Intended for healthcare professionals

Soundings Soundings


BMJ 2000; 320 doi: (Published 22 January 2000) Cite this as: BMJ 2000;320:259
  1. Ricardo S Silva, psychiatrist
  1. Sâo Paulo, Brazil

    Last year I grew a beard—after 13 years with a small goatee that, as I used to say, was my “true” face and would not change.

    Last year I learnt to ride a bicycle—after years of trying, after quitting at my 19th birthday, sure that I wouldn't change.

    Last year I resigned my job at the hospital—after almost two years of hard working with many new friends, and believing that this couldn't change. But after one of my friends was fired there wasn't another way to express our vehement opposition. So 20 of us, almost half of the internal medicine staff, signed our resignation letters and sent them, along with our manifesto against the whole affair, to all competent powers in the university, explained our position to them, and waited.

    I must say that it wasn't a decision made serenely. I hate changes. I favour stability and order, and anything that endangers my peaceful private corner of the world is a personal threat to me and it's dealt with as such. But we had to take the action. If we couldn't risk everything for a friend's sake, who could we risk it for?

    And then, one week after the start of the crisis, everything changed. One of the administrators resigned in a most unexpected way, ending 11 years of inflexible rule.

    The atmosphere at the hospital is so different now. People laugh more, talk in the corridors and restrooms more freely. And we have started to meet for breakfast in the dining hall every Friday morning, just as we did until it was forbidden, months ago.

    As doctors we should welcome changes, shouldn't we? If we didn't believe that a state of illness could change into a state of health we couldn't cure anyone. If we didn't know that a state of health could change into a state of illness we couldn't prevent any disease, could we?

    Small and big, simple and near miraculous—changes can happen, once in a while.

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