It was Saturday morning, and by force of habit, I woke up early even though I had nothing scheduled for the day. It was the end of my second week in private practice. Lying in bed, staring at the circular lamp set against a deep blue background which is my bedroom ceiling—meant to simulate a full moon on a starless night sky—I wondered if I had made the right decisions thus far.
Nine years had passed since I graduated from medical school and got my license to practice medicine, two years since I finished residency to become a neurosurgeon, and one year since I completed my pediatric subspecialty training abroad, yet I was, still, just at the beginning. My work as a teacher would usually keep me preoccupied—I had only recently concluded my biochemistry review for students preparing to take the physician licensure examination. My neuroanatomy classes for first year medical students were not due to start until a couple of months later. Though I refused to admit it, anxiety was building up.
I knew I had to moderate my expectations, having heard the same story from classmates and friends. Pagalingan magbilang ng butiki sa kisame ng clinic. I should even consider myself lucky; I had one patient on my first day.
So when the demons started to creep at the fringes of my deep-blue sky, at the ready to cast frustration and doubt, I got up, took a shower, and did what any self-respecting patient-less physician would do: I cleaned my apartment. Nothing could clear my mind faster than washing the dishes.
Being a first-generation doctor, I had to start from scratch. My parents are not doctors. No one among my immediate maternal and paternal relatives is a doctor. My family cannot afford to buy shares of stocks in private hospitals. After finishing specialty and subspecialty training, I did not have a clinic to take over and neither did I have practice privileges waiting to be used. As to which course my neurosurgical career would take, whether things would pan out after I obtained my diplomate certificate at the end of last year, there was no way to be certain. Where to begin? How to begin? I was on my own.
I suppose every Filipino physician goes through this stage. It is like standing on a cliff with an immeasurable vertical drop, your heart in your outstretched hand, and it’s raining hard but you cannot do anything except let the wind and water batter you as you shout, hoping the universe hears you amidst the intermittent thunder: here I am!
Was it right to stay in the Philippines to practice medicine? Was it the correct decision to come back after my fellowship training? What happens if things do not work out as I had envisioned then as an idealistic, young Filipino doctor?
On my last day in Melbourne, I took an Uber to the international airport. My driver was an immigrant from Malaysia, an engineer, and I told him I was a Filipino doctor leaving Australia for good. It was my father’s sixtieth birthday the following day and I would make it just in time. I did not look for another training program after my year-long contract at the chidren’s hospital ended. I did not explore the possibility of permanently working and settling in the country either, although I could have as many did.
“You should have stayed here!” my driver said in disbelief while we were on the freeway, in the same tone one’s friends would say, “Ang tanga-tanga mo!” with good intentions. As he admonished me, a Ganesh figurine stood witness on the dashboard. The Hindu deity was the good omen that I needed.
Back in Manila, my worth as a physician has been reduced to an envelope of photocopied diplomas, licenses, and certificates, which I carry around as I do courtesy calls to senior neurosurgeons, turn up for interviews, and apply for a consultant position at different hospitals. Residency and fellowship trainingopen doors of opportunities, but they do not necessarily mean patients will beat a path to your door. That is the caveat.
I had to learn the intricacies of Philippine taxation, PhilHealth, and setting up a clinic. My secretary would teach me how to charge professional fees, something I still feel uncomfortable discussing with my patients’ families. It was a moment of triumph, holding up my completed income tax return, which I filed on my own because I wanted to save on accountant fees. I compute every single peso I shell out for my clinics.
Most work days, I spend three hours driving between hospitals and medical schools. It was one of those mornings when, stuck in traffic inside my secondhand car, I told myself that I just want to earn enough so that I would not have to worry about gasoline, toll fees, and parking.
One good thing going for me is that I have been able to save money while I was training abroad. I earn a decent income when I teach in medical schools, too. Living in laid back Melbourne for a year taught me to enjoy the slowness of things. Everybody is in such a hurry to achieve something or become someone, that we forget to be thankful for what we have in the now. We are always where we are meant to be.
More than ever, I would turn to my consultants for advice. I realized that although peers are conveniently available for sharing daily frustrations, it is wisdom that comes with age and experience that helps one make the right decisions.
Just make sure that you don’t take in more than you can chew. Other opportunities will come your way as time passes. Pick the options that will make you happy. Good luck.
I had been told of this just recently, and as a first-generation doctor, it is advice like this from a mentor that provides reassurance.
That Saturday morning, at the end of my second week in private practice, I decided to give myself a deadline before seriously considering plan B. Maybe even plan C.
While I was walking home after paying my apartment’s electricity bill, the universe responded to my cliff monologue with a text message from Dr. AS, a senior neurologist, and one of my teachers at the UP College of Medicine. She was also the very person who interviewed me for medical school admission sixteen years earlier.
“Ronnie are you in town?”
I replied to her message. She called shortly after to discuss a patient, an elderly father with a head injury.
That was how I got my first neurosurgical referral as a consultant.