The Pathophysiology Of Our Suffering

It has been many days since I was last insulted by a consultant. I thought I had reached the bottom of this valley we are in when I started seeking someone to tell me that my head was "stony dull to percussion and full of sawdust." Just for the rush, of course. But now that I am not sure if I want to come back, I think I am truly standing on and staring at the bottom of the bottom of rock bottom.

I remember asking a few people during the protest at the time of the Minister of Power's visit to the hospital if we should also protest the strike and our prolonged house arrest. The response: the consultants gave no notice of their strike, no reasons for their strike, and no directives for us to help. It looks more like a petulant tantrum than an organized strike action. And so, no. This is not our fight, and we will not protest. I agreed back then. 

Now, however, it is becoming clearer to me that the Medical and Dental Consultants Association of Nigeria (MDCAN) has played a masterful stroke, the very quintessence of good chess. What has played out is peak scheming. Allow me to explain the pathophysiology starting with the etiology of this disease that has only one patient: the students. 

The Etiology

There was recently a push for a more reasonable payment structure. After all, if pure hospital consultants earn about ₦800,000, it is logical that academic consultants, who add obligatory lecturing and research duties to hospital work, should have a remuneration greater than - rather than half of the pay of their hospital consultant counterparts. This push was effective, and the new CONMESS payment structure was implemented everywhere, except for three outliers: the University of Lagos, Obafemi Awolowo University, Ife, and the University of Ibadan College of Medicine. The reason? Somewhere along the payment structure chain of command, certain individuals in each school decided not to implement it, choosing instead to keep the old numbers. The reasoning behind this decision is unknown, but speculation suggests that these individuals are disgruntled about the MBBS/BDS-holder-or-not cold war that still rages in these schools. In fact, we can see the immensity of this problem clearly when we consider that the Vice-Chancellor of the University of Lagos is a medical doctor too. 

The Pathogenesis

I am very sad to announce this, but in actuality, we, the students are the only ones losing. There are four main components to the inflammatory mechanism that MDCAN has chosen to express their grievances:

1. MDCAN: The strikers and the aggrieved. 

2. The university management: The caretakers and the parties to be held responsible if this matter reaches the ears of the Federal Government. 

3. The Federal Government: The employers and the ones expected to solve the problem. 

4. The students: The grass beneath the elephants, the pawns. 

The mechanism chosen is that, despite non-endorsement by the schools of any such thing, MDCAN has withheld services to the students, the normal pathogenesis of strike action. The Federal Government does not like to acknowledge issues. Due to the government's aversion for problems, the university management has two options.

The first option is to take care of the problem, which due to the suspected nature of the mindset causing it, is all but impossible. The second option is to act as if there is no problem and hope that, through placebos, assurances and concessions, MDCAN will be appeased and deconstruct the problem. Since the university management has chosen this second option, they cannot withhold salaries from the MDCAN lecturers on strike. If they do, they must either be prepared to face the Federal Government when MDCAN finally breaks its sullen silent treatment, or they will have to reverse such a decision, because the consultants on strike can defend their continued salary payments on the grounds that they are still involved in research(which also counts as academic work). 

Hence, as long as nothing changes, nothing changes. 

The Morphological Chnages

The morphological changes are: increasingly obese, increasingly depressed medical students and increasing numbers of detached, going-away-to-seek-greener-pastures consultants. 

Treatment

There are two pathways to break the loop. The unchanged parameter in either scenario is that the receptor that activates the Federal Government to break the status quo from outside the government's membrane is noise, embarrassing noise. Such noise is the stimulus for government action.

The first pathway is if the session ends without a resolution. When the time comes to admit new students, the lack of space for new medical and dental students will create noise and trigger whatever needs to be done to resolve MDCAN's grievances. Due to the prestige of the universities involved, the parents of aspiring students will either be influential enough or loud enough to draw the Federal Government's attention to the state of things. Unfortunately, this pathway depends too much on probability. 

The second pathway directly activates the receptor. Since the university management refuses to resolve the issue and the consultants refuse to abandon their well-played position of safety for ungentlemanly warfare, the students are the only ones left. If the students choose to scream their predicament and make their problems heard, the receptor will be activated. Whether time activates the parents, who then activate the government, or the students activate the government directly, the consultants will win in some way. 

MDCAN has played a wonderful game of chess here. We are the grass, but among the fighting elephants, one is totally immune to damage, one refuses to hear the cries and thumps of war, and the last is unwilling to look pained. If we don't make noise and cry for help, we could be here for a very long time. Unfortunately, after such a long time at home, too many have lost motivation. Time has weathered the knights in shining armor and planted them solidly in a thick state of inertia. It remains to be seen which pathway will be the light at the end of this dark, bleak tunnel of stagnancy. 

As for me, I shall continue my research on the average number of hours required to indelibly immortalize the shape of my gluteal region into the seat of the corner couch. 

Salami Wisdom