Lest we forget

(c) Wellcome Library; Supplied by The Public Catalogue Foundation

“The practice of medicine is an art, not a trade; a calling, not a business; a calling in which your heart will be exercised equally with your head. Often the best part of your work will have nothing to do with potions and powders, but with the exercise of the influence of the strong upon the weak, of the righteous upon the wicked, of the wise upon the foolish”

Sir William Osler
Advertisements

Students of Medicine

tumblr_lk661w30rF1qb7wr3

The following is a transcript of a post by ‘Egyptian Doctor’ in the thread “Being a good medical student doesn’t mean you’ll be a good doctor” in the forum.facmedicine.com discussion board started October 2013. All copyright including graphics depicted remain with their respective owners.

There is a saying that you enter medical school wanting to help people but exit it wanting to help yourself. It may be a cynical view, but a realistic one. The criteria to being a good medical student are far different from being a good doctor. Medical education may be breeding a legion of self-serving, grade-grubbing, SOAP-note spewing machines rather than the empathetic, compassionate and caring physicians of admission essays yore.

 I was no different. My first two years of medical school, I was largely a disinterested student. I didn’t care for basic sciences, research or pathology. Like many others, my knowledge waxed and waned with the test schedule, and after Step 1, I entered my clinical years an acceptably successful medical student.

 Excellent medical student, terrible clinician

 Third year begins a reign of terror lead by the constant gauntlet of heavily-weighted rotation grades, standardized exams and the looming threat of residency applications and the Match, when, after 20 years of schooling, some pie-in-the-sky computer would tell me if I was good enough or not to be a doctor, and subsequently determine my life for the next three to seven years.

Grades were a priori to make myself the most competitive residency candidate possible. I studied and worked hard. Each patient became an opportunity for me to impress on notes, rapid-fire oral presentations and predict nuanced “pimp’ questions. I learned to charm patients just enough that they’d acknowledge my care to the attending during rounds. I interrogated my patients just enough to write the excellent notes I knew I’d be evaluated on. I learned about my patients by memorizing their daily lab values to proudly recite on rounds.

Patients weren’t people with problems but stepping stones to rack up points with the attending. Once rounds were over, patients became time-sucks from studying time, an exam worth 30% of every rotation grade. Real humans do not follow textbook presentations, but exams do; the warm body in front of me only detracted from my evaluation by cold scantron. By my attendings’ clinical comments, I was an excellent medical student, but I knew I was a terrible clinician, rehearsed only in the games of academia, not medicine.

How I learned to stop worrying about the Match and love patient care

My shift in paradigm came with a shift in career path. My worst fear as a fledgling surgeon was not matching for a residency spot. My worst fear as a fledgling emergency physician was killing a patient. Suddenly playing doctor became very real, and in the middle of my OB/GYN rotation, I started to care not about textbook presentations but real-world ones. I didn’t care for OB/GYN and volunteered to cover the peripartum critical care unit, a similar environment to emergency medicine.

My first day on the unit, I saw a patient roll in as I was in the middle of practice questions on the computer. I glanced up but returned to my test preparation, justifying my delay in evaluating the patient because the resident was still in surgery. Half an hour later, the resident came to evaluate the patient and I followed — the patient was obtunded, hypotensive and sitting in a growing pool of her own blood. It would not have taken a MD to realize that this patient required immediate medical attention, and I kicked myself for not evaluating her sooner. I may have been a pretend doctor, but it finally struck me that I was a pretend doctor on very real patients.

For the rest of my time in the unit, I made it a point to personally round every hour, on the hour, on every patient. I didn’t always write notes for these hourly rounds — getting credit was no longer important to me — patient care was. While they initially questioned my obsessive rounding, the residents quickly came to trust my dedication and leave me to my own in the unit, knowing I’d alert them if necessary.

At my institution, hell hath no fury like an OB/GYN resident unnecessarily interrupted, so I spent my time reading on appropriate treatment courses for the different conditions I saw in the unit. After I rounded, I’d give the resident a list of orders to put in, and the nurses began to treat me as the main provider in the unit. I got to be the first person to make critical medical decisions, responding to truly acute situations and drastically changing the course of a patient’s treatment. I pulled long hours and hardly studied in the traditional sense with prep books and practice questions, but I was constantly reading on my patients. That shelf exam and clinical evaluations were my best of the year. I had learned to stop worrying about the Match and love patient care.

Not “just” a student

After that revelation, I fought to earn more responsibility and trust on each rotation; I learned more, gained competence and became more satisfied in my chosen career in medicine. During emergency medicine , the specialty that started it all for me, I learned more medicine in one month than I did in my entire third year. It was a pass/fail course with no motivation by grading, but I was terrified I would be the first person to evaluate a patient and not recognize a critical condition. That hemorrhaging patient from day one on the peripartum critical care unit still haunted me. People can decompensate quickly and unpredictably — at any moment, you may go from being “just” a student, to being the only medical provider in the room.

At the end of that rotation, Step 2 breezed by with none of the misery I experienced with Step 1. Behind each question I’d see faces of patients with that exact presentation; behind each answer choice, I’d see the clinical consequence of making the wrong decision. Finally, I understood what it mean to be both an excellent medical student, and (at my level of training) an excellent clinician.

The academics of medicine often makes us forget the “59 yo AA M, PMH CHF dx 2010 (EF 20% by TTE 8/2013) p/w SOB x 2d” is a real person, with real vulnerabilities and real fears. We are not “just” students, but trainees and members of the medical profession. Grades and exams do not define us, but are simply checks on clinical competence. Trite as it may be, remember what you wrote about in your admissions essay — why you embarked on this journey in the first place. We came to medical school not to become excellent medical students, but to become excellent doctors.

Always keep that in mind. Everything else, the grades, the Match, the exams, will fall in place.


Salvation in a Bottle

The man wearing this fancy yellow long-sleeved polo and navy blue pants was on fire. His face was drenched with his sweat as well as the excessive hair gel that failed in its duty to hold his hair together. He reached out his left fist as he shouted, “Do you want to be prosperous? Do you want to solve all your problems and worries? Do you want to be healthy and at the same time wealthy and free from the burden of your financial obligations?”

Another man, with the design of his green t-shirt hidden by the dirtied white blazer bearing the logo of a government hospital, extended his arms to the air as he closed his eyes as he became emotional with his reply, “Yes, yes! I want to be prosperous! I want to be stable! Yayaman na ako!” Everyone else around him was doing the same thing – some were even jumping up and down while the others had their faces wet with their tears and sweats.

No, I was not in some Christian church that was having its fellowship.

I was at the presentation of an organization promoting its line of healthy products.

 

It was not the first time I have attended such a “presentation” – and certainly this would not be the last time. In some, I had been duped into going because I was told that my opinion as someone who has medical background would be needed, while in some I willingly went out of courtesy to the person inviting me.

I know the routine already: it would involve an audiovisual presentation of how the world is already falling apart and that the people are putting their lives at risk because of their unhealthy living. It will also show how people are getting poor because they do not know that they should be prioritizing their health, and instead of spending their hard-earned money on being healthy, they were spending it on things that would not matter in the long run. Some statistics would be cited as to how health products are only starting to be the rage and how investing on them now would mean a bigger share of the market in the future. It will be followed by a testament by the host, who would introduce a few people who were wise enough to have invested – those who belong in certain echelon of their organization because of how much they have already sold (this will include a mention of how much they were earning in a month). They will then tell the participants that they were “lucky” that one of those in the upper echelon was able to squeeze his or her time (which was supposed to be spent in talks or a vacation abroad) to give a testimony of how the product has changed his or her life.

This upper echelon person will then stand up amidst the cheer of everyone, and he would go on stage like a shining professional wrestler who was acknowledging his fans. He would introduce himself and would not fail to mention that he was a graduate of this or that course and that he did not make it in the board exams, and then say something about the hardship of his pre-health product-selling life: how he would spend countless hours in the office laboring pointlessly but never earning much to even buy himself a car, how he wanted to buy an expensive and branded gadget but he could never afford one, and how he wanted to earn enough for his family so that he could give his parents the comfort that they have always deserved but never gotten. He will then testify how much he sacrificed to start up, including what he sold or gave up to invest. Of course, it will end with a happy ending – that he was now earning almost half a million pesos a month and how miserable he is now that he does not know what else to spend on, as he already has a beautiful house, a sports car, and he could buy anything that he or his loved ones wanted.

By the way, more importantly, he was able to help make the world a healthier place. Not bad.

Of course, there is no force-selling those health products. The presentation, after all, is just to expose the invitee to the potential of earning huge money – and half a million pesos a month is not just a pretty penny even to the CEO of a small business. If you’re interested, just approach one of their “coaches” who will help you become a member, purchase their products, and maybe give you a pointer or two on the art of selling.

 

Now what is the point of all of this? The keyword was already right there – “health.” The product is about making everyone healthier and the seller prosperous. This is where physicians go in the picture.

After the presentation, I was introduced to my inviter’s other friends. They were from several different backgrounds: some were office workers who wanted to earn more, others were hardcore business people who were looking to expand their profits, and most of the rest were a mixture of eager students, bored housewives, or fresh (and not-so-fresh) graduates who were looking for work. One of my inviter’s friends left a bigger impression on me than the others.

He actually did not need to introduce himself to me, after all, his name and the capitals “M” and “D” that followed it were embroidered in dark blue above the breast pocket of his dirtied white blazer. I am not sure, however, if he were still affiliated with the hospital whose logo patch was still on his blazer, but as far as I know, residents and consultants usually have their respective fields also embroidered below their names. Seeing he has none, it was not unsafe to assume that he was a general practitioner who went to that hospital for his internship and did not bother to remove the logo anymore when he started his own practice.

Para sa atin, ‘tol. Kayang kaya natin kitain ito,” he said rather confidently. “Ang dali lang, di ba?

Yes, he was the same person who had his eyes closed, head bowed down, and arms extended upwards during the presentation. At that time he looked like a grave sinner whose sins had been mercifully forgiven by God and he had been delivered from eternal damnation by the speaker.

Pare, ilagay mo lang sa reseta mo yan tapos sabihin mo sa pasyente mo na hindi pa available sa Mercury iyan, pero meron ka sa clinic mo. O e di tapos!” He smiled and clapped as he said “tapos” as if it were the solution to the dilemma I was having.

It made sense though: putting it on prescription definitely makes it a “must buy” for the patient. After all, as one commercial said, “magrereseta ba si Doc ng masama sa iyo?

 

I decided to defer jumping in the bandwagon, as I prefer making my own investigations on the products. In another presentation, it was emphasized that their products were already in the latest issues of MIMS Philippines as well as Physician Desk Advisor. This, according to them, makes their products legitimate for prescription. But these publications also include milk formulas, nutritional products, vitamins and minerals, and other health supplements too – and while helpful, these do not guarantee that the health products being sold are indeed therapeutic. Unless these had been approved by the Food and Drug Administration (FDA) as treatment medications, they ought not to be advertised as treatments or health solutions. The label “No Approved Therapeutic Effects” should be emphasized. Better yet, maybe the label ought to be bilingual, and in Filipino it should state “Hindi Pa Talaga Napatutunayan Na Nakagagaling.”

The problem really is not just the labeling, but rather with the aggressive marketing that they are having. Of course, a patient who is coming in with a disease or medical condition that is bothering him or her or a loved one would expect the doctor to give something that would make them feel better – a drug or an antibiotic that will lessen if not totally remove their symptoms. What would be a better way to sell the product than by prescribing it?

I am not in the practice, but it is not unusual for me to be approached by acquaintances and friends who would ask me about their condition. Not a few of them would tell me that their medications are so expensive that they do not know how else to budget their finances. One acquaintance once told me that her child was diagnosed with a respiratory disease, and she could not bear the expenses for the treatment. I mentioned to her that medications for her child are relatively affordable, as the disease is one of the priority diseases of the government. She showed me the prescription and said that all in all, she would spend almost two thousand pesos every two weeks for her child’s treatment.

The health supplements were placed on “number one” and “number two” on the prescription, and the actual medications for the disease were numbers three, four, and five. As the two medications were more expensive outside, they would buy them from their doctor and the other meds from a pharmacy.

I do not want to make accusations, but it seemed that her prescribing doctor made sure that the health supplements would be bought first before the actual medications.

The sad part about it is that there is nothing wrong about that. Well, technically, there was nothing wrong with how the prescription was written.

 

Hippocrates once said, “primum nil nocere,” which in English means “First, do no harm.” Of course, Hippocrates is not a licensed medical practitioner and he probably did not have fancy cars, several houses, and state-of-the-art electrical gadgets as proof of a successful medical practice, and so his teachings – while important in passing worthless subjects in medical school such as “Medical Ethics” – are not really emphasized anymore once a person finishes medical school and passes the physician board exams. Maybe this is why a lot of physicians would make prescriptions of products that they do not really know about. Maybe this is why a lot of patients would go from one doctor to another to find someone who would actually help them make their lives better. Maybe this is one of the reasons why, when physicians had been subjected to an embarrassing advertisement by the government, most of the people cheered and even made exaggerations on physicians in the web.

One of the common arguments I have heard about prescribing health supplements is that it is usually covered by health maintenance organizations (HMOs) anyway. If given during their hospital stay, HMOs would be the ones paying for them anyway, so what was the big deal? In some companies, employees are given medical allowances for their medicines, and so it will be covered as well. The doctors who would prescribe the health supplements would earn extra money that they deserve, the patient will be “healthier” because of the rich components of their health supplements, and it will be carried over by people (or organizations) that are not them. Again, what was the big deal?

The big deal perhaps is not really the coverage – after all, HMOs are huge evil corporations ought to screw people from their hard-earned cash – but rather it’s about missing the point of Medicine – that of making people’s lives better. More so, it involves doing no harm in the first place. It is good if these health supplements are useless and would just be passed out as urine or fecal material, but more often than not, they are not. Health supplements are health supplements and not medicines for a reason, and it is not because of the conspiracy of huge pharmaceutical industries that want to keep healthcare exclusive to themselves. Rather, it is because health supplements are not yet fully proven to be effective and their side effects are not completely known at the time.

Of course, who will stop them? There are no laws stating that health supplements should be prescribed on a limited bulk. There is no memo among specialty societies saying that health supplements ought to be prescribed on a separate prescription pad and the patient instructed that these should take a backseat to medicines and antibiotics prescribed to actually treat their conditions. There is very few if any healthy discussion of these health supplements during medical conventions. Maybe because health supplements can afford to sponsor the conventions in cool venues such as Boracay and Camarines Sur?

The image of the doctor with the closed eyes, bowed head, and outstretched hand saying “yayaman na ako” will forever stay in my mind – much worse, his not uncommon or unusual solution of prescribing the health supplement to his every patient will haunt me and hurt me not just as a medical professional but as a human being who is genuinely concerned about his fellow human beings. I don’t know where he is now, but I have directly and indirectly encountered quite a number of doctors who use the same strategy and who try to convince me to do the same.

Forget Hippocrates and his ethics, there is salvation in a bottle.


April Fools and Medical Tools

14219_10154608833780182_8853127446711111472_n

Earlier today, I was reading a blog… It had reasons why you shouldn’t become a doctor. Natawa ako. I understood and mostly, I felt what the author was trying to say about the medical field. In summary, he said that you shouldn’t delve into studying medicine if you are not ready to sacrifice your friends before Medical School, your relationships and pretty much your own health and sanity.

Doctors are not the healthiest people on the planet, they are sleep deprived, eat irregularly and do whatever it takes to survive the stress. Maslow’s hierarchy of needs is evident when you’ve been on duty and you had to choose between sleep or quality time with a significant other. Sleep wins. Physiologic needs trump the need for love and belonging, for security. You need to find either a partner who is in the same field or a SAINT who would willingly put up with the craziness you’re going through. However there is ONE reason why you should take up Medicine. If it is your calling, if it is the one thing you see yourself doing FOR THE REST OF YOUR LIFE then by all means, GO FOR IT.

Tomorrow is April 1. What’s special? Wala naman because I don’t have any summer vacation picture to post in my page nor a “mouthwatering” body to display in the beach. Sa totoo lang, wala pa ako maayos na tulog. Hindi dahil nag-inuman kami hangga mag umaga, nagpagulong-gulong sa beach, sumayaw buong gabi ng “Feel this Moment”. Nasa hospital ako, naka duty. Habang pinagmamasdan ko ang pasyente ko pinapa nebulize, sumagi sa isip ko na mag ta-tatlong taon na pala ako nung unang sinabak kami sa hospital bilang doktor. Oo, April 1, trending na naman nyan ang mga hastags #clerkship, #juniorinternship , #lowestformofanimal ,#ninjaintern , #boyatgirltakas , #anakngdiyoskayapullout at kung sosyal ka,#shetwhitelacosteshoeskomayblood

Mahabang pasensya ang kailangan sa #clerkship. You have to survive this step in your medical career even if it means hardly seeing your family whom you live with, even though you won’t be able to see your best friends that much, even though you’re in a group different from your friends, even though you would be seeing your ex’s girlfriend/boyfriend in the hospital every single day, even though another ex is dating your group mate, even though you would miss a lot of events including weddings of friends and christening of their kids birthdays and everything else, even though you would end up not watching your favorite shows or get to watch movies you’ve been dying to see, even though you are going to lose the guy/girl that made your heart skip a beat again (whom you just met a couple of weeks before clerkship), You just got to deal with it. Everything would fall into place if it is in His will.

But before you can go further, you need to be able to fulfill your basic responsibility. As a medical student, that responsibility is to study well. The pervasive nature of mediocrity is such that medical students who get by with “Pwede na,” “Ayos lang iyan,” and “Bakit ko ba pahihirapan ang sarili ko?” later on become the doctors who deprive their patients the opportunity to receive the best possible medical care at the soonest possible time. Remember that every minute of delay translates, not just to inconvenience at your patient’s end, but to another minute of unnecessary pain, or anxiety, or hopelessness.

You’ve already invested so much into this, your parents gave so much for this. Sweat, blood and tears went into your career path and it’s not over yet… There’s nothing else you can do but survive. Let’s take it one day at a time. Matatapos din yan  As I’ve always been saying, by choosing to become a doctor, you make a commitment to pursue excellence, to go above and beyond expectations whenever possible. That commitment starts, not during #clerkship, not when you pass the licensure exam, but on the day you turn page one of your Anatomy book

___________________________________________________________________________________

About the author:

Francis Xavier “FX” Apostol, MD is a graduate of the Angeles University Foundation Medical Center School of Medicine Class of 2012. Aside from being a highly respected and dedicated doctor, is also a loving father and husband, a mentor, educator and lifelong learner. He also describes himself as pogi.

NB: this first appeared on the author’s social media account, accompanying pictures and words by Dr. FX Apostol. No copyright infringement intended.


Called to Serve

The following is a written narrative of the events that transpired during our stint as medical volunteers for Mission Tacloban some time last year..

1470147_10202695523891944_1264252207_n

The MedCentral Team 5: Mica Veloso, Allen Mallari, Vince Alimurong, Ginggay Hontiveros, Gary Yu, & Anna Javelosa

Day 1:  Getting Ready (November 21, 2013)

It’s been barely a week since our last medical mission at Ormoc City, Leyte when I was once again called to serve. The meeting place was at MedCentral HQ at BCLI in Makati, meaning I had to commute from Pampanga to Makati. Designated time was at 4 AM, but since I went early was already in the Makati area 2 hours ahead of schedule. I killed time at the nearest convenience store then at a 24 hour Jollibee store before hailing a cab to the Universal RE Building where I was instructed by the guard on duty to proceed to the 6th floor where I was greeted by the guard on duty. I was the first to arrive and I was required to log my name among the roster of other volunteers. The records showed that we were the 5th batch to be deployed, a 5 man team delegation. I scanned and noted the names of my other fellow volunteers: Dr. Vince Alimurong, Dr. Ana Javelosa, Dr. Mica Veloso and Dr. Gary Yu, who I was just with last week on the Ormoc mission. After the customary greetings and group photo, we went to the airport for our hour long flight. Upon arriving at the airport, or what was left of it at least, Vince commented that this was probably one of the few times when so many necks craned to either side of the plane at one time to see firsthand the level of destruction. We were definitely going to have our hands full. Transportation was already been arranged for us, a run-down but working and functional van brought us through what would seem to be a war torn city had we not known what happened here just the week before. We arrived at our destination, RTR or Remedios Trinidad Romualdez Hospital which was to be our base of operation. Since we came in at mid morning, most of the other teams have already been deployed and so we were tasked to take over and assist at the makeshift out-patient clinic where people were waiting patiently in line for treatment and free medicines. The lines were momentarily cut and the people were told to come back after an hour to give time for us to have some respite and eat lunch, which was a small block of meat and rice served in small plastic bags. No complaints here, knowing that every resource counted. We continued until late in the afternoon, only calling it a day when we could no longer see patients because the sun was beginning to set. After dinner, with nothing else to do, we settled into our room for the night, and having experienced sleeping in nothing but a concrete ledge outside of a birthing station before, having a mattress and a functional fan was a luxury. And so was sleep. And it was definitely savored.

20131121_030556

volunteers all

Day 2: The Work Continues (November 22, 2013)

Feeling refreshed and ready to go, we were deployed in the town of Tanaoan where we were able to cover a 3 barangays and provide much needed medical assistance at first in the scorching heat and later in the afternoon, in torrential rains. But as Dr. Ana pointed out, no patient who came in was turned away or not treated. Only the setting of the sun prompted us to head back to the operations center where it was not yet the end of the day for the team as we had to collate the data that we gathered regarding what were the prevalent diseases and what the locality actually needed. We also had to replenish our stocks of medicines and supplies that we were to bring the next day. The other blessing of the day was that the other outgoing team endorsed to us their place at the CT scan room where there was a fully functional and always on air conditioning unit. Needless to say, we were asleep in no time.

Day 3: Signs of Hope (November 23, 2013)

With the influx of new teams coming in for relief and medical efforts, the team decided to cover more ground by splitting up: Gary with Mica, Vince with me and Ana with the other members of team PSN (Philippine Society of Nephrology). We originally, and ambitiously, wanted to serve 9 barangays, but breakdown in logistics caused some delay in our deployment and at the end of the day, we were only able to serve 5 barangays. All the new data gathered were then expertly encoded and made into usable data by the more than capable Vince. Along the way we have also noted small signs of recovery: electric poles being erected, lumber yards starting small operations to provide planks and beams for restoration and repair as well as the occasional makeshift sari-sari store on the roadside. The long and arduous road to recovery has definitely begun.

20131121_133529

the mission continues..

Day 3: Journey Home (November 24, 2013)

For the people back home, today would probably have been spent glued to the TV watching in anticipation for the Pacquiao fight which we would later learn he won of course. We would have also wanted to attend mass for the solemnity of Christ the King, but as Simon our Canadian born, white skinned Asian, as he’d like to describe himself told us: there is always a proactive way of sharing God’s work and we were at the moment, living it. Once again the people greeted us warmly when we arrived and again we were told that we were to be the first team, medical or otherwise to give them solace and a sense of renewed hope. There was a noted reluctance in setting up the makeshift tents and unloading of supplies as it dawned upon us, this would be for the moment, our last hurrah. And just when we thought we’d seen it all, right there on the roadside while Vince was taking the history of his young patient who had high grade fever for the past few days just suddenly went into seizures. Thankfully we were with a paramedical team who brought their own ambulance and we were able to send the child to the nearest functional hospital for further treatment. What a way to end this journey. But as we all know, we were but a small part of a big effort that just came in together. In the end although we were to ones who came in to help, we went home with a deeper understanding and respect for the power of the human spirit.


Living, Learning, Earning and Leaving

mch

helping the sick get better.. that’s my job

“One day I’ll be missing this place”

I read these words from a former staff nurse as a comment to a picture of the hospital where I am both a visiting consultant and a volunteer doctor. And I can’t blame them really, with the economic turmoil and the harsh reality of the nursing profession. Sometimes I myself am asked why I continue to stay despite the difficulties of medical practice and I tell them the story of one patient in particular who helped me place things in perspective.

I went to see this particular patient because she was referred to me for cardiopulmonary risk evaluation prior to a planned open cholecystectomy procedure, nothing out of the ordinary at first but when I looked briefly at her chart, I noted that she came from a far off town, at least two to three hours away. I confirmed this with the patient when I did my rounds and she told me that they even had to take a boat as part of the commute. I recall being to that town before on a medical mission at a friend’s invitation, so I know that it’s really a long way. When I asked how come they happened to be admitted at this particular hospital, she told me, and this would not be the first time, that her National Health Insurance Program (PhilHealth) payments were not up to date and hence, were not eligible for the program.

But the patient continued with her story and told me that she was not looking for a free accommodation and hospital services but rather, where the rates were lower, at least in more affordable compared to the private hospital where she first sought consult and later upon knowing the amount she had to pay, just opted to go back home despite the pain and discomfort she was feeling at that time, simply because she could not afford it. She tells me she has some money with her, but not enough she reckons for the expenses after the surgery; so that is why she will be asking for financial aid from the local politicians, a common practice I observed. She does not want to be begging for alms, but what can she do? She really wants to get well, to be relieved of the pain and suffering she told me. I finished my examination and promised her to help her in the best way that I could medically. I excused myself to make notes and place my written evaluation. The medical assessment would be the easy part; it’s all based on objective and sound scientific and medical data that’s readily available. It’s the human aspect of the healing process that’s a little tricky. The part where our mentors would say the art of medicine comes in, making that human connection and not just treating the patient as a compilation of lab results and imaging studies. In a way I’m thankful that she chose to go to this quaint hospital where it may be a little out of the way, not have the most advanced equipment, and sometimes where things just don’t go the way we plan them to be; but its doors are always open to those who seek medical aid, regardless of creed, race or stature in life. Likewise, the doctors who choose to serve here are more than willing to help out, despite the hurdles and insurmountable odds they have to face. And maybe that’s one of the reasons I choose to stay, because more than just a job, it’s a calling if you may, where I can practice my profession and give back something in return. Besides, here I can be an agent of change and there will always be something new to learn; mostly in the practice of medicine and sometimes, life in general.

In the words of the Blessed Mother Teresa: “Stay where you are. Find your own Calcutta. Find the sick, the suffering and the lonely right there where you are – in your own home and in your own families, in your work places and in your schools.. You can find Calcutta all over the world if you have the eyes to see. Everywhere, wherever you go, find people who are unwanted, unloved, uncared for, just rejected by society – completely forgotten, completely left alone.”

This article uploaded in response to today’s daily prompt


Hearts, Doctors, Love

20130719_161134

lub dup.. lub dup..

Out of breath? Palpitations? Skip beats? It could be signs of heart problems.. That or you could just be in love. Either way, have a date with your doctor today and find out. Happy Healthy Hearts’ Day everyone!


%d bloggers like this: