The Doctor I Do Not Want to Be

Through Ofelia Reyes, a 36-year-old laundrywoman and mother of two, I would get to know the resident physician who I’d never want to be. To this day, remembering what transpired that night in Ward 1 still makes me shudder, for I had never thought anyone could commit such atrocity to a patient spending whatever was left of her short life confined in her charity hospital bed, not knowing whether the next attempt to take a deep, painful breath would be her last.

Ofelia Reyes was sent to the ER from the OPD because of difficulty of breathing. I was a clinical clerk then, and Internal Medicine being my first clinical rotation, she was among the first patients I took care of as student-in-charge (“SIC”) in the IM wards. Ofelia’s physical examination and imaging studies revealed pulmonary and neck masses. Her right upper limb was also markedly swollen. What doctors originally thought to be inadequately treated tuberculosis was becoming more compatible with stage IV lung cancer. She was showing signs that the tumor’s uncontrolled growth had begun to obstruct blood flow from her affected arm.

Her every breath was punctuated by chest pain. Wary of giving narcotics that would depress the part of her brain that controlled breathing, my resident and I were giving her both oral and intravenous pain medications round the clock. Still, it hurt every time she tried to breathe.

But worse than chest pain, Ofelia told me, was air hunger — inhaling without air getting into your lungs, a constant sensation of drowning, except you are not submerged in water. Her bed was at the right corner of Ward 1, farthest from the ceiling lights and thus darkest at night, but nearest the hospital windows so that she could take in as much unadulterated air as she could.

We needed to prove the diagnosis of cancer. Pulmonary tuberculosis could be treated with antibiotics, cancer couldn’t. Hence, my resident referred Ofelia to a surgical department for biopsy of her neck masses, which were more accessible and posed less risk than attempting to biopsy her lung mass.

I was preparing to endorse my patients to the medical interns and clerks on duty when Dr. X, the resident who answered the referral, came to see Ofelia. It was past 6 pm. Most people who were not on duty had already left or were getting ready to leave the hospital, but because I knew that he would obtain tissue samples that needed to be sent to the laboratory, I led Dr. X to my patient’s bed. Watching over my patient at that time was her 12-year-old son.

There was no “Magandang gabi po.” Dr. X didn’t even introduce himself, proceeding instead to get a quick clinical history and physical examination.

“Gaano na katagal ‘yan? Bakit ngayon ka lang nagpa-admit?”

The tone was stern and devoid of any pleasant emotion. My patient responded with slow answers; breathing alone was difficult, speaking more so. Still, Dr. X asked one question after the other, often not letting my patient finish her sentences.

Why bother asking if you’re going to dismiss the answers anyway?

“Payag ka bang tusukin natin ‘yung leeg mo?”

“Kung ‘yun po ang kailangan, Dok.”

Dr. X prepared his biopsy needs and asked my patient to sit straight up. He donned his gloves, applied the antiseptic, plunged the needle into my patient’s neck mass, and attempted to aspirate its contents.

“Aray, aray ko po, Dok.”

“WAG KANG GAGALAW!”

I was startled.

“Dok saglit lang, masakit po!”

“SINABI NANG ‘WAG GAGALAW. HINDI NAMAN MASAKIT ‘TO.”

My patient could not maintain her position. She kept shifting and moving away, making the procedure understandably difficult for Dr. X.

But did he really have to shout?

Exasperated, Dr. X pulled out his needle.

“Bakit ka ba galaw nang galaw? Hindi naman to masakit!”

My patient was gasping and crying and could not even say a word anymore.

“Nakikita mo ba ‘yang naka-drawing sa dibdib mo? Alam mo ba kung ano ang gagawin diyan bukas? ‘YAN! ‘YAN ANG MASAKIT!”

Now that’s foul.

My patient was also referred to Radiation Oncology for radiation treatment, which we hope would kill the tumor cells obstructing blood flow from her right arm to the major vessels of her heart. That morning, radiology residents put markings on her chest, to serve as landmarks for the next day’s procedure.

Radiation treatment is not painful at all. It’s just like getting an x-ray, so I was perplexed, why the hell is this resident threatening my patient?

My patient sat still, trying to suppress her crying as Dr. X re-plunged his needle into her neck. He pulled out the syringe and walked away with his specimen.

During the entire ordeal, Ofelia’s son stood at her bedside, watching.

I was seething with anger. This resident had just abused my patient, and being a clinical clerk — belonging to the lowest rung on the health workforce and only two weeks old in the hospital — I felt helpless. I could not even tell him that what he did was wrong.

He could be exhausted and he could have many other things to do, but nothing could justify what he just did to my dying patient. In front of her son.

In medical school, I was often asked to identify doctors to whom I looked up and who I aspired to be. Dr. X was the antithesis of that.

I remember staring at Dr. X’s back as he prepared the slides for submission to Pathology at the nurses station.

That was when I said to myself: if one day I find Dr. Ronnie Baticulon acting the way he did, perhaps I should stop being a doctor altogether.

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28 comments

  1. Angelo Gerodias

    Sir, pansin ko lang, madalas niyo gamiting ang name na “Ofelia Reyes”. Out of curiosity lang, bakit sir? 🙂

  2. If you were to go back to that incident, would you have the courage to talk to the resident?

  3. “That was when I said to myself: if one day I find Dr. Ronnie Baticulon acting the way he did, perhaps I should stop being a doctor altogether.”

    Tingin ko naman po ay hindi kayo magiging tulad ni Dr. X, dahil naranasan, nakita at naramdaman ninyo rin naman po yung injustice na naranasan ng pasyente. Magiging guiding light po natin yun to do better and to treat the patients more lovingly (kahit na minsan ata, ‘di na masyadong lovable ang ilan sa mga pasyente).

  4. I hope Dr. X stumbles upon this and recognizes himself. His character flaw of 10 minutes probably scarred someone for the rest of her life.

  5. Sir.. Writer ka talaga i love your stories ,ill remind you of doctor x when you acted that way.. Godbless!! More inspirational stories pa…

  6. hi sir..
    i was an intern (PGI) last year in PGH and I am just happy to know that someone boldly say something about this kind of situation in our government hospital..
    Sad but true getting through clerkship and internship(alive ! :>), I saw the in and outs, the good bad on how our government hospital works.

    I for one was guilty being arrogant to patients especially if there is lack of sleep, food,tired of standing and walking for 24hrs or more and so on.But the thing is that what i had mentioned earlier can be our excuses, or maybe its because we are also human beings. We do get tired and our idealism of being a good doctor fades off..
    Well, here’s the thing, people see doctors in a different way( or light?) than any other profession..People look after us. they trust us with their lives. it’s true and we all know it.
    Now how do we handle this kind of situation? we can be conceited and arrogant just like Dr. X, or the ideal doctor(kind,caring,empathize pt. etc.. the works!) ,or a blank affect and to our job well and don’t care about patient anymore( saw a lot of this during my internship)..then you ask yourself from which archetype of doctors do i belong…
    For this I can say it is overwhelming and be trap and lost once in a while.it’s either you “sink or swim” in this kind of situation.
    Nevertheless, the important thing is know what is inside your heart.
    your intention on why did you choose this profession…

    From my own point of view… I know I am not the perfect doctor( things still get into my nerves at times) but i know my heart and it tells me to show compassion to others(may they be a patient or not) just as Jesus did show His compassion to us..
    I may not become a great doctor someday but rather I what to become a GOOD doctor…

    Godbless sir on your residency…

    P.S.
    like your blogsite hope you could write more pa…

  7. sana maunang mamaalam sa planet earth si DR X kesa kay aling Ofelia…hehehehehe

  8. In the course of medical training, we’ll never run out of encounters with seniors that leave us thinking and promising ourselves “I won’t be like that someday.” Hopefully we’ll never get to the point of being the insensitive automaton with a stethoscope/syringe/scalpel.

  9. Ronnie, I’m just SO curious who Dr. X is. 🙂

  10. ronnie, since ako ang intern/JAPOD mo nun, dapat ba kilala ko Dr X? hehe…Ofelia Reyes sounds familiar…

  11. hmmm… surgical department… FNAB of neck mass… horrible person… written mga 2006/2007… teka, parang dapat kilalang kilala ko si Dr X ah! hehe!

  12. sumakit ang dibdib ko habang binabasa ko ito. ang galing nyo dr. ronibats. idol na idol kita sa peyups webite pa. namiss kita nung nawala ka sa peyups. buti nalang may ronibats.ph na!

  13. What an unfortunate thing. People like that really get on my nerve!

  14. Rebecca Millare Starankewicz

    I thoroughly enjoyed reading your postings and am so thankful for your dedication in taking time to share your experiences/opinions/feelings/insights. I am an RN in Med/Surg unit of a hospital here in the USA. Patient care is the most noble profession there is — sad to say that there are Licensed professionals like you have mentioned who should not be in the field. Unfortunately, someone like Dr. X is not unique to where you are now….it is pretty universal ,which makes being a patient in any health institution scary. ..Sadder still, I find nurses (who spend more time with the patients’ direct care)….having similar temperament and “coldness” towards the people who needs caring most. I am also in awe of your family. How blessed you and your siblings are .. for having two parents such as yours. Yes, indeed, they deserve at least a platinum award.

  15. ‘if one day I find Dr. Ronnie Baticulon acting the way he did, perhaps I should stop being a doctor altogether.’
    – epic statement doc. 🙂

  16. I’m now teary-eyed. I remembered the times when my father was confined in the hospital also for lung cancer. There are doctors that has stiff reaction but thankfully, didn’t encountered a doctor like this. But still, I also have shares of hospital horror stories. (not ghost and stuffs but just like this)

  17. I hope all doctors will have a compassionate heart like yours…

  18. I’m enjoying reading your blogs dr. Roni. Dapat requirement din na pumasa ng mga doctor sa GMRC! Sad to say but I think she was treated that way because she is poor. I don’t think na kung paying patient sya she would be treated that way. Haysh! Kudos to you dr. Roni!

  19. What the hell was that? Well, some time in our life we will encounter people which will make us realize what we don’t want to become some day. At least, you’re able to know something that you don’t want to be.

  20. Everything happens for a reason.

    This “incident” helped you, early on in your career, to clearly see what you need to be, i.e., to stay the same and improve for the better – not for yourself but for your future patients.

    I see goodness in your posts. I feel the goodness in your spirit. And I kid you not!

    We make a living by what we get. We make a life with what we give.
    AnitoKid

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Names, dates, and events may have been changed to protect the identity of patients. The stories are not meant to provide medical advice for specific illnesses. The author neither accepts online consults nor gives medical advice online. Please consult your trusted physician.