Why I Do It (and Why I Continue Doing It)

You never forget your first love. Even if you’ve already come into terms with the fact that you’re definitely not going to end up together, your first love still occupies a special part of your heart. I initially had qualms about facing my first love again and to make things even more difficult, we were to spend two whole months together. Dear Lord, how am I going to survive this? 

But here we are. It’s over. My OB-GYN internship rotation is officially over, and I’m exhausted. I feel so drained both physically and mentally, but every day of that seemingly endless pre-duty-post cycle was worth it. I learned a lot. I had fun. And most of all, I got to be a witness (as well as directly assisting) in the everyday miracle of bringing new life into this world.

Pre-Duty days were spent charting countless of new and follow-up patients at the OB-GYN General Service out-patient department. Normally, I liked seeing patients in this kinds of environment, since it’s relatively more benign and there was no pressure of urgency, but there were days when the OPD still went a bit out of hand. Intense. One particular day had us charting way past 5pm in the afternoon. I didn’t get the chance to eat a proper lunch! Still, our days at the OPD gave me the chance to learn from the rich pool of patient cases in UP-PGH. I know the basics of pre-natal check-up like the back of my hand, and can confidently do internal examination and the Pap smear test. What a far cry from my old self, who basically panicked at the thought of having to do IE. (Read about my memorable LU IV OB-GYN experience here: Crepes, Cramps, and Contractions)

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Service B-est! :) Endless charting at the OPD is nothing when you’re with awesome co-interns and residents! || Photo from Biel Faundo

Duty days were, of course, where the action was. It was real roller coaster ride going through 4-5 straight OBAS (OB Admitting Section a.k.a. OB emergency room) and LRDR (Labor Room – Delivery Room) duties. All those unbelievably toxic duties! In the OBAS, we practically defined fast charting. And every time our resident would yell out “Admission!” caused a rapid call to action to ‘admit’, which entailed inserting an IV line, drawing blood, making the patient’s identity “flag”, and of course, the insistent reminder to fill up that patient info slip (the perpetual Kaalaman form). I was unfortunate to have two Labs Master duties, both on High Risk Fridays. This meant that I had no other task during the duty day, except to run up and down to and from the Department of Laboratories to submit specimens and retrieve and take note of results. And when there is a suspected pre-eclampsia patient, stat Alb meant stat Alb, and make sure the labs know it!

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The benign color spectrum at the LRDR :) Thank you, thank you to our stellar clerks and our awesome residents for everything! And of course, thank you to all the mommies who allowed us to be a part of an important milestone in their lives. || Photo from Gienah Evangelista

 

On the other hand, LRDR duties were spent on labor watch. Whew. All that toco-monitoring! All that TIC (Temporary-In-Charge) work, what with all the LR backlogs I had the weird tendency to get decked Young Primigravids (ie. 18-year-olds and below who were pregnant for the very first time), so you can only imagine how my patience was repeatedly tested by these obviously-too-young-for-this types. They generally had a low pain threshold, so they didn’t take labor too well. I had to repeatedly counsel them about the responsibility they were to face as new mothers, and that they had to stop thinking only about themselves from that point on. Another life was going to be at the mercy of their hands, come the birth of their child.

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I love Pay duties. I love witnessing the “ideal” side of things. But most of all, I love Complete Bed Rest duties. Yaaay~ || Photo from Gienah Evangelista

 

I definitely wouldn’t miss the 24-hour monitoring duties at the OB ward, not to mention the grabe-naman-tama-na-po list of To-Do’s that required me to line, line, extract, and line some more. The end of OB-GYN also marks the potential end of my OR career, should I choose not to go into a cutting specialty in the future, so there’s that to think about. And yay, no more 7AM Summary Rounds! No more I-don’t-know-anything Gyne Onco and Tropho Rounds!

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“Nasaan na ang pasiyente? Higa na sa kama! Tanggal ng pambaba!” 

All-in-all, I’d say that I had a pretty fruitful OB-GYN Internship rotation. I had a blast helping all the new mommies. There were definitely days when I would repeatedly question why I continue to do this doctor thing. God knows how extremely difficult duties can get. And though you are granted a day of rest what with the true post-duty status, it can never be enough, ’cause before you know it, you have to go on duty yet again. It never ends! It was definitely a bloody business, but I learned that as long as you push hard enough and don’t give up, good outcomes can definitely be expected. It was all definitely worth it, considering everything you’ve gained at the end. #BabyOut

Hinga ng malalim, pigil, and push! Only 70-something more days left of Internship! Let’s do this!

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Community Medicine Week 5: Familiar Paths

“Home isn’t a place. It’s a person.”
– Stephanie Perkins

Tita Nini, the midwife of Barangay Luksuhin Ibaba, and I were walking towards the tricycle terminal, together with one of our Barangay Health Workers, Nanay Aida, after another long Wednesday clinic day. Wednesday was our busiest clinic day, the day when most of the patients came to consult, especially the pregnant women who were to be seen by the midwife for their prenatal check-up. That said, it was quite understandable why the three of us were eager to go home and rest a bit.

We were halfway towards the Luksuhin Public Market when Tita Nini remembered she had to check something out at one of the local parlors. Parlor-parlor din ‘pag may time! Nanay Aida offered to come with her. I smiled and said that I’ll go ahead of them.
“Sigurado ka ba, dok?” asked Tita Nini, looking a bit reluctant to let me go off alone. “Kaya mo ba mag-isa?”
“Ay, oo naman po, Tita Nini! Kayang-kaya!” I laughed, reassuringly. My two companions heartily laughed along while waving good-bye and walking towards the direction of the local parlor.

As I proceeded towards the tricycle terminal on my own, I thought about the ease at which I reiterated that I was fine on my own. I also realized that it was true, that I could easily head back to Barangay Sulsugin by myself, that I no longer feared getting lost, that I knew my way back to my foster home, that a lot about Luksuhin Ibaba has become familiar.

Five weeks can never be enough to fully understand a place and a way of living, but in this very short time, I’ve grown to be fond of these paths. It is a far out cry from my first week, during which I felt like a lost wanderer most of the time. I remember being so wary of having to commute everyday just to reach my assigned barangay. I remember being so afraid of getting lost, of ending up who knows where with no idea how to get back home. But now, the paths have become familiar. The place has really grown on me.

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The barangay health workers of Luksuhin Ibaba, Dr. PJ Francisco (Family and Community Medicine resident), and I after our vital signs OSCE || It’s been a great five weeks. Thank you for making me feel right at home! :)

But more than the place, what I’ve really grown fond of are the people. Also among my fears upon starting out was feeling a bit lonely amidst all the new people. Though I’ve never been much of a shy person, there is still always that worry that there’ll be difficulty getting along with people. But everyone here has been more than welcoming. The new-found friends in my health team as well as within the other people of the community will surely never be forgotten. I’ve learned a lot from them about the simplicity of life, the dedication to work, and the importance of family. Because of them, despite being a mere visitor, I felt that I found something of a home here in Luksuhin Ibaba and in Sulsugin.

As my community medicine rotation is slowly coming to an end, I hope I was able to contribute something, no matter how little, for the betterment of the people of Luksuhin Ibaba.

Community Medicine Week 2: Breathless

“Life is measured not by the number of breaths we take, but by the moments that take our breath away.”  

                                                                                                                                             – Author Unknown (Uncertain Origins)

When a patient comes to you, complaining of difficulty of breathing, a long list of differentials come to mind, ranging from the apparent pulmonary etiology to the more complicated renal pathology. But in the case of A.D., 23/F, it is highly probable that her shortness of breath is caused by an exacerbation of her bronchial asthma, most likely exercise-induced. It is probably her own fault, knowing that her lungs can’t handle prolonged walks, much less keep up with her healthy, non-asthmatic friends when it comes to physical activity, yet still attempting to assert herself. Ayan tuloy, hingal na hingal…  To think I’d have an uncontrolled asthma week here in the community. Sigh…

It is ironic that an aspiring doctor such as myself would have several co-morbidities, yet it is proof that physicians, no matter how much they are sometimes revered as mortals attempting to combat death, one disease entity as a time, are still quite human when it comes right down to it. A beloved Family Medicine consultant once told me that I should look at my illnesses as a sort of blessing in that they help me empathize more with my patients. I know first hand what pain is, and not just physical pain, and I know first hand how difficult and extremely debilitating it can all get. I know what it’s like to feel so hopeless, when you feel so, so weak that it’s hard to even feed yourself. I know what it’s like to gasp for air, to literally be breathless. 

when the doctor becomes the patient…. || 23-year-old female presents with shortness of breath and slight chest tightness; Tx: Salbutamol 2mg/tab q6 for now || Never take breathing for granted. Some of us find it so difficult to do.

So, even more so now that I’m in a way running my own clinic at the Luksuhin Ibaba Barangay Health Station (BHS), I make it a point to listen to my patients’ stories, to believe in pain scores, to take note of all complaints. If it is something they deemed important enough to warrant a consult, then by all means, let me do my best to address all concerns. I’ve heard all sorts of complaints during my clinic duties at the BHS. There was a young mother who brought her 2-month-old baby for ‘loss of appetite’ when in fact, the baby was well and healthy, just a little bloated and  needed a little burping. I simply taught the mother about feeding cues and to not force feed her baby. I also had a variety of ‘headache’ complaints, the history-taking of which was almost enough to induce a headache of my own. Di ko po alam, doc. Basta po masakit! goes on, while another insists, Ay, 10 out of 10 po talaga, doc! Ganun kasakit! Still, pain is subjective. 

My determination to hold clinic today despite my breathlessness seems to bear little as I only saw three patients today. But maybe, for the three of them, my efforts were a big deal. They were able to see a doctor (well, almost a doctor) today. They were able to get free medicines today. They were able to be advised today. And as always, I am comforted by their grateful smiles. 

I remain constantly appreciative of the little moments, those quiet patient times when you can just converse freely with patients. A welcome change from hospital life (UP-PGH life, in particular) where everything seems to be in fast forward and just the mere thought of taking your time is seemingly punishable by demerit. It is these quiet moments that frequently go unnoticed, frequently taken for granted. We are sometimes so overcome with excitement, with adventure, with twists and turns, that we fail to appreciate the quiet times. 

But they are, in fact, what we live for. They are the very moments that make every breath we make worth making.

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

Stepping Stones

"The river rushes ever so fast,
ever so constantly.
It is a struggle to make the crossing. 
Take one stepping stone at a time,
one foot after the other,
slowly, but surely...
Make the great leap to the other side."

- Stepping Stones, 07/18/16

Celebrating 5 years of this amazing flight through life, I present the new look of theangeltakesflight! Cool, yeah? :) Credits to Shari Altamera for the shot taking waaaay back in 2012 during our trip to Guimaras Island, and to my lil’ bro, Chino Dumatol for the great editing work!

We’ve been medical interns for three weeks now! And so far, so good, I think. It felt bittersweet to be back in the hospital after a month’s break (the happenings of which I have yet to fully chronicle), and though part of me will always yearn for the chill life, another part is actually glad to be back.

Opening the year with a week at the MICU and a week at the Gen Med ER was tiring! Thank God for awesome residents, great duty mates, and amazing block mates to make things bearable and, at most times, fun. It does make a big difference. I’ve still got a lot to learn, but I’m very eager to continue growing to become the very best doctor that I can be.

It’s definitely not easy. Once again adjusting to daily grind of the pre-duty-post cycle, as well as the countless number of orders to carry out, chart and conduct, proved to be a challenge for the brain and body that still weren’t satisfied with a month of restless vacationing (blame it on the novel that has STILL yet to be finished!). To make things worse, at the back of my mind, I’m still really worrying about STILL not having a clear picture of what I want to do after internship and boards. What path to take? What path to take?

Still, as with every journey that requires a giant leap of faith, you can only take one stepping stone at a time, one rotation at a time. With hard work, prayer, and some miracles here and there, anything is possible. The right path has yet to open for me, and I only have to believe in it!

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Presenting the Ladies of UP-PGH Interns 2016-2017 Block J!  Here’s to a great year with you, girls!

We’re currently on our Orthopedics rotation, and while I’ve never pictured myself in the field, it’s been okay so far! Then again, I haven’t had an ER duty yet, so yeah… I maybe speaking too soon. Haha! Here’s to a benign duty tomorrow! Hoping for the best! :) Now if you’ll excuse me, I’ll be spending the rest of my pre-duty day, getting some writing AND studying in.

Soar high!

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Donning the Intern’s coat really does make a difference! It makes me feel more responsible in the way that I have to be extra mindful of my actions as well as decision-making! Patients and watchers designate me with the title “Doktora” without any hesitation now. With the extra kulit bantay even jokingly calling me Doktora Kim Chiu (after the Chinita actress) and promising to help me find my Xian Lim (said actress’s love team partner). Haha!

 

 

Adrenaline Rush: Grand OSCE 2015

“Med School provides perhaps the best substantiation for Charles Darwin’s theory of natural selection. For here we see in its cruelest form the survival of the fittest. Not the smartest, as one should expect. But the fittest to cope with the inhuman pressures, the demands made not only on the brain but on the psyche…”

 – Erich Segal’s “Doctors”

Where have the months gone by? It’s the last week (hopefully) of LU V, my fifth year in the college and my third year of Medicine Proper. I’ve been so caught up with everything that I have utterly failed to continue chronicling the magical journey that is Med School.

But, as the last bits of adrenaline drain from my body, it seems only right to write this obligatory blog post not only to vent out my feelings after one of the most challenging experiences of  my life, but also for it to serve as a sort of tribute to the amazing year that was.

~

So, the Grand OSCE is held at the end of the year and is somewhat a rite of passage for the third year medical students of the UPCM wherein, before they are deployed to the hospital as full-fledged clerks, they must manifest the clinical skills they have learned during their “bridging” year. That is what ICC (Intergrated Clinical Clerk) year is all about, after all – bridging the gap between the classroom and the hospital, the textbooks and the clinical picture. The Grand OSCE is composed of multiple stations, representing each department, where we are expected to manifest what we have learned.

By the cruel dealings of fate, my block was among this year’s first takers – FIRST BLOOD! That meant less time to study and to practice and to memorize! Of course, we had the entire year to learn, but come on, students are notoriously known for their short-term memory! It’s so hard to remember stuff when you’re trying to learn something new at the same time. Our brains can only take so much! And to make things worse, the Grand OSCE was scheduled in the middle of Hell Week, wherein we were also to take several final exams and the dreaded Comprehensive Exam (we had that yesterday and that was a whole other experience!).

Yesterday, the day before the exam, I could already feel the panic. I slaved through OSCE reviewers and desperately tried to come up with ways to remember details – how to do this, how to report that, how to do both things at the same time, what to look for, what to use, when to use/administer, etc. There was one point wherein I got so overwhelmed with stuff that I just had to keep everything away, close my eyes, and just cry. Cry and pray. The stress is VERY real. I was that afraid.

Reggie, Sha and I spent the evening of Tuesday reviewing and practicing. I realized that I was at a struggle for words – I know right, big irony there. I’ve always thought I was ‘word smart’ as per the multiple-intelligence theory was concerned.  One thing I really didn’t like doing was annotating – that is, explaining what I was doing as I did it. I felt like it was such a big confusing factor. You’re trying your best to do the skill, but you get so side-tracked trying to explain that you end up lost and a bit confused.

The adrenaline came a bit too soon, I think, and I couldn’t sleep! I was reviewing up to 3:30AM and was repeatedly staring at my reviewers until I realized I wasn’t going to get anything from them anymore. My real problem? The stress. The nerves. I had to relax. So, I played a few of my favorite songs and tried to do breathing exercises. I fixed my battle gear – stethoscope, clipboard, BP app, penlight, measuring tape, and my all-mighty ballpen – and went to sleep.

~

I woke up at 6:30AM, with a single thought repeatedly looping inside my head: OSCE day na. OSCE day na. OSCE day na. Tachycardia. Tachypnea. And gosh, my stomach! I felt like vomiting! Forget about having breakfast! And woah! Look what decided to act up today of all days? Yep, my wrist!

The last few minutes before we began the Grand OSCE was killer. We were all throwing random information, mentioning stuff about this and that, in our futile attempt to squeeze in high-yield stuff before we went into battle.

Experience from the previous OSCE has made me realize that the first station is always the sacrificial one. I’d lose it on the first station due to nerves and eventually get back my exposure come the succeeding ones. The Grand OSCE turns out to be an exception. It went pretty well, thanks to the Ortho consultant who was not only very nice but also chose to guide and teach me every step of the way. He wasn’t the only one who was nice! I highly appreciated the consultants who chose to make the OSCE as a real learning experience for us by pointing our areas of improvement and by guiding us along the right train of thought, knowing that with just a few probing, we’ll eventually get to the right path.

Of course, there are exceptions. As much as I want to say that I easily did my parents proud by doing well in the Pedia and Surgery station, I think I did not. I think I made a lot of mistakes in that vaccination station. The fact that the consultants were not really saying much during the entire process did not help much. I couldn’t tell whether I was doing okay or not. My Surgery station went a bit loco because of three things: 1) my nerves; 2) my painful wrist; and 3) yung pata na makunat. My needle wouldn’t bite! Gaaaaah. I was super annoyed at the fact that I practiced that simple interrupted suture multiple times and am fairly confident in my ability to do it, only to struggle with it come the OSCE just because of the annoying pata. So much for that. And probably because of that annoyance, I was totally in panic mode for the Breast Exam. I missed a freakin’ mass. Gah. Oh well, I guess I have the elective period to perfect that skill. I hope and pray that I did enough to pass both.

Two words sum up my common mistake for a couple of stations: HAND HYGIENE.

I think the panic was really showing in my manner, stance and way of speaking. Practically all the consultants had to take a minute to smile at me and ask me to relax. Not that it did much, of course, since I was still drowning in adrenaline. What did help was their subtle affirmative remarks – those “good”, “don’t worry, you did very well”, “very good”, “excellent, that’s right” sentences go a long way for my self-esteem. Of course, my panic was also the reason behind my babbling – as the struggle for words became harder and harder, I just mention the first things that come into mind. I hope I didn’t make too much of a fool of myself! Haha! In my ORL station, I actually forgot to put on the head mirror at first! The patient practically laughed at me when I realized my mistake and she told me, “Relax ka lang kasi.”

Over-all, I think it went a lot better than I expected. Maybe it was really a test of grit. Nerves are your number one enemy during these kinds of experiences. Because if you did your part throughout the entire year and made an effort to really learn what was expected of you, the knowledge is really there, somewhere, and when the time comes, it really just shows. Even the words come out quite unexpectedly.

To end this rant, I would like to thank our consultants, residents and most especially, patients. More than a parameter for me to be graded based on my knowledge, skills, and (yes) grit, I think of the Grand OSCE as a big learning experience, one that I am truly very thankful for.

“The most fundamental principle of Medicine is love.”

– Paracelsus’s “The Great Art of Surgery”

Thank God it’s over! Pedia and NeuroPsych finals on Friday, and it’s break time for me! I hope I don’t have to repeat OSCE stations. *crossed fingers* 

Clerkship Block 4 post-Grand OSCE lunch! :) Here's to the year that was and the year that will be! || Ang tanda na natin, I realize...
Clerkship Block 4 post-Grand OSCE lunch! :) Here’s to the year that was and the year that will be! || Ang tanda na natin, I realize… || photo c/o Gienah