WHAT WILL I DO?

Medicine. In its broadest definitions at a time in your professional life when you are most recent on all fields and more adaptable in implementing them in practice. You are not being sent out as the Bwana of Hope to take over the practice of medicine in an area and set a new standard for them to follow. These are the last months of your being a medical student-you can still claim culpable ignorance, and a lot of humility pays very much bigger dividends in the adaptive tricks your supervising practitioners can teach you. I have had some regrettable contact with newly arrived very ugly Americans who opined loudly at every opportunity that the contemptuous practices they were witnessing were so far below their exalted standards that they thought it a waste of time to get involved in learning bad habits. There are many ways of expressing fear-and being overwhelmed by the volume and severity of the disease and poverty confronting them had these haughty products of the world's richest (but not necessarily most generous) nation reeling back into the sanctuary of derision. The reason you-and they-are out here to begin with is that this is NOT the "same old dart". This is a learning experience, and you will learn as much or more as you would here with as much or more respect for those who teach you under very different circumstances and with vastly different resources.

I do not need to remind you: you are medical students-you will respond appropriately in this new environment. You are better at it than many postgraduates to whom I have introduced this world, since they were more frightened than you, being further removed from, for example, their first delivery. Now is not the time for you to take on solo neurosurgery either, but when someone comes to you with a toothache, the appropriate response, is not "Not my job!" or with something a little closer to home, but for which you were feeling inadequate "I was sick the days of those lectures." That is why you are not alone-then, or now-and you will have supervisors-there or here-to ask advise and guidance, often in the simplest things for which they assume a generic doctor is equipped. For some problems, this is not rocket science-as in the example of a toothache, and you do what you can. If you would rather defer (remember, there is only so much room in the "waiting room" even if that is as much shade as an acacia tree provides) you can do so with the face-saving acknowledgement that you are a medial student here to learn. I have a little more weight to the problem when they asked "The University Professor of Surgery if he would mind if they added another case to his list for the morning, and would he mind if it were the first one since it seems urgent"-and my first surgical case in Swaziland in the last trip there was my life's first (and only one I have subsequently heard of in consultation with friends after the case) Caesarian hysterectomy!

Relax. You have done, will do, and will continue throughout your professional life what is appropriate during the further development of cautious judgement.