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Opinion

Let the debate continue

- Art Borjal -

There is something good about the raging debate over the state of the nation under President Estrada. Apparently, both the pros and the cons are acutely aware that they are talking about their country. Yes, the nation's welfare is the center, the lowest common dominator of the debate. And there is no straying from the point. Otherwise, politics and personal motives will becloud the issue. That would be sad, to put it in the mildest term possible.

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What President Estrada should do, in my view, is to make a real sense of the problems besetting the country. In other words, he must first believe that the country is in big trouble. Then, he has to have a deep and accurate grasp of the dynamics of the country's problems. This will counter what his critics are saying: That instead of admitting the storm raging in our country and rallying the nation behind his efforts to stir the ship to safe harbor, the President and his men often trivialize the problems.

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The tragedy of the situation is that we Filipinos have the penchant to be adversarial. What we cannot help build in the area of governance, we often tend -- wittingly or unwittingly -- to help destroy. Like other countries in perpetual turmoil, the Philippines has been dubbed as ungovernable. And there are strong arguments to that view. After the usual brief honeymoon, the relationship between a newly-elected Filipino president and his constituency begins to cool down. Then, history repeats itself.

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In the case of President Estrada, he was not to enjoy even that traditional honeymoon. Some people had already firmed up their adversarial opinion of him, long before he entered Malacañang. To his hardcore critics, every little fumble and error confirmed their low regard of his ability to lead the nation.

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The current bashing of President Estrada is not an Erap phenomenon. No president of the Philippines ever had a prolonged romance with the people. President Ramon "The Guy" Magsaysay was the nearest to a popular president the country ever had. But he did not live long enough to prove that he could carry his mass appeal to the end of his term.

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President Cory was thrust into the limelight of the presidency in a dizzying atmosphere of national celebration of unity and brotherhood. She was the leader of consensus who could have been beatified as a political icon if she held the presidency for only a few weeks. But she stayed in the presidency for quite some time. Thus, the Filipinos' short admiration span caught up with her.

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Unless we as a people learn to temper our adversarial nature, it will be hard for our nation to move forward. Our penchant to act as an adversary, an enemy and a critic of the Estrada administration will make it terribly difficult for President Estrada to rally the nation behind his program of government. For whatever he says and whatever he does, even though laudable, will always be subjected to a barrage of criticisms from those who have no faith or confidence in his ability to govern. Kawawang Pilipinas.

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Actually, President Estrada has a program of government which, implemented expeditiously and properly, can push our country forward. The big problem, though, is that the government minions supposed to implement this program are dragging their feet. Yes, they have neither the passion nor commitment to make things happen in the implementation of the Erap program. Will President Erap ever be able to whip his minions into line? Political observers are pessimistic that this will ever happen.

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How should one afflicted with a sickness choose his doctor? Michael Lerner, in his though-provoking book, Choices in Healing, has an apparently sound advice on how to go about doing it. Let me cite what Lerner says:

After 10 years of listening to hundreds of cancer patients tell their stories, I have concluded that many patients choose an oncologist, surgeon, or radiation therapist with less care and less comparative shopping than they would pout into their choice of a new car.

How you choose a new car and how you choose physicians is not as farfetched an analogy as it may seem. Most of us do not know a lot about the technology of automobiles. But when we decide to buy one, we usually go to considerable lengths to try to identify the best car for us. We read the Consumer Reports comparison of the different makes and models. We talk with friends who own the car we are considering and ask about their experience. We may talk with a mechanic about his opinion. We may rent the car to see what it is like to drive. Or we may simply test-drive the car at the dealer and visit some other dealers to test-drive other cars we are considering. For an informed car buyer, purchasing a new car may take a number of weeks, if not several months. This is entirely reasonable: it is a major purchase and you will be living with the car for some time.

Consider, then, the process by which the same person chooses a surgeon, oncologist, or radiation therapist. Apart from being in shock from a cancer diagnosis, a patient is often overcome by a sense of personal incompetencies in making the pressing medical decisions. Obviously, he is making a choice that is far more important than choosing a new car, and yet all his confidence in his capacity to assess technologies that he does not understand deserts him. Culturally, Americans have what might be called a pattern of learned helplessness when it comes to choosing physicians and treatments. We sense that it is somehow illegitimate and embarrassing to shop for quality and medical care with the same attention that we shop for a new car.

Even my father -- an assertive and highly intelligent man, with boundless curiosity, had trouble in the early days after his diagnosis finding his own balance in the doctor-patient relationship. In his book "Wrestling with the Angel," he writes: "Few patients have more than an inkling, on their own, of the know-ledge and experience needed for intelligent decisions. Most, like me, start as medical illiterate. The traditions of the profession call for the specialist or internist to deliver the verdict and recommend the decision, and the patient to accept it."

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Art A. Borjal's e-mail address: <[email protected]>

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