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Something happened that really, really gave me the shits. Essentially I made a mistake. I caught up with a friend(ly acquaintance) of mine (a healthcare student) whose sister happened to call asking for advice as she was possibly unwell. It turned out to be a good description of a severe allergic reaction so I told her to go to emergency urgently. They stuffed her around a bit and so given the urgency I asked a friend if anyone we knew was working in emergency that night (answer: no). In the end she was okay and got seen by someone who knew what they were talking about and went home safe and sound.

Fast forward to a few days ago when aforementioned individual’s significant other has a broken nose. And I get a couple of text messages and a missed call asking me to pull strings to get them seen in emergency faster.

A broken nose is an accident but it’s not an emergency. It’s painful, unpleasant and ugly but it is not life or limb threatening and the surgery for fixing it is usually done a few days later, not even on the same day.

Pulling strings is a form of corruption. Really speaking, I should never have done it in the first place- my only justification can be that not intervening in a potentially life threatening situation would have been a worse evil. Pulling strings is a common thing in Australia. So much is about who you know. You know someone connected to the head of a big company? Let’s arrange an internship. Your father went to school with someone who is the head of department in a hospital? Instant research opportunity. A politician’s or staff member’s family member is in emergency? Let’s fast track surgery.

Who knows which other patients were in emergency when they walked in with a broken nose? Someone with chest pain? Someone with a stroke? Someone with appendicitis? There is a cost to every string you pull. There is always someone who loses out. I knew a couple of junior doctors who used to bribe the bookings clerks with chocolates and coffees to get their unit’s scans done faster. Who was missing out on an urgent MRI or CT as a result? Someone with an acute stroke? A patient with bowel contents leaking into their abdomen? Someone who had been hit by a car?

The scarcer the resources and the more underpaid the people on the receiving end of bribery, the more susceptible society is to corruption. Additionally, the less it is policed by independent bodies with the power to investigate and prosecute, the more likely people are to get away with things. In the hospital setting this means rigorous auditing procedures and systems analysis.

In the end I politely declined to intervene and explained my reasons. By the time I’d gotten the messages in the first place it was too late. They were already making a complaint to the health minister.

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