The Makings of a Master Surgeon

For the past two days the second and third years have been attending surgical skills workshops organized by the department. We’ve been practicing vascular and bowel anastomosis on rubber tubes and cow intestines hopefully developing our skills and building confidence when the time comes when we’re the ones who’ll be doing these on actual patients.

These two essential skills of any surgeon, are probably the two toughest to master. So many morbidities, even mortalities, come from the “poor surgical technique” factor, begging the importance of these two workshops.

While med students practice on pigs legs on basic suturing, we residents also have this. Hehe

We’re also very honored to have been taught by the masters, Dr Concejero for the vascular anastomosis, famous for being one of the vascular surgeons of the first liver transplant in recent years; and Dr Dela Paz showing his superb skills on bowel anastomosis.

This is definitely a milestone in the makings of a master sugeon.

I am Happy

Lately I’ve been feeling a little bit confused over my BIG life decisions coming my way. For the last 7 years, I’ve been confined only to the walls of UPCM and PGH just living my life determined ONLY by a very small box I ticked when I filled up my UPCAT application form last August 2002. I think the last MAJOR MAJOR decision that I made that made me a more specific person in society was to pursue the interview for Intarmed. I told myself then that if I didn’t make it, then medicine is not for me. But I did. And out of pure jest, I accepted my life and just went with the flow for the past 7 years…

Now that it’s all over, I’m at another MAJOR MAJOR crossroad. Last week I passed an application form for Surgery residency in PGH. How I made my decision is a another story on its own. On one hand, I amused myself with going into Pediatrics — the easier way since my mom is a Pediatrician. On the other, of course, I wanted to pursue a career I’ve been dreaming of since I first laid my eyes on FHM our first lecture in surgery.

Pediatrics was my actually first love, and when I entered medicine in 2005, that was my goal. Eventually, the crying kids and disrespectful mothers caught up with me, and soon I found myself liking surgery more and more.

Training in surgery is great, and the lifestyle of a surgeon fits my personality more. I really want to become a surgeon, but it’s the long, arduous, and hardcore training years is what I’m reluctant to go through. Practice wise, I’m definitely going to have a DIFFICULT time establishing my own practice. Definitely NOT the easier path.

Until that day in PGH when I finally filled up my application form, I prayed and heard a voice in my head to tick “[ ] Surgery”. The hesitation was definitely there. Up until recently, especially that the entrance exam is about to take place in 2 days, my head is still in a blur. Am I ready to make THIS decision? A decision that I should NEVER EVER regret for the rest of my life? Is this what I really want? Will I be happy?

Then I read Kathy’s blog, and then Ivy reblogged the article below, and I began to enjoy reading Schwartz, and so many people affirmed my decision to pursue surgery…

I think I am happy. I should be.

It hit me across the back of the head like an angry parent. There I was, minding my own business, wallowing about in a mopey state of woe at my dissatisfaction with my own life, when reality bit me fair on the butt. Hard. I regularly bang on (and on, and on) about the importance of independence, that is, not seeking a partner to complete ones-self, but rather, ones who complements us. I rant on about the importance of goals, incremental personal … Read More

via View from Wit’s End

2010 PGH Interns’ 100 Days Collage

I made this for the Interns’ 100 Days Countdown before the end of Internship. All 26 regular internship blocks and 4 straight internship blocks represented!

Worth the Wait

It was midnight.

After dropping Maan off at her dorm across Taft, I was walking back to Rob when I passed by the PGH-OPD (Out Patient Department) gate in Faura. I chanced upon an elderly couple, both around the age of 65 maybe, asking something to the guard on duty:

“Boss, saan yung pila ng oh-pee-deh?” the man asked.

“Dito ho ba yung pila ng oh-peh-deh?” his wife assumed.

It was quarter past twelve, midnight.

And they were the only ones there.

I kept on walking, and never followed what had transpired from their inquiry to the guard. I know for a fact that the line for the OPD starts there, right where they were. But it was midnight; they weren’t supposed to be there until 5am, when the line usually starts. The OPD opens not until 8am.

Out of curiosity, just to see if they did fall in line (or start the line for that matter), I looked back at them…and I saw two people, seated in front of the gate.

They fell in line.

+++

We will not be starting at the OPD until our 3rd year. It is at this year that we’ll be given partial responsibility (at least 1/5 of the praise/blame) to our patients. Patients who have too mild a-case to be admitted in the PGH wards. Patients who have traveled from every part of the country just to be serviced by the nation’s top doctors for free. Patients who have waited in line just to be included in the doctor’s patient list. Patients who sleep on the side walk of Faura, just to be the first in line. Patients whom we, as third year medical students, will practice history taking, physical examination, and diagnosing upon.

Will we be worth it? Will we be worth their time?

Passion for Service

As if we hadn’t had enough of the premiere tertiary hospital in the Philippines, kanina, pumunta kaming PGH para sa isang “field trip” (whatta field trip, katapat lang namin yun no!) sa aming HISTORY 5 class, a.k.a. History of Philippine Medicine. Our class, which is compposed of the two Intarmed blocks, was divided into 4 groups. My group was called the special group…why? Kasi kami lang ang tanging group na makakapunta sa Cancer Institute (CI) ng PGH whereas yung iba ay sa OPD (Out Patient Department) lang pupunta since 10 people lang ang kayang i-accomodate sa CI. So there, we went to CI, met our “tour guide” who was actually a nurse there. She was making rounds on the different wards in the Institute and made us tag along with her.

Personally, I was really excited in going to CI? Why? Because that is where I’m planning to specialize when graduate from Med School! Yeah! After taking my residency in Pediatrics, I plan to sub-specialize in Oncology and become a Pediatric Oncologist like my mom. A what? Ok, in common terms, a doctor for children with cancer. But why? Because according to my mom, you can count with your fingers and toes the number of Pediatric Oncologists here in the Philippines…and our country is in need of more.

I asked my mom once, isn’t it hard to become a doctor for children with cancer? She blatantly said yes. Imagine not knowing whether your patient, an innocent child, would live or die…all because of the uncertainties of the disease. However, if you do know what would happen, you are then given the burden of having to tell the parents of the child how many days, weeks, or months…they have left to cherish the presence of their child. Its the innocence that hurts…pure innocence already marked with death.

So why am I still considering this specialty as my future career? Aside from what the nurse in the CI told us (that there are only few Pediatric Oncologists in the country; read: less competition, more money! *evil laugh*), I am considering it because of necessity. Not mine, but of the country. I promise, when I DO become a doctor, I’ll work in at least two hospitals: one public and one private. The public hospital would cater to my long-term goal of serving the Filipino people someday (for they had invested so much on me, being a UP child since Kindergarten…); and the private hospital catering to my need for survival. I mean, lets face it…we need money to survive these days.

But being a Pediatric Oncologist does not only include being of service and having more money than the more populated specialties…it also includes having both a strong mind and soul. As you hone your craft while playing dangerously between life and death, being a Pediatric Oncologist requires you to be stable physically, emotionally and spiritually. You cannot be too attached to a patient for if he/she might die, you can just get along with it just fine. But you cannot also be not sympathetic for the child would feel neglected and unimportant. You have to know your limits…and the limits of your soul.

I am not saying that you cannot have the same experience in other fields. Its just that I am more exposed to this specailty because I am the son of my mother. I grew up in her clinic and saw children, as the same age as me, bald and feeble. I grew up being typical to conversations like

“Alam nyo, patay na si ____,” my mom would say while we’re on a trip to somewhere.

“Gaano mo na ba siya katagal pasyente? Ilang taon na?” my dad would reply.

“Mga 3 years ko na rin siyang inalagaan, ‘di nakayanan ng katawan nya e. Sa Sunday ang libing.”

Then suddenly I’d butt in and say, “Punta tayong Jollibee! Gusto ko ng Chickenjoy!” partially apathetic and ignorant of what the adults were talking about.

I grew up in a family where death was part of dinner time conversations.

But of course, though saddest moments are the ones often remembered, happy ones are also shared. My mom has learned to celebrate the ones which survived and not mourn for the ones which hasn’t. Every year, they organize a camp for cancer patients along with the survivors. There they have fun and celebrate life! Maybe its there where my mom gets her dedication and passion for service — the feeling of knowing that there is still hope.

*sigh* I still have a Zoo Lec exam tomorrow and this is what I’m doing…blogging about the future. geez…I haven’t finished studying yet! But I’m so glad that I’ve become vocal about this now…lately kasi I’ve been having qualms of continuing my TOXIC med life…but after this, I’ve still another reason to not stop.

In 5 and a half years, supposedly, I’ll graduate from the UP College of Medicine. Then I’d have to take the boards to become a liscenced physician. 8 years or more…I hope I’ll be a Pedia-Onco by then. Hope is all I have right now…and hope is all I need…with dedication, love, support, passion, money, patience, commitment…blah..blah…blah…