Being the Happy Resident

Earlier today, as I was walking past the guard who checks employee IDs at the hospital entrance, my attention was called by a colon cancer patient whom I took I care of as a general surgery resident a couple of years back. “Doktor Baticulon!” he called out. I sat beside him and asked how he was. I was glad to find out his cancer has been in remission since his surgery and chemoradiation.

I could never forget the old man. Two years ago, after a non-stop, 12-hour surgery in which I was second assist, his heart stopped beating as he was being transferred to the recovery room. He was revived and eventually discharged cancer-free. Since then, whenever we passed by each other in the hospital corridors during his outpatient followups, he would always ask, “Tara Dok, kain muna ta” with his cupped right handΒ  making a gesture of stuffing rice into his mouth.

I took a picture of us, and then he said, “Dok, nananaba po kayo ah.” I laughed and waved goodbye, certain that we would see each other again at another time.

What he did not know was that I had just come from another hospital, to meet my mentor in neuroradiology whom I had not seen in a year. Shaking my right hand, my boss and teacher said in greeting, “Mukhang hiyang na hiyang ka sa residency ah.”

Needless to say, the patient and the senior physician were referring to the 30 pounds I have gained since I started working as a resident doctor. My cheeks, which used to be sunken, have now become puffy, beginning to conceal the cheekbones that used to be overly prominent. It seems to me that such weight gain is considered an unimaginable feat when one is doing neurosurgery residency in a government hospital.

If I wanted to, I could say in defense, “Stressful kasi, kaya kain ako nang kain.” But the truth is, I think that friends and acquaintances can only make such remarks about physical appearance in good light,when they see that the same person seems content with what he is doing, despite the hard work that every day entails. So I don’t ask myself, “Do I look that fat?” Instead, I end up wondering, “Do I look that happy?”

Apparently, I do.

I have just passed the halfway mark of my neurosurgery residency training. To me, it means less scut work, but an ever increasing responsibility to make sensible and timely decisions pivotal in the management of patients. There is also pressure to master the surgical skills that would ultimately lead to safe surgery for every patient. The remaining two-and-a half years would be just as difficult as the first, if not harder.

I have been thinking (which is always a good thing to do whenever you are halfway through anything in life), and looking back at all the duty days that I have had to endure, all the patients that I have had to serve, all the important family occasions that I have missed, all the surgeries that I have had to cut and close, and all the a**holes I have had to put up with in the name of honest-to-goodness patient care, I would never take back my decision to apply for residency in a government hospital.

A week ago, a co-resident and I were discussing a UP College of Medicine graduate’s decision not to pursue his neurosurgery residency application in Philippine General Hospital. As an intern, he initially expressed his desire to be part of our team, but a year after graduation, he told me that he had decided to pursue research instead. I knew him to be a good and smart person, no doubt a loss to us; nonetheless I wished him luck, knowing that he would do well.

“What’s up with them?” asked my co-resident, also a UP graduate.

“No. What’s up with us?”

That is the question you ask when you find yourself tired, hungry, sleepless, and wearing the same clothes inside and out for the last 48 hours. Why choose to suffer when it seems that the better life lies elsewhere, where the lights and air-con are always on, where the patient list is manageable, where you never run out of time for self-study, and where you can allocate entire days for the other important things in life?

The temptation to quit is a traitor. It does not announce itself boldly during the peak of your work load, often you are too preoccupied to ponder on your lack of a life. Instead, it sneaks in during that silent minute in between surgeries, as you slump on the floor and wait for the next patient to be brought in; it stares at you from a corner as you wait for the elevator doors to open, you holding both stretcher bed and oxygen tank and it’s only an hour past midnight; it whispers in your ear, to wake you up from a nap on the first Sunday afternoon that you get to spend at home in a long time;Β it holds open your apartment door, as you don your white coat, grab your trodat and keys, and rush to your morning rounds.

Only the patients whom you serve will keep you moving forward. Not pride. Not your family. Not even your ambition.

From our UPCM class of 159 graduates, 67 eventually pursued residency in PGH. It is a good number, at a time when doing residency abroad was a viable and certainly more lucrative option. Whether one decides to stay or leave though, the only important thing is that you are content with what you do. Anything less will always be a waste of your time.

I have realized that when every day is seen as a burden, it inevitably affects the way we treat our patients. We end up cranky and abrasive. Worse, we turn to apathy. We are not just being unfair to our selves, but more so to them, whom we have sworn to take care of with utmost responsibility and integrity.

So choose to be happy.

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28 comments

  1. Mary Judith Clemente

    Not once did I ever regret having my residency in PGH. Despite the, sometimes sorry working conditions, I always felt privileged to have patients entrust themselves to my care. Residency will be difficult. Count on it. But I think it’s just a matter of finding the purpose in your work. Once you have discovered this, you’ll realize that it’s not so hard after all.

    • I have to admit that there were times when I did doubt my decision.

      But doubt is good, because when you overcome doubt, you become even more convinced that you’ve taken the right path.

      Thanks Ma’am Judith! πŸ™‚

  2. Re: weight gain… Alas, the same has been said to me but I’m an ORL resident (in the Visayas) so there’s time to really eat. Hehehe.
    I pray though that majority of the graduates would go on training or at least update themselves. Frustrating kasi yung mga referrals na kaya naman I-manage ng isang GP.

    Nice post sir. Happy duty po!

  3. It’s a pleasure working with you, Ron! πŸ˜‰

  4. A great read brod, as always! Pulled my heartstrings too many times while reading this and I especially liked the statements about quitting. You really don’t feel it at the height of all the toxicity, its when you get the chance to pause and rest…YUN NA. The questions just keep coming in.

    Is it worth it? I’m pretty sure it still is. It’s just a matter of acceptance and keeping yourself fulfilled, one way or another.

  5. It’s nice to see a former patient’s face light up when you bump into him/her along the corridors of PGH (especially for us newbies in the hospital). Kahit history and PE pa lang ang ginagawa namin, it makes my heart swell to see them sincerely thankful, and when they use the word “doktora” kahit sa totoo ay student pa lang.

  6. Why choose to suffer when it seems that the better life lies elsewhere, where the lights and air-con are always on, where the patient list is manageable, where you never run out of time for self-study, and where you can allocate entire days for the other important things in life?

    wow sir! What you just wrote, that specific part resonates how i feel now. I’m currently a PGH PGI and I feel ambivalent about pursuing a PGH residency knowing at the back of my head that other hospitals can be less toxic but not necessarily as high yield or as hard core. But oddly, PGH has this special thing wherein at times you feel like you’ve reached your super threshold of being tired then something extraordinary happens making all the sleep deprivation & stress all worth it. Because it happens too often, I adapt the mindset that despite toxic-ness, something wonderful will come out of it. Hehe πŸ™‚ Also what’s great about PGH is that, it’s filled with people who worked really hard to get to where they are. Rarely can you see people wasting their opportunity of being in PGH, getting in is very hard… Surviving it, so much harder. Being surrounded with that kind of cutlure somehow motivates you.

    Sir, was it ever hard for you to decide what to specialize on & where? πŸ™‚

    P.S. Sorry for the mini blog on your blog. Hehe your entry as always is thought provoking & this particular time really hits a chord. πŸ™‚

    • Hi Nikki! I knew I wanted to be a neurosurgeon when I was in third year. Was it a hard decision? During some points in clerkship and internship, I had second thoughts about the specialty. But by the time I graduated, I already knew ito talaga ang gusto ko. But that’s another article! Hehe.

      Thanks for reading! Good luck with the rest of internship πŸ˜€

    • Mary Judith Clemente

      I was also a PGI a long way back and I do understand the hesitation about pursuing residency in PGH. But what convinced me to proceed was the wealth of clinical material and the opportunity to serve. PGH certainly does not represent ideal working conditions. I frequently found my hands tied because management was limited by the patient’s financial status. But it taught me how to improvise and persevere. I guess what I am trying to say is PGH residency us a totally different experience which has taught me A LOT.

  7. Hi sir ronnie! Lagi ako nag rere-read ng blogs mo kapag may nagsasabi sa aking pangit sa PGH and the training nitong mga past weeks… I guess they will never understand.

    Nagturn down na ako ng offers abroad. I chose to stay. Sana mabait sa akin ang PGH.

    Nag-apply na ako sa IM and sana matanggap (at pumasa pa ng boards).

    Nice read sir! πŸ˜‰

    • Eh Dr. Magallanes ka na pala ngayon! Haha!

      I’ve observed that UP medical students have an “all or none” attitude towards PGH when they graduate: either you really like it (thus, making you stay) or you really hate it (thus, making you want to leave as soon as you can). Just go with your gut feel. As I said, it doesn’t really matter where you do your training, just as long as you find satisfaction in what you do.

      Congratulations and good luck on your residency application. Kayang-kaya ‘yan πŸ˜€

  8. A great read! Very inspired. πŸ™‚

  9. Sir, salamat dito. Minsan siguro kahit alam naming ito ang gusto namin, malakas talaga ang temptation na tumigil na lang dahil mahirap.

    PS: Siguro pag sinabihan din ako ng mga tao na tumataba ako, iisipin ko na lang din na I look happy. :p

  10. Hi sir! Maybe the graduate decided to do research in the meantime and not for good. Probably He/she is still choosing between two fields anyway: the field that is his/her first love and the field that seems to promise him/her a new niche. But he/she is definitely already missing the feeling of doing service for pgh patients now, that Im sure. =)

  11. i suddenly found myself relating to this, though im not a doctor, but an ICU nurse in a gov’t hosp. We need more doctors who think and feel like you do.

  12. Sa isang katulad ko na suki ng mga doktor at madalas nagtatanong bakit kaya mukhang bawat taon nagbabayad ako ng pangdownpayment ng bagong kotse ni dok ???? lubha mong pinapabalik ang paggalang ko sa mga doktor! Mabuhay ka at sana dumami ang doktor na tulad mo.

  13. I am an ICU nurse in PGH and I see you around. I am grateful for doctors like you because you understand service and you do it so well. Our jobs tend to burn us out and change us into worse people, but you seem to be able to resist — every single time. So thank you for writing and reminding us what service is and how we should do it. You are an inspiration.

  14. hi sir πŸ™‚ great entry!
    most often, i choose to be happy as well. rarely do i get angry or sad.
    i am a pedia resident in a private institution. while it is a fact that where i serve “the lights and air-con are always on” and “the patient list is manageable (compared to PGH of course)”, i would like to believe that we have our own toxicities πŸ™‚
    that paragraph on the temptation to quit hits me hard in the gut. Mine sneaks in while waiting for another baby to catch, or when i’m alone to eat my brunch, or while waiting for the jeepney to ride home. (pero walang binatbat sa moments of temptation mo, sobrang ganda ng prose by the way)
    but everytime i’m tempted, i know i cannot give in. i always say i’m almost there. no reason to quit now. so i just choose to be happy and enjoy the bliss of being with kids πŸ™‚
    permission to share this blog ha? πŸ™‚

  15. Romer J. Tubongbanua

    Sana Doc mag publish din kayo ng Book nyo. Same as Dr.Ting Tiongco. Thank you very much for every topic you’ve made here. Very inspirational. Stay humble Doc.

  16. My friend’s elder brother decided to pursue research after graduating from UP INTARMED last 2009/10. That made me wonder if he was the one whom you are referring to. πŸ™‚

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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.