Wednesday, 11 July 2012

"Attitude, attitude"

Attitude, not brain, is the most important thing during clerkship. It has its own set of grading. It can mark you up or mark you down. And since clerkship is essentially a sneak peek of the [medical] workforce, it could be safely assumed that attitude is also the most important thing in the professional working world.

The problem is, the word "attitude" has a wide interpretation.

Merriam-Webster has a handful of definitions for "attitude":
1 : the arrangement of the parts of a body or figure; posture
2 : a position assumed for a specific purpose <a threatening attitude>
3 : a ballet position similar to the arabesque in which the raised leg is bent at the knee
4 : a) a mental position with regard to a fact or state <a helpful attitude>, OR b) a feeling or emotion toward a fact or state
5 : the position of an aircraft or spacecraft determined by the relationship between its axes and a reference datum (as the horizon or a particular star)
6 : an organismic state of readiness to respond in a characteristic way to a stimulus (as an object, concept, or situation)
7 : a) a negative or hostile state of mind, OR b) a cool, cocky, defiant, or arrogant manner

The attitude referred to in clerkship has a slightly different meaning, though clearly it is not "a ballet position". It generally means how you conduct yourself. But here's the catch: your conduct has to appeal both professionally and personally.

We all know the examples of a professional conduct in medicine: coming on time, doing all the assignments, dressing appropriately, assessing patients systematically, so on and so forth. There are written rules governing these matters, and usually no one has a problem following them.

A personally-appealing attitude, on the other hand, is a lot trickier. It relies heavily on the concept of respect; but what, then, is respect? This is when the definition of attitude, and respect, gets easily abused. Because, it's not only about, say, addressing your superiors correctly. Frankly speaking, often it's more about kissing people's asses and/or bribing. Actually, these two overlap so much so that I will just consider them as one and the same thing.

Well, kinda like this, but a little less cute.

Of course, most would explicitly deny the need of such [un]professional conduct (although yes, a few others will just plainly "request for your generosity"). But really? It's like, when you bring a gift to someone and they say, "Aw, you don't have to!", what would you do? Do you withdraw that gift? No, you still give that gift, and that person will still accept it. It may need a little soft coercion here and there, but we all know it: that polite rejection at the beginning is a reverse psychology trick to make sure that the giver is giving sincerely, without previous threats or pressures from the receiver or other people, even if said threats/pressures do exist.

That's what happens in clerkship here in Indonesia. The typical bribing in secrecy is very rare; it can be officially sanctioned, and even though the law enforcement is weak, still there's a law against it. Gift-giving, however, is very much welcome, because... well, it's a gift, an act of kindness. You do not refuse an act of kindness. The gift in question is commonly some kind of food or snacks for "daily ransom", and larger ones, even a full lunch with appetizers and desserts, for farewell at the end of each rotation. Depending on the department, some will require something else, like maybe a new vase, a new cupboard, a new couch for the doctor's lounge, a TV,... you can never tell.

No one ever begs to differ. And none of us wants to imagine what will happen if a group of students leave a rotation WITHOUT leaving something, a tangible object in that department. Well, there may or may not be a problem. But it would be so uncommon that problem is more likely. *sigh*

I'm aware that I'm walking on a tightrope here. There's a fine line between diplomacy and bribing. Throwing a feast, a banquet, a party, is an integral part of political diplomacy around the world. This is especially prominent in Indonesia, where the concept of "kekeluargaan" (Google translates that as "kinship") is still very strong. If you ask me now, I can't even articulate exactly when diplomacy stops being diplomacy and starts being ass-kissing. But somehow, you know it when you see it (or do it).


So. Dear people NOT in medicine, please please PLEASE respect your doctors! You had no idea, didn't you?

PS. If you can suggest some clear contrasting features between diplomacy and ass-licking/bribing, I'm all ears.

PSS. Fortunately, there are still doctors and professors who uphold competence, both theoretical and practical, in a superior place. God bless them.

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