the real world a.k.a. life after med school

The memory is still fresh on my mind. You can't quite describe the feeling, you have to have gone through the experience to understand what I'm trying to describe. It's the feeling of being FREE, a dizzying mixture of ecstasy, excitement, hopefulness, relief and panic.

Ecstasy. Excitement. Hopefulness. Relief. Panic. Five words I'm using to attempt to verbalize the feeling of freedom I felt after I passed the medical boards. For me, that was the point in my life when formal education ended and real life began.

It was surreal at first. The first thing I realized was that I actually have full control of how to spend my time. After 2 years wherein days have been renamed pre-duty, duty and from-duty, I now have Sunday, Monday, Tuesday, Wednesday, Thursday, Friday and Saturday once again. I can go to bed as early or as late as I want to and don't have to count the number of hours I have left to sleep before getting up again. I am FREE.

Now, once you have fully grasped the idea that you are free, your conscience will start making its presence felt. For me, this took about a month. After all the parties, the oath-taking and the days spent doing nothing, I began to feel uneasy. I was itching to be productive. I know I have to be. After all, I now have a shiny new license to use.

I know I wasn't ready to embark into another training odyssey, there are still so many things I wanted to do. But I HAD to do something productive. If I go into residency, I'll be kissing at least 3 years of my life away...it'll be back to pre-duty, duty and from-duty days again. No holidays, no weekends, just those three freaking days. I am not ready to go back to that...yet.

So I decided to go into moonlighting. This way, I still can choose how many times a week to go to work. I am being productive and still having control of my time. Another plus is that for the first time in my life, I am earning my own money. Cash I can spend however I want to. By moonlighting, I get to hone my clinical skills and tick off things from my bucket list at the same time. Now I have the means to do the things I've put on hold while I was busy training.

I don't have any regrets for choosing to go into moonlighting. While it's true that by moonlighting you are putting your career on a stand-still, a good thing is you are somehow introduced to medicine in the real world. You will realize that you don't actually use every drug in Katzung or MIMS, and that you only encounter a handful of diseases. Rare diseases are really rare. You will learn how to do a complete physical examination in seconds. You will learn how to think outside the box.

All these and at the same time you get to create for yourself a life. Travel. Spend time with the loved ones you have neglected or missed during med school or training. Get back into shape. Catch up with movies and TV shows you've missed. Re-connect with yourself.

In time though, you will feel the need to advance your career. I've been feeling it lately, probably because my med school classmates who went straight into residency are now close to finishing their training. Perhaps somewhere in our training, a desire to do more and to learn more had been inculcated in us such that we'll always seek for new challenges and knowledge. After sometime, private practice will lose its novelty to you and you'll know that it's time to get back into training. I just hope that by the time this thirst makes itself known to you, you have done most, if not all, of the things you neglected doing while you were in med school. You may be too old, or simply be too late, to do this after quenching your thirst.

Enjoy your youth and freedom, new doctors! Do the things you've always wished you were doing while you were stuck in training. Don't be in such a hurry to advance your careers, residency and fellowship will always be there and they have no age limitations. In the real world anyway, patients will always prefer an older doctor.


This entry is a contribution to The Blog Rounds March 2009 Edition: Letter to a (Medical) Graduate

exodus, part 2

It's never been a secret among my relatives and peers that I have my eyes trained to the greener pastures of developed countries. My mind's made up and at the moment, I am exhausting all avenues to be able fly out of the motherland and practice my craft in foreign lands. My reasons for this may be selfish, but unfortunately, my love for my family overrides my love for my country.

In a previous post on this blog, entitled Exodus, I have elaborated my reasons for this decision. Composed several years ago, Exodus still holds true for me. My sentiments then have not changed. Not a bit.

I am deeply saddened and outraged by the government's House Bill 4580. To say that I am surprised by the UP College of Medicine's move to require their graduates to serve the country for several years before being allowed to go abroad is an understatement. I am SHOCKED. HORRIFIED.

I am not an expert on human rights or related laws but there has to be a breach of this in the government's decision to pass this house bill. UP used to be a staunch protector of these rights and freedom. My alma mater has let me down by devising this return service mechanism.

I still do plan to return after a stint abroad. But my conviction in doing so is being rattled by these ridiculous attempts to keep doctors in the country. Pandora's box shutting close might just be enough turbulence to completely rid me of this conviction.

I end this entry by repeating a quote from Fr. Bienvenido Nebres, SJ:
"If you have a heart that cares for your native land, you will find a way to make a difference even if you are far away. And, perhaps, on the other hand, if you do not have a heart, you will not make a difference even if you stay."


This entry is a contribution to the Blog Rounds 17th ed., hosted by Bone MD.

facebook

It's amazing how a bunch of simple games and applications could start an addiction. That's how my facebook story began. I was hesitant at first because I thought facebook was just another version of friendster or multiply. My friend told me with a vehement "No!" that facebook is different, it's more interactive.

So I opened the account just to see how much more interactive facebook is. My first impression was that the homepage looked boring. Nothing flashy, it reminded me actually of MS Word. I figured I'd give it a couple of weeks to see how much work maintaining the account requires, then if I am still bored with it or find it too tedious, I'd simply delete the account.

I began adding friends, then friends sent me application requests, which I then accepted. Soon I was super-pokin', creating a lil' green patch, going on high-seas adventures, taking care of virtual puppies, playing in a virtual stock market (where I am now a billionaire), driving virtual cars and flying virtual airplanes. I now have a street named after me where my friends can park their virtual cars, and I am the mayor to a city whose citizens are being added daily by my friends. Time just flies when I log into facebook.

This morning, the first thing that came into my mind upon waking up was that I need to repark my cars because I might get a ticket for illegally parking them.
From my bed, I went straight to the computer and logged in. I haven't moved since, and it's a few minutes past noon now. I predict I'll spend the rest of the afternoon stalking the pack rat markets.

They say the first thing to do in getting rid of an addiction is admitting it. It's been fun with facebook, but now it's interfering with my productivity. So here it goes...I'm a facebook addict. Now that I've said it, I've done the first step. That will do for now. Meantime, I gotta go check my cars, puppies, stocks and pack in facebook.

er

Why did you become a doctor?

The question was asked, answered, asked again, answered again. I doubt if I'll ever stop coming across this question. Other versions would be the question in the vernacular and the question in the future tense (which I encountered in pre-med and in med school), and frankly, I don't remember what answer I gave each time the question was fielded to me. I don't remember because I know I haven't been truthful in answering that question.

The root of my untruthfulness in this matter is this: my reason for choosing to be a doctor is really so trivial. Or maybe I should say TV-ial. Probably for the first time ever, I'm going to come out and say what really pushed me to be a doctor:

Not the emergency room, no life changing experiences in some emergency room, but the award-winning series ER, starring Anthony Edwards, George Clooney, Noah Wiley and Eriq LaSalle. I was at a very impressionable age when ER was at the height of its popularity. The drama, the action, the challenges, the characters...I don't know what it was with this show that propelled me to make one of the most important decisions in my life based on a TV show. I didn't know it then, but now I can honestly say I became a doctor because of ER.

I'd like to think of myself as a critical viewer, and even then I knew how deceptive TV and movies are. So to base my career choice on a TV show is really ludicrous. But I know in heart that the show was responsible for my being a doctor.

Back then I have no idea how close to or far from reality ER was. I can't even pinpoint what it was in ER that made it so influential to me...after all, the show portrayed over-worked and underpaid doctors, dealing with self-destructing patients, health catastrophes and disdainful hospital politics. Doctors are not intellectual gods (like House and associates) nor glamorous beings (like Chicago Hope docs and Nip/Tuck surgeons). As I think about it now, I do believe ER probably is as close as medical movies and TV shows get to the real thing.

Or maybe I'm being biased. I most probably am. After all, I had my epiphany during the golden years of ER, and amazingly, I do not regret this decision. Maybe in my darkest hours I have had second thoughts about it, but eventually, I'll come back to the same conclusion. This is my calling, and I'll have to thank ER for God's vehicle of getting this message to me.


This entry is a contribution to the Blog Rounds 14th Ed., hosted by Em Dy.

word nerd

Blog. Blogging. Blogger. To the uninitiated, these words are simply funny sounding. At first, I thought that these terms sounded so silly that no one can possibly get anything more than a few laughs from their content. Who would've thought that one could stumble into a fount of great ideas from something with such a funny label.

I had always been enamored with words, that is, the written word. To borrow David Cook's term, I guess you could say I'm a word nerd. I just love playing with words and getting what I feel and think on paper. When this all began, I don't know. I have this secret dream (well, now it won't be a secret anymore) of having a best-seller published and winning literary awards for it.

Writing has always been an outlet for me. I have journals that could document the development of my handwriting from a school kid's scrawl to the doctor's chicken-scratch penmanship that I now have (unfortunately, in some cases, my handwriting when I was younger is actually a bit more legible than the present). I wrote in these journals for a release, and because secretly, I also hoped that someday, I'd be someone important enough for people to want to know how I lived. Such Narcissistic delusion of grandeur actually led me to start my first blog.

Now, i don't pretty much care if people read my blogs or not. My views about blogging have changed somewhat. I have come to realize that through blogging (as I have stated in my blog's description), I am attempting to make life move slower for me. My blog entries are attempts to preserve the "now." It's not that I don't want to move forward; it's just that I'm finding life's pace to be a bit too fast. Blogging can capture for me what photographs cannot; I guess you could say that my blog entries are snapshots of my thoughts and memories, painstakingly converted into text that tries to convey them as eloquently as I could.

A couple of weeks back, a friend introduced me to a blogging world I haven't discovered yet: the world of physician bloggers. As I hopped from one blog to another, I was surprised to find that these blogs hold unique treasures unselfishly shared by their writers. I found solace in the array of blogs, written by physicians who are undoubtedly very different from myself, but kindreds nevertheless in this path we all chose to traverse. The anonymity allows for a more open sharing, and yet, all these inputs from doctors I don't know are amazingly very comforting and empowering.

Now, I try to take part as often as I could in the Blog Rounds. Again, the Narcissistic part of me eggs me contribute because fellow MDs might like reading what I was writing. However, I think I'm doing this mainly because composing an entry helps me collect my thoughts and somehow by putting these into words, some sort of order is established in my mind. I like the feeling of satisfaction after completing an entry and clicking the publish post button.

To end, I still think the best thing about posting is that I get to play with words.



This entry is a contribution to the Blog Rounds 13th Ed., hosted by Bone MD.

he had me at hello

I think it was when he sang Bryan Adams' Everything I do, I do it for you that I first noticed David Cook. I've always rooted for the rockers in the competition, but with their not so good record on the show, I thought then that the best that I could hope for is for him to give us a couple of good performances and hope he'll be given a record deal like Chris Daughtry. I was resigned to the reality that while AI showcases some really talented rockers, America doesn't really vote for rockers.

When he sang Lionel Richie's Hello, I was hooked. Hooked on Cook. I began downloading his performances and I would listen to them over and over. The first time I heard the Beatles' Eleanor Rigby was when David Cook sang it, and I actually liked it. Loved Billie Jean and Always be my baby (which I didn't like when Mariah released it). The Phantom of the Opera fan that I am, I was mesmerized by The Music of the Night.


I'm glad I was proven wrong. I would rank David Cook as one of the three most talented American Idol winners, along with Kelly Clarkson and Carrie Underwood. Chris Daughtry is still my favorite AI contestant, especially since he followed his Idol exit with a superb album, but Cook fast rising up to his rank.

Congratulations to the new American Idol David Cook!

a sick system

The Philippine Health Care system is very easy to understand: if you have money, you can get treated. If you don't, sorry. Plain and simple, harsh but true, in the Philippines, a sick person can get well only if he/she has the money to buy the medicines he/she needs. That's just the way it is.

Government hospitals exist, but these hospitals can only do so much with the meager budget given to them. Health care workers are already overworked and underpaid, yet very little money is left for the maintenance of the facilities and equipment. Because of this, government hospitals can only provide service and facilities for the people; the patients have to buy their medicines and other medical supplies they'll be needing. Basically, a patient gets diagnosed in a government institution, and after that, it's up to the patient to acquire the funds to buy his medicines.

In private institutions, the patient will have to pay for everything: hospital room, medicines, diagnostics, professional fees of the doctors who treat them. Because private hospitals are forbidden by law to ask for a deposit upon admitting a patient, problems arise when the patient fails to hold his end of the bargain: pay the hospital bill. The patient gets well, and because it's forbidden (another stupid law) to detain patients because they cannot pay, he gets discharged, leaving the hospital and the doctors only his word that he'll be back with the payment. Meanwhile, where will the hospital get the money to pay for the medicines and medical supplies that the patient had used? Where will the doctor get the money to sustain his and his family's needs? The answer to both of these is the same: from other patients. Both the hospital and the doctor will now charge their other patients more.

This is how it is in the health care profession. It's sad that lawmakers are making it even harder for us by making stupid laws. The only real solution I can think of is to increase the budget for health. That way, government hospitals can do more for more needy people, and sick people won't have to resort to unethical means to get treatment.

For now, we'll have to live with what we have. Save for the rainy days, and do what we can to prevent getting sick. This is just about all we can do, really.