Every day begins at 5:30 am. As I walk past the charity wards on the way to the Neurosurgical Special Care Unit, I mumble a short prayer asking for a little more kindness and a little less impatience. That has become my morning habit. I used to wish for fewer patients, until I realized that I didn’t need the daily disappointment, and thus directed my morning offering to self-improvement instead.
Healing the sickest of the sick and the poorest of the poor in the largest tertiary hospital of the country requires an attitude that is beyond Harrison’s or Schwartz’s. Suffering from eternal lack of sleep and burdened with an endless list of things to do, I have to constantly remind myself that our patients come to us because they cannot afford health care elsewhere. They do not have a choice, and our surgical team may very well be their only hope for a cure.
On an average duty day, I would see anywhere from 5 to 15 new patients, on top of the patients I would examine in the outpatient department during Wednesdays and Fridays.
“Dr. Ronnie Baticulon po ako sa Neurosurgery. Kami po ang mga nag-oopera sa ulo. Kung sakaling kailangan kang operahan, kami po ang mag-oopera sa iyo.”
I have interviewed them all: the wife who tentatively promises to procure operating room needs for her husband suffering from a hypertensive intracranial bleed, the loud mother carrying her toddler who fell down the stairs, the drunken bastard who crashed his motorcycle into another vehicle, and the clueless bantay who couldn’t even tell me where his patient’s blue card is.
After hundreds of patient encounters, I have learned that the least useful question in our institution is “Bakit ngayon lang kayo kumonsulta, eh (insert time frame) na pala niyang nararamdaman iyan?”
The answer is inevitable (“Eh kasi Dok, wala ho talaga kaming pera.”), with neither diagnostic nor therapeutic value, and whose sole purpose is to irritate any overworked physician, so I have long abandoned asking the question.
I can say that from Day 1, I knew what I was getting into. As a clinical clerk and a medical intern, I have seen how my then residents struggled to provide the best possible care to patients despite our hospital’s limited resources.
Still, I chose to become a government physician.
When I signed my employment papers that officially designated me as Medical Officer III, I was prepared to spend the next five years in the hospital not knowing when I could eat or sleep, push stretchers from the ER to the Radiology Department and back, pilfer antibiotic vials and surgical sutures for patients who couldn’t afford them, prepare copies of clinical abstracts for PCSO no matter how many times patient relatives ask for them, and even shoulder the cost of mechanical ventilator rental and cranial CT scan of abandoned patients.
I did, and I continue to. Such is the price I have to pay for the wealth of experience that can be gained by training in a public hospital.
Some days can be unrelenting. I have learned to survive by taking things one day at time, hoping that with a little more kindness and a little less impatience, I might just make a difference in somebody else’s life.