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 hand 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; 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.