Tuesday March 21 2017

Forty years later, not ready to hang up the stethoscope



Muniini K. Mulera

Muniini K. Mulera  

By Muniini K. Mulera

Dear Tingasiga:
It has been 40 years since our class took the final bow from undergraduate life at Makerere University.
We had shared five long years of learning together, of pushing each other to excel, of building friendships and of supporting each other through very difficult experiences.
We had enjoyed the privilege of being tutored by some of the most outstanding scholars and clinicians.
Now here we were, on the morning of Friday March 18, 1977, atop Makerere Hill, a symbolic acknowledgement of our conquest of academia’s Kilimanjaro.
The glorious tropical Sun and a cool gentle breeze was the perfect backdrop to our final act before taking our different paths.
With hands raised and heads bowed, we took the Hippocratic Oath, that single most profound secular creed.

Sitting in the audience were my parents, whose delight knew no bounds. Medical school had not been my career choice, you understand. I had wanted to do law or political science, but my father would have none of that.
As a result, my choice of A-Level subjects had changed from the arts to the sciences. Like all his choices for me, a career in medicine had already shaped up to become a passionate love affair that would intensify with time.
By God’s grace, my father is alive, now aged 96, a witness to his son’s 40th year of a fulfilled professional career. What he does not know is that while I graduated from Makerere in 1977, I am yet to graduate from medical school. I am a lifelong student.
What have I learnt so far? First, my practice of medicine must never be about me but about the patient, always putting the child at the centre of everything.

That includes digging deep to understand the socio-economic and spiritual milieu in which the illness has been nurtured and amplified, and to which she will be returning.
Second, dogma and overconfidence is a recipe for bad medical practice. Many medical truths of 1977 are now confirmed fallacies. Today’s truths will be debunked tomorrow. One must, therefore, be tentative and humble, subjecting everything to rigorous inquiry, basing one’s practice on best evidence, not mere belief and conjecture. And one must always listen and learn from all colleagues, especially the nurses, who always know the patient better than you do.

Third, the practice of medicine is not about application of science to a human being in distress. It is about the doctor being a human being first, sharing the frailty of the patient, actively listening to the patient, always being a healer and comforter, not a technician dealing with body parts of a soulless organism.
Medicine is about a simple message that was shared by four Englishmen who defined our youth.
Ten years before our graduation, the Beatles had already captured our musical ears with their song: “All you need is love.”
Medicine is about love of knowledge. Love of truth. Love of justice. Love of freedom. Love of life. But above all, love of people, the only reason why anyone should pursue a career in medicine.
Medical school taught me to help my patients to live. But my patients have taught me how to live even “when sorrows like sea billows roll.”

One of my little friends, just over two years old now, was born with a missing right leg. Like her mother, a woman of faith, the little girl has faced her challenges with great courage and determination to walk.
I have watched her learn to crawl on one leg, and then walk with her new artificial leg, always determined, never discouraged, even after falling down, always looking ahead. Yes, always looking ahead.
She reminds me of the Class of ’77. We were always looking ahead, even in the darkest moments. As we raced towards the finish line, our stride was broken by the gruesome murder of Archbishop Janani Luwum and cabinet ministers Erinayo Wilson Oryema and Charles Oboth Ofumbi on February 16, 1977.

That was exactly four days before we started our final examinations. With hearts filled with grief and fear, and without the benefit of any psychological counselling, we kept looking ahead, calmly faced our tough examiners, and convinced them that it was safe to release us onto the public.
It is an honour to be part of a class that did not disappoint the trust of our outstanding teachers and examiners.
With sadness, we remember those classmates who have passed on, 11 of them at least, and lift them up with fond memories and very high esteem. We were blessed to learn with them, and from them.
Many of our colleagues who stayed in Uganda became a great anchor to a healthcare service that faced, and still faces, extraordinary challenges. They are the unsung heroes.

Many others left to train and serve in distant lands. They have distinguished themselves in their chosen specialties and helped reaffirm Makerere’s eminence in the world of medical education.
Our brothers from Lesotho, Nigeria and Tanzania have done equally well, serving and educating our younger colleagues.
To the Class of ’77, and our distinguished teachers, thank you for serving humanity. Do not hang up your stethoscopes. Our work is not yet done.
muniini@mulerasfireplace.com