Embracing Medicine

Last July 24, 2011 (Sunday) was my last day as a medical clerk in the Internal Medicine department. To orient you, my rotation started with 3 weeks of being with an IM resident assigned to the floors (or wards as some would call it). Then, I had 2 weeks of ICU/ACSU rotation with the 2 best consultants I have ever met. Then, 1 week in the Pasig City General Hospital in their out-patient department. Lastly, 2 weeks in the Emergency Room.

My first week as a medical clerk was bumpy since I am totally clueless of what I should do and how the definition of "initiative" comes in so many forms. The endless continuum of such noun is hard to grasp. Initiative may be defined as doing almost everything. It can be termed as continuously asking questions and participating in the discussion with your consultants. Or volunteering to be on duty despite completion of requirements. Yes, I know it is complicated. People who show initiative get merits. Merits where the criteria are taken from space.

First lesson I've learned as a medical clerk, INDEPENDENCE is the key to survival. No one will guide you or watch out for you. If you would show an inch of such need for guidance, they would mistaken you as being pampered or spoon-fed. You can never lean on someone to help you out (except for your co-clerks) especially in times of influx of patients. With independence comes self-directed learning. You seek for your own answers to feed your hunger pangs for knowledge. Read, read and ask.

Second lesson is the need to be FEARLESS and SHAMELESS. Note that the adjective I have used is not courage, bravery nor boldness. Fearless in terms of conquering whatever fear of inadequacy you might feel in your bones -- try to get rid of it. I have had my own dose and it did not help. The fear of not knowing on how to handle a case of difficulty of breathing and seeing the patient gasping for air made me crumble before my residents. Now, I have learned my lesson. I need to be shameless to learn. Emotions are not entertained in this kind of field and training. Physical endurance is the key in the floors and the ER. I almost cried due to the physical struggle I had to deal with during my first few days in the emergent and urgent section. Despite giving your all, your ALL isn't still good enough. But, learn to shrug it off and keep on going.

Third lesson is, of course, EXCELLENCE. Excellence comes hand in hand with initiative (which I believe still needs clarification). The competitive nature of medicine stems from this value. In any patient that you encounter, one is expected to provided optimal care and to know everything about the patient from their history down to their physical examination and laboratory results, the pathophysiology of their disease, your different differential diagnoses -- would I still ramble on? I think you get the point. There is no excuse of being ignorant once you enter the realms of the hospital or any clinical setting for that matter.

Despite these, I was able to get a good realization from my 2 months of rotating in IM. I have learned to appreciate happiness in its ultimate simplicity. Ever since my duty started, my mother would always try to make time in making me sleep comfortably and prepare my things. She would pack my things since I have decided to stay in the hospital for 4 days straight. The simple lending hand a co-clerk would offer would be much better. The little jokes that we make during the dead hours of the night just to keep us awake make me feel better. A simple sign of gratitude from your patient keeps the heart warm despite the freezing temperature inside the hospital. A good night's sleep makes me excited every now and then. A simple chat with a friend in a coffee shop assures me that everything will be okay. The wonders of simple Facebook messages reminds me that people still care for me.

It is not all that bad. I am slowly entering reality and its diversity. Bumps in the road come along the way but I must keep a steady hand on the wheel and my sight along the horizon. I am still trying to find my place here and unleash that firework kept hidden for a long time.