Posts Tagged ‘physician’

A few days ago, my batch wrapped up our first three years in medical school with a week-long “celebration” marked with a series of written, oral, and skills exams. Now, we are officially done with classroom-based learning and are (supposedly) ready to embark on a journey of gaining knowledge from the hospitals full-time.

On the last day after our final exams, the batch partied in a way only medical students knew how – wildly. Prior to that however, the lower year level and the school administration threw us a send-off party, where a couple of people who’d gone before us gave us tips on how to survive clerkship. One of our favorite doctor-teachers, who specializes in obstetrics-gynecology, also wrote each one of us a few tips on how to survive not only clerkship but also internship and residency as well. I’m collating all of their tips here and philosophizing on each one because, despite being medical clerks, we are still extremely philosophical beings.

  1. Remain humble; in short, don’t be a primadonna since you are the “lowest animal in the food chain.” How can we not respect the hospital peking order? Learning from the experience of other people is a privilege. Why be a primadonna over that?
  2. Always show professionalism; don’t answer back. I used to think that being professional meant doing your job and, as much as possible, doing it well. It sucks that it actually also means doing it with a smile on your face, which transparent faces could sometimes be unable to do when faced with lack of sleep, food, and camaraderie. How do you hold your tongue when you can’t even hear yourself thinking?
  3. Always smile; kill them with kindness. We have to admit that, when faced with an extremely disagreeable person, killing him/her with kindness instead of with violence is quite hard, if not humanly impossible, to do.
  4. Take the initiative; always go the extra mile. I was telling a friend the other day that one of the advantages of living away from family during medical school is the absence of familial obligations. It’s a sad but somewhat valuable fact at this point in our training.
  5. Look forward to a “toxic” duty.  I cannot remember a lot of things from the lectures but I am hoping sincerely that I learn from doing.  So yes, bring all the toxics!  I just hope I don’t unwittingly kill a lot of people in the process.
  6. Be assertive without being aggressive. Middle children, which I am, are particularly flexible and good compromisers but, having been surrounded with testosterone growing up, being aggressive in the face of apparent attack is what I know how to do. How do you fix that part of yourself in a little over a month?
  7. Be confident without being cocky. In all honesty, I have no idea how one can be cocky when one is at the bottom of the food chain. It’s like trying to be the alpha male when one is apparently a puppy. Furthermore, if one has no idea what one is doing, I am not sure the line “confidence is key” applies.
  8. Pray. Human limitation is the most common reason why our actions, our knowledge, our ability to be kind and understanding, and our endurance can only go so far.

Perhaps the most important thing medstudents can learn from shadowing their seniors is this rare virtue called humility.  The medical field is rife with people with egos the size of Jupiter, which in some way could be understandable given the vast amount of knowledge they have had access to over the years and given that they literally hold other people’s lives in their hands.  Maybe they have a right to those egos?  Gee, I don’t know but, before they were doctors with big egos, they had been medstudents with even bigger egos… and the medical training system had found a way to ensure that those ego could be brought down a peg or two… or a thousand.

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Going home to celebrate the holidays with my family does not mean that I’d left medicine in the closet in my dorm room to rot for two and a half weeks.  In a family of (mostly) doctors, the topic of conversations usually is (you guessed it) medicine.  By now, you’d think I’d be bored to tears or, at the very least, frustrated with the commonality of it all but no.  As funny as it sounds, I feel more of a (would be) doctor in the company of other doctors who believe that I actually know what I’m talking about as opposed to being in the presence of doctor-teachers who look at me as if I know nothing despite three years of drowning myself in all these medical shiz-nits.  See what I just did there?  I just allowed Pride to run its mouth.

Going home to my hometown also means having to meet up with the few high school classmates I’d chosen to keep in touch with over the years and bumping accidentally into those I’d tried very hard to not come into contact with in the last several years.  With these people, the topic of conversations usually revolves around what everyone else is doing – to put it simply, who’s at the top and who’s at the bottom, who’s the winner and who’s (still) the loser.  I would be a hypocrite if I said I’d never listened intently or asked prodding questions myself but the bottom line is that high school never ends, does it?

As one of my medschool friends would tenderly say, we rise up in people’s estimation with a medical diploma.  The honorable part of me wants to believe that that medschool diploma does not make one better than the other, despite the other thinking it himself already, but the realistic part of me has got to accept that we, as a society, put so much emphasis on education, especially further studies, because acquiring one seems to be tantamount to inevitable future success.  What people seem to forget is that a diploma can only serve its purpose if partnered with the priceless experience necessary to achieve that level of success.

I am halfway through medschool but I froze – totally poleaxed – when I saw a woman fall to the floor in the grocery store a few days ago when a thick holiday crowd was milling about.

The one other thing that made me ashamed of myself as a medical student, besides the fact that I totally went cold and froze as I watched her spontaneously fall, hit the floor, and look disoriented, is the fact that, at that time, I was thankful I wasn’t wearing my white medschool uniform.  Only when people had rushed to her aid did my brain start working again – ticking off the signs and symptoms, trying to come up with differentials etc.  As penance for my inaction, I stood at one side for a good 20 minutes just in case while the grocery store staff brought her a chair and her companion started to fan her.

I don’t like giving excuses so I cannot say that I was not able to help like I’d wanted because I did not have a stet or a pen light or a sphyg because who would I be kidding then?  I thank the good Lord that it was most probably just hypoglycemia or acute mild hypoxia instead of stroke or a seizure.  So, no.  I was not proud to call myself a doctor-in-the-making at that time… and my medschool education did nothing during an emergency situation when this supposed doc was on vacay.

As such, I repeat.  A medical diploma needs the necessary medical experience to be able to achieve expected results.  So, really – I do respect my mentors for they’ve seen more patients and been in more emergent situations compared to me.

I am humbled.  Humbled me shall now go take an ocean swim.  Pass the suntan lotion, please!

When I was a kid, my parents enrolled me and my brothers into a lot of classes.  For learning and improvement, they said.  My mom tells me now it was their way of making sure that their kids would be able to achieve all of their potentials in life.  Thus, from my childhood to my teenage years, I had taken classes in piano, ballet, karate, taekwondo, landscape sketching, portraiture, acrylic painting, guitar, typewriting, computer technology, swimming and First Aid, declamation, theater, and journalism.  My older brother got enrolled into a summer course on automechanics once.  He was ten.

As a result, there are a lot of things that I know how to do.  The problem is that I’m not sure if I’m that good in all of them.  As such, each one of them is a hobby that I don’t share with a lot of other people, simply because I don’t think they’re at that level of share-ability.  This desire to know or maybe to learn was probably the one thing that my parents had painfully but successfully instilled in me because of the constant barrage of diverse information during my formative years.

Speaking of the constant barrage of diverse information, which sounds suspiciously like medical school, perhaps the downside to being enrolled in an MD-MBA program is that it can be a bit confusing sometimes.  Sure, we know we are here to become clinical doctors but how can you focus on becoming that doctor when you also have to put aside what little time you have to become a public health practitioner, a quick-witted businessman and a social catalyst all at the same time?  Excuse the whining but I’m simply wondering, in earnest, how can you compete, clinically speaking, with other medical students from other medical schools whose only concern is to become the best clinical doctors ever?

It makes me think sometimes that, to have an MD-MBA attached to your name, you have to become sort of like a jack-of-all-trades –you have to know how to do a lot of things but you can’t be so sure if you’re that good in all of them.  Not unless you get the balls to try them all out, all at the same time – now that’s some serious balls.  However, these days, whenever I feel the urge to complain about the work load, I think about Daddy and Mummy and how they used to (irrationally) bombard me with diverse information that are so unrelated, I sometimes thought they were torturing me.  Yeah, my parents were very loving people.

The point though was that I learned how to do many different things and, in a way, I was able to achieve the potential to achieve.  I don’t care that I cannot readily define Ashermann’s syndrome or that I do not know what to call lub-dub-click-whoosh when I auscultate a cardiac patient or that I still cannot pinpoint the parts of the basal ganglia.  I mean, I am doing a lot of things here, okay, I am trying to be a lot of things here so chill, okay?

That is the reason why I am still slaving away right now, not for the MD-MBA titles (although, of course, they are still a major reason why I’m doing the shiz nits I’m doing right now, haha), but because I want to learn something new everyday and, these learnings may not be totally related to each other but they will help me achieve all of my potential – as a doctor, as a social catalyst, as a businessman, as a person.

Boom, we just had a pseudo-mature monologue right there.

Bullshit Ahead warning in style of warning roa...

It is not (that) difficult figuring people out. I am of the belief that we, as human beings, inherently wish to be understood by those around us that, even though we would like to seem mysterious and unreadable, that innate desire to be understood is reflected on our faces, on our body language and even on the simple physiological processes (i.e. sweating, increased blinking rate, body position and even the occasional smirks and eye-rolling etc.) that reveal the emotions that are boiling within us. Yes, I am a big believer of body language reading. However, although observation plays an integral part in showing the realness within us, intuition plays an even greater role in how one is able to gauge the character of another human being. This is what we call getting vibes or testing aura and, in my case, this is how I gauge the level of another person’s genuineness.

Genuineness is (personally) an important concept because having surreptitious agendas or putting on a mask of overt plasticity for no productive reason is, admit it, somewhat a waste of time. A mentor once said that the only way you will be able to spot bullshit is by being completely honest with yourself. Her point was this: how can you tell if another person is being honest with you if you are always lying to your own self? An argument could be that constantly bullshitting with yourself will make it easier for you to recognize other people’s bullshit but that would probably lead to a slap at the back of my head so I just keep my mouth shut.

It is a difficult endeavor, this being honest to self thing, which is why I truly appreciate people who have the most transparent faces. It makes spotting either bullshit or genuineness easier in the sense that there is no need to be paralyzed by analysis. There is no need to try to sift through their childhood and what could have gone wrong and the motivations that make them the way they are and how you can possibly help them and, damn, would prayer be enough to yield change in these people? Don’t hate on the effort at Psychiatry – I’m trying to make myself believe I didn’t flunk that exam. In short, it makes life easier… and why does life need to be easier at this point?

Because we do not have time for bullshit. Just kidding. Life needs to be easier because we are here to work, boo, not to produce, um, stool.

But what do I know anyway? There is a land called Denial-asia and I am their top monarch… and I bet I’m ruling this kingdom with several other monarchs.

Teamwork logo

My batchmates have always complained that the school administration makes our lives difficult by assigning us to different groups with different people for the many SGDs, preceptorials and other group works that define our medschool life.  One of the teachers told us that there was a reason why admin opted to try this constant reassigning of groups but the reason was never really made clear.  However (because I am a philosophical medstudent and all that), I have figured out the reason.

Doctors work in teams to ensure that a patient is given maximal care.  You don’t always get to choose who you work with.  That’s the point.  Assigning us to different groups for different tasks allows us to develop the necessary skills to deal with other people in a teamwork setting, especially with people we find most difficult to work with.  After all, what is the challenge in working with people you’re already comfortable with?  Constantly assigning us to different groups with different sets of people teaches us how to be professional, ergo thick-skinned, results-driven machines.  Just kidding.

Perhaps it is all about developing the kind of work ethics that we could someday be proud of.  In all honesty, I find working in groups, even partnerships, somewhat stressful but there is one principle that I follow when teamwork is necessary:  always give credit where credit is due but don’t overdo it.  You do your work well and, if you have leftover time, do more/help your teammates out but you don’t just hog all the credit to yourself.  It is, after all, group work.  Contribute to the formation of your teammates by making them do some work that they can be proud of as well.  However, if you are not able to do your work well because of some uncontrollable turn of events, apologize profusely and try to make up for it the next time and do not let your preceptor or your senior think that you’d done work that you hadn’t.  Give yourself enough credit – the operative words being just enough… not too much, not too little.  Just for the sake of fairness and balance.

There are people who I truly admire in my batch, not just for being exceptional leaders, but for being excellent team players.  The thought of working with them excites me because you learn so much from them – how to lead without using a condescending/offending/dominating tone of voice, how to include people without compromising the results, how to allow teammates to recognize their potential without truly pushing, how they praise their teammates for a job well done while themselves trying to keep a low profile.  It is amazing just observing how they go about it.  They’re very inspirational.  They make you want to better yourself.  Tear.

In my opinion, some doctors and even some soon-to-be doctors have this arrogance – a sense of entitlement – that makes it so difficult for them to sometimes see from the viewpoint of the other.  We are not perfect.  We make a lot of mistakes but, if these mistakes were made in a teamwork setting, you, my friend, have got to brace yourself.  Sooner or later, you’d find out you’d been called incompetent bitch or bastardous slacker at least once in your medschool life.  Just kidding, medstudents are not (that) mean.

So, how do you deal with fellow (pseudo-) doctors?  Haha.  I have no freaking idea, man.  I’m still trying to figure it out myself.  Considering the many mistakes I make in a teamwork setting, I’m just really trying to stay out of the rumor mill.  This ain’t professional school, boo.  This is high school with scalpels right here.  Fun.  

English: Med school

A few weeks ago, I told my aunt that I sometimes felt as if I’d made the wrong decision of going to medschool.  Don’t get me wrong.  I love medschool and enjoy being in it.  I constantly feel excited when I’m learning things that very few people have the privilege to learn.  However, for someone who does not exactly come from an affluent family, the decision to pursue medicine was probably one of the less practical decisions ever made, considering that finding work right out of college could have been elemental in alleviating the family’s financial situation.  However, after much reflection (because, yes, I cannot help but say once again how philosophical we, medstudents, are), I’ve realized that there are many things that are keeping me here.  These are the reasons why I’m still in medschool and why I intend to stay.

  • LEARNING.  The difference between studying and learning is vast.  For most people, studying in medschool means cramming.  You see, given the barrage of information and the lack of time available to digest all of it, studying can be tantamount to mindless cramming if one’s only concern is to exceed the minimum passing score of each exam.  However, one thing I’ve realized in all my three years here in med (because I am such a sage, you know) is that time should not be one’s enemy in medschool.  Studying could be such a burden, especially if you feel that you don’t give a rat’s ass about the topic.  But if you muster even just a little gram of excitement for the subject matter, as in find just one little bit of it that makes your brain go whoa and your heart go yeah, absorbing and retaining medical information won’t be so difficult.
  • MEDECINS SANS FRONTIERES.  I’m not referring to the organization that sends doctors to war-torn areas around the world, although that is a very noble cause and I would love to be a part of it someday.  I mean, being a doctor without borders, without limits, without prejudice – that is the kind of doctor that I would like to be.  I honestly believe that most of us who are pursuing medicine could not just be in here for the glory and/or the riches.  First of all, an MD at the end of one’s name does not define the person… except if the person does not fail to remind everyone he meets that he is a doctor who is supposedly entitled to whatever.  Second, having that MD at the end of one’s name does not necessarily equate to big bucks.  I (desperately) believe that most of us are in here because we have a (secret/innate) desire to serve others.  I (desperately) believe that most of us are in here to become medecins sans frontieres.
  • INVESTMENTS AND SACRIFCIES.  Think about it.  The money our parents/benefactors/donors have spent on our medschooling could have been used for something else, something more… tangible.  Beneficial.  Something that could’ve churned out more immediate returns to equity.  We, my friends, are long-term investments, the returns of which can only be attained six or more years from now.  The road that we are travelling is fraught with potholes and obstacles but there are people who had enough faith and belief in us.  We have the goods to someday make them feel that we are worth the cash.  We are merely assets here, boo.  We’ve sacrificed too much and we’ve invested too much and, if your reasons for leaving cannot be justified by yourself and by those who’ve given up so much for you, for the sake of all that is good and holy, STAY AND WORK IT OUT.
  • PERSONAL REASONS.  Roughly 13% of my class have left for pastures that are of a different color from this one.  I have reason to believe that this will probably rise to around 18-20% by the time we begin clerkship year.  Most of the people who’ve left were academically fine but the universal question for most, if not all, medstudents is this:  “Is this really what I want to be doing for the rest of my life?” I don’t know if young adults with ages ranging from 22 to 26 could be old and experienced enough to answer life-altering questions such as this but, I guess, after a while, you arrive at an answer that will ultimately coerce (?) you to make a decision, not just for yourself, but for the significant others who are expecting something else from you.  Personal reasons are, perhaps, the most important factor that could be fundamental in formulating that make-or-break decision, especially if you are not meaning to come back.  But you know something though?  To each his own.

In all honesty, I often wonder what are keeping other people in medschool.  I mean, it’s not all that glamorous at the end of the day.  In fact, even now, patients sometimes scare me, not because they’re scary per se, but because they trust their (pseudo) doctors, ergo me and my classmates, with their health and their lives.   That much responsibility is honestly terrifying and is not a very “glorious” concept.  To be here and to stay here, your reasons have to be your own, not somebody else’s.  It is easy to lose your drive in medschool, especially if your reasons for being here are not enough or simply are not clear to you, because, man, this is a damn long journey.

I am getting my little pillow out and sleeping through the entire duration of it.

Ever wondered what it is that distracts people so immensely that they find it hard to concentrate on the task at hand?  In medschool, the most challenging part is not the intense studying per se, although that in itself is quite challenging already, but the crux of the challenge is more the actual studying.  By that, I mean the actual process of sitting down, opening the books and transcriptions and keeping at it for the next six hours or so without having one’s attention diverted.  Don’t kid yourself, by the way – bathroom or coffee breaks are considered unnecessary diversions.  Thus, after much reflection (because we, medstudents, are philosophical creatures), I have come to the conclusion that there are four categories that contain the many distractions that make medschool kind of hard, well, for mere mortals such as myself.

  • Personal obligations.  I’ve lived in dorms for the past six years so, for me, family is not much of a physical problem or distraction.  Only when they text me or come see me do they become a distraction and, boy, what a distraction they can be.  It’s because you simply cannot say no to family, especially family you haven’t seen in months.  Even friends – especially friends – whom you see day in and day out that you consider them family already, when they ask you to go to lunch dates and such, it’s difficult to say no and, oftentimes, you don’t even want to say no.  Whoever said people are what matters should be kicked in the ass.  Obligations are already difficult enough to handle as they are.  What more if they become personal in nature.
  • Hobbies.  This and, I mean, this – what I’m doing right now – is a hobby and a distraction.  It’s two in the morning and I should be sleeping but what do I do?  I think about crap and I write about it.  Wattahabi.  However, hobbies are just stuff you need to do because they’re no-brainers that you actually enjoy doing them.  I enjoy studying, honestly, but my neuronal circuits often feel like on fire when I’m studying.  So what do I do?  I start thinking about crap and write about it.  What about you?
  • Extracurricular activities.  Oftentimes, even extracurricular activities become personal obligations, especially when you’ve invested so much time (and often emotion) in them.  In medschool, I’ve met and mingled with some fascinating people known for their passion for service and public health.  There comes a point when you realize that, when you’re a full-time student immersed in a curriculum that tends to drain you for and of all your worth, grand plans at the beginning of the school year become burdens when the requirements start piling up.  Then frustration creeps up on you.  Screw passion, right?
  • The opposite (or same, whichever you prefer) sex.  In all honesty, I think emotional investments are messy.  But, sometimes (and, I mean, in the rarest of occasions), you just have to admit that the human heart… is a freaking slut.  Imagine yourself in your favorite study corner in school, with your laptop open and your highlighted transcriptions before you.  You’re so into the topic that you feel like you’re on fire!  Then, for whatever stupid reason, you look up and see someone from afar.  Even if you don’t see his/her face but just recognize that trademark strut, you feel your heart jump to your throat then stop for awhile then start beating again like you’ve run a marathon.  So, tell me now, how is that not a distraction?  Don’t fret though, I have a solution for you right here.  Find out he/she is dating someone else – that’s sure to extinguish the slutty fire out of your extremely human heart.  That’s what you get for cheating on Med, boo.

It’s very sad to think that medschool tends to take up so much of our time that life becomes so unbalanced.  The things that are supposed to matter, like family, friends, non-med talents, passion, relationships, don’t – can’t – seem to matter anymore.  Do you know what they are right now?  They simply are… distractions.