How Many Roads Lead to Rome?

Initially, I thought I was in love with the British. When I arrived in the wards, I was greeted with an enthusiastic welcome. The nurses smiled and invited me to ask them for help should I have any problems on the wards. The interns (they call them House Officers here) were so warm and all of them asked me if I wanted some tea, including the nurses!

I had to pinch myself to remind me that I was in a real hospital with real nurses.

The senior resident (they call them Registras here) took an actual interest in me and my goals and what I would like to gain out of the elective. He made sure I was introduced to everyone on the team, including the patient and he didn't patronize.

Man, I am doing medicine in the wrong place. This is what I thought as a young sapling, googling at the wonders of a new green house, thinking: that's really nice that they do things like that here.

Fast forward seven days. I am presently introduced to another Registra, who only just recently obtained a position at Guy's. The British medical system is socialist in nature and currently, there is a surplus of doctors in the country since Britain is required to accept medical graduates from all over the EU. A new graduate can find himself stuck in an internship (house officer) position for several years, sometimes like 10 years, before Registra jobs open up.

I guess I am immediately stunned by his cockiness. This is something not foreign to me as we too have our cocky bastard equivalents in the American system such that I have learnt to ignore people like them who are too keen on letting you know how smart they are and how gloriously stupid you are. He's just recently read a research paper for his interview and for the life of me, I cannot remember what his snotty speach was about because I was so immediately put off by his arrogance that I had mentally shut him up. I think it was something about risk factors for mesothelioma, a rather prevalent cancer in this population, or some googoo gaga shit like that.

And because I have been introduced as "the medical student from America," he is giving out quotes from the New England Journal of Medicine, citing this randomized controlled trial and that randomized controlled trial.

It all sounds very intellectual and everything and he has a table of four just mum because we are polite, I by default because I am with polite people, just listening to him over coffee and croissants. I doubt anyone was drooling at his wealth of information but we were, nevertheless, paying apt attention, as opposed to rapt.

After his speech, Mr I'mawhitemanandIknowitall redirects his attention at me and asks:" So where in America do you go to school?"

So begins this question that has a complicated answer, which I relay.
"It's rather complicated," I begin and tell the story.
"In the Caribbean, eh," says Mr I'mapompousassandidon'tknowit.
Yes, I say and start to explain when Mr Ilovetohearthesoundofmyownvoice turns away and looks at his nails, sighs, stretches his arms across the back of the booth where we were sitting in the corner and yawns.

And I think to myself: I guess this is politeness, some sort of 1000-year history of etiquette where one asks a question and makes an attempt at genuineness but is not really interested in listening to the answer.

Fast forward three days. I am with Mr Pompous Prick getting ready to watch another marvelous day of surgery in the back drops. The Attendings here (they call them Consultants) don't want the medical students to scrub in and since this particular consultant likes to make a 4-inch thoracotomy versus a 6-inch thoracotomy, one can really see shit even if one is scrubbed in. He asks me these series of questions:

"What is the percentage of people who survive a pnuemonectomy?"
Er, do I give a fuck? Is this a question a medical student would genuinely know?
"I don't know but I will make an educated guess; 15%"
"No too high, try 2%."
"What is the percentage of people IN THE UK who survive a pneumonectomy versus a lobectomy."

I laugh. And since he likes to hear himself talk and pat himself on the back due to his absolute smartness because he can rattle off percentages like he is rattling off latin conjugations, I let him rattle. Can I recall what they were? Can I even barely recall the questions to these ridiculous answers he's asking of me like I give a damn what the percentages in the UK are?

And to add insult to injury he says to me in the middle of his rattling: "Are you chewing gum?"
"Why does it bother you?"
"Yes, you really shouldn't chew gum. You should NEVER chew gum while talking to your patient."
So his British ass spends about five minutes chastising me on the bad values of gum chewing and in my head, because I am so polite, I am thinking: well Buttfuck, I would rather chew gum and have nice breath talking to my patients than not chew gum because some 1000-year etiquette says it is bad form to chew gum and gum chewing is akin to hooliganism and have bad breath like yours and kill my patient.

This starts me thinking about the utmost importance the British (and to a certain sense, a part of the medical profession in the US) place on the value of appearance. They dress up in their suits and cuff links in the wards and look absolutely, spectacularly professional, but have bad breath because all they've drunk in 10 hours is a cup of coffee. Everything in the appearance and for the sake of it; I quote the New England Journal of Medicine and I can rattle percentages off the top of my head and I can quote you this randomized controlled trial and that randomized controlled trial. Watch me, I'm a British thoracic surgeon and I'm so fucking smart.

Sounds so much like the Singapore I left behind and much like the greater establishment I have spent the best part of my youth fighting against.

So I chew my gum a little harder and make small popping noises with it becuase God strike me dead if I become like Pompous Prick and start to quote jibberish as if intelligence can be measured by that yardstick. Empty pinata.

At this point, I am thanking my lucky stars that I am doing medicine in the US where one is allowed to be himself and nobody cares. No one is trying to conform you to the amalgamation of goo and even if they were, no one faults you for resisting. Albeit there is a price but by this time, you are fully aware and fully prepared to reap the consequences because there are many avenues to take to Rome.

I realize the British are nice, not because they like you, but because they are merely polite, which may be the worse of the two.