By: Beverley Dias
Postmortem is Maria Phalime’s début offering which won her the inaugural City press Non-fiction Award. I expected the book to be a whiny, ‘blame game’ piece where the author attempts to justify her actions by heaping responsibility on others for her ‘failure’ to endure. However, the beautifully written memoir is a sad, gripping account of her journey from humble beginnings in Soweto, where she describes her upbringing as emotionally unstable, tinged with the grief of losing both her parents and brother at a young age. As a student at UCT, Phalime had high expectations for a career in medicine, but the reality which faced her during her last years of study and her initial years in practise, led her to hang up her stethoscope after just four years as a professional.
At no point does Phamlime presume to speak for others like herself who chose to walk away, but instead, she endeavours to unpack the reasons behind her own unravelling. She also touches on the pressures and expectations which come with being a doctor in South Africa. With an insider’s perspective, the author shares her views on the pressure under which doctors operate as a result of the overburdened public health system. Long working hours, poor resources, inadequate security, medicine shortages and overcrowding are some of the realities faced by health professionals within the public health sector. Workload is another factor , as junior doctors are required to execute reesponsibilities outside their scope. In her quest to uncover what went wrong, she interviews other members of the profession who chose to leave, exposing the heartbreaking void left in a country which is struggling with a high disease rate. The exodus of young, South African-trained doctors to Western countries further exacerbates the problem.
During her time in practise, Phalime witnessed the spike in the HIV/AIDS pandemic at a time when the government was unwilling to roll out ARVs, while it attempted to determine a link between HIV and AIDS. She also recounts the under-the-counter collusions of medical practitioners and pharmacists to rip off medical aid schemes, as well as doctors and civilians ripping off the government with false sick notes for grant applications. The author touches on an interesting point regarding medical schools’ tendency to admit Type A overachievers, which might be their downfall as well as the possibility that many of the students who opt to study medicine are not fully aware of what they are getting into. At her own valedictory, a professor, in his speech, said that only 75% of her class would still be practising medicine in 10 years and she watched this phrophecy unfold in her career.
In summary, Postmortem is an honest, critical look at the health sector and a must read for policy makers. The book opens the floor for healthy debate at a time when the health system is undergoing transformation with the impending introduction of the NHI. The author offers perspectives which could improve the situation for South African doctors and addresses the reasons behind doctors leaving the profession as well as the country. Phalime is a gifted writer, weaving a lucid story with just the right amounts of sadness and joy, pride and disappointment. Just 208 pages long, Postmortem is an easy read. It is entertaining and educational and, for a first time author, Phalime has hit the mark.