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Abdul Mannan: The Moral Injury of Practising Haemato-Oncology in a Resource-Limited Setting

Abdul Mannan/LinkedIn

Jun 1, 2026, 13:39

Abdul Mannan: The Moral Injury of Practising Haemato-Oncology in a Resource-Limited Setting

Abdul Mannan, Consultant Haematologist at Betsi Cadwaladr University Health Board, shared a post on LinkedIn:

” ‘Nobody talks about what it costs the doctor. Not financially. Emotionally.’

They know the ideal treatment. They also know the patient can’t afford it.

They walk into that consultation room anyway.

This is what practising haema-oncology in a resource-limited setting actually looks like.

Three burdens carried at once.

The medical burden. Diagnosing a complex, potentially treatable disease. The financial burden. Securing tests, drugs, basic support. The emotional burden. Explaining that effective treatment exists, but remains out of reach.

That last one leaves the deepest mark.

We call this moral injury. It is not burnout. It is something more specific. The distress of knowing exactly what should be done, then watching financial barriers, drug shortages, and systemic gaps make it impossible.

Many consultants carry grief.Frustration.Helplessness. Sometimes guilt, for a system they did not create and cannot fix alone.

But they still show up.

They offer honest counselling. Symptom control.Transfusion support when possible.Infection management. Whatever chemotherapy can be accessed. And compassionate palliative care when cure is not an option.

There is a quiet promise in that kind of medicine.’We know what the ideal treatment would be. We will not abandon you, even if the full treatment is not possible.’

That promise matters more than we realise.

Feeling pain in these situations is not weakness.

It is evidence that you have not lost your humanity.

To every doctor who keeps showing up when the system falls short. This one is for you.

What keeps you going?”

Abdul Mannan: The Moral Injury of Practising Haemato-Oncology in a Resource-Limited Setting