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 on 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 correct decisions thus far.
Nine years after graduating from medical school and getting my license to practice medicine, two years since I finished training to be a neurosurgeon, and yet I was, still, just at the beginning. My work as a teacher would usually keep me preoccupied, however 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 welling up.
I knew I had to temper expectations, having heard similar stories 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 better 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? In my case, was it the right decision to come back? What happens if things do not work out as I had envisioned as an idealistic, young Filipino doctor?
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 training open doors of opportunities, but they do not necessarily mean patients will come rushing in. 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 second-hand 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 has taught me to enjoy the slowness of things. Everybody is in a hurry to achieve something or to become someone, that we forget to be thankful for what we have in the now.
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 this just recently, and as a first-generation doctor, it is advice like this from my mentor that provides reassurance, something I will be eternally grateful for, and hope to pay forward.
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 a senior neurologist, one of my teachers in UP College of Medicine, and also the very person who interviewed me for medical school admission 16 years earlier. I replied to her message, she called shortly after to discuss a patient.
That patient would become my first private case as a consultant.