Monthly Archives: March 2015

A Doctor’s Lamentation

"It is such a mysterious place, the land of tears." - Antoine de Saint Exupery, "The Little Prince" (Photo taken from Pixgood.com)

“It is such a mysterious place, the land of tears.”
– Antoine de Saint Exupery, “The Little Prince”
(Photo taken from Pixgood.com)

I came into his office a cynic. In my mind I was expecting another series of complaints about not getting paid what he thought ought to be paid to him given his stature and his tenure as physician. He was, after all, one of the oldest physicians in that hospital and he had been a great help in establishing our line of work not just in that hospital but in the entire province as well. I traveled to the south of the country from the urban jungle of Makati to establish rapport with the doctor and rejuvenate the company’s relationship with him. I had prepared to receive verbal abuse and maybe a few profanities, but instead I was greeted with a firm handshake and a smile.

I readied my “physician force field” – that mysterious, powerful energy I was trained to create during my internship that filters any transference of emotion from the person I was conversing with for me to remain objective and “professional.” I was telling myself that in case he’s angry, he’s not really angry at me but rather on certain… things and aspects. On the days prior to that meeting, I reviewed my old style of establishing rapport with a complete stranger using the weird combination of pathetic corny jokes (trust me – they actually work positively) and genuine concern about their plight, hoping that I had packed enough to diffuse the entire situation.

We discussed the success that his hospital had achieved, and how quickly it was expanding. I mentioned how it was pretty much at par with – and even better than – many of the hospitals in Metro Manila. He gave me a hesitant smile, but there was just this palpable loneliness in his eyes. We conversed about professional matters that I need not write about, but I could not help myself from asking him.

“Are you all right, doctor?”

“This… this has nothing to do with our relationship as physician and HMO, OK? I understand that you are a doctor too, aren’t you? I just need to get this off my chest,” he said to me as he looked at the pictures on the small cabinet near me.

I smiled at him and assured him that our conversation would just be between two men, nothing less.

“You know, I’m disappointed about the whole thing. I’m regretting this.”

“Doc… I-uh… I don’t understand.”

He was practicing in the biggest and most prestigious hospital in that province, and he was practically its top dog. Recently, the hospital went into a partnership with one of the biggest business groups in the country, and there was really nowhere for it to go but up. As I said, the hospital was expanding, and aside from the prestige, there would also be an expected financial success to go with it.

“Tell me: why did you become a doctor,” he asked me.

I had to point out to him that I was not in the practice – that I was “just” an employee earning a fixed amount every month. Still, I gave him my reason when I decided to become a doctor when I was young. It sounded too idealistic as I look back to it now, but I could not lie to him.

“You know, this hospital only started as an extension of our house,” he said. “My dad converted part of our house into a clinic, and he would see his patients there.”

“Well, doc. Look how far your father has gone,” I smiled. I was to tell him that he had brought his father’s hospital to greater heights, and they have become pretty much a formidable entity in the region when he interrupted me.

“No, no, no,” he shook his head. “You know, most of the time, people didn’t have anything to pay him that time, and he was all right with that.

“He was happy. He was practicing Medicine because it was his passion. The payment did not really matter to him, but still he was able to send us his children to good schools. I even became a doctor like him.”

I stayed quiet – waiting for him to just let everything out from his chest.

“To be honest, this hospital was still doing well before we entered into a partnership with the big business group. We were told that we could help more people with the partnership.

Right now, yes, business is booming and we are expanding, but at what expense?”

“You are not happy with that, doc?” I queried.

“Where are the poor patients now? Now, they could not afford being seen here. They have to pay for everything.

“My father’s legacy is that he would not turn away patients, especially those who are in need. That was his joy. He would often tell me that he would prefer those that could not afford to pay him because then he could charge it to Him,” he said as he pointed upward, pertaining to God.

I then told him about this hospital in Metro Manila that used to be run by nuns. A business group had to eventually drive those nuns away because the hospital operated at a loss. An investigation later revealed that they would frequently just ask the patients to pay whatever they could afford if they could not settle the actual bills. There were several rooms filled with crutches, wheelchairs, and other worthless personal effects that the patients gave in payment for their bills.

“Exactly. You know, my father and I used to do that here too. We also had nuns operating this hospital, and we would distract them and let the patients abscond when they’re well.” He let out a mischievous smile as he recalled.

“I’m sure that they were good nuns, but we have to face the reality, doc,” I said. “Without money, you can’t pay for the hospital’s other expenses. You can’t buy medical supplies and equipment with crutches and wheelchairs, and you can’t tell your nurses and hospital staff that you’d just pray for them.”

“I know, I know,” he said. “I just wish I could do more.

“I just wish I could turn back the deal and just get back to healing people instead of conducting a business.”

He then turned quiet as he got lost in his thoughts.

“I really wonder what Dad would say to me when we meet again.”

He paused again as he looked at the black-and-white picture of his father on his table.

“What’s that saying again? ‘What profits a man…‘”

“‘What good is it for someone to gain the whole world, yet forfeit their soul?‘” I quoted.

“So, what good is having the biggest hospital, if I lose the meaning of being a physician?”

From my seat, I noticed a glint on the side of his left eye.

“You know, it’s not really fear that feel when I think about the day that we would see each other again. It’s embarrassment. I’m sure he would ask me, ‘My son, what have you done?

“I’m an old man now, and everyday that’s what I think about. I’m embarrassed to see Dad again and tell him what I have done to his legacy.”

I tried to comfort him, but most of the time I remained quiet. It was a mysterious place, the land of tears, and part of me was wondering why he was telling me all these. Perhaps because I listened to him and did not dismiss the idealism that remained in him that I have come to realize as lost in many if not most of the doctors I get to interact and communicate with often. Don’t get me wrong – I’m still blessed enough to meet so many of these doctors – some of them are even my colleagues in medical school, but in several moments, it’s all about the money, even if we’re already speaking as two normal human beings talking about our lives.

I remembered the reply I gave him when he asked me why I wanted to become a doctor, and as I left the hospital, I thought about the conversation that my present-day self would have had with the young child that wanted to become a doctor back then. The old doctor was embarrassed to see his father again and explain what he had done to his legacy – but still, he did the best that he could. I was fearful about seeing my younger self again and explain why I lost his idealism.


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