Harsh Decisions Need To Be Taken By Bold People In Tough Situations

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From Dr Venugopal Balchand
In my line of work as a specialist doctor, I am used to making hard decisions regarding people’s lives. Tough calls. I have been at the receiving end of tremendous gratitude and, of course, the occasional disappointment.
But as I sit down to pen these few paragraphs, I must confess that I am consumed by anger, frustration and disbelief, but most of all an overwhelming sense of fear and concern as to how our nation is battling the pandemic.
How difficult can it be to make the right decisions? Especially when you are not alone but supported by an armada of staff and infrastructure?
Personally, over a 30-year career in a demanding medical specialty, I have relied on three important criteria when making decisions.
Data
Doctors have a lot of Data at their fingertips but what they don’t know or can’t remember, they at least know where to look for it!
Since December 2019, when the virus first popped up in Wuhan, the amount of data that is available about the structure, mode of spread, infectivity, course of illness, high-risk groups and mortality among others in just 18 months is incredible. An extremely dedicated scientific community and the wonders of the internet have made this data available to all and sundry.
Experience
In clinical medicine, nothing beats personal experience as long as you have made the effort of reflecting on both your triumphs and disasters. Often, when you lean on your personal experience, it has a way of leading you to the right or at least better decisions. Very few people actually make the same mistakes, over and over again.
Common sense
Certainly not so common these days but an integral part of sound decision making! Would I persist in trying to achieve the ideal in an 85-year-old gentleman with multiple comorbidities or would I opt for a lesser but safer surgical procedure? Would I consider a surgical coronary bypass operation in someone who unfortunately has terminal cancer and only a couple of months to live?
This combination of data, experience and common sense has stood me in good stead all through my career. Which is why I am stunned by the total lack of all of these three elements in some of the important decisions taken when tackling the pandemic. The incessant flip-flops have only added to the confusion.
Yes, it is a battle of lives vs livelihoods but you need to be alive first to have a livelihood. Without doubt, mass movement or continued interaction of people is the most important trigger for rapid spread. How difficult can it be to stop this when you have an entire machinery at your disposal?
The decisions on how to battle Covid-19 in Malaysia, I know, are not taken by one individual but a team, assisted by other teams. With so much support, why can’t at least one team come to the right decision?
Twice in my career, I have had to make the gut-wrenching decision of turning off a patient’s life support. At this stage of a raging pandemic, there is absolutely no room for emotion, no room for politics, no room for religious sentiments. All that matters is the health of our nation.
Harsh decisions are required to be taken by bold people.
There is a silver lining though. Decisions are something that each and every one of us can make without relying on anybody else. The onus is on us.
Let us then mask up, wash our hands regularly and maintain social distancing. Common sense tells me that God will listen to our prayers, whether we recite them from the comfort of our own homes or in the hallowed halls of a place of worship.
Let us stop moving from home to home, whether immediate family or just friends, trying to promote cheer because in all honesty there is absolutely nothing to cheer about. And let us vaccinate ourselves at the first available opportunity.
It is an absolute no-brainer that unless we are truly serious about combating the virus, this beloved country will head the way of one of our beleaguered neighbours just four hours away by air. Mass cremations make for more gory and compelling viewing but mass burials are equally catastrophic and sad.
The decisions are all ours and ours alone. - FMT
Dr Venugopal Balchand is an FMT reader.
The views expressed are those of the writer and do not necessarily reflect those of MMKtT.

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