Curing – or 'making better'

Jonathan Page

Jonathan Page writes as an 18-year-old medical student at UCT, where the first year course offers a unique opportunity to study a specific community, and later to participate in a 'hands-on' case simulation during which they learn more about individual people in difficulty and the organisations which serve them. The emphasis is on 'patients as people' and of functionality in families and communities “as against pathology.

Upon entering the health sciences I think that everyone is touched with the Utopian belief that, with your medical training, you will have the ability to cure anybody and anything. And what our group learned is that this is a fallacy. We studied Down's syndrome, those who suffer from the disorder and those who work with them.

Down's syndrome is something which cannot be cured using any form of modern medicine. The only thing that can be changed is the attitude of the people surrounding the person concerned, thereby ensuring the integration of that person into society. Unfortunately, what we heath service professionals can do is so limited. The people who have the largest role to play are the family, in particular the parents.

In the handling of a Down's Syndrome case, the parents are the single most important element. Without their support, any form of constructive progress is almost impossible. Out of this came the realisation of the need for education for doctors – education which will enable them to help set the parents in the right direction: to link them with organisations which may be most helpful. It was, however, realised that the health worker should not simply act as a referral service, washing his or her hands of the case after the referred. An interest should be maintained in the case, not only to provide motivation for the parents, but also because it will serve as a learning curve for future cases.

We also discovered that the services provided for people with Down's Syndrome were not adequate. And from this came an understanding of the difficulties involved in the practice of medicine in an economy where priorities have to be decided according to economic parameters, and not necessarily according to the needs of patients. But, as mentioned before, it is not the doctors, social workers and state or private organisations who are of most importance; it is the parents. The parents are the primary link with the patient; they represent a force which, when put into motion, can accomplish nearly anything. The reason for this is that they, out of everyone else in this world, really care about the patient.

The bond between parent and child is one of the basic necessities of life, without which nothing can be accomplished. The most important lesson that we learned during this project is about the role we will have to play as future health care workers. Our role will be limited by a number of things: economics, time, lack of facilities – and the fact that we will not always be able to cure a patient.

We have to accept that some things are not curable, but that things can be 'made better'. Our role may be, rather, to prepare and support the people surrounding the patient, and to help them with this acceptance. We learned that the people surrounding the patient back home are more important than any form of medical services which we had to offer.

Putting that into simple terms, we learned that our scientific training is limited, and that we should accept this. We must start from there, especially in the management of a person suffering from Down's Syndrome, which is not curable in any way. The only thing that is curable is the often negative attitude of the people coming into contact with that person.