Wednesday, November 26, 2014

Risks and rewards

In the opening monologue of the film Trainspotting, Renton says “what people forget (about injecting heroin) is the pleasure of it, if it wasn’t pleasurable we wouldn’t do it after all we’re not stupid, at least we’re not that f***ing stupid”. On the face of it working with Ebola and injecting heroin don’t seem to have much in common but they do share the mixture of pleasure and danger which some people find addictive.

I’ve been highly introspective about my motivation for coming here and the reasons I enjoy it. One thing it definitely is not is altruism. That would mean incurring more risk than the rewards you get out at the end and I doubt many people are genuinely in that position.

The risks are hard to quantify but are real; while many local healthcare workers have died the mortality rate for foreigners who are evacuated to high resource settings is very low, in fact for those who recognise early signs of illness and are evacuated quickly the mortality rate is zero. That doesn’t take into account the terror of catching this illness and the concern it would cause to friends and family, not to say the cost, but it's some reassurance. I think that if the mortality rate for me was anything higher than about 30% I would be too scared to work here.

It has taken some deep introspection to work out the rewards that outweigh these risks. Firstly, there is definitely an adrenaline rush from being at the frontline of something really important. The outbreak has had devastating effects on west Africa and as a healthcare professional it feels like the most important place to be right now. There are always other places with competing needs and less media attention but right now this feels like the place to be. In short, if your normal life feels like the First division, this feels like a temporary shot at the Premiership. I can’t feel bad about that. It is true of many professions from the military to the media that you want to be ‘where the action is’ and I am no different.

There is more to it than that though. There is a side which feels like a guilty pleasure and that is the power and attention. I don’t like being the centre of attention at a social gathering, it makes me uneasy, but in a medical setting I think I enjoy it. My personality enjoys being the one out there in front of the hospital talking to the relatives in their time of need. I certainly don’t enjoy the power to decide who does or does not get admitted to the unit; that is something I could easily do without but being the one with the information and communicating with people at the gates is very rewarding and even intoxicating at times. That is difficult to share and doesn’t give me pride but I guess there are worse ways of satisfying a need for power and attention.

While my transition to the Premier league has felt pretty seamless I am not sure how easy it will to adapt to normal working conditions again. I common with many of my colleagues here I'm concerned that life back home might just feel too normal and bring on the depression that was expected after arriving here.

1 comment:

  1. A very fair and understandable set of feelings. I think the best thing to do is not to worry too much about what will happen when you return. Either you will find pleasure and challenges in life back home, using your experiences in Sierra Leone to forge new paths of work, or you will find that moving on to something different is the way to go, be it in West Africa, or elsewhere on the continent. You are not tied to South Africa, nor to your job, so you are free to choose. [Frodo faces the same dilemma at the end of Lord of the Rings]. Whatever happens, you will find your feet. My suggestion of extended leave on your return to have time to think, was with this issue firmly in mind. The offer remains. Keep hydrated and enjoy life on the front line. BW, Marc