Something to ponder before migrating


From a doctor who stayed
The Malaysian Insider
Jun 01, 2011

JUNE 1 — It has been illuminating reading the various stories of the people who left and the people who stayed. I personally feel it is the individual’s choice and I agree largely with the opinions of John Rahman. However, I do want to share a couple of angles from a physician’s perspective.

1. To all those who have migrated whose parents are still alive, please make provisions for them if they are left behind. Most people write about the opportunities they need to give to their children but rarely mention what happens to their parents when they migrate.

As a doctor, I see this every day. There are many elderly patients who are admitted to hospital and their children are all living abroad. It is very sad.

One old man when I asked where his children were, told me that he had no more tears left to cry, they had all dried up. This frail man took two buses and a taxi to get to hospital. Sometimes there are siblings who are left behind who take care of their parents and I hope silently that they are getting all the help they need from those who left.

Very often we get requests from a patient’s relative who is only there as next-of-kin “to talk on the phone to the son/daughter who is in the US/UK/Australia”, always said with a hint of what I feel is misplaced pride. Generally doctors do not like giving news over the phone even to someone within the country.

There is much room for misinterpretation and of course the issue of patient confidentiality. I always insist on giving news in person to avoid such things from happening. When such requests are made I cannot help but feel irritated.

They always want to know if they should come back to Malaysia to see their parent. They tell me, “Doctor, it is so far, inconvenient and expensive.” I believe they should be asking themselves that question, not me.

Sometimes they do come back to visit. Sometimes it is very unpleasant as they assume that we are not competent and they say that “medical care in the US/UK/Australia etc is so much better”, statements that I believe do not even merit a response from me. Sometimes when the patient dies, they come back to Malaysia demanding to see the doctor and they blame the medical team for the patient’s death when there is no reason to. Obviously to us, but not to them, this is out of guilt for their not being there.

I do not blame people for migrating. It is an individual choice. But I plead to all who do to please make provisions for your parents. Make sure you send money regularly to your siblings who are left behind to take care of them. Make sure they have enough for food, medications and transportation to the hospital. Please call them often to see how they are. Please don’t forget that your parents are also still your responsibility, not just your children. If you find it is “inconvenient” please change your mindset. This is part and parcel of your decision to migrate. Accept it.

2. The second angle that I want to share is something that maybe people don’t think about when they migrate and I hope they never have to. I once had a request from a patient’s sibling to see me to discuss organ transplantation.

The patient had organ failure which required transplantation but as he/she was not a citizen in the country in which he/she resided, this was not an option there (unless he/she made a very substantial monetary investment in that country to gain citizenship — an option he/she had already explored).

So the only place where he/she could join the transplant list would be in Malaysia. This patient was “too busy” to come home to discuss it as he/she was an “important person.” So he/she sent his/her siblings instead to ask a list of questions which soon became apparent to me was designed to assess our hospital’s “competence” and if we were worthy of him/her.

It was difficult to hide my irritation but I politely explained our hospital’s protocol for listing someone for transplant. It soon became apparent to them that far from the patient assessing us, it is we who will assess the patient whether he/she is worthy of an organ donation from Malaysian people.

I do not know what happened to this patient but honestly, I think he/she should thank his/her lucky stars that we even have a successful transplant programme in our country. So the learning point is that even though medical facilities may be “far superior in the US/UK/Australia”, there are some treatments that will still not be available to you unless you are a citizen of that country.

In conclusion, I would like to ask those who are planning to migrate to please factor in your parents as well and not just your children. If they are in good health now, they will not always be. Please make plans for that bend in the road.

All this obviously does not apply to everyone who migrates. There are many people who do not behave in such ways but what I have written is based on real-life experiences as a physician and I wanted to participate constructively in this discussion.

  1. #1 by drngsc on Thursday, 2 June 2011 - 8:04 am

    Yes, I agree with my colleague. I also see a fair amount of this in private practice.
    Certainly, migration is an individual’s choice. Usually stated reason is children’s education. That is good. BUT also remember your parents who brought you to this world and care for you through thick and thin. Abandoning them, is that reasonable? Sometimes when you need to speak to next of kin, they call you on the phone and some of them even sound “arrogant” as they are now in first world country, thinking that we are still leaving on tree tops.
    Anyway, there is a God above, who sees all these things.
    For me now, is to ask that all of you register to vote. Please also ask all your overseas friends to register to vote. And on GE 13 day, come back and vote. We need every vote that we can garner.

    We need to change the tenant at Putrajaya.

  2. #2 by Rick Lim on Thursday, 2 June 2011 - 9:04 am

    I do agree that those who choose to migrate should also take into consideration of their parents and I can certainly sure they did, however it is not always possible as most parents would not want to leave the environment that they are familiar with and move to an “English” speaking place. In fact, no one in their right mind would want to move out of their birth place. To any parents, be apart with their children is certainly the last thing they would want to do. However most of them (if not all) would still encourage their kids to have a better life elsewhere. Speaking of the medical facilities, my personal experience is I have been advised by a doctor in a GH to send my sister to private hospital. Reason being there is not enough equipment in the GH and he could not guarantee my sister’s life if I send her there. On the being arrogant part, one should not be arrogant regardless where/who you are. I am not a doctor but I sincerely hope the writer choose to be a doctor because he want to help people regardless of who they are. Because from this article, what I can see is he himself feel inferior being a doctor in Malaysia, and hence feel offended by the questions asked from the patient’s next of kin.

  3. #3 by Jeffrey on Thursday, 2 June 2011 - 9:23 am

    ///To all those who have migrated whose parents are still alive, please make provisions for them if they are left behind///

    I agree. Even our TDM had once said if parents have taken care of you when young its only fair you take care of them when they are old and enfeebled. Whether one calls it reciprocity, gratitude or affection or ties, this is the first tenet of ethics whatever one’s moral system whether based on religion or otherwise. Especially one parent has died, and the other (surviving) has not much money, or even if has money, is old half blind, weak legs hobbling around, and could not walk without stumbling and fracturing her leg without support, couldn’t pay bills because he/she could not read or write!

    Can a maid that you could offer by sending money from monies earned abroad be sufficient? It is not money – its your presence. Of course its a sacrifice but if you are young an your parent is old, why can’t you go later after they’re gone? Because onec gone you can’t get them back even if you regret and want to do things that you never did! What good you conquer the world in your what’s or me generational attitude if yuou can’t spare consideration for people who gave you life, linked by blood, and more important have treated you well, given you the best of opportunities and education and you have put your self interest above theirs – all for what, Perkasa or UMNO goons? Don’t miss the forest for the trees!

  4. #4 by Jeffrey on Thursday, 2 June 2011 - 9:31 am

    Of course one can say my children’s future, nd who does not love their children ???

    But so do your parents love you. Your children have a life ahead of them, they have more time and opportunities to find their way around the world with whatever help, financial or emotional you could provide – but your aged and enfeebled parent???

    Their problem is now. You’ve got to thionk of how to balance the conflicting imperatives & needs of your parents, yourself and children and not just looking into the future, oblivious of the present and forgetting the past!

  5. #5 by wanderer on Thursday, 2 June 2011 - 10:19 am

    I emigrated only when my parents passed away, even though, I still have brothers here. I want my parents to feel I will be with them until their dying days. I was not a hero just Fidel son …not a feral up stud.
    The same situation can also happen in Bolehand, this is
    purely the selfishness nature of an individual!

  6. #6 by boh-liao on Thursday, 2 June 2011 - 10:23 am

    What 2 do? D social texture has been changed n many families in 1M’sia r dispersed in different places, with some families 3 generations in different locations
    We r going 2 hv more n more senior ppl around as ppl live longer these days
    R they burdens 2 families, esp if they r not healthy n mobile (1 old person needing 2 or more persons 2 look after) n if they need big $ 4 their monthly medical bills?
    A tough Q, emotional, financial, moral n ethical issues included

    Who knows, later our BN gomen may hv a solution 2 assist unpatriotic citizens who migrated n left their old folks here 2 fend 4 themselves
    1 possible solution is 2 hv “assisted sui cide at a government clinic, converted for mass eu than asia, a process referred to as ‘going home’.” – ala Soylent Green
    http://en.wikipedia.org/wiki/Soylent_Green

  7. #7 by boh-liao on Thursday, 2 June 2011 - 10:25 am

  8. #8 by boh-liao on Thursday, 2 June 2011 - 10:28 am

    What 2 do? D social texture has been changed n many families in 1M’sia r dispersed in different places, with some families 3 generations in different locations
    We r going 2 hv more n more senior ppl around as ppl live longer these days
    R they burdens 2 families, esp if they r not healthy n mobile (1 old person needing 2 or more persons 2 look after) n if they need big $ 4 their monthly medical bills?
    A tough Q, emotional, financial, moral n ethical issues included

  9. #9 by boh-liao on Thursday, 2 June 2011 - 10:30 am

    Who knows, later our BN gomen may hv a solution 2 assist unpatriotic citizens who migrated n left their old folks here 2 fend 4 themselves
    1 possible solution is 2 hv “assisted su i cide at a government clinic, converted for mass eu than asia, a process referred to as ‘going home’.” – ala Soylent Green

  10. #10 by Loh on Thursday, 2 June 2011 - 1:02 pm

    Yes, these are some of the problems faced by those who had to migrate. But in most cases, it is the government, the BN government which makes Malaysia inhabitable to non-Malays that they choose to migrate, or rather to work overseas. All those ketuanan non-sense only makes a few thousand UMNOputras fabulously rich, and millions of non-Malays have to resort to working overseas. The greed of so few makes the sufferings of so many; those who had to leave plus those who are left behind that one wonders when they pray to God, have their conscience been clear that they were not fit to receive blessing from God.

  11. #11 by digibee on Thursday, 2 June 2011 - 3:32 pm

    Singapore is not that far.. you can probably still visit back home 4-6 times/year. Any emergency can be back in a few hours notice. That is where most Malaysian professional went anyway.

  12. #12 by Winston on Thursday, 2 June 2011 - 5:04 pm

    Uncle Lim, I think that the PR, especially the DAP can do something concrete about the problem.
    Like:
    1. for elderly malaysians who are still healthy and
    are computer literate, perhaps at-home online
    work or similarly work can be found for them.
    2. we can also take a page from the Philippines
    where clusters of folks who are in need of work
    can have cottage type industries created for
    them. Refer to Rags2Riches website.
    This is applicable to both the elderly and the
    young.
    3. small business training for the poor can be
    initiated to enable them to earn their keep.
    This means, not only giving them the fish
    (initially), but also teaching them how to do the
    fishing.
    This should also be applicable to both young and
    old.
    This list is not exhaustive.
    The crux of the whole matter is to let those who would like to improve their financial standing to do so, so that they can have a sense of pride in our society.
    Wide publicity should be give to such projects should they be initiated.

  13. #13 by Winston on Thursday, 2 June 2011 - 8:26 pm

    1 possible solution is 2 hv “assisted sui cide at a government clinic, converted for mass eu than asia, a process referred to as ‘going home’.” – ala Soylent Green – #6 by boh-liao

    I think that this suggestion is not too far fetched.
    I have known of one couple where the husband has become afflicted with Alzheimer’s disease.
    He later became comatose and his every need must be attended to by his wife as they were staying alone.
    This has been going on for a few years and can go on for many more. In Ronald Reagan’s case, it was ten years before he passed away!
    Fortunately, they are rich enough to hire a maid to assist.
    What about the poor?
    As it is, it needs at least two persons to look after a person in his condition, full time.
    Some people, including doctors may shrink from practising euthanasia but this situation can be helped if the patient has what is called a “living will” BEFORE he becomes incapacitated, thus stating the conditions under which this will will be carried out.
    I understand that such a will is valid in the US.
    Perhaps it can be practised here.
    Of course with all necessary safeguards.

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