Medicine, University of Natal, Durban, South Africa. She obtained her degree at the University of Cape Town, and did her postgraduate and doctoral thesis at the University of Natal. She has been a consultant neonatologist since 1976. Who was your most influential teacher and why? Professor P Smythe who introduced me to the principles of research and to the need for an understanding of pathology and pathophysiology as the basis of disease processes. What would your advice be to a newly qualified doctor? To keep a balance between work, family, and contact with friends. What is your worst habit? Chocolates What is your greatest regret? I studied medicine right after school and did not do an arts degree first. What do you think is the greatest political danger to the medical profession? Politicians dictating to the medical profession and interfering in academic medicine. What complementary therapy have you tried? Did it work? None. But then orthodox medicine did not help my minor ailments. What is your favourite book and why? Dominique La Pierre’s The City of Joy, it explores human suffering and endurance from both medical and social perspectives. Do you apply subjective moral judgments in your work? I try not to. What part of your work gives you the most pleasure? The results of research and follow-up of patients who do well despite the doctor. Describe your ethical outlook. Autonomy, justice, and equity. What is the least enjoyable job you have had? Paediatric medical officer during the peak summer diarrhoea period. Where were you in your sibling order and what did you gain or lose as a result? The eldest—too responsible. Had to learn to relax, but did learn responsibility and accountability.
680
A bottle of beer here is a cold bottle of beer sitting on my living room table. There are many more chilling patiently in the fridge, or sitting with good humour in a box on the kitchen floor. Still more wait hopefully in the supermarket. I speak fondly. Luke proclaims that life is more than meat, and the body more than raiment. Beer, likewise, is more than an adult beverage. “When the sun rises”, Blake asked, “do you not see a round disk of fire somewhat like a Guinea?” “Oh no, no,” he answered himself, “I see an innumerable company of the Heavenly host crying, ‘Holy, Holy, Holy is the Lord God Almighty’.” Just so with beer: it is more than a drink. As the olive branch was to Noah, so an open beer to me is a promise. Being able to drink a beer means I am not on call, that I am free. It means no prospect of a midnight battle through the freezing English winter wearing surgical scrubs of the thinnest cotton. It means one’s sleep is at the mercy only of dreams, not of an electronic bleep that knows no compassion. So I wince as my housemate brazenly drinks a beer in front of me, flaunting the fact that I am on call and he is not. I would find his behaviour intolerable if I didn’t have a dim memory of starting that gloating tradition myself. But once past the cold night and onto the hospital wards, how friendly, how sociable everyone is. How surprisingly warm is the atmosphere that comes over the place when the day is done. There are the endless cups of coffee or tea made for each other and passed around: brimming gestures of good will from one person to another. They too satisfy a thirst not wholly physical. Those mugs have a warmth that comes from the spirit in which they were filled.
T
We are creatures with minds, and the world we live in is our own imaginative creation. Paranoid people truly live in worlds where everyone is out to get them. The suspicious and jaded see what they fear. While those in love discover wonders! Just read Tolstoy’s captivating account of Bezuhov wandering through Russia suddenly smitten by the beauty of the brave new world and all the people in it, unable to understand how he had failed to see it that way before: all because Natasha smiled at him. The reality of things is their imaginative reality, whether they be a cold beer or a cup of tea made by a warm-hearted colleague. There are moments within a string of bad days on call when one becomes wholly an inhabitant of the corridors and wards, a creature living by fluorescent light and in the shadow of disease. All thought of outside life dissolves and the pangs for it slip away without feeling. It can seem discomfiting, odd, and wrong, to go home at the end of a long shift—as though one’s only natural state was to be permanently working. In such feelings lies the hope for success in medicine, for joy in work can come only after that work has bitten into one’s heart. But the seeds of obsession are close by; hanging with grey sleeplessness under one’s eyes, delighting in the grandiosity that comes from working ridiculous hours, and believing more are always possible. It can be a difficult path between those two extremes. Excess in all things, preached Blake, is the only way to live. Truly an excess of work can vitalise it, turning the mundane into the zestful. One must allow oneself to be swallowed whole by work—and yet retain the hope of emerging again. I enjoy the tea, but I look forward to that beer. Druin Burch
THE LANCET • Vol 358 • August 25, 2001
For personal use. Only reproduce with permission from The Lancet Publishing Group.
LIFELINE Miriam Adhikari Miriam Adhikari is acting head of the Department of Paediatrics, at the Nelson R Mandela School of Medicine, University of Natal, Durban, South Africa. She obtained her degree at the University of Cape Town, and did her postgraduate and doctoral thesis at the University of Natal. She has been a consultant neonatologist since 1976. Who was your most influential teacher and why? Professor P Smythe who introduced me to the principles of research and to the need for an understanding of pathology and pathophysiology as the basis of disease processes. What would your advice be to a newly qualified doctor? To keep a balance between work, family, and contact with friends. What is your worst habit? Chocolates What is your greatest regret? I studied medicine right after school and did not do an arts degree first. What do you think is the greatest political danger to the medical profession? Politicians dictating to the medical profession and interfering in academic medicine. What complementary therapy have you tried? Did it work? None. But then orthodox medicine did not help my minor ailments. What is your favourite book and why? Dominique La Pierre’s The City of Joy, it explores human suffering and endurance from both medical and social perspectives. Do you apply subjective moral judgments in your work? I try not to. What part of your work gives you the most pleasure? The results of research and follow-up of patients who do well despite the doctor. Describe your ethical outlook. Autonomy, justice, and equity. What is the least enjoyable job you have had? Paediatric medical officer during the peak summer diarrhoea period. Where were you in your sibling order and what did you gain or lose as a result? The eldest—too responsible. Had to learn to relax, but did learn responsibility and accountability.
680
A bottle of beer here is a cold bottle of beer sitting on my living room table. There are many more chilling patiently in the fridge, or sitting with good humour in a box on the kitchen floor. Still more wait hopefully in the supermarket. I speak fondly. Luke proclaims that life is more than meat, and the body more than raiment. Beer, likewise, is more than an adult beverage. “When the sun rises”, Blake asked, “do you not see a round disk of fire somewhat like a Guinea?” “Oh no, no,” he answered himself, “I see an innumerable company of the Heavenly host crying, ‘Holy, Holy, Holy is the Lord God Almighty’.” Just so with beer: it is more than a drink. As the olive branch was to Noah, so an open beer to me is a promise. Being able to drink a beer means I am not on call, that I am free. It means no prospect of a midnight battle through the freezing English winter wearing surgical scrubs of the thinnest cotton. It means one’s sleep is at the mercy only of dreams, not of an electronic bleep that knows no compassion. So I wince as my housemate brazenly drinks a beer in front of me, flaunting the fact that I am on call and he is not. I would find his behaviour intolerable if I didn’t have a dim memory of starting that gloating tradition myself. But once past the cold night and onto the hospital wards, how friendly, how sociable everyone is. How surprisingly warm is the atmosphere that comes over the place when the day is done. There are the endless cups of coffee or tea made for each other and passed around: brimming gestures of good will from one person to another. They too satisfy a thirst not wholly physical. Those mugs have a warmth that comes from the spirit in which they were filled.
T
We are creatures with minds, and the world we live in is our own imaginative creation. Paranoid people truly live in worlds where everyone is out to get them. The suspicious and jaded see what they fear. While those in love discover wonders! Just read Tolstoy’s captivating account of Bezuhov wandering through Russia suddenly smitten by the beauty of the brave new world and all the people in it, unable to understand how he had failed to see it that way before: all because Natasha smiled at him. The reality of things is their imaginative reality, whether they be a cold beer or a cup of tea made by a warm-hearted colleague. There are moments within a string of bad days on call when one becomes wholly an inhabitant of the corridors and wards, a creature living by fluorescent light and in the shadow of disease. All thought of outside life dissolves and the pangs for it slip away without feeling. It can seem discomfiting, odd, and wrong, to go home at the end of a long shift—as though one’s only natural state was to be permanently working. In such feelings lies the hope for success in medicine, for joy in work can come only after that work has bitten into one’s heart. But the seeds of obsession are close by; hanging with grey sleeplessness under one’s eyes, delighting in the grandiosity that comes from working ridiculous hours, and believing more are always possible. It can be a difficult path between those two extremes. Excess in all things, preached Blake, is the only way to live. Truly an excess of work can vitalise it, turning the mundane into the zestful. One must allow oneself to be swallowed whole by work—and yet retain the hope of emerging again. I enjoy the tea, but I look forward to that beer. Druin Burch
THE LANCET • Vol 358 • August 25, 2001
For personal use. Only reproduce with permission from The Lancet Publishing Group.