Community Medicine Week 1: Wandering and Wondering

“Not all those who wander are lost.” – J.R.R. Tolkien

Beginnings and endings are equally difficult to experience, but for different reasons. In the case of this week, beginning our community integration proved challenging because everything was new and different. Adjusting needed to be done as we prepared for living with our foster families, and working at our respective barangay health stations. We were to meet and converse with a lot of people, and truthfully, there was really no way of preparing oneself. That we will feel lost is an understatement. No amount of orientations or endorsements would be able to give you the exact picture of what you were to face. You only ever learn by experience, by opening yourself to discovery.

The Alfonso Municipal Hall, which doubles as the Rural Health Unit

This past week, I began my duties as the medical intern of Barangay Luksuhin Ibaba. One notable difference I had with my fellow interns was that I was the only one who didn’t reside within my assigned barangay. This made me consider two things – First, what the residents of Barangay Luksuhin Ibaba may think : could the fact that I wasn’t living in their barangay create some sort of gap?; will this make them more distant, less willing to deal with me? Or am I just overthinking things? I don’t know if it has ever been done that the Luksuhin intern be assigned a foster home in Luksuhin per se, but I wonder if it will make some sort of difference.

Second, how can I, a partially directionally-challenged person, survive daily commutes without getting myself lost? I dislike communting by myself as I tend to get off at all the wrong places. I really fear not knowing how to get home, so imagine the internal panicking that happened when I found out I was to commute daily to my assigned barangay. Still, I let myself be open to this challenge and learned the routes and fares from Sulsugin to Luksuhin (and vice versa), as well as from Alfonso Proper to Luksuhin (and vice versa). Not a lost wanderer anymore!

Ready for clinic duty at the Barangay Luksuhin Health Station!

Still, as one of my favorite authors, J.R.R. Tolkien, wrote in his famous poem, not all wanderers are lost. I certainly felt like a wanderer this first week at Alfonso, going about day-by-day without a clear direction in mind, simply aiming to get to know the ropes of things. And, so as not to get lost, I gladly opened myself up to the challenge of integration, of slowly getting to know and engaging within the community.

I had my first interaction with the Barangay Health Workers (BHW) of Luksuhin Ibaba last Wednesday. The previous interns said that Wednesday Barnagay Health Station (BHS) clinics were busy, and boy, was it really busy! I barely had the time to converse with the BHWs, aside from our short chitchat over lunch, what with the number of patients that came for consultation. I saw more than 20 patients on my first day! Wednesday’s rush got me browsing through my clinical notes, much that I was a bit more prepared for Thursday’s clinic. Truthfully, I was a bit hesitant about holding clinic duties on my own, without the familiar guidance of a resident or consultant to guide me, especially in my diagnosis and management. To make things a bit worse for my nerves, the people here have such great respect for doctors. How they smile as they greet you, Good morning doktora! How they hang on to your words as you attempt to explain their illness and treatment plan. Oh the pressure. But, I think I did alright. I certainly found talking with the patients enjoyable. One notable patient, an elderly man with hypertension, even made an effort to come back a few hours after I saw him for a consult, just to give me a small token of his appreciation – a pen. His simple effort made in complete gratitude did not fail to made me smile.

I had another interesting patient encounter during my duty at the Rural Health Unit (RHU) earlier today. It was a morning filled with consults of coughs, colds, and fevers, when come the afternoon, an 8-year-old boy came with a laceration on his forehead, brought about by a rough round of play time at school. Thank God it spared his eyelids! But the wounds was deep enough to require suturing. So suture, I did! To think that I’d still need my surgery skills during my community medicine rotation! At first, I was wondering how I was to go about it, what with the need for instruments and all, but it was good to know that the RHU was equipped with the basic suturing supplies!

After this first week of wandering and wondering, I plan to continue getting to know Barangay Luksuhin Ibaba and its people. I look forward to hearing their stories. As the new place slowly turns into a different form of home, and the stranger slowly becomes a familiar face, this wanderer will soon find direction amidst all the challenges she will face.

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2016: a farewell

7 years ago, 16-year-old me unknowingly made a decision that would change her – our – life forever. As she embarked on the journey that would shape a great deal of the person she would become, she felt like the end goal was lightyears away. 7 years was definitely a long time. 

But look where we are now, 16-year-old Angeli. 2017 is but hours away. This is our year. 

~

I spent the first hours of the last day of the year, December 31, 2016, as the duty intern at the UP-PGH Cancer Institute. As the dawn set in, and I started my scheduled monitoring of the patients undergoing chemotherapy, the patients as well as their watchers began greeting each other a happy new year. When I entered one of the rooms to check on the patients’ vital signs, one of them, Mr. S, a middle-aged man undergoing chemotherapy, smiled me and enthusiastically greeted me, “Happy New Year na, doktora!” 

It was a mood uplifter in the middle of yet another duty night at the hospital. I smiled back at him and greeted him back. I proceeded to take his vital signs and ask him again how he was doing, how he was feeling. Mr. S just smiled and gave me a thumbs-up. He then told me how excited he was about being able to go home to spend the celebration of a new year. His chemotherapy session ended that morning and he was being discharged right after. I gamely shared my own gratitude for being able to go home to celebrate. Internship has been really tough in that you sometimes have to accept that you’ll be absent for a lot of things going on in the world outside the hospital, but when you get those rare times off, you have to make the most out of every second and spend those moments with the ones that mean most to you.

The sun was beginning to rise and for a short quiet moment, before returning to the Intern’s Corner, I found myself gazing at the mini-playground found in the middle of the Cancer Institute. Little by little, the expanding sunlight brought into view the humble garden that serves as a sanctuary of some sorts to the warriors fighting the battle known as cancer. The light signals the end of yet another duty night and I am overcome once again with gratitude. It was time to head home. 

~

That’s how I’d like to summarize my 2016. Tons of gratitude for being able to come home.

 Home has never been a singular concrete place. It is that feeling of belonging, of acceptance, of love, of simply being yourself. And after the rollercoaster that 2015 had been, 2016 was spent slowly finding my way back home. 

So, thank you, 2016. It hasn’t been easy, but I’m definitely glad to be here.

I’m definitely glad to be here to face the coming year and make it what it is meant to be: my year. 

2017, here I come. 

Live While We’re Young

I’m a little behind on my writing, aren’t I? Okaay. Maybe not just a little. Ugh. As much as I’d like to blame the whole ‘I-can’t-access-Wordpress-what-on-earth-is-wrong-with-my-Internet?!’ situation, that’s not really the real problem here. Once again, I found myself caught in between my two worlds. I spent any free time I had, resting while I could, spending time with my loved ones, and indulging in good books, movies, and dramas. I am such a lazy writer, gah. 

Thus, here is my effort to get back on the road of the written word. I have at least two blog entries I have to write to catch-up (will work on those soon!), but before I backtrack, I’d better get these thoughts written down before I get too lazy again… #internshipissoooooootiringyetfun #howtomaketimeforwritingpo

As we were ending our Ophthalmology rotation (much to my absolute regret, see more in a future blog post), I was suddenly struck with an unexplicable sense of impending doom. It was weird. At the back of my head, I wondered if something bad was going to happen, or if it was a symptom of some sorts (Med Tidbit: feeling a sense of impending doom could actually point to a variety of diseases, including  anxiety attacks, depression, myocardial infarction, and even aortic dissection). Thinking back, it was probably just because we were starting our Pedia rotation the next day after. Something about dealing with such a toxic rotation, and the fact that I’ve never been really good with kids, must have had me in jitters. And the only bad thing that happened that day was that I forgot my umbrella and got wet from the starting drizzles. 

And now, all of a sudden, I find myself halfway through Pedia. It wasn’t bad at all. In fact, there are several moments when it was actually fun.

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Weeks 1-2 of Pedia Internship consisted on unlimited charting at the OPD Sick Child Clinic and the numerous Subspecialty Clinics, and at night, ER back-up duties. Our three-woman duty team did great! Jobs tend to get a lot easier when you’re working with awesome people. But, since it’s the PGH PER we’re talking about, it is inevitable that things get a little rough every once in a while…
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And we end up pretty tired from it all. But of course, being the benign team that we are, we do get short nap times. :)) PER Triage hits! #kinderjoypamore #presentingKatyFairy || Photo credit (c) JB Besa — stolen shot! 
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Always a treat to go on post duty binge eating with these two! :)) Much to the regret of my stomach and wallet though… Haha! The post duty sleep that soon follows this is quite something as well, and the eventual realization that things have once again come full circle and you have to repeat the whole Pre-Duty-Post cycle once again. Haaaay Buhay Medisina! || Photo credit (c) Myza Espallardo

~

Weeks 3-4 sent me back to the Pedia Wards and this time around, I got to spend time with the Hema Onco patients. One of the challenges of being a Hema Onco (HO) Intern was that you went on duty alone and you were semi-in-charge of all 15 HO patients admitted for the tour of your duty. Mini-JWAPOD-ship every duty!

Still, the greatest challenge for the HO intern was probably training your heart to deal with the hardships of caring for children with cancer. It honestly broke my heart, seeing all these children, some as young as 11 months old to adolescents at the bringe of adulthood, dealing with such a complicated thing such as cancer.

One time, when I was in the middle of monitoring duties, 18-year-old L.O. (not her real name) caught me off-guard with such a difficult question. As she held her arm out so I could take her blood pressure and pulse rate, wearing such a sad expression on her face, she asked me, “Dok, kailan po ba gagaling ‘tong leukemia?“. I honestly struggled with an appropriate answer, completely unsure of how I should go about it. I went with a general reply, saying that patients, being different from one another, also responded to treatment regimens differently. She only had to do what she ought, be compliant with her medications and to take care of her self, so we could hope for her best shot at recovery.

It was a sad reality, what these children have to deal with. Instead of spending time playing, having fun, learning, making friends, discovering the world and what it had to offer, they were stuck in a hospital, getting their blood examined daily, dealing with medications and diagnostics here and there. They were forced to struggle with the war of life versus death, when they haven’t really gotten their fair shot at life yet. Meanwhile, their families, especially the parents, were facing their own battles. It is unimaginable how a father or a mother could bear seeing their child suffer. Dealing with mortalities at the Pedia ward was difficult, to say the least, both for the loved ones left behind and for healthcare workers like us.

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A beacon of light within such a sad reality… It was a common sight at our HO Ward, having do-gooders come to share food, gifts, and time with our patients. :) These characters from Star Wars came not only once to cheer up patients and to wish them a speedy recovery! || Photo credit (c) Teedee Estrada

~

And just like that, we’re in Week 5-6 of Pedia internship! Time to spend time with the newborns at the catchers’ area/NICU. First duty down, and it went pretty well! Here’s looking forward to more fun and learning! Can’t believe I actually worried about this rotation in the first place… Hehe!

Twinning! :) My first catch of  Pedia Internship is this live baby boy! Cutie! Photo taken and posted with mommy's permission
Twinning! :) My first catch of Pedia Internship is this live baby boy! Cutie! Photo taken and posted with mommy’s permission || Photo credit (c) Myza Espallardo

Tales from the SOD

Late post! This blog entry chronicles some of my favorite experiences from our Surgeon-on-Duty (SOD) rotation last August 12 – 25 2016 . It was a challenging yet fun two weeks that consisted of rough ER duties, seemingly endless OPD charting, and solo Minor OR stints.  

 

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Bringing a little dose of sunshine into the gloomy ACU! Team Sachi-TeeDee-Angeli-Biel, reporting for SOD! :D Photo grabbed from Biel Faundo (C)

 The Emergency Room can be a pretty tough place to handle, what with the need for quick and systematic action in facing what may be the difference between life and death. This is especially true for the UP-Philippine General Hospital, where patients come in overwhelming numbers on a daily basis.

And when you happen to be among the Surgery interns on duty at the SOD, you have to be prepared for the rush. Wounds of all sorts of shapes and sizes. Abdominal pain of varied character, severity, location, and radiation. The different shades of jaundice. Vomit there, vomit everywhere. Bleeding love. And there never seems to be a shortage of mauling cases. All these and more, and before you know it, it’s already 7AM or 7PM – shift over!

Tale 1. What Really Matters

Two patients arrive at the SOD, both sustaining multiple injuries after a vehicular crash. Our four-man intern team quickly divides into two and takes action – fast-chart, insert IV access, extract blood, prepare imaging requests, do skin tests for tetanus shots and antibiotics, and clean wounds. History reveals that our patients, who I shall pertain to as Girl and Boy from this point on, are sweethearts who were on an afternoon drive, and a mistake on Boy’s part caused their unfortunate accident.

Girl’s most obvious injury is her forehead laceration and Sachi goes to work on suturing. With the injury not so deep and not so long, the repair is easily finished, the wound cleaned and dressed. Meanwhile, I grab a 1L bottle of plain LR, a macroset, and an IV cannula and proceeded to insert an access on Boy.

“Naku, Doktora. Tatahiin niyo na po ba ako?” Boy asks, clearly a bit nervous about getting stitched up, as I tie a tourniquet (actually a tourni-glove) around his left hand. I reassure him and say that I’d only be inserting an IV line for now.

Holding up his hand as I try to look for the ideal vein to puncture, Boy takes a deep breath. “Masakit po ba ‘yun?” 

“May anesthesia naman po, sir. Pero siyempre, may kaunting sakit pa rin sa umpisa,“I reply. I get the IV cannula inserted with no problems and set up the line.

Eh, yung kasama ko po? Kumusta siya?” Boy asks, peering outside the suturing area where his girlfriend was stationed.

Ah, OK na siya. Natahi na ‘yung sugat niya.” 

He sighs in relief. “Mabuti naman. Ang mahalaga kasi, siya…” 

Amazing how love can make a person think so much of that special someone to the point of forgetting himself. Boy’s thoughts are so concentrated on how Girl is that he failed to recognize that he’s the one in a much problematic state. While Girl only sustained an easily repairable forehead laceration, Boy suffered what appeared to be an intense hit to the inguinal area, causing gross swelling and erythema of his scrotal area. One can imagine just how much that hurts, but what really matters most to him at that moment was how Girl was.

#TrueLoveAtTheER How sweet! Pa-CBG naman po ‘dyan! 

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No task is too great for this awesome duty team! :)

Tale 2. While I Can

One of things I like the most about OPD clinic days is the fact that you get to sit down, talk and examine patients at a relaxed environment. In contrast to the super fast-paced and confusing ER environment, the OPD actually allows you to take time to build rapport, the first step in any history-taking and physical examination lecture I’ve ever attended since I started medical school.

My team is relatively toxic when it comes to OPD days. Our new patient numbers always approaches or even exceeds 50, meaning charting galore! On one particular day, everyone seemed to have urinary problems, requiring me to do the digital rectal examination more than a couple of times. Oh boy…

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The feeling when you finish charting a patient only to find 10 more new charts freshly piled on the nurse’s desk… Sigh. Chart pa moooore! || The aftermath of 53 OPD consults

My patient encounter with a 80-year-old grandmother, who we shall call Lola in this story, was particularly memorable. She comes in unassisted, shuffling towards the seat in front of my desk, looking a bit winded from walking, but with a smile pasted on her face nonetheless. I greet her with an equally enthusiastic smile and proceeded with “Ano pong pinunta niyo rito sa PGH?”.

I still find it a little striking how patients can put so much trust in their doctors, especially ones they have just met, as to immediately reveal parts, if not their entire, life story. This is especially true when you actually succeed in building rapport in that short period of introduction. Lola immediately begins telling me about this mass she noticed on her left shoulder, a mass that started out small and that she ignored until it became big enough to catch her daughter’s attention. The conversation then strays away from her medical problem – the mass – and towards what I suspect is her more pressing problem, her family situation.

With times being as hard as they are right now, Lola is the one taking care of her grandchildren, even the one who brings them to school and cooks their baon. They were the real reason why it took her so long to consult about her shoulder mass. In fact, she wouldn’t be consulting at that moment, had it not been for her daughter’s insistence.

Sabi niya sa akin,  baka kung ano na ‘yan, ‘nay. Ipatingin mo na…” Lola narrated, her eyes a bit watery. “Lumalaki na. Hanggang kaya natin, ipatingin mo na at ipa-opera…”  She dabs at her eyes before continuing. “Ang sa akin naman, OK lang kahit anong manyari sa akin. Matanda na ako eh. Pero para sa kanila, hanggang kaya ko, sige. Magpapatingin na lang ako…”

I did my best to reassure Lola, that we would do our best to help her. Physical examination points to a simple cyst and excision seems to be an easy option for her. She looked relieved to hear that it didn’t appear to be anything serious and thanked me for taking time to see her.

Our patients truly are our greatest teachers, more so than any textbook, trans, reviewer, or lecture. Life can be a very confusing journey, with its endless ups and downs, twists and turns. But as Lola said, for the people we love the most, we must do what we can while we can. No one knows what lies ahead, so we have to cherish the present.

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Hooray for the clingiest SOD duty team ever! Hanggang sa Radio, nagpunta para sabay-sabay pa ring uuwi. Thank you to our SODs, Dr. Joan Flor, Dr. Denor Sotalbo, and Dr. Kat Guillermo, for everything. On to the wards~!  Photo grabbed from Biel Faundo (C)

 

Scarred

This goes out to all the survivors, who proudly wear their battle scars both externally and internally. Fight on, warriors of life! 

 

You won’t immediately see it, but it’s there.

If you look a little closer, you’ll find that it’s unmistakable.

That mark. That permanent mark.

Once you see it, it becomes pretty hard to look away.

To some, it might look like an imperfection.

It’s a scar. Those are scars. She’s scarred. 

 

Because even if time does its magic,

And heals the wounds you’ve sustained,

There are some wounds that never do fully go away.

They leave behind scars.

Those marks. Those permanent marks.

That serve as a reminder of all the hurt and pain.

But more than that, it serves as a symbol of survival.

Those little blemishes are all that are left of that time.

You’ve done it. You’ve gotten through it.

So, never mind the stares of the ignorant.

Let them stare.

They have no idea what you’ve been through.

Wear those marks with pride.

They are proof of your strength.

It’s a scar. They are scars. We are scarred. 

Rehabilitating the Heart – 2 Stories

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.

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My three companions for the duty – putting a little bit of PLE 2017 (yes, trying to! this early on in the game :) ) studying with Biochemistry, leisure reading and celebrating #BuwanNgMgaAkdangPinoy with Dean Francis Alfar’s The Kite of Stars and Other Stories (brilliant fantasy short story collection!), and of course, getting some writing done (LAST.THREE.CHAPTERS.)

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.

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On Mondays, We Wear Pink. :) Who run the world? #Jirls || One month of internship done with these awesome ladies, eleven more to go. Thank you, UP-PGH Department of Rehabilitation Medicine! || Having fun with your friends does wonders towards the rehabilitation of the heart. 

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.

 

Heal Them with Kindness

I had my last Ortho duty last Monday and it was, like all the previous duties before it, extremely tiring! ER duties at UP-PGH have always felt like stepping into some kind of battlefield, and heading into the chaos solo is a whole new experience of its own. Huhu for clerk-less rotations! Still, I am very grateful for our kind residents who, despite facing a whole different level of stress and pressure, take time to teach and guide us as we deal with our patients.

That said, it was not at all surprising that I felt so exhausted come post-duty Tuesday. We are given a grace period in the morning to freshen up before heading to the OPD to see patients at a less toxic environment. After taking a shower, it was a bad idea on my part to decide to lie down and take a short nap. It took all I had to force myself to get up and head back to the hospital. Thank God I remembered to set alarms! My exhausted body and sleep-deprived brain were both begging me to just keep on sleeping, but of course, I must fulfill my duties as a medical intern.

At the OPD, I did my best to see patients, partially struggling with the Ortho Special Tests, what with my lack of upper body strength (I blame biology!) and the fact that my hands still bother me every now and then. All the while, I tried not to let my exhaustion and sleepiness show, knowing very well that my patients deserve my full attention and the best care I can possibly give them.

One particular patient made my day. She’s a middle-aged lady who came to the OPD on follow-up after getting closed reduction for her laterally displaced right patella. Our encounter began with me repeatedly calling out her name so as to show her into the examination room. After getting no response after about 5 times of calling, I was about to set her chart aside to be seen later on when I finally caught sight of one of her watchers desperately waving her arms up to get my attention. Her voice had been drowned out by the sounds of the OPD hustle and bustle. I instructed her to guide the patient into to the examination room, only to be met by a hesitant expression on her face. When I finally approached where she and the patient were, I immediately understood the reason behind her hesitation.

The patient was stretcher-bound! She couldn’t walk or even sit comfortably on a wheelchair, what with her right leg immobilized with a brace. As with all OPD rooms in our hospital, the Ortho OPD was a cramped space and there was no way the stretcher could be brought inside. And so, I decided to interview and examine the patient outside, right there at the waiting area.

I didn’t think I did anything unusual with the way I talked with her, asking after any new complaints, if she still felt pain, how she was reacting to her medications, as well as with the way I did my examination. But after a while of waiting and after eventually getting my chart entries and findings confirmed by the resident, I diligently explained what we saw on her post-reduction x-rays (her patella was back in place!) and what she should do about the persistent pain and swelling as well as when she should come back for her next follow-up.

It was then that she smiled and repeatedly thanked me for seeing her. She happily praised me on how from the very moment I approached her, she immediately knew how kind I was and she wasn’t at all disappointed when we began talking.

“Ang sarap-sarap mong kausap, doktora! Napakabait. Sana ikaw ‘uli ang tumingin sa akin pagbalik ko rito…” she regaled, her words instantly perking up my mood. Bibihira na ang mga mababait dito, alam niyo naman!”

 I eagerly returned her smile and expressed my regret over almost shifting out of Ortho, making it very unlikely for me to be the one to see her come her next follow-up. “Sayang naman! Good luck sa ‘yo ha. Hahanapin ko ang pangalan mo ‘pag lumabas na ang resulta ng board exam niyo!” 

Suffice to say, it was like my exhaustion practically vanished.

 

It’s funny how spending a mere 30 minutes with that patient, wherein I did nothing but talk with her and quickly examine her aching leg, had such a great impact on her. Hearing how happy she was just because I greeted her with a smile and made an effort to make the interview a lively conversation affirms my belief on how kindness can truly contribute towards the process of healing. Though there will truly be times when exhaustion and stress would get the best of us, and our tempers would be repeatedly tested, making the effort to be kind will always be worth it, not just because it is what our patients deserve, but also because it is a treatment in itself.

After all, what really makes a doctor great is not the size of her brain, but the size of her heart. 

It’s been a terrific two weeks of Ortho. I had fun and certainly learned a lot, thanks to our consultants and residents, and of course, our patients. Here’s to the continuing battle of saving lives, limbs, and functionality! :) Let’s continue healing, not just with our medical knowledge, but also and more importantly, with our kindness.

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Block J during last week’s Casting session || Had multiple chances of applying my casting skills at the ER! :) || Thank you, UP-PGH Department of Orthopedics! || Photo credit – Regina Estrada