Part I. A Little Bit of Space
The world of Medicine can be a bit overwhelming at times. Throughout the past six years, I’ve spent quite a number of hours in deep thought, repeatedly questioning the decisions I’ve made and fearing over the decisions I have yet to make.
My first duty as a Rehabilitation Medicine intern last Saturday bore witness to yet another one of my deep thinking episodes. If you’re not in the ER, weekend duties are generally a bit more ‘benign’ in UP-PGH. Even more so, if you’re in Rehab! With no pending jobs left for me at the ward, I decided to take time to walk around the place that has become my second home.
It was a bit overwhelming thinking about how far I’ve come. I’m already a medical intern, for crying out loud. My coat bears my name with two additional letters attached to it, and I am a year and a licensure exam away from making it all official and legal. It’s been quite the journey and honest to goodness, I can’t believe a month’s already come and gone as far as internship is concerned. It all feels so fast.
I still have days when I think about just abandoning the world of Medicine, in favor of a less stressful life. It’s true, after all, that Medicine is not for everyone. It takes a lot of sacrifice and patience, dealing with people at a very difficult point in their life, dealing with that gray line in between life and death. It takes a lot of heart. You’ll find that the simple act of going home becomes more of a privilege during non-duty days, and golden weekends become such a rarity that you have to properly manage your time to make the most of every moment.
But no matter how much doubt builds up within me, I always find myself going back to the start, to the reason behind all these sacrifices. Because in the end, it’s all going to be worth it. And these little bits of space in between, these little bits of quiet and deep thinking, gives me time to take it in, to take the entire journey in, with all its highs and lows, twists and turns. Every single moment, worth it.
Part 2: Love Hurts, Love Heals
Quite an interesting patient I had at the Rehab Med OPD the other day. R*, an elderly man in his late 60s, comes in with the chief complaint of low back pain, more so near the hip area, with pins-and-needles sensation and occasional numbness radiating down his right leg. History and physical examinations, including a positive straight-leg-raise test, points to lumbar radiculopathy, and by the looks of the MRI results he’s got, it looks like it’s due to spinal stenosis. He’s gone through several pain medications and initial physical therapy sessions, all to mere partial relief of his symptoms.
“Kahit anong gawin ko, masakit pa rin talaga, doktora…” With his persistent pain, R is doubtful of another round of physical therapy. After undergoing 2 sessions, he doesn’t think it’s doing much for the pain. I reassure him and try to explain that therapy doesn’t work instantaneously. It requires patience and diligence, and results will only manifest if you are continuously compliant with your program. It will take time.
“Kung magpa-opera na lang po kaya ako?” R asks, wondering if surgery will be a better option. I explain to the patient that with his work-up findings, surgery is an option, but he’ll have to follow-up with the Ortho Spine clinic to better understand his treatment choices. I then remind him that surgery, of course, has its risks.
R, however, doesn’t seem that bothered. “Ayos lang po sa akin ‘yun. Eh, kung mawawala ba ang sakit eh! Ang hirap-hirap na po kasi, doktora. Matindi na po ang sitwasyon ko sa bahay dahil sa sakit kong ‘to. Nag-aaway na po kami ng asawa ko.”
“Kaya hindi po ako naniniwala sa pagmamahal eh. Hindi talaga nagtatagal.”
Talk about #walangforever! I was really taken aback by my patient’s statement. Then again, I, of all people, understand what he means. I know just how much pain changes people and the people around that person in pain. It is during those hard moments, the moments when your real self gets buried underneath your sickness, that the support of your loved ones matter the most. Because their support is a treatment all on their own. Their support paves the way towards true recovery, towards returning to your self and, perhaps, even discovering a whole new you and a whole new them.
The heart takes some sort of a beating as you deal with all the stresses of sickness, especially if that sickness involves a certain degree of pain. The heart would benefit from a rehabilitation program of its own, probably focusing on lots of exercises on understanding and forgiveness, and just like any therapy, you’d need a lot of patience and diligence. Results will only manifest if you are continuously compliant with your program. And of course, it will take time.
In the meantime, we must appreciate and take comfort in our sources of support. They serve as our walkers, our wheelchairs, our handlebars, as we regain the ability to stand on our own again, completely recovered from the pains of disease.