Christmas Musings… & Happy New Year 2011

Christmas Musings… & Happy New Year 2011

Dr David KL Quek, drquek@gmail.com

MMA News, President's Message, January 2011

“And so this is Christmas
For weak and for strong
For rich and the poor ones
The world is so wrong
And so happy Christmas
For black and for white
For yellow and red ones
Let's stop all the fight
A very merry Christmas
And a happy New Year”

~ John Lennon, “Happy Christmas (War is Over)”[1]

“Few people want to do without those who care most about them – the family members, close friends and others who constitute their ‘community of companions.’ We sense that without them our lives could change in unwelcome ways. If truth be told, most of us want our closest life companions nearby much of the time, even if ‘nearby’ sometimes just means ‘accessible by e-mail.’ We invest important hopes in these companions. If we're fortunate, our closest companions bring out our best, not our worst; they have our well-being at heart. It is not just their presence we value, but all the forms of support they offer – their faith in us, their hopes for us.” ~ David Gibson, Emmanuel, the Lord of Undashed Hopes[2]

Christmas: A Human Message transcending the Glitzy Commercialism

Christmas for me is mostly about family, and a timely reflection upon the religious significance when Jesus Christ was born, more than 2000 years ago.

This religious message is increasingly difficult to decipher apart from all the extraneous commercial noises, which fog over the true meaning of this singular event. The consumerist buying sprees and sales, the Christmas trees and decorations, the glitzy partying are but secular distractions.

I suppose when one is younger, Gen X and Y, all these have special appeals to usher in a Dionysian respite of fun and games. But that said, it is not necessarily the wet-blanket approach that most middle-aged or ‘mature’ generations should enshroud themselves with, in grim joyless austerity.

Because the music, the carols and hymns, the pleasure of the gift-giving and sharing, the peaceful connotation so attached to the meaning of Christmas, are a joyful expression of the message intended to further enhance if not embellish the true gist of the ‘holiday’ season.

Essentially, Christmas time should dictate a renewal of faith as well as a renouncement of evil and sin. Basically this is at the personal level, a call to forgiveness, a return to godliness and a promise of faith keeping, to acknowledge the goodness and authority of a Higher Being.

It is also time to remind ourselves of our human imperfections, our proclivity to error-filled ways and our inherent sinfulness, and a resolve to aspire to be better than our human weaknesses and foibles would allow us, or tempt us to be otherwise. Because in all honesty, we are all more likely to be less than good, often times driven by innate selfish motives and actions, and we are prone to be less than kind to others, than we can or should be. But, we can do better…

“Agape” a selfless love for others, expressed without ulterior or selfish reasons is that fundamental gift and message of Christians. Above all we are exhorted to be more human and humane, to work toward peace, to be better national and global citizens, and we are entreated to champion unreservedly for human rights and dignity for all, especially the underserved, the indigent and the marginalized, i.e. those who have so much less by virtue of fate or circumstances…

Time Out Relief & Reminiscence

I treasure this time of the year for winding down—the pent-up tensions, the ratcheted-up rhetoric, discordant disagreements, combative battle of wits and wills, brutish alpha male infighting, ad hominem attacks and more, all need an assured space and time to dissipate, to simmer down a few notches…

Like a recurrent active volcano, its sporadic eruptions need always that intermittent dormancy to rebuild its tamped down energies, which while so potentially destructive, its consequential lava flows can also be so enriching and fertile, otherwise…

So I cherish this perforce moment of quietude, by opting for a much-needed vacation from the daily ‘drudge’ of work, toil, duties and “responsibilities”.

Truly, if one does not once in a while step back, it is possible to remain forever trapped within the clutches of never-ending grind of day-to-day humdrum affairs. We all need to chill out, to take a break, to time out for some much needed freedom from work, to be able to reminisce and ponder even if a little while, even if for the simplest distracted thoughts—if for nothing else to be able “to stand and stare”.

Serious burnout and ennui can etch psychological scars on our crowded fatigued minds. I believe we would perform the worse for it, if we let these psychological millstones weigh down or becloud our vision, our purpose in our individual lives.

For many of us though, we are so embroiled in the work of the living that we could not easily extract ourselves from its claw hold of remaining connected, of wishing to remain relevant, constantly on top of things, in our small if ephemeral niches of our increasingly hyper segmented lives...

Thus, it is not surprising that one finds it very hard, even well-nigh impossible, to be totally removed or cut off from the world: the ubiquitous background noises, the incessant sound bites, the strangle-hold of constant connectedness of the mobile phone, the emails, the tantalizing yet very tenacious stickiness of the internet, Facebook, Twitter, etc.

Perhaps many of us think we are more than what nature has in store for us humans, that we have a greater or more meaningful impact on others around us. Perhaps we do, but then again these are in some mostly small, fleeting and inconsequential moments and ways, in hindsight.

Some of us of course prefer the close comfort of home and our own cloistered world of just a few—believing that we do not need to be too involved in the world out there, with all its changeable and discordant political or social clatter. Somehow, we would quietly get along and simply work for our own families, our close-knit circle of friends, our own interests…

Sometimes, we overplay our roles and overstep the boundaries of propriety, and we get hardboiled into believing in our own superiority, our own self-importance.

Sometimes we are just indifferent and we couldn’t care less…

This converse reaction however, more often than not, stifle us into stagnant morass of inaction, inactivity and fearful non-action when faced with hurdles or challenges, mostly because we are unmoved or simply feel too helpless to do something. Our greatest weakness is to remain apathetic and simply moan within, subsuming to a culture of the ‘silent majority’ or worse, to that Mammon of overarching but all-consuming personal self-interests…

Christmas is that special time to rekindle the humility, which would make us that much more caring, kindlier and compassionate, especially for those engaged in the healthcare business. And yet we are reminded to be more proactive and find the inner strength to act more unwaveringly toward a greater good, tempering our profit motive, our baser instincts toward callous fee-for-service earnings at all costs, and a deteriorating sliding adherence to our much-vaunted altruism.

Our lives and actions interweave and impress more easily than we expect, our ‘6 degrees’ of chancy interconnectedness or intrusions on others, are often less obvious than we can imagine.[3]

But more often than not, our influence is less than meets the eye, of lesser consequence than we believe. It is certainly not the case of ‘half empty’ vs. ‘half full’ perspective of the world around us, but bare bones realism. Some of us are habitually more sedate and pessimistic than others, some more cynical, while a smaller number subscribe to a more optimistic and ‘feel good’ attitude.

But truth be told, most of what we do unfortunately have very little long-term impact on society and others; they pale in comparison to those made by politicians, policy makers, government, etc. So perhaps for those of us who wish to leave bigger imprints on society, we do have to commit to some paradigmatic shift, to engage more forcefully and more steadfastly into causes, which can then be better addressed for larger segments of our society.

Down to Earth Issues: 2010

The year 2010 is nearly over.

The year began ominously. Following the 2009-2010 budget, fifty 1Malaysia clinics were quickly established which challenged our concept of who should rightfully man any health clinic—the MMA and most medical professionals believe this must be physician led and manned. The health authorities and the government feel otherwise—the urban poor need urgent service, albeit at a questionable level of care.

What began quite contentiously as 1Malaysia clinics manned by paramedics became a serious point of contention with the health authorities and the government, but after some dialogues, greater understanding of our misgivings was represented, with the authorities still remaining entrenched in their position of its right to act. This year some more clinics, including mobile clinics, are being deployed, but we are made to understand that medical officers would be manning these clinics to help the rural underserved communities.

The MMA has loudly expressed its misgivings as to the potential glut of medical graduates and medical schools. We worry about the quality and growing dearth of sufficiently empowered public training hospitals to provide for supervised quality training and apprenticeship for our fresh doctors—we worry about the final product, which might be less competent than meets the eye.

“Excellence is an art won by training and habituation. We do not act rightly because we have virtue or excellence but rather we have those because we have acted rightly. We are what we repeatedly do. Excellence then is not an act but a habit,” had wisely been articulated millennia ago by Aristotle[4]

We worry about public safety in the shorter term and the employability and competition among doctors in the longer term. We worry about the public being shortchanged by this bureaucratic rush to attaining the magical doctor-population ratio of 1:400—some 90,000 doctors by 2020!

“The volume and complexity of what we know has exceeded our individual ability to deliver its benefits correctly, safely, or reliably. Knowledge has both saved us and burdened us.” ~ Atul Gawande, Surgeon and New Yorker staff writer, author “The Checklist Manifesto”, “Better” and “Complications”.

We worry about the impending Public-Private integration of healthcare services, with an ambiguous ‘work-in-progress’ scheme of social health insurance initiative and the planned ballooning of the public sector manpower needs. Would we be able to attract and retain some 55,000 doctors in our public health service?

We worry about the possible demise and marginalization of the private medical practitioners particularly the GPs. Our GP Summit attests to the seriousness with which we medical doctors envision the diminishing roles of GPs. We worry about the subtle credentialing processes, which could subsume the GP into a lesser less rewarding role, dominated by the few family medicine specialists who are now chiefly driven by public trained mechanisms and perspectives.

We fear change, which has not been fully articulated or formulated to encompass all our concerns and misgivings. We seek greater transparency and dialogue to improve our health care systems so that together we can achieve more than what has been simply planned, without the necessary oversight of experience or scrutiny or input from other “out-of-the-box” stakeholders.

We are fearful that the government has been whittling down its commitment to healthcare allocations from tax revenues, instead of increasing its obligations when most countries around the world has been convinced to provide. Despite global escalating healthcare costs, most nations around the world are battling with changing, modifying mechanisms to try and tamp down spiraling inflationary costs, while addressing much needed health reform.

We worry as to the gradual passing of the buck back to consumers and tax payers, who would be once again be made to accept higher payment mechanisms to help defray the bloating healthcare budget. We worry that the much-needed tax subsidies for healthcare would be gradually removed to further burden the poorest and the middle class, whose savings for retirement, are already hugely inadequate. We worry that the poorest 40% of the population would be left once again marginalized, to accept bare minimum healthcare products and services, without a social safety net such as Medicare, Medicaid or CHIPs or whatever.

Yet we all aspire to be better—to reach the 2020 goal of a developed nation with per capita income of some USD 15,000 or more. We need to beat the so-called middle-income trap, but we appear to be least prepared for the obligatory sacrifices and the mandatory leap in productivity—so elusive for most Malaysians these past few decades.

We need to prod our population to do more, now and continue to improve all the time, to keep up with the highly competitive world out there. We cannot afford to be bogged down by petty and nonsensical parochial interests and partisan prejudices and rhetoric, which destroys the fabric of our fragile unity amidst our increasingly touchy mindsets.

We must strive to work together to be better than one ethnic or religious fraternity alone—collectively we should be better than one, in the true spirit of ‘One Malaysia’, or a ‘Bangsa Malaysia’.  But this must not be an empty slogan, a meaningless outdated discordant shibboleth which rings hollow, when one does not walk the talk! No one wishes to be left behind; no one wishes to lose this unforgiving strife for advancement and one-upmanship.

Yet we must actively find more meaning and purpose in our lives, to enhance the development goals for all Malaysians. We can do better to help reduce, even eradicate poverty, enhance living skills and standards including healthcare and quality of life, abolish social ills such as corruption, street crimes, sociopolitical injustice, ethnic and religious bigotry and intolerance.

Thomas Friedman, New York Times Columnist and author argues that Americans have “to postpone gratification, invest for the future, work harder than the next guy and hold their kids to the highest expectations.” Otherwise he says the country will be unable to keep up with China and other emerging economies… This aptly applies to us Malaysians in more ways than others! We must and can do better!

Ah, Christmas time is that time for thought, for reappraisal, for re-aligning our purposes and goals—most importantly, to refocus on our lives and clarify our individual and collective purposes… Are we ready to invest in the future for all Malaysians, or just for the one or few?

May the coming year 2011 be an especially meaningful, prosperous and love-filled one for everyone! Happy New Year!

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[1] John Lennon. Happy Christmas (War is Over) lyrics. http://www.lyrics007.com/John%20Lennon%20Lyrics/Happy%20Christmas%20%28War%20Is%20Over%29%20Lyrics.html

[2]
David Gibson, Emmanuel, the Lord of Undashed Hopes. Catholic News Service, Faith Alive!-No. 44 STORIES Dec-13-2010 http://www.catholicnews.com/data/fafeeds/stories.htm

[3] Frigyes Karinthy. Chain-Links. Translated from Hungarian and annotated by Adam Makkai and Enikö Jankó. (Six degrees of separation: Karinthy believed that any two individuals could be connected through at most five acquaintances. Karinthy believed that the modern world was 'shrinking' due to this ever-increasing connectedness of human beings.)

[4]Durant W. The Story of Philosophy: The Lives and Opinions of the World’s Greatest Philosophers. New York, NY: Pocket Books; 1991.