It’s 10pm local time in el parque de los Periodistas and a subtle rufescence plays on innumerable styles of graffiti. It’s a friendly 18°C, the humidity is mercifully low and a local man has a switch blade under my ribs. I figure that he’s angling just below my spleen- in fact the spleen has to get pretty big to poke out from under the ribs and so unless I have caught malaria in the last month I should be fine. He is wearing full Colombian national strip and 10 minutes earlier the national team have just been knocked out of the Copa America. I think I’m being mugged to make up for a bad evening in sports. Does this make sense?
It all happens very quickly; as his friends relieve me of my possessions with cordial vigour, I’m struggling to find the words I want to use and as I’m thrust backwards into a pile of rubble, I realise that I’ve made a terrible mistake: I forgot to ask this guy what he thought of the resource distribution in the financially constrained Colombian healthcare system.
I’m a medical student, I’ve just travelled to Colombia and in the brief space remaining. I want to give you an idea of what I learnt. First: salsa! Of both varieties actually and for both you’ll need a local to hand. Have a look at some works by an artist named Botero but don’t pay- these are on free display in most cities throughout the nation- this guy was prolific and you will get bored. Find a local football team and cheer or cry with the locals over a beer and strange bacon maize snacks. But we’re just scratching the surface. I was there to look at culture, healthcare and ethics.
I think that the approach to love in Colombia is bizarre; Catholicism still reigns supreme and yet sex is everywhere, strict nuclear family values resemble the world that my grandparents grew up in and yet breast and buttock augmentation surgery is the norm. To me this looks like two worlds co-existing together in the same people. It is hypocritical. But how does this apply to medicine? As part of my undergraduate finals I studied a course in medical ethics. It was very informative and, above all, logical. And I thought that this was the only way to study the discipline. And then I met Sandra and her family. We would chat and each day I left a little confused- I couldn’t argue my points well. I couldn’t work out if her arguments were fantastically simple or subtly complex but I left with a sense that there might be more to ethics than the application of cold logic to a warm and passionate topic. Romance isn’t logical; why should ethics be?
And so I can’t give you a neat logical conclusion. All I can hope to convey to you is that I think that the ethics of healthcare provision, state funding and whether you buy your daughter bum implants for her 18th birthday is just a little more complex that we were taught in med school.