The End

Photo from here

It was going to be hard. I knew that. But I didn't know it was THIS hard.

I chose to rotate at the Supportive, Palliative and Hospice Care unit of our institution this February for 2 reasons. First, it's only 28 days (2-3 days shorter than your regular month) and I will be done with it soon. There's just something about palliative care and terminal care that makes me uncomfortable.

I know it's not because I fear my own death. In fact, I always tell Chuy my death plans: no intubation, DNR (do not resuscitate), cremation and I already know to whom I will give my priceless collection of books and stamps.

As I was faced with a dying patient this afternoon, I couldn't think. I didn't even know what to write in the chart or what to say to the patient's family, especially her daughter. It started with a lump in my throat and I knew that any moment, it will roll down my cheeks. I had to excuse myself.

As I was going out of the room, I was wondering why this reaction? I know I'm a toughie especially about patients. I am almost always objective and that's not hard to do.

But as I let my tears flow freely after the rounds, my Senior made me realize what it was about -- I empathized too much. I can relate to what the daughter is going through. After all, she's also a doctor. I imagined myself going through the same thing with the people I love. Not patients, this time.

I don't fear my own death but I fear the death of my loved ones. And that's awfully hard to think about. Harder to talk about. Now I wish February is longer so I can deal with this.

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Samu't Saring Kwento

Photo from here

After attending a research summit today, I realized several things.

First, primary care in the country needs major make-over. I was seated right beside a Malaysian primary care physician. He was surprised that I was training in a hospital. He asks, "You practice primary care in a tertiary hospital?" Yeah, that made me think. Primary care should ideally be outside hospitals. After all, being in the hospital defeats most of our goals. I hope I live to see the day when primary health care in this country is really primary in nature.

Second, age can sometimes be your liability, especially in the field of medicine. I was the youngest in our group and I felt like I had to exert more effort to be heard. I felt like I always have to prove my credibility. Or maybe it's just me. But I swear, I had several statements ignored. But when another consultant said something of similar meaning, they listened! Sadness.

Lastly, language can be a very big barrier. I felt left out because my group mates discussed in Bisaya. I have nothing against the language or the people, but I felt insulted by the act. They know I can't understand it. But they went on discussing in it! I was so glad when the small group discussions ended.

It was a fruitful yet stressful day.

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Doctor for Health

Are you a doctor of the sick or a doctor for health asks one of our consultants.

My seatmate uttered, what’s the difference? One said, isn’t it given that we are a doctor of the sick? In my mind, I have a difinte answer, I am a doctor for health, or at least, trying to be one.

What’s the difference? Humongous. Big. But one it not entirely better than the other. Just different.

Yes it is already given that doctor cures the sick. This is what we were trained to be in medical school. One who is biomedically oriented treating the physical illness of person. Those who are skilled at these will make great specialist.

A doctor for health is not usually emphasized as much in our training. He is biopsychosocially oriented. Treating not only the physically sick but apparently well patients with underlying psychosocial illness. This is what will make a very good family physician, among others.

The latter is what I hope to be in the next 3 years.

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