Currently in my Obstetrics and Gynecology rotation at QMMC, I am a witness to the continuous decline in the luster of hope for our country. In each duty, no doubt almost 50 patients give birth to either healthy or unhealthy babies. Many say that the youth is the new hope for our country. Looking into the process of bringing hope to our tired motherland, it is a process anyone would not want to witness. A maximum of 20 mothers undergo labor all at the same time in one room, with 2 pregnant women sharing a bed. The stench of a woman's vaginal secretions and feces emanates from the room. Being only dressed in their gowns, their private areas are exposed for the whole world to see. Inside, it seems like a zoo where a number of mammals are trying to give birth. Many complain of the pain - then ask them, why did you then get pregnant? Such question speaks of how uneducated many Filipinos are. The lack of knowledge on the process of bringing life and how delicate it is seems to be missing in the lustful process of making it.
Such an ugly picture that I have illustrated right? But that is the reality. As one doctor told me, we are exposed to both worlds: ideal vs reality. However, shouldn't we aim for idealism in any institution? Are we just content with inefficiency, ineffectiveness and pain? The sincerity of service in the health sector appears fake in text and in teaching. How healthcare providers treat their patients speaks for itself. On the other hand, no one can blame such attitude given the stubborn patients that we get. Then, who should be blamed for such disparity? Everyone. It just takes one to make a change. We tried and were appreciated by our patients. But does it work? That I cannot still answer. The growing population stems from 16-year old girls giving birth and multiparous mothers who never quite understood the consequences of a large family. Frustrating.
From the patient, we go into the realm of the healthcare practitioners. In order to provide proper healthcare, we need materials - needles, gauze, tubes and the like. It is like a scavenger hunt every time blood should be extracted or change of dressing should be done. Endless donations breed learned helplessness on the side of the patients. I have noticed how Filipinos lack the will to improve themselves continuously. The attitude of contentment with simplicity seems to be wrongly construed. Again, another frustrating fact. No efficient system was ever developed to hasten processing of laboratories, OR scheduling and other requests. Going in and out of the room and dressing up again wastes time and energy. Yes, you will learn skills but are these the correct ones?
Guided-teaching seems not to be the thrust in Philippine medical practice. You are left on your own, figure things out on the spot given the current problem that is facing you and swallow up that fear you are about to feel. Misaligned expectations bring about frustration among the team members, creating misconceptions of each other. A student is expected to be knowledgeable of being a first assist in a CS case on her first try. There are no excuses for being slow or ignorant - or else you will be judged by the audience. Other healthcare workers smirk or laugh at your mistakes, bring you down and raise an eyebrow whenever you ask for help. Yes, that is the service they have sworn in their own oaths. This is the kind of service and camaraderie the Philippines is capable of.
All of what I have written is irritating and ugly. Yes, many would say that I should not write this especially on the net, but this is the truth - the accepted reality so it seems by many. A number of students have passed by this hospital, yet improvement appears to be stagnant. Many have lost to look farther into the horizon and venture into new paths.
As a future doctor, one should ask the following questions: 1) Are you sincere in providing service to these kinds of patients?; 2) Are you satisfied with the kind of service that you provide?; 3) Would you say that you take part in the process of grooming future physicians who are better?; 4) Would you say that you care enough to the point of doing more? and 5) Do you think your kind of service is what the patient expects of you?
Wanting to be a doctor is easy. But being a sincere one is the most difficult task one would ever do. Skills can be taught but the matters of the heart are learned through time.
Sunday, November 20, 2011
Sunday, October 16, 2011
A Surprising Turn
I just finished my rotations in Surgery and Orthopedics. I would say these were the best days of my clerkship year. It started out bumpy but it was fun in the end. I have learned a lot and felt more like a doctor compared to my other rotations. Yes, I've gained weight given the crazy and overwhelming supply of food. Surgeons, really, are the well fed species in the medical arena.
For the past 2 months, I have done my first 2 minor operations - excision of a sebaceous cyst and a tendon sheath cyst. It was hard doing the suturing and cutting but I felt proud of myself after - and more confident. In order to survive surgery, all it takes is confidence and courage. Confidence in yourself, that you can do the procedure powered up with courage knowing that you have done your part in studying it before doing it.
Surgeons are not mere butchers who would carelessly cut through tissue just to get the job done. Surgery is an art where in each slice, you open yourself to awe and wonder of the human body. Surprisingly, after my rotation, I placed surgery as part of my choices for residency.
Thank you to the great surgery residents that I've been with. You may have pushed me to my limits, but I have realized an undiscovered part of myself. But I am afraid there is a need to tame that stronger side of me given the environment and types of people that I will be working with.
For the past 2 months, I have done my first 2 minor operations - excision of a sebaceous cyst and a tendon sheath cyst. It was hard doing the suturing and cutting but I felt proud of myself after - and more confident. In order to survive surgery, all it takes is confidence and courage. Confidence in yourself, that you can do the procedure powered up with courage knowing that you have done your part in studying it before doing it.
Surgeons are not mere butchers who would carelessly cut through tissue just to get the job done. Surgery is an art where in each slice, you open yourself to awe and wonder of the human body. Surprisingly, after my rotation, I placed surgery as part of my choices for residency.
Thank you to the great surgery residents that I've been with. You may have pushed me to my limits, but I have realized an undiscovered part of myself. But I am afraid there is a need to tame that stronger side of me given the environment and types of people that I will be working with.
Tuesday, August 2, 2011
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.
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.
Sunday, July 10, 2011
A Slap on the Face Will Do
First day jitters is a common experience for everyone. I've had my share recently before my clerkship started. Now, before I start my Emergency rotation, I'm having it again! It is normal to notice a certain level of inadequacy in our part as clerks but not an excuse to be at that certain level for quite some time. In admitting my inadequacy as a medical clerk, I have to learn to slap myself once in a while and get over the endless fears that I have constructed many times in my mind.
There were moments where I was just standing in an empty hallways or walking along the corridors of the hospital early in the morning, then I catch myself trembling deep down, not knowing what my next step would be. Every medical student will experience a sense of being thrown into the unknown with no one available to hold your hand as you both jump together into the abyss. Life is not that easy inside the hospital. Each has their own task to do -- which seems endless. Seeing one little lost creature ask a multitude of questions would be a grave mistake.
Here students should not ask questions but learn it in some other way. For some reason, people of experience hate being asked questions. They would rather bounce it back to you and let you do the searching yourself. Thus, making students refrain from asking questions -- having an unproductive learning environment for the both of them. I guess there is no room for critical thinkers in the hospital. However, there are a few who appreciate questions and I feel blessed whenever I meet such doctors. Usually, these doctors are the best in their field. I was taught to ask questions endlessly since it is from questions that we begin to search for answers. Questions are sparks for curiosity, for interest. From interest, we can derive meaning from everything.
I guess my jitters come from the fear of not knowing enough and of not knowing who to ask when I have problems or committed mistakes. Good luck to me tomorrow and my last 2 weeks in Medicine!
There were moments where I was just standing in an empty hallways or walking along the corridors of the hospital early in the morning, then I catch myself trembling deep down, not knowing what my next step would be. Every medical student will experience a sense of being thrown into the unknown with no one available to hold your hand as you both jump together into the abyss. Life is not that easy inside the hospital. Each has their own task to do -- which seems endless. Seeing one little lost creature ask a multitude of questions would be a grave mistake.
Here students should not ask questions but learn it in some other way. For some reason, people of experience hate being asked questions. They would rather bounce it back to you and let you do the searching yourself. Thus, making students refrain from asking questions -- having an unproductive learning environment for the both of them. I guess there is no room for critical thinkers in the hospital. However, there are a few who appreciate questions and I feel blessed whenever I meet such doctors. Usually, these doctors are the best in their field. I was taught to ask questions endlessly since it is from questions that we begin to search for answers. Questions are sparks for curiosity, for interest. From interest, we can derive meaning from everything.
I guess my jitters come from the fear of not knowing enough and of not knowing who to ask when I have problems or committed mistakes. Good luck to me tomorrow and my last 2 weeks in Medicine!
Tuesday, June 7, 2011
16th French Film Festival
This event reminds me of my passion for foreign languages and culture. Still, I haven't tried studying French. So far, my checks go for Mandarin Chinese and Japanese. According to my Philosophy professor, the mind can accommodate 5 languages, wherein you can be fluent in each. I envy him so much since he can speak in French, Greek, Latin, Spanish (I think)... I believe he tried to master the various European languages. My dream is to master the following: Mandarin Chinese, French, Greek and Italian. Each language brings about a unique taste of the country's culture without even traveling to their cities. It is in their languages you can get a glimpse of their short history and greatness as a society.Below are the movies I'm interested in, to be shown at Shang-Ri La Plaza Mall.
7 Ans (7 Years)June 10, Friday 6:30 p.m.
June 13, Monday 6:30 p.m.
June 17, Friday 9:00 p.m.
Adele: Rise of the MummyJune 11, Saturday 1:30 p.m.
June 17, Friday 4:00 p.m.
Dans les cordes (Inside the Ring)June 14, Tuesday 9:00 p.m.
June 15, Wednesday 6:30 p.m.
June 19, Sunday 6:30 p.m.
La Tete de Maman (Mama's Smile)June 16, Thursday 4:00 p.m.
June 19, Sunday 4:00 p.m.
Un Poison Violent (Love Like Poison)June 9, Thursday 9:00 p.m.
June 13, Monday 4:00 p.m.
June 18, Saturday
MadamoiselleJune 9, Thursday 1:30 p.m.
June 14, Tuesday 6:30 p.m.
June 18, Saturday 4:00 p.m.
Saturday, June 4, 2011
A Question on Professionalism
This is my third week as a medical clerk. So far, I believe that I have an idea on how to go about things when I am stationed at the Medicine floors. Yet, the self-directed way of learning is still ever present. Clerks, interns, and residents run around the floors when they see consultants -- run around to hide or to go after them. Being equipped by our school with a new perspective on how Medicine should be, we never fail to receive a rude comment, a constructive criticism or just plain gossip going around from consultant to resident to intern to clerk. Imagine, it's as if my idea of high school life in medical school suddenly had a sequel! It is hard to hold on your reigns since you don't have anything to hold on to. Yes, you will feel that you are the lowest of all creatures or even frustrated since 3 years of medical school seem to have just slipped away in a dark corner.
Despite the many personalities and moments of ignorance, a few have tried to shed some light on a new way of teaching medicine. One of the values that keeps medicine firm is compassion (I would like to believe so). Compassion since this profession is service-oriented. Service does not matter when done out of necessity. It's just empty. In relating to their patients, it is a must to show such value. What amazes me is how such compassion and sincerity sometimes disappears when faced with their colleagues. Superiority does not equate with respect. Respect is earned. It is not an obligation. It is just funny to observe those who got their MDs to be still acting like little adults. In that tiny world, all medical professionals are really shut off from reality. Now, I have a dilemma on how should I be.
The rigidity of the system puts pressure that it reminded me of my previous dilemma of continuing medical school. Imagine a consultant reprimanding you in the corridor because you are holding a cup of coffee. It looks unprofessional. How should professionalism be defined in the healthcare system? Is the participation in a circulating gossip becoming of a professional? Does superiority issues reflect true professionalism?
If we bring this structure into a business perspective, this will soon become bankrupt and close down. Rigidity in its systems will not help a company survive. Flexibility is the key since globalization is fast approaching. Healthcare is one of the big industries that should keep up. In that rigidity, many have become narrow-minded. In that setting, frustrations easily arise, insecurities pile up on top of the other, suffocation and death due to social pressure can be a possibility.
It is fun to observe a new clique of individuals. In each day that I wake up and enter the office at 7 am, many of assumptions are affirmed and some are negated. On our part, we should learn the value of patience and humility. Both are hard to master but should be mastered. Hopefully, the time would come where you would feel your importance as part of the medical team. Appraisals rarely come in this field, which is sad. The pressure that such profession builds is in its unstable form that it may just explode. It is easier to say "You did well." rather than comment on the wrongs they have done.
I would like to stay, it would take more than a decade for the school's VMO to take place. Now, I would say we are still far from it.
Despite the many personalities and moments of ignorance, a few have tried to shed some light on a new way of teaching medicine. One of the values that keeps medicine firm is compassion (I would like to believe so). Compassion since this profession is service-oriented. Service does not matter when done out of necessity. It's just empty. In relating to their patients, it is a must to show such value. What amazes me is how such compassion and sincerity sometimes disappears when faced with their colleagues. Superiority does not equate with respect. Respect is earned. It is not an obligation. It is just funny to observe those who got their MDs to be still acting like little adults. In that tiny world, all medical professionals are really shut off from reality. Now, I have a dilemma on how should I be.
The rigidity of the system puts pressure that it reminded me of my previous dilemma of continuing medical school. Imagine a consultant reprimanding you in the corridor because you are holding a cup of coffee. It looks unprofessional. How should professionalism be defined in the healthcare system? Is the participation in a circulating gossip becoming of a professional? Does superiority issues reflect true professionalism?
If we bring this structure into a business perspective, this will soon become bankrupt and close down. Rigidity in its systems will not help a company survive. Flexibility is the key since globalization is fast approaching. Healthcare is one of the big industries that should keep up. In that rigidity, many have become narrow-minded. In that setting, frustrations easily arise, insecurities pile up on top of the other, suffocation and death due to social pressure can be a possibility.
It is fun to observe a new clique of individuals. In each day that I wake up and enter the office at 7 am, many of assumptions are affirmed and some are negated. On our part, we should learn the value of patience and humility. Both are hard to master but should be mastered. Hopefully, the time would come where you would feel your importance as part of the medical team. Appraisals rarely come in this field, which is sad. The pressure that such profession builds is in its unstable form that it may just explode. It is easier to say "You did well." rather than comment on the wrongs they have done.
I would like to stay, it would take more than a decade for the school's VMO to take place. Now, I would say we are still far from it.
Thursday, April 21, 2011
Fear, after all, is our real enemy.
This is a memorable quote about fear from the movie, "A Single Man" starring Colin Firth. :)
"The Nazis were obviously wrong to hate the Jews. But their hating the Jews was not without a cause… But the cause wasnʼt real. The cause was imagined. The cause was FEAR.
Letʼs leave the Jews out of this for a moment and think of another minority. One that can go unnoticed if it needs to.
There are all sorts of minorities, blondes for example, but a minority is only thought of as one when it constitutes some kind of threat to the majority. A real threat or an imagined one. And therein lies the FEAR. And, if the minority is somehow invisible……the fear is even greater. And this FEAR is the reason the minority is persecuted. So, there always is a cause. And the cause is FEAR. Minorities are just people. People……like us.
Fear, after all, is our real enemy. Fear is taking over our world. Fear is being used as a tool of manipulation in our society. Itʼs how politicians peddle policy and how Madison Avenue sells us things that we donʼt need. Think about it. The fear of being attacked. The fear that there are communists lurking around every corner, fear that some little Caribbean country that doesnʼt believe in our way of life poses a threat to us. Fear that black culture may take over the world. Fear of Elvis Presleyʼs hips. Well, actually, maybe that one is a real fear. Fear that our bad breath might ruin our friendships… fear of growing old and being alone. The fear that we're useless that no one cares what we have to say."
Subscribe to:
Posts (Atom)
