"Dissonance (if you are interested) leads to discovery."
- William Carlos Williams
Dear Editor,
Living life on the other side can be humbling. I remember struggling a lot in the first few years in Glasgow – not just because of the content thrust upon me as a student, but also because of the uphill battle against the thick working class accents of the Glesga men and women.
Scottish patter is not only its own series of rules of pronunciation, or an enigmatic lexicon of terms designed to replace words for common nouns and actions – it is also the prosody that varies depending on which Scottish coast you find yourself on and its subtle relations to Northern Irish accents (which will be saved for another discussion).
It would be easy to regurgitate best practices for an Objective Structured Clinical Examination station, if it was not complicated by the effectiveness of communication. Being unable to go more than ten words without getting stopped with a "...pardon?" as a fresher might be equivalent to a hard-of-hearing patient not being able to understand why you're taking away their water tablets.
In a foreign land
As the years went by, I now relate these early experiences to how life may be for the newcomers to Singapore. Glaswegian cordiality and friendliness parallel Singaporean courtesy and openness, by my estimate, but this might prove initially hard to tap into as a person from a foreign place.
When you don't understand a place and the people living there, you have two options. One, you challenge your own assumptions of what the place is, and perhaps even your assumptions of where you are from. Two, you hold an irreducible idea of what you are in the middle of and trust that you could safely interface with your idea of the place without ever needing a more well-resolved understanding of its complexity.
The scale of Scotland – its people, the place and the way of living that is accepted – is perhaps able to match the scale of medical practice and understanding. As I understand it, its long thread of historical narrative is complemented by an equally intriguing contemporary slice of time, although the nuance of either were lost by way of the game of Chinese whispers that are often played with its customs and traditions.
Either approach, in my personal opinion, is not a wrong one. The idea that Scotland is a place of natural wonder, industrial grit and too many brands of collectible whiskey, is probably good enough to guide your intuition as a traveller and as a healthcare provider. But I have also found it constructive to see it as a place where acute pancreatitis episodes, alcohol-related liver disease and GCS-3 yielding trauma are simply the scars to be borne by a people who repeat traditions for better or worse, who are looking for reprieve and who are living lives that they yearn to make good use of.
I personally neither condone nor condemn the place that I see before me as I see it as a whole – even as the externalities wrought in it bring much suffering – because I believe it is equally likely for other ways of living, realised or not, to bring equal amounts of frustration to people as what a career in medical school has made me privy to.
Both ideas come with caveats – hold the single irreducible idea and you risk the chance of that perspective becoming ignorant. Challenge each idea unceasingly, and you may never truly recognise the value of any of these. (I suppose that by reading this you are now quite clear on where I have chosen to stand!)
The medical student experience reminds me that growth is less an expansion of one's horizons and likely more a refinement of personal convictions. These personal convictions are derived from a better understanding of one's self.
In order to make good on the threads of time and chance that brought you to this point, and to carry them forward, you must become that which carries forward at the expense of not becoming any of the things that do not.
As you sculpt yourself towards the likeness of a doctor, you might dread who you might have to give up being in order to keep on the narrow path. But at the same time, do know that sacrifice is part and parcel of how life has to be, how life is.
The idea of seeking more – seeking what is better for us – is echoed in the lives of all of us in the Singapore Medical Society of the United Kingdom. We sit with the knowledge that what we are doing and choosing to do reduces our unstable potential (both as medical students and as people) to hopefully create a more stable state.
As much as I have prized the lessons learnt from charging headfirst into misadventures, I have made a roundabout detour to the realisation that life is not simply about achieving a blanket state of "success" in everything that you set out to do, and perhaps is also a matter of choosing the series of games that, should you play them well, will bring the most meaning to you and those around you.
Final notes
I will end with some short notes.
A few years ago, I had the privilege of visiting the Hebridean Isles just after whiskey season. I learned about the region after I came across the efforts of a woman from Toulouse, who interviewed and photographed youths living in the Isles who made great efforts to leave Jura to seek a better life. Having been to Islay, I can say that its ways of living are organised, in opposition to metropolitan habitation – large expanses to seek solitude within, a slower pace – where life appears stripped down to its essentials for a Singaporean acquainted with a life within cement-formed walls.
Over the past summer, I became acquainted with an English conversation "class" meant for attendees to hone their command of English. The class was run by a pleasant Scotsman who had received a great deal of education about how to educate others, and he was enthusiastic to explore options in getting more participants despite issues with resource allocation and learning. I noticed that many of the local helpers would have issues with trying to explain concepts to the participants, who are learning English as a Second Language (ESL) – they might explain an idea as it relates to Scotland without being mindful of how the ESL participant might relate to that idea as it was understood in Queen's English. And for a moment, I saw myself in the shoes of the students even as I attended as a helper, and I became thankful for having had the chance to experience a place that I have yet to even scratch the surface of from different perspectives.
Warmest regards,
Jeremiah Sim
About SMSUK
Established in 1994, the Singapore Medical Society of the United Kingdom (SMSUK) is a student-led non-profit organisation with over 1,100 lifetime members.
Being so far away from home can be daunting, so it is our primary goal to ensure that medical and dental students studying in the UK are supported from pre-enrolment to graduation. We advise prospective UK medical/dental students, create networking opportunities for existing members, and update all members on career opportunities in Singapore and abroad.
Through our diverse repertoire of exciting events held throughout the year, we also aim to provide a "family" for fellow Singaporean medical/dental students studying here so our members can establish, as cliché as this may sound, a home away from home. Some of our events include: a student-run conference co-organised with other international student medical societies, our signature Weekend Away retreat outside of the UK and of course, our glamorous annual dinner to wrap up the academic year!